1st Christmas in the UK

this would be remembered for the wrong reasons.

i was on-call & the 1st case for the day was a 70+ year old lady for a DHS insertion, a procedure to fix a broken hip. the standard anaesthetic technique in that hospital was to give a general anaesthetic supplemented with a local anaesthetic (epidural).

the general anaesthetic went smoothly but i had some difficulty with the lumbar epidural, resulting in the accidental puncture of the dura. instead of abandoning the epidural & just have the general anaesthetic, i proceeded against better judgement to attempt again at a different (higher) level. after administrating the full 20mls of the local anaesthetic, true to form, the blood pressure crashed & the patient heart stopped. resuscitation was unsuccessful.

i can't tell you how angry i was with myself for such a novice mistake. maybe i was indifferent, maybe i was over-confident but i will never, ever forget how a lapse in concentration resulted in this unnecessary death. one good thing that came out of this was the unwavering support the consultants gave me, even at the inquiry for peri-operative morbidity and mortality.

i want to believe this made me a better doctor today & that death was not in vain.

Mini culture shock

In my 1st job in the UK, I was waiting for the hospital transport to get me to another hospital. As the van stopped in front of the lobby, a middle-aged gentleman in a full suit, coat, tie & all, disembarked from the vehicle. Trying to be friendly, I approached him.....

Me: Hi, is this the van to the WH hospital?

Him : Yes, indeed it is.

Me : By the way, I am Dr T & I am the new SHO. And you are Dr........?

Him : I am Ray & I am the hospital porter.

Lesson #1 : in the UK, most men in the service industry, from top down, wear full suits.

Lesson #2 : Introduction is commonly by 1st names.

Therein, began my memorable 4-year sojourn in a foreign country.