Saving lives is part of the job

The path to becoming a medical doctor is long and difficult. And that’s a good thing. Would you like it if the person stitching up your gashed leg, or putting you to sleep before surgery, had skived off during their human anatomy lectures? Not likely.

And that’s a good thing. Would you like it if the person stitching up your gashed leg, or putting you to sleep before surgery, had skived off during their human anatomy lectures? Not likely.

But, despite the academic challenges and endless hours of training, both Louise Poynton and Pip Stuart - registrars at Wellington Hospital’s emergency department - are quick to dispel the idea that it takes super-smarts to make it in medicine.

“You have to be able to learn a lot, just to tick the boxes, but that won’t necessarily make you a good doctor. Common sense makes you a good doctor,” Louise, 29, says.

“But it’s just a pathway. I think it’s important that people don’t get put-off by the length of training.”

Pip, 31, who hails from the Wairarapa, and is also a graduate of Otago University, agrees.

“I remember feeling like a real hillbilly from Masterton, wondering ‘what am I doing here?’ [at medical school].

“There were all these people who had been head girls and got 100 per cent in their bursary exams and I was feeling completely intimidated.

“But they are not necessarily people who can speak well and engage with patients.”

She says it’s important for young people considering a career in medicine not to be put off by stereotypes, “silly pressures” that don’t really exist.

“It’s all worth it.”

I’d never been to a hospital, really. And I had never had a family GP. I am always surprised looking back at how little I knew what I was doing. I didn’t know what I’d signed up for.

There are challenges, but “you need them”, says Louise.

“They are what will make you into the doctor you become.”

Louise is five years out of university, Pip seven, so it takes some looking back for them to remember why they wanted to become doctors in the first place.

They say it wasn’t due to any idealistic vision of helping people.

“That is a big part of the job satisfaction”, Louise says.

But, in her last year of high school, with the real world fast approaching, she just needed a plan to attack.

“I’d always quite liked things that have people interaction, and I knew I was good at science, so I always thought - teacher or medicine.

“That year there were teacher strikes, and they told me ‘go do medicine’, so I did. It seemed like a good idea.

“I’d never been to a hospital, really. And I had never had a family GP. I am always surprised looking back at how little I knew what I was doing. I didn’t know what I’d signed up for.”

Animal-lover Pip initially wanted to be a vet, but decided to follow in her sister’s footsteps down the path to becoming a people-doctor.

“It sounded like a really interesting job,” she says. “And I thought, if she can do it, maybe I can.

“She’d come home and tell us stories and I thought, ‘wow, that sounds really cool’.”

Acquiring first aid skills that might one-day be called upon to save someone’s life was a big part of the appeal.

“I thought it would be awesome to know what to do in a bad situation,” Pip says.

The decision wasn’t without its hurdles, mostly mental barriers she imposed on herself.

“Growing up in Masterton, there was this feeling that we couldn’t do that job, that it was for ‘high-up’ people, that it was outside the realm of what was expected or achievable.”

You’d think it would be the big dramas, but sometimes it’s helping the person who thinks they are dying, but from a medical perspective isn’t. For them it’s a genuine fear.

But, before long, and with her sister as inspiration, Pip laid her worries to rest and realised that she really could do well in the life-saving business.

So, have they saved lives?

“Everyday,” says Louise.

“It’s part of the job,” Pip adds.

Although, another part of the job, which they say can be more harrowing and as important as saving lives, is helping people deal with death.

Or, conversely, assuring someone that despite how bad they feel, they are not dying.

“The funny thing is; sometimes the most enjoyable jobs are not the big things, says Louise.

“You’d think it would be the big dramas, but sometimes it’s helping the person who thinks they are dying, but from a medical perspective isn’t. For them it’s a genuine fear.

“Sometimes dealing with things that medically aren’t that dramatic, but make a big difference to people, can be just as satisfying.”

It gives you that feeling that you’ve really helped someone, “one-on-one”, really made a difference in their lives, she says.

Handling a death well, making it a “good death”, can feel just as good, too.

“That can make a really big difference for sick people and their families. Taking fear away, giving them comfort and dignity.”

She says that takes interpersonal skills, emotional intelligence, which is receiving increased attention at medical school.

“It’s about being open and realistic,” Pip says.

“A lot of people come in with this idea that you are going to save them, or their family member, because they’ve seen it on TV.

“But say their relative is really old and has so many medical problems that it would be futile. It’s really obvious to us, but obviously not to the family, so communication is a big thing, so they know why we are doing what we are doing.”

“Some things are not reversible. Whereas that’s not what medical programs on TV tell you, they make everything seem reversible,” Louise laments.

I have to ask.

“I haven’t watched Shortland Street in a long time,” Louise answers.

“Is it still running?” Pip asks.

“It’s not like Gray’s Anatomy, I’ll tell you that.”

So, what is it like in the ED?

Registrars at Wellington Hospital work 10-hour shifts, day and night, which averages out to a 40-hour working week.

Louise is doing just 20 hours a week for now, to meet the equally demanding task of being a first time mum.

“On the days I work, my partner drops my boy off at daycare and picks him up, because it opens too late and closes too early for me to do it.

“I have a good husband. That’s how I do it. It’s pretty much essential. It would be very challenging without him.”

It’s not easy striking a work-life balance, Louise says, but she mostly manages to enjoy her work, depending on how forgiving her baby boy has been the night before her shift.

“A lot depends on if I’ve had enough sleep. If I have, ill have fun on 95-per cent of my shifts,” she says.

On any given emergency department shift there might be a motorbike accident to clean up, a pregnant mum needing reassurance and possibly a place to deliver, or a kid who’s lost a toenail or broken an ankle.

Of course, on weekends there are plenty of drunks too, which is “frustrating”, and they are seeing increasingly more ED presentations by people with health problems from ‘legal highs’.

“There is a real excitement in not knowing what’s coming in, and the variability can be really quite refreshing,” Pip says.

“It links back to knowing what to do in a bad situation. It’s a survivalist thing.

“There’s complex medical things, with lots of people, like motorbike accidents. But other jobs can be emotionally complex. Like, someone’s just had an accident and the other person is dead and they are at fault, or anything like that.”

Sexual assaults are amongst the hardest aspects of the job to deal with, as well as anything involving children, who might have suffered an injury, or are critically ill or dying.

But, those “bloody hard” shifts are also the most rewarding, Pip says.

She and Louise think back again, to when they were fresh-eyed first-year-health-science students at Otago.

“I don’t think anyone can prepare you for medicine,” Pip says.

“It set us up well with academic basics, and ‘Dunners’ was a really good experience, moving away form home, living in the halls, flatting - personal development, which in itself is really important for medicine,” says Louise.

But study never beats experience, which is why qualification takes a long time.

“Its funny, the little things. As life goes on you realise how much your life experience does contribute. I deal with parents differently now that I’ve got a child.  You can relate better. Its not a criticism of what I was like before – it’s just growing up. You are better at what you do.”

Now well on their way to becoming senior emergency department doctors, Pip and Louise have had years to reflect on how much they enjoy their jobs, and whether the long road has been worth the while.

Both have reached the same conclusion: It’s the right job for them.

WHAT IS A REGISTRAR?

After university, graduates must complete two years of general practice in a variety of areas of medicine. Several short-term placements are designed to equip the fresh junior doctors with the basic tool-kits they need to patch up almost any medical problem.

“It’s your two years of learning how to be a doctor,” Pip says.

Then, usually in the third, fourth or fifth year after med-school, many graduates choose to become a registrar.

“It’s kind of the in-between between a very junior doctor and a consultant. It’s the next tier of responsibility, but not quite a senior medical officer,” Pip says.

Both she and Louise are ‘training-registrars’, studying to become senior emergency department consultants. That means about five more years of specialist study and training, and exams.

“There are a lot of boxes to tick,” says Louise.

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