Emergency doctor in La Casamance

Why did you choose this profession? What attracted you to this profession?

I don't know, why did I choose it? Because it gives meaning to my life, I think, probably.

What is your educational background?

I trained as a general practitioner. I first worked in a town practice for about ten years, and then for personal reasons (linked to my husband's work), I moved house and then came here because I wanted a change of activity. What interested me was working in a hospital environment again.

As far as my training is concerned, I trained as a general practitioner. I don't have a DU in emergency medicine or a DU in rehabilitation. However, I am currently training in pain medicine.

Does this correspond to the idea you had of the profession?

When you're 16 or 18 it's hard to have a vision of a profession. I don't come from a background where my parents were doctors, so I didn't really know what to expect and I didn't have any idea of what it was really like.

What are your main responsibilities and activities in the emergency department? In the hospital?

In the emergency department, I work 12-hour shifts and there are 2 of us doctors at the same time taking on all patients, so we don't have any predefined specialities and we don't divide patients up by diagnosis. We take patients as they come in, whether it's trauma, medicine, cardio or abdominal pain, or a neurological problem.

At the same time, I work half the time in the follow-up care and rehabilitation department. I'm one of the department's general practitioners. I look after certain patients who are so-called polyvalent medicine patients, and we also give our general medical opinion on all hospitalised patients under the responsibility of the rehabilitation doctor. I don't interfere at all in his rehabilitation care.

What is your day-to-day life like as an emergency doctor?

That's the funny thing about being an emergency doctor: you don't actually have a daily routine. One day is different from the next. Sometimes you're swamped with work, and then there are quiet hours when you can have a coffee. From one day to the next you can't know in advance whether it's going to be quiet or not, what you're going to have. You can't predict anything.

That's why it's nice, you don't know what to expect. Sometimes you have good problems and sometimes things go well.

In which situations do you encounter difficulties? What's the most difficult thing about this job on a day-to-day basis?

What's difficult is the fact that work is very irregular and that in busy periods you're in demand everywhere: from families, from departments that need help and want information, when you're on your own. Yes, in busy times it's not easy at all. It's difficult because there's no room for error.

The families are quite demanding, not all of them necessarily. Fortunately there are some nice families, but on the whole they're demanding. They don't understand. We make them wait in the waiting room because otherwise it's impossible to manage them in the emergency department. We can't work if the families are there, but they're not happy about waiting outside.

On the one hand, there's no room for them, because there are two patients per cubicle, so bringing in families is out of the question. In terms of confidentiality, that's not possible either. Secondly, because it's unmanageable; the families would keep calling us. We can't, we don't have the time. We come in regularly to check up on the families in the waiting room, but we can't do more than that.

The nurses, if they can, will reassure the families; if they can't, we can do it without any problems. For example, if the nurse tells me that she doesn't really feel it or doesn't really know what to say, we'll go ahead, there's no problem. It's true that the first hurdle is the reception nurse. She acts as a buffer as best she can.

What are the positive aspects of this job?

Teamwork, being together, you're never alone. You're overloaded but you're never alone. So that's great. If you have a real problem, a real case of conscience where you don't really know, you always have someone to ask. That's very important. For doctors who work the night shift, the activity is a little less sustained because there are fewer admissions, but they are on their own. That's hard, especially as they're in such high demand from the inpatient departments. They have all the emergency patients to deal with, knowing that they have no other doctors and only one nurse and one care assistant.

In your opinion, what are the essential qualities of a good emergency doctor?

To be concise, to be quick and also to be human, otherwise it won't work. One of the faults of emergency doctors is that they are perhaps not very human. They want to be too technical and less empathetic. We still need to be a bit empathetic, especially with families, otherwise it's not easy. But above all you have to be pragmatic. You can't get bogged down in details that don't interest you at the time. After that, if patients need to be looked at in more detail, we don't do it in emergency. They are admitted to hospital for comprehensive care. In emergency, we see what they've come for. We don't necessarily look for anything else. We manage the acute problem and if we realise that there are other concerns that require more long-term care, we admit them to hospital. If we start doing more general medicine as soon as we get to A&E, we won't be able to cope.

In the emergency department, there is a short circuit and a long circuit. The short circuit is what we call "bobology", minor traumas, minor general medical consultations that could have been done in a surgery. People don't usually stay long. Then there's the long circuit, which requires more comprehensive care.

How do you manage your stress?

I think that's what we're used to: you're either stressed or you're not. To work in emergency and enjoy it, you can't be too stressed or too anxious, otherwise you can't do it. You have to have a cooler temperament. You can't be afraid of being pushed around a bit. If you like everything to be straightforward, you shouldn't work in an emergency department.

What situations give you satisfaction?

From a purely medical point of view: making a good diagnosis. People come in, we don't know what's wrong with them and they leave with a good diagnosis. We'll tell them we've done a good job and they'll be pleased with us.

Otherwise, most of the time it's recognition, either from the patient or their family. When you get thanks and you feel that it's sincere, you tell yourself that it was worth it.

Would you advise your children to take up this profession?

Yes, I love my job, but it's not easy every day.

Where do you see yourself in 10 years' time?

I don't really know. I've only been here a short time, so I don't really want to move now. But I don't know how long I'll last at this pace.

What are the differences and similarities between TV series and reality?

I've never watched any TV series. I don't know.

After asking Dr RAHOU about this last question, he replied that TV series were the antithesis of reality.