The weeks go so fast, yet at the same time the days move so slowly.
Working elective surgery is, at times, like working on the factory line. The primary difference of course being the care afforded to the patients being operated on. But while this fact is sacrosanct there is something every nursing or medical graduate discovers very quickly and certainly within their first year: Get them fixed and get them out.
Because there’s plenty more to treat coming through behind them.
This might shock but it is a pragmatic opinion. And I was a pragmatic person even before I took my first class in Nursing 101, so I hardly think I’ve lessened my opinion with all the ‘wet and wild’ shenanigans the NHS has dealt me.
I’ve only moved to elective surgery recently. An environment so different from the coffee-fuelled extremes of trauma it might as well be on another planet. One of the singular differences being the end of the shift, which is usually structured to coincide with the end of the day’s operating, with a slight final lip of downtime in order to square-away any loose ends and clean down.
Apologies for the “square-away” phrase, I’ve been watching too much ‘Generation Kill’ on repeat. It’s amazing….
It’s that lip of quiet-time I want to focus on here.
Anyone who’s worked on an assembly line will know that feeling. The whistle blows, the line grinds slowly to a halt and you have to clear up your work station before you can change and bolt for the door and the freedom lying beyond it.
There can be times when everyone is running behind, and the operating finishes late, and the clean down is frantic and everyone hurries to the change rooms at 17.58, due to be off at 18.00. Just time to strip, spray, tug the boots on, grab the lunch-bucket and book. At 17.59 I am yours, but at 18.00 remember I am mine.
But there are other times when the final duties of the day are more languid. Not sandbagged, a work practice I personally find abhorrent, more-so a feeling of focus, stillness, inner reflection and self-learning. Something that unfortunately rarely happens in my job, given the current financial circumstances of UK healthcare.
It’s these moments that I find give me more professional gratification than the rest. The chance to look back and check what we’ve done, discuss what we can do better, laugh, and leave. it releases a sad understanding from inside me, not only from some faux-Buddistic impulse on how every day is unique and if you don’t use it then you lose it, but on a larger scale of finality.
I remember my first Christmas Eve, in hospital Christmas Eve is a day when everyone tries to finish early, for obvious reasons, the day in question the time one of the new consultants brought in a couple of bottles of champagne for the staff as a thank you.
The crews from two entire theatres procured mugs from anywhere they could and we all sat in the staff room, with 15 minutes on the clock, passing the bottles round, drinking, chatting, refilling and just enjoying the feeling that the workday was over for now, we’d all survived, the patients were doing well and the company was good. We weren’t all friends. Heck, some of us couldn’t stand each other. But like the Christmas truce of WW1 we could put down our guns for now, enjoy the grog and agree to stop sniping until the New Year, when normal service could resume.
Then the line manager turned up, and was a little less than impressed that her teams were knocking back the vino on company time. A few of us sniggered, the rest tried to sit on the booze, the consultant was incredibly apologetic and that was that. The excuse “But it’s Christmas!” really is that powerful.
There are other times I remember. All year round. In the pitch black of night, when my only company on the last walkaround was my own reflection, looking back at me in the glass, to the hazy summer dusk with the long shadows, the lazy sunlight. I remember the last time I walked around my old hospital. I left a message.
Someone also wrote on the message board, situated at department reception and open to anyone who came to the door, just a simple message. Nine words only.
“Would The Last Person Out Turn Off The Lights”
Poignant. And to some, heart-breaking. Because the whole building is now nothing but dust. We had a ringside seat to that demolition, giant clawed and tracked monsters ripping the walls and roofs apart. Knocking the supporting walls away like bowling pins, the structures eventually sagging under their own weight, deflated. This was the scene we all spent the entire spring observing, walking out the hospital at the end of the day. Fate telling us that history was marching on, day after day after day, and we shouldn’t get attached to anything for very long because nothing lasts forever.
This September I’ll be leaving my hospital to go to graduate school. Only for twelve months but we all know how fast life can change in that time.
Many years ago I left university for a year. The reason isn’t important but I soon realised that I had left my support network of friends behind. And even though I would return the following autumn, I knew that for that year I’d lost the moment. And, like Al Pacino in Carlito’s Way, I began thinking of all the things I’d do when I returned. And, like Al Pacino in Carlito’s Way I came to understand that everything was different. Everyone had changed. And you’re alone, left looking for that one thing, that one single face that didn’t change.
I was too immature then to realise change is the natural order of things. I don’t feel that way these days, yet I recognise the hospital that I come back to in the winter of next year will not be the one I leave this autumn.
It’ll be the same hospital (short of an earthquake or someone 9/11-ing the place) but the dynamics will be different. New faces appearing, old faces departed, new techniques, old procedures sidelined, more happiness and sadness and sunlight, and everything changed but still the same.
From the old to the young, the greenhorns to the greybeards, we’ll all just be walking off the line at the end of the day.