What is it like to have an emergency and need a visit to the hospital in England?
You, or somebody close by if you are unable to, calls 112 (the official emergency throughout Europe): 999 (the long-standing British number devised in the days of rotary-dial phones) and 911 (because many people think that’s what it is by cultural osmosis) will also work fine. You ask for the ambulance service. The operator will ask for your location and details of symptoms. Your answers are already being relayed to the nearest ambulance, which is on its way even as you talk. Unless you are in a remote area an ambulance will arrive within 5–10 minutes, A paramedic will attend to you immediately. You will be wheeled to the ambulance and you will be taken to the nearest Accident & Emergency (A&E) facility with paramedics administering any treatment necessary on the way. On arrival you will be taken to a bay where you will be given any support you need, Your temperature will be taken. A gizmo will be attached to your finger to monitor your heartbeat and blood oxygen. An inflatable sleeve will be attached to your arm to measure your blood pressure at intervals. You’ll be given an identity tag and a cannula in the back of your hand. All within the first few minutes. Once you’re settled, or earlier if the emergency warrants it, you’ll be assessed by a doctor and prioritised. If you are to be kept in for observation, a bed will be found for you. All being well, that will have happened within the hour.Very occasionally, something may go awry. That occasion may end up in the media and there will be wringing of hands about how the NHS is failing. Of course, none of the many, many more occasions where everything goes to plan end up in the media.Every so often there is a news report about the NHS failing “targets”. Targets (for waiting times, etc) are there to make politicians look good, not to improve emergency care. If you are in A&E because you broke your finger taking a wild swing at somebody who glanced at your girlfriend in the pub then you are probably going to have to wait a few hours. You are seen strictly in order of need and the hell with waiting time targets,
What is something one learned as a doctor that they never taught in medical school?
They don't tell you that first time a patient dies who was directly under your care, how much it will hurt. It's gut wrenching.You replay it in your head again and again.And again. It doesn't matter if there was nothing you could have done. The minute you get alone you cry.But you have to go on because there are others who depend on you to function. For me, it was two weeks of sleepless nights. You learn then, you can't save everyone even when you do the best you can. You learn to learn from each such case.All your weekends enter the barter system of duties. One of you, among your colleagues will be on call over weekends. When you are junior,there will be more holidays and Sundays. Weekends won't ever solely belong to you.Some of the best work you do will go unnoticed, unappreciated and unthanked. A cured patient is a happy man who moves on to the other important things in his life.The job will ask for not only sacrifices from you but from your family as well. Missed birthdays, anniversaries and events will be not uncommon.There will be days that you will feel it was all worth it, that you have the best job in the world.If you are not careful, you will become restricted and boxed into “just a doctor”. Hobbies shouldn't be forgotten.A good bedside manner and compassion will get you farther than most things. Both need time and practice.There are limits to what you can do. You can advise but not convince. You can treat the illness, not the social problem, not even if the patient wanted you to, not even if you want to.
Why would homeless people's family allow them to be homeless?
A large number of homeless people are mentally ill or brain damaged and their families cannot deal with them any longer. My own father went homeless after being released from prison for pedophelia, having sexually molested me, my step sister, and a child he was babysitting (these are the ones known, there are probably many others). The family could not deal with him any longer. He was brain damaged from repeated concussions from sports and several car accidents. It's hard to know what caused what. Did he drive so crazy and have bad judgment from brain damage, or did he get brain damage from driving fast and poorly? But it released his inhibitions and allowed him to prey on the innocent.Pedophelia was not the only manifestation of brain damage. He was also irrational and quick to anger. He borrowed or stole things from the family. He couldn't keep a job. He pushed the family towards the poorhouse.It was an attempt to stabilize the family that led to my dad being kicked out of the family home. He was likely 30 by then, living with his parents. He had been lovingly called the black sheep until his conviction. After that we just did not talk about him at all. It's as if we were part of the family by adoption rather than birth. The family kept tabs on where he was and gave him some money occasionally. He eventually was employed enough to rent a tiny studio apartment and buy a beat up bicycle. Rather employed long enough in a union job to get unemployment whenever he was laid off. He lived in that apartment over 10 years until he died of an illness rather suddenly. He never did admit to having molested me, only saying that he did not remember. Perhaps that is the brain damage, but I don't know how a person could forget a thing like that.It's painful to have a family member who is homeless. When people ask about your family, you either have to lie or become a victim of their pity. It's kind of horrifying, but the family was being ripped limb from limb while he was present so this is the best alternative. It is a relief that he is no longer around.
If natural child birth is so painful why do most women opt for it? Instead why not go for cesarean delivery? What are the benefits and costs of natural childbirth?
As a co-founder of International Cesarean Awareness Network, a cesarean mother, and a natural birth mother, I feel that I am qualified to answer this question. I have given birth five times. My first birth was, basically, an unattended hospital birth. The hospital staff didn't think I was in actual labor, so they never called my doctor. He finally called the hospital to see if I had come in. He arrived after I had birthed my daughter. I tore extensively due to poor nutrition and poor positioning. My second child was born by emergency cesarean, weighing one ounce more than her sibling. The surgery went well, and my recovery was uneventful. However, it was six months before I felt back to normal physically.My third child was a VBAC-Vaginal Birth After Cesarean-in a hospital with a family physician. The labor was intense, but I was able to sleep between contractions. My baby was born in one push, and weighed 2 1/2 pounds more than her sisters. I only needed one stitch, and I felt back to normal physically in a week and a half.My last two children were born at home, with midwives attending. Both births were calm and easy, despite my last baby birthing face up. Both home birth babes were 2 pounds bigger than my first two babes. Natural, unmedicated, unmanaged birth is the safest, easiest, least painful way to birth a baby for over 90% of all women. Unfortunately, doctors and hospitals in the USA do not understand this. Doctors want to manage birth, make it faster, more efficient, more convenient. These goals may be helpful to the doctor. They are not helpful to the mother. Birth, in most cases, should not even be considered a medical procedure. It is a natural process, but a delicate one. Mothers cannot labor and birth easily if they are feeling unsafe. Hospitals are inherently scary places filled with beeping machines, gowned and gloved strangers and super germs. No wonder so many labors end up stalling, or even stopping. Which would you prefer-eating a meal of your choosing at your own pace, or having a feeding tube shoved down your throat and proper nutrition pumped directly into your stomach? The tube is very efficient, and the nutrition is more than adequate. I think we would all want the meal, though. Woman would do best birthing in a place of their own choosing, birthing at their own pace.
What do you do when you are 73 yrs old and trying to care for your 90 year-old bedridden mother, and you suffer from chronic back problems, and no help?
First of all, I feel for you. It must be very hard to take care of your mother with your pain problems.I think you should try to call a non-urgent care phone line and ask them if they know of any programs that might exist to help your mother. Where I live, there are CLSC where people can ask for help and be directed to the right service.Where do you live? Have you seen a doctor for your back problems? Is there a medication you can take? Is there someone who can help you (children, sibling, niece or nephew, etc.) look for such a resource or help you take care of your mother?Of course, there are places where your mother could live and have trained people like nurses take care of her needs.It’s a very hard dilemma and not every country or state/province has services to help older people directly at home. You have to think about yourself and be careful not to hurt yourself even more by trying to help your mother.You can write me back and I can look for resources that might have a better answer than I do. I really hope you take time for yourself to try and feel better and I hope you find a solution for your current situation without impacting your health.Much love,Audrée xxxx