Tuesday, 29 July 2008

Happy days indeed

What a good day!  I don't even know where to start.  I read all sorts of interesting things in the paper, such as this by Julie Bindel in the Guardian.  And I loved shadowing in the hospital.

The day actually started in a muddle.  I took my train ticket from home to DGH out of my bag, then left it behind.  I cycled all the way to the station before I realised, speeded back and started again.  Luckily, even after getting changed I was only a couple of minutes late for my teaching on prescribing drugs at 8am this morning.  The format was good and the presentations well done.  I also got a very sweet text from a young man I rather have my eye on, which made the morning look brighter.  

By 10am I was on what will next week be my ward.  It's one I know from a student placement, but the firm is different.  Looks like I shall be working for Rheumatology for my first 5 weeks of house jobs.  This particular firm has coffee and biscuits on consultant ward rounds and seems generally friendly and kind to baby doctors.  

Having visited occupational health and medical staffing and been fully kitted out with computer id and passwords I returned to hunt the house officer I was shadowing for the day.   No sooner had I written a discharge summary for her, but I was phoned by another house officer.  This one works for surgeons, but I won't be doing that job for 6 months.  Still, he knew me as a keen theatre-goer from my student placement and thought of me when summoned to theatres to assist my previous consultant during a bowel resection.  Now, for me, assisting in theatre is the best thing I did at medical school, and I won't get to do it for my first 6 months of work, so I raced off to theatre like a 6 year old at Christmas.  Miss X the consultant was pleased enough to see me volunteering to let me mostly close up the abdomen after the operation.  

To compensate for abandoning medicine, I offered to show up for the post-take ward round tomorrow, where the consultant who's been on call the night before goes round all the people admitted by their team.  This is sort of optional for me on shadowing week, but I think I should show willing.  Better go to bed soon as it will start at 0755 tomorrow.  

I sometimes feel I ought to make more reflection on things, like the Fortunate Man and other medical authors.  I hope to do so in the future, but since this is all pretty new and I am still quite excited I will stick to informing you for the moment of my activities and I will reflect a bit when I calm down.

Monday, 28 July 2008

First day

My first day was uneventful.  The security people had my room key, but not my i.d. request from personnel, which felt inauspicious.  However, the first doctor I saw was a lovely surgeon, my favourite in fact, who had told me in my finals OSCE that I should come and be her house officer!  That felt a bit more auspicious and I cheered up.  The rest of the day was spent doing administrative things.  The talk was good, the medical staffing team organised, efficient and excellent (I know, I was shocked too!), but the IT training was incredibly slow, in a hot room, after lunch.  I am still impressed that I stayed awake through the whole hour and a half.  The only other bonus was finding another silly creature who likes spending their weekends cycling around big hills looking for good views, tired legs and pubs.  She and I will no doubt be off on bikes in the near future.  No medicine today, but shadowing my predecessor tomorrow, so no doubt I will have some more to report anon.

My first day at DGH

Well, blogspotters, if anyone is still reading this after another week of silence, you will be glad to know I am about to stop swanning about the place and start working.  Any minute now I will set off to the DGH and start being administrated, photographed and lectured to within an inch of my sanity.  And then at some point let loose on unsuspecting patients.  I'll keep you posted.

Tuesday, 22 July 2008

Not long now!

Good morning campers, less than a week to go before I head off into the wilds of suburbia to my new district general hospital and start being inducted into doctor-hood.  I am starting to get nervous, but I am tackling it by making this week excessively busy.  I have taken on the writing of an audit based on data I collected in Tanzania, I have arranged a trip to a friend this evening, he's already a doctor in a nearby hospital.  Tomorrow I head into London to see old flatmates and drink sangria and Thursday there is a picnic planned.  I am also dating again.  Boyfriend of 4 years broke up with just after finals, but it seemed a natural end to things.  Someone new is working very hard at chatting me up and I am deciding what I think about it.  There will be dancing with the girls on Friday night and cinema with this boy on Saturday.  By the time it gets to Sunday I plan to be asleep all day, so I won't have a chance to worry about Monday until it's too late and I am already there, signing contracts.  How exciting!

Friday, 18 July 2008

Duke Elder

Way back in September, I was told to take the Duke Elder prize exam for CV building purposes.  It's set by the Royal College of Ophthalmology and is worth money if you win and kudos if you do well.  So in January I got an email from the medical school with dates and I applied.  

Fast forward to May and I was up to my eyeballs in finals revision and stress.  I had forgotten all about Duke Elder until I received the examination details about 2 weeks before it was due to take place.  Obviously I attempted some revision, and I have to say it is my special interest area.  Still, I walked in on the day with trepidation and no great hopes. 

Finals came and went.  Results, graduation and holidays have all intervened and I had sort of forgotten all about it until today.  I discovered by email that I had come 19th out of 319 candidates.  Now, although I didn't win, I never expected to.  And I have heard on the grapevine that coming in the top 20 is considered pretty good.  Good enough, in fact, to be worth putting on the CV when it comes to applying for specialty training in 18 months time.  

Needless to say, I am a very happy bunny.

Wednesday, 16 July 2008

Micro-surgical techniques

I haven't yet heard what happened to the girl with air in her CSF, but if I do I'll let you know. 

Today I practised micro-surgical techniques.  Well, I practised creating and cutting and sticking very small things.  It's my great aunt's birthday party on Sunday, so a mass family gathering with cake and champagne has been organised.  My grandmother (great aunt's sister) always used to make sugar flowers, very tiny and detailed, for such occasions.  My mother decided that in her memory, we should make some.  She said to me yesterday to get the kit together and start the flowers to help her.  What I didn't realise is that she actually meant would I please make them.  So off I went. 

I have Grandma's instruction books, and between her and Mum they have all the tools.  I have certainly attempted this before.  Still, it was incredibly tricky.  The flower paste needs to be rolled out really fine, and stuck to the wire stem.  Then each layer of petals is stuck to the one before with egg white.  They tear, they get caught up, they stick wrong.  It takes forever!  But I'm pretty happy with the results.  The tiny manipulation required was fun, maybe it's a good omen for my surgical career.

Tuesday, 15 July 2008


Oooh strange!

I have just got back from Sweden, where I went to visit a girl I made friends with on elective.  We shared a room and a group of friends and some ridiculous experiences for 7 weeks, at the end of which we felt pretty close.  Then we both went back to our medical schools for finals, so we haven't seen each other since.

When we last saw each other we were medical students in Tanzania, but when I climbed off the coach on Friday to see her again we were doctors in Sweden!  It was odd.  Luckily, as soon as we started talking and walking (activities we both particularly like), it was as if 6 months had not in fact passed since our last decent gossip.  We went all over the place, onto the lake near her little town, 20km round trip to a viking burial mound on single-speed, clapped-out bikes, into Stockholm, to a party.  We ate fike (coffee and cake), korv (hot-dogs) and lax (salmon).  Then today she went to work.

She's working in the infectious diseases ward of a district general hospital, just outside the town centre.  So, I stole her bike and spent the day exploring the woods and islands around Lake Malaren, made some stew for dinner and went to collect her.  The ward is a separate block, with 12 rooms on each side around a central 'island' containing the kitchen, nurses station etc.  It was pretty similar to home, except all infection patients have one of these isolation rooms.  From the inside is a sort of air-lock, containing a sink and aprons.  Then the actual room opens onto a veranda, so that patients can go outside from their own room.  I thought it was all rather swish.  

Today my friend had a new patient with a complicated problem.  The patient was a child with otitis media and possibly externa, and suspected mastoiditis.  They were worried and got an ENT review and a CT.  The ENT review said it wasn't convincing for otitis media or externa, and the CT didn't show a collection.  However, it did show an air-bubble in the CSF!  Now, I've never heard of this before, but that doesn't mean much!  The radiologist said it must be from the L.P., but this was done after the CT, so that's impossible.  Clinically, this kid isn't too bad, and certainly isn't meningitic.  Any thoughts team?