From Barclay’s to Blood Splashes

What do computer programmers have in common with hospital doctors? They both get asked for advice at parties, according to Dr Andrew Harrison, who has done both jobs. Following his Christmas IT wishlist for the NHS, Dr Harrison compares and contrasts hospital life with his previous role among the City slickers.

It was five and a half years ago that I decided to give up being a computer programmer for Barclay’s Capital in the City, and study to become a doctor. It was an incredibly difficult decision, and when making it I knew that it would be a long time before I could be confident of having made the right choice. After five months in the job, here are my thoughts.

Work

For me programming was like doing brain-teasers all day – solving logic problems. I could feel my brain being stretched to the full and it was satisfying to gradually work out the answers. It was even more satisfying that I was paid very well to do it. The downside was sitting in front of a computer screen all day.

My prime mental activity in medicine is reaching into my memory. Logical thinking helps, but it can only take a doctor part of the way as the human body contains many complex interacting systems, and textbook physiological models are never fully accurate. Faced with a collection of symptoms, the doctor must recall a list of possible causes, the set of relevant investigations and know the correct treatment based on these.

The other key cerebral skills are an ability to talk to all kinds of people, and some logical thinking for time management and prioritisation of jobs in an overstretched schedule.

So at the end of the day when I reflect on the tests that I have ordered, the forms I have filled in and the elderly patients that I have chatted to, I rarely feel that I have exercised my brain fully. On the other hand when I sat in front of a computer, I never heard people’s life stories, never witnessed courage in the face of illness, nor saw love and hope shared between families, nor indeed got splashed with blood and urine.

Sadly I am now paid £28,000/year for a 53-hour week, rather than the £40/hour I received as an IT contractor.

However I come home feeling satisfied because each day brings new situations, I learn more and I feel more confident than the day before. And many surgical patients spend only a few days in hospital, so when they leave there is a feeling of completion. IT projects usually lasted for months.

Environment

At Barclay’s I worked in a spectacular brand-new building; now I work in a grim concrete block. Personally I don’t mind this, but it must be very depressing for patients as they arrive. Ironically both buildings have a small group of smokers outside the front entrance. At Barclay’s they were smartly-dressed city slickers discussing their social lives; outside the hospital they are wheelchair-bound amputees wishing they had been able to kick the habit before they lost their limbs.

The buildings also smell very different. I am now used to corridors scented with disinfectant or urine, but I still hate the smell from some of the operating theatres where electric scalpels are used, which cut the skin by burning.

I never witnessed any heated arguments in the City though they must have occurred occasionally. In hospital I see one every couple of days – between members of staff. I think this must be due to a combination of emotion that is generated by trying to help sick people and the stress of working in an environment where all facilities are fully stretched. (Rarely are there more than one or two spare beds in the hospital so there is no slack in the system.) And of course another stress factor, which everyone has at the back of their mind, is a terrible fear of making a fatal mistake.

I once worked on a computer project where there was a test database and a live database. Before making any changes I always used to check and re-check mentally that I knew which one I was altering. However on one occasion, despite all my care, I managed to delete several important tables from the wrong one and crash the live system. I often think back to that day, knowing how much more serious a mistake could be now.

But there are relaxing times. When all the jobs are done, I can sit in the doctor’s mess with nothing to do except joke and chat with colleagues, until inevitably my bleep goes off again. As a programmer, there was always work to be done.

Personal Life

I certainly prefer telling people that I am a doctor. Saying that I was a computer programmer seemed to carry equal intellectual kudos but non-technical acquaintances would smirk at me for being a geek.

Now I am often asked for medical advice at parties – people told me this would happen – but it is no more often than I used to be asked for computer advice. Unfortunately people seem to expect answers to medical questions, without any examination or investigations, whereas they did not expect me to know the answer to their IT questions unless I was able to see their computer.

The most annoying part of being a doctor is having to work nights and weekends. I sometimes used to work long hours in the City, but I had far more control over when I did so.

In summary, I do not have to use my brain as hard as I used to and I am paid less for longer hours, but I do see far more of life. Overall I am very glad that I made the change.

Following his first article in E-Health Insider, Andrew was offered a Microsoft Tablet PC for a road test in the rough and tumble of a busy hospital. We’ll be publishing his review.