Sloth and Competence and knowing when to use them.

It's half past two in the afternoon.

I've just managed to teach my brain to communicate with my body again.

My brain was awake for an hour trying to convince my skeletal muscles that listening to what it has to say is a good idea.

Brain was saying that Skeletal Muscle should help Body get out of bed, hunt for food and evacuate the bladder.

Skeletal muscle was telling Brain to go fuck itself.

Brain won in the end, after a lengthy hour long debate.

Skeletal Muscle got it's own revenge though, and operated like a sulky teenager after being told to clean up it's room...apathetically, slowly, and with no respect.

Which is why I looked something like the illegitimate retarded offspring of Shrek and a three-toed sloth...slouching round the house half-blind, in last night's scrubs top, underwear and socks...mumbling incoherently while in search for the kitchen.


My keen sense of smell led me to the fridge - On which I pinned all my hopes and dreams for a nutritious lunch.

I opened the silver doors and the holy light from within flooded my sleep encrusted face ...

Aahhh *insert choir of angels here*

# Leftover pizza that someone ordered last night ( Score! It's mine now!)
# Crackers with gourmet prawn dip with real prawns from Woolworths.
# Zoo biscuits.
# And a jar of Nutella's spreadable chocolate.

This surely is heaven, and just reward for the shitstorm of last night. Thank you, Fridge Gods!


My call was insane. Which is why I was so tired that when I got home, I couldn't even perform my usual post call ritual of jumping in the shower and scrubbing off the evening's filth, until the top layer of my skin has washed down the drain.
I just shoved an energy bar down my gullet - took off my pants and collapsed on the bed.

The bullshit started out when the locum doctor, who was supposed to be on call with me, arrived two hours late.

While awaiting his arrival, I called the emergency contact number for the locum agency he was from to find out:

Exactly.
Where.
The fuck.
He was.

The middle-aged lady that picked up on the other end could possibly have been a product of incest.

Product of incest:"Oh, um, ja, who are you?"

Me: "It's Dr S from ________trauma unit. Where is the locum you are getting paid to send us tonight?"

Product of incest: "Oh yes, he called three hours ago to say he would be late. But, where is the other doctor for tonight?"

Me: "I AM THE OTHER DOCTOR. If you knew that he was going to be late - WHY HAVE YOU NOT INFORMED US of this fact timeously."

To which the product of incest replied...and wait for it...this really was her excuse..." I was in church!"

Me: "Being in church is no excuse for incompetence. You should stop using your religion to justify not doing your job properly. We'd all LOVE to be in church, or in mosque, or at home on the couch watching the Sunday night movie. But we aren't. We are here doing our jobs. "

I was too pissed off to listen to her ranting and raving that "being in church " was a valid excuse for letting us flounder in primary health care hell on a Sunday night without assistance. So I very politely put down the phone. That woman should take a good look at herself and pictures of her uncle/mothers cousin. There will possibly be very striking similarities.

When the guy eventually arrived - the tragic thing was, I realised that I was probably better off working alone as he was NO HELP whatsoever.

In total, we saw 100 patients from 17h00 to 07h00.
I saw 70. He saw 30.
He would do things like, send a patient off for a urine sample and then WAIT until the patient came back. One can see up to four patients by the time it takes a paralysed stroke victim to go to the bathroom and pee.

When a man walked into the unit and immediately collapsed while having a generalised tonic-clonic seizure, he just stood there and watched me ( 5o kg, petite female me) try to move the man onto a bed to begin treatment.
What a dick. I ended up asking the porters and security guards for help.
They were brilliant and knew exactly what to do - handing me the correct fluids and instruments for IV access.
Fuckwit doctor strode around the bed with hands in his pockets issuing instructions which I, of course, ignored. I don't take advice from brain-donor men who believe that they are automatically in charge - just because they own a penis.

The sisters and I spent the rest of the night ignoring him and swearing at him in Afrikaans. The guy was from Durban so had no idea what we were saying. They don't speak Afrikaans in Durban. Mean - but necessary.

The cherry on the top was when at o3h30 he announced that he had a plane to catch and would be leaving to get his things in order. He then asked the sister in charge to sign his on call sheet from 17h00 to 07h00 so he could get a full night's pay.

He clearly did not know about Sister CrL. She didn't sign his sheet at all. Good girl!

Can I just say - that as I am a community service officer - my rates are standard, very low and fixed regardless of how hard I work. These locums get paid more than double what I make as they are from the private agencies -so in effect I got paid half the amount and was working more than twice as hard.

Did I mention that it's five weeks and counting?


Jeez - just got a whif of myself while reaching over the table. I smell like the hospital!!! AAAAAAAAAAHHH!

I thinks it's time for that shower now...

This is not an entertaining post.

This is a post full of complaints. It's not funny or entertaining in any way. It's just the truth.


Doctor's are currently picketing and toyi-toying in their lunch hours in South Africa.

We are sick of the pathetic working conditions we suffer.

We are tired of the ridiculous hours we are forced to work.

We are insulted that compared to other government workers in similarly highly educated fields in this country ( the judiciary for example) - we are getting paid 50 percent less .

We are emotionally drained by the sheer volume of patients we are under pressure to "see" every day.

This disheartens us as we are unable to provide the quality of service we know we are capable of, simply as a cause of poor management.

We are tired of being told that we chose to be doctors, and that we should just deal with it as this is the way it has always been.

We are disgusted by the service we "provide" to our patients. It's unfair that this will be their health "care" experience.

Why are other fields not forced to do community service like us Good Samaritan medics?

Teachers could do community service in the township schools.

Engineers, lawyers, IT consultants, business graduates should all be forced to serve their communities in the way medics are.

The members of those disciplines would be up in arms about it.

Not like us - we just blindly accept our fate, and continue pushing ourselves to our limits.

Why are doctors such pushovers when it comes to our own quality of life?

I'm certain it's a mixture of guilt, compassion for others and indoctrination by the heirarchy.

I'm very worried about the future of government health care in this country. There is no incentive for us to continue working for the government sector. Why would anyone continue here? The department of health only have themselves to blame for the "brain drain" of doctors emigrating for a better life overseas.

I get to work, and am scared because people get shot in the area that the hospital is situated in.

When I walk in the door - I'm immediately confronted with 200 or more patients crammed into the small waiting area - who have been sitting there since 4am to ensure that they are the first to get a number. The magic number that means you will be one of the patients lucky enough to be seen by a health professional that day. If you don't get a number - you are turned away and told to come back tomorrow - where it's not certain you will even be seen then.


The patients know I'm the doctor - despite trying to be inconspicuous - and immediately start harassing me with demands.

"When are you going to see me doctor?"
"I've been waiting for ever!"
"Please just rewrite my medication so I can get it from the chemist."
"Can you have a look at my foot please it's turning black"
"My baby, doctor, just listen to my baby's chest please!"


This occurs while just walking down the passage to the consulting room. Although one can't exactly walk down that passage - it's more like an obstacle course, having to step over people lying on the floor and children running around everywhere.

I have no safe place to leave my things - we are not issued with lockers or keys to the rooms. Even the tea room is unsafe - so wherever I go I have to take my bags and coat with me. Even into the toilet. Or across the hall to use the one phone in the whole hospital.



The nurses tell me that everything gets stolen - even your food out the fridge, even the plug socket coverings on the wall, even the metal plaques on the doors. everything!


By the time I start seeing patients they are already so pissed off from the long wait that they are not interested in a damn thing I have to say. They just want their meds and want to get the hell out of there.

If I even leave my consulting room for five minutes just to pee, the patients start grumbling...Where is she going? Is she going on lunch? How long will I have to wait NOW!? These doctor's don't care about us at all!. I don't make eye contact with them.

While on call in the trauma unit - all night, despite having worked a full day as well, we deal with violence on an unimaginable scale. The doctor's from first world countries are shocked by the violence. I met a doctor from the UK who had seen one gunshot wound in his life. His first night in the trauma unit and we had five gunshot wound cases - one guy had 16 holes in his body.

While on call, the security guards supposedly protecting us have been beaten up by gangsters, the trauma unit has been surrounded by gangsters with guns and I've narrowly escaped assault by patients.

And if that's not enough. It is perfectly acceptable, after working a full day and night - NOT to be allowed to go home when the on-call shift ends. Oh no - it's law that you have to stay and see a certain amount of patients post-call before you go home.

Their thinking is that if you just went home, it would mean that you didn't actually work on the day post your call. Which is BULLSHIT as you actually already worked 7 hours of that day - from 00h00 to 07h00. Assholes.

How is this going to change? I don't know the answers - but it has something to do with making us feel valued. Pay us properly. Improve our working conditions. Give us a reason to stay here. Pump more money into education - so that we have a bigger pool of candidates to train to become health professional - thus alleviating the short-staffing.

Perhaps the fault lies with doctors themselves, who have allowed themselves to be mistreated for so long. Our dog's life is simply accepted as par for the course. Our way of coping is to put our heads down, and just get on with it. This is our normality. We don't know any better.

I'm very tired today. Last night's call was exhausting. And then I still had to deal with rude patients in the consulting rooms this morning. I had to restrain myself from shouting at them.

There - I've gotten all my moaning out my system. Will try make the next post entertaining. There were a few things from last night that stood out.

Have I mentioned that this blog is my catharsis? I figured it would be safer than being an alcoholic or drug addict. And certainly cheaper than therapy.