Disclaimer

No patients were identified, no confidential details were harmed in the making of this blog, and any clinical references have been kept deliberately broad enough to keep both professional standards and my blood pressure intact. Some details of clinical situations have been intentionally altered to preserve patient anonymity in accordance with NMC professional guidance.

Last week had a very particular pre-Easter energy to it. Not quite festive. Not quite restful. More that familiar NHS seasonal mood of, “Let us just get through this week in one piece and then perhaps consume chocolate with the intensity of people who have earned it.”

There were changes straight away. New postgraduate doctors started in surgery, as the previous four-month block came to an end and the next one began on 1 April. April Fools’ Day, incidentally, feels like an unnecessarily on-the-nose date for rotational changeover. If one were designing the NHS for comic effect, one might choose exactly that date. Fresh faces, fresh enthusiasm, fresh logins that may or may not work, and the annual reminder that nothing says spring quite like teaching people where things are, how things work, and why surgery occasionally appears to function on a mixture of clinical judgement and sheer determination.

Monday was unusual for me because I took a rare day off. My usual day off is a Thursday, which means taking a Monday off felt slightly rebellious, like moving a bishop in a straight line just to see what happens. The reason, however, was far more sensible: my wife had an appointment in Bristol relating to her British citizenship application, and she asked whether I wanted to come along. There are some questions in life that do not require reflection. So off we went.

In a small but entirely predictable twist, I was not actually allowed into the relevant offices and instead remained in the lobby. So while my wife was dealing with something mildly life-changing and important, I became a temporary decorative feature in a waiting area. Still, the appointment was quick, efficient and left us with a rare luxury: unexpected spare time in Bristol.

Naturally this meant food.

We ended up at Cabot Circus and tried a Korean food place we had not been to before. Very good food. Very tasty. Very, very spicy. This was not helped by the fact that neither of us had paid proper attention to the tiny chilli symbols next to the dishes. Those little icons, it turns out, are not there as a design flourish. They are not for atmosphere. They are a warning. A kind of culinary traffic-light system which we both ignored with quiet confidence and then paid for in full. Excellent meal, though. Just one that briefly made lunch feel like a competitive endurance event.

After that small excursion into citizenship administration and accidental chilli warfare, it was back to work for the rest of the week. My wife was off on Wednesday and Thursday, but worked today and tomorrow, while I carried on through the surgical week knowing that an Easter break was finally visible on the horizon. A proper one too: next week we are off to Cornwall.

That knowledge alone can carry a person surprisingly far through a difficult week.

Our son, meanwhile, had a fairly relaxed run into the end of term. His house won the term’s competition, which meant on Monday he was allowed into school without uniform. Always a major event in primary school life.

Few things generate more excitement than the chance to dress “normally” in an environment where that is usually forbidden. Tuesday involved a farm visit, which I suspect was significantly more enjoyable than anything involving handwriting practice, and Wednesday, his final day before the Easter holidays, sounded gloriously low-effort. Not doing much at school is sometimes exactly what is required.

Tennis training still made its usual appearance on Wednesday and again yesterday before the Easter break. Happily, there is now a short pause from competition and training for a couple of weeks. This feels wise.

Even highly committed small people occasionally benefit from not being marched relentlessly from one organised activity to another like miniature professional athletes with questionable agents. That said, I have already noticed that my wife has entered our son into a tennis tournament for the weekend after next, so the phrase “couple of weeks off” should probably be understood in the broadest and most imaginative sense possible.

Work itself was challenging in two fairly classic ways. First, new Foundation 1 doctors starting in surgery. Second, genuinely sick patients doing what genuinely sick patients tend to do in hospital, namely requiring timely assessment, decision-making and a level of senior input that occasionally takes a little persuasion to secure.

Both Wednesday and Thursday ended with me leaving late because I wanted to make sure patients were sorted appropriately by the surgical on-call team. Challenging, yes, but in truth also fairly straightforward once the right senior-level discussion happened. That is often the key. Sometimes the difficult part is not identifying that something needs doing. Sometimes the difficult part is getting the conversation to land properly, with the right emphasis, at the right level, in a way that convinces someone this needs attention now rather than at some vague point in the theoretical future.

It can be tedious at times having those discussions with senior members of teams when they are not immediately persuaded by your presentation of the patient.

I suppose a lot depends on how the case is framed, what concerns are highlighted, and whether the urgency is made sufficiently clear without sounding like one has simply decided to develop a personality made entirely of escalation.

Fortunately, in both of these situations, the case was made well, the patients were reviewed more or less straight away, and things moved on quickly from there. Which is, really, what you want. No drama for the sake of it. Just the right decision, at the right time.

There was also a genuinely excellent moment in the week: we opened a new surgical multicentre trial and managed to recruit patients almost immediately. In fact, within 30 minutes of opening the trial at Musgrove, we had recruited a patient.

That is superb work from the team. Efficient, collaborative, and exactly the sort of thing that reminds you that even in a busy week full of operational challenges, there are still these bright little moments where everyone quietly gets on with being very good at what they do.

By yesterday, with the main week done, I headed home knowing I was now off until 13 April for a well-earned Easter break.

Admittedly, I have agreed to do a half-day locum shift on Sunday morning into early afternoon, which should be manageable and will no doubt add just the right amount of last-minute chaos before holiday packing. Still, compared with a full working week, it feels entirely survivable.

And then: Cornwall.

Cornwall, where the pace is slower, the scenery is better, and the weather may or may not decide to behave like weather at all. It rarely matters.

Even when Cornwall is wet, windy and looking mildly offended by your presence, it still usually offers enough to do to make it worthwhile. At the very least, one can stare moodily at the sea, buy something overpriced but pleasant from a bakery, and call it recovery.

So with that in mind, this will be the last update until we are back from holiday.

An Easter pause, a temporary break from hospital routines, school runs, tennis training and all the rest of it.

Or at least that is the official version. The unofficial version, as already noted, includes a tennis tournament appearing suspiciously soon after our return.

Naturally.

Because in this household, “rest” is often just another word for “slightly different logistics.”

HAPPY EASTER