Life, by rodedun.

The musings of a complicated human being.

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Resilience – a term used so widely in the medical literature at present; have we become resistant to its meaning?

Looking up the definition of resilience in a dictionary, you will find “the capacity to recover quickly from difficulties; toughness”. You also get “the capability of a strained body to recover its size and shape after deformation caused especially by compressive stress.”

This term particularly evokes the image of multiple hardships causing the eventual casualty, otherwise known colloquially as ‘the straw that broke the camel’s back’.

So, how do we recover our shape after multiple knockdowns?

Recent events have affected the hope & morale of our profession. The Bawa-Garba case has particularly resonated with paediatric trainees. Many of us identify with the scenario of holding multiple bleeps and being inundated with jobs seemingly out of our control. Recruitment for paediatrics is struggling given that increasing numbers of foundation year 2 doctors are opting to take time out before choosing their specialty, with the additional strain of more paediatric trainees leaving before CCT for various reasons. As per the 2017 State of Child Health Report, general paediatric and neonatal rotas are currently experiencing an average vacancy rate of 14%. Community paediatrics trainees are starting to identify as the new ‘Lost Tribe’ of this decade, with vacancies variable across the country, but widely, ours is the least filled subspecialty across the board.

I look to categorize factors affecting resilience as fixed and flexible; some contributors are debatable. For example, rota gaps and winter pressures for those who cover the acute medical rotas are a fixed inevitability which become increasingly profound year on year. Exams tend to be another fixed factor; postgraduate studies, along with fulfilling clinical duties, reclaiming social life and other commitments can often take their toll on the hardiest of professionals. I view flexible factors as those that are fluid and dependent on the individual – sometimes change of personal circumstances including pregnancy, a house move, a bereavement, a difficult commute. Often, the ability to show resilience is determined by the ratio of fixed to flexible factors, along with other influences such as general wellbeing. It is important to improve personal health to address flexible factors, and to work as a team to try and address fixed factors that affect so many of us.

One of the ways that we can help to improve resilience in addressing flexible factors is by talking to each other and providing peer support. As one of the new BACCH National Trainee Reps, we encourage networking and discussion; at our Trainees Day, we will be holding a workshop on ‘surviving and thriving’ as led by the wonderful Dr Ellie Nash, GP registrar.

One of the recurring comments by trainees in community paediatrics is that they can sometimes feel disconnected from their peers. We can feel alone and alienated from those often going through similar experiences. Some deaneries have already established close connections for their community trainees; for those who don’t ‘know their neighbour’, we propose that you take a moment to think about how you interact with your peers. We will be actively instigating this to encourage networking on a personal level. Instead of offering a cupful of sugar, perhaps we could start by meeting to discuss not just the usual woes of ePortfolio and ARCP – but, maybe start with – how are you doing…can we help each other?


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Is Natural Hair Unprofessional?

This week was a milestone for me.

This week, for the first time ever, I wore my hair to work in its natural, curly state.

Don’t get me wrong, I’ve been TO work with the afro out, but only as a visitor, not actually working on the shop floor. It’s either been straight, or tied back into a messy, curly, afro bun.

My hair has a confused identity because of the common perception that natural hair is not professional.

As a doctor, from an infection control perspective, I would normally tie my hair back, particularly if working on a neonatal unit, but currently, the freedom of working in a job with a significant proportion based in outpatient clinics has led me to wonder what I’ve been so afraid of in wearing my curls free.

My Hair Story


As a young girl, I was styled by my parents in a simple and ambiguous Afro, with only my clothes a clue as to my gender.


At school, those pesky kinks were moulded into a schoolgirl plait cum bunch affair and adorned by a non offensive ribbon.


At the age of 11, I was finally allowed to conform to my mainly Caucasian peers’ style by relaxing my hair. This led to years of chemical damage.


At university, I came up with the idea of shaving off all my hair, solving the problem of the damaged hair, whilst raising money for Macmillan Cancer. The planning was meticulate; I did this in my BSc year, for fear of the backlash of this renegade do whilst doing clinical medicine attachments in a hospital setting.


Well, I’d gotten this far and I was never ging to be this crazy again, so I decided to dye my stubble blonde.


I even got to do a bit of modelling with my natural hair, although, still in 2009, this was not the mainstream thing to do.


I played around with hairstyles – from simple cornrows, to a lighter tone pick and drop braid style, to an all out brown weave as a treat…

..To the present day work looks – straight hair styled into a simple bun, or the messier, Afro bun version…

In The Media

For many years, persons of colour have conformed to the Caucasian stereotype of straightening their unruly hair into manicured, relaxed dos and weaves. But recently, there has been a wave of non conformism, a wave of noveau natural hair sweeping the United States of America. And that wave has arrived in the United Kingdom.

There are loads of articles sweeping about on natural hair and its acceptance in the workplace:

And yet. how does that affect me? Why do I feel so self conscious about my hair?

I’m sure you’ve read about the story of the person who Googled ‘unprofessional hairstyles’ to see an array of Afros and other natural hairstyles, compared with the search for ‘professional hairstyles’ encompassing many straight, Caucasian dos.

What does it say, in this day and age, where an educated person is afraid to wear their hair in the way that it naturally falls? And more importantly, what message does this send out to youths about the link between our natural selves and our projected image?

So what happened when I went to work?
I held my curly head high and took a deep breath.


(yes, this is what a real doctor looks like, under eye bags and all)

And was met with a barrage of ‘your hair looks AMAZING!’ ‘Never seen your hair like that before!’

And my answer, at least in my head, is that I still don’t like my hair.

I don’t like the way that the curls are never perfectly defined.

I don’t like the way that if I sleep on it, my curls are immediately squashed out of place.

I don’t like the fact that I have to cover it in product to make it look ‘presentable’.

And then I realised something – maybe it’s not just teenage girls who are guilty of looking at Instagram, comparing themselves to idealised versions of other people.

But I’m still saving up for a trip to Errol Douglas or Charlotte Mensah…and that’s ok, as long as I can realise that my hair is beautiful in it’s own way too.

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‘Presenteeism’ in the NHS and other healthcare systems

It’s been a while since I last wrote as I’ve been busy with other projects, but something that caught my eye was an American article sent to me by my brother on ‘presenteeism‘, a subject which I feel quite strongly about.

It was only recently that I had a scenario in which I worked 12 hour shifts over a weekend and was due to have a ‘rest’ day on the Monday. However, due to our team being ‘post take’ (ie. inheriting the patients admitted over the weekend) and our staff grade being on call on the Monday, I was asked to come in on my day off, and reschedule my rest day. What happened was that, due to the combination of working long days over the weekend and already running my immune system into the ground with revision for an impending exam, by Sunday I was unwell. I trundled through the day, but woke up on Monday morning unable to breathe through my nose, nursing a cracking headache and general muscle ache. I considered soldiering through with paracetamol and ibuprofen… but then stopped and realised I had a duty to look after myself.

I rang work and called in sick.

I spent the morning in bed, watching daytime television, with alternating thoughts of how little Andi Peters has aged over the years, to feeling guilty about abandoning my team on a busy day, to self ridicule about feeling guilty for taking a day off when I was due to have one anyway.

Medics are notoriously bad at looking after ourselves; we take pride in popping pills just so we can slog through yet another 12 day stretch of unforgiving and emotionally arduous work, not counting the overtime. It’s a challenge many healthcare professionals have to face when not 100% fit; a bad cold is probably not enough to send someone home from work, but it is an infection risk, especially when looking after vulnerable populations such as the immunocompromised. However, if we all went off sick every time we had a bad cold, the economic cost to the NHS would be insurmountable.

And this is merely for physical symptoms; given the stress of the job, there are many, many people who go to work with mental health problems who, it could be argued, are not fit to work, but do not want to burden their employers, or indeed inconvenience their patients. This is known as ‘moral obligation.

One of the well known policies in most hospitals is that, at the risk of spreading infection, healthcare workers are asked to stay away from work for 48 hours after an episode of diarrhoea and vomiting, or ‘D&V’ as it is more fondly known. But absenteeism for other health issues is a much less clearly defined subject.

This article from Medscape defines ‘presenteeism’ as workers being on the job but, because of illness or other medical conditions, not fully functioning.”

Not being fully functioning in a job in the healthcare system can cause problems ranging from inefficient time management to, in more serious cases, drug errors and other mistakes. For some reason, this is something that we, as a workforce, do not seem to take as seriously as it should be. Having said this, I have noticed in personal practice that there is a difference between nursing staff and doctors. It is much more common for nurses to be sent home from work by their seniors than it is for doctors. Is this because they have more of a hierarchical presence on the ward in that their ‘off duty’ co-ordinator is often present on the ward itself? Compare this with the doctors, whose rota manager is often a non clinical person working in a completely different department and not available out of hours.

An interesting point in this article is that when doctors are off sick, apart from the rare occasions when a locum can be employed at short notice, the remaining workforce are expected to take up the extra work in addition to their usual tasks.

“Most healthcare settings have no mechanism for what to do when a doctor suddenly can’t come to work. There is no coverage—no substitute doctor. Everyone just assumes some of the sick physician’s workload. It’s the way that physicians have always handled it, but it makes the sick physician feel guilty about not coming to work.”

This can be challenging physically and mentally. Nurses often have a maximum ratio of nurse to patients that is deemed safe; staffing numbers are checked at least once a shift in many place where I have worked. This is in contrast to doctors, where in a big hospital, there can be little communication of doctor staffing numbers between wards, A&E departments and higher care facilities. Indeed, I have worked on shift where the doctor staffing was at 50% below normal, with an expectation that one would just get on with it.

The physical and mental health of healthcare workers is often the elephant in the room. I’m sure that, after that weekend, I could have taken some analgesia, lived off hot drinks and soups, and suffered through the day. But the reality is that I would have been a distraction to others; the care I would have given would have been less than 100%, and I would probably have felt more unwell, needing to take more time off than the 24 hours that I rested in the end.

It should be that our employers need to think of some better policies for sick day cover. But perhaps we, as healthcare workers, should also take more responsibility about our physical and mental well being in relation to the care that we can provide for our patients.

Thoughts on presenteeism and the above article welcome.

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My Top Twenty One YouTube Videos Of All Time

Because twenty just wasn’t enough.

Always good for a bit of random procrastination.

21. Stupid Americans.

We love them really, but boy, are they thick. And the Australians LOVE IT.

“Name a country beginning with ‘U'” –   oh dear.

20. Dancing Queen.

The way this lady spends her time waiting for the bus makes us cringe.. but it’s also frickin’ HILARIOUS.

19. Wedding Dance

Before Chris Brown became a faux pas in himself, his popularity was somewhat boosted by this feel-good video of the wedding party entrance to his song ‘Forever’. Through this, the happy couple managed to raise over $50, 000 for the Sheila Wellstone Foundation, which works to end domestic violence. Good on them!

18. Keith Lemon Meets Fabio.

Before Keith Lemon aka. Leigh Francis saturated our TV screens completely, we actually found him funny. This clip is from his world tour, kicking off in the USA. Here, he meets the male model Fabio and attempts to persuade him into his ‘securi-pole’ business. Awkward.

17. Cereal Girl.

A golden oldie before the dawn of the YouTube generation. A Sesame Street classic parody of ‘Material Girl’ by Madonna.

16. ‘Single Ladies’ Dancing Baby

There are too many YouTube videos of dancing babies and animals. But this is the creme de la creme of them all. Several of Beyoncé’s backing dancers were sacked to make way for this superstar in her next video*.

*this is not actually true.

15. Gas Pump Karaoke.

Featured on the Jay Leno show in America, this video went viral until the backlash revealed it was actually a set-up. Still hilarious in my opinion.

(Sorry, unable to embed)

14. My Humps

The overtly sexual ‘My Humps’ by The Black Eyed Peas was hilariously turned on its head when the sarky Alanis Morissette covered this in a more laid back fashion. Fergie was said to have loved the cover and sent a cake to the Canadian singer in the shape of a bottom.

13. Here It Goes Again

Not a paraody, but one of the best music videos of the century. Simple choreography and the use of six treadmills in unison led the OK Go rise in popularity to a whole lotta gym injuries (probably).

12. Evolution Of Dance

One of the most watched YouTube videos of all time, this catapulted Judson Laipply into the big time with over 274 million views.

11. Newport State Of Mind

Jay-Z was reportedly unimpressed with this parody of his 2009 hit. So were Goldie Lookin’ Chain, who were upset that someone had out-Walesd them. I think it’s amusing.

10. The SuperBass Girls.

Entertaining with a strong suspicion of Pushy Mum syndrome. Sophia Grace Brownlee and her bemused sidekick cousin were a YouTube sensation covering the somewhat inappropriate-for-young-girls-song ‘SuperBass’..

Catch their appearance on the Ellen DeGeneres show where they met Nicki Minaj here:

9. Being A Dickhead’s Cool

To the ire of those skinny jeans adorned, fake black rimmed glasses wearing men, this YouTube video became huge. And really, it’s an excellent guide to East London.

8. Walk Off The Earth

This parody band really hit the big time with a cover of ‘Somebody That I Used To Know’ by Gotye & Kimbra, featuring all five members of the band playing one acoustic guitar. Clever. 

7. Evolution of Beyoncé

Pentatonix are famous for their covers and ‘Evolution Of’ series but they really hit gold with the back catalogue of the former Destiny’s Child. A true auditory treat.

My fave is the guy in the checked shirt – what a range!!!

6. I’m F**cking Matt Damon

Another American chat show classic. Jimmy Kimmel was well known for his continued fun-making of Matt Damon. However, the Bourne Identity star got his own back by creating this chuckleworthy video with Kimmel’s comedienne girlfriend of the time, Sarah Silverman.

The reply video which Kimmel made with Damon’s BFF Ben Affleck and a star cast is here:

5. Bed Intruder Song

He became famous when this American TV News report went viral, and finally Antoine Dodson was able to escape the projects with the help of AutoTune (and The Gregory Brothers).

See the original news report here:

4. I Wanna Channing All Over Your Tatum

A promo appearance on the Jimmy Kimmel show for the stars of the movie ‘White House Down’ had the audience in tears when the talented Jamie Foxx hit the piano with dancing accompaniment by Channing Tatum. Sadly, the official version of the song, featuring the infamous Miley Cyrus, was less of a classic.

3. Where’s The Chapstick?

Probably one of the most random videos on YouTube, its simplicity captured the hearts of all the dry lipped people in the world.

2. Ant & Dec ‘Opposites Attract’

Back in the medieval times when Simon Cowell hadn’t completely ruined the music industry, and there had only been one series of (UK) Pop Idol, cheeky Toon Chappies Ant & Dec decided to rumble the media mogul for an episode of their hit TV show ‘Saturday Night Takeaway’. The confusion on Paula Abdul’s face as they murder her hit song is wonderful.

1. Motherlover

The combination of The Lonely Island with America’s favourite ex-boybander was to start a long and fruitful relationship between Justin Timberlake and chat show parodies. It started off with the SNL short ‘Dick In A Box’ featured here:

However, the stand out video was the sequel, ‘Motherlover’ with a cameo appearance by Susan Sarandon. A blissful mix of 90’s cheesy R&B and outrageous sentiments, it soon became one of the most viewed SNL shorts ever.

This was followed by ‘3-Way (The Golden Rule)’ featuring a back-to-her-roots Lady Gaga, which sadly fell flat of its predecessor:

If you like this sort of thing, may I highly recommend other Lonely Island Classics such as ‘Jizz In My Pants (also with Justin Timberlake) and the inmitable ‘Shy Ronnie 2’ (featuring Rihanna, here:

So there you have it. Feel free to comment, although if it’s just to say “Well XXX should be on the list” – it shouldn’t, because these are MY favourites.