h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

I was on call a few days ago when I had a thought, a thought that I was scared to write down or say out loud because that would mean that it was true.

So I wrote it down on a shiny desk and wiped it off with a tissue before anyone could notice.

'I want to be an intensivist'

I'm training to be a geriatrician. I have a training number, a training job, and they're paying for me to do an MSc. I'm darn lucky to get all of these. I know a lot of people who I respect really went out of their way to help me.

The thing is that I'm starting to get worryingly drawn towards the guys in blue scrubs with really exiciting toys. Intensive care that is.

The thing is I really really really enjoy looking after very sick people. This is the bit of the job most people really hate. In the last few months I've developed the skill of not only staying calm myself but when I arrive to see a very sick person everyone else starts to calm down.

I'd assumed that if I wanted to do ITU I would have to go back to being an SHO in anaesthetics and do another lot of Royal College Exams, and also spend a long time learning how to give a general anaesthetic. Which I have zero interest in doing.

But apparently there's couple of jobs around that I could get where I would be able to become a consultant in - wait for it

1. General (Internal) Medicine
2. Geriatric Medicine
3. Intensive care.

So what was an idle fantasty when I was bored in falls clinic and doing yet another stroke ward round is now a possiblity.

The advantages are.

It's just so cool and sexy, and they have really shiny machines. Oh and I would get to make people better.

I think I'd be good at it.

The disadvantages are:

1. It might make me unemployable - I could end up too specialised.
2. It would make it more difficult to get a PhD - just in terms of the sheer amount of time.
3. It wouuld mean doing nights and weekends until I'm 65. Or perhaps 75.

My boss has got te idea that I'm a bit bored of geriatric medicine thinks I just have to chill and spend more time, and move out of my comfort zone. For instance my comfort zone is ITU more than it is Falls Clinic.

I'm afriad I don't know the answer, but I want to stay subscribed to your journal to find out. Whatever you do, I'm sure you'll do to the best of your ability, because that's just... you. And I love that about you.

What said. Good luck with the dilemma!

I say go for it. Life's too short to spend your time doing something that doesn't excite you.

I wasn't familiar with the term "intensivist". Interesting.

Anyway, I'm in the "go for it" camp. I'm also in the "you're married now so it isn't a decision you should make alone" camp.

Is there some way you could have a proper taster before jumping in?

Well we do quite a bit of HDU stuff in our general med on calls out in the sticks. And yes I can do an ITU attachment to get more information. Also the extra training is two more years of ITU work in amongst hte 5 more years of gen med and geris.

At the risk of stating the obvious, go do it and see if it works for you (and the missus).

Well yes, but an 8 week attachment when we're living together isn't really an idea. Damn this MMC business.

Though since I posted this I've really enjoyed geris.

Bizarre as it is, guess what I'm doing for the next four weeks...

Went to a course (On supervising Foundation Dr's actually) ran by the STC chair in ITU. He was really encouraing but did say that I may need to go back to the begining and do anaesthetic and ITU SHO jobs. He also mentioned that if I really wanted to do it I wouldn't let that get in my way, and there's no use having one of the coverted precious NTNs if the NTN is in something you don't want to do.

That said there's a great PhD in Geri's advertised which I would just love to do, and since I've posted this I've started enjoying my job a lot more.

I'm ashamed to say that whilst I really love my current boss, she's a wonderful person, and really good fun, she doesn't really explain how she comes to her decisions, she tends to just come to them. THis leaves me feeling a bit left out and hopeless. She's been on holiday this week (half term) and the consultant who's been covering for her really explains how he comes to his decisions. In Feburary I'll be working for him anyway.

Z, do you think this might have something to do with your regular boss being female, and the covering consultant being male?

See, a lot of my professional decisions are based on a 'gut' feeling (that is probably based upon quite logical facts that I'm not aware of that my brain picked up in the first place).

And there is simply no way I would be able to explain *why* or *how* I came to make those desicions.

That's true - but if the judgement you are making is one you might have to defend against a charge of negilience you have to have the logic for the decision available. 'I just felt that way' isn't really a logical argument.

Though the other day I said (To B) that I had a 'bad feeling' about the state of health of one of our friends. She asked me why I had a bad feeling, and I stopped to think about it and gave the evidence based reason. The bad feeling was based on logical argument of course because the test was only just in the normal range,a nd because of a variety of other reasons It was probalby not a vaild result.

I suppose I ought to subscribe to this, and to your page, now we're hitched an' all.

Well I don't follow your twitter feed. I reckon you'll tell me the important stuff.