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Hopefully this is not gauche to do but:
@self_made_human, how are you liking the U.K.? Haven't seen a legit update.
I'm greatly touched that someone remembers what I'm up to haha, thank you!
Ever since I got here, I've been mulling a proper effort post about the place, but haven't really had the time or energy. But since you asked, I'm certainly happy to summarize:
This time, it was far smaller a culture shock than when I was in England 2 years back. I know how things work, and the sight of double decker buses doesn't quite give the same "you're in foreign territory" vibes as they once did. Thankfully, I understand Scottish accents quite well, so no issues there either.
It's been terribly hectic, everything from dragging a large suitcase up Edinburgh (you'd swear you had to go uphill both ways), figuring out work, the millions of little things necessary when shifting countries, it's absolutely drained me.
I currently (and temporarily) live in the middle of nowhere, to be close to the hospital that's my first posting. I'll be moving to a respectable city in a few months, but this was what I opted for because I wanted to live closer to work till I acclimatised or bought a car.
Said work has been a chore. Psychiatry in the UK is rather different from my expectations, worsened by my initial placement being in Old Age psychiatry, with the majority of cases being dementia patients of some description. Wouldn't have been psych work back home, I tell you. It's boring, and not to my taste, I feel like a glorified geriatrician fussing more about last night's falls and who's had constipation (and can I shirk another PR, having made it 3 years into my career only ever having done one) instead of real psychiatric work. I can only hope my stint in adult and adolescent psychiatry is more interesting.
They've also had me running up and down the country, you don't have the luxury of working out of a single hospital during a residency like the rest of the planet. I swear I've done enough miles in a month and a half to circumnavigate Scotland.
The isolation is getting to me. It's been difficult surviving on my own. First time I've been away from home for this long, I tell you. I was nominally away living away from it for 4 years in med school, but in reality home was just a weekend bus ride away. Now I really haven't got anyone but distant relatives in the span of a continent.
I live out of the way, it's hard to make friends when everyone commutes in from the larger cities, though I have the saving grace of my landlord and landlady being lovely people. Another thing I hope changes with a move.
NHS bureaucracy is a headache, the sheer hassle I had to undergo in order to send a picture of a patient's rash to dermatology.. Can't just click a picture on my phone and send it over as is the norm back home, nope, breach of patient privacy. I had to dig out a digital camera approved for "clinical photography" lurking on the wards that predates microUSB and is likely as geriatric as the patients. Predictably, it didn't work (the old batteries blew up and had to be scraped out by me using a pencil, and I couldn't get photos off it if I tried as it needed drivers off a CD advertising Windows 98 compatibility, not we had an SD card or a way to read off one). I ended up googling the closest pictures I could find online and sending those off with fervent apologies. So much busy work and utter wastes of everyone's time, but it's how things are done here. I find it farcical that so many important investigations are indefinitely postponed because the patient declined when I asked if I could take their bloods or do an ECG, when they're involuntarily committed because they lack capacity in the first place. Leaving aside that doctors being responsible for taking bloods and performing ECGs would be farcical in most countries, not just India.
It's also bloody cold, unseasonably so for September, I can barely get out of bed in the morning, everyone agrees it's only really heater time in October.
I've been modestly depressed, for the reasons above. Occasionally I get to see the aspects of psychiatry that actually excite me, but they're few and far between at the moment. I can only pray it'll get better. Either way, it's going to be a long 3 years, and assuming I want to go in the UK, yet another 3. I'm being run ragged, and I can't quite muster up the energy to engage here like I used to. I'm sure I'll write a proper post eventually, but thanks for keeping tabs on this poor soul!
Geriatric psychiatry sounds like a truly miserable way to spend your time. I'm no doctor, but it seems like there's little improvement you can provide for most people like that.
Curious to know if you've met any other Indians about the place? And what are you missing the most from home? I recall when I did my year in Asia, my parents sent me a box full of American candy; little knowing that I could buy basically the same things at the corner store. But the sentiment was nice. (They also sent me a lot of underarm deodorant at my explicit request, and that was a lifesaver.)
I appreciate the update. We do miss you. Hang in there and try and make the most of it. If nothing else, as you continue to suffer various indignities, bear in mind that these will be great sources of stories you can tell in the future. "I'm telling you, it was 2024, and I had to try and use a bloody digital camera. What's that? You don't even remember what that is?"
You're right, in the majority of cases they're really far gone, especially the ones who are in-patients, and care is mostly palliative.
I do know another Indian doctor in the same program, but he's at a different hospital. There are far fewer of us than further south in England, but I'm not particularly fussed either way, I'm not particularly clannish! It's more that I don't have too many peers where I work, albeit the ones there are nice enough.
The things I miss from home, well, my parents can't send them to me short of flying over to visit themselves, and that's not happening this year. I'll go visit them instead which is nice!
My older dog is doing poorly, and I miss them both, so a trip home to be bowled over and licked senseless would do wonders haha.
Thank you. I mean it sincerely.
You're very spot on about the NHS having endless potential for shitshows that can, in retrospect, be very funny. Especially in psych where the patients can do the darnedest things haha. If you want to read a very good book about, check out This is going to hurt by Adam Kay, though the poor bastard made the mistake of taking up gynecology and I was never fooled into that!
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