Post call Mania

The above mentioned is a well known, but little documented condition amongst doctors. As the name states, it is a condition associated with being post call- meaning, that you have worked all night the night before and are awake probably for more than 24hrs. It's a kind of delirious state. During the night, there are stages through which most of us pass. Usually, if we've been working from 8h00, around 23h00 or so, you start to slow down and feel somewhat irritable.

By 2h00 or so, you usually get something of a second wind and feel quite energetic, you might even sing and make pleasant banter with those around you as you work.

By 5h00 your eyes are burning and you hate each patient who's keeping you up, you feel dirty and hungry and if it's summer you're very glad to see the light in the sky, it starts to feel like there might be some hope after all.

By 8h00 the next day you've accepted your plight and trudge on, most often until around 12hoo or 13h00 when, if it's not too busy, your colleagues will tell you to drag yourself home and to be careful while driving home.

This description is something of a generalization. Conditions differ between specialities. If you're a dermatologist you get to sleep all night, if you're a surgeon you only leave the hospital around 16h00 the next day if you're lucky and if you're an anaesthetist, you're in a whole different league. (More on that another time.)

Now once you're released from the hospital around 13h00, after being under hospital arrest for about 29 hrs (many hospitals have a policy that you're not allowed to the leave the hospital premises when you're on call, at all!) you suddenly feel this strange desire to make the most of your time off. It's one afternoon when you're out of work before the shops and banks close.

Or, you might be post call on a monday afternoon and find that this is the most pleasant time to go to the beach, because everyone else is at work and you have the beach to yourself.

But the thing is, that you probably haven't slept for more 30hrs and what you find yourself in, is actually a sort of haze. But since your mind is sleep deprived, you don't realize that this haze is delirium, you feel happy and woozy at the same time, you suddenly feel like you can take on the world. But a few hours into it, you usually crash hard, and hopefully you're near to your bed when that happens!

What I often find myself doing, is going in search of food. Many a time, I've walked into a mall feeling ravenous. But instead of sitting at a coffee shop, I first head to a grocery store, because I have all of these images of the wonderful meal I'm going to make for myself. Walking out of the grocery store, I'll see a shoe store or music store. I'll then spend at least 30min in that store and walk out with a pair of shoes I don't really need, or a packet full of all the CDs I've been thinking about buying for the past year.

Yesterday I walked into the mall to quickly get some milk for my cereal, but the book store was having a sale, and had set up a stall outside the store right in my path. Books on sale are a no brainer, I have to buy. I found myself drawn to 2 books: Spanish Cooking and Cafe Food at Home. I opted for the latter, and promptly headed to the grocery store to buy all of the things on the list of "recommended basics for your grocery cupboard" and bit extra for a pasta I wanted to try. Since I was post call, I believed I had all the time in the world to try new things. (Thank goodness I didn't forget to get the milk.) On arriving home, I unpacked my grocery bags, ate a bowl of cereal and realized that all I wanted to do was sleep. I convinced myself that I would cook when I woke up. Last night, I had a sandwich for supper.

But right now, a day later, my pasta sauce is simmering as I type. I think good things can come from post call mania...

Working Weekends

For most people the weekend means time off work. Not doctors!

For us the weekend can be a most miserable time. The only pleasure is that for once there's no traffic as you drive to work on a Saturday or Sunday morning. Other than that, you can be certain that the common man's pleasure is going to turn into your pain when he lands at the hospital the victim of a drunken driving accident or after coming into sharp, irregular contact with the wrong end of a "friend's" broken beer bottle.

I often find myself with a bitter taste in my mouth when driving to work on a Friday morning listening to the radio DJ saying "It's the WEEKEEENNNDD baby!!!" and knowing that I will be working on that particular weekend.

Something else that I've noticed, which doesn't seem to be quite the norm, is that often on a Saturday evening I feel like a quiet place to drink a cuppa and read. It doesn't seem that many people feel this way on a Saturday. I've yet to find a suitable spot.

On one occasion I thought an outside cafe in the local Botanical Gardens would work, but the place was so full and not at all conducive to quiet time. I tried another cafe a few weeks later and it was full of older people watching sport and shouting in unison in encouragement or despair.

Today I am "post call" i.e. I was on call last night. I got a maximum of 3hours' sleep, in an uncomfortable bed in a room off a noisy passage in the hospital. My phone rang at 2h30, 3h00 and 3h25 again. When my alarm went off at 4h30 (time to take morning bloods and examine patients before 8h00 ward round) I didn't exactly feel rested.

Arriving home around 9h30, I thought I had enough energy for an active day, but after a bubble bath I decided on bed. In bed, I tossed for a bit, dozed for about an hour then gave up.

Now, all I'd like to do is sit quietly with a book and a cup of tea, and hope that by 22hoo I'll be tired enough to sleep heavily through the night and wake up full of energy for work tomorrow. My neighbours; however, have other ideas. Children are screaming and splashing in the pool. Braais are sizzling, beer bottles are clinking.

I suspect that I may have it wrong, maybe Saturdays are not meant for quiet evenings spent reading. I can't be sure.

What I can be sure of though, is that weekends are NOT meant to be spent working. Unfortunately, somebody's gotta do it...

Education

Around March 2009, myself and a dear friend visited the Eastern Cape, we explored the Wild Coast to be exact, staying in Coffee Bay, stopping over for a few hours at Hole in the Wall and then spending most of our week at a place called Bulungula. You can read about them at www.bulungula.com. In a nutshell it's a lodge on the beach in the Eastern Cape, which is trying as hard as possible to benefit the surrounding community and leave as little of a carbon footprint as possible. It is by no means a luxury lodge, but when you leave and you have to pay your bill, you're still surprised by how little it costs to stay there. It's not for the luxury traveler who requires white linen and high pressure showers, in fact there is a communal ablution block and communal dining room, but it's an experience which I'm glad I had, and I dare say that I might even be convinced to go back there again, next time better prepared.

But I digress, the title of this entry is Education. Being a past visitor to Bulungula, I'm on their mailing list. I received their latest newsletter today and they say that the government has cut the education budget in the Eastern Cape.

Now this baffles me, I cannot comprehend how a developing country can cut the roots of the tree of development.

Believe me, I know there are countless areas of the country which have huge shortfalls, but is education not the key to a better future? How can we hope to have a better future as a country, if the future of the children of the country is not a priority?

There are numerous wrongs which need to be righted in South Africa, but I firmly believe that education should not be compromised.

At present, unfortunately, I feel that the state of education for the less fortunate is no better (dare I say worse??) than it was during the apartheid era. I cannot begin to understand how this injustice goes on, and is in fact justified by the powers that be, everyday in South Africa.

So if change starts with me, what can I do? I have thought of this often. I was fortunate to have a private school education despite coming from a disadvantaged background. My parents most certainly couldn't afford the school fees, I had a bursary.

Sometimes I think it was just pure luck, but some may not believe in this. I've thought about possibly affording a child with a similar background a similar kind of schooling, but I'm not sure if that's where the need is greatest.

If you would like to do something about the Eastern Cape schools, you can make a donation via Bulungula, which directly supports the school nearest to the lodge, I can vouch for it. The link below takes you to a page which tells you how:

click here to donate online via credit card

I swear that no money comes into my personal bank account. But if you would like to give me money, I won't refuse.

If you have time and energy, maybe speak to the school nearest to you, if you think they might have a need, or contact your old school and see if there's something you can do there. At the danger of waxing philosophical and sounding cliched, I do believe: Even one small change, can make a big difference.

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Politics...

Image by Zapiro. Used without permission.

Politics is rife with idiosyncrasies, combine this with medicine and things can get quite tricky...

Working at possibly the best run government hospital in the country, definitely the best hospital in KZN, means that many government "VIPs" bypass the normal pathways normal people have to go through to receive quaternary level health care, and I assume they're not charged the rates you and I would be charged should we end up in a quaternary level government health care facility.

Now is this kind of behaviour unique to politicians or would you and I do exactly the same given half a chance?

I confess: I recently spoke to a specialist at a regional government hospital in order for my grandmother to be seen by him in the specialist clinic, without having to first go to the general clinic at the hospital or wait 4 months for a date to see a specialist. I did, however, wait in line with all the rest of the patients on the morning of her appointment and paid the fee necessary to receive her file. Throughout the morning we spent in the hospital, I avoided mentioning that I was a doctor and tried as much as possible to be just like one of the other patients...

In a resource poor country and in a cash strapped health system, is it wrong to try to get better care for yourself and your family? Does my act of selfishness contribute to the death of a 12 year old boy who dies because the ICU facility at the peripheral hospital he went to was full and he took more than 12 hours to reach the referral hospital?

And the ever difficult questions prevail:

1) Who are politicians in this country serving? The citizens of the country or themselves?

2) Does the fact that someone went into exile to fight for the freedom of the country, entitle that person to an indefinite amount of benefits at the expense of tax payers?

3) Are some citizens more equal than others?