Dawn

It was bound to happen eventually, that I would be sitting here typing instead of in bed sleeping, when the four other precious hearts in the house are beating peacefully and making their little delicious snuffly sounds in their respective beds.
And I really don't mind.
It probably is the steroids, but it's also because I have Other Things to think about. And that is a wonderful thing.
Some of my thoughts are sad and anxious, because of life-changing events that other people close to me are currently going through, and I wish I could do more for them.
Some of my thoughts are excited and giddy, because we are planning a trip! on an airplane! out of the country! this week! to Legoland!!
I have just finished making really poor quality little cakey things for the school fair tomorrow.
I have been cleaning ballet shoes and writing names on cardigans for the big show tomorrow afternoon.
I have been plotting the downfall of a certain mobile phone network who have made the mistake of attempting to charge me five hundred euro to use my unlimited data contract to tether off my laptop for 2 hours while I had chemo this week.
I have been planning the Gratitude party that I have decided to throw in the summer. (Like Latitude. Get it? Mmmmm, might need some work...)

The sun has come up and I am grateful for another day.

And glad that my brain has room for the little things again.

I just couldn’t leave the cancer stories alone, could I

I am back at the Centre of Excellence. They gave me the radioactive stuff this time. 

No bloody superpowers!

I would demand my money back, but since the taxpayers paid for it I guess that would be rude. I don’t even want to know how much it costs. I am justifying it based on the amount of tax I’ve already paid in my life and the fact that when I’m better I’ll be back doing something relatively useful. I try not to think about how people who don’t pay tax or contribute to society can happily consume our free healthcare with an “I’n entitled” attitude. 

Oh I see, my superpower is being Jeremy Clarkson!! Cool!!

The stuff (oh all right then, make me spell it again. Yttrium. Ha!) arrived in an hilariously James Bond-esque perspex box with a tiny vial inside it. Two medical physicists had to be in the treatment room. To read out the instructions. Cue the “how many physicists does it take...” jokes. 

In another James Bond reference, there was a pointy gun thing aimed at my abdomen, a la Goldfinger. Thankfully no one said “No Mrs Chambers, we expect you to die”. That would have been in poor taste, I would have thought.

The microspheres have made their way down my hepatic artery and are currently radiating away in my tumours. I am radioactive within a half-metre radius and it decays fairly rapidly, with most of the radiation gone after five days or so. I have to sleep on my own and manage my children at arm's length. So I'm the Queen for a few days. Must get me a natty handbag, 

Afterwards, I was puking and in pain. Daniel Craig would be appalled. But it got better and I had a good day yesterday. Bad bout of pain again this morning though. That stuff must really be burning away brightly inside me. 

I'll be back in six weeks for the next round. More chemo in the meantime. Onwards and upwards. 

In Other News

At the moment I don’t feel like writing about cancer. Here’s something I wrote last week which will be of very little interest to non-GPs.

I went to a meeting organised by the National Association of General Practitioners last week. The government is hoping to introduce free GP care to all children under the age of 6, regardless of the family’s income. GPs don’t want this, for many reasons, but the main one being that it makes very little sense to pay for snotty rich kids to attend the doctor whenever they like, while others who are properly unwell but are a few euro over the income threshold for a medical card would have to pay to sit around in a waiting room full of snotty but well rich kids. 

The NAGP is trying to be a union for GPs, but it doesn’t have a negotiating license, and the Competition Authority says GPs can’t act collectively anyway, so we are not able to withdraw services or go on strike and the government can unilaterally impose new working conditions on us whenever they like. 

The Irish Medical Organisation is in negotiations with the Department of Health about this Under 6 contract. They do have a negotiating license but the Competition Authority rules still apply, so it’s a little bit unclear how much use they are as a union. They also managed to get rightly screwed by their last CEO, who sorted himself out with a 10 million euro pension and then did a runner. 

The HSE pays GPs to look after patients with a medical card. The average payment per patient is €11 per month, regardless of how many times the person attends the doctor. There are some other extra payments, if the patient requires a particular service like an ECG or a nebuliser. There are also separate payments for things like childhood vaccinations and smear tests. Overall these payments have been reduced by 48% since 2009. This is a reduction in the payments to the practice, not to the GP as an individual. This money is used to pay for premises, utilities, staff wages, equipment, insurance etc. It doesn’t take an economic genius to work out that if you reduce your income but your expenses remain the same, then your profit is wiped out. The profit is what the GP takes home. So now they take home very little. To minimise expenses, doctors no longer pay for a locum doctor to cover them when they go on holiday or need to take a day off. Instead their partners work twice as hard to cover their absence, but don’t get paid any extra. Doctors are taking on extra work at weekends or in the evenings in an attempt to maintain their income. So they work harder during the day, work longer hours and at weekends, get paid less, and take fewer holidays. Not a recipe for happy healthy workers. 

The government have also decided to encourage the Daily Mail bottom-feeders with their anti-doctor agenda, and regularly issue press releases about the latest fat-cat greedy doctor scam, like GPs claiming money for dead patients. These press releases fail to include the information that it is the HSE who gets notification of a person’s death, it is the HSE who authorises payments to GPs, and it is the HSE whose administrative staff have been shown time and again to be eye-poppingly incapable of joining dots. 

So anyway, I went to this meeting to see what we are going to do about all this carry on. (Individually obviously, not collectively.) I was disappointed with myself for being nervous about entering a room with seventy or so of my peers. I had that feeling that I would be whispered about, or that people would avoid me. So I arrived late, slipped in the back and kept my head down. But after a while I became more concerned about the pervasive feeling of misery around me. Everyone in the room seemed dejected, broken, disillusioned, worn out. A small bit of infighting and sniping started, but was thankfully quickly smoothed out. Afterwards, everyone seemed a bit flat. There seemed to be very little chit-chat or banter, people just filed out in ones or twos with no suggestion of a “pint after”. I have noticed this a lot with GP meetings, that there tends to be quite a bit of scurrying straight home when the meeting ends. I hate to say it, but I think it’s because of the increased number of women in the profession. It seems counterintuitive to suggest that women are less likely to talk to each other or be on for a natter, but it does seem to me that in these circumstances it is the men who pat each other on the back and go to the bar together. I suspect the women are heading home quickly to feed the cat, hang out the washing, get the lunches prepared for tomorrow and sign the homework. 

One of the people who stood up at the end said he was encouraged by the number of young and female GPs in the room. He was right, there was a lot of women there, mostly of my own age range +/- 10 years. And yet only two women spoke, out of maybe 15 or 20 contributors.

I took on the role of Chairman of the Cork City Faculty of the ICGP in September. I chaired two meetings then had to resign. I wasn’t very good at it anyway. But one of the main reasons I made myself do it was to encourage other “young” female GPs to stand up and be counted. 

I’ve really put them off now. Sticking your head above the parapet gives you cancer!

(I thought I wasn’t going to write about cancer. Oh well.)

Not Dead

I realise I should probably post here a bit more often.
In case anyone is interpreting my silence as my demise.

Though I am feeling a bit poorly after last night's karaoke...