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Medical Machiavelli?


Being kind to colleagues doesn’t always come easily but one junior doctor found you reap what you sow. Martin Kaminski was highly commended for his entry in the 2014 writing competition

On my first day as a bona fide junior doctor, I bought orange juice, biscuits and a gigantic greeting card for the ward. 

My fellow new house officers thought I was sweet. I thought I was being sneaky; I saw myself as a medical Machiavelli.

In the nervous weeks leading up to my fateful first Wednesday as a foundation doctor 1 in orthopaedics and trauma I had tried to read every tip and trick on junior doctoring. 

I attempted memorising the Oxford Guide for the Foundation Programme front to back. I scoured internet forums in search of the One Essential Medical Trick They Don’t Teach You in Medical School. I re-watched a few episodes of Scrubs.

In the end, I did find something. It wasn’t quite a trick but a word of advice that lodged itself in the deep recesses of my mind. It was simple enough, but it also worried me as it was almost too simple: be nice to the nurses (and secretaries, physiotherapists and everyone else, but especially the nurses). 

To me, at least, this was more difficult than it would appear. Outwardly, I am not a friendly person. More than once I have been told that I should smile more (despite my default facial expression being set at a neutral yet stern-looking flat line). 

I am very bad at names. To add to it all, I am a self-taught master in the art of speaking in monotone.

Pure intentions

From my first day I wanted everyone to know that I really cared, despite my external appearance hinting otherwise. My intentions were pure. I wanted everyone to know that I would answer their bleeps as soon and as courteously as I could. 

I wanted them to realise that I would do my best in our shared goal of healing and comforting the sick and injured. I wanted to send a signal that I cared about our future working relationships and what everyone had to say.

Somehow, on my first day working as a doctor, I hoped to convey this through biscuits and cups of orange juice. 

Weeks later, I was typing discharges at a doctor’s station on the wards when a fellow junior doctor known for a cavalier attitude towards patients and nurses stopped by with a stack of blood request forms.

The doctor brusquely informed the nurse on duty that he would be on call over the weekend, covering the ward and that, as a doctor, he was going to be very busy. 

Looking at the forms in his hands, he cocked an eyebrow and in a dismissive voice asked if any of the nurses would be on call over the weekend as well. 

‘Can any of you take blood?’ he followed while cocking his eyebrow even higher — I was in awe of his facial acrobatics — only to be told that unfortunately, no, none of them could. 

Dashing across the hospital

Shortly thereafter, I too experienced my first on-call weekend. Doing my best to juggle my responsibilities I ended up running back and forth across the hospital. Trying to answer questions with a crooked smile and end all requests with a ‘thank you’, I ended up skipping lunch.

Yet just when I was on the verge of running completely out of steam, a senior nurse bleeped me and told me to come to her ward. Upon arrival she told me to sit down and gave me a bagged lunch from the hospital canteen. Having seen the state I was in, she ordered me to eat, which I did with gratitude.

It was just then that I remembered I still had bloods to take on the ward in which I was happily munching, the same ward where my colleague had been told he would have to fend for himself. In anticipation of that fact, I had left out all my blood request forms, collection tubes and the rest in the morning.

But when I looked for where I had placed them, they were gone.

I calmly asked the nurse who had been kind enough to force me to take a break where they were, worried that someone had cleaned up what they mistook for a mess.

‘Oh, don’t worry,’ she replied. ‘We saw how busy you were and one of us sent them off to the lab for you.’ She gave me a wink and left me to chew my sandwich. 

Afterwards — I like to think it was sneakily — she offered me a biscuit.

Martin Kaminski is a core trainee 1 in medicine in London

Find out more about the 2014 writing competition and read other entries