Tom Dolphin 🏳️‍🌈 🏳️‍⚧️

Doctors/med students: fill in @bma.org.uk's survey on advanced practice roles and their potential impact on training and for employers to extend their scope into work only doctors should be doing.

It closes this Thurs at 4pm so be quick! (It takes ~10 mins)
www.surveymonkey.com/r/MVXCB99

Thank you to the Isle of Man Medical Society for their warm welcome. The doctors here are united and the solidarity is clear to see. ✊

It literally hasn’t stopped raining the whole time I’ve been here but I’ve found Man to be a friendly, delightful place. Will be back! 🇮🇲

Agreement on having tripartite negotiations BMA-ManxCare-DHSC to reduce back-and-forth; agreement that Man can learn from England’s missteps on doctor substitution; agreement that the Man Clinical Senate must be key to ensuring doctors’ voice in service decisions. ⚡️

Prakash Thiagarajan (Isle of Man Medical Society), Tim O’Neill (Chief Officer of DHSC), Claire Christian MHK (Health Minister) and me in the Isle of Man government office underneath the island government’s crest

Helen Robinson-Gordon (BMA head of media) and me crossing the road outside the Tynwald (IoM Parliament)

Prakash and me in Noble’s Hospital near Prakash’s department - behind us is the entrance to the children’s ward with an undersea-themed mural

After a stormy arrival on Friday, had a full day yesterday meeting members on the Isle of Man; followed by Manx Care’s Chief Exec & MD; then the Chief Minister, Treasury Minister, Health Minister and DHSC’s Chief Officer. Productive conversations, progress on important issues:

If the microscope comes in for an appendicectomy I’m calling the Consutlant

Thinking back to how totally different the anaesthetics that I gave back in 2006 were to today, I do wonder what we'll be doing in another few decades. If someone could invent a reliable tool to predict the duration of a "quick appendicectomy" that would be a great start, maybe!

My current team are the best, and we grew even closer during covid, when we looked out for each other and our patients together under intense circumstances. We came out of it with a bond I'm lucky to experience in the workplace, and working here is still great. Thanks guys! 💙

[2008ish, Cardiothoracics] My Educational Supervisor: During your training, you will have some placements you enjoy and some you don't. A key skill is concealing when it's one you don't.

Me: 😳

ES: Yes... Anyway, I've signed you off so you never need come back here again.

Me: Thank you... 😬

I've liked most places I've worked, but am very pleased to be a consultant where I started, at Charing Cross Hospital and at St Mary's. Along the way I've worked in 14 different hospitals in 20+ rotational placements across London and Essex, sometimes for as little as 3 months.

And there have been the patients who didn't make it, whose injuries or disease were unsurvivable, but for whom we tried our best; the anaesthetist is there with the rest of the team, doing the needful until the end. These patients aren't many, but one remembers them.

I've experienced a few serious mishaps along the way, fortunately none with lasting impact on the patient.

Often the day was saved by quick-thinking colleagues and our irreplaceable skills from lengthy, rigorous training; we give up those standards at our patients' peril.

I should add that the first anaesthetic I ever gave was actually aged 17, to Drosophila fruit flies for A Level Biology, so I could sort them for breeding. They all survived, but by month 2 I think I'd bred them for resistance as some were literally coated in ether, wide awake 🪰

Or the time I got lost in the hospital's basement corridors, unable to find my way back and with all the swipe card door panels refusing to recognise my card until I finally found one that let me back upstairs, to find myself about half a mile away from theatres by the post room.

Or the prone neurosurgical pt being extubated while I was giving a colleague a coffee break by someone standing on the tubing, and me reintubating him prone and then nonchalantly telling my colleague "It's been fine, no problems" when she got back, while the poor ODP sputtered protest behind me

Less fine was the furore the next morning when I arrived at 8am to find Recovery in chaos with dozens of relatives round his bed. Moreover the hospital had to be locked down because his large family had kicked off when his attackers turned up and machetes had been produced... 😬

Or the pt who *insisted* on dictating a lengthy farewell note to his mum before he'd allow hand-saving surgery - I had to stop him when he then started a note to his sister as well, lest he bleed to death while contemplating his own mortality (he was fine, as I knew he would be)

Or watching a famous surgeon eviscerate an interviewee visiting in theatre to discuss a fellowship role, while he operated endoscopically per rectum (like an anal laparoscopy) in front of an entourage of >10 residents who winced along with me as the poor guy went bright red

Some of my weirdest moments have been funny in retrospect: the surgeon who refused to stop operating despite flooding literally carrying equipment down the corridor outside theatre; or transferring a patient and the ambulance being repeatedly diverted to accidents on our way back to our hospital

Anaesthesia is an enabling specialty. We facilitate other specialties to do their work by getting the patient through the unpleasantness, pain, fear or physiological disruption that otherwise would make that work unbearable for the patient or impossible for our colleagues to do @rcoanews.bsky.social

Anaesthesia is the most populous hospital specialty; I've always said we're like rats, in that you're never more than six feet from an anaesthetist in a hospital. And yet we've been understaffed in pretty much every department I've ever worked in, becoming ever more so over time.

I've been lucky to have worked with some truly amazing doctors and nurses and ODPs over that time, some doing extraordinary stuff, and others doing basics brilliantly. My colleagues have been there for me whenever I or my patient have needed them, never more so than during Covid.

Thousands of people have trusted me enough to let me render them unconscious and look after them while they are totally vulnerable. It's an immense privilege, which I feel whenever I'm looking after someone, not least as visceral unease if I move more than about 5m from them.

A photo of me from (I think) the Daily Telegraph used to illustrate a story where I gave a quote on behalf of the Junior Doctors Committee, roughly around the time of starting my anaesthetic training (that's definitely Charing Cross Hospital theatres...!). I'm in scrubs, with the surgical lights arrayed dramatically behind me and a stethoscope around my neck

Me photographed in late 2025 in scrubs (still with a stethoscope around my neck) in front of shelves arrayed with anaesthetic drugs and labels; a pair of shears hangs invitingly on a hook

It's twenty years today since I started my anaesthetic training, at Charing Cross Hospital. In that time I've looked after many thousands of patients, placed innumerable cannulas, injected rivers of propofol, and stuck a pine tree's worth of needles into people. 🧵

in case you're curious about how angry Minnesota is about ICE, it was -20 today

Email invitation to Dr. Emma Hilton from Sex Matters about meeting the new chair, Dr. Mary-Ann Stephenson.

FOI reveals that within the first week in office, Dr Mary-Ann Stephenson requested a meeting with Sex Matters to discuss "mutual priorities and ways to work together going forward"

“This conclusively demonstrates that this widely publicised concern as part of the culture war against trans people is not supported by documented evidence from service providers," @translucent.org.uk

A fruit bowl on offer at lunchtime at a recent all-day meeting I attended, which includes bananas, plums (for which there is no emoji, weirdly), pears, grapes, oranges, apples, little tomatoes and a single whole lemon

Fascinated by the fruit options at lunchtime
🍎🍐🍌🍇🍋

Dr Tom Dolphin at the Winter Scientific Meeting lectern.

Consultant Anaesthetist and BMA Council Chair @tomdolphin.bsky.social talks about the importance of collective action and local organising.

If we want medicine to continue to be the viable career, the profession needs to behave as a group. Solidarity matters.

#WSM2026

A message for doctors and medical students for the New Year (and check your inboxes 📩):

youtu.be/G8uZqQW51wY?...

Thank you for all you did in 2025 for @bma.org.uk, our profession and our patients, and wishing everyone a peaceful and happy 2026. 🕊️

YouTube video by BMAtv Tom Dolphin's New Years Message | British Medical Association

A message for doctors and medical students for the New Year (and check your inboxes 📩):

youtu.be/G8uZqQW51wY?...

Thank you for all you did in 2025 for @TheBMA, our profession and our patients, and wishing everyone a peaceful and happy 2026. 🕊️