Light at end of the tunnel

Dear Friend,

Happy Sunday to you all. For the first time in ages, we finally got to see some sunshine this week. It is really important in the winter months to get outside and see light, it can have a big effect on your energy and mood levels. 

Over the course of this week, I noticed something strange. I had been on back-to-back weekend shifts, with night shifts beforehand. Not only this, at the moment, I am also juggling applying to specialty training, writing my second book as well as all trying to maintain gym, social life etc. I went through similar experiences last year and the year before that – and more often than not, in such a busy period, it would start affecting my sleep and my mood. I would start thinking very negatively and take it out on those around me. 

However, for some reason this time, that has not happened. Yes I am still pretty exhausted, and some days when I come back from work I just crash out completely. Yet, those around me have commented that on the whole my mood is a lot better. 

And over the weekend I realised why this is the case. I think, for the first time in about 4 years, I can finally start to see flickers of light at the end of the tunnel. I know that in 8 months (hopefully), my time as an SHO will be over. That means goodbye to the medicine rota, 1-in-3 weekends, A&E shifts, medicine ward cover etc. It’s a lot easier to get through when you know that there is an end-date in sight. 

It’s also a bit of an exciting time. Next week, I have my oncology ACF interview. Similarly, once I get my job confirmed, I’ll then be able to start looking for a permanent house – in essence growing up. I guess it’s like that feeling when you are in the final year of university and ready to break out into the real world. 

So my message this week, is that for everyone going through a tough time, whether that be at university or working as a junior doctor – there is an end. And, when you start getting a glimpse of your goal in the end, it makes it much easier. The key is to not lose sight of your end goal. Of course, I could not get my job and things might not go as planned – but for now at least, I’ll just keep my fingers crossed and power on through. 

Have a lovely week. Wrap up warm, I hear it’s going to be a very cold one.

I was looking for quotes, and this one really caught my eye. 

Drug of the week

Nystatin

This has a similar mechanism of action to amphotericin B, allowing it to forming pores in the fungal cell membrane.

It binds to ergosterol, a major component of the fungal cell membrane. When present in sufficient concentrations, it forms pores in the membrane that lead to K+ leakage, acidification, and death of the fungus

It is toxic, so reserved for topical treatments (e.g., for oral thrush as a mouthwash). 

Common side effects when applied to the skin include burning, itching, and a rash

A Brain Teaser

The police bring in a 39-year-old male with schizophrenia, who was being brought to the hospital under Section 136 of the Mental Health Act when he ate a boiled sweet and sadly choked and died. He last saw a psychiatrist 10 days previously.

Which factor in this case would require it to be reported to the coroner?

A: Diagnosis of schizophrenia

B: Under the age of 65 years old 

C: Being in police custody at time of death

D: Having not seen a doctor in the last 7 days 

E: Death outside a hospital environment