Senior Trainee at Work, New Starter at Home!

Published: 21/06/2020
Dr David Cegielski

ST6 Anaesthetist

Recently my logbook has been quite an interesting read – diverse and full of emergency cases including some of the most acutely unwell surgical patients I’ve seen who’ve required post-operative level three care due to how deconditioned they were pre-operatively. I’ve also received some positive feedback from consultant colleagues for how I’ve handled these attentively and competently with only peripheral supervision. It’s a great feeling to finally be getting a winning formula in place, alongside the confidence to manage these cases independently. All this reaffirms that I’m putting my skill mix to good use and I can apply knowledge to a variety of situations because of my experience. Despite goings-on at home and at work, I seem to be doing this pleasantly and without showing too many signs of fatigue – perhaps after many years of adjusting to working days and nights, perhaps a fluke! However, while being a father to two children, sometimes I feel like I’m back on day one again. Some of this can be attributed to any career, but it’s especially relevant to our work in the NHS, given the current circumstances.

Appreciably, my daughter had a challenging start to life that frightened us all at home and, coupled with COVID-19, it has denied us all the opportunities, experiences and general harmony that family life brings. My wife has been nothing short of phenomenal throughout all of this, often having no support to raise two children for the best part of most days, yet still having the energy to get up at night too, when I’m working.

To establish a new routine when so much of it has been wiped out by lockdown measures, to balance potty training with cooking, cleaning and playing/teaching has meant a huge amount of self-sacrifice for which I am indebted to her and it has taught me so much more than I could believe about self-discipline. Caring for patients with COVID-19 or preventing exposure to it has been mentally exhausting for me, far more so than any laparotomy or septic vascular patient, but my wife’s incredible efforts take that to another level.

To me, many years of medical training prepare you for caring for the unwell patient. Ideas like fixing the ABCDE acronym of management in your mind, polishing it with past experience and finesse provided from consultant colleagues anecdotes, enable you to manage most situations to a point. However, on returning home at the end of my shift, the concentration I need to fully engage with my son and daughter is immensely more, mainly as I want to be a decent father, to provide that level of knowledge, insight and fun that they both deserve while trying to condense it into a short period of time before bedtime.

In essence, what I’m trying to say is that it feels like I’m overcompensating so much that it’s almost like I’m trying to exert my control. I know that has upset my wife a few times as she perceives her efforts during the day have been in vain, despite juggling a complicated situation of lockdown while ably managing to look after two young children. For that, I am incredibly sorry, and I have made it my prerogative to avoid bringing the ‘perfectionist’ work mind-set home and instead adopt the considerate father role. Asking sensitively and listening attentively to what my family have to say rather than exerting the control I like to have at work. 

It’s also been a massive challenge addressing some of the finer childcare issues. You think you’ve achieved something, then lockdown was imposed, distracted periods of attention from me and my wife and you feel like you've made a complete step back. I will openly admit my frustration and disappointment; I thought I’d failed as a dad and spent hours at night researching and looking for explanations like a diagnostician. But what’s important is that rules and patterns shouldn’t apply to your family, and you shouldn’t allow this to impact you as a parent. In these demanding times, everybody is simply working unbelievably hard in unprecedented circumstances. Whilst versatility and compassion with technical expertise are common themes, I’ve realised parenting requires tact, patience and most importantly passionate attention. Very useful attributes to bring to your personal life from medicine – just not a critically appraisal of who, what, where and why.

However, I must stress that I’m able to separate my work life from my home life, so that my wife and children have my undivided, non-medic attention so we can enjoy our times together when we have it. I would wholeheartedly recommend this to everybody. I feel this reflects well on me at work too, as it provides me with an incentive to be competent and diligent which enables me to get home to my family on time. It also helps me have the time and space to ask my colleagues how they are during these challenging times creating a more harmonious team ethic.

So, in summary and for future experience, it should never just be about a logbook, but the welfare of everybody that we share our experiences, frustrations and happiness with – both family and work colleagues alike. Otherwise, the internal resilience disappears, the morale drops and on returning home the gloominess may reflect on your family. Distancing yourself to a degree from work actually helps you the next day. It not just recharges the batteries through sleep, but also makes you more accommodating to the team around you so you learn more from their experience and are more open-minded to possibilities – a bit like child’s play, or being a new starter again.

David Cegielski