The Growing Up Stage

I feel like a lot of things have happened these past few weeks. But at the same time not that much, isn’t it a little weird?

Work is getting busy. I’m now seeing more patients a day (about 20, which is a lot for me!) and I really felt the pressure this week when my time per patient was cut down. Because of the increasing number of people I’m seeing, I’m definitely learning more things. I just hope that I’ll get used to the time management side of things.

Sometimes I get little highs of actually seeing a difference in people I’ve been following up, such as a woman who is on the way to losing weight (using a technique I learnt called ‘motivational interviewing’), or someone who is recovering from post natal depression. I now find myself seeing individual members of families for different ailments, like a family doctor. I try to maintain that ‘holistic approach’ we get taught about in our training by building real relationships with patients over time. It’s nice to know that they like to see me, or at least that’s how I’m looking at it!

However because of the higher numbers I am seeing at work, it also means that I get my fair share of patients who aren’t quite as appreciative of our services, simply because they don’t know how overstretched we are as a country. Traditionally general practice was provided by small practices, run by just one or maybe two doctors looking after their local community. This model of care survived over 100 years, but is now being radically changed. Primary care has existed in the UK since 1911, and is right now going through a massive transition due to funding cuts by the government, the increased work load being transferred from secondary care to primary care, and the pressures of having to deal with (some unrealistic) patients’ expectations. All in all this is making me feel very exhausted, and I feel this most towards the end of the day.

Though nothing is set in stone, I can’t help but wonder if I should move abroad. I know some others who have done the same and they are much happier now. They get treated with a form of respect from authorities and patients alike, which we don’t always get here. For all the years we spend studying medicine, (6 years at university and 5 years training in total to become a general practitioner), is it all worth it if we’re not content? The other option is to go FastLane. I just wonder.

On another note I turn 30 in November and though I am reminded that I still have at least a couple of weeks in my 20s, I couldn’t help but feel strange about it all. On looking back on the decades maybe things are slowly getting better, but at the same time there’s a lot more I still want to do and I fear I’m not reaching the milestones I want to achieve. Don’t worry I won’t be listing them all here, that’s for another time. In the meantime I will be tucking into a chocolate cookie dough dessert, that’s what grown ups do.

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Uganda Healthcare Expedition Part V

I’ve been spending this weekend back home in London. Unfortunately, it didn’t start off quite so smoothly…

I developed a bout of conjunctivitis towards the end of the week, and was slowly recovering from that. It was also on the Friday when I headed to London, that I heard about the terrorist incident at Parsons Green earlier that morning. People were naturally more cautious about their travels and that included me. What made things more difficult, was telling my family that I was going to the Uganda-UK convention in central London the next day. They were NOT happy.

While I was brainstorming on the train, and trying to think of what I would like to achieve from the convention, I received a certain-toned phone call from the family, asking about the sort of convention I was attending.

Then that classic saying came along:

“We’ll talk about this when you get home”.

No, not an unfamiliar saying. But if anything, it probably fired up my drive more so. Listening to some of my favourite movie themes (yes, this includes How To Train Your Dragon), I was even more focused in my planning for the convention!

I tried to think why it is that parents don’t want us to do certain things. Do they think differently from us? Do they feel like they are losing us? Are they worried that we could fail? Maybe all those things. Or maybe, we’re supposed to be “settling”.

I don’t think such a thing as “settling” exists. To settle and accept things as they are, almost means giving up on life. I actually think that’s somewhat disrespectful to life itself. To strive, however and whatever you decide to pursue, means to live life to the fullest. If you choose to be of service to others, why shouldn’t you? Anything which increases your options is a good decision. If you do the same actions, you’ll get that same results. If you do different actions, you’ll have a different life.

So I went.

After an early morning wake up (6.45am on a Saturday morning is early for me!), I got ready and headed out. The convention itself was quite easy to get to, only a few stops on the underground and just a couple on the railway. Once I got there I signed in, was given my pass and waited around…unfortunately for a long time! It turned out that not only I had gotten there ridiculously early (I thought 9am was quite decent!), but they were running very late. The hall where the convention was being held at was divided into two parts. The front consisted of the stage, the tables at the front and the stand alone seats at the back. Behind were all the exhibition stands. The people who attended were spread across the two parts, though the exhibition area was naturally much louder! Before you realise people approach you, and you can’t help but network as well-exchanging contact details and dishing out calling cards (I was probably one of the few who DIDN’T have one, I don’t think your NHS smart card quite qualifies!).

Sneaky photo before the crowds came

Before the rest of the people arrived 

The chairman opened up the convention with a saying I thought was clever, in the context of us being allowed to use our phones to take pictures!

“Life worth living is one worth recording”.

The convention commenced with the singing of the Ugandan National Anthem. This was soon followed by various speeches given by many distinguished invited guests-such as the Ugandan High commissioner to the UK, and the Vice President of Uganda, Edward Ssekandi.

Vice President of Uganda Edward Ssekandi giving his speech 

One of the presentations which interested me more so, was delivered to us by Dr Ian Clarke-a physician, philanthropist, entrepreneur and the chairman of the International Medical Group. I found his work inspiring, particularly how he used agriculture from his roots to keep his medical work sustainable. I adored his motto:

“Sustainable Development with Social Impact”

I was very fortunate to have a face to face meeting with him, which was just as well as I missed a part of his presentation (because it was during his presentation that we had to register to meet with a specific speaker…funny that!).

The meeting itself was a delight! I had my notebook with my questions written and my pen at the ready, to write haste his answers and advice. However I soon as I sat down, I didn’t even look at my notebook properly. It didn’t seem all that appropriate. I asked just one question, and the rest of the time we just chatted away, completely informal and relaxed. He was taken aback that I was a doctor, as I think he thought like many others, I was seeking for an investment! It was almost like we were uni friends, getting to know each other and comparing notes about medicine and life. I felt absolutely honoured that we spent the length of time we had talking. To me he was like a celebrity, and it was probably my highlight of the convention!

After leaving the meeting room, I walked through a very crowded hallway where out of nowhere, a calling card flung across, hit my face by accident and landed on the floor. I picked it up and didn’t think much of it when a gentleman said:

“I’m really sorry, did that hit your eye?!”

“No no it didn’t, not to worry”

“Oh then you can have it!”

Suddenly there was a loud uproar of laughter and I couldn’t help but join in. But it wasn’t until I left the hallway, that I realised who the card belonged to-the Ugandan High Commissioner!

After a cup of tea and a croissant for lunch (the queue for lunch was incredibly long and I didn’t have the stomach to wait), I managed to speak with some other people in the crowds, before taking my seat at the table. The lecture after lunch was provided by a Ugandan Physician, which captivated me yet again. She first talked about the Diaspora in Uganda. Ignorant as I am at things, I had to look this up. She then spoke about how the healthcare system there is “corrupt and broken down”, and that a lot of work still needed doing. This was followed with a story, one which almost brought me to tears…

A senior physician at her hospital became unwell and needed a ventilator. Unfortunately the ventilator broke down and he was deteriorating. “Hospital X” where he was staying would not let him go to “Hospital Y” to receive treatment via their working ventilator, until he and his family paid the fees. This was in the hundred thousand region and despite appealing to the administration, they would not let him go. “The fees were coming in but his health was getting worse”.

Once the payment was made to Hospital X, Hospital Y refused to take him in. This was because he now needed to pay for the ambulance, and this was even more expensive (in the millions region). SOMEHOW they managed to get this payment sorted and thankfully, he was transferred across. Maybe it was the way she told us this story (which is far better than how I am saying it here), but this sorry horrified me and I was heartbroken.

After a couple more speeches I decided to call it a day. I had taken more than enough knowledge and insight than I could have hoped for and decided to head back, to spend the rest of the day with the family.

My trinkets from the day 🙂 You could only speak with the guest speakers if you applied for a VIP pass-so worth it! 

Attending this convention only reinforced what I want to do with my life. There are many messages which I took home with me, but one of my favourites still is this one, which was mentioned by the Ugandan physician. It couldn’t be put more simply:

“It was just something different and that’s what I chose to do”

Much Ado About Somethings

Why is blogging good for you? Here are some reasons I found:

  • It reduces stress and blood pressure
  • It improves the immune system (don’t ask me how!), mood and memory

There are few things that I’ve been meaning to write about. They’ve sort of accumulated over the last couple of weeks, but I’ll try my best not to ramble on too much!

I’m starting to look closer at what I eat. I couldn’t help but notice what I found displayed at my new practice. It’s advice advocated by the Food and Agriculture Organisation of the United Nations (The FAO), but I don’t really know what I make of it.

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I agree with some of the portion sizes displayed. But why is the yellow carbohydrate section so big? Shouldn’t the red protein section be a stand out portion too, even more than the carbs? That’s what athletes focus on. I know with most published guidelines you have to tailor them to the individual. As everybody is different, it’s interpretation will also vary. This would be mine.

I showed this above diagram to my boyfriend. He then gave me the idea of creating a list of foods that I could focus my meals on. But the difference is that this list must include food that I actually enjoy eating, not food I should enjoy eating.

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My makeshift list of favourite foods I love to eat. You’ll notice that fish is the only meat I have written. That’s because I’m a pescatarian. 

I then tried to think how I could incorporate some of these items into an ideal lunch. One that I can take to work that is filling, and will last until dinner time.

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Oats, chocolate protein powder, milk, yoghurt and banana slices. I later added variations such as honey over the bananas. DELISH!

My food musings was the first thing I wanted to talk about. The second thing was work.

I’ve started running my own surgeries, which include the standard morning and afternoon sessions. I’ve done similar surgeries before at a different practice, but for some reason how I look at it all is changing. I think it maybe because of the experience I am accumulating over time, including the increasing number of patients I see. The partners have even got me running the 6-8 week baby check clinics. I do enjoy this added responsibility, because it adds a bit of variety to the day. I think my maturity is also boosted by the added bonus that I can now drive! A particular happy moment I recall was at the end of a busy Thursday this week. I had my raincoat on, my doctor’s bag in one hand and my car keys in the other. I felt so grown up, as I said goodbye to the receptionists at the end of the day.

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My first attempt at reverse parking at work, courtesy of my boyfriend-who taught me how to do it

I’ll admit when I first started working here I was naturally nervous. It had been a while since I was in a general practice setting. I was however, taught another invaluable lesson by my boyfriend…accept that you won’t know everything. It was only once I accepted that, that I found myself letting go of my insecurities. I went with the flow of the surgery and whilst I sought appropriate advice, it went much smoother. Maybe that also applies to life-it can turn out smoother when you learn to let things go.


I thought I’d end this post by uploading a simple photo of how we’re spending our bank holiday weekend…by good eats! Yay! Have a good weekend :))

 

Uganda Healthcare Expedition Part IV

After a fun couple of days of vegetarian home cooking (burgers and lasagne!), I had a few days off work and so set off to London. I was a little lazy at home but at the same time, hung out in the high street and enjoyed the summer sales!

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The view from the top floor of the bus, the best seat in my opinion!

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My sales items, totaling £62.75

It was also a good opportunity to meet up with a family friend, one who I’ve known for almost 25 years.

It was on the day that I met up with her, that I had an appointment with the dental hygienist in the morning. Just a typical appointment which I had booked the day before…or was it?

Everything was going pretty normal. My teeth were being inspected and the dental hygienist was doing a ‘deep clean’ on them, when his phone rang and he answered accordingly.

‘Oh I’m very sorry but I had to take the phone call’

‘That’s ok’ I replied.

‘Yeah it’s from Uganda’

‘Oh really?’

It was at this point that my voice changed to one of excitement. Of course I let him finish off the session, and then we talked about all-things-Uganda. We spoke about my trip there last year, his origins there and what we were both hoping to do. I told him about what I was setting up and interestingly, he told me about his plans to improve the dental hygiene there. We exchanged contact details and I left soon after. The very next day, I received an email from him.

He alerted me of the Uganda-UK Investment Convention which is scheduled for this year. I don’t know if I would have even be aware of it, if it wasn’t for the dental hygienist! Did I sign up for it? Well of course I did. I considered it a sign that he was there! Interestingly, I was contacted by two key organisations soon after-The Ministry of Health in Uganda that day, and the RCOG the next day.

So yes, things are still going. My next steps are:

  • Look into fundraising and obtaining the medical equipment.
  • Once this is done, we can set up the services for the cervical cancer screening programme and look into keeping it sustainable.
  • Make plans to go to Uganda towards the beginning of next year.

I wanted to end this post by sharing a Youtube link, because of the impact it has on me every time I watch it. I find it very inspirational, focusing the importance of creating change and making a difference in people’s lives. This is what I want to do.

Gary Vaynerchuk in Ghana, a country I have been to previously and love dearly. The ending of this vlog almost always gets to me. I hope you enjoy it as much as I did 🙂

Sweet Child O’ Mine

Over the past year or so, I’ve had my fair share of conversations with taxi drivers. The majority of them tend to start off in the same way…

‘You off to work?’

‘Yeah’.

‘Oh what do you do?’

‘I’m a doctor’.

Yes, at times it can get boring. It’s the same responses and especially when I’m tired, I prefer to keep my answers brief and read a book instead. However over the past couple of weeks, there have been two chat encounters which I wanted to reflect on, both of which have a recurring theme-the drivers were parents, and they wanted their children to be doctors.

The first conversation involved an driver, who told me that his son had graduated from medical school one year ago, and is now working as a doctor. I congratulated him.

‘So you must be very proud of him. How is he finding it so far?’ I asked.

‘Oh he doesn’t like it, he hates being a doctor’.

It turns out that the driver has always dreamed of his son becoming a doctor, so he saved up to put him through medical school. He paid for his accommodation, travel expenses, petrol, everything. His son, however never wanted to become one. He wanted to study economics. And now he hates his dad for his new found career. I was curious and asked the driver what he would like his son to specialise in…

‘Surgery, I want him to be a surgeon’.

The second conversation involved a driver, who inquired about what type of high school I went to, where I studied medicine and what I specialise in. He then went on to speak about his 3 year old daughter. He explained that he wants her to be a doctor, and has made several attempts to get her interested in science.

‘She can tell you all the planets. We also bought her one of those books about the human body…oh what’s it called?’

‘Anatomy?’ I replied

‘Yes, an anatomy book!’.

I then started to think about how I got into medicine. Did my parents want me to become a doctor? Deep down yes. I think the difference though, was that they didn’t pressure me into becoming one. They didn’t force me to attend medical school, nor did they thrust anatomy books upon me as a 3 year old.

I don’t think I had any real external influences to become a doctor. We don’t have any in my family apart from my grandfather, who passed away long before I was born. But a part of me always knew I wanted to be one, and I couldn’t see myself becoming anything else. I think in the end it comes down to the individual, and there is no point in resenting others for a choice they made. If your parents really want you to become something which you don’t believe is you, why would you go down that path? After all it’s your life you’re living, not somebody else’s.

Uganda Healthcare Expedition Part III & Other Musings

It feels like the last couple of weeks have been a little ‘strange’ to me, since coming back to Leeds. There have been days where I was so driven to do things, but there have also been days where I haven’t been quite as motivated. For a while, it felt like time was going so slowly and I was feeling rather blah about things…and it’s only been two weeks!

The first weekend I spent since coming back to Leeds may have been a productive one. This is despite having many movies running on at home, probably too many to count. I was able to sit down and literally brain storm ideas on the whiteboard, for the cervical cancer screening programme I am organising in Bwindi-the objectives, statistics, equipment, screening and treatment options, current infrastructure, collaborators, funding organisations, questions to the hospital, the list is endless.

Despite taking a solid weekend, it felt like for the first time, I was able to create a vision in my head of what the programme should encompass. I have already sourced the equipment in Uganda instead of in the UK as I originally planned, and am looking into funding options for these. I have also been in touch with the Royal College of Obstetrics and Gynaecology, Manchester University and important charities who have expertise in this field of medicine. I’ll admit some responses have been slower or less helpful than others, but I do have some direction of focus. If there’s anything that I’ve learnt, it’s that you should keep going until they tell you no.  I’ll give you an example…

In my previous blog post on the expedition, I mentioned that I was in contact with a gynaecology registrar at the hospital. Unfortunately responses from him thinned out, to the point that I directly made contact with the Royal College itself for advice and about a potential staff training course for the healthcare workers. It was useful to know that this is a pilot, in which they require more information from the hospital. At least I knew this now and in my mind, this still wasn’t a no.

The beginning of last week was probably not one of the best ways to start the week off…my uncle passed away.  I received a flood of text messages from my family asking me to ring them back, and this was unusual for them. Though we weren’t very close, I was still upset. He was my uncle, and every time we made trips to Sri Lanka, he was always there.  I took a couple of days off work though weirdly enough, it felt like I wasn’t present most of the week. However we’re managing to carry on. I found it weird how every time my family asked if I was ok, I actually felt worse. I don’t know if that’s normal, maybe I just wanted some space for a bit.

This week almost feels like things are a little bit normal again. I’ve been trying to get on with things-marathon training (which I recommenced today), chasing jobs for the expedition, reading and establishing a routine again. Yes sometimes I like normal. Normal is trying to keep yourself busy and occupied with something, wanting to wake up in the morning to do it. Its important, it helps you get through the not so nice times, and it can help you feel a little less blah about yourself.

Live Your Life

As I head back to Leeds on the train again, I reflect on how I spent the last few days in my home city, London. I use train journeys as a golden opportunity to recollect the good memories we made at home. It’s always something I can come back to.

I hadn’t been at home in just over two months, and hadn’t seen my family since I did my exam. It was nice to actually spend a few days with them, not just a weekend. In addition to getting a hair cut, I took the opportunity to meet my cousins. A couple came over to see us and I met up with a close one in the city.

I always enjoy going to central London, and this trip was no different. I love the fact that it’s literally a 30 minute trip on the Underground to get there. I met my cousin at around 5pm in London Bridge, at a fresh Italian Pasta restaurant called Padella. Despite the early dinner and neither of us being particularly hungry, we somehow managed to consume 3 pasta dishes, a chocolate torte and a bottle of Prosecco between us! I hadn’t seen her since Christmas, so there was a lot of catching up to do.

After having our meal, we walked across the city centre. Starting at Borough Market, we made our way along the River Thames and passed many London landmarks-Shakespeare’s Globe, the Royal National Theatre, London television centre, the London Eye, Sea life London Aquarium, Dungeons and Dragons, skateboarding sites, the list was endless. Streaks of sunlight were seeping through the clouds still, yet nobody was cold. Everybody looked happy and was in a good mood. We said our goodbyes on London Bridge at around 8.30pm and we went home our separate ways. My understanding is that the London terrorist attacks took place two hours later.

The following morning, after waking up to numerous Whatsapp messages to check people were safe, I went to a barbeque my sister was organising for me and my parents. We were joined by one of my old family friends who I hadn’t seen in almost a year, and her American cousin who I briefly met at my sister’s wedding. I won’t lie, I thought I had felt a little awkwardness between us, maybe because I hadn’t seen her in a long time or maybe because they were guests. However I think it settled…my sister showed us wedding videos (some of them I knew I’d seen before) and we chatted again like old times.

After the barbeque, we drove to my friend’s house where she was staying with her parents, whilst she was back in England. Her house always reminded me of happy childhood memories and the days we used to hang out there. Her cousin was a medical student and talked about the medical school system. He also invited me to come to America. Yay! My first American friend! It was even more lovely seeing her parents again. Her father is a retired GP and I had the utmost respect for him. He had a very good work ethic which my mother always talked about when I was younger, and I’d like to think  that he was proud of me. Hilariously he exclaimed, “ahh Chitra, you look like a 10 year old!”, and we had an energetic conversation. We talked about the hospitals I worked in and he was happy that I can do LPs, (lumbar punctures), stating “yes, you’re a doctor”.

I definitely enjoyed my time in London, I always do. I love trying to make time to see old friends and family, because I want to be reminded of my roots when I tend to forget them. This trip back to London will probably stick to me more, because of what happened in London Bridge. Last time I met up with my cousin was around Christmas time last year. We met up later in the evening and I came home later. What if we decided to meet up at a similar time this year? It’s almost terrifying to think that, and I did lay awake that night thinking about what could have happened.

My mum mentioned that I should stop going to central London often (as if I go often!), and brought up many a time, how I encouraged her to take trips there that very evening, before we heard the news. But really, should something like this stop us from carrying on with normal life? According to her, it almost felt like she believed that. Yes maybe I’ll be a little cautious, but I won’t be living in fear. We have a life to live and we should live it.