Small Talk and Responsibility

 

When asked about the skill’s you think a good doctor needs, what do you think of? Calm? Empathetic? Hard working? leadership? All fantastic qualities, but none the answer I’d give. Do you know what they really need? An endless bank of great small talk, making each and every consultation 100 times smoother. But unfortunately in this consultation, my bank was falling well into its overdraft.

Helen, the F1, had ushered me to the exam room, instructing me to take a history from and examine Mrs S. Apparently she would be back in less than 15 minutes to check my findings. Well apparently, Helen and myself have a very different understanding of the meaning of 15 minutes. It had only really been 25, but 10 minutes of “how long have you lived in Cornwall then? “, “ I’m in my 4th year now, only the 1 more to go” and “no you’re right, I’m not from around these parts” does a pretty good job at grinding time to a halt.

Yet my dwindling supply of small talk wasn’t the only reason I was anxious for Helen’s return. I was fairly adamant Mrs S’s grumbling abdominal pain wasn’t just a bit of trapped wind. My forced smile and false interest in her 4 dogs only just masking internal visions of Mrs S keeling over as her appendix violently exploded within. As my waking nightmare extended to her being wheeled into surgery, still avidly explaining how she first met Larry the Lab, there was a knock at the door. Help had finally arrived.

After quickly presenting my findings and expressing my concerns, Helen began examining Mrs S’ abdomen, each poke and prod filling the gaping anxiety pit in my stomach. I always had found the company of competence much more reassuring than my own.

“Well I think he’s right, this could well be your appendix” I have to stifle a smile of success as my ego gives itself a solid pat on the back. I find people with impending surgery rarely appreciate an openly smug medical student. “We’re going to need take some blood to double-check though”. She turned to me, but I’d already read the walls, here comes the question all students want, but simultaneously dread being asked. “You do cannulas, right?”

Helen was right. Technically I did do cannulas, two to be precise. Once on an extremely vascular colleague, the other an unconscious gentleman pre-op. Unfortunately the elderly lady in front of me was neither vascular nor unconscious. If anything, the prospect of being cannulated by myself was making her visibly more conscious. However, before my brain could fumble out an excuse, I nodded and slipped out a foe-confident “yeah, sure”.

Like passing the baton, I was passed the tray of cannulation equipment. It was my race now, Mrs S’s care was now, if just briefly, my responsibility. With everything prepared, I began to read her arms, hoping the tourniquet would reveal a map of possible routes. Yet I was disappointed; the plan of small, winding B roads in front of me wasn’t filling me with much confidence. About to turn to Helen, succumbing to defeat, my fingers brushed over a small swelling on the back of her right wrist. It was no motorway, a short dual carriageway at best, but this was possible.

“Short scratch coming up” My medical-cliché alarms ringing as I say it. I hated that phrase, but what else were you supposed to say? About to stab you with a needle, probably going to hurt a bit? My alarms settling, I advance with the needle, the skins elasticity initially resisting its sharp point before succumbing to defeat. I continue advancing, attempting to ignore Mrs S’s wincing whilst I watched for the splash of blood at the back of the cannula; signifying my success.

Nothing yet, just got to keep going. I could have sworn I was in the right place, but I also could feel the doubt setting in. In retrospect, my lack of experience was the likely cause of my negativity, but at that point I just thought I’d messed it up. However I’m glad I persisted, because my patience was rewarded by a splatter of red hitting the back of the chamber. He’d put up a good fight, but in the end, I’d done my part; won my race.

 

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Small Talk and Responsibility

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