Friday, December 16, 2005

Platybelodon't you love me anymore...

Five AM, the interregnum between the drunks and the cardiac patients, and I've been thinking about this whole taking a break from the training programme thing.

The way it stands is changeover happens in less than two months, and I pretty much have to decide what to do for the next six months.

My main options are another term of emergency half-time, a term of intensive care half-time, or going full time drugs and alcohol.

The ICU term would be educational and doubtless deeply praisworthy, but to be honest whenever I think about it I get this surge of tiredness. The same kind of thing I get when I think about studying for the exam again.

Going full-time drugs and alcohol is a lot better hours - regular hours, with maybe even a day off a week. That's the option where I would presumably be either studying for the exam (unlikely) or really taking my writing seriously. Writing the novel, the tv series, the comic book, the short stories.

I don't know. See, writing it down like that, it seems the only sensible thing to do is leave the ED, even if only temporarily.

By the way, I know that they'll take me back any time I want. I know this because Dr Pippi has quit and Dr Anya has quit and that's two of thier better registrars - one because her husband has left and the other because otherwise he will leave. So I don't have to worry about coming back.

And at least once a week I get a flyer saying "Why not become an emergency registrar in Queensland/Tasmania/New Zealand/Cairns etc." These advertisements feature images of doctors shoving tubes into various orifices on plastic looking patients, shots of beaches/tropical jungle/rainforest/whatever and photographs of the most photogenic nurses of either sex. The message implicit in this is that you will spend your time lounging on the beach with some microbikini-wearing babe, but the truth, I know, is that while the bikini-wearing babe lounges on the white sands with the jungle in the background, I will be grappling some hundred and thirty kilogram psychotic who reckons he doesn't need stitches.

So why haven't I quit yet? Why haven't I just picked up the phone and given them the six week's warning?

part of it is, of course, the obvious reasons. I work with really good people. It's helping people. It's interesting. It stops me forgetting my basic medical skills.

But I reckon that there is a less palatable reason as well.

I reckon part of it is ego.

A few days ago I was seeing a patient at SMACHEAD and he mentioned that he had some kind of knee problem.

"I've got to see a doctor about that" he said. "Not you, a real doctor. No offense meant."

"Real doctor?"

"I mean, not just a methadone doctor. Like in the Emergency Department"

"Well, if you turn up there Thursday night I'll see you. That's where I work. When I'm being a real doctor."

Fairly juvenile on my part, but still.... I wonder if there isn't some of that I'll miss. Some of the mana, some of the self esteem.

And then I wonder at how revoltingly shallow that is, and why after all these years I need that kind of prop.

As far as I can tell I despise that kind of thing in others, that whole "hot damn, I'm a physician" thing. Theoretically I find that kind of "I'm defined by my job" stuff pitiable. So it makes me wonder when i find it in myself.

How come I've still got this ongoing requirement, this chronic dependency on the praise of others. Am I ever going to be able to shake it off?

I think some of this dependency comes from certain unpalatable facts. Being hospitalised several times throughout my medical degree didn't help things. Being surrounded by people who are better than me at things like interpretation of CTs or the reference ranges for certain blood tests - while that's good for my training, it's not that good for that squalling thing inside me that screams until it is fed.

How come there is this need?

I feel things are getting better, they are certainly a lot better than they were four years ago. The fact that I have not been hospitalised in that time pretty much demonstrates that. But the fact that I have to tell people that probably demonstrates that it's not all good yet.

If it's a self esteem thing, if it's a lack and a fear and a hole where something should be, where is it coming from? Is everybody like this?

I remember thinking one time that no amount of external validation can compensate for a lack of internal validation. I reckon it's fairly clear that a lot of people are like that, that the degrees and the cars and the jobs and the spouses serve primarily to demonstrate one's personal success to some group of onlookers - agroup of onlookers that includes one's self, one's parents, old school teachers and people who didn't want to go out with you.

The weird thing is, when you look at this, that misery and low self esteem and insecurity seem to be not so much impediments as requirements for success. It's almost as if there is some kind of "evolutionary pressure" driving us to be miserable and needy.

Think of two tribes of cave-people, the Happies and the Needies. The Happies have no requirement for external validation - they all beleive in themselves, they all accept themselves for what they are, they don't measure their worth based on the opinions of others.

Just across the valley are the Needies. They are a population of psychological cripples. They loathe themselves. They are lonely, uncertain, yearning, there is a black hole within them that devours attention and love, a beast that cannot be filled, something that grows strong as it is fed, and weakens you as it grows strong.

Who's going to "win": the Happies or the Needies? Or put it another way, who's going to create the works of art, discover the new elements, make songs and make wars? Who's going to need something to believe in and make cathedrals and crusades, who's going to have a requirement to be better than their neighbours and make archers and armies? Who's going to have a need to be loved and make poetry )and progeny)?

See, happiness and contentment are evolutionary suicide. What happened to Platybelodon and other majestic beasts of the past? Is it possible that rather than a meteorite, that it was positive self belief that killed off the dinosaurs?

Well, I don't know about that, but it is entirely possible it will be emergency registrar mediated neglect that kills off the drunken man in cubicle 18 if I don't get off my bum and see him.

Thanks for listening,


Blogger Foilwoman said...

Is there any particular reason that Platybelodon is accompanied (or ridden, as the case may be) by a nubile young Asian women in a white (or red) bikini and wearing heels (or barefoot)? Scientific accuracy? Perversions involving prehistoric animals? Just a guy doing the illustration?

5:13 AM  
Blogger Bronze John said...

Hail!! My God - this is almost a real conversation!!

Platybelodon is the one with the Japanese woman in white underwear and stillettos - I don't know how well the underpants fossilised. Deinotherium was apparently preyed upon by Japanese women in red bikinis.

Thanks for reading, better go work now.


6:08 AM  
Blogger Foilwoman said...

Oh, I always read your new posts as soon as I see them and try to think of something witty to say. Sometimes, I even succeed. I'm still betting that the illustrator had a Y chromosome. And was Japanese or had a thing for Japanese women.

8:17 AM  
Anonymous Camilla said...

"Well, if you turn up there Thursday night I'll see you. That's where I work. When I'm being a real doctor."

HAHAHAHAHAHAHAHAHA!!!! That's bloody hilarious, nice catch :D

How come I've still got this ongoing requirement, this chronic dependency on the praise of others. Am I ever going to be able to shake it off?

Cos you're human. And no, probably not entirely, cos you're human (unless you have other plans for Friday).

If it's a self esteem thing, if it's a lack and a fear and a hole where something should be, where is it coming from? Is everybody like this?

I'm not everybody, but I'm certainly like this. (Perhaps I'm not a good example. I clearly remember you telling me some years ago that no amount of external validation can compensate for a lack of internal validation, and feeling like the Faery of Epiphany had just fetched me a good whack over the head with her magic wand. Then I went right back to chasing unsuitable men.)

Flippancy aside, I think we sort of do need to be needy to an extent. Your example of creating art, building cathedrals etc. is a good reason. Who cares about the deep, dark motivations of whatsisname who painted the Sistine Chapel ceiling? Thing is, we can admire it now because it's a bloody gorgeous work of art, and I'm GLAD that he did it, even if it was only to please some Pope or other (pardon my ignorance).

Also. Re: cars and huge houses and things. People who sell Porsches rely on us getting off on being watched by the envious hordes as we drive past in said Porsche (Well, make mine a Bugatti Veyron actually). And yeah, it's a NICE feeling. Nothing wrong with that in my opinion, so long as it doesn't become the sole driving force of your entire lifestyle. Which I don't see happening in your case.

And finally. Be proud of being a doctor. You worked damned hard for it, and you have a job that's way more responsible and stressful than most. You have every right to be recognised for this. "Just a methodone doctor", pshaw!

7:59 PM  
Blogger Bronze John said...

Hail Cam,
Hope the wedding plans are going well. Actually, the bloke from the previous post who was going to fight me at one stage swayed forwards (fists cocked ineptly) and said "And you! You're nothing but a doctor! Are you? Huh?". Which was a really weird thing to say.

2:32 AM  
Blogger Foilwoman said...

Who's Camilla marrying, and do you and the Pope approve?

10:43 AM  

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