Liam Farrell - Accepting advice is not always good advice

Time has softened the bitter memories, but I still remember the travails of being a junior doctor.

As I was on a GP rotation, the other junior doctors hated me because I was on a scheme and had a guaranteed job for the next few years, and the consultants hated me because I was going to be a GP and didn't have to suck up to them. And both hated me because I was a big hit with the girls.

So the newly arrived GP trainee had to be wary. Finding out who you could trust for sage advice took a bit of time; in medicine, there is always somebody out to get you. To paraphrase La Rochefoucauld: 'There is something in the misfortune of other doctors that is not entirely unpleasant.'

Just as with a tip for the horses, the responsibility for advice lies not with the donor but with the recipient; words are cheap, and it's your choice whether to act on them or not.

On my first night as casualty officer, a young man was brought in unconscious. In those days I was very thorough (I've matured since), so I ordered a drug screen.

Then the lab technician rang me, explaining politely that it was not lab policy to perform drug screens on unconscious patients without certain other indications. They had a 'protocol', she said, which sounded quite new-fangled and impressive.

In those days, also, I was easily persuadable (I've matured since), but when I described this over coffee to the medical reg, who'd been working there for donkey's years, he fairly bristled with rage.

'I'm sick of those bastards,' he said. 'That guy is your patient, you are the doctor, you are responsible, if something goes wrong, the buck stops with you; if you think you need a drug screen, damn well order it.' It was pretty rousing stuff.

Again easily persuaded, I rang back the lab tech and damn well ordered the drug screen done with no messing, right? I was the doctor, he was my patient etc.

A few minutes later, the casualty sister came in and, portentously discreet, whispered deafeningly and rather moistly in my ear that the professor of chemical pathology wanted to speak to me AT ONCE.

'F***,' said the reg, making the traditional medical hand-washing gesture. 'You're in big trouble now.'


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