Vital Signs: Heartbreaking, sometimes hilarious stories of a junior doctor's first year

by Izzy Lomax-Sawyers

An insight into what it's like to be a first-year junior doctor - the ups and downs, the drama, and how terrifying it is to finally be making decisions.

Diagnosis and death; uncertainty and urgent laxatives; sleep deprivation and synthetic drawstring this debut work by Izzy Lomax-Sawyers chronicles her first year as a tired junior doctor at Auckland's Middlemore Hospital.

How can Izzy be a thorough and compassionate doctor while still leaving work before 7 p.m.? How does she uphold dignity and autonomy for people whose liberty has been taken because of severe mental illness? How will she know when what can be done for a critically ill patient is different from what should be done? And is this floor clean enough for her to sleep on?

Izzy grapples with these questions and more as she rotates through psychiatry, orthopaedics, medicine and surgery.

Thoughtful, funny and at times heartbreaking, Vital Signs invites readers to join Izzy through the highs and lows of being an apprentice in the art and science of medicine. Get your scrubs on, chug your coffee; ward rounds start at 6.45.

Genres: Medicine, Nonfiction, Memoir, Medical, Health

224 pages, Kindle Edition

Published September 20, 2022

Reviews

[Petra X · Rating 2 out of 5]

I never thought I would find a medical memoir boring, let alone dnf one, but this one alternately bored and frustrated me. The 'origin' story is like an introduction to a reality show, where all the characters, all her friends, and what they did before they went into medicine and why they went into it is detailed. But as I read about some of them (maybe all, who knows), I couldn't really differentiate one from the other, nothing stuck in my mind.

There were some good bits, mostly about medical procedures, but the author likes extreme detail. It isn't interesting to know who followed who in ward rounds and who took the notes and who put them on the computer or whatever. Similarly, I don't care which doctor wore light blue scrubs, which surgery blue and which some sort of aqua. I just don't see the point.

The second-to-final straw was reading about how the author woke early in the morning and gave her girlfriend a pillow to cuddle instead of her and turned on her phone torch so as not to wake her and got dressed and ordered her coffee from the only place open, drove to pick it up and selected a book to listen to and said hello to this person and drove to the hospital and parked her car and walked across a bridge and down the other side and into the hospital and along the Rainbow Corridor and got changed into scrubs and and and ....

After that I just skimmed until I got to a chapter on how to break bad news written in extreme and mundane detail. The author tells patients, "I'm not telling you this to scare you but to be honest with you." That was it. I don't find that sensitive at all, and she copied the phrase from another doctor without being able to see there is nothing reassuring in it at all to the patient. There has to be a better way than that. Any doctor who said that to me would have scared me shitless. And I didn't like the chapter on poo either.

I didn't find anything heartbreaking or hilarious in the book. The writing is lacklustre and could have been improved by a decent editor, so I'm not sure who is at fault for this uninspiring book.

The author wrote an article about being fat and a medical student, it's really rather good, although could be improved as could the book have, by a good editor and shortening the whole thing. Maybe the author's best writing is in short-form rather than whole books. mine certainly is. Everyone who urges me to write a book about my rather unusual life hasn't experienced the tedium others who have read more than three pages of mine. Being friends and writers themselves, they have been very blunt about it. Thankfully. Maybe she just needs to team up with a 'brutal' editor that will cut out the filler and leave in the interesting bits? She does seem to be a very nice lady, and I would like her for my doctor, but as an author... not for me.

I don't say others wouldn't enjoy this book, especially if they were new to medical memoirs and definitely hadn't read This is Going to Hurt: Secret Diaries of a Junior Doctor which is among the very best of the genre, but it wasn't for me. 2 stars.
__________

Reading notesAdam Kay's This Is Going to Hurt: Secret Diaries of a Medical Resident set the bar for medical memoirs of junior doctors really high. Can this one vault over it, or is it going to be limbo under?

I'm on chapter 5 and it looks like it's going to be the limbo. But, I've been surprised before, it may pick up, but right now there's nothing to distinguish it from the many others in this genre.

[Bronte · Rating 5 out of 5]

I had the absolute privilege of working with Izzy and Brittany in Tiaho Mai, and it was such a surreal experience to read about it on published ink.

Furthermore, I think Izzy’s description of hospital culture absolutely hits the nail on the head. Every medical student in New Zealand, especially those heading to Middlemore, should read this book to grasp everything one needs to know, from hospital politics and the very real experience of burnout, to the superiority of Elixir.

[Mel · Rating 5 out of 5]

Loved this book! It’s the first book I’ve read in a very long time where I couldn’t put it down and read in one sitting

[Belle · Rating 4 out of 5]

I really liked this book. Each chapter has a different focus, and some were more interesting than others, but it was easy to read overall. I really liked learning about the specific details of what it's like to be a doctor, such as all the steps required to scrub in for surgery, or the admin process that has to be followed when a patient dies.

[daniella ❦ · Rating 3 out of 5]

great read! super interesting insight into being a first year doctor in new zealand :•)) im reading a few other books along side reading this so it took me longer than usual and at times i did need to put it down to wrap my head around all the medical scenes. it’s at times a little too over detailed (less to do with overly technical medical scenes more to do with overly detailed non-medical scenes) but the explanations of all the medical jargon and procedures was extremely well done. also being a greys anatomy girlie it was a lovely look into this slice of life and i was tearing up near the end.

[rose · Rating 5 out of 5]

I adored this book and finished it in a single domestic flight. I recognised Izzy’s name from the amount of times I had to call her team as a general surgical RN and knew I had to buy this book. It had me laughing, tearing up and feeling inspired. Much like Izzy, Equity inspired my move from Wellington to MMH and I finished this book with such a wholesome and humbling feeling. Take home points:

✨ Nurses and Doctors will never understand each other’s jobs but we respect each other. I wish doctors had both protected meal times and free meals.

✨Middlemore is a magical place but it’s understaffed and under resourced. MMH is reliant on the perseverance and hard work of its medical professionals and reading that undertone made me happy but sad. Lots of overtime not paid or acknowledged to help patients.

✨I liked that Izzy wasn’t tokenistic, I find it so easy to write about equity in medicine that looks like saviorism and tokenism. Her attention to detail avoids this.

✨ 10/10 for detailing the sexism without putting down nurses. I loved it, did it so well and flawlessly.

✨ Junior House Officers work incredibly hard and I’m very glad that Izzy briefly touched on the issues with new generation doctors vs. senior doctors whom do not like change, because it affects us all.

✨ Hot shout out to David Murdochs graduation speech, I loved that. Very timely

LOVED THIS BOOK

Lauren lol #famous

[Nadine Houia-Ashwell · Rating 3 out of 5]

Dr Izzy Lomax-Sawyers has an attention to detail that leaves no step in the process of scrubbing behind -including the constant reminders at each stage that if you fxck it up, you gotta start from the beginning again. As an anxiously excited but simultaneously terrified, five-days-out-from-starting-PGY1, I appreciated this level of detail as it was both “heartbreaking” and “sometimes hilariously” TRIGGERING based on my own medical school experience 😂😂. However, I can see how non-medical people might find these details mundane and boring -but such are the administrative realities of being a first year junior doctor that most people don’t realise.

“On my first day as a doctor I was equal parts eager and terrified, sick of being a student but not feeling at all ready to be a doctor. You adapt. Like a root-bound pot finally replanted, I have grown to fit my new job, and even to work through a pandemic. The everyday tasks that once filled me with dread have now become routine”. Gosh, I hope this remains true for myself. Thank you Dr Izzy Lomax-Sawyers for writing a medical memoir that is more realistic and closer to the truth of the NZ medical student & junior doctor experience. I would recommend this to anyone who would like to know what being a junior doctor in NZ is actually like & also to medical students who may be struggling with imposter syndrome -you’re not alone.

[Maia · Rating 5 out of 5]

‘Why do they nail coffins shut?
To keep the doctors out.’

Hi Izzy, unsure if you’ll ever read this but I read this book as I’m preparing to go into my 5th year as a medical student and it was so near and dear to my life and I loved not feeling alone. Everybody in medical school has imposter syndrome and nobody really talks about the incredible highs and the deep deep lows being a medical student/house officer brings.

‘Sometimes I think clinical medicine is a circle of hell designed specifically for smart, anxious, competitive people who want to be liked’ - this one hit

Reading and relating to the hospital politics, the clinical information (light study! Thanks!) in a New Zealand setting makes this a very unique and incredible book for NZ young doctors.

I too am from Otago University :)

[Laura · Rating 5 out of 5]

I've never been a Doctor but I've worked within NZ hospitals and this is such a good snapshot. Highly rate.

[Zoe · Rating 5 out of 5]

Was given to me by a fellow UK med student who hopes to emigrate to NZ one day, it was an interesting look at life as JD in NZ. I felt able to relate to Izzy as someone who came to med later in life!

[Ashleigh Blunden · Rating 5 out of 5]

Incredible insight in what its like to be a doctor in New Zealand particularly post covid and the pressures doctors are under and our healthcare system.

[Sasha Ruggiero · Rating 5 out of 5]

I loved this. The reflections are extremely insightful and well balanced. Izzy gives us an emotionally, socially and culturally well rounded view of her experiences. The only critique I have is that the Māori terms used in the text would have been better understood if the English translation had been given right next to it. I sincerely hope that Izzy continues to document every single year of her life and publishes a book about each one! I will surely continue to pick up her work. She humanizes the experiences she writes about in such a logical way- she definitely has a talent for writing and I can’t help but think that all this reflection will make her an even better doctor. She is indeed ‘one of the good ones’.

[Ashley · Rating 4 out of 5]

Thought this book gave me a real good insight into the life of a junior doctor in New Zealand especially during/after Covid and I was able to at least relate to some of the content. It's actually quite a motivating read. There were bits of Izzy's hospital experience, her life outside of medicine, procedures and protocols and even the small things that are important but are often overlooked at.

I loved the fact that each chapter focussed on different aspects of her life. Some of the chpaters were a bit boring and quite short but each chapter definitely gave you a good insight to each area of focus with detail and no sugar coatings.

[Lauren · Rating 5 out of 5]

I moved to New Zealand to pursue a career switch into healthcare, and my classroom learning hasn't exposed me to the realities of the profession yet. I was really glad to stumble upon this gem at the library; Izzy's memoir gave me a good lay of the land from the perspective of a junior doctor. It's well-written, easy to follow despite my limited healthcare knowledge, and full of insight in terms of how medical staff relate to patients and each other. I highly recommend it!

[Sam · Rating 2 out of 5]

I really wanted to like and enjoy this being that it's set in my local hopsital, however it was beyond boring. It's prob more an introduction to being a Dr for those who intend to be a Dr. It's very dry, not really interesting and full of boring medical day and day life stuff. I've read loads of medical biographies but this one is terribly written. It doesn't really serve a purpose?

[Rose · Rating 4 out of 5]

It took me a while to read this one due to life getting busy… this book was a joy to read, a lot of familiarities, comfort and pearls of wisdom gained. Very easy to follow writing style. I loved the way she closed off each chapter. Can’t wait to see what is next for Izzy 💞

[Liz · Rating 4 out of 5]

It's probably a book you need to read if you're considering being a med student but it's perhaps a bit too much in detail in parts, without the thematic storytelling, to get quite where I think it wanted to go. But serious kudos to all the junior doctors out there.

[Row · Rating 3 out of 5]

I appreciate being in medicine/hospital life must be draining both emotionally and mentally and writing this book must have been good therapy for the author and no doubt accurate. But I didn’t find the content living up to its titled ‘heartbreaking or hilarious…’ stories.

[Sophie · Rating 5 out of 5]

Loved it! The chapter structure/flow is very engaging to the point where I found it hard to put down. Writing was great and content was interesting, even to someone who has little knowledge of medicine.

[Rebeckah Dell · Rating 5 out of 5]

Awesome book- working in the same hospital so much of the book resonated with me. And I could feel her emotions as I go through then weekly too ! I love that she had a chapter on nurses - it was nice to be recognised 🤪

[Sally Hinkley · Rating 3 out of 5]

3.5 stars. Interesting read about the realities for junior doctors. I enjoyed the medical details and the different chapter themes. Overall an enjoyable read. However, the mundane details included did not add to the book at all. "I take a bite of my muesli bar and start the car" etc etc.

[Francesca Pashby · Rating 3 out of 5]

A Y9 student recommended this to me (her mother is a surgeon), and whilst it didn't have the hilarity and pathos of Dr Adam Kay, it was an interesting enough tome. My son is studying medicine in Otago, so I was curious to see what his future might hold within NZ ... apparently A LOT of coffee!

[Veronica Huntington · Rating 5 out of 5]

Enjoyed this book and learnt some things too!!

[Sophie · Rating 3 out of 5]

Good to read a book about being a doctor in a New Zealand hospital but the book was a bit of a slog.

[Ryan Kennedy · Rating 5 out of 5]

Great read; wonderful insight into the challenges of the medical system

[Benny Shen · Rating 3 out of 5]

Relatable lived experiences of working as a first year house officer. It is as raw as it gets.

[Malaika Brownlie-Armstrong · Rating 5 out of 5]

I really liked this book because it felt honest. I think it was also a good insight into a NEW ZEALAND healthcare context, which is not written about that much.

[Jess Stowe · Rating 3 out of 5]

3.5! ⭐️

[Ness VDH · Rating 1 out of 5]

Hmmm I wasn’t actually a huge fan of this book. I thought it sounded similar to one of Adam Kay’s novels however I was sorely disappointed. I thought it sounded more like a doctor writing down her thoughts into a diary - yes a bit harsh.

~ Read physical book ~

[Maree Tollenaar · Rating 4 out of 5]

A great insight to what my Neice may go thru as a new doctor.