My Medical Adventures

Happy days indeed

2008-07-29T21:30:00.005+01:00

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.

First day

2008-07-28T19:37:00.002+01:00

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

2008-07-28T07:31:00.001+01:00

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.

Not long now!

2008-07-22T08:19:00.003+01:00

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!

Duke Elder

2008-07-18T14:59:00.003+01:00

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.

Micro-surgical techniques

2008-07-16T22:39:00.002+01:00

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.

Sweden

2008-07-15T00:15:00.003+01:00

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?

2008-07-10T23:02:00.002+01:00

Oh my. The bicycle fitting was an amazing experience. It took hours, and involved cycling on a stationary, highly adjustable test bike. My riding was video-taped, and the pressure differentials between my 2 feet were measured. My femur and leg lengths were measured, my range of motion was measured. Little wedges were placed under the cleats on my bicycle shoes. The difference was incredible. Just slight adjustments made it much easier to achieve the same wattage. I loved it.

Now it's a matter of waiting to see whether the man in the shop can fit my measurements to a suitable frame or not. If not, I might get one custom-made in pink-coated steel. And then insure it heavily.

In fact, yesterday was altogether a wonderful day. I saw an old friend for the first time in a year and spent the afternoon catching up on his travel adventures. In the evening I met a new friend, with whom I clicked instantly. We talked non-stop for 4 1/2 hours and only stopped when the restaurant kicked us out. Although the interaction with old and new friends is very different, both were wonderful in their way. It strange to see someone I had known so well and not seen for ages. The conversation just fell into place as if it had never stopped. With the new friend, it was strange that the conversation picked up as if we were old friends, as we found more and more attitudes, strengths and vices in common. I think it will be an interesting summer all round, what with being newly single, new friends being made, old ones rediscovered, a new job on the way and no more revision to do.

Off to Sweden tomorrow, to catch up with a friend I met in Tanzania on elective back in November, when this blog fizzled out. I will let you know how that goes when I get back on Monday.

Spending my inheritance

2008-07-09T10:15:00.002+01:00

I am about to go into London to spend a great chunk of my inheritance.

My very elderly grandmother died around Easter this year, freeing her from immobility and vascular dementia, but depriving me of my visits to her for still very entertaining chats. In her will, she left money to me and my cousins, which she wanted us to enjoy. My investment (I will insist on calling it an investment, as well as an indulgence!) is to be a new bicycle, fitted to me so that my myriad injuries are accommodated as well as can be. The fitting alone will cost over £150, which is more than I have spent in one go (except on flights) for a couple of years. I'm very excited about it, and will post again later on how it goes.

It does seem a little over-board, as I am starting work in a district general hospital in August. I will be living in, so I won't need the bike to commute as I did in London. Still, next year I hope to be back in London as a cycle-commuter again, and this year I shall use the bike for adventures in the countryside around my new hospital. Today is a bit of bleak day for a cycle ride, but I refuse to let the English weather dampen my enthusiasm.

Super Duper Doctor Holidays

2008-07-08T16:34:00.002+01:00

Finals really takes it out of you! For days after exams I awoke early, full of nervous energy. For a few brief and awful moments I would worry about all the work I'd have to do in the day ahead. Then realisation would dawn that I was finished. No more exams, no more revision, no more stressing out. Once results came out I didn't even have to worry about that! Yet, it was still only 2 weeks after the last exam, when we graduated, that it felt real. I am in fact a doctor. Wow!

In celebration, I went away on a super-duper doctor holiday to Greece with 7 other newly minted baby doctors, a med student and a lawyer. The busy days were filled with swimming in the sea, lying on the beach or the terrace reading novels (novels, I tell you, novels! Not a text-book to be seen!), eating souvlaki, ice-cream or fish and drinking ouzo or beer. I had afternoon naps, lie-ins, pointless wanders round shops and games of pictionary all with no guilt and no need to rush off to study. The sheer bliss of this can be best understood by everyone who ever did medical finals, or perhaps a big dissertation. When your life has been occupied by constant, all-consuming study for literally years on end, nothing is quite so disconcerting and yet rewarding as knowing it's all over!

Ms Medic is a DOCTOR!

2008-06-19T01:08:00.000+01:00

I passed! I passed finals! It's all over. I have a hell of a headache from the celebratory drinking already, but I think well earned. More news later, I think I'm going to curl up in a ball now.

Sobering up

2008-06-16T17:42:00.003+01:00

Well, I have sobered up. The Boxwood Cafe is really really good, not that I ever like plugging things much. We had a really good meal, went out for drinks in our dresses and stayed up, 8 of us, drinking rum and gossiping til 4am on Saturday morning, when the sun came up and scared us all into bed.

Saturday I wandered round Oxford Street and nursed my hangover. I remembered why I didn't like going to Oxford Street, especially on a Saturday, since it took me about an hour to make it about 400yards down the road. People are bonkers. I never seem to get road-rage in a car, and I only get bike-rage if someone came really really close to killing me. But somehow, I am very prone to pedestrian-rage. There is something in me that snaps when the umpteenth group of selfish dopes decide to stop in the narrowest part of a crowded street, spread out and have a think about what to do next. They seem to pick areas like beside a bus-stop, or by the traffic lights. If you try to squeeze through the middle, all 'excuse me' and 'pardon' they look insulted that you interrupted the conversation. Well, dearest tourists and assembled self-absorbed idiots. you interrupted my wander! How dare you look at me like I'm in the way when you're the one blocking one of the world's busiest footpaths!

Anyway, rant over. I abandoned Oxford Street and went home to get ready for our finalists ball. The tickets cost a fortune, so I was a bit skeptical about the the whole thing, feeling like it might be a bit of a rip-off. Then I got there to find it was far more exciting than I had expected! The venue was beautiful and it turns out the medics scrub up pretty well when you take the grey mask of revision away and put them in full finery. I was pleasantly surprised by the whole event. Even the food was pretty good. Still, another 4am bedtime nearly killed me. I'm not that old to need a respectable bedtime, but I think I'm out of practice. I spent yesterday and this morning recovering at home with the kitten, who helpfully bit me a few times and then curled up exhausted on my knee. It really does seem tiring to be a kitten, all that running about to do, sofas to claw, curtains to climb and people to shout at. I'm feeling pretty tired just watching him. Or maybe that is the cumulative effect of finals. I am certainly enjoying the recovery period, but I wonder if I am alone in finding it hard to shake a lingering guilt at doing nothing? It's been so long since I last slugged about on a sofa with a novel and a cup of tea that I feel like I should be busy working on something. I hope I will get better at lazing about with practice, so I shall be taking my cup of tea back to the cat, the sofa and the tv!

Over and out

2008-06-13T01:14:00.002+01:00

Finals are over.

My short case OSCE was on Wednesday and now I have nothing to do! I felt at a very loose end, but filled it with moving out of halls. I am now at home surrounded by boxes and bags and not sure what to do with myself now I don't have to revise! It's exciting, but none of us seem to know what to think. It's not exactly an anti-climax, but we've been so busy for so long now I think we're a bit lost without revision! No-one has done anything exciting lately and we haven't had any normal conversation for a while, so I think everyone is stuck.

I hope it will get fixed with a posh dinner tomorrow and the ball on Saturday! I'll report again when I sober up.

3 down, 2 to go

2008-06-07T21:16:00.002+01:00

Written finals, I never want to see you again!

On Wednesday I had my pathology and data-interpretation paper for 3 hours, followed by my clinical single best answer paper, for another 3 hours. The path paper was off the map, I have never seen an exam like it, and we have been examined at least twice a year for the last 6. The paper bore no resemblance at all to the pre-exam lectures. None. We were told to look at some pictures of histology, but not to worry too much, because we'd get a history with the picture in the exam, and that's what we were really expected to interpret, with the picture for added clues. Well, there were at least 3 pictures with no history at all and one that said "this patient has a cough". Well, that narrows it down! For Heaven's sake, if you want us to learn histopath, fine, we're trained to learn what's required. But why tell us outright not to do so?! Nutters. I was not a happy bunny.

Then in the afternoon, shattered, we went back for the clinical questions. Ok, clinical is easier for final year medics than path, because it relates much more closely to what we do and see on the wards. Still, there were some startlingly ambiguous questions. One started with a patient who had sensory loss in the feet, then went on to say they had no sensory loss. Helpful. Did they or didn't they? I was now not happy and disgruntled, and exhausted!

Luckily, the paper on Thursday morning was so incredibly straightforward that I worried I might have been given the 3rd year's paper instead. Baffling. All that stress on Wednesday and a perfectly reasonable Thursday morning. So on Friday my body gave up and got my usual post-exam cold. I have been so sleepy ever since, you'd think I was gearing up for summer holidays. This might prove to be a mistake as I have my long cases exam on Tuesday and a short case OSCE ('objective structured clinical exam', which is a pretty biased and chaotic exam for medical students) on Wednesday. Let's hope I start getting the fear back or I risk falling asleep in the middle of the exam...

Poisonous witches and nonsense journalism

2008-06-02T19:30:00.002+01:00

I was directed by a post on Doctors.net to a blog on the News of The World posted on the 1st of June. Now, I know that the rag in question is not famed for it's quality investigative journalism, but the sheer screaming vitriol of this article, it's absence of factual accuracy, made me want to throttle the writer. Her name is Carole Malone and she basically blames doctors for all that's wrong with world.

Very sadly, her father died of colon cancer. She feels this is the fault of his GP for referring him too late. However, rather than complaining to the GP or through appropriate channels, she has written a spiteful rant about how all GPs do is cadge money from the government for doing less and less work, in fact, it's their fault the NHS is short of cash and they get paid a quarter of a million pounds each.

If only! I don't understand why people are allowed to write journalistic articles containing such wild inaccuracies. Firstly, GPs don't really earn anything like that much. The income to their practice (as a partner) has to pay for the whole practice for heavens sake. And just because they had horrendous hours in the the past, for which they were not renumerated, doesn't mean they should be treated even worse now. And whatever the GPs salary, she's not publishing her own in the national press, is she?

I just don't know why people have it in for doctors at the moment, I really don't. 2 days before my finals is not a good time to be thinking this is really not a promising profession.

My black eye

2008-05-30T23:18:00.002+01:00

I have had dark circles under my eyes for weeks now. There's something about the quality of revision sleep that means it isn't refreshing, no matter how many or few hours you get. I'm constantly sleepy, possibly because I have been constantly bored by revision. Pathology and surgery and now done I think, and just haematology and oncology to go before I give up on medicine as well and move on to practise questions. The dark circles I think will stay until after the post-exam drinking.

Now, though, I have one eye with an extra-dark circle. And a small claw mark. My parent's new kitten thought surgery revision looked boring too, and decided to help cheer me up by playing with my ponytail. When he fell over my shoulder and onto my lap he looked up into my glassy eyes and I was cheered up. So far, so good Mr Kitten. But then he saw some escaped hair hanging over my eyes. He sized it up and jumped, perfectly swiping the hair in mid-flight. And catching me square in the eye on the follow-through. Oh well, it was worth it since he's so cute.

7 days to go

2008-05-28T19:40:00.002+01:00

The clock is ticking away, the days disappear underneath me and the exams loom large on the horizon. And am I panicking? Am I finally getting my arse in gear and becoming more productive? Am I confident and collected?

Well, no.

In fact, I am so de-motivated I can barely work up the energy to worry about it, let alone work effectively. Oh dear. Let's just hope my consultants told the truth when they said what counts is to be on the wards every day and get involved in managing patients. I think it'll come good in the OSCE and the long cases, but I fear for the pathology written paper, I really do. My knowledge is patchy, so I pop with things like BCR-ABL and can't work out which antibiotics work on gram negative bacteria. Let's hope it's enough!

Charlie Brooker and the pathology of heart disease

2008-05-26T11:48:00.002+01:00

Yesterday I abandoned ship. There's only so much time you can spend in your room with a laptop and a pathology revision guide without very bad things happening to your will to live. I ran away to my parent's house and spent the day there, with the laptop and the pathology, but most importantly, a kitten. I felt much better reading with a kitten on my knee.

This morning I was back in my flat, with (you guessed it) the laptop and the pathology. No kittens available here, so instead I have the Guardian online and the joys of Charlie Brooker. He is the perfect expression of how I feel about the world at the moment, that is, not friendly toward it. Not only is it raining, Boris is Mayor of London, people are dying in China and Burma, not to mention Iraq, Sudan and Afghanistan, AND I have to revise. Oh what a joy to be alive. So, now I am still avoiding work, but with a warm love for grumpy Charlie B in my heart and a cup of tea.

If I pass these exams, I shall have write him a thank you note.

PS

2008-05-25T00:49:00.001+01:00

And thank you for the encouragement Little Medic, every little helps at the moment.

Pathology

2008-05-25T00:43:00.003+01:00

So today I have been trying to read pathology for surgery, and I was so bored I could have eaten my own brain with a spoon. Luckily, I decided watching "Mean Girls' on tv was a better plan. And drinking Pimms. Oh dear. I have to say, it's a good thing for patients everywhere that I want to be a surgeon and not a histopath or they would be in real trouble. So far, I have worked out what red blood cells look like under the microscope and then I gave up. I can just about manage to pay attention enough to have learned the acid-base stuff and calcium metabolism. But that felt like such an achievement that I got nothing else much done after it.

Oh dear. I know that revision always makes every subject feel awful and dull, but I do hope that I get my joy back before I start FY1 in August. I really have lost interest at the moment.

Finals are approaching...

2008-05-23T11:25:00.002+01:00

So this blog dropped off the map a bit when I went to Tanzania. I have been back about 6 months now, dragging myself through final year and towards exams. Being in a different place for clinics every single month is tiring and unsettling, so I have got to this point (10 days from finals) with an underlying sense of grump and the overwhelming desire to be on holiday already. Oh well, not long to go now and I start working as a junior doctor...

Time to fly

2007-10-27T12:36:00.000+01:00

I'm not sure if anyone reads these infrequent posts, but if anyone is reading, heads up! I am about to head to Tanzania on elective for 2 months so posting will be even less reliable than it already is. However, if I do get internet access I shall keep you posted on the state of medicine in Dar Es Salaam and the sunshine in Zanzibar.

Foundation forms

2007-10-20T13:15:00.001+01:00

I am prevaricating on an award-winning basis today, the culmination of a week spent successfully avoiding facing the dreaded form. But it has to be done. My goodness I wish it didn't.

To go or not to go

2007-10-16T22:27:00.000+01:00

To answer Little Medic, who knows where I shall go! The other major issue with the evil application forms is where to apply. All deaneries with have their equivalent of Chase Farm, or Maidstone, the only difference being you don't know in advance which one it is outside your medical school. So, to stay in London or not, question one. I think I lack the balls to go, as it were. My friends and family are here, and when you get down to it, that's what makes me happy. Then, to stay in the deanery related to my medical school or go elsewhere. Pro of staying: I know most of the ophthalmologists and they know me and that's what I one day want to do. Con: I will feel as though I never left medical school. Pro of going: if I want to experience a new hospital/area, I will be in the same boat as a whole bunch of other new FY1s and it will be easy to make friends and settle in this time around maybe more than later. Con: I am a scaredy cat.

Foundation Training Application forms

2007-10-15T22:07:00.001+01:00

I think this is the hardest bunch of pointless questions I have had to answer! There is something about the format that makes me anxious just looking at it. The worst question for me is thinking of an example of prioritising information.

"Describe one example from your undergraduate medical training of your ability to prioritse tasks and information from any clincial or educational area. What was the outcome, what have you learned and how will you apply this to foundation training?"

I know I prioritise things non-stop all day, like whether to go to clinic or the computer room, whether to clerk a patient or drink coffee and read the paper... But I cannot think of a decent, clinical example. I am starting to get quite stressed about the whole thing.

Having a cold

2007-10-15T12:20:00.001+01:00

I make a terrible patient. I am in fact an impatient. I have a cold, sufficient to cause cold sweats on walking to college and a nasty cough which hurts my chest. This is all pretty minor in the scheme of things, but I am going mad with boredom already. The problem seems to be that I feel pretty much ok when I am sat down. However, any activity that exceeds, say, turning the page of my book, makes me feel faint and sick. I am not impressed. I went to radiology teaching this morning at the hospital and coughed my way through it. I think I learned something, but I decided not to go up to a ward full of chemo patients and expose them to my virus. By the time I got to the bus stop I felt quite unwell again, which only confirmed my confidence in my choice.

Now I'm at home, making a desultory effort to read a cancer biology textbook and I am bored brainless and feeling much better. I am now very impressed by the stoicism and fortitude embodied by the patients on the ward, who seem to take infinitely more serious and distressing illnesses with infinitely more patience!

Kids and cancer

2007-10-10T19:14:00.000+01:00

I know in the last post I said I wasn't scared of cancer patients. I'm still not. But today was sad indeed. I went to a radiotherapy clinic and saw 5 children with cancer one after the other. I normally talk in clinic, to patients and doctor alike, asking questions, getting involved and so forth. Today, however, I sat in the corner very quiet, feeling a whole range of emotions for the children, their parents and about the random events that change people's lives so much.

I thought too about my cousin, who committed suicide 2 weeks ago. He was a lovely lovely man who felt he had nothing to live for. It's hard not to contrast that knowledge with those children fighting so hard to live.

It was a strange morning indeed.

Don't be scared of cancer patients...

2007-10-03T21:56:00.000+01:00

In a lecture at the start of our oncology block on Monday, we were told that it will take time to learn to talk to cancer patients. Cancer patients will be scary to us young uninitiated things, we will be awkward and find it hard.

Ok, I thought, fair enough. I can imagine some people will find it hard to know where to start. But I was a little puzzled at this idea that cancer patients were somehow beyond the pale for us. We have all talked to patients who are terminally ill by now, after 2 years of clinical medicine. I spent 2 hours talking to a patient yesterday, ah, the time luxury we have as students! I thought it was sad that a young (52yo) woman had metastatic breast cancer, in her bones, her liver, lungs, uterus and now her brain too. I was amazed at her fortitude and determination to be as well as she could be. I was impressed by anyone talking even more and even faster than me. But I wasn't scared of approaching her and asking if she would talk to me. I wasn't scared to hear her say the word 'cancer'. I wasn't scared at all. In fact, I was glad I could talk to her and I wish we were encouraged to spend time with people in this situation, stuck in hospital for 5 days of radiotherapy. We're about the only people in the hospital all day with big chunks of spare time. I think I will mention it to the lecturer, as the only thing I found scary was the attempt to scare us in the introductory talk...

Ah, freshers!

2007-09-25T23:41:00.000+01:00

I helped move a load of freshers in to halls over the weekend. They make me feel old! I know it's just that I'm older, but they look younger than last year. It was scary. I'm quite glad Uni is nearly finished now, after 6 years, but it did make me nostalgic for the days when my liver could handle drinking until 3am and still making a 9am lecture.

Are medics really that clever?

2007-09-20T23:48:00.000+01:00

I worked at a posh reception this evening, as a waitress to supplement my measly student loan. I've done this for about 4 years now, and normally the guests completely ignore you. This is ok, as in a sense we get paid to be invisible service providers. When people are outright rude, as does happen, I still get cross. Luckily this is rare. Rarer still though is when people treat you as a human as happened today.

I was topping up champagne for the guests, the employees and clients of (I think) a property firm. Two separate groups engaged me in conversation, which made me feel like a person instead of a robot. Both asked what I did when not waitressing/if I was a student, and what I studied. When I told them, both said I must be terribly clever, despite one having studied engineering at the same university as I attend, and the other having been to another prestigious university. I was basically embarrassed! And it's not the first time it's been said either. People seem to assume medics are very clever, which I actually disagree with. So many other courses seem conceptually harder than ours. I don't doubt that intelligence is there (and needed) in most medical students and doctors, but I don't think they have extra brains compared with other students. Rather than sheer intelligence, I think what we have is tenacity and a facility to manage great quantities of information. I'm not sure this is the same as intelligence. Any thoughts?

Noah and The Whale

2007-09-17T23:25:00.000+01:00

I'm always a bit nervous when I go to see a friend's band. I worry about what to say if they were awful, or just dull. Luckily, today's experience was a gem. I have seen Noah and The Whale before, but this time I took my flatmates. They were able to say they really liked the band, and the place was packed. Hooray for Noah and the Whale!

Dessert

2007-09-12T22:02:00.000+01:00

I have just experienced something new. So far, boyfriend has cooked excellent savoury food, but in 3 years together he has never made dessert other than fruit salad. That is, until today. He made chocolate fondant bake things with truffle in the middle. It was death by chocolate and it was heaven. I think I might explode.

Business Visa

2007-09-11T14:54:00.001+01:00

I felt very grown up today. I went to Bond Street to get my visa for my elective. It turns out I need a business visa, not just a tourist one. Don't ask me why, but it's quite exciting. And I even got some work done. I may not have learnt my eye anatomy properly but at least I have read it once.

By the way,

2007-09-09T11:59:00.000+01:00

My last post before going away was to complain about exams. I did recover things on the OSCE and I passed. I found out in Namche Bazaar at over 4000 metres above sea-level.

Traveller returns

2007-09-09T11:45:00.000+01:00

There's a bit of a gap between now and my past post. Pretty much as soon as exams were over I hopped on a plane to Kathmandu. From there, 56 other students/junior docs and I hopped on other tiny propeller planes to Lukla. The airstrip there starts at the edge of a sheer drop and finishes up against the solid rock of a cliff-face. It was not my favourite flight ever, especially when I noticed that the windows were mostly held in by duct-tape.

From Lukla we walked for about 10 days up to Everest Base Camp, including stops to acclimatise and stare at the views. Then walked back again over 3 days. They were long days.

Our junior docs were in high demand. We had 2 of the team get AMS, and 2 of our guides get sick, one with a suspected perforated gastric ulcer, he was carried a day's walk to hospital. The docs were tracked down in tea-lodges by other trekkers, the locals, and by one woman who walked for hours to find us, as she had a wound infection and their village had not seen a doctor for years. It felt very very strange to get back to Kathmandu and the flushing sit-down toilets, let alone to get back to London on Saturday. It made the stresses of a London teaching hospital seem pretty tame.

Still, I'm glad to be back. Ophthalmology is suiting me very well. The instant-gratification aspect has a lot of appeal, especially since the results of cataract surgery are so good. I've not seen so many happy people in a clinic for a while.

So, back to the grind-stone and more updates on final-year medicine in London will no doubt follow.

One down, one to go

2007-08-08T09:01:00.001+01:00

Well, we have discovered that written exams are not my forte. EMQs are a funny format and only work of the question is well written. The ones yesterday were too ambiguous. Lets just hope I can recover things a bit on the OSCE tomorrow...

Oh dear, exams melt the brain

2007-08-04T23:48:00.000+01:00

I have been frantically avoiding revision for weeks now. And I still have managed to do some Obs reading. Shame about the Gynae and the Inf. Diseases. Ah well, the career system is so stuffed up anyway a few exams down the pan won't matter anyway. If the MTAS lottery is still in place I could be straight As or scraped by and still get the same job random allocation.

If anyone has any top tips for O&G last-minute revision do let me know...

2.5 hour tutorial

2007-07-19T22:36:00.001+01:00

I really appreciated that the O&G prof made the time to teach us for two and a half hours. But I'm not sure I remember much of it because the sheer quantity of information got too much!

GTAs

2007-07-09T15:40:00.000+01:00

For those of you who are not in the medical sphere, a GTA is a gynaecology teaching associate. That means a lay-woman who is trained in performing speculum and bimanual pelvic examinations and then teaches them to students on her own body. We had this session today, two GTAs with 5 students. We each passed a speculum, talked through a cervical smear test, and performed a bimanual examination.

I'd got the impression (as many might) that this would be weird. It actually was very straightforward, not awkward and I thought a really good way of learning the skills. It helps to get feedback on technique, what is uncomfortable for the patient and how to phrase things. Definitely better than doing your first exam on a patient, who is nervous like you.

If only I'd had this session before my first O&G attachment...

I can't help but judge...

2007-07-04T15:44:00.001+01:00

I spotted this in clinic today, above the trolley of speculums and paraphenalia for gynae examinations. I know it's wrong, but I can't help but judge. I just HATE it when people abuse grammar like this. For some reason, the fact that the perpetrator clearly thought they were being accurate and authoritative makes it much much worse. Oh dear, I am going to make a bad, judgemental doctor...

PDS the bane of our lives

2007-07-02T20:22:00.000+01:00

PDS, or professional development spine, is the bane of our lives. Today we learnt about bereavement after miscarriage or perinatal death. We saw a very interesting video about a couple who had a termination for serious foetal abnormality. The video was good, but the session before, more than an hour long, was not.

Medical students definitely need to be aware of the serious emotional distress experienced by women and their families after a death, but we're not morons, I promise! We spend a lot of time learning how to avoid becoming robots. We resent time we see as wasted going over and over the different theories of bereavement reaction, when the information has been covered before and could be laboured a lot less. Make it specific for heavens sake. I really wanted to be home before 6:30 today, but no.

Medicalstudentitis

2007-06-30T21:06:00.001+01:00

I have a severe case of medicalstudentitis. I have a runny nose, sneezing, coughing, lethargy and sulks. But, rather than the common cold, I am suspecting many things, including TB, leukaemia and HIV seroconversion. And I wouldn't dream of asking an actual doctor. I'll just mutter darkly about my suspicions to medical student friends who will tell you about how they diagnosed themselves with Crohns and Behcets last time they got a mouth ulcer....

Things that make me sad

2007-06-26T22:30:00.000+01:00

I saw a man today who had recently developed AIDS. Only he did so with probably lymphoma, so the prognosis looks a little bleak, even if he starts HAART. For some reason, his optimism, his little rationalisations and his conviction that a definitive diagnosis would make all the difference all made me feel heartbroken. He showed me his wedding photos. His partner has HIV too, and has been on ARVs for years. He is a lovely man.

It makes me worry that medicine is not the career for me. I am going to spend so much time heartbroken.

2007-06-23T14:56:00.001+01:00

I'm reading about HIV today. An ABC of AIDS is the book, but it was last updated in 1999/2000, so I'm pretty sure some of the stats are so far out as to be wildly misleading. Oh well. I am learning, by reading everyone else's medical blogs. I'm just not sure this will help me pass my exams...

2007-06-23T10:25:00.001+01:00

I was reading the http://fatdoctor.org/ blog today, talking about this sense of entitlement that people seem to have. Ok, it's US not UK, but it sounds very familiar. Is society going down the pan?! It's always me me me, isn't it?

I was at the check-out with my boyfriend and our groceries. At the next till was a little elderly lady reaching slowing and determinedly into the bottom of her trolley to get her shopping out on to the conveyer. Boyfriend and I looked at each other and the elderly lady toiling away, and he went over to help. Initially, she was totally baffled, then she realised he was offering to help and accepted. At the other side of the counter, as boyfriend was packing our shopping and her husband was packing hers, she came to talk to me. She said at 91 her back was fine, but her feet were easily tired. She explained that initially when boyfriend had gone to help she hadn't understood what he was doing, she rarely gets offers of help from strangers. How sad is that? Made want to give her a hug.

It reminded me of being on the bus, sitting on a double seat downstairs, no-one next to me yet. Lots of others were in the same position as it wasn't very busy, but no double seats were left. A woman got on with her small child and looked around for somewhere to sit with him. He must have been about 5. So, I got up and moved across to another seat so they could sit beside each other, no big deal, involved me moving about 3 feet. She was so amazed and so grateful, when I had hardly done anything at all. I have to assume that people don't often do these little things for other people. If it costs you nothing, then why not? I don't think my parents did anything special, I am no different than anyone else, but I do these things if I notice or realise (not always the case I admit). Is this a new thing, have we got less friendly or have people always been oblivious and selfish?

2007-06-21T22:58:00.000+01:00

Well, my finalist friends got their results last night. I know somone who got their rota for their FY1 post already, taking them from August to January. At least he knows what he will be doing next year. Sadly, there wasn't much rejoicing last night. MMC/MTAS has completely knocked the stuffing out of junior doctors, but also out of their future colleagues. Not that many people were running around full of joy to be entering the medical profession in a few short months.

No great suprise there then. How can you get excited about joining a so-called profession where you are not even allowed to apply for the jobs which are available? How many other public sector workers would put up with not being allowed to have any say in where in the country they were to work? Is it any wonder that the suicide rate among doctors is higher than any other profession, that people are dropping out like rats from a sinking ship and heading to the city, so at least they can afford to live where they want to? On the topic, where is the European Working Time Directive that tells city boys that they can't work all night?

I applied for an academic foundation post today. If I do get it, I will know by the end of July where I will be working in August 2008. So, can't complain in that sense. But, what is the point of fighting for a prestigious post when like as not I will have to enter what is effectively a lottery in 2 years time to the point where I won't even get much choice as to what branch of medicine I will specialise in? Having just spent a week or two doing nothing but fill out a form, I am starting to get an insight into how it must feel to be a junior doctor. How can you justify yourself in 5 or 6 150 word questions without a CV? I was stressed enough and I got to list my academic achievements (such as they are) on my form.

Watch this space, you might find it turns into "my accountancy adventures" all too soon.

...

2007-06-21T00:35:00.000+01:00

We raised over £500 for Great Ormond Street tonight as part of our run-up to a trek in Everest for research and fun and fundraising. It was a really good night actually, 5 bands played, mostly with medics in. I'm suprised they all get out so much!

Wow, a blogging widget!

2007-06-19T18:13:00.001+01:00

Aren't macs wonderful?! A little dashboard accessory to let me fill this blog up with totally pointless wittering whilst I fail to finish my application form. I am hoping a promised trip to the pub will motivate me to get it done, but we shall see.

Foundation applications

2007-06-19T14:07:00.000+01:00

Justify your application to this competitive academic foundation training post in 150 words each over 5 questions. Shouldn't be to hard, right?

Why is it taking all day and feeling like banging my head against a brick wall? No fun at all.