Sunday, June 26, 2005

Whys

Hail, and sorry this has taken so long.

What's been going on?

Well, made a bit of a career decision in the last week or so, which I am now going to talk everyone through.

Emergency trainees like me are expected to move around the hospitals, learn new stuff. I've been at Florey two years (one of them half-time) and it's pretty much time for me to move. So I was looking around and after excluding the obviously unsuitable (too far away, too small, regularly mentioned on "Today Tonight" and similar tv shows, run by certifiable psychopaths), I was left with two.

Option one was the Royal. The Royal is the city's top hospital. It has a neurosurgical facility. It has the burns unit. It has the biggest paediatric and neonatal intensive care departments, it has the spinal unit, the "secure" psychiatric institutions, one of the only two transplant facilities in the city, craniofacial surgery and so on.

It's where the top people go. It makes you a top doctor. It inculcates and accepts nothing less than the highest standards. It's the logical next step. It would seem, one of the senior consultants said last week, "wise to consider the Royal. People who don't go to the Royal tend to ..." and here he paused, "stay in their comfort zone. They take a long time to go through the training programme."

The alternative is Lazarus General. The ED at Lazarus was pronounced clinically dead a few years ago. It's thrid director in as many years had resigned in disgrace. Multi-million dollar payout disgrace, but still disgrace. It was avoided by ambulance staff and was no longer on the trauma pathway - every significant motor vehicle accident in that part of the city went straight to the Royal. Finally it was denied accreditation by the College of Emergency Training - as far as the College was concerned, if you did five year's work at Lazarus it meant you were no more highly trained than someone who'd done none. They've only just got back on their feet.

Anyway, I picked Lazarus, and I've never felt better.

I tried to pick the Royal, I did.

But I was thinking about what the senior consultant said about it being "wise" to go to the Royal. It was a word which had struck me as unusual, archaic, almost incongruous in the ED (you rarely hear someone in the ED saying "I believe it would be wise to give this man some magnesium"). On a quiet night you might hear words like "evidence" and "guideline" and "protocol", but you don't hear "wise".

"Wise" to me suggests the product of considered reflection, of careful, unflinching self-analysis, of teasing out the truth from amongst the probable, the plausible and the palatable. So I'd tried to do a bit of that over the week I had to make my decision and this is what I'd come up with.

I could not take myself seriously at the Royal. The head of the Royal, in discussions with the minister, recently referred to Florey as a "first aid station", in an off-hand way, as if he were describing the weather. I could not sit by while someone talked unutterable crap like that. And I would alugh at the thoguth of us (the Royal) with vast amounts of money and prestige, talking about how much better we did than other places with much much less.

The Royal would not be comfortable with me working half-time. Hogarth, visiting the prisons, all that would have to go. And so would judo with my son and the new writer's group my wife and I are joining.

I cringe at the thought of telling someone at the Royal about my bipolar.

And "wise": I don't know that those people generally regarded as wise rated career advancement that highly. This will show my hippie roots, but Lao Tzu and Jesus and Epicurus and so on versus those people on The Apprentice

Now I know to some of you this sounds transparent: as if I have decided something, out of fear or laziness or lack of self-confidence or whatever and am now seeking to justify my decision.

But wisdom to me sometimes means accepting unpalatable things about yourself. I am the kind of person who is going to go slowly through the training programme. My friends are going to be consultants when I am still a registrar. People I went through Uni with will be telling me what to do.

I am not focussed. I am not going to give my all, I am not going to "make any sacrifice necessary". All that "ad astra per aspera" stuff always struck me as daft. If I went to the Royal and stopped writing and stopped Hogarth and stopped judo with my son and stopped drinking merlot and eating pizza with friends I haven't seen in years like I've been doing the last few weeks (since I finally got the meds right), but I ended up a specialist in five years rather than ten, it would seem more like a diminution than a gain in stature.

My career is not my sole interest.

I think it is fear. But sometimes fear is your body's way of telling you you're about to do something stupid. And it's easy to do something stupid here.

One of the consultants here hasn't had a partner in a five years. She lives here. When she goes home and opens the fridge there's a can of baked beans and two sixpacks of beer, dead set. She fast-tracked.

Anyway, I send my CV to Lazarus Monday. It's not a smart career move, it's not fast-tracking, but all things considered, it seems wise.

5 Comments:

Blogger Foilwoman said...

John (or whatever your real name is): I initially fast-tracked in my chosen profession. While right now I am in a bit of a career crisis (brought on mostly by unexpected fertility at age 43 shortly after starting a new and demanding job), I'm pretty happy for an underemployed previously type A- personality. And I'm actually having time to play with the Foilbaby and observe the new teeth, the dimpled knees, etc. While I am striving for career security after the dreaded "second child" (in my chosen field, people always say to women who ask about becoming mothers: "Sure, you can have a kid. I don't know how you could seriously manage two, though."). Who wants to be in a job where you can't make allowances for your own frailties (for me, clinical depression and ADHD) and your family (two kids, spouse, handicapped sibling, other sibling and nieces and nephews I like to spend time with, mother who just passed the five year point after breast-cancer surgery). What are you supposed to do? One colleague kept rescheduling his son's fifth birthday party. I think by the second time, the kid got the message. So, go Lazarus.

BTW, I love the fictitious names you give these places. At least, I hope they're fictitious.

11:52 AM  
Blogger Stoic Stranger said...

Damn John, best of luck. Sometimes, especially as bipolar, it's best to do things that maintain the mental status quo and wellbeing, and not necessarily that which others consider needful. Courageous step.

4:07 PM  
Blogger Benedict 16th said...

John,
Your choice shows you are not the man that the "Crow l'obix" is (well obex anyway), and we would all be first rate neurologists.

Or "Just because you are a prick doesn't mean, deep down, you are a nice guy" Modus tollens

11:09 PM  
Blogger Chade said...

It has often been said "Don't jusge a book by its cover". I am not of this inclination. More often than not, the cover is what has led me to some absolutely brilliant destinations. Remeber Susana Clarke's 'Jonathon Strange & Mr. Norrell'? Mark Millar's 'Wanted'? Haruki Murakami's books published by Vintage Press?
These covers atrract. They tantalise.
Then you have Rob Liefeld's 'X-force' and you know not to go near it. here's a sinking feeling, a twist in your gut, a clench in your bowels... fear. You don't touch, you don't approach, and you know you've made the right decision.

Just remember to keep an opening for Toby and myself to catch you up when I hit civilisation in July.

8:50 AM  
Anonymous Camilla said...

Sounds like you made the right decision. Good for you. And in my opinion, Lazarus is lucky to have someone like you.

11:54 PM  

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