Paul Southall
@pjsouthall
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Doctor. Consultant Anaesthetist @WorcsAcuteNHS . Rugby. Football. Cricket. Milk, no sugar. @RCoANews Environmental Advisor. Sustainability in Healthcare
United Kingdom
Joined October 2011
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I’ve just seen the campaign to get “American Idiot” to the top of the charts to coincide with Trump’s visit, and quite frankly, I’ll be disappointed in the whole nation if we don’t make it happen
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So I’m picking my lad up from school this week, and his teacher stops me and says he can’t remember what type of doctor I am, but that “I’m a doctor who watches whilst other doctors make people better”
Strong work, son - the best work-based put down I’ve ever had
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Another night on call, another emergency teddy repair in theatre to make the owner feel a bit better when they wake up
(Operation note anonymised to protect tiger’s identity)
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I remembered out of the blue last night that as the pandemic started and it was clear that I would be helping to look after the sickest patients, I asked some of my best mates to make sure they helped raise my lad if I died
It all seems like a dream now
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Without doubt the highlight of my last night - asking the surgeon to suture a broken and well loved teddy of a scared child when they come to theatre.
And then giving them the operation note for the repair...
(Anonymised to protect teddy’s identity)
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One of the best things about working in theatres is being able to help fix issues with favourite toys (thanks to some quality stitching from the scrub nurse) whilst their owners are being fixed…
(Octopus’s name removed to protect their identity) - posted with permission
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I’ve been paid.
Time to restart the monthly cycle of living like a Russian oligarch for the next 48 hours, and then a Buddhist monk for the following 25 days
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Forget about your multinational groundbreaking studies - in anaesthesia we do studies on the effectiveness of toy cars.
Beat that, rest of medicine
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All I can say is this - I’m deeply embarrassed that I share a job title with that guy on the news today.
Out of all the events of the last two years, seeing a ‘colleague’ publicly spreading gibberish has probably got me the most enraged
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Seeing a child pass away despite the heroic efforts of everyone in ED resus never gets any easier - to be honest I hope it never does. Today was the 12th of my career. I’ll remember all of them until the day I die
Hug your loved ones extra tight while you can, everyone
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I’ve seen loads of tweets on here about how covid is a global conspiracy and ‘the NHS’ is complicit. A few thoughts:
1) Today - in 2021 - I sent a fax
2) It took me 15 MONTHS to get various committees to agree to recycle some cardboard from theatre
3) We still use bleeps
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Final thought on NHS pay in general. The argument that medicine/care work is a ‘vocation’ (ie - we should pipe down and accept whatever we’re offered) belongs in the 1950s
It’s a job - albeit one I’ve trained for 20 years to do and that I love. Claps alone don’t pay the rent
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I’m always amazed how every single hospital I’ve ever worked in only opens the ID badge office for around 23 minutes every fortnight, at a time arranged for maximum inconvenience for clinical staff
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The longer you do medicine, the more normal it gets. But I’ll never, ever not be amazed when we put less than 3ml of a liquid in someone’s back and they can then have major surgery awake, pain free and comfy
And then it wears off as if nothing had ever happened.
Blows my mind
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It seems that there’s a genuine assumption from senior consultants that those of us just starting are as comfortable as they are
To put it in context, I don’t live a lavish lifestyle, I’m three years into consultancy, and I have £157 in savings.
There’s no zeros missing. £157
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Just to be clear to junior doctors as a whole - I’ll support whatever industrial action you feel you need to take.
The days of pulling up the ladder as you climb should be over, and we as a senior group should be crystal clear in our support, now and always
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Junior doctors - another reminder that if you decide to strike, we’ve 100% got your back for as long as you need us
(As long as I’m not asked to cover ITU, in which case, it’s outrageous)
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Kudos to our trust for providing a free meal for all staff members in the canteens every day for the next three weeks. It’s a nice touch for the festive season
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December 2018. I’ve done my first month as a consultant and despite the nerves, I think I’m doing ok
I go to change my email signature to add the dept phone number, and discover that for a month, I’ve put that I work at the ‘Worcestershite Acute Hospitals’, not Worcestershire…
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For anyone in any doubt about how much difference we could make in the NHS if we fully embraced recycling, this is the potential recyclable waste generated from the scrub team laying out for ONE case. Not including anaesthetic waste
We do about 450 cases a week in our trust...
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The most entertaining approach would be to let Djokovic into Australia, but insist that he spends every second there in full PPE, including when on court
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When you’re 39 and an enthusiastic 8 year old asks you to have a go on her skateboard and you think “I’m fit, I’m good at sports - I’ve got this”?
Take it from me - you absolutely DO NOT have this
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We had our emergency consultant rota yesterday, and it’s - understandably - brutal
I’m not going to see much of my lad for a while, and when I told him he said “it’s ok - you’re helping poorly people”
We won’t be seeing our loved ones to look after yours so - please - stay home
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A response time of 8 mins from first call to resolution is astonishing. The emergency services are heroes
#LondonAttacks
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I’ve just had what I’ve started to call the Modern Medic’s Breakfast ™️:
A sertraline and an espresso
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Going to IKEA inbetween two nights on call is in the top three worst decisions I’ve made this decade
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I got a lot of unpleasant comments when I said last week that I was embarrassed to hold the same professional job title as a certain individual following their TV appearance
I’d also like to say that I’m somehow even more embarrassed now I’ve seen this photo
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No, YOU made chimichurri from scratch for the steak you’d got for tea, then after getting distracted by a phone call, didn’t remove the wrapper and marinaded the plastic wrapper covering the steak in the fridge for three hours
How’s your day gone?
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Last night I put in a central line whilst wearing:
- Gown
- Apron
- 2 sets non-sterile gloves
- Goggles
- Visor
- Theatre hat
- Sterile gown
- Sterile gloves
- FFP3 mask
For ten minutes, I was POSSIBLY the most protected person in the UK. I was DEFINITELY the sweatiest…
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No matter how long my anaesthetic career turns out to be, I don’t think I’ll ever not be amazed by putting just over 2mls of a liquid in someone’s back, and for them to have major surgery whilst chatting and not feeling a thing. It’s bonkers when you think about it
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Any medic who introduces themselves to other medics at work as ‘Dr/Mr (Surname)’ is most likely a Bad Egg
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I’ve said it many times, but I’ll say it again - the BBC Natural History Unit is worth ten times the licence fee on its own
#BluePlanet2
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25 years ago, my parents took me to the cinema to watch The Lion King. Today, they’ve come with us to take our lad to watch the remake
The Circle of Life is complete
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We had our departmental emergency meeting on coronavirus last night.
With facial hair disappearing at a rapid rate (mine is staying until mask fitting) a fellow hirsute colleague pointed out “it’s like the beginning of a hipster apocalypse”...
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A quick Google search reveals:
- private school education
- qualified in 1969 (no tuition fees, will have retired on final salary pension, eligible at age 55)
- registered with companies house for PP
Ergo, unlikely to have a scope of the current issues.
Opinion on this ➡️ 🚮
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The hospital WiFi now blocks Ocado, meaning that I can’t do my weekly shop during a quiet 10 minutes on call, and I feel like I’m in the middle of a ghastly first world middle class nightmare
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Just when you think you’re making progress on the sustainability front, you arrive at work to see individually plastic wrapped, single use facemasks 🙄
[SCREAMS IN SUSTAINABILITY]
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Just binged watched all of
#AfterLife
in one sitting (which I’ve never done before). Equal parts hilarious, crushingly sad, and thought provoking. Truly excellent
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Anaesthetists - spare yourselves having to wonder whether propofol hurts if you accidentally get some in your eye, and take it from the tit who did it this morning that it really does, quite a lot
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I find it ironic that so much emphasis seems to be put on ‘resilience training’ in the NHS, when if it was just staffed adequately, the reason for giving out the resilience training in the first place would go away
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Yes, I’m getting old, but this happened today, and the story is definitely true, and I think it’s amazing
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When junior doctors undertake IA this time around, please, PLEASE learn from 2016:
Have one (at a push two) spokespeople, and one simple message. As sad as it sounds, there’ll be colleagues who will be looking to raise profiles and/or coinage from this. Don’t let that happen
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I can’t believe all of my fellow NHS workers that are kicking up such a fuss over the 1% pay rise
I, for one, haven’t spent a single one of those claps that we received last year yet
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In my humble opinion, cheap NHS white toast, smothered in cheap NHS butter, served with a cup of tea at 6am on a night shift is the greatest meal in the history of ever
The one thing that the
#NHS
does terribly, awfully, surprisingly badly is its toast.
NHS toast is DREADFUL
How do we get it so wrong?
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What’s got two thumbs and has just been appointed as a consultant?
This guy...
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Call me old fashioned, but any debates regarding the availability of period products, or anything else to do with womens’ health should be decided and debated exclusively by women, and women alone
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Another day in theatre, another teddy bear boo-boo fixed by the anaesthetic team whilst the surgeons were fixing their owner…
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Southall’s Corrected Surgical Timings Estimates:
“laparoscopic” - increase estimate 4x
“+/- proceed” - increase 2x
“revision” - dinner is in the dog
“free flap” - cancel any holidays you’ve booked this year
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I’ll tell you what, lads. When the pubs and clubs finally reopen, the first night should be NHS night...
I’ll see you all there
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So I’m off trampolining this afternoon. I’m also anaesthetising for the trauma list tomorrow. I’d say there’s a 90% chance I’ll end up on my own list…
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I’ve just completed my first year as a consultant, and my only hot take of any worth is that doing a 40 hour week, as opposed to a minimum 48 hour week as a reg (and often significantly more than this) makes you feel MUCH healthier and happier overall
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I've been triple vaccinated against Covid-19.
Vaccinations have probably saved more lives than any other medicine in history - they’re one of humanity’s greatest achievements, and we’re lucky to have them
Vaccines work, and I’d urge everyone to
#GetVaccinated
if you can
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This is the amount of potentially recyclable packaging generated from one vascular case, just from the kit that is opened before the patient even enters theatre.
Currently across the UK, the majority of it is incinerated or goes to landfill. We’re now working on a solution
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The boy was refusing to come out the bath this evening
“Who’s in charge?” I said
“Don’t know” said he
“I am” I said
“Not when mummy’s around” said he
True dat, son. True dat
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When you forget your mask for the school drop off, and have to squeeze into the five year old’s dinosaur one instead
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As an indication of how bad working a night shift can mess you up, I was in theatre all night last night (having been up all day), and not for the first time after a night shift, this morning I spent a good 30 seconds attempting to open my front door with my car keys
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Our toddler is a shepherd in the nursery nativity-
When I asked him if he knew what the Xmas story was, he paused and said:
“Baby Jesus came out of a Unicorn’s Tummy”
Which, quite frankly, is the version I’m running with from now on
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In case anyone thought taking an ITU patient to MRI was enough of a logistical nightmare, I can confirm that adding in covid and PPE and deep cleans increases the ‘ballache’ factor by at least 10
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So I’ve been largely absent from Twitter for a few months. I’ve been struggling with my mental health for a while now, largely due to personal and relationship issues.
It steadily got worse, all the time with me thinking that I could handle it
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If anyone needs me from now on, I’m presuming you’ll just be able to see where I am at all times using Microsoft Outlook
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So apparently I can’t get the only antihistamine that works for my hayfever as a repeat prescription request, because I haven’t had it in nearly a year
It’s almost as if hayfever occurs at the same time each year and then goes away...
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The canteen at one of our sites is genuinely amazing. Most of the food is cooked in house, including this massive tub of porridge (the photo doesn’t do it justice), which is some of the nicest you’ll ever have anywhere. The cost?
£1
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Nutmeg’s first groom today:
- On the left, ‘gap year’ Nutmeg
- On the right, ‘job interview’ Nutmeg
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“When you get your puppy home, they’ll be very nervous and need some quiet time” say all the books...
She’s been home less than 20 minutes
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I realise this could read as a humblebrag, but it genuinely isn’t. The F1 who I was educational supervisor for last year came back to the trust today (without telling me) to give me this. It’s the nicest thing that’s happened to me at work for years, and I’ve been beaming all day
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Normally, I’m extremely low key about my birthday, but this year my lad gave me a jar of sweets that he’d taken from his own stash, and put some pork scratchings in the top that he got with his mum
I think he’s my hero
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I read a tweet on here yesterday that said if you say Covid-19 to the tune of ‘Come On Eileen’ it makes you feel better about the whole thing, and it really does
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I don’t want to start another ‘anaesthetists are pedantically obsessed with drug labels’ discussion.
But I do just want to point out that whoever has done this is The Worst Person In The History Of The World
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If you speak about pay, it generates a “what about *insert job*? You earn more than them!” response
We’re not playing pay top trumps. I was at uni for 7yrs, then another 10 before consultancy. Wanting pay that reflects the essential skill set doesn’t make us ungrateful monsters
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I SLEPT IN A HOSPITAL ON CALL ROOM AND WATCHED US LOSE A GRAND SLAM, SO MAYBE CUT ME SOME SLACK
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To give you an indication of how the 24 hours of my on call are likely to go, I initially went to the wrong hospital this morning
Strong work Southall. Strong work
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If you are no longer a junior doctor I don’t think you can comment on the experience of being one currently
I’ve not been one for five and a bit years and I’m already too far removed from what it’s like now
If you’ve not been one this century, you may as well shout at a cloud
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So my six year old is obsessed with bath bombs.
The colours of his latest one, however, have combined to make it look like we’ve decided to do an in-out catheter on a severely dehydrated elephant in the bathroom
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Part of the sustainability work we’re doing is looking not just at the big projects (like anaesthetic gas capture) but the small wins.
Buying a reusable coffee cup (made from rice husk) for everyone in theatre and ditching the polystyrene and plastics cups should help
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For anyone needing to self-isolate at the moment, and who also grew up in the late 80s/early 90s, all of the episodes of Bananaman are on amazon prime.
You’re welcome
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To illustrate how tiring night shifts can be, I've just spent a good 45 seconds trying to open the front door with my car keys
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I know I’m biased, but taking a very unwell patient to theatre, and then seeing them smiling and pain-free on ITU in the evening is the best feeling in the world
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There were some PROPER beasties out and about in the countryside today (pictured just after the dog nearly trod on it)
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As someone who was a junior doctor during the contract disputes and the strikes, admitting that Jeremy Hunt is now consistently and repeatedly the voice of reason regarding coronavirus strategy means we’re finally properly through the pandemic looking glass
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I think it’s fair to say that unlike in 2016, the junior doctor committee of the BMA are definitely not messing about
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Lesson learned from day one of induction:
- people on induction who introduce themselves as “Dr <surname>” to a room full of other healthcare professionals, are the worst kind of people
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I found out today that I’m likely to get a £3,000 AA pension tax charge this year
I’ve only been a consultant for 3.5 years, and do no private practice. I can see how this will rapidly become unsustainable
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The Kurdish barbers that I go to have always been lovely with their customers, but today one of the customers clearly had mobility issues, and one of the barbers walked him home after they’d cut his hair.
Absolute top drawer
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“May you forget where you put your cup of tea, and when you find it, may it be lukewarm and over-brewed” is the most crushingly polite British insult I’ve ever heard
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In the space of 12 months, it seems that my specialty has rapidly gone from the one that has - for generations - treated its trainees the best, to the one that seems to be treating them the worst
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So I’ve just done my first clinical morning in nearly five months, and I got both cannulas in first time.
I’ve lost nothing, lads
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By the time this is all done, I’m not going to have any skin left on my nasal bridge. But with no haircut for three months, I probably WILL have a mullet
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By a twist of fate, yesterday was my second on call in a row where I was in the hospital for 24 hours straight and reader, let me tell you, it is NOT a good time
I’m also trying to push on through to tonight, and am currently at the stage of tiredness where I can hear colours
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The four year old developed sudden onset “tummy ache” that coincidentally came on at leaving-to-go-to-school time.
I had a look at him - “I think you’ll be fine” I said
“Hmph - well I don’t think you’re a very good doctor” he said
Touché, son. Touché...
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I think we should discuss today’s pay offer for what it is, given inflation is likely to reach 4% this year:
- A 1% pay cut for all NHS staff
- A 4% pay cut for junior doctors (who have - let’s be frank - given up their lives and their training programmes to manage covid)
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I’ve toiled with whether to post this for a long time. It’s the note that I wrote to my lad when I was at my lowest, just over a year ago.
I’m not posting it for likes or ‘well dones’. I still read it every day, but now it reads as a list of reasons to be here (1/3)
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For anyone who hasn’t taken the plunge with the NHS subscription to
@Headspace
- I’ve always been sceptical of apps like that, but last night I used one of their sleep ones before bed, and slept better than I have in about five years
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About 15 years ago I was fairly sure that when I got to the age I am now, I’d have at least a bit more spare cash
My younger self was clearly a naive idiot
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You can treat your medical role as a vocation and stay as late as you want (like lots of us often end up doing). That’s your right
But don’t expect others to feel the same - the day the profession gets treated as a job will be a good day for everyone’s mental and physical health
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Christmas Day update - it’s 7:11am, and I’ve already nailed an entire Terry’s Chocolate Orange
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