On your bike: A day in the life of Paul McCoubrie

2023 04 19 22 46 6303 2023 04 25 Paul Mc Coubrie On Bike 20230419221818

My day begins slowly. The alarm is set to a gentle piano-based theme to coax me out of my twitching stage IV REM sleep. With a 25-hour body clock, I am ill-suited to early mornings. Well, mornings full stop, really. A lark I am not.

My first act is to grunt morning greetings to family members. They aren't morning people either; their greetings are similarly guttural. I then scratch the cat and feed him as otherwise he'd bother me endlessly until he's fed and scratched.

A double espresso kickstarts my brain before I sling some black pudding around the pan with a few mushrooms. I find a pork-based breakfast a balm to my reluctantly waking body.

Dr. Paul McCoubrie arrives at work on his bike.Dr. Paul McCoubrie arrives at work on his bike.

I've always cycled to work; it's a complete no-brainer, as you exercise while you commute. On entering the radiology department shortly after 9 a.m., I enter professional mode. Irrespective of my inner mood, I deliberately exude a bright and cheery air. I smile, even if I secretly would like slit throats.

How you conduct yourself is crucial, especially as I am one of the older consultants (senior doctors). It sets the tone for others. Ranting about the iniquities of clinicians and laboriously detailing your burnout helps no one. You feel more miserable and induce the same in others. Smiling, kindness, and making light of issues makes you and others feel better about the world.

I work in one of the newest hospitals in the country. Its light and airy design aids and abets a light and airy mood. With over 50 consultants and 20-odd registrars (fully qualified junior doctors), we're also one of the biggest U.K. radiology departments. But despite our size, we've long prided ourselves on being friendly and supportive. Relationships with our clinicians are therefore good. We have their back and they have ours. It is so important in these straitened times that a radiologist can walk down a hospital corridor without the fear of a metaphorical dagger in the back.

Given that my neocortex doesn't kick in until around 10 a.m., I usually start my day with something light requiring only the basal ganglia, like a brace of films from general practitioners or some vetting. Once the grey matter is fully firing, I'll turn to the serious stuff.

If it isn't a multidisciplinary team meeting day, I have a sweeper role that involves hunting the murky depths of various worklists, mopping up difficult scans that others have passed over, and making sure that studies don't get forgotten about.

Good coffee and colleagues

More coffee is required between 11 and 12. A cafetière of good light roast Ethiopian or similar helps punctuate the thoughts and fuel the reports. I usually try to catch a colleague or two, spending five or 10 minutes catching up. It's a vital act. Whether you call it checking in on mental health, in-house continuing professional development, mentoring, or just being friendly, it's an important part of being a good colleague.

Having good colleagues makes a world of difference, highly sustaining at low professional times. We all have low moments. If you haven't, you will. And your worst low may still be to come. I cannot overestimate the importance of being a good colleague. Especially when you've been there, done that, got the t-shirt. I try to be that wise and calm senior colleague, alert to a struggling team member.

Lunch is a protein-heavy salad. Carbs at lunch is a no-no for me; each slice of bread is like 10 mg of diazepam. I often use lunchtime to check the work of our registrars.

I make a point of getting to know each registrar rotating through the department. After 18 years, hundreds of ex-registrars I've worked with are now all around the U.K., many of whom are dear friends. I treat registrars like I treat consultants: I check on them regularly, particularly at difficult times. The more registrars you have, the more consultant trainers should think pastorally. Otherwise, you risk them suffering in silence, their distress unnoticed and unalleviated.

My afternoons vary, sometimes more of the same. Monday is PET/CT, Thursday is ultrasound, and Friday afternoon is "McCoubrie Club," in which I mould the delicate minds of our first-year trainees, inculcating good habits so that they never ever write, "Clinical correlation advised."

I normally leave work just before 6 p.m., and after a brisk cycle home, it's family dinner around the table followed by an episode of something agreeable on the TV. Then at 9 p.m., I retire to my study to sweat over volume two of my book, The Rules of Radiology, which should be out in early 2024!

Dr. Paul McCoubrie is a consultant radiologist at Southmead Hospital in Bristol, U.K. Competing interests: None declared.

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