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Touch of pain from a career choice

They’re coming to check up on me, to make sure I’m not a danger to my patients.

I read it in the trust email bulletin. But I don’t have a tendency to violence, I’m virtually teetotal, and I have no substance addictions, unless you count chocolate.

The problem is that I suffer from eczema, and infection control are coming to our department next week. Sometimes things are fine, not really a problem at all, but at the moment, while the rest of me is pretty much normal, my hands are shredded with fissures.

I wince as I rub in a blob of alcohol gel, waving my hands frantically in a bid to make the stinging subside. I screw my eyes up tightly. Lemon juice into a paper cut. As I curl my fingers around my biro, a crack opens up in one of my knuckles, the fissure now delineated with a narrow crimson line. I cover the bleeding with a plaster, and put on gloves to examine my next patient. It’s not because I don’t want to touch them. Just that I don’t want them to have to touch me.

If I am completely honest with myself, a career decision made half a lifetime ago was probably the wrong one, but it’s hard to give up on a career like medicine.

As a teenager I received no career counselling, no one suggested that constant hand-washing, daily exposure to irritant substances, and dozens of potential contact allergens might make medicine an unsuitable choice.

Our family GP, aware of my medical history, gave me advice and encouragement, and made suggestions as to where I should apply. But that was in the days when house officers still wore white coats. No one was bare below the elbows. It was also before MRSA became famous in the Daily Mail.

Perhaps I should have done psychiatry or public health, specialties with minimal or no physical contact with patients. But I didn’t want to be a psychiatrist and, and by the time I thought of public health my CV was so tailored towards a completely different specialty it would have meant starting from scratch.

The problem of hand dermatitis among healthcare workers is widespread. Those affected should be provided with a combination of occupational health and dermatology advice, emollients and the least irritant substances for hand-washing.

But ultimately, sensitive, realistic career counselling for sixth formers, medical students and new doctors would also enable individuals to make pragmatic choices about their future careers.

Melody Clarke is a specialty trainee

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