Honeymoon Over

There is a period when you move abroad when everything seems more shiny and rosier than your previous home. Greener grass syndrome some may call it - no medical name as yet. Mostly we wandered around translating everything from dollars to pounds and saying 'wow, isn't that cheap?'. We also marvelled at the scenery, the slower pace, the friendly work environment and the ease of transition. This will inevitably wane like the moon and real-life, with all its unfortunate 'realities' will eventually set in.

The winter was reasonably harsh here - much worse than it has been for the last 40 years - but we did not mind the weather particularly. Since the New Year, work has descended upon me like never before. An unprecedented amount of patients have joined my patient list and my husband tells me I have become obsessed with the electronic task list generated by my electronic medical record system. Every day this list is full to bursting with results, referrals to be written and endless demands for phone calls and scripts. If you do not keep on top of it, it will be on top of you. This is how I have discovered that there are not enough doctors per capita on the Sunshine Coast and I am heading well past 1200 patients currently. 

Unlike in the UK, where you have a practice from your local area and you are one of the doctors that cares for the patient, here you have your own patient list. Difficulties therefore ensue when you are taking patients from other doctors and even worse when they leave you. I have had one patient who took her leave and it is hard not to take these things personally. I had invested some time in this patient, who was very ill, including home visits (and a trip to the ER for a tetanus shot after her dog managed to get its teeth into my shoulder) and felt very aggrieved about this for some time. I have since learnt that this 'doctor shopping' is very common and should not result in hours of wondering where you went wrong. The doctor should also move on to new patients and other problems. 

As a doctor who has always taken her work 'home' emotionally-speaking I am still finding things a struggle. I feel as if I can not be 'off-duty' at any point and selected cancer/housebound patients have my cell number in case they fall ill out of office hours - this is not compulsory, but it is another service I like to provide. This also means that when patients die, you are going to associate with the grief so much more, especially if all their family members are also patients. 

The other thing that is new to this doctor is being the place where the buck stops. In the hospital in the evening and at night you are the only person available to treat all the patients - in the ER and on the ward, which includes a small intensive care unit. Recently I had one of 'those' nights that doctors dread - a huge trauma case in the ER (a man with fractured scapulae and pulmonary contusions), several ER cases involving sick and injured children who needed constant attention and a lady in the ICU who needed resuscitation. I ended up throwing in central lines and intubating people - this after being yelled at by the nurse in ICU who felt she was not being listened to when I was hardly twiddling my thumbs in the ER. The only bonus from this was the flying paramedics offering me a helicopter flight which should make for an excellent blog.

I must admit to tears after this night - I suddenly missed my family, missed my friends and most of all missed my doctor support network to discuss the wins and losses of a horrible night in the hospital. 

So reality does really bite, but this will be a good thing - we need to start living our life here and realise that it is not an extended holiday but a place with ups and downs and not just on the mountain trails. As our second summer approaches, there have been changes and they are welcome. Bring it on, Sechelt.