Friday 30 March 2007

Of locusts, sunshine and family

I am currently at large in Cyprus visiting these lovely people:



It's lovely to see the two in the back, they live here all the time but this year I will be seeing them lots which is lovely! It's nice and warm here and I am enjoying the sun [read: should have worn more sunscreen, look like a lobster] and reading lots and generally relaxing.

This morning the three lovely people and I took a trip to the north of this wee island which is Turkish, and which requires passports and stuff. It's very different over there, very Islamic and very run-down - lots of derelict hotels next to gorgeous stretches of beach, but because the land is still disputed (and in places pretty heavily mined), nobody goes there and it's in ruins. It's such a shame as it's so beautiful. There are minarets everywhere and the mosque called while we were in Famagusta - the sound is so familiar to me because of all the time I've spent in Cairo and Israel, it makes me feel at home [but does not make me wish to convert to Islam as my brother suggested!]. We also went to Salamis, where Paul and Silas landed about 2000 years ago [Acts ch 11 if you are interested] - although I suspect the jetty is somewhat more modern! The ruins of the Venetian city are awesome (in the true meaning of the word), and really shows how civilised life was then - they had running, heated water and everything!

Tonight we are off to Nicosea for dinner and Greek musical entertainment. I am looking forward to it as I have heard that there is a very ancient man who plays excellent violin, and for those of you who don't know, I am sometimes a violinist when the fancy takes me, so always like to hear others play!

Medically, I have a job which looks survivable, as MTAS kindly told me yesterday - but boy did they leave us hanging! It was very late here when I got the email, I was starting to panic! I am reading bits of my trusty Oxford Guide to the Foundation Programme (hereafter referred to as OGTTFP!) just to keep the stress at bay.

Right, I'm off to find some socks and get ready for tonight. Have a good one!

Tuesday 27 March 2007

Countdown Mark One

So it's a mere fifty-eight days until the names are posted on the board and we are given our longed-for doctor badges.

I am bricking it.

Tomorrow morning I am going to see the parents, hideously early start, but guess what I have in my rucksack? That's right kids, my faithful and increasingly well-thumbed copy of the Oxford Guide to the Foundation Program. I do not know a thing, and the time is fast approaching that people will expect me to know things. I'm dreading stupid things, like the times when, try as I might, I can't get the darned venflon in the vein and I don't have a nice, friendly F1 to run to for help because I AM THE F1. Oh, the horror!

My boss in paeds said she has a strategy for telling whether or not new F1s are going to have an attack of newly-qualified-itis, a dangerous syndrome where the new doc in question mistakenly believes that they know things and know what they are doing - it is bad, it leads to death, and not of the doc. Apparently the thing to do is ask new F1s after 48 hours in the job if they still feel sick - if they say yes, you can relax, because when they have no idea what to do and someone looks a bit sick, these nauseated souls will call for senior help, pronto. The problems come when the new doc says 'no, I feel ok now, I'm getting the hang of it' - this is Bad News and means they must be watched closely for the first six months to prevent serious medical errors caused by misguided confidence. Depressing though this thought sounds, I reckon you can practice medicine for years and years and still not really have a clue what you are doing.

I can say with some confidence that I will still be puking several weeks after starting work, and I will have burned my SHO's bleep number into my arm for fear of losing it. I am already having 'starting work' dreams - the first crept up on me a week or so ago, and involved me losing my bleep on the first day and finding a bit of paper saying 'this girl seems to be trying to minimise her potential for promotion as she has lost her bleep already' - I woke up sweating.

But enough of this paranoia, I must go and pick up a t-shirt from across town to take out to my parents (my brother has seen the guy who has it every day for the last month and yet we are going the night before we leave...I won't ask). Have a good week, I may blog from the sun if I can think of anything sensible to say!

Sunday 25 March 2007

Blood, sweat and tears

This afternoon, after my run (yes! I went running! Twice in three days!) I spent some time wandering through the world of medical blogland. These poor medics, they have some ordeals! I was reading a blog by a chap known as The Angry Medic who is studying for exams in one of the posh English rowing-mad universities where they have The Suicide Watch patrolling the tower of one of the colleges and people have to queue for tables in the open-24-hours library during the holidays. From his blog I came across this quote:
Studying in medical school is like having sex while you are drunk. You never actually finish, you just keep going until it’s not worth it anymore.

...and I laughed so hard!!! It's so true, medical school is sooooooo long and so hard that we all wish we could get out, and while I have no experience of drunken sex I can appreciate the similie!

Portfolio time is looming - the final hurdle. I lived with a final year medic when I was in fourth year and so have seen the final product - it only just fit in a lever arch file, which should give some idea of how much work is involved! Unfortunately I am on my merry way to surgical shadowing (I'll do the rubbish jobs that the FY1s don't want to do and not get paid a penny for it, what joy) which won't leave a lot of time to produce pieces of work to go in the dreaded folder, so I will have to make the most of evenings and weekends when I'm not working. Oh, how glad I am that it's all over!

As for this week, I have two more days in paediatric oncology, then I am going to visit my parents in far off places in the sun for a week. Hurrah!

Friday 23 March 2007

Sunshine and flowers

It's a beautiful day! The sun is shining, the birds are singing, the daffodils are out. I am happy because I have done my scary presentation and it went well, and also it is saturday tomorrow so I can sleep late!

I'm thinking of going for a run later. It's such a nice day, I should be outside enjoying the weather, and may as well get in some exercise. The problem is, the run will become more of a power walk than a run because I am not very good at running! I can swim for days but running is really hard! My chest burns very badly and I can't catch my breath so I end up walking most of the time. Apparently all beginner runners get chest ache for the first couple of weeks and then it gets better, but sadly I never get that far! Really like being out in the fresh air though, so will try harder - by the time I start work I work I would like to be able to run for a cardiac arrest without needing oxygen by the time I get there!

That's a good aim I think. Yes.

Thursday 22 March 2007

Wow

Came across this AWESOME violinist today (thank you Suman Biswas) - have a look, it's incredible!

Last night I stayed up late working on a big presentation but never got to give it because the ward was too hectic. Don't you just hate that?

Tuesday 20 March 2007

Madness

The weekend was great, thanks for asking - how was yours?

The gig was great, Elaine's sister cooked a fantastic roast, and all was well. I'm shattered though, and it's only Tuesday! Yesterday was pretty normal, ward round, clinic, multi-disciplinary team meeting, essay work, hung out with a friend in the evening. Also another friend who I haven't talked to for ages called, it was good to talk to him and catch up.

This morning was a bit mental - both our team's registrars are away, one on nights, one on annual leave and the boss was away interviewing people in a different city, so it was just the F2, the associate specialist and me. Normally we don't have much to do on a ward round, but today we had a very young patient come in very sick, and she started to decompensate, so we spent all morning putting lines in her and giving various drugs and fluids to try and stabilise her, then spent a while on the phone to a major surgical centre trying to arrange a transfer and trying to find a registrar to go with her in the plane in case she gets sicker...all a bit fraught, and the boss will no doubt be on the phone this afternoon for all the news.

Got a presentation to give on Thursday about chemotherapy regimens and protocols for childhood acute lymphoblastic leukaemia, so am home this afternoon working on that. Wish me luck!

Friday 16 March 2007

Livin' for the weekend

I've been really tired this week, and have had some pretty tough clinics with a few heartsink patients, so I'm glad it's the weekend now!

Tonight I am going to the medics' revue - a night dedicated to the ritual slagging of the various clinicians and scientists in charge of 'educating' the medical students. I've actually never been before, but by all accounts it is very entertaining so I'm looking forward to going with some girlfriends, catching up, relaxing and having a good laugh.

Tomorrow, I am going back to the Auld Reekie for what promises to be a great gig by, yes, you've guessed it, The Mars Patrol!!! You can see the flyer for their gig here. They've just released their new single so will be playing that among other things, at Studio 24, 7pm, free entry..........spot the plug!!

Then on Sunday I'm going with my friend Elaine to her parents' house near our uni city for Sunday lunch - Elaine comes from a family of great cooks so no matter who is cooking on the day I am bound to be well fed!

So a nice, relaxing-but-not-boring weekend planned. What are you planning?

Monday 12 March 2007

The youth of today...

In clinic today. Lots of kids, all on chemotherapy for various cancers. Lots of potential side-effects of chemo, including hair loss, nausea and the topic of the day, infertility.

One of the patients was a teenager who had an interesting question - well, actually his mother raised it when we were just thinking about long-term effects of his chemo. She just said 'of course, there's a girlfriend now' and straight away my consultant said 'you must assume that you are fertile and take proper precautions' while the mother nodded enthusiastically.

I was shocked!

No 'that's nice, do you go to the cinema/bowling/whatever?', just straight onto contraception! Gosh, I'm so naive.

Just feels a bit weird giving contraception advice in a paediatric clinic!

Sunday 11 March 2007

Glass half full?

So, in the absence of any emails stating otherwise, I have got a job! I'm pretty happy about it really, especially as I've been told time and time again how competitive my chosen rotations are.

However, while I am feeling happy and am looking forward to starting my career, a huge number of junior doctors everywhere are panicking about theirs...yup, you guessed it, MTAS. Nobody likes it, and it really doesn't seem fair. I was having a look round some blogs written by fellow medics this evening, in the absence of anything productive to do, and I have to say it makes pretty miserable reading.

Most of the docs out there seem to truly hate their jobs.

I can't really say anything because I have yet to become immersed in the NHS proper, but I really, really hope that I won't end up that disillusioned with medicine, and I hope I won't end up as miserable as these poor people.

I love medicine, I'm a total geek about it, I read things when I don't have tests to study for, I look things up randomly, I look forward to going in to the hospital. Sometimes I even get goosebumps, I love it all so much. Obviously I have bad days, as everyone does, but the good days far outweigh the bad.

Am I destined to become disillusioned, grumpy and hateful of my chosen career? Is MTAS going to ruin my oncology dreams despite all my best efforts and prayers? I sincerely hope not. I want to become one of the doctors that I have admired during my training - a doctor who really cares about my patients, who is keen to teach students rather than dismiss them or give them crap jobs, who loves medicine and for whom it shows.

Is this too much to ask?

Friday 9 March 2007

Gormless

I forgot to mention...the student who was the 'subject' of yesterday's rant was in again today - still with his badge on his crotch - but he also managed to do the entire ward round with one black trouser-leg tucked into his (white) sock!! Didn't have the heart to tell him, but giggled quietly to myself...well, my F2 saw as well so we both giggled. Quite typical of the madness we encounter with colleagues every day!

[It's now 17:34hrs and I still have no email...am I 'home' and dry?!]

Ding! Round One

Today is Round 1 in the world of Scottish MTAS. I am nervous.

Today, those of us unlucky enough to not match any of our top six foundation programmes will be informed by email that we have to enter Round 2 and choose from the jobs that are left. If you matched one of your top six, you won't hear anything.

I applied to Edinburgh for all of my choices - notoriously competitive, hence the nerves.

At noon today, my inbox is empty. So far so good. I'll keep you posted.

Thursday 8 March 2007

Grandma? Moi?

I have a question for any guys who might be reading this. Medical guys, in particular, or any who wear ID badges to work really.

Is it really neccessary to wear it in the middle of your belt?

Because it means that if I am trying to work out who you are, I have to look almost directly at your crotch. If you have a particularly difficult name, I have to look at it for rather a long time. It's not very enjoyable, and it makes me feel like a perv, when in fact I just want to know your name, and, where appropriate, your status.

A particularly nasty example of this happened to me not 'alf an hour ago (as they might say in the dead parrot sketch) - there's a guy working on my ward at the moment and I have no idea who he is. Apparently he's a med student, but instead of wearing the easily-identifyable med student badge (about the shape of a bourbon biscuit and pin-on) he is wearing a badge which looks awfully like that of a doctor (credit card shaped and on a clip). He must be a student because nobody seems to know who he is, and he doesn't seem to know anyone (or anything for that matter), but I find it pretty annoying that he has a doctor-like badge because he probably thinks it makes him look more like a doctor, because it's very confusing.

Imagine what it would be like for the nurses, who don't know any of us and sometimes need a doctor rather urgently - might they grab this rather gormless looking student, assuming he's a doctor? What chaos could ensue.

Rant number two - along a similar theme: when I was a kid (read: junior medical student), it was a very well-known but unwritten rule that only senior medical students (and by this I mean 5th years and, depending on the block, 4th years) were allowed to wear their stethoscopes round their necks. It was partly a status thing for the student - it's rubbish to be nearly a doctor and have passed your finals and still be in the same general category as the kids who are still going 'what's a femur?' (as I overheard on a bus recently) - and partly for ease of recognition by other members of staff. This seems to have fallen by the wayside, and I often see second year students (not usually first year because they are still totally in love with their white coats and have not yet realised how inconvenient they are) with steths round necks.

Every time this happens I have to resist the almost overpowering urge to grab the offending steth, thrust it into the offending second-year's hand and say 'not for you, sunshine'. Of course I never do, I just rant about it on blogs like this instead.

There is nothing happening on my ward this afternoon, which is nice, but as I am not paid to be there hanging around and as my lovely F2 has dismissed me, I am going to bury myself in the library for a bit.

Tuesday 6 March 2007

MTAS - Medicine Torture Application Scam

The more I hear about the MTAS malarkey, the worse it all gets...

So far, the Panicking Junior Doctor Grapevine (PJDG) has reported people not getting interviews at all, people getting 2 interviews on the same day 500 miles apart, and consultants refusing to attend interviews at all because the whole thing is such a sham.

The most disturbing PJDG rumour is that if you are unsuccessful in your application the first time round, you can locum for a year, but if you are unsuccessful the second time, that's it. You can't apply for your chosen specialty any more. 2 strikes and you're out, on the next train to dermatology/urogynaecology/GUM. It's like saying, well done for training to be a geography teacher, unfortunately you must now teach maths.

I think this picture sums it up nicely.


Monday 5 March 2007

ALL/AML/CML/CLL/HD/NHD..........OMG!!

Started a new block today, in paediatric haematology and oncology (colloquially known as paeds haem/onc). You'd think it would be really sad, all these kids with leukaemia and no hair...but actually, I didn't see a properly sick kid all day. The prognosis for acute lymphoblastic leukaemia (ALL), the most common cancer in childhood, is actually really good - over 90% of kids will achieve permanent remission.

Saw a few kids with other tumours - one had Hodgekin's disease (yes, what Delta Goodrem had!) and one had a Wilm's tumour (kidney thing) - but most had leukaemia.

I'm the only person on this block, which is a bit scary, and rather lonely...it also means I don't know how much I'm supposed to know - nothing to compare knowledge with. Also means I spend a lot of time sitting in clinics on my own waiting for stuff which could get a little tedious!

Today I left the hospital at 6pm which was a bit later than I would have liked...I don't have a timetable yet but hope I'll get the occasional afternoon off!

Apologies for the spraffy post, I am shattered, so I'm going to shut up now!

Saturday 3 March 2007

What if I took the risk, would I be dismissed?

Went to watch my rock star brother play in Edinburgh last night - it was AWESOME!!!

For those who haven't been exposed to my ravings, he is the bassist in a great band called The Mars Patrol (no, they didn't copy, they had the name before snow patrol did!) - plug coming up - check out their official site (see my links) or their myspace to hear some tunes...www.myspace.com/themarspatrol.

I haven't seen them play for a while, and now the band has a permanent drummer (the last few were fruitcakes!), so this was the first time I heard them as a four-piece for a while, and, all bias aside, I was really impressed! Not to mention a wee bit proud :-)

It's a bit surreal being in a packed-out venue with a load of strangers screaming your little brother's name though...

Today I went to the hospital in which I am hoping to work next year. [Never end a sentence in a preposition!] I got an unofficial guided tour with a good friend of mine who is a med student there and therefore knows his way around! I was really impressed, it's all really well laid out and nicely new and shiney - the wards system has the potential to be a tad confusing, but no more so than the hospital I currently spend most of my time in! I also ran into a friend from my med school who came here (Edinburgh) to work, and she had her FY1 with her who is doing the job I am hoping to do - it was really useful to grill her about various aspects of the job. She seems to like it, all in all, which is always good!

Am now back at home in my parents' house listening to the new Mars Patrol single, 'Hit the Lights' - GET IT, IT'S AMAZING!!!

Plug, anyone?!