Friday, 22 March 2013

Hard Work

After the 200m mens final in London last year, Usain Bolt went to his hotel room with the entire swedish womens handball team.

If that isn't an example of hard work paying off, then I don't know what is.

Speaking of hard work, my diary entries have been thin on the ground recently. You may remember me saying that I transferred to a major trauma hospital early last year, and despite my doing lots of courses in preparation, it's proved to be much harder than I had anticipated. It's been good experience,though: I like being able to handle car crash victims more efficiently, as well as other critically ill and injured patients. However, the intensity of the environment, never finishing on time and often not getting to eat or drink during a shift was starting to take its toll.

During the first six months, I was only barely coping. While nothing overtly disastrous happened, it was quite clear that I had some adaptations to make, and my performance appraisal at that point reflected that. While I'm good at seeing and treating patients, running a department of that size and turnover was a big jump from anything I'd ever done before. Paradoxically, my supervisor, who gave me that appraisal, is actually the person I like most in the entire institution. Anyone who went to 6th form with me, imagine a medically trained Richard Coberman.

I know.

Frightening, isn't it...?

The parallels are uncanny, and sometimes I have to consciously remind myself of which one I'm talking to. They're both the kind of people who, even before they've said anything, will make you laugh, often because you know that whatever they say next is just going to be hysterical. Not only hysterical, but outrageous- and only they can get away with saying and doing things like that.

For example, at shift changeover meeting once, one of the female doctors was scratching her head, and found a pen that she'd used to tie her hair up. "Oh! I wondered where I'd put that!" At which point, my supervisor interjected "Thank God you weren't scratching your bum when you said that- that would have been a bit awkward, wouldn't it?" Everyone burst out laughing.
I laughed as well, but looked on in consternation, thinking "How the Hell are you getting away with this???"

Thinking back to school, I remember one afternoon when we were all about to get the coach home, Richard was sitting on the pavement when a very pretty girl walked past in her horse riding gear. I was standing on the other side of the road. As she passed between us, Richard said out loud, for all to hear:

"Kinky boots...!

Boots.... kinky...!

Boots that are kinky...!"

Far from being offended by this, she actually laughed, and merrily skipped along, positively buoyed by the experience.
I just looked on and thought to myself "How the Hell are you getting away with this???"

"Screw it", I thought. The following week, after her horse riding lesson, that same girl was walking towards the coaches again. I thought I'd say exactly what Richard said the previous week.

It went badly.

Really....

REALLY....

badly.

Hmmm.... maybe that kind of gregarious sexual humour isn't quite for me. While I can laugh at it, I certainly can't execute it like those guys.
I do have my own brand of risque humour, but it centres more on subtle innuendo and speed of thought.

For example, I remember seeing UK comedian Jasper Carrott doing a sketch on men being unable to recognise that remote control batteries do eventually run out. He mimicked a guy in front of a TV set, repeatedly hitting the remote control saying "What the Hell's wrong with this thing?!? I put these in seven years ago- there should be plenty of life left in them!!" Both funny, and with a foundation of truth, to which I then added:
"Whereas women, on the other hand, can tell with remarkable accuracy how long a set of batteries can last... ;) "

Think about it......

Anyway, listening to my appraisal at 6 months wasn't pleasant, but everything my supervisor said was true and justified. I had to do something about it.

Such is the structure of emergency medicine training here, that you can take your consultant exam one year before you complete your advanced training, which, for me, will be this August. Like I do for every set of exams, I set myself a structured and intense study program basically consisting of 10 hours study for every day I'm not at work,and 2 hours for every day I am at work (that's why you haven't heard from me since September). I also called Russell- one of my few genuine friends at work- who's brilliant, and asked him for some advice as to how I should go about things.

I made a very conscious effort to put all of this studying and practical advice into practice. As the weeks went by, I was feeling more sure of what I was doing, but couldn't really tell if it was enough.

I had another appraisal with my supervisor 3 months later. I wasn't sure how it was going to go, but I didn't feel like I could do any more. We sat down.
"There appears to have been something of a Victor revolution!" he said.
"Oh." I replied.
"Yes- universal opinion is that you're doing very nicely."
"Oh." I replied again.
"How did you do it?"
I explained to him my study program, and my modelling myself on Russells method of working. He told me that all the bosses were amazed.
"It's almost unprecedented for someone to make such a big turnaround in such a short time as you've done".
"That's very nice of you to say, but realistically, what was the alternative?"

We both paused momentarily. He was about to say something when I interrupted:
"Do you mind if I draw an analogy?"
"Sure" he said.
"Have you seen the movie Waynes World?"
"Not for a long time..." he replied.
"Towards the end of the film, there's a scene when they're preparing for Waynestock, and one of the stage assistants keeps failing to pick up the microphone stand in time. Eventually, Wayne runs upto him and says

[at which point, I get up, start pointing, screaming and shouting]

YOU'RE USELESS!!!!! YOU'RE PATHETIC!!!! YOU'RE LESS THAN NOTHING!!!!!

WHY DON'T YOU JUST QUIT????!!!!????!!!!

[then, sobbing]

BECAUSE I'VE GOT NO PLACE ELSE TO GO...!!!"

My supervisor was rocking in his chair in hysterical laughter.
I then sat calmly back into my chair, folded my arms and said "That's the kind of situation I was really hoping on avoiding."

There's something very validating about making a funny person laugh. I'd never seen him laugh like that before. He's not just a funny person, but also a brilliant doctor, and I love him dearly, in the same way that I love Richard. However, I would NEVER do that in front of any other senior doctor, ever.

Ever.

EVER.

When he calmed down and wiped the tears from his eyes, he told me "It's funny you should ask what the alternative was, because a colleague of yours [who he quite correctly declined to tell me the name of] was also underperforming in a couple of areas. As I was explaining this to them, they said

[slams his fists on the table]

"I REFUSE TO LISTEN TO THIS!!!!!"

and stormed out of the room!"

I burst out laughing.

We concluded the meeting and left the room to encounter two of the other bosses outside, one of whom was the lovely Dr Swinburn who said to us "There was a lot of hilarity coming from that meeting- what the Hell was going on in there???"
I smiled and said "For a moment, there were two [my supervisors name]s in the room."
"Heaven help us all, in that case!" She laughed.
"It's OK- I'm back to normal, now" I replied. "The danger is halved".

At the end of our meeting, he explained to me that medical school is formed from an academic elite, who are exam-passing machines, at the sharp end of the intellectual curve, and at a big, prestigious hospital like this, that end is even sharper. Being told that you are less than brilliant at something is often met with fierce resistance, and sometimes frank denial. He praised me for not being like that.

I have many more non-medical than medical friends, and I've succeeded and failed at enough things to know that the most important step towards being good at something is to be objective and recognise that you are not good at it in the first place. Then, you can make an objective plan as to how you can move forward.

While I try and do well at everything that I do, and be almost terminator-like in my pursuit of it, occasionally, I get a reminder that I'm just as human and vulnerable as anyone else. This was one of those reminders. But, while you can't always control how you feel, you can always control what you do. Apologies and excuses, no matter how well-meaning they are, don't actually achieve anything. If you want to achieve something, you have to do something. I do something.

Tony Robbins is touring the country at the moment, and as you know, he's been around for decades trying to get people off their lazy butts and do something with their lives. I look at him and think to myself "Yeah... this all sounds great, but I don't see anything here that can't be achieved by a set of strict parents telling you to sort your life out. Seriously, just think of your Dad pointing and shouting at you- "F*#KING SORT YOUR SH#T OUT!!!!"

I think that's much more cost-effective than paying thousands for a Tony Robbins seminar, don't you...?

Until the next time.

Victor.