Liam Farrell: Play the game and know your enemy

The annual surge of new interns is always a time of anxiety in the media; 'Black Wednesday', they called it this year, as if patients were dying like flies.

Social media has responded with reams of good advice and '#tipsfornewdocs' has been trending for the past few days. Feeling obliged to make a helpful and practical contribution, I tweeted: 'Patients can be anxious; play them a tune on the banjo.'

But my most important advice was on reading material. Every intern needs to read three books: The House of God by Samuel Shem, The Houseman's Tale by Colin Douglas, and ahem, The Flagon with the Dragon, the selected columns of ... erm ... Liam Farrell.

But nothing in even these legendary tomes comes close to some of my own experiences.

An elderly lady had been admitted to our ward; our ward was renal/metabolic and the consultant was unhappy with a patient who didn't have a complicated electrolyte disturbance and who had the impertinence to be, you know, old and sick.

Her son, for some reason, was unhappy with his mother being bounced from ward to ward like a rubber testicle and lodged a complaint.

One morning, the consultant (excuse me, the professor) revealed a problem. He was also captain of a golf club (cliche piled upon cliche, like Pelion upon Ossa), and the complainant had apparently applied for membership of said club.

The complainant was obviously not golf club material, said the professor, but could he use this knowledge, gained as a result of his medical practice, to block this bounder's application? It was an agonising ethical dilemma, he explained, shaking his old baldy head in distress, what should he do, what did we think?

The honest answer was, of course, 'We think you are an unbelievable prick', but Irish medicine was a feudal system. We had to play the game, or fall foul of the Old Boy's Network; old, partly senile, yet unrelentingly vindictive.

Which informed my next tweet; #tipsfornewdocs: 'Never let the enemy know what you are thinking.'.

  • Dr Farrell is a GP from County Armagh. Follow him on Twitter @drlfarrell.

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