6 weeks since my appendix tried to kill me, including an inter-hospital transfer on inotropes, I have learned some hard truths about serious illness that will inform my practice going forward.
A thread.
1/13
The tweets I posted at the time? I have no memory of writing them. Ditto this text exchange with hubby👇.
I apparently signed a consent form for the operation. No memory of that either. In future I'm not going to equate 'apparently oriented' with competence.
2/13
Being a suspected #COVID19 case (at that point I was septic with no clear cause) was incredibly hard on family. Hubby was not allowed to accompany me in the ambulance or visit. He was told to stay home and wait with the kids in case they all had to quarantine.
3/13
Nothing was heard for hours. The poor man fell asleep next to his phone. In actual fact I'd been cleared via rapid test within an hour, but he didn't get a phone call until the next morning. Staff had assumed I would tell him. We need to do better at keeping family informed.
4/13
When you're really unwell, every movement is an impossible effort, even opening one's eyes. But other senses still work. I was grateful for the voice in my ear giving me updates or warning of a painful procedure. Please keep doing this, even for 'unconscious' patients.
5/13
All the #MedEd and #CultureChange IS WORTH IT. I only have brief visual memories- little snapshots. But they are of people I trained, or trained with, at the bedside, looking concerned. My overwhelming sense was of peace and relief at seeing them. I knew I was in safe hands.
6/13
Think twice about rushing to visit unwell colleagues. I hesitate to post this shaky selfie, but I will- because I need to stress how dishevelled, how unable to perform social niceties I was. (Also how badly those one-size-fits-all gowns fit😬)
7/13
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It’s fascinating to see ‘[insert man] was the first to speak up about sexual harassment’ when it was simply that many women had spoken up… AND BEEN IGNORED.
Even the men being named as women’s great grand champions are dismayed to see this gendered silencing. 1/
There have been MANY papers about sexual harassment in medicine and surgery. A cook’s tour-
Miriam Komaromy described sexual harassment in medical training in 1993. In one of the largest journals in the world. And it has been cited more than 300 times. 2/ pubmed.ncbi.nlm.nih.gov/8419819/
Phyllis Carr et al. described it in 24 medical schools and 3332 faculty members in 2000.
Dr Claire Stewart presents the results of the @ANZCA Gender Equity survey and they are devastating- almost half of women have experienced bullying and over a third have had difficulty obtaining a position, compared to just 3% of men. 1/5
The nature of the disrespect experienced by women anaesthetists is insidious, not overt- this makes it particularly challenging to address. This is amplified by a lack of awareness/allyship by men.☹️ 2/5
Nearly half of women anaesthetists experienced #discrimination relating to pregnancy 🤨🤰3/5
.@drpwh62 and I supervised soon-to-be Drs Angela Chen and Neha Ravi in a #LGBTQI+ literature review. Very impressed to see students present 'off podium' with minimal notes at the @BondUniversity MD conference! #MedEd 1/5
The review looked at the gap between medical students and consultancy/attending practice. This is the career stage with the least research, and yet makes the biggest difference to eventual specialist workforce #LGBTQI representation. 2/5
There were just 19 studies, and the results were as awful as expected. Bullying, discrimination, poor mental health, burnout, and lots of emotional labour. There were risks in both disclosing and not disclosing personal #LGBTQI identity. 3/5
I've been asked what I mean by responsibility = privilege.
If you are poor you can't afford masks or sanitizer.
If you live in crowded housing you can't isolate.
If you don't speak English there is almost no messaging for you. 1/4
If you have insecure work you can't take the time to queue for hours to get tested.
If you are First Nations you might only recently have had access to your First Jab.
If you're a rest home resident your 'personal responsibility' lies entirely in the hands of others.
2/4
If you don't have a car there are limited testing locations on public routes.
If you care for kids it's really hard arranging care or wrangling them while waiting for jabs/testing.
If you have a vax contraindication you take a risk even just going out to get tested.
3/4
Do you need a TL break? Here's some wonderful work from @RACSurgeons- the latest Surgical News, with an Indigenous theme 🖤💛❤️and cover art from Sumaya Issa. Too many highlights to cover them all, but here's some highlights. Full link at surgeons.org/-/media/Projec… 1/6
Profiles of two rising stars, Dr Rachel Farrelly who will be the first woman Aboriginal orthopaedic surgeon, and Dr Andrew Martin, who joins @KelvinKongENT as an Indigenous ORL and is just starting his Head and Neck fellowship. 2/6
Wise words from @KelvinKongENT, Dr John Mutu-Grigg, and Dr Alan Woodward about the #COVID19 pandemic response and Indigenous people. For example, initial vaccination prioritisation for age 65+ meant fewer Indigenous people vaccinated, due to the pre-existing mortality gap. 3/6
How much bullying is there NOW in surgery, and is the #OperateWithRespect project working?
In much anticipated news, the results of the @RACSurgeons 2021 Building Respect prevalence survey are out, as part of the very comprehensive Phase 2 evaluation.
A thread-
1/-
The whole report is BIG- 185 pages. I'll bet this is the most substantial report into disrespectful behaviours by any specialty medical college anywhere worldwide. It indicates how seriously RACS takes the issue and makes me proud to be a Fellow. Link-
2/- surgeons.org/-/media/Projec…
The prevalence survey results span pages 100-147 with the survey instrument spanning pages 148-185. This is all in the public domain and any College wishing to conduct similar research is welcome to access and build on it. Disrespect isn't just a surgical problem!
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