Survey of Junior Doctor Parents Show More Than 50% Considering Leaving NHS England

jdcchildMore than 1000 junior doctor parents have spoken up voicing grave concerns about the new contract, set to be imposed this August. In an online survey conducted in April 2016, 99.4% consider the contract will have a detrimental effect on their family life and less than 5% of respondents plan to continue their career as it currently is. 93% consider the proposed contract will have a detrimental effect on their relationship with spouse or partner. More than 25% are considering leaving the profession altogether, with a further 26% considering a move to another country.

“There are around 54,000 junior doctors. A junior doctor is anyone graduated from medical school up to consultant or GP level. Most are of child rearing ages and many have children. When doctor recruitment is already in crisis and only 5% of junior doctor parents plan to continue as is, imposition of this contract could throw the entire doctor workforce into disarray,” states survey creator, Dr Sethina Watson, junior doctor and mother of four. “This contract threatens both lives of medic children and, with a potentially reduced workforce, the lives of patients too.”

The survey asked a range of questions on current level of training, current and potential childcare and whether or not they envisaged continuing their current career should the contract be imposed. The survey identifies extreme difficulties in finding childcare, 93% state that finding childcare with the new contract will be more difficult. The governments equality analysis of the Junior Doctor contract openly states that it disadvantages women but that this ‘indirect adverse effect on women is a proportionate means of achieving a legitimate aim’. The equality analysis suggests that some women may find it easier to arrange informal, unpaid childcare in the evenings and weekends. The survey results showed that nearly 60% of respondents do not have access to such childcare. Of those who do, 86% believe it will be unreliable for ensuring attendance at work. There may be a surge in doctors requesting part-time working, which can still entail up to 55 hours per week.

Of particular concern are the doctor and doctor couples that comprise nearly 40% of those who responded. “I cannot imagine how it would be tolerable if the frequency of our weekend working were to increase; I could easily imagine this causing marital and family breakdown,” said one married male doctor.

Jeremy Hunt’s rush to impose the contract threatens to create a potential time bomb that could explode as early as August as thousands of junior doctor parents struggle to find childcare or quit their jobs. The legacy could harm generations of children and lead to a loss of thousands of years of medical training from the workforce.

Survey Results Summary:

  • 1060 Respondents
  • 84% aged 30-44
  • 82% female
  • 84% married/civil partnership
  • 38% have doctor partner/spouse
  • 38% full time employment, 41% less-than-full-time
  • 39% caring for one, 39% caring for two
  • 59% use nursery and 58% spouse for additional childcare
  • 34% ST 5+
  • Of those choosing to stay in medicine 58% will stay in speciality
  • 40% spend between 20-39% of net household income on childcare
  • 58% do not have access to unpaid informal childcare, those who do 86% say not robust or reliable enough for work
  • If contract comes in 48% plan to use partner for childcare, 48% don’t know what they will do (you could have more than one answer for combination arrangements)
  • 75% expect to pay for this additional childcare
  • 93% said that finding more childcare would be more difficult
  • 4.6% will continue their career as it currently is
  • Those considering other options 87% cite impact on children, 79% impact on spouse, 53% cannot afford further childcare, 77% emotional strain and stress as key factors
  • 74% state the proposed contract will definitely have a detrimental impact on their relationship with spouse/partner (19% state probably)
  • 93% state it will definitely have a detrimental effect on family life and 6% say it probably will

Complete survey findings are available JDCchildcaresurvey2016.

Survey conducted by Dr Sethina Watson, Anaesthetics Trainee, mother of four and former founder of MomMD.com. Follow me on Twitter @morefluids.

For a short link to this survey use http://wp.me/p3pm8R-bk

Featured in The Guardian – Junior doctors: ‘over half could quit NHS England over Hunt’s contract’ and Hospitals braced for walkout as Hunt says doctors’ strike must be defeated.

For more information on the survey and permission to use findings, please contact me below

Being a Junior Doctor & Parenting a Child with Cystic Fibrosis

Last week junior doctors staged another strike in opposition to the proposed enforcement of Hunt’s Junior Contract. A contract which most doctors believe will endanger patient lives and destroy the NHS. On the eve on the third strike, while my daughter recovered from anaesthetic I wrote the following piece.

“My husband and I are both junior doctors. Unfortunately, we cannot join the picket line this time.

We aren’t there because we are in hospital with this little one.

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Smiling despite low oxygen saturation and high fever.

Our three year old daughter has cystic fibrosis. She’s not been well recently and she’s in for a general anaesthetic, bronchoscopy, fixed intravenous line and two-week course of heavy duty antibiotics. The NHS is so vital for her care and future. We have no doubt that she will be well cared for the next two strike days.
The junior doctor fight is for every patient and every person working in the NHS. Doctors looking after her (and everyone else) should be well rested, motivated and valued. She starts nursery soon, we’d like to see her and our other children at weekends. We already work many weekends away from them. CF shows us that life is precious; it is too short.

Doctors involved in her care over the next two weeks will be many; junior doctors, respiratory consultants, anaesthetists, radiologists and microbiologists. But also ward nurses, recovery nurses, operating department practicioners, specialist nurses, student nurses, ward clerks, pharmacists, pharmacy technicians, porters, health care assistants, domestics, dieticians, psychologists, physiotherapists, radiographers, play specialists and more. Behind the scenes are lab technicians, estates workers, IT staff, medical secretaries, central sterile services team, theatre managers, ward managers, volunteers, security staff and a huge long list of others.

We all work together for our patients. We make something pretty amazing. To think that adding just junior doctors to the ward at the weekend is all that is needed ignores the rest of that amazing team.

When times are tough, we remember this phrase, ‘Dum Spiro Spero’. It means while I breathe I hope. Perhaps one day there will be be a cure for CF. We try to remain hopeful about the junior doctor ‘fight’ too.

Junior doctors are standing up for the future of the NHS. Let’s all stand together. Good luck, we’ve got our badges and banners on the ward ready for tomorrow. She says a big thank you for everyone looking after her.

Mr Hunt, I request that you engage with us and take our concerns seriously.”

Since then, she has been recuperating in hospital and faces further treatments prior to discharge home. The contract in short, may mean many doctors simply cannot afford to work in the NHS, whether financially or emotionally. Minty’s story was featured in The Independent and on Doctors of the NHS.

As always, fundraising for the CF Trust is a goal. Minty’s Godfather and family friend aim to cycle from London to Paris to raise money. Find out more about Magical Minty Cycling Team on Facebook or donate here.

To understand more about the Junior Doctor contract this recent Facebook post is an excellent summary. 

Greater Than The Sum of Its Parts #PowerOfUs

Much of what we do in medicine involves the work of teams. To deliver medical care however basic or complex involves the work of more than one professional. Ideally, shared decision making involving the patient and their families helps to deliver high standards of care using best practices and weighing current available evidence. Working within that team requires respect for others, shared and open goals, a desire to seek and prevent potential errors and continuous re-evaluation to improve our work. These words may sound like ‘buzzwords’ or ideals, but their value has become more evident since my youngest daughter was born nearly two years ago.

It was a Friday afternoon, we’d had a lunch meeting about how the acute medical take needed to work; how we needed to work together to improve patient care. A consultant listened as we shared our experiences, where things needed to improve and who could do what. My phone rang with no caller display; I knew it would be the hospital calling, but about what? It is those personal calls at work that twist your stomach.

The news was layered slowly and deliberately, your daughter has grown Pseudomonas with antibiotic resistance and a bio-film. Again it felt like our lives had been shattered, the pieces we had carefully constructed to build a normal life and retain hope for a beautiful future seemed in disarray. I was unable to re-order them into any meaningful shape. The trouble with being a doctor and a parent of a child with a serious chronic medical condition means you know too much. I know the implications of this and imagine the worse outcomes possible. My darling toddler, the situations she must deal with.

Cystic Fibrosis is a hidden condition. Here she is a picture of health and happiness!

Cystic Fibrosis is a hidden condition. Here she is a picture of health and happiness!

In she went for two weeks of IV antibiotics. There for a good few weeks  we were in despair, hope lost. I sought the fragments of hope, I looked for it and couldn’t find it. I know that the outcomes of young patients with Pseudomonas can be tragic. I sought inspirational stories from those with young children with Cystic Fibrosis who had cleared such a strain of Pseudomonas. I found none.

We made it through the weeks in hospital. But we felt different. I returned to work a different person. I feel for every patient whose stay in hospital is longer than they imagined. Who wait, two days or two weeks for test results. Who sit without families, without basic creature comforts and lose levels of dignity and privacy which we take for granted. I know the feeling of waiting for the ward round, that piece of news you need, something, anything. Doctors breeze in for a few minutes and are gone again. Packing your bags and going home is the best feeling in the world. After her hospital stay we drove to her next follow up appointment nauseated with worry. Future feeling very bleak.

My daughter (and us) have a team of people who look after her. A team made up of doctors, specialist nurses, physiotherapists, dieticians, psychologists and social workers. There are several such teams dotted across the UK caring for children just like ours. Social forums ask ‘what’s your team like?’ People discuss varying advice given and there seems differences across teams and situations. People won’t even move house for fear of having a different CF team! CF is an individual condition, what works for someone might not work for someone else. Atul Gawande wrote about a determined doctor who redefined the approach to CF care and how they deliver excellent care as a team. CF team care perfectly demonstrates how the whole is greater than the sum of its parts.

As I sat waiting for the doctor he arrived. Bright, enthusiastic and engaging. Matter of factly he told me her latest cough swab was clear. Relief was almost too difficult to express, it bubbled slowly from within, but too hard to fully allow. It will take days to sink in. However, it was what I learned that day was about the power of teams and a team ‘mission statements’ to borrow corporate terminology. He told me they believe in Aggressive Antibiotic Eradication Therapy (AET) for Pseudomonas. ‘No need to feel bleak at all,’ he said. And here’s why.

We got her CF on newborn screening. These kids are doing very well.

We are monitoring her like a hawk. If we suspect Pseudomonas and can’t find it we will hunt it down. If we find it and we will do everything we can to get rid of it. If that means bronchoscopy and two weeks IV that’s what we will do. If we need to do that several times, we shall do that. That’s what we believe in here. We will not accept it living in there. We will not accept a cough as normal for her.

When she transitions into adult CF care, which she will, I want her to have no evidence that she even  has CF. And that is what we expect.

She may be too young for clinical trials, but once there is one for her, we can try it. There is lots going on at the moment.

You as a family are fully on board, you are doing her physiotherapy, you call when you are worried, you give her the treatments we recommend. You are doing very well.

We are doing very well. I had never thought of that. I had never heard those words. Her treatments and life are fully integrated as normal for us all. Or as normal as things can be. We never use negative language around her. ‘Yucky medicine’, ‘palaver’, ‘time-consuming’ are words we never say in front of her. The nurse who came into the room proudly praising her for taking ‘that repulsive’ medicine’ (flucloxacillin) easily was doing more harm than good. It took months to get her to take that with ease. One thoughtless comment could cause endless problems, luckily she is too young to decide to stop taking it. In that afternoon I left bursting with hope again. The doctor and his team have our backs. They lift us up when we are down, the guide us through this journey, they teach us, listen to us, hear us and help us. Each individual on that team plays an important and key role in taking care of her. I was struck by our daughter’s consultant sharing their team ‘mission statement’, we used them all the time in my corporate career. I used to write them for my business clients. They may be seen as ‘naff’, by they are important and make sure everyone is on the same page, with the same goals. Perhaps we should be using them more in medicine.

During her last hospital stay I really saw how the nurses really are her main carers, with no disrespect to others. They see her and us more frequently. If a patient gives a box of chocolates for the nurses only there’s a reason behind that. We doctors, though important too, blast in for moments at a time. We come in with needles, syringes, intimate questions, test results and leave again leaving the nurses and other health professionals to take care.The Reith lectures again changed my medical practice, Gawande suggests that we ask patient’s what they actually want. Do you want that test that I am ordering, the result of which may change your future, or do you want that surgery? I know why we are rushed, for I do this myself, we are busy, we may have 30-40 patients to be seen in a single morning. The pressures are on us. But some of the most rewarding moments are when we have time to ask, time to sit and talk to patients and their families. But this balance is hard. A medical career often comes at great personal cost. My child’s life expectancy is shorter than most, I want to be there for her. Do not consider me ‘not a team player’ if I want to get home on time. I need to deliver her physiotherapy, medications and nebulising treatment before her bedtime. One Friday I was leaving at 7pm (two hours late), I was rushing home so that I would see my children before bed. A patient’s family member grabbed me as I was leaving in the lift to ask me a complex question that required a measured response. That night I did not see my children.

Atul Gawande’s Reith lectures recently spoke about how medical care is too complex for one individual to deliver. Teams with individuals specific and expert roles can deliver a care that is synergistic. One part of the team breaks down and care can suffer. Not only can patient care suffer, team members themselves can suffer. However, the balance between individualism and medicine is complex. I find it hard working with others who have their own self-serving goals. To impress, pass exams, get to do something ‘cool’ at the expense of another colleague who also needs to learn that procedure. Those who do not communicate with the rest of the team, not sharing what they have done or are doing. Tests get duplicated, tests get missed. The consultant asks for patient updates and you do not know whether something has been done or not because your other team member hasn’t told you. Worse they have gone to theatre or clinic leaving you to figure out what they may or may not have done. The team member who speaks to other staff with disrespect or worse doesn’t speak at all. These individuals make the team look bad and, worse, can cause patient harm. To reiterate medicine is too complex for one individual to deliver.

Doctors regularly have to be assessed as to how they are functioning as part of a team. We ask colleagues from all disciplines to rate our team behaviour anonymously. A Multi-Source Feedback (MSF), 360 degrees, Team Assessment of Behaviour (TAB) are what they are known as. You then sit down and discuss your performance with your supervisor. You pick the people who want to fulfill the form as apparently you will most value their feedback. However, not selecting those with whom you may have conflict or personality clashes with may omit the most valuable feedback. Another important group missing are the patients. Patient feedback would also be invaluable. My MSF is currently happening at the moment. Always feel slightly nervous about them.

As a doctor working in a team can make the job much more bearable. Team work is what gets one through the difficulty of nights and weekends where stripped down medical teams care for huge numbers of patients. My most memorable nights are when working alone in different parts of the hospital we meet briefly for tea and catch up, helping someone with a job or encourage someone to take a break. It can be stressful when the only time you meet is at a cardiac arrest and dissappear shortly after rushing back to your work. Thank you to that nurse who made me that cup of tea as I nearly tripped with exhaustion at 4am in the morning and to the Senior Registrar who prescribed a warfarin I had not gotten around to doing. The domestic serving tea, the cleaner mopping the floor, the pharmacist checking your prescription are all there with one common goal to deliver safe and effective patient care. We are all members of the same team. Having just worked the Christmas period that bonding and camaraderie of being together at work is enhanced, when you know others are with

Now more than ever do I understand how teams can make or break the patient’s journey. The words you use, the part you play as part of a bigger picture of care are very important. I thank our CF team for restoring our hope, I thank the team who cared for her in hospital from the doctors, nurses, play therapists, domestics, cooks, cleaners, physiotherapists, pharmacists, dieticians, anaesthetists, theatre staff, ODPs, recovery staff and more. One special thanks to the nurse who went and got her a coco-pops bar when she was hungry and eating no food, you know who you are.

Here is to Aggressive Antiobiotic Eradication Therapy and the power of teams. Next time you’re off to an MDT know that they make a massive difference to patients.

Some of her daily meds. Just totalled up Minty's meds & care for the year just to keep her healthy! Dornase alpha £2019.10 per 3 month course Creon Micro £31.50 per pot, 5-7 per year Flucloxacillin £26.04 per week x 52 - £1354 per year Saline around £80-100 per year Azithromycin about 3-4 courses per year at £11.04 each Co-amoxiclav around 4-5 courses per year at £3.60 each Vit E 4 x £42.12 per bottle Dalivit 10 x £5.58 bottle Salbutamol - around £3.50 a year! Clenil - around £3.70 per year Colomycin £324 per 3 month course Tobramycin £3.77 per day, 2 x 2 week courses Ceftazidime £8.95 per vial, 3 per day, 28 days around £751.8 eFlow Nebuliser (specifically for CF patients ) around £800 extra eFlow kit for Dornase alpha around £300 MDT clinic follow up every 8 weeks - doctor, dietician, social worker, psychologist, physiotherapist, specialist nurse. Appt lasts 2 hours 2 x hospital stays (approx 2 weeks each) including 2 GAs, one PICC line and 1 long line - hospital bed around £225 per day Minty has had 5 chest x rays in her life Microbiology - around 10-12 cough swabs per year with results Home visits - as many as she needs from CF Team.  Meds & Nebs alone cost over £7000 This is all funded by the NHS from tax payers like yourselves. With extra support from CF Trust.  This is to say thank you to everyone involved in keeping her healthy and giving her a future.

Some of her daily meds.
Just totalled up Minty’s meds & care for the year just to keep her healthy! Approximations.
Dornase alpha £2019.10 per 3 month course
Creon Micro £31.50 per pot, 5-7 per year
Flucloxacillin £26.04 per week x 52 – £1354 per year
Saline around £80-100 per year
Azithromycin about 3-4 courses per year at £11.04 each
Co-amoxiclav around 4-5 courses per year at £3.60 each
Vit E 4 x £42.12 per bottle
Dalivit 10 x £5.58 bottle
Salbutamol – around £3.50 a year!
Clenil – around £3.70 per year
Colomycin £324 per 3 month course
Tobramycin £3.77 per day, 2 x 2 week courses
Ceftazidime £8.95 per vial, 3 per day, 28 days around £751.8
eFlow Nebuliser (specifically for CF patients ) around £800
extra eFlow kit for Dornase alpha around £300
MDT clinic follow up every 8 weeks – doctor, dietician, social worker, psychologist, physiotherapist, specialist nurse. Appt lasts 2 hours
2 x hospital stays (approx 2 weeks each) including 2 GAs, one PICC line and 1 long line – hospital bed around £225 per day
Minty has had 5 chest x rays in her life
Microbiology – around 10-12 cough swabs per year with results
Home visits – as many as she needs from CF Team.
Meds & Nebs alone cost over £7000
This is all funded by the NHS from tax payers like yourselves. With extra support from CF Trust.
This is to say thank you to everyone involved in keeping her healthy and giving her a future.

Araminta

During my pregnancy we went round and round in circles looking for names. My husband and I simply could not agree. We started looking for names that ‘were a bit different’. My husband told me how he once met a girl called Minty. I loved it initially but thought who could actually call their child Minty!! Bonkers. But we looked up the origin of the name and found Araminta. We added that to our list, should it be a girl.

When she was born we spent all day going over and over, could we actually use this name. Will people think we are silly. In the postpartum room I read up on the amazing Araminta Tubman and it was decided there and then. Who was Araminta Tubman? She was born in 1820 and was one of the strongest, toughest women of her era. Born into slavery she escaped and led more than 300 slaves to freedom via an underground railroad. She was a suffragette, a humanitarian and spy. As a child she was beaten by her ‘owners’ suffering a severe head wound which plagued her for life, causing seizures, narcoleptic attacks and severe headaches. Harriet Tubman, widely known and well-respected while she was alive, became an American icon in the years after she died. A survey at the end of the 20th century named her as one of the most famous civilians in American history before the Civil War. She inspired generations of African Americans struggling for equality and civil rights. ‘Minty’ Tubman told others when she died she ‘will go to prepare a place for you’.

Naming our daughter after such an amazing woman seemed apt and an honour. Same day we found out her Ghanaian great grandparents were called Minta. We gave her the name of a strong, independent woman who fought her life through great adversity and hardship. Little did we know that 3 weeks later we would be told our darling Minty had a life-shortening condition of cystic fibrosis.

ImageMinty is now one and what a strong little darling she is. She’s proving to be feisty, energetic, humorous and assertive. Everyday she kicks the ass out of CF. She will be an inspiration to us I am sure. Rancid tasting medications, physio and infection is part of her daily life. We are used to it now. Last year we were in a dark place and now we are totally and utterly dedicated to supporting her and hoping for a cure. Who knows what her future holds? I hope it is a bright one.

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So where are we now? Next week she has her yearly check up, including her first bloods and chest x-ray. I am hoping that all is well and the continuous coughs and colds she’s had most of the year have caused no lung damage. (P.S. please add yourself to the organ donation register as someone and their family would love your lungs should tragedy befall).

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We’ve amassed a huge array of blowing toys for physiotherapy – many of which come from my lovely brother and his wife (a community paediatric consultant who has to deliver such diagnosis to other families). These are great as they help create positive end expiratory pressure which splints the lungs open nicely. Great gifts for any child with CF. (Avoid bath toy gifts with holes in that collect water and culture hazardous moulds). CF physio can be fun!! Siblings can join in too.

I’ve met and talked to some other amazing parents who’s children have CF. We’ve cried together and shared our stories. We give each other hope and support.

2013 was pretty bad in places, so I wanted to start 2014 with a bang. So I have assembled a team of amazing people who are going to jump 10,000 feet out of a plane with me to raise money for the CF Trust. Scared to death of it. Freefalling at 120mph might put hairs on my chest, or rather blow them off. I am humbled and extremely grateful for the folk who are joining me in this challenge. Why raise money for the trust? CF is a life shortening condition that kills thousands worldwide and is carried unknowingly in the genes of millions. There are around 10,000 people living with CF in the UK, only half will celebrate their 40th birthday. In the UK five babies each week are born with it and two people lose their lives to the condition. We MUST raise money to find a ‘cure’, help people and their families live better lives with the condition.

Please visit our team fundraising page and consider sponsoring us, however little you can give, many will appreciate it.

We are JUMPING FOR HOPE!!

P.S. Next week I find out if my anaesthetics training application was successful. Nervous.

Toddlers & Teens: The Twilight Times

Sometimes I look at my children and I think , “Bloody hell, I’m their mother. I’ve no idea what I’m doing.” Truly, each day comes and goes and I hope I’ve just done my best. I hope I’ve given them some happy times, good food, love, hugs and not shouted too much. But parenting brings such new challenges every day. I have to constant re-evaluate myself, adapt and proceed with that unknown outcome of producing sane adult children. I am in envious awe of you parents with grown up, well adjusted adult children. You deserve to sit back and feel smug at your success. I’ve no idea how you got there, but you did.

As a mum of four I’m often asked, “how do you do it?” Honestly, I’ve no idea. My four are in groups of two separated by ten years! That makes quite a difference really. In some ways it makes it easier, but at the moment I am going through the challenges of having both a toddler and teens. My delightful little three month old daughter with cystic fibrosis (another story) easily just fits into the bigger picture. But step into my house between the hours of 4pm and 8pm and you will descend into another world, a twilight zone. That is when you will see my most frazzled. It begins post toddler nap, after which he always has a meltdown, and he is then stuffed into a car to pick up his older sisters from school. He likes to wear his dressing gown and space monkey pyjamas at all times at the moment. They sometimes stick to his chubby little body with jam, sand and whatever else he’s been into that day. If you see me in the bank with such a child, do forgive me and don’t judge, for its easier to take him like that than face another tantrum. Pick your battles I say.

The school run complete we return home for toddler supper that coincides with infant cluster breast feed (between 5 and 7.30pm). This also happens to occur at teen snack time, of which they always ask me “What can I eat?” and evening meal preparation. Really evening meal overlaps with toddler and baby bath and bedtime. I can stick the rice on and run upstairs to bath one, while breastfeeding the other or the baby has to wait screaming until I can get to her. The act of producing a home cooked meal at this time I consider a small miracle. In a word – it’s CHAOS! Chaos hopefully filled with laughter, tears, frustration and lots of love. Please forgive me that if I answer the phone during that time or you ask me a question, I’ve no idea how I will respond, I may be short with you. This is far more challenging to me than many of my days struggling with the demands of being a junior doctor.

Rather apt, trying to balance the see saw of ages.

Rather apt, trying to balance the see saw of ages.

Now it has struck me now that I am facing very similar challenges in parenting a toddler and a teen. I have my lovely 12 year old, she’s almost 13, so for sake of argument let’s call her a teen. And, my oldest is 14, soon to be 15 (read her excellent blog here) has already traversed some difficult stops on the teen journey, but at the moment is on a nice smooth flat section of the teen rollercoaster. My toddler pushes me to the limit, he’s seeking his boundaries. “I WANT BISCUIT. I WANT CHOC-CA-LAT” he has been known to scream at 5.15am when he wants breakfast. “No, darling, we don’t eat biscuits or chocolate for breakfast” is what I try and say. Really, I want to scream “FOR F~@$’s sake WE DON’T EAT THAT FOR BREAKFAST. I AM IN CHARGE HERE, YOU WILL DO AS I SAY!”

Whatever, we parents have been given the tough job of not causing emotional damage and setting the example. Crikey, we must be perfect. But I can tell you what, my kids have unfortunately heard me use some very bad words, shout and scream and throw my own tantrums. Now, never mess with a MUM TANTRUM as they can far out-do any toddler or teen. Now my toddler has found a new object of joy. An object of mischief. It’s his Stool of Power. This red plastic stool has been introduced as my latest parenting challenge. It came with an electronic drum kit, which I have hidden as it has only one volume – extremely loud. (Manufacturers, I’m sure you don’t want your drum kit implicated in some parent-child altercation, so please put a bloody volume control on it.) Now the Stool of Power goes everywhere with him. It has enabled him to reach into drawers containing matches, find sharp knives, pull down books, pick up the kettle using no handles just the bare metal (thankfully it was cold) and other such mischief. I need eyes in the back of my head to see where and what he is using the stool for. Rationalising that touching the ceramic hob after I’ve made a stir fry is going to hurt doesn’t seem to work. I am forever providing safe limits to his testing of boundaries. If you see me in the Emergency Department (where I may well run into my husband as he’s there more than at home at the moment) with a toddler in pyjamas, screaming baby and grumpy teen, know that I did try, honestly I did try.

Now where can I begin with the joys of parenting teens…. My oldest daughter’s recent blog post of the challenges of living with a Belieber will give you some insight. I find myself facing different boundary challenges. What is acceptable speak between mother and child, when to come to the table for supper, how I cannot buy yet another thing and so on and so on. Now, I come from the school of frank parenting. I don’t like the idea of my girls not being equipped with the things I didn’t know. So we have frank chats about:

  1. condoms (and how they aren’t 100% reliable)
  2. sexuality
  3. trimming pubic hairs
  4. waxing hair on the upper lip
  5. how never to get a credit card (if you do make the limit tiny)
  6. how to use a debit card
  7. not to go to there area as that’s where the doggers go (“What are doggers?”. We’ll come back to that one.)
  8. to save for a pension
  9. to save for a deposit on a house
  10. how to make a delicious pastry

I always have my ‘lectures’, hopefully some of it will go in. I just want them to be loved and grow up and be happy. Hopefully, not get a job as a pole dancer or doctor (but I will love you even if you do). But teens.. they really try me to the limits of my patience. It’s not that long ago that I remember the teen years, but believe me I do know that I didn’t know a lot of stuff. So, I SPEAK FROM WISDOM and EXPERIENCE my lovelies. I find the teens so often depicted on TV and the movies so obnoxious, the parent’s so dysfunctional and they seem to talk so rudely to each other. I hope this isn’t what my girls think is normal teenage behaviour. I hate the sexualised music videos, the constant depiction of seeking love and losing your virginity. I find myself asking for things to be turned off and sounding like my own mother! Our latest attempt to blend our family into one functioning unit, complete with happy memories, is to embark upon camping trips. This has met with considerable teen groans. Disdain even, as my embarrassing ‘Mum-Mobile’ arrives to pick them up from school. A seven-seater enormous ‘car’ complete with roof box. I do suggest that they may walk. We must be mad to consider camping with teens, a baby with CF and a toddler. But I’ve got a spread sheet checklist for all eventualities – slightly embarrassing, but organisation is key to everything.

Vehicle of Embarrassment

Vehicle of Embarrassment

Must go as toddler now has a heavy metal object and is swinging it over the head of little baby sleeping peacefully. Oh, she is saved by him trying to put Borat into the DVD player. Which shall I retrieve first? All this and it’s not even 9am. But I’m filled with this feeling that this time is short. My girls are growing older and I can count the family Christmas’s left with them living at home on one hand. My youngest may not even remember living with three other siblings. I’m trying to capture memories for you in video and photos.

But let’s end on this. I love my kids, I love every one of them with their differing personalities and smells. I’ve been sniffing the tops of their heads and smoothing my chin on their soft hair since minutes after birth. I am your mummy and I hope I am doing OK. Happy Mother’s Day to my friends in America.

From There to Here

Medical school graduation and my girls!

Medical school graduation and my girls!

My previous entries are from 10 years ago. Just a brief re-cap to bring you up-to-date. Moved 5000 miles from California to England. Changed lifestyles, divorced, re-married and graduated medical school 3 years ago (see pic with number three in my tummy). Now a mum of four children and married to another doctor. It has been quite a journey – never focused on the destination just took each day at a time. Sometimes it felt as if I would never graduate medical school, much as it feels that I will never finish foundation year 1 as a doctor. But I did graduate, even managed honours, and am now set to finally finish FY1 this year having taken three years with two babies during it.  The journey still continues and I am enjoying (when I can) the ride. The destination? Who knows! Ride along with me.

The Blog Resumes

I had a blog many years ago, it talked about my journey into medicine. I may edit some of those posts and add them here. Though I probably won’t! You can read it here.  My daughter persuaded me to give it another try. So we shall see how it goes. Most importantly I’m waiting to understand exactly how the new GMC guidance will affect my online profile and may change what I say.

I’m mum to four lovelies, from infant to teen. Three girls and one boy. I’m attempting to combine a challenging career in medicine with a fun family life. My youngest daughter aged 11 weeks has recently been diagnosed with CF, so we are on a new journey in life.

Baking is another passion of mine so don’t be suprised if there are copious food pics!!