Friday 29 June 2007

Alcohol, my permanent accessory

Alcohol, a party-time necessity,
Alcohol, alternative to feeling like yourself -
Oh alcohol, I still drink to your health...

...oh, hello, didn't see you there. Bonus points for guessing the song and the artist!

It's been a crazy week. I've been following the FY1s who are on the ward I'm going to start on, trying to learn the ropes and how things work. I've met lots of nice people (I had heard that BCI was not the friendliest of places but everyone's been lovely so far, including all the consultants), everyone's really friendly and the two girls I'm working with are really cool, I think we'll get on well. There are some oddities about how things work in this hospital compared with University Hospital, but I think that would happen anyhere. And yes, I have got lost a lot!

Parking at BCI is extortionately expensive and there aren't really any alternatives to park - there's a housing estate close by in which you might get a space if you're lucky, but otherwise it's a bit of a nightmare. Thankfully I only live 2 miles away, so I've been walking there and back this week. I've actually really enjoyed it, I like the fresh air, the exercise, the fact that there are lots of trees on the roads I walk along, and the fact that I can have some free thinking time before the day starts. I'm planning to walk to work in August when we start as long as it's still light, except perhaps on late days. Or when it's chucking it down.

My ward is GI, which I was expecting, but what I wasn't expecting was it being only upper GI, and the fact that the vast majority of my patients are alcohol enthusiasts and look like a cross between Tweedle Dum/Dee and Homer Simpson! Alcoholic hepatitis is the order of the day for most of them, with a few scary alcohol-associated things which give me The Fear and involve a lot of management about which I know nothing. Oh, and just in case life gets boring, half of them have varices and like to puke their circulating blood volume all over the place. This has happened a couple of times this week, with one fatality and a couple of ITU transfers. I am pretty scared of this too. The only non-alcoholics have oesophageal cancer, which is not particularly cheerful either. Good grief, this was not quite what I had in mind. Must read some books before I start and the fate of these people rests considerably on my decisions!

Anyway, I'm still missing my social life but I've been really knackered this week and I still have a lot of stuff to sort out at home - still unpacking, oh the misery - and I'm trying to be realistic about it. I can't expect to make friends as good as my friends from uni in a week, but I've met some nice people and I've managed to get in touch with a few people at the church I mentioned before who are going to introduce me to some more people. All good. I am Joey, Networker Extraordinaire.

Right now, I'm going to try and do something about the dreaded unpacking so that I can actually see enough of my bedroom floor to hoover it!

Sunday 24 June 2007

Nerves and missing uni

Back in the rainy UK now, after a very scary flight! Seriously, the most turbulence I have ever experienced, actually thought we were coming down a few times, people were screaming and everything. Not so nice. Consequently I got no sleep at all, though I went to bed for a few hours in the afternoon after I got back. Feeling back to normal today after a nice rest.

This morning I went to church. Not an unusual thing for a Sunday morning, but this week was the first week I have been to church in this city since moving here. I have provisionally decided to go to a large, pretty lively church which is connected to the one I grew up in (same denomination and many decades ago they were the same church before it got too big and split into two, one suburban and one in the city), but at the moment they are doing up their building bigtime so are moving about locations in the city. It's usually in the university halls, there's a big room there, but this week it met in the city centre.

It's a great church, it's really lively and there are lots of people about my age and lots of families and stuff, but it also has the usual problems of a massive church - how to break in! It's so big that you don't often meet the same people twice, and today I didn't know anybody, I sat on my own and nobody talked to me which was a bit crap, though what with the new location and stuff it must be hard to tell who's new, but it sucks to go to church alone and leave alone without having talked to anybody. I'm gonna go again tonight, so hopefully I'll have more luck then! I think the way to do it is to join a homegroup - I guess the nice thing about moving is that I no longer have any evening commitments so I'm free to arrange things. I know one guy who runs a homegroup (didn't see him this morning but I know he works funny shifts) so perhaps I'll try to go to that.

Missed my old church at uni quite a lot, and it's just starting to strike me that I'm actually completely sans social life at the moment since I don't know anybody here! Will have to put on my Sociable Hat and go to lots of things where I don't know anybody and try to make some friends without feeling like a total pratt!

Tomorrow I'm shadowing at Big City Infirmary - I'm pretty nervous to be honest, but also a little excited, it will be great to see the place I'm going to be working and to ask all the silly questions I need to ask and to meet the people I'm going to be working with (another sociable opportunity!). It feels like everything I do and everything I go to in the next few weeks is going to feel like being the new kid at school - the majority of people who are shadowing at BCI trained here so will probably know each other, but hopefully I'll meet some people and we'll get on well.

Sorry to air all my insecurities here, and sorry nothing that interesting is happening, I'm just trying to settle in and build a life I guess! Will post about shadowing if it provides something blog-worthy!

Wednesday 20 June 2007

In dispraise of cockroaches

Hey ho people, I know there are a few out there - and I have cancelled my sitemeter thing because after my previous rant I got several comments and still it registered no visits, so I ditched the useless piece of junk, it wasn't helping my ego!

Anyway, here I sit in my parents' living room under the sweet, sweet air-con after everyone else has gone to bed, swatting away the very persistent mosquito which seems intent on getting a piece of me and feeling pretty pleased with myself for managing to swim around in a pool all day and not get burnt! Lovely to see the parents, even if they still do my head in the way that only parents can, and lovely to get out of the rain!

We've been battling the monsters here though - Catherine my travelling buddy and I had a fight with a massive cockroach last night after it had the audacity to sit on her Marie-Claire magazine and wink at her as she tried to go to bed! We have a can of magic bug spray which kills them dead but I think it's a bit like mustard gas for them, they go a bit mental before they die and scrabble around on their backs (always their backs, why?!) while we stand there and watch, feeling ashamed and villainous. I'd be a crap Buddhist. Anyway, the magazine just happened to be next to Catherine's toothbrush which was a bit of an issue - this bug spray does not smell good so I doubt it would taste good either - but after some obligatory squeaking we sprayed it lots and sure enough, the scrabbling began. Catherine pipes up in a wee plaintive voice, 'can we put it outside? I don't really want it dying in my room!' so we hatch a plan to scoop it out of the window. This plan fails when we can't find a dustpan - we have a long handled broom and neither of us is willing to get closer than the length of this broom, so in the end Catherine sweeps it down the stairs! She was sweeping one stair at a time, but since the floors are patterned marble and it was dark it was kind of hard to see this here roach, so eventually we swept it down about seven at once and out the front door. Drama over! Amazingly, we didn't wake the parents, despite all the squeaking. It was a BIG roach. It was. I'm not just being a wimp. Really.

Anyway, I've just finished reading a great Ben Elton book called 'The First Casualty', I recommend it highly - I started it on saturday and finished it today, but I read another book in the middle about a guy who died for like 9 minutes and had a bit of an Ebenezer Scrooge experience, it was interesting but very far out. Now I'm gonna get back to the Jodi Picoult I was in the middle of before finishing Ben Elton became a priority so I could leave it for my mum!

Sorry for the boring post, I'm using safari on a mac and it doesn't allow html so I can't do anything exciting. Well, that's one reason - the other is I'm on holiday and it's bedtime and I like bedtime!

Back to the UK on friday night, get in at some ungodly hour (yes, 5:30am straight off a plane onto a bus then a train then another bus, grooo) on saturday morning and have to hoof it back from Even Bigger City to Big City and try to unpack some of the seven thousand boxes that still remain before shadowing on monday! More then, sure I will have some adventures getting lost in Big City Infirmary!

Thursday 14 June 2007

Many, many things

Wow, it's been a crazy few days. I went to the grad ball extravaganza which was awesome but knackering, then the day after I got back I packed up my [mountains of!] stuff and moved house, which was not in the least bit fun and very knackering, and now I am surrounded by boxes and bags and stuff and I have to pack up and go again tomorrow!

For tomorrow, ladies and gents, I am going to the sun to see the lovely people again! I am really looking forward to seeing them, though I am not really looking forward to being sweaty all the time (it's very warm there) and I'm not particularly looking forward to the 5-and-a-half hour flight - I get bored! But when I get there, I will have a week of parent time and I can't wait.

I'm sad though, as well, because my friend was meant to be coming with me and due to (CRAPPY) circumstances (and medical school IDIOCY) beyond her control, she can't come. I amd GUTTED about this, as is she. Another friend was able to step in and buy the ticket which means nobody lost any money, so it worked out alright, but I feel so bad for my friend.

But I'm trying not to dwell on the guttedness, and I don't want the friend who is coming instead to feel bad about taking the ticket, so I will mention it no more. I hope this doesn't offend anyone.

For now, I found this silly quiz thing on this blog and thought I'd do it, just because I feel like it!

Two names you go by: Joey, Dr Joey

Two things you are wearing right now: Brown linen trousers, med school class of 2007 hoodie

Two things you would want (or have) in a relationship: Trust and patience

Two of your favourite things to do: Walk barefoot in grass, take long showers

Two things you want very badly at the moment:
my first paycheck, my stuff to be magically unpacked and all the crap that I don't need chucked out or given away!

Two pets you have had: several guinea pigs, a rabbit

Two people I would like to do this: I don't really mind, and if my sitemeter is anything to go by then nobody actually reads this thing so I can say ANYTHING I WANT!!!!!!!!!!!!!

Two things you did last night: unpacked some boxes, cooked dinner for my roomies

Two things you ate today:
chicken and mint imperials (not together)

Two people you last talked to: parentals and Matt The Roomie

Two things you are doing tomorrow: Going to a big post office to get a passport application form for my dad who is running out of pages in his despite it not expiring for another 5 years, and flying out to the sun

Two longest car rides: from Uni Town to Big City, then tomorrow from Big City to Even Bigger City to catch the plane

Two favourite holidays: Last summer's elective was pretty darned awesome. And I love Cairo too.

Two favourite beverages: Diet Coke and OJ with bits in!

So there you go people, I did this without being tagged too, but that's because I am a rebel. And I'm defying my sitemeter!

Anyhoo, I might post while in Sunland, otherwise see you in a week!

Friday 8 June 2007

Finito!

Today I finished medical school! This morning was the last of the preparatory foundation lectures, and, after a lunch provided by the dean (with proper food and cakes and everything) I cleaned out my locker (read: stuffed my not-been-worn-for-at-least-3-years white coats into my rucksack and chucked out several ancient editions of the Times) and got back my £5 deposit, and bid farewell to the hospital which has been my home for the past nearly six years. It was a strange moment, all things considered. I'm really happy to finally be finished, but I'm a little sad to be leaving behind all things familiar. And the best doctors' mess in the country, so I'm told!!

Still can't really believe I'm leaving so soon...I'm moving to a city that I know like the back of my hand and yet I don't know anybody. I really hope the reputation that the medical students in Big City Infirmary have as being stuck up is not true! I know two guys who study there and neither of them are stuck up so maybe that bodes well!

I haven't heard ANYTHING from the good people at BCI, not a peep. No contract, no rota (though I wasn't expecting that quite yet), no confirmation letter, nothing about the shadowing week coming up. I'm going away on friday for a week in the sun and shadowing is supposed to start the day after I come back, so hopefully something will come before I leave or I'll have to get on the phone!

So yeah, the end of an era. The medics' grad ball is this sunday till tuesday, which I'm sure will provide a lot of madness - I'll share some tales when I get back, provided I'm in one piece!

Monday 4 June 2007

ohgoodheavensidon'tknowanything

Today was a bit of a crazy day, and by the end of it I realised once more that I did not know a damned thing!

First off was a lecture about how to interpret and fix dodgy blood results (man I hate renal failure but I hate dodgy LFTs more and oh my word I'm on GI for some of my first block I am so screwed), then we had a lecture from two of the FY2s on what it's like starting work - one of them was a graduate of my uni, one was a graduate of the place where I'm going to work. The former was fairly positive and talked a lot about careers and stuff, the latter was less positive and said when she started work she had shadowed for 5 DAYS (compared with our 2 months) and so wasn't very organised for the first few weeks (oh hell, am I going to be expected to be really organised?!), and she basically scared the crap out of us - she apparently stayed till 10pm on every shift for a month and didn't know how to do anything. Ooooooooh goody now I can't wait to start!

Then came a lecture on perioperative management, which wasn't that bad actually, but it was in the afternoon that it all got hairy!

We had a scenario exercise where we rotated round 3 stations in groups and were taught on various aspects of acute management by some anaesthetists. The first room was fine, nothing we couldn't handle, just use of GCS and things.

The second station was to do with management of respiratory problems - basically A and B of the ABC thing. Stupidly, I volunteered for the first scenario, and MAN WAS I CRAP. I managed to get an airway and find a suitable sized Guedel, but couldn't explain how I sized it (knew it was something to do with the jaw and the chin/teeth but couldn't explain exactly, oh dear) and then put the patient on 100% non-rebreather (yes, he was breathing, I'm not a total dope) despite the fact that he had a past history of COPD (yes, that was correct too) but then when I auscultated I was told the patient had really crap air entry. By this time I was starting to freak a bit under the scrutiny of this here anaesthetist, and apparently my Reg was still 5 minutes away and my patient was going down the tubes, and the crash team anaesthetist was also 5 mins away so it was still down to me. I was faffing about trying to think of what to do while burbling something about getting lines in, and she was going, 'are you happy with breathing?' and I (having not seen the bag and mask lying on the side) was thinking, oh hell, what can I do now other than intubate which wouldn't help because the problem wasn't with the airway but with the lungs, but eventually found the bag and had my 'nurse' bag the patient. This helped a bit and got a nod from the anaesthetist so I could move onto circulation - oh dear, shocked patient, shut down, 2 large bore venflons, bloods off for FBC U&E clotting cultures and various other things, then fluids ('what?' - 0.9% saline, 'how much?' - 1 litre) then oh thank goodness my Reg arrived and I was saved and could take my seat again in shame for my poor performance!

The next station was even worse - in fairness to us, it's really hard to run a peri-arrest with a dummy because they don't do anything and we never know whether we are supposed to just get on and do stuff or wait for the supervisor to tell us the clinical situation. Anyhoo, we started off and I have to say we were a bit crap! Because we haven't had any CPR training since the new guidelines came in, we are still a bit rubbish at them, so we were a bit unsure and a bit slow, and basically pretty scared!

Question time saw one of my stupidest questions to date: 'if you charge the paddles to 360 and you don't need the shock after all how do you get rid of the charge?' - it turns out that you can just turn it down, but to do that you need several hands, and so I dug myself further into the hole and said, 'can you not just discharge them?' - OH WHAT A DUNCE apparently this is a sure-fire way to kill random people in the room! In my defence I had remembered that you could discharge the paddles at some point but couldn't remember if it was a good thing or a bad thing to put the paddles back on the machine beforehand (good!), and although it was a stupid question we were all thinking it and it was just me (as ever) who voiced it!

Anyway the anaesthetist was really nice about it and said it was fine to ask dumb questions because when else could we ask, but I still felt like a pillock.

RIGHT I'm not even going to read this post because I have just proverbially spewed it out in a big panic, so I will just post it and stuff the poor grammar and layout!

The main message is, I am terrified again, I don't know anything and I am going to SUCK. But I will try soooooooo hard and dammit I will get there in the end.

Repeat ad nauseum until you believe it!!

Sunday 3 June 2007

State of annoyance

In a fit of mental agility, my flatmate, her boyfriend and I decided to play the States Game (you know, the one where you have to name all of the states).

We got off to a bad start when we couldn't agree on whether there are 50 states or 52.

I think we did quite well for non-Americans. We got 48, but we realised that we'd made up 3 of them, so in actual fact we got 45. Apparently Arkansas and Arkansaw are the same place, there is no state of Chiboigan (I think it's a city), nor is there a state of Milwalkee or East Virginia (which is really stupid, because if there's a West Virginia and a Virginia then SURELY there should be an East one too).

The ones we missed were Oregon, Maine, Nevada, Louisiana, Vermont, Wyoming and Utah.

I was cross about the Vermont one because it's the place that Diane Keaton runs off to in Baby Boom. We were all cross about Utah because it's massive and it's where the Mormons live. We were cross about Louisiana because of the many songs.

We agreed it would have been unlikely that we would have got Wyoming. And the boyfriend was upset that he didn't get Maine.

But otherwise, we thought we did pretty well.

Then we looked at state capitals...woah, bad idea! The capital of New York State is not, as one may think, New York City - it's Albany. The capital of California is not Loa Angeles or Hollywood, but in fact Sacramento. The capital of Florida is Tallahassee (come on! Is that even a word?!). And the one that bugged me most, the capital of Illinois is not Chicago, noooooooo, it's Springfield. Honestly!

So we were all a bit annoyed about that and figured that unless we were planning to become American (no chance, too much of a faff to get a green card and we kind of like our wee island I think) then it wouldn't really make a great deal of difference to our lives if we didn't know the state capitals.

I'm sure American people will think we are stupid, but hey, if Ross Geller can't get them all then how are we expected to?!?!?!

Friday 1 June 2007

Frazzle

Today has been an annoying day - or rather I have been annoyed by a lot of things, often very irrationally. Some things were not even worth mentioning, like my darling flatmate using all the milk so I didn't get any breakfast (I know I could have eaten something else, but I didn't have any bread!), and like waiting in a queue for ages for some free stuff from the BMA only to be told to go into the lecture theatre as the lecture was starting when I was 2 people from the front!

There were a few other things that really got me angry, but I don't want to mention them here really, they were just to do with attitudes, but it's not important and I'm positive I was more annoyed about them than I should have been!

It was a beautiful sunny day here, I went to lectures in the morning (which were very useful, we heard what our salary is going to be and I got dollar signs in my eyes!) and then had a gap in the afternoon before the Yearbook launch at 5pm, so I went round to visit some friends who live close to the hospital and sat in their garden - they are the only friends I have who have a garden, it's a luxury! Anyway, I sat and read in the sunshine for about 2 hours, it was very pleasant. Until I got inside and got my red vision back (you know how when you've been in the sun a long time you see everything bluey?!), and I looked at my shoulders and thought, oh dear, I look like a LOBSTER!!! 2 measley hours in the sun and I'm burnt to a crisp! Seriously, when I got home from the yearbook launch I had a shower (one of my friends said she heard if you have a hot shower it draws the heat out, I thought anything was worth a try but it doesn't work folks) then had to wander about in my bra for ages while the inch-thick layer of aftersun I smeared all over my shoulders dried in :-(

I'm an idiot, I KNOW that I burn easily, but here?! It's crazy. So I'm generating my own heat at the moment, and feeling sorry for myself - there are one or two patches that look like they might blister, so hopefully that won't happen, but I'll be an interesting shade of crimson for several days I think.

May as well make use of my thermogenic abilities...bacon, anyone?