‘Good morning Dr Kratos. There’s a request for you to come to the ward,’ David, one of the admins, passed on a clipboard to me. I hadn’t even walked into my office! His ginger hair hung low down his face. Slim and tall, he passed more as a teenager than a grown young adult.
‘Thank you, David. Who requested it and which ward?’
‘Doctor Ayo requested it. I, um, think it’s the Majory Warren ward. It should be on the notes,’ pushing his fringe across his head, he nodded towards the clipboard I held.
‘Accident and Emergency patients?’ I flicked through the pages.
‘Jeremy, you’re here,’ breathed out Dr Raj.
I looked up and noticed a very tired Consultant. ‘Kunal, it’s far too early to be tired.’
‘Yes, I guess you’re right. The nurses are in a worse position, to be completely honest. But could you come and see a patient for me,’ he looked across the room and ran his hand through his greying hair.
‘There are quite a lot of patients waiting to be seen by Dr Kratos, doctor,’ David interrupted.
I looked over the number of patients waiting in my territory. David was right.
‘Kunal, I need to start off with the appointments. Can you not ask,’ I looked up at the board, ‘Doctor Zen? He should be free now for at least half hour it seems. Probably preparing for this,’ lifting the clipboard, I passed it back to him.
‘Yes, maybe,’ he conceded hesitantly, ‘but could you not spare just a few minutes? She had an operation,’ he was being persistent. He was never persistent.
‘Look Kunal, you need to trust Ying. He’s a good Neurologist.’
‘You’re a Consultant, and that’s what we are lacking,’ he grumbled.
‘I’ll see what I can do but let him attempt a diagnosis.’
‘That’s better. Ping me. Its tiring being the Consultant in that ward. Do you realise how big it is?’ He smacked the clipboard against his forehead to emphasise his point and walked out.
‘Right, where were we, David?’
‘We’re still in Outpatient Four and your patients are waiting,’ David walked back off to the desk.
I watched as more patients came in and signed in through the self-check in. Technology was beautiful.
9:10 AM, late as usual! Scanning the centre once more, it didn’t seem too busy. Opening the tray, I pulled out the first file and walked into the office. Placing everything down onto my desk, I picked up the file and skimmed through it.
The best thing about being a Consultant was the bond you develop with the patient. They were the ones you would be seeing every four to six months. The level of trust was important to me. But the hardest bit was remaining detached. Controlling my emotions was significant to my job and I had yet to overstep that barrier. I could have the same patient for over ten years, but rules dictated that I control my feelings, whether it was watching a child grow up over time or trying to increase the lifespan of a patient despite knowing that my attempts would be fruitless. This was what a doctor meant for me and I would in no way compromise my principles. They may be the rules that we followed, but they had become principles for me. I had engraved them in my mind. Though, I had a long way to go yet.
My room wasn’t large. It was a typical room a consultant had. I was just lucky enough to have a window. The usual desk with a worn-out extra chair for the patient. A long bed lay against the side of the wall, again for the patient. Never really used. We definitely needed new furniture. I was sure that if I cleared out my desk, one would be able to see just how chapped the desk was. Or rather, how chapped it is. But at least it was still standing and at least the patients had yet to complain. The walls were the pale green, pasted with posters relating to medical information. I shared it with another consultant when I was carrying out duties in another hospital.
Considering that I was yet to be an established consultant, I couldn’t call the office my own. That also meant that I could not personalise it.
With everything in place, I checked the time once more. 9:30 am, first appointment of the day.
Walking out, ‘Mrs Owens,’ I called. ‘Ah, Mrs Owens, how are you? Please do come in.’
A lady in her mid-forties hurried into the room.
‘Good Morning Dr Kratos,’ she greeted.
Mrs Owen sat down and straightened her dress.
I perused her details again. It wasn’t stored in the system yet considering she had been attending the place for years. Although, that was probably the reason why it wasn’t stored on the system. The GPs would definitely have an electronic copy of everything.
‘How are things? Anything new?’
‘Nothing has happened. Everything has been the same since I last saw you.’
‘That’s great to hear,’ looking up at her, I passed on a smile, ‘then I don’t think we need to increase your medication. How does that sound?’
‘I’m happy. But, there’s one thing I wanted to mention. The new medication is working but,’ she closed her eyes and tried to look for the words, ‘I feel drowsy and something is wrong with my memory. I seemed to forget things.’
‘Well,’ I began, ‘the side effect of the medication can be drowsiness. Does it affect your day to day life?’
‘Does it affect your work? You drive, so does it make you feel sleepy when driving? If that’s the case, then we need to rethink.’
‘No, no. Nothing as serious as that, it’s just that I get tired.’
‘Yes, that is a side effect of the medication. If it is having a significant affect on your daily life, do let me know. However, I will say this, that you’ve been on these medication for,’ I flipped back the pages, ‘for several years now. Did you not bring it up with Dr Anderson?’
‘I didn’t notice it before.’
‘Mrs Owens, I do need you to be aware that your condition will make you tired. Have you been given material to overcome it? Your nurses, I mean?’
‘Not really, although I will see them next week.’
‘I’ll put in an email to hand you some when you see them next. This also applies to your memory. I know it is a terrible condition, but we find ways to overcome it as well as giving you the right medication. Again, I will stress, if the medication is having a negative effect, then you must let me know. Also, are you taking the larger dosage at night or morning?’
‘Hmm, we tend to tell the patients to take the larger dosage in the evening, if it’s a drowsy medication. I’ll add that to the email, just in case it has been mentioned before. Are there anything else that you want me to include?’
‘Yes. The pain. I’m experiencing some pain too.’
‘Hmm, where does it hurt?’
‘My head. I keep getting headaches and it can last for hours,’ she pushed her fingers against her right temple.
‘How long has this been going on for?’ I knew my brows were knitted.
‘For a few weeks now. Bright lights affect me the most. Sometimes I feel sick, like I’m about to vomit.’
‘What part of your head starts hurts?’ I looked at her head, ‘Also, any part of your face too?’ Lightly touching the side of her face, including her cheekbone, temple and jaw, I added.
‘It’s usually my left side. My eye, and then it starts spreading.’
‘How long does it last?’
‘I haven’t really, I mean, I’ve never.’
‘Don’t worry,’ I patted her hand, ‘just a few more questions.’
‘You said that it’s your left side, how about left eye?’
‘It aches a lot when I get these headaches.’
‘Blurry vision? How do you feel after? Dizzy, change of mood?’
‘I haven’t really paid attention to my vision or the after effect.’
The first word that clicked as soon as she said headache, was Migraine. It was debated in which condition it feel under, whether it was neurological or vascular. Being a Neurologist, and considering it affected the nervous system, for me at least, I considered a Migraine to be a neurological condition, but I was also still a Doctor. I had to be careful, and I just hoped it was a passing pain.
‘Tell me, Mrs Owen, have you spoken to your GP about it?’
Looking down at her hands, ‘No,’ she responded.
Reeling back my chair, I wrote a few notes, and turned back. ‘I’ll include all this in the summary for your GP to look at, but I need you to go to them,’ I said as I scribbled down a few more notes.
‘I thought it would be better to let you know.’
‘It is important that I know, but GPs make referrals. I don’t want to diagnose you with something without your GP having check it out first. They may identify something not related to us at all. Take caution and studying all paths before diagnosing. Is that alright?’ I smiled encouragingly.
‘What do I do for now?’
‘We’re keeping the medication the same, as there’s been no change. For now, take paracetamol for the headaches, but you need to book an appointment,’ laying my pen on top of the paper, I stood up, ‘let them know, six months, unless things worsen.’
Standing up with me, she shook my hand, ‘Thank you. I just hope these headaches go.’
I smiled at her and walked to the door. So do I Mrs Owen, so do I, I couldn’t help thinking.
Following her out, I picked up the next folder and called out the name. This went on for the rest of the day. After making sure everything was in order for the reports that needed to be typed and sent out, I picked my up my bag and made my way out of the Neurology ward.
‘Jeremy, you’re done for the day?’
I jumped at the voice behind me. Spinning around, Dr Raj caught my arms and steadied me. ‘Your balance is terrible,’ he said.
‘I honestly don’t have time to take these extra classes that some take,’ I chuckled. I watched him flinch as I gathered my balance.
‘At least your strength is strong,’ he began rubbing his arms.
‘Sorry about that, you just scared me. How was Zen?’
‘Fine. He examined her and read through the notes. Nothing concerning your department. I think it may have just been the pain and everything happening at once, that may have worried her. I got Michael, from Orthopaedics, and Emma from Rheumatology.’
‘Emma? Michael? Who are they?’
‘They were the ones sent. Michael wants her sent to Radiology to get a copy of her right arm, so we’ve booked that for tomorrow. Personally, she just needs recovery. I know she was hit, but healing and recovery is needed.’
‘Don’t forget medication’
‘Yes, that, but we need a reason other than the ones she’s already been given.’
‘See, you just need to place a little trust.’
‘Forget all that, now. You’re off, and I’m not until another,’ he looked at his watch, ‘two hours, so you might as well give your opinion on another patient. I plan to discharge him soon, but just to be on the safe side for this one,’ he explained.
‘Come, show me,’ I pushed him forward and yawned. Life as a doctor in a hospital.
We continued our conversation as we made our way to the
ward. I couldn’t wait for tomorrow, planning to stay in bed all day, until the
evening event started. Events organised by my parents, I could not say ‘no’ to.
Any other informal gatherings, I always found a way out. Sleep took precedence
over boredom. Life.