Monthly Archives: March 2010

Further news about my sister

"You know Auntie Ruth?" I enquired rhetorically of my children.  "Well, she's got some exciting news.  There's a baby in her tummy!"

"In MY tummy!" from Little Miss Don't-Dare-Leave-Me-Out-Of-Anything.

"Er, no, Katie.  In Auntie Ruth's tummy.  It's still very tiny and it has to stay in there for a long time still, but it will get bigger and bigger and some time in September – maybe about the 14th of September or maybe earlier or maybe later – it will be big enough to come out.  And then it will be your cousin!"

"Of course," Jamie agreed equably.  "Now, we have to draw all these A's on this piece of paper."

If anyone would like to respond with any more conventional sentiments, do feel free to do so – I am exceedingly pleased about the upcoming prospect of aunthood.  In the meantime, huge congratulations once again to both Ruth and Neil.

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Filed under Family values, Here Be Offspring

The Sane Person In The Attic

I do realise that my new initiative of getting myself to blog more by following the inspirations of the writing workshops and breastfeeding carnivals is, unfortunately, proving to have the drawback that I never seem to find time to blog about anything but writing workshops and breastfeeding carnivals, and thus am now not only neglecting my children for my blog, I’m even neglecting to blog about them for my blog.  So, really, the decent thing to do would be to give the Writing Workshop a miss this week.  However, twelve years ago I had a six-month live-in SHO job at St George’s Hospital in Morpeth, and living there was the kind of experience that I’ve always felt deserved its very own blog post despite being nothing whatsoever to do with my life today, and hence I’ve been just waiting for Josie to have ‘Tell us about an interesting place you used to live’ as one of her workshop prompts so that I have an excuse.  She hasn’t, but her second one this week is ‘Tell me about somewhere you used to work’, which is just as good a lead-in for this topic, and I could not resist the opportunity. The kids can wait to be blogged about.  What the hell – they’ll still be cute next week.

St George’s is a large psychiatric hospital in a very small town in Northumberland.  It was built back in the Victorian era, isolated on the top of a hill, a throwback to the days when people with mental illnesses were shipped off to the asylum and never seen again.  (I understand that ‘going up the hill’ was the local colloquialism for ‘losing your mind’.  One inpatient told me ruefully of his moment of doing something absent-minded and automatically thinking to himself “You’ll be going up the hill at this rate!” before it hit him that he was in fact already there.)  I arrived there very late on a Tuesday night, four days after the last-minute interview at which I’d seen the hospital for the first time and nine and a half hours before I was due to start my six-month stint as a junior doctor there.  The grounds were dark and deserted, the beautiful place I’d seen in bright sunshine at my interview a mere memory to augment the shadowy building I could see.  I presented myself at the main reception just inside the front door and the receptionist/switchboard operator called for the caretaker, who set off in his van with me following and drove half a mile past half-seen outbuildings before pulling up outside a door and leading me through it, through a huge hall with rooms either side, and up two very long flights of stairs to the door at the top.  I wondered how long it would take me to find my way back to the main building in the morning; it was only in the morning that I realised I was still in the main building and had simply been taken round to a handy parking space at the back of it.

It had been a busy few days.  This was at the time when junior doctors with too much wanderlust to sign up for a three-year training scheme in one place could take matters into their own hands and apply for each of their six-month posts individually as they went along; a far more exciting way of doing things, as long as you could live with the constant interviews, with the uncertainty as to where or when or whether you’d be working at the end of whatever post you were currently doing, with the chance that you’d one day find yourself moving almost two hundred miles on four days notice.  For me, all those things ultimately just added to the fun of it; but it had been an anxious and confidence-rocking few months of scouring the BMJ careers supplements and being turned down at interview after interview, followed by a mad whirl of activity after St George gave me the last minute job; packing all my stuff, taking back library books, arranging for my mail to be forwarded, all on top of 8 – 4 shifts on the Monday and Tuesday at the A&E department where I worked in Liverpool.  I did get away from my Tuesday shift early, got back to the house where I rented a room, nibbled rapidly at the sandwich I’d been too excited and busy to eat at lunchtime, and spent an hour heading up and down stairs loading everything into my car that would fit.  (I’d given the landlord a month’s notice on my room – everything I couldn’t take with me would stay locked in there for as much of that month as it would take me to arrange to get back with a van.)  It wasn’t until seven o’clock that I’d said goodbye to my housemates and got into the car for my journey away from the city where I’d learned my trade and lived for almost eight years.  I remember that ‘We Built This City On Rock And Roll’ was playing on Liverpool’s local channel as I drove down the M62 for the last time, and I kept it tuned to the channel for as long as I could, until the last of the song faded into indistinguishable static.  And then I drove on into my new life.  That was where I was coming from when I got to St George’s.

In the days that followed, I got to know the hospital.  The main building was a huge, sprawling, red brick creation, surrounded by outbuildings holding various wards and a handful of sheltered accommodation-type places for patients with long-term mental health problems, all set in grounds so beautiful they could have been a famous park or the garden of a stately home.  The whole lot was magnificent.  It was like living in a mansion; I used to stand outside and admire it and marvel at the fact that I lived here.

And it was mostly empty, a relic of a bygone age.  The two acute wards were in a much newer outbuilding, as was the higher-security unit; there were also innumerable long-stay wards for people with various shades of long-term mental health problems or dementia.  (When I say ‘innumerable’, I mean it fairly literally.  We had, of course, a list of what wards were where and what variety of patients they were meant to contain, but on one on-call I had a bleep to come and see a patient on a ward that I’d never heard of before.  I followed their directions and found them buried in the main building, their existence hitherto entirely unsuspected by myself and by, apparently, whoever had the job of compiling the complete list of wards at the hospital.  The ward appeared to be thriving and entirely unbothered by having their existence generally ignored.  I daresay someone more official than me must have been aware of them, but that didn’t stop me coming up with mental images of them surviving by growing their own food in window boxes and on bathroom flannels and simply never dealing with the outside world at all.  Well, except when they had to call the on-call doctor for something.)  But most of the wards were in the outbuildings.  Apart from one long-stay ward that I covered, the Mystery Secret Ward that I saw just that once, and, I suppose theoretically, any other Mystery Secret Wards that were similarly hidden away and that I never did get bleeped to (in that building, anything was possible), the main building stood empty.

It was huge.  It was Gothic.  It rambled and sprawled.  Late at night I would wander around it, unlocking doors with the master key to explore the hidden corners, feeling like the prison warder walking the corridors in the opening credits of ‘Prisoner: Cell Block H’.  (Just to relieve any misunderstandings caused by that last, I would like to clarify that I didn’t watch ‘Prisoner: Cell Block H’, or at least not deliberately – I just had a boyfriend who did.)  It reminded me (to switch comparisons completely) of the girls’ comic story I used to read as a child about the orphan who lived hidden away in the basement of a huge theatre, using her knowledge of all its secrets to spy on and help the performers who worked there.  Admittedly I never actually found much in the way of secrets other than the Mystery Hidden Ward, but, then again, I always felt like one of the secrets.  In that huge building of wards and empty rooms, few people knew about the doctors’ flat hidden up at the top, where I lived and from whence I crept out in the evenings to explore.  It was like being the mad person hidden away in the attic in Victorian novels, only in reverse.

I would unlock the door of the hospital library on the ground floor and look round there.  Not that there was anything very exciting there unless you happen to enjoy poking through a few years’ worth of back issues of a few journals and a motley handful of books about psychiatry (and don’t knock it – it filled in a few slow evenings), but it was the principle of the thing; how cool is it to know that you live in a place that has its own personal library?  I checked out the gym, although unfortunately it had been shut due to health and safety issues and so I never actually used it, but ditto the above comment.  (Health and safety issues, by the way, do become more of an issue when you live in a hospital.  One Friday afternoon, I received a call telling me that my freezer had failed the routine safety testing and had to be switched off immediately.  If I’d lived in a house I’d probably have kept on using it for years, quite unsuspectingly; as it was, I had to make a hasty trip to the nearest Comet to buy another freezer, while meanwhile the hospital staff helpfully allowed me to keep my frozen food in the occupational therapy department’s freezer so that it didn’t go off over the weekend, and I just had to do without ice cream that weekend, to my extreme chagrin.  My father was quite tickled by the thought of my food spending the weekend in occupational therapy.  “So will your frozen peas come back knowing how to weave baskets?” he inquired.)

I loved my little flat, but, looking back, it was pretty obviously originally designed for people to spend on-calls in rather than live in; the three bedrooms were large and comfortable, but there was no living room, the kitchen was a tiny slip of a room, the bathroom was standard-issue institution, and there was no washing machine.  The first three weren’t a problem to me but the last was; Morpeth didn’t have a launderette, and I had no intention of spending six months schlepping all my dirty laundry to another town to wash it or washing it by hand.  I brought the problem up with the hospital administrators and they agreed I could use the washing machine on the acute ward – the one the patients used for their own laundry.  Carrying an open box of washing powder over there without spilling it was a minor nuisance, so, as there was a locked walk-in cupboard in the laundry room that could be opened with the master key, I kept my washing powder over there.  On one occasion, I put the washing powder back and walked out of the cupboard to see one of my patients coming into the room; we exchanged nods and hellos and I headed off.  “I’ve just seen Dr W__ coming out of a cupboard in the laundry room,” he commented to a staff member.  The staff were most relieved when I confirmed the next day that this had indeed been the case; they’d been worried the man was hallucinating.

By the way, one other benefit of the flat worthy of mention was that no-one ever seemed to charge me anything to live there.  It was initially agreed that I’d have it at a fairly nominal rate, but nobody ever asked me for any money and, as far as I could see from looking at my pay slips, nobody ever seemed to remember to dock the rent from my pay either.  I spent six months living in a Gothic mansion in stunningly beautiful settings absolutely free of charge.  Life does not come much better than that.

I recognise that I’m not saying much about the actual job in the midst of all this raving about what a great place it was to live, but I did love the job as well.  The life of a trainee GP doing hospital posts is one of forever being the lowest on the totem pole, forever moving on just as you get the hang of one specialty and one hospital, forever being a learner.  On top of that, I’d mostly done acute posts up till then – obstetrics and gynaecology, A&E, the usual house officer jobs – the kind of jobs that involve a lot of rushing around and quick decisions, which is not a pace that comes naturally to me.  Psychiatry works at a whole different speed (‘urgent’ means ‘try to make it later on today’; taking a basic history can take a full hour without anyone thinking you’re taking too long), and the specialty suited my temperament much better.  I liked having the time to spend to listen to people, and liked doing something that I actually seemed to be good at for once, and liked not feeling so darned rushed the whole time.  On top of that, I’d picked up enough general knowledge along the way that I was finally starting to feel like a useful doctor.  It was a good six months.

I was there for New Year’s Eve, 1997.  I spent the evening stitching together the sweater I’d been knitting over the past couple of months, finished it a little while before midnight, and strolled over to the ward to see the New Year in with the patients.  They were trying to switch the TV on – it was a fairly old one that took several minutes to warm up and for a few minutes it was touch and go whether we’d get a transmission in time to hear the chimes at midnight, but the TV just managed it and my patients and I watched Big Ben together and wished each other heartfelt Happy New Years and I exchanged celebratory hugs and smiles with a personality-disordered self-harmer, the two of us finding a contented moment of common ground.  My all-time favourite New Year’s Eve celebration was the one in 1999; 1997 is a close second.

I left St George’s on a Tuesday evening.  This time, I’d succeeded in getting my next job – a palliative care post at a hospice in Nottinghamshire – in plenty of time to find a flat and move the bulk of my stuff into it.  I packed my last few things up after work while talking to the new SHO who’d turned up at the flat ready for her job the next day, got into my car, and drove away.  I stopped off at the Metro, Newcastle’s giant shopping centre; I wanted to take my last chance to ride the funfair rides there.  Then I drove south, onward to the hills of the Peak District, to the town of Mansfield, to life’s next set of adventures.

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Filed under I think this line's mostly filler, The doctor is OUT. To lunch.

You Don’t Have To Be Crunchy To Like Breastfeeding

Welcome, Carnival of Breastfeeding readers!  The topic for the March Carnival of Breastfeeding, in counterpoint to last month's tales of challenges and difficulties, is to write about the things we like about breastfeeding.  This post will be published on Monday, March 22nd, the day of the Carnival.  As is the custom with the Carnivals, each carnival participant will put a list of links to all the other carnival posts at the bottom of their own posts.  This means a certain amount of updating throughout the day, so, if you are reading this post on the 22nd, please do check back later to see whether any links to new carnival submissions have appeared at the bottom.

My first reaction to the topic choice this time around was "I've already written that!".  Back when I was still breastfeeding but facing the imminent end, I sat down and wrote my farewell to breastfeeding.  I wrote about what it was like and I wrote about why I found it awesome, and I don't think I'll ever say it better than I said it then.  I thought about just retrospectively declaring that post to be my blog submission for this month, and Angela agreed I could do so as long as I republished it to be at the top of my blog, but in the end I decided that putting an introduction from 2010 into a 2008 post would just make my archives too confusing and that I'd prefer to write a new post and put a link back to the original one in it.  So, consider this a two-for-the-price-of-one: here's a list of the reasons why I liked breastfeeding, and that link earlier in the paragraph will take you to my ode to how I felt about it at the time.

Those of you who were up really early (or really late, depending on your time zone) and read this post then may have noticed that I've changed the title at the last minute.  This is because I think breastfeeding is sometimes seen as the preserve of crunchy earth mother types – especially in a carnival like this, where the majority of the participants are going to be crunchy earth mother types – and I wanted to stress that that isn't the case.  I am about as crunchy as jelly and, in spite of all the problems I initially had with breastfeeding, I still found plenty of reasons to love it.

Things I Really Like About Breastfeeding

1. Breastfeeding, when it goes all right (which in the vast majority of cases it does if you can hang in there during the initial rocky patch), is one of the few times in life where the right thing to do is also the easy thing to do.  I'm all for avoiding hassle where possible, but so many times the trade-off is guilt – I feel guilty over the times I let the children watch TV because it's easier for me than thinking up things to do with them, over the times I throw together bread and cheese and lunch meat for them because it's easier than making a proper meal, over the times when I don't go the extra mile in the other areas of my life because I don't want the work but know that really I should do it.  But, when it came to feeding my baby, I got to avoid all the hassle of mixing formula and washing bottles at the just-want-to-flop end of the day stage and packing bottles every time I went out, while simultaneously feeling really good about what I was doing.  It's the equivalent of someone inventing chocolate that's good for you.

2. Ear infections and tummy bugs in babies are utterly miserable for all concerned.  I liked knowing I had less chance of having to deal with them.

3. I had a hand free while feeding (without having to mess around with baby-propping or with expensive Podee systems).  When I gave Katie bottles (which I unfortunately had to do on a regular basis in hopes of getting her used to them before I went back to work), I found it quite noticeable how much more my actions were restricted.

4. While getting up for night feeds will never be anything other than a pain, at least I could just scoop the baby up and unclip my bra rather than having to go down to a cold kitchen and wait impatiently for a bottle to warm up.  It also meant I had the option of simply pulling the baby into bed with me and falling straight back to sleep again while I nursed.  Having read a stack of research on the possible risks of this I did avoid doing this in Katie's early months as there seems to be slightly more of a SIDS risk then (in Jamie's case, I had so much trouble getting him to sleep I just went ahead and slept with him anyway, risk or no), and I do want to stress that this is not something you should do unless you have read and are following the right safety precautions because it really can be dangerous to the baby otherwise.  But, done with all appropriate risk-minimisation strategies, it was great for night feeds a few months down the line, when I was back at work and desperately needed my sleep.

5. Apart from the whole lousy tongue tie experience, I never had to worry about how much the baby was taking in at each feed.  I mention this one because it's so often mentioned as a disadvantage of breastfeeding rather than as an advantage; many people, it appears, prefer knowing how much the baby is taking in at each feed, and I frequently see this listed as an advantage of formula feeding, but I have never seen it that way.  Knowing how much the baby was taking at each feed would have done my head in.  I would have had to worry about whether it was too much or too little and what balance to draw between making up enough formula that I could be sure the baby was getting enough but not so much that I was wasting excessive amounts… good god, it would have driven me nuts.  I was glad to avoid all that.

6. I loved the idea of this whole extra ability my body had.  I once read a novel in which one of the characters, a young breastfeeding mother, muses on how amazing it is that her body can produce something that you'd buy in the supermarket.  Her body works, she thinks proudly.  That was how I felt.

7. It's a lovely snuggly enjoyable experience.  Do I think it helped me to bond with my babies better?  No.  Was it a fun thing to do that I'm glad I had the chance to do?  Yes.

And now – please check out the other Carnival submissions!

Breastfeeding is how I connect with my little one after work – Pat Grace (Life Of A Babywearing And Breastfeeding Mommy)

No need to count calories when breastfeeding – Lauren (Hobo Mama)

Poems About The Joys of Breastfeeding – Melodie (Breastfeeding Moms Unite)

Nursing My Little Person – Whozat (Lucy and Ethel Have A Baby Toddler)

A Joyful List – Maman A Droit

The Top Five Things I Love About Breastfeeding
– Jenny (Chronicles of a Nursing Mom)

Milk Songs – Dionna (Code Name Mama)

The Joys of Nursing To Sleep – Sheryl (Little Snowflakes)

Things I loved about breastfeeding my son – Tanya (The Motherwear blog)

Nursing Haikus – Mandy (Living Peacefully With Children)

What Makes Breastfeeding So Great – Elita (Blacktating)

The Joys of Breastfeeding a Toddler – Claire (Adventures of Lactating Girl)

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Big circus

In the latest Writing Workshop, one of the prompts is: Tell us about something, or show us something that you do
really, really well and are proud of.

What I do really, really well, it appears, is come up with good on-the-spot answers to questions like "What factors would you have to consider if the PCT asked us to set up a sexual health clinic as part of the practice?", "What have been the biggest changes in general practice in the past few years and what do you think the future of general practice will be?" and "Tell us about the pros and cons of big practices versus small practices."

Well, it is perhaps an exaggeration to say that I do that really, really well – I suspect, for instance, that there is probably a very long list of better answers to the second question than "I try to avoid thinking about the future of general practice as much as possible!"  However, it appears I did it better than anybody else called for interview for the new salaried GP post at the huge, smart, generally wonderful medical centre in our town.  Last Tuesday, I had a phone call telling me that, on condition that my references were all right, they would be pleased to offer me the job.

And thus it is that, after almost five years of trying to get something nearer to my home than my current forty-minute commute, I finally have the perfect job.  I'm working out three months' notice at my current job, which, as chance would have it, leaves me finishing that job the day before my fortieth birthday and starting the new one the day after; a wonderfully apropos before-and-after split.  I have loved my current job (apart from the commute) and will be sad to leave, but the new job is the best thing I could possibly have imagined.  The medical centre is superb, the location is perfect for me, and I'll get to take part in teaching the students and F2 doctors and doing some other interesting stuff – they want me to help with the community wards at the local hospital and to take over the medical care for one of their local nursing homes.  It'll be an upheaval, but one of the best upheavals ever.

Some years ago, my family were discussing books we'd hated in childhood and my mother told us about a book she'd read about a little boy who saved up all his money to go to the little circus when it came to town, then didn't have any left to go to the big circus when that came to town soon afterwards and was reduced to languishing outside while the other children enjoyed the show.  It's hard to know what in the world the take-home message was meant to be for the children who read the book – effectively, the story was advising them to pass up the bird in the hand just in case it caused them to miss out on the potential two in the bush, which is hardly the most pleasant or constructive of philosophies to live your life by -  but this incredibly depressing storyline became a family analogy.  Whenever we're in a situation of potential trade-off between a good thing and a possible (even hypothetical) subsequent better thing, we speculate on whether we may be settling for the little circus and missing the big circus.  Or, alternatively, we will reconcile ourselves to losses by philosophically commenting that no doubt that was just the little circus and the big circus will be along in due course.  That last is what's happened to me.  When job opportunities pop up as rarely as they have been doing in the area close to my home, it's hard not to get discouraged when, time after time, each of the handful of interviews you do manage to land is unsuccessful.  Those jobs, it turns out, were the little circuses.  This job is the perfect one for me, better than anything I could have hoped for, better than any of the others for which I interviewed.  In my mind, I can almost see the crowds cheering the acrobats on as they turn and leap.

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