Cut the new old doctor some slack!

Issue: BCMJ, vol. 59 , No. 10 , December 2017 , Pages 494-495 Editorials

Being new isn’t easy. I don’t mean young and new, fresh out of training.


Being new isn’t easy. I don’t mean young and new, fresh out of training. That is a time when we are more accustomed to change, to seeing new faces, and learning new processes. But being a lot less young—and new—that is a tough combination.

Because I am moving to New Zealand, I have been reflecting on the process of going to new country, to work with new people, and into a new position—sounds, er, great, doesn’t it? 

But this is my second foreign foray. Hopefully, the challenges and pitfalls I fell into last time I left home and went to work in Australia will be avoided. I didn’t realize how distracting newness is when you are doing clinical medicine. The illnesses are the same, but the environment feels so different. How things actually get done and who does it can be a mystery. And, I don’t have a baby face anymore signaling to others, “Okay, newbie here, will need to be cut some slack.” 

What I have this time is a badge with a picture of an older woman that says “Senior Staff,” a.k.a., “should be right up to speed.” 

Some common generic drug names were different Down Under. I was oblivious to the fact that there was no acetaminophen, it is paracetamol; no ibuprofen, it is nurofen. It’s tough to order a drug that no one has heard of. In Australia, there are no vital signs, only obs (“observations”)—that took me 6 months to remember. There were no IV starts—it was “insert a cannula please.” What the heck is that?

At times, my Canadian accent meant that no one understood what I was getting at. Aussies didn’t seem to know that Canadians don’t even have an accent. A patient was puzzled about why I was asking about his goat, as he didn’t have any goats. “Gout,” I said, “Not goats.” He shook his head, still perplexed. No matter how I said it, it still sounded like a farm animal to him. He was “crook” by the way, which someone later told me implied he felt sick. I thought he was talking about farms, too.

One of our trainees had written a prescription for furosemide but she had spelled it “frusemide.” As I had to sign all prescriptions it gave me the opportunity to expound on how a prescription was a legal document. Correct spelling was important, blah blah blah. She looked at me completely dumbfounded and said nothing. I didn’t know that frusemide is the correct spelling in Australia—clearly she wasn’t the one who needed the spelling lesson. 

After just 4 weeks on the job I became famous. A politician from the opposition party decried the state of health care, with foreign doctors endangering the lives of babies and sending them home from emergency when they were in grave danger! He was referring to the little-old-foreign doctor—me.

This had come about because earlier in the week I had seen a child who had been unwittingly fed a small piece of white Velcro, hidden in his bowl of rice. Velcro is pretty scratchy as it travels down the esophagus. Kids don’t like eating it. I didn’t know he had swallowed any Velcro and by the time I assessed him he looked just fine. His workup was normal and so I sent the happy, cooing baby home. That good idea lasted an hour before the parents brought him back, morsel of Velcro in hand, outraged at his being released. How could I have not realized he had Velcro poisoning? It became known as the case of the “Velcro dot baby.”

The parents were well connected in state politics, staunch opposition supporters, and an election was looming. Well that’s it, I thought, I will be packing my bags and heading home after this one. The chief administrator came to my office the next day. She was worried I might leave! She wanted to tell me how much support I had. Health care was a political plaything here, she said, and anything that could make a headline would make a headline. Colleague after colleague came to check up on me. Was I okay? Did I want to talk about anything? How could they help? Frankly it was all overwhelming, with support from people I didn’t really know yet, in a place where I was so new. I was tremendously gratified by their kind words, humorous approach, and for helping put it all in perspective. They had worked there their whole careers and no one had ever talked about them in Parliament! Wow, I must be very, very special. So I didn’t leave, and I had a fantastic experience. 

My upcoming move will likely not be as smooth as silk, but, perhaps at my age, I can draw on my experience and milk the whole new thing to my advantage. I do pray, though, that I am never thought of as “special” again.
—AIC

Anne I. Clarke, MD. Cut the new old doctor some slack!. BCMJ, Vol. 59, No. 10, December, 2017, Page(s) 494-495 - Editorials.



Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.


For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org

BCMJ Guidelines for Authors

Leave a Reply

CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Image CAPTCHA
Enter the characters shown in the image.