Ramrakha Punit - Oxford Handbook of Acute Medicine

The most important person you ever encounter in the hospital is the patient. They are often frightened, and following admission to hospital, they have little say over what happens to them. You need to give some control back to the patient. To do this, they need information from you as to their possible diagnoses and what might happen to them, and they need to be given space to express their views.

Listening to your patient is the most important thing you can do. Some doctors have this skill, and others do not. If in doubt as to what is wrong with your patient, fall still and just listen to the patient. The diagnosis often becomes obvious if you listen.

You are the front piece of your hospital. Take pride in where you work, and give your best. If you see someone lost, you should direct them or, better still, show them the way.

One of the most gratifying aspects of medicine is talking to your patients and their relatives. If you are on call in the evenings, try and take time to talk to the patient and their relatives. Try and avoid situations where you are separated from the patient while talking to relatives, as this can set up distrust where none existed before. Our advice is to be honest, acknowledging doubt when doubt exists, and accept that we can only do what we can do.

We all have to accept that we will die at some point. With media hype over the years, it has become almost standard practice to try and eke every last ounce of life out of lives that have stopped living. One has to accept that there is a point when it is important to allow a patient to die with dignity. Do not let process and false duty go beyond what is right and dignified for your patient.

As a junior doctor, you will be frequently asked about results or investigations by the consultant or registrar. If you do not know, it is much better to be honest and just say, rather than make up a result which is wrong. This is obvious, but it is important, since wrong information can lead to harm.

Many junior doctors agonize over career choices in medicine. There is a place for everyone, and it is important to find the area of medicine that you enjoy and can use and maximize your talents. When making this choice, it is important that you listen to your heart.

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Punit S. Ramrakha and Kevin P. Moore 1997, 2004, 2010, 2019

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First edition published 1997
Second edition published 2004
Third edition published 2010
Fourth edition published 2019

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Library of Congress Control Number: 2018941855

ISBN 9780198797425

eISBN 9780192523822