into the fray...

The end is nigh

2007-07-29T06:57:00.000-07:00

So, after thinking about it for a few days, I have decided that this blog is not really going in the direction I would like it to, so I won't be posting here any more. If anyone is interested in reading my new blog, feel free, but it won't be a 'medical' blog, but more of a 'thoughts about life' blog.

Oh dear, I sound like a hippie. Sorry.

Anyway, it's been fun being a medical blog, and I'll still read medical blogs, but I don't think I'm really contributing much and the confidentiality issues are far too complex, so I'm jumping ship!

so farewell, it's been fun. you are welcome to join me in the new world!

Funerals, flooding, rotas and toothache...a random mixture!

2007-07-26T06:24:00.000-07:00

Back home now, Oxford was pretty flooded and I've heard it got worse after I left which is bad - Aaron and I went to look at his next house (his lease is up in August) which was on the other side of one of the flooded streets, so we had to take our shoes and socks off and roll up our jeans and wade through it all! Aaron's house is ok, not flooded, but some of his old flatmates had to move out of their new house because of the flooding - it's pretty bad down there.

Aaron has a hard time staying away from scary situations! When we were in Israel last summer, we got bombed by a couple of katyusha rockets on our first day, and, rather than going to a shelter (there weren't any) or a basement or something, we all went to the roof to have a good look! Not content with this, Aaron was all for running down the hill to where the rocket hit to have a look - he was the same with the flooding, couldn't stay away in the safe bit but had to go wading in! Nutter...

Anyway, no trains were running but I managed to get a lift up to Birmingham with my dad who was travelling from Heathrow for the funeral. All a bit complicated, but got there in the end.

The funeral was my dad's uncle's, but he was only 62 and it was pretty sudden so quite sad. It went as well as could be expected though, and I got to spend some time with my dad's aunt and cousins (who are more my age - there's a big gap between siblings so the generations are a bit mixed up) which was really good. It's a shame about the circumstances though.

And now, I'm back home with horrible toothache so I'm going to the dentist tomorrow - is it acceptable to be scared of dentists when you're a doctor?! I just hate the noises and I hate having stuff in my mouth and I REALLY hate then putting needles in my gums, there's no squidge there! Will stop being a wimp though, I need to go and get my dodgy tooth sorted...

Oh, I said I'd mention my rota...briefly, it's a bit weird - I start with 2 days annual leave which is annoying when I already feel like I'm on death row, I just want to get started! Then I seem to be working 4 weekends of the next 8, and I have several days of 'zero hours' which I assume are days off, but I think they are just to keep the rota a bit more compliant than it would be otherwise. Still, it seems a bit all-or-nothing - I work a lot of long shifts in a row, then a weekend, then I have a few days off. I don't know what the other people on my ward's rotas are like, I guess they are pretty similar. Very strange!

Travel and Torment

2007-07-22T13:24:00.000-07:00

So about that road trip...I decided to go to Oxford by rail instead! Only this has caused its fair share of problems - firstly I went to the station and they told me that there were no trains running south of Birmingham. So after some huffing, I went home. And sat on the doorstep for 40 mins because I'd left my keys at home so my mum could drive my car while I was away (but heaven help her if she scratches it!!).

Then I phoned my friend in Oxford (his name is Aaron) and asked him what he thought I should do, and he phoned a lot of people, and eventually I went back to the station and got on a train which was going all the way to Oxford. All good.

Until we got to York and they announced that the train would be terminating at BIRMINGHAM. Grrrrrrrrr at Virgin!

So I had to call my long-suffering friend who very kindly agreed to drive up to Brum and pick me up. What a star.

When we got to Brum, I asked a guy at the information desk where cars could pull up as I was trying to get to Oxford, and he said, 'oh, this bloke here's going to Oxford too', so I was introduced to a lovely young guy who assured me he wasn't a serial killer rapist or anything and turned out to be a History student at Leicester on his way back from a TA training weekend in Aberdeen. Anyway, he provided amusement and conversation until Aaron arrived and drove us both back to Oxford. So you see it worked out ok in the end.

And now, it's Monday - yesterday, I went with Aaron round the colleges, sneakily avoiding all the tourists by waving Aaron's student card at the many security people, and wow, were they amazing! I felt kind of stupid wandering about in all the academic glory of these gorgeous old buildings, and kept having to tell myself 'you're a doctor, you are not stupid' - the Oxford mantra, I think!

Anyway we had a nice day wandering about, it didn't really rain and there were lots of tourists to avoid and awesome buildings to see.

And today, the Thames and the Ouze are both flooding and I may well get stuck here! The trains from Oxford to Birmingham all go through Banbury, which is totally under water, and there are no replacement buses, so it looks like the only chance to get back is to get a lift to Brum again and go from there. Aaron's working at the moment (he's a med student, grad fast track so back early!) so I might have to think again.

In other news, my rota is apparently FINALLY winging its way to me through cyberspace and should be in my inbox in half an hour or so when the lady I called about it finished whatever she was doing. More on that after I've scrutinised it...

Vehicular bliss!

2007-07-17T09:13:00.000-07:00

Aaaah, I am in love with my new car! It's soooooo nice, it is smooth and handles beautifully and it's so pretty, I am a happy girl!

Now, for those of you who are very observant, you may notice that this post has changed since you read it before...

Basically I was planning a big road trip down to Oxford to see a friend, then to Birmingham to see another friend and go to a funeral, but I'm having doubts...

I blame my mother really! She suggested that it might not be the wisest idea to drive for several hundred miles alone in a new car when the (quite considerable I've worked out) petrol money will be coming out of my overdraft. So I've thought about it and maybe she's right - I've never driven this far (I've only had my license 6 months after all) and perhaps it would be better to do it with someone else for the first time rather than on my own.

Anyway I haven't decided for definite yet, promise I will commit my indecisive self to something soon!

Vehicular nightmares

2007-07-12T09:16:00.000-07:00

Man, having a car is a stressful business. We phoned and confirmed the car this morning which is awesome, and we have to go do the paperwork tomorrow and can pick it up on tuesday which is great.

Unfortunately now I have to enter the tedious world of insurance! I got a quote from a leading four-sided company which was much better than the other ones - bearing in mind this is my first car, I have had my license for 6 months and I've been on my parents' policy so don't have a no-claims bonus yet. So I went onto the website having got a quote from a baffle-free-we-get-all-the-quotes-for-you site, and lo and behold, it wouldn't take my password, so I had to call them up. When I get through, I am told that the quote I have been given is only valid if I pay IN ONE GO, as if I have £712.98 lying around! Was very cross, the price if I pay monthly is £170 more than this but I don't have that kind of money.

Grrrrrrrrr. Back to the electronic drawing board I think.

The other thing about this car is, it's pristine. I'm used to driving a slightly battered Nissan Almera which has rusty bits and scratched bits and a dent where my brother backed it into a lamppost after going to see a particularly exciting Pirates of the Carribean showing. So if I scratch yon Nissan, tis not a big deal. Or at least it is easily hidden. Or blamed upon somebody else. But if I scratch the new shiny car which is mine and mine alone, I have nobody to blame but myself! Also I have never driven a Ford, what if the clutch is weird and I drive it into a wall the first time I try to get it out of the shop?! Can I just get it home and then just leave it in the driveway and not drive it and polish it lots?!?!?

I think having nothing to do is playing havoc with my rational thinking faculties - I keep playing over and over all the terrible things which could happen to this pretty car in my hands and wondering if it's a bit too much responsibility and perhaps I should just leave it in the drive!

My word, if I can't handle having a car, how on earth am I going to cope with being a doctor and having to make decisions about people?! Or owning a house? Or (heaven forfend for the next 10 years or at least until I'm a registrar) having a baby?!?!

Oh what a disaster I am, I think I'll go and play the piano to calm down a bit!

Sorry for the slightly hysterical rant, will be calmer next time I promise!

PS Thanks for the comments people, it's great to know that people actually read this sometimes!

Graduation day!

2007-07-11T13:47:00.000-07:00

Yesterday was graduation day at my uni, and a good day was had by all. The weather was good, the gowns were appropriately Harry Potter-like, the ceremony was mercifully shorter than last time I graduated, and we didn't have to sing in Latin again which was a bonus! The garden party was champagne-filled, and in the evening I went out for dinner with my family and my friend Elaine, her parents, and her flatmate Anna.

Now I'm back home, and today was very exciting for several reasons:

Firstly, I went to look at a car with my dad, and I think we are gonna buy it which is awesome! I am very happy, it's a great car, and it's pretty which is good, and the reverse is in the right place (down right, opposite 5th, not push-down-and-in-first-ish) which is brilliant.

Secondly, I went to a financial advisor and learned all about ISAs, which was really interesting - I am loving the finances.

Thirdly, while I was out doing the above, my mum had a go at my pigsty room that I've been struggling with for weeks and made it beautiful in like 2 hours! It must be a mum thing.

So anyway it's been a good day.

Now I am watching Election, I'd forgotten how funny it is! More another time.

Alcohol, my permanent accessory

2007-06-29T08:08:00.000-07:00

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!

Nerves and missing uni

2007-06-24T05:17:00.000-07:00

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!

In dispraise of cockroaches

2007-06-20T13:15:00.000-07:00

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!

Many, many things

2007-06-14T13:35:00.000-07:00

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!

Finito!

2007-06-08T09:26:00.000-07:00

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!

ohgoodheavensidon'tknowanything

2007-06-04T12:42:00.000-07:00

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!!

State of annoyance

2007-06-03T13:01:00.000-07:00

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?!?!?!

Frazzle

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

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?

Sunshine and showers

2007-05-31T13:32:00.000-07:00

Today was lovely and sunny, but the previous two days it rained constantly! It was crazy, I mean, it's not unusual to have rain but it's pretty unusual to have solid rain for two days. Where I grew up we had what we used to call the '5 o'clock sun' - basically no matter how crap the weather was, the sun came out sometime in the evening. Admittedly sometimes it wasn't at 5pm, sometimes later, but still.

And there's a phrase where I live - 'if you don't like the weather, wait half an hour'!!

Have been going to lectures this week - I know, I know, have the exams then the lectures, very weird, but still. Most of them are useful, although I wasn't expecting them to be! Stuff like how to prescribe things, how to hand over well at the end of a shift, and tomorrow we're getting talks about how to handle stress, medicolegal issues and stuff from the BMA.

Today, it was a friend's birthday - she started the day in lectures with the rest of us, then managed to win a prize draw for £150 to spend in a shop of her choice! What a cool birthday present! We went out for lunch, me and another friend with nine Malaysians - I feel like a giant next to them, it's disturbing! But they are lovely, so all is well.

So not a lot to report - I'm trying to pack up my room in preparation for moving to Big City near to Big City Infirmary in a couple of weeks. It's pretty therapeutic chucking stuff out! The grad ball (or more accurately, the grad ball 3 day extravaganza) is next weekend, I still need an outfit that looks vaguely seventies, any ideas?!

It's nice here on the other side

2007-05-25T04:18:00.001-07:00

So, today, ladies and gentlemen, I became a DOCTOR. Yes, me. Yes, a doctor. Who'da thunk it?! I have a badge that says so and everything. The results for the final viva exemption exam went up, and I was on the pass list.

I'm pretty sure there's been a mistake, but I'm gonna keep quiet about it. Shhhh, don't tell. I'm still waiting for the letter saying I was admitted to medical school because of a clerical error.

I'm pretty chuffed, when I really think about it, but honestly it's a bit of an anti-climax. It's like, when you're a kid, and it's your birthday, you feel like you should feel different, sparkly or tingly or something, but actually it just feels like another day (except people give you presents and cake and things). Also a couple of my good friends didn't get so lucky and I'm so gutted for them I could cry. I don't feel like celebrating if I can't celebrate with them, there's no point.

Tonight I'm not going to stay in, don't worry, but I'm going to have some Chinese food, wine and a movie with two of my best friends - I started this epic six-year journey with them and it feels right that we should end it together too. There will be much remeniscing, much chat and probably some old photos where some of us look skinny and young (ah, those were the days) and one of us always seems to have coloured icing on his face. What krazy kids we were.

So yeah. Dr Joey. Freaky.

Will you still need me, will you still feed me?

2007-05-23T13:23:00.000-07:00

Well, I still have exactly 40 years to find out, so for now I will feed myself! Thanks for all the messages people, I felt loved.

Have had a really good day, I talked to my family, I went out for lunch with a friend, I offered my *limited* medical skills to a lady who got vasovagal in the bathroom at the cafe and knocked herself out on the sink (I know, I know, can't take me anywhere or I'll try and do something medical), saw another friend who came round in the afternoon, talked to my family again, and now I'm faffing about. Brilliant.

The exam is tomorrow, I'm not studying any more. I've read everything I wanted to read, I've been over every angle I can see the examiners picking up on yet I'm sure they will ask something I haven't read about. I've heard mixed reports - some people have had a bit of a grilling, some have had more of a chat, I think it all depends on your examiners and your perspective and expectations, and I'm sure the experience alters with hindsight.

This time tomorrow it will all be over, I can't wait for that moment! And 36 hours from now I will know, one way or the other. Wish me luck, I'll see you on the other side!

Fun in the Sun

2007-05-20T10:47:00.000-07:00

Been an alright couple of days, I finally managed to do an eensy bit of work, although still not much. Today though I took a break and went to a beach and forest close to my uni city - it was our church summer barbecue, always held in May before all the students disappear. Here are some pictures.

It was really nice to run about in the sun for a while and play rounders, chuck a ball around and enjoy the sun for a bit. Am now back home, going to do a little work, then we have some friends coming over for a take-away dinner.

This is the last week of study, so I'm really going to try and get my head down. It's my birthday on wednesday (gosh I am so old, I found a white hair the other day and was really upset!) so I'll go out for lunch then, and then my viva exam is on thursday. So after that, I'm free! I hope...

Friends in scary places

2007-05-18T09:36:00.000-07:00

Today I had lunch with a good friend who is a medical student in Big Scary Teaching Hospital where I'm starting work in August. It was lovely to see him, although he got stuck in a tutorial so I was wandering about for a while feeling lost and panicking that there were two 'main entrances' and thoroughly regretting my decision to move and wishing I'd chosen to stay in Uni Teaching Hospital where I know my way around and who to be scared of and where things are and I recognise people and feel like I belong!

What a wimp. I'm sure I'll get used to it quickly, and it's not the most complicated hospital because although it is massive it is pretty new, so it was built in a sensible way and doesn't have random extra wings tacked on like Uni Hospital. Also it has a lot of artwork on the walls which is good for navigational purposes (oh, look, here's the big wooden thing, I must be near radiology.......of course this bites the dust if they ever move the art around...). I'm getting more scared by the day, it's all going to be new and they have different blood bottles and a different bleep system and I don't know anybody, but thankfully if there's an arrest the number is the same!

Anyway it was great to see my friend, who is currently my only friend in a big, alien, rumoured-to-be-not-that-friendly hospital, and I appreciate that and him so much! He's even offered to come and do some bloods for me because they don't get much chance at his med school. What a sweetheart.

Back at uni now, after picking up the car and driving back (and feeling quite sleepy - had the occasional moment where I thought, 'oh, I can't see' and realised in a truly petrifying manner that my eyes were CLOSED and that's why I couldn't see! Cue opening windows and turning up music! DO NOT tell my mother about that bit!). Feeling actually like I'd like to do some work tonight, which is awesome, must capitalise on motivation while I can!

Home on the range

2007-05-17T10:49:00.000-07:00

I write this from home, where I shall shortly move permanently, on the very snazzy iMac which currently graces the study desk. It's a beaut, but at the moment, since the study has become Editing Suite Extraordinaire while my brother is working on stuff for the band, there is the iMac screen, then another screen, then a tv all on the desk, so I feel a bit overwhelmed by technology! The weirdest thing is that I click on the safari icon on one screen and the window opens on another screen, and the mouse cursor moves between the two. Clever.

It's nice to be back, although I may feel the need to clean things in a while - my brother's flatmate is fastidious about his personal appearance but doesn't lift a finger otherwise, and consequently I am baulking a bit about having to clean my contact lenses in a bathroom where you can no longer tell what colour the tiles are! This current flatmate is moving out in the summer and a different guy, who just so happens to be the drummer in the band and a bit of a neat freak (hallelujah!) is moving in, so all will be well when I live here!

It's always nice to see my brother Stephen, and always interesting to see what he looks like - he changes something every couple of weeks! I understand that he has to be on trend for the type of music they play, but I still find it very entertaining that he knows more about hair than I do! He's starting to get recognised now - we went to pick up a copy of a music magazine in which there is a very glowing review of the band, and some girl gave him her email address, which was weird but good!

Anyway, I like to have the chance to catch up on band developments, fashion changes and things when I'm home, but on this particular occasion he had a slightly disturbing tale to tell...

(You should know, my brother is not ugly. In the slightest. He has never even seen the ugly tree, whereas I clipped a few branches on the way down...it's ok, I'm fine with it, I got the brains, he got the braun!)

Part time, Stephen works late shifts in a busy bar/club in town in order to fund his developing rock-and-roll lifestyle (!!). Mostly these shifts go off without a hitch, but recently, he was working on a pretty quiet bar, mainly serving two American men. He wasn't alone, there was another female staff member, who was chatting to the men too.

As the night progressed, they chatted to these two guys while serving other people. Then one of the guys calls my brother over to a quiet corner of the bar and beckons him to listen:

GUY: So what time do you get off work?
STEPHEN: 4am. Why?
G: Want to make some money?
[I have sussed what's going on already - naive brother has no idea]
S: Sure, doing what?
G: You know where the ****** hotel is?
S: Yeah...(getting suspicious)
G: Well, you could meet me there.
S: But why?
G: We could, you know, fool around and stuff.
S: (horrified) NO WAY!!!!!!
G: Oh, ok, how about for £100?
S: NO WAY!!!
G: Ok, is that not enough? How about £200?
S: No, I don't think you understand me, I said NO WAY!!
G: Oh, sorry, £300?
S: (growing more horrified by the second) What part of NO WAY do you not understand?!
G: Oh, right, ok.

[Guy exits, Stephen relays the story, traumatised, to his colleague. Shift forwards a few hours, the men are about to leave...]

Guy: How about £400?
S: (verging on GBH) NOOOOOOO WWWAAAAAAYYYYYY!!

...man, I was so horrified! If I'd been in the bar I would have said (after I had knocked the guy senseless for hitting on my straight-as-an-arrow brother, oh my word) that solicitation is illegal in this country and I'd take his £400 as payment for not shopping him to the fuzz!

My word! Once I'd got over the horror, it was actually pretty funny, but what was even funnier was the look on Stephen's face as he was saying, 'but I was just being nice, why do people not understand that I'm just being nice?!'

So that was the main shocker of the day, but also the main hilarity! Poor kid, apparently it's not the first time he's been hit on by a guy and not had a clue what's going on, it seems that it's not possible to look individual and still convince people that you don't paddle the kayak that way!

Back to uni tomorrow, final stretch...must...study...must....learn......useful.........things...............

Wish me luck!

Change of heart?

2007-05-15T06:13:00.000-07:00

Had a good day yesterday, despite not doing any work whatsoever! (Unless watching ER counts...) Went with my lovely friend to Local Posh Area where there is a beach and lots of nice shops and cafes to wander around. We had some lunch, talked about medicine a bit, which might be thought of as work, wandered around the shops, went for a walk on the beach and generally enjoyed the sunshine (yes, the sun was shining!). Enjoyed it, was a great way to not-work. I figure if you are going to skive, you should do something fun with your day!

Today has got off to a similar start, but I am DETERMINED to do something this afternoon! Perhaps I should change my working remit though? If I think, 'I am working for the portfolio exam' then I tend not to do anything useful and just get cross about it instead, but perhaps if I think 'I am working because I start work in 8 weeks and people will die if I don't know stuff' then I will feel The Fear which is a very good motivator! I know that this thought is something of a hyperbole, I would hope that if I don't know something then someone else more senior will come and help me, but that rather detracts from The Fear, which as mentioned I need in order to work!

My parents called the other day and told me about their summer plans - it gets VERY hot in their part of the world during the summer, so they are planning to be 'swallows' and fly back west where it's cooler for a bit! (Oh, and they also might be coming for that graduation thingy that I have to go to!) Anyway, they are coming back at the start of July for a couple of weeks, then my dad has to go back out and hold the fort for a while, but my mum is staying for 2 MONTHS!!!!!!!!!! I am SO EXCITED!!!! Man, I miss them LOADS and it will be so awesome to have them back, and to have my mum for so long is brilliant. She wanted to be here for when I start work, and is staying till the end of August so will achieve that! My dad's coming back for a couple of weeks at the end of August so they'll go back together. So much looking forward to some good parent time, they've been away over a year now but so far I've been able to see them a fair bit - on the way to my elective last summer, then for a while on the way back, then a few other wee trips too.

I am also hoping that my dad will help me buy a car (hopefully this one) while he's home - I currently 'share' a massive Nissan almera with my brother (by this I mean he has it most of the time and I occasionally get a look-in) but I really need my own, and I don't want to buy my first car without my dad (yeah, I know, 'but Jo you're an adult grow up etc etc') and also I need help with finances until September when the cash starts rolling in!

Right, enough spraffing, really must go and learn useful things now, like when to call the procurator fiscal, which I have no idea about!

Motivation? Where?

2007-05-14T04:30:00.000-07:00

Gaaaaah, it's now ten days till the dreaded portfolio viva exam which will elevate me to the long-awaited Doctor Joey, and I am having trouble studying!

Today I have hit the snooze button about 20 times (actually, some of the time I just switched the alarm off for half an hour to save waking up every 8 minutes to press the button again), got up, did some cardio, had a shower, dealt with emails, listened to some music, ate my Special K, and now I'm really hoping that when I've dried my still-all-wet hair it will be lunchtime so I can put off learning stuff for a bit longer!

Apologies for the lack of funny stuff to post about these days, apparently exams and studying just aren't that amusing...I'll endeavour to improve on the funnies soon, I promise.

Right, it's definitely lunch time now, more skiving coming up!

Social conscience

2007-05-13T08:44:00.000-07:00

What happened to spring?! I'm so cold! Plus I put the heating on yesterday and when we got up this morning we found a big puddle on the kitchen floor under the boiler, which is never good, so we are kind of afraid to put it on again, which means many jumpers and much shivering. And several pairs of socks.

I've really enjoyed being sociable this weekend, although I've seemed to manage to offend people left, right and centre - mainly Offended Flatmate (who is a bit sensitive if you ask me), but I've been coming back from these social gatherings and wondering how I did.

I often wonder this, ever since I was a kid and used to say stupid things around strange adults who used to come to our house a lot (usually my parents knew them, but as a kid they all look pretty similar), which I'm sure was embarrassing for my mum, but what do you expect if you put a kid in a be-polite-to-the-guests situation almost every sunday?! One such guest was a colleague of my dad's, and I always thought he was a bit weird...anyway he came back to visit when I was in early uni sometime and reminded me that he had come for lunch and I had kicked my brother under the dining table. Thanks for that, I thought, I really needed reminding of my ineptitude in social situations!

The thing is, I either talk too much, or I don't talk enough, or I don't follow the conversation closely enough and end up saying something really inappropriate. Once we had someone staying at our house who I didn't know and have not met since, but I was home for the weekend before some exams and was really stressed out, which always rids me of any social graces I still had. Anyway, I had seen my primary school teacher at some event or other and she hadn't recognised me, and I said later, 'oh, I don't care, I'll make more money than her one day anyway.' WHAT?!?!? Who was this monster who said that?! I don't care about money! It was such a ridiculous thing to say, my mother was horrified, I have no idea why I said it, and it still haunts me to guess at what this poor woman who was staying must think of me.

During third year of uni I got really depressed for quite a long time, and to be honest I don't remember a lot of those months - apparently I wrote a Cochrane review for a paper that one of my supervisors was writing, but I have no recollection of doing so. I basically hid in my room for about 6 months and avoided all forms of social contact, because it was too hard for me to smile and say 'fine thanks' when people asked how I was and I really wanted to die and not smile ever again. I stopped going to any events where there were lots of people, especially happy people - Place To Avoid #1 was the uni Christian Union, which, though I was an active member for many years, was always a place inexplicably full of perfect slim blonde (usually Irish) girls with perfect teeth and pearl earrings, and since I never really fitted in with these people to start with (my friends are an altogether more normal-looking bunch, who I love dearly - this means you, people who I know read this!) it took more effort than I had to smile back at them and say, 'yeah, fine thanks, six miracles in my life this week, how about you?'

I actually hate it when people ask 'how are you?' and don't listen to a proper answer - especially I hate it when people say how are you as they pass me in the corridor without breaking their gait, it's so pointless! But after a little experimentation, I discovered that as long as I smiled and nodded I could say anything and they wouldn't notice. I tried this out on a bloke I used to date (who to be fair was not noted for his observation skills), and when he asked how I was I smiled and said, 'pretty terrible actually, life is really crap at the moment' and he said 'oh, that's great, pleased to hear it'. Wonderful.

How did I get onto all this? Ah yes, social stuff...

Anyway, the main thing is that I spend a lot of time after social gatherings wondering 'how I did' - did I say anything disgraceful? Did I join in the banter/teasing of someone with too much gusto? Did anyone actually want me there at all?! Did I talk too much? And so on and so on ad nauseum.

I'm so much better than I was in third year, not depressed at all any more, but somehow this fear of social situations seems to be the thing that still lingers (along with some excess weight, thank you mirtazapine). I wonder if I'll ever shake it?

Several things

2007-05-11T08:27:00.000-07:00

Still feeling terrible about offending the flatmate, but the other flatmate says she has walking on eggshells all week so I should just put it all down to stress...haven't seen Offended Flatmate since the incident so hopefully she won't kill me when she comes home! Gah I can't wait to live with boys, they are so much easier, and next year one of the boys I'm living with is my brother, so no hassles there!

The portfolio got handed in today, which was a great relief - I'm so pleased to be rid of it! Again is was a great disappointment actually handing it over. Where was the parade? Where were the balloons? Where were the party poppers and the cake? I was very upset. All I got was, 'right. Fine. Next?'

Disappointing.

I've got quite a sociable weekend coming up, which is great because I've been such a boring recluse recently. Tonight I'm going to a wine and cheese party for some friends who are leaving soon, which sounds very civilised, and it will be nice to see some people and chill out for a bit. Then tomorrow I'm going to another friend's birthday picnic, which will be awesome! I really hope it doesn't rain, it's been weird weather here recently.

So hopefully I'll get some chillout time this weekend, I'm reading a great book and I'm planning not to do much work if any until monday, when it starts again in earnest to prepare for the portfolio exam which is on the 24th.

What are your weekend plans? I hope you have fun...

Shame

2007-05-10T11:59:00.000-07:00

I am feeling awful right now - I just really upset my flatmate and I had no idea, and now I feel terrible about it. It was just some careless comment I made days ago and had forgotten about, I mentioned Tchaikovsky and she said, 'who's Tchaikovsky' and I thought she was kidding and laughed, then teased her a bit about not having heard of Tchaikovsky, which I guess was mean, but I just thought it was a general knowledge thing not a specialist musical thing.

Then this evening she asked what work I had left to do now that my portfolio is finished (yes, finished!!) and I said I had to study for my viva which is 2 weeks today, and she asked if my viva exam is a written exam and I said no it's a viva and she got really upset and said she didn't know what a viva was and I was making her feel stupid and I feel AWFUL about it. I totally didn't mean to upset her, I didn't know that she didn't know what a viva was, do all courses not call interview-style exams vivas?

Anyway, I went and apologised and she said it was ok but I think she's still mad at me. I don't think she's stupid at all, but she seems to think I do, and apparently I haven't done much to convince her otherwise, but I had no idea.

Man, I am such a horrible person, I'm going to my room to hang my head in shame. What a bitch.

Profound

2007-05-10T03:44:00.000-07:00

My final portfolio for this endless degree is due tomorrow, and I am playing solitaire.

There is no fun in doing nothing when you have nothing to do. Idleness, like kisses, to be sweet must be stolen.

-Jerome K Jerome

Terror again

2007-05-07T13:59:00.000-07:00

Today has been a day of many things. First of all, I did an exam - it's not a major one, it's a computer assessment that we have sat every year since first year, and the idea is that we improve our percentage scores over the years until, in 5th year, we are meant to pass it. The pass mark is 70%, and last year I got 78%, so I wasn't that worried - I really hope it hasn't backfired on me! I did study for it, honest!

Secondly, I did some work on my portfolio, which is due on friday, and which was very boring but necessary.

Thirdly, I did some boxing and it felt awesome! Really enjoyed it as usual.

Fourthly, I GOT MY JOBS ALLOCATION which is really good to know, but TERRIFYING again! My scariest job would be to start in acute receiving, on nights, with the arrest bleep. And guess where I'm starting? Acute receiving. In Big City Infirmary. Ooooooooh I am so scared, I can't stop giggling! I really hope it's not on nights or with the arrest bleep. I may start throwing up now, with several weeks to go before starting!

So, the lowdown: 2 months in acute receiving with 2 months of GI medicine in Big City Infirmary, then 4 months general surgery in Big City Infirmary, then 4 months general medicine in Fairly Nearby DGH. So all in all, my ideal jobs! More medicine than surgery, some time in acute receiving, and some time in both a big teaching hospital and a DGH.

But man, am I scared!!

End of an era

2007-05-03T11:42:00.000-07:00

I'm writing this on the eve of my last day on the wards as a medical student! Man, it's been a long time coming. I don't think bricking it is the term really any more, I've reached a whole new level of stress, which is manifesting itself on the ward in a variety of embarassing ways...

Firstly, I have developed a fear of the blood book. Each day on the ward round, one of the juniors has the folder with all the blood results in it and, if asked, tells The Boss what the bloods are doing. Now, the old Joey would actually quite like holding the blood book because it gave her something to do, but the scared new one is terrified that when asked she will either say the wrong value, not be paying attention, or, most likely, forget the normal parameters for the results (which are not written on the sheet) and read out something plum normal when asked for the abnormal values. Much potential for mistakes, especially with Terrifying Registrar around.

[I had to bleep her the other day, I was shaking, but she was nice, so that was good, and I live to see another day!]

Secondly, I have started to miss bloods. Especially when I go to see a patient, blood tray in hand, thinking I will be fine (as I always used to be), and the patient says, 'oh, well, you can try, but Dr X tried 10 times yesterday and couldn't get a drop', at which point I almost immediately adopt a defeatist attitude and think, 'oh well, I'll never get this' and give up after the third attempt rather than carrying on till I get something. I bet if there are more senior people reading this, they will think I am a moron, but please remember the days when to you this was a big deal too, I'm not a total fool, I just want to get it right!

Then there's the slightly panicky going back to patients after I have taken the bloods (especially ABGs, man, especially those) and checking the puncture site to make sure that they are not bleeding all over the place or I have not knackered their arteries so their hands go blue and then black and then fall off and I get sued.

Now you are thinking, 'call the shrinks, this girl's a nutter!' but it gets better!

What if, when I start work, I prescribe paracetamol for someone's pain, and they have actually already had some and they get liver failure and it's my fault? Or what if, when I start work, I prescribe ibuprofen and someone gets a peptic ulcer and bleeds out and dies and it's my fault? Or what if I miss their crazy arrhythmia on the ECG and they die and it's my fault?!?!?!

See a pattern here?!

I'm getting a bit sleep deprived because I stay awake thinking about all the things that can go wrong, so my bedtime reading has, for the last week, consisted of frantic cramming of medical knowledge in a vain, petrified attempt to avoid such disasters.

I said once in this post that fear was a good thing, but at this magnitude, and so early? Am I going to be like this in worsening degrees until the dreaded 1st August?! I really hope not because I need more sleep than this!

Right, I have to go write up a case for my assessment tomorrow, but to end this on a totally un-medical more positive note, I have recently started to do some boxing again - I used to go to Muay Thai kickboxing training on a wednesday night for a few years, and I absolutely loved it, but then I had a few shoulder injuries (that looked like this) and had to call it a day for a bit, but I have started again very gingerly and am getting huge endorphin rushes from it, it feels amazing!

But now to the case, no more procrastination...

Currently reading...

2007-04-29T11:09:00.000-07:00

...this book:

I went to the book launch on Friday night, and I'm ploughing through it. Laughing lots at some of the things that Richard Dawkins thinks are valid arguements!

I'm having a good day, have eaten fairly well and done some boxing which was really tiring but I really enjoyed it. I'm dreading going back to the hospital tomorrow a bit...I'm on the acute admissions ward this week, although I'm helping out with the 2nd and 3rd year OSCEs for 2 mornings. I really need a patient to write up for my portfolio, and I need to get my act together with work stuff because the portfolio hand-in is drawing near...gulp! This is also the last week of the block, and thus the last time I'll be on the wards until I'm shadowing the person who's doing my job in July. So I'd better ask all the stupid questions I need to ask this week!

The problem is, I'm moving cities to start work in a different place so I suspect things will be done a bit differently in New City, but hopefully I'll get the hang of it. And hopefully I'll make friends! It's been a while since I've been in the don't-know-anyone situation so hopefully I'll meet some people to hang out with and settle in well.

Sometimes I get a bit overwhelmed by the impending change, and sometimes I can't wait to get started. I'm kind of dreading moving again, this time I have to get 6 years worth of stuff into a much smaller room, and it's very stressful and tiring moving anyway, so thank goodness my muscly brother is coming to help me, and bringing his band's van too, so between me in the car and him in the van we should be able to get it all home!

So it's a bit mixture of emotions being me at the moment, with occasional moments of rising panic about the coming portfolio hand-in!

Springtime brings new leaves

2007-04-28T13:42:00.000-07:00

...in more ways than one!

I've had a good day today. I've been really lazy and eaten some rubbish, but not an inordinate amount, and I think that with the apple I will eat before I go to bed I have achieved my 5-a-day and I am feeling a lot better than I did yesterday.

I should explain that.

This week has been a bit weird and at times a bit stressful. Firstly, the change of ward has thrown everyone off and means that requests go to the wrong place, porters come to the wrong wards, and to top it off the pod system for the bloods hasn't been working that well so whenever porters are called to pick up bloods they come to the wrong place! Annoying. But because our previously 24-bed ward has now been reduced to 6 beds plus a few boarders, which makes for a lot of boredom.

This week the solution to the boredom seemed to be to gossip lots. Basically our (terrifying for several reasons) registrar came to hang out in the doctors' room and initiated a really graphic gossip session which removed any shred of naivety I had retained through uni, and I really didn't want to get involved. I have this thing where if I do or say something mean, it plagues me for days/weeks/months/sometimes even years afterwards, and the day before Crazy Gossip Session I had said something mean about one of the 4th years who has been skiving a lot - it was totally unnecessary and I didn't really mean it, but it meant that I didn't sleep too well for thinking about what a bitch I was. So I really just didn't want to get involved in this gossip, but couldn't really escape because Terrifying Registrar was present and there weren't any jobs I could go and do.

This particular gossip session served to inform me that in this hospital, in which I have worked/studied for the last six years, it turns out that everyone is shagging in every available cupboard/oncall room/sideroom and, apparently, I have been oblivious to it all. I learned (reluctantly) about the MDT Challenge (in which, in order to complete the challenge, one must sleep with a member of each discipline in the team), the Med School Challenge (in which one must sleep with a student from each year), and I learned about the nurse on one of the wards who has slept with nearly all of the doctors in Terrifying Registrar's year, and who believes that one of them will fall in love with her, cries in the cupboard when they treat her badly, and is totally ignorant of the fact that they are in fact asking each other, 'have you slept with that nurse yet? You really should...'

This totally APPALLED me. For a start, SURELY people don't really do these challenges. Oh no, I am assured, they do. And SURELY people don't take sex this lightly, and think it's ok to abuse this poor nurse who mistakenly believes that the doctors are after more than a quick shag in the oncall room. But yes, it would seem that this is the thing to do.

This gossip session went on for nearly an hour and a half, in which nobody was safe, and all secrets were revealed. Then, unbelievably, just as I was going to escape for lunch, Terrifying Registrar says, 'How about a quick game of Consequences before lunch?'

I couldn't believe it! How old are we?! There was no way I was going along with this, so I sneaked off to check some results, and was then stuck in the corner while the game finished.

I just found this whole thing so depressing - to find out that this 'caring' profession sometimes cares for patients (when not moaning about how annoying they are - we are all guilty of this, me included) but seems not to give a rat's ass about fellow colleagues. I just couldn't believe the total lack of respect that people seemed to show for each other.

Now, I'm not so naive as to think that these stories haven't been well embellished by time and rumour, but there's no smoke without fire.

So was pretty shocked by all that.

The other solution to the boredom, for me, was to work lates on the Acute Admissions ward. This was fun for a bit, but after I worked 14 hours on thursday, saw the F1s get their paychecks and realised that not only was I not learning a lot on these long days but I was also not getting a penny, I decided that enough was enough.

I woke up on friday planning to do the late again and go in about 1pm to stay till 9pm, but actually my flatmate asked my why I looked so gloomy and I cried (which was embarassing) and poured out my tale of gossip-ridden, boring-days-and-busy-evenings, not-getting-my-portfolio-work-done tale, and she told me off and said I should stay home and do my portfolio stuff and not do any F1 jobs for which I am not getting paid because it's not my job. So, ever-so-slightly guilt-ridden, I stayed home, and tried to do some non-medical things, regain some sanity, and try to get rid of the disillusionment of working life in the hospital.

So, today, I feel good - I ate lots of fruit, baked some cookies (non-medical activity of the day - this is a good aim I think, to do something non-medical every day and stop getting into bad geek habits), read a good book and have done some blogging (both reading and writing, as you can see).

New Leaf for this week: Tip the work-life-balance a little towards the latter.

Apologies for the lengthy post, I hope you are still awake! I'm going to take my little self off to eat some raspberries. They are good for the soul. And you can stick them on your fingers a la Amelie and giggle at your own absurdity for a while, which is always theraputic.

SALT leads to hypertension

2007-04-24T11:28:00.000-07:00

I'm in a weird mood today. It's a combination of indignance, anger, grumpiness, despair and exhaustion. Here's why:

Indignance because today I called the speech and language therapists to try and arrange a time when I could go with one of them to see a patient so I can get it signed off on my evil record of achievement, since they have turned me down every time to date. The conversation went a little like this...

[Please note: the line was engaged the first 3 times I called and there was no answer the next 2, so I am already a little exasperated]
Me: Hello, I'm a final year medical student working on the surgical floor, I was wondering if there would be a convenient time for me to come and see a SALT assessment as part of my record of achievement.
Very Helpful SALT Lady: I'm sorry, we are very busy, we don't have time for you.
Me: Right...um...I appreciate that you are busy, I worked on the Stroke unit during my medical placement and they've agreed that it's ok that I try and see one of their patients so could I watch a swallow assessment?
VHSALTL: I know you have to get this signed off but we just don't have time to fit in all the medical students just now.
Me: Ok, is there a more convenient time for me to call back?
VHSALTL: No, I don't think there will be.
Me: Right. Thanks for your, um, help.
[Hangs up phone and screams with annoyance!]

So yeah, no speech therapy for me. I was hopping mad by the end of this (WARNING: rant coming) THIS IS A TEACHING HOSPITAL where people are supposed to be TAUGHT and how many times have juniors been yelled at by SALT for inappropriate referrals but how are we supposed to know how to refer if they persistantly refuse to teach us anything?!?!?! There are approximately 150 medical students in each year, and given that a third of these will have the good fortune to get their box signed on an out-block, that leaves a mere 100 students. SURELY the SALT people see more than 100 patients in a year, especially since (despite massive hints to the contrary) I'm pretty sure there is more than one speech therapist in our 900-bed unit.

This pretty much ruined my morning - I knew they were going to be arsy, but this takes the cake.

So that was emotion number one, and two.

Grumpiness: Partly boredom-induced I think (our ward has been displaced to what's left of the acute surgical admissions ward in which the HDU is currently being done up, while acute admissions go to what was our ward, leaving only the side rooms for our patients) - 5 patients for for 3 JHOs and 2 final year med students does not a busy day make. Especially when one of the patients discharged against medical advice, leaving only 5.

Despair at my persistant inability to be a size 10 - all my good intentions seem to desert me when there is food to be eaten or an extra 40 minutes in bed instead of exercising.

And exhaustion because I've not been sleeping too well, and 8am starts don't suit everyone.

Man, this is a gripey post, I do apologise. I'm off to browse free-standing boxing kit on which I am planning to spend some of my *eventually* hard-earned cash come September.

Super-skinny me?

2007-04-22T14:04:00.000-07:00

I just watched a programme on Channel 4 called 'Super-Skinny Me'. Basic plot was that two female journalists, both with plum-normal BMIs and both size 12, underwent a 5-week intensive diet and exercise regime in the hopes of dropping enough weight to become a US size 00 (UK size 2 I think).

The point of this exercise is, apparently, to show how awful a life of extreme dieting is, how miserable it makes you, and how it affects you physically and mentally in an adverse way.

I've watched two of these things before, one a female journalist and a 5-6 week plan to drop weight and get to size zero, and one following Louise Redknapp with the same aim. Both were made with the intention of showing how rubbish it is to be a size zero.

I was jealous. Every time.

I would LOVE to be a size zero, or even just the size that these girls start off at - I would love for a size 10 to fit me, to have a personal trainer to kick my ass every morning, to go shopping and find that everything is too big rather than too small. I would love to have ribs that stick out, to have really prominent clavicles and for my hips to be the widest part of me rather than the fat over my hips.

I don't think this is the idea - we are supposed to feel sorry for these people, but instead I find myself planning exactly what I'm going to eat tomorrow and planning to get up early (I already get up at 6:30am so this will be a challenge) to work out for 30 minutes before I go to the hospital, then to go for a run when I get home.

[I'm told it gets addictive and you eventually get an endorphin rush from running, so I'm determined to get past the stage where my chest burns and my feet hurt and reach this wonderful goal of actually wanting to go running. I do enjoy the moment of mutual sheepish grinning that happens when you puff around the park and pass another runner - it's kind of a, 'yeah, we look stupid but at least we are trying' moment of unfit solidarity!]

So I think that for me, the programme did not fulfil it's intentions. I'm already trying to lose 1kg a week (I thought this was a reasonable goal) since for various reasons to do with illness and medication and sheer lack of willpower I have put on A LOT of weight during university, but this programme provided rather a lot of tips on how to increase that goal to 2kg or more...

Roll on the weight loss!

Lucky

2007-04-20T14:04:00.000-07:00

Today some good things happened. Firstly I am very excited about something which seems trivial but made me very happy - last week I purchased a new MP3 player because my old one had started to randomly switch off which was very annoying. When I have a salary I intend to get an iPod, but right now I can't afford it and there's no way I can last six months without portable music, so I bought a Creative 1G to tide me over. It's small, pretty, and plays music, which is what I need, although the filing system is a little confusing and I haven't quite figured out where all my music is yet! Anyway, I noticed the other day that the battery cover was missing from the back - it's a tiny piece of white plastic, but I thought, it's okay, it'll be in my bag/pocket/room.

It wasn't.

It's very annoying to lose the back of a brand new player which has to last 6 months at least, and despite me retracing my footsteps and hunting high and low, there was no sign. I was just giving up and trying to work out a way of holding in the battery with micropore (magic stuff) which would look a bit crap but would mean nothing else fell off, when my flatmate came back from the shop down the road waving the precious piece of plastic at me! Hurrah! It had survived three days in the gutter with only a few scratches, so I was very happy.

So that was good thing number one.

The other good thing is that I got one of my boxes signed off this morning which was proving very difficult - as part of our course we have to get about a million boxes signed off, some for procedures we have to do/see, some for examinations, that kind of thing, and I'm now down to the last four boxes which are a bit of a chore. Anyway, I managed to go with a patient to mammography this morning, which was not only a great box-signing opportunity while avoiding the masses of students who have to queue up to see a mammogram at the clinic, but also a great chance to spend some time with a patient and chat - I really like talking to people as people and not just as 'lady with mastitis' or 'man with bowel obstruction', and this lady actually said as we got back to the ward that she appreciated having me come with her as she was able to ask question and it took her mind off things, so that made me feel like something I did today was worthwhile and actually made a difference to someone, which is a rare thing to feel as a medical student since we spend a lot of time filling in forms and taking blood. I'm aware that come August I won't have time to go with patients to investigations and get to know them a bit better, so it's also a priviledged position to be in as a student, and one which I hope I'll be able to be in more in my last few weeks.

On a more scary note, I'm still bricking it about starting work - I'm painfully aware of all the things I don't know and think I really should, so this weekend will be a lot of reading and learning I think, partly to alleviate my rising panic and partly to avoid the embarassment of having your FY2 saying 'you need to know this, you'll be a doctor in a few months' in front of the fourth years!

Win some lose some

2007-04-16T15:09:00.000-07:00

I've been kind of ill over the weekend. I woke at 5am on sunday with searing pain in my back, bang over the loin, which didn't really go away all sunday and prevented both significant movement and sitting still - so basically i just lay in bed and fidgetted all day. Frustrating. Whole history sounded rather renal colicky when I put it all together but I'm in denial about that!

Anyway, today I stayed in bed in the morning and took a lot of painkillers (co-dydramol, mmmm) till I was able to get up and move about, then I went to the hospital for the afternoon. Ended up staying till about 7pm with two of the F1s as it all started to get busy at about 4pm - how annoying when that happens! The good thing was I got to do lots - lots of bloods, anyway, and an ECG.

Most of the bloods were successful, but there's this one lady on the ward whose veins are becoming my nemesis! The thing is, every time her exceptionally needle-phobic daughter is visiting, I seem to be approaching with a tray full of needles with which to stick her, and the daughter goes a bit green and has to leave...today it happened 3 times. First off I stuck her for venous bloods and couldn't get a drop, despite using several different kinds of needle - it's not that she doesn't have veins, it's just that none of them bled or stayed still enough for me to get anything significant out of them. This irritated me no end, because I don't usually miss bloods, and at this stage I get the panicky oh-no-in-a-couple-of-months-I-won't-have-backup feeling, and I'm starting to feel like the more I miss the more likely I am to miss and so I lose confidence. So stupid.

Anyway, no sooner had I stuck her and missed, and gone back to the F1s with my tail between my legs, than she needed flippin' ABGs. D'oh! By this time in the evening I'd already got ABGs of a guy in one of the siderooms perfectly successfully and was feeling pretty confident, and sure enough, once I had placated the needle-phobic daughter and apologised for disrupting visiting time once again, I got blood pretty easily.

Went to analyse the sample and it was VENOUS. Grrrrrrrrrrr.

Tail between legs again...better get the ECG machine and do that instead while someone else does the ABG, even I can't screw up an ECG.

I know everyone has good days and bad days, and the fact that I wasn't feeling 100% today anyway probably didn't help, but it doesn't stop me beating myself up about being crap at simple things. Tomorrow, I WILL do better.

Thank goodness my rather smug fellow shadowing student had scampered off home by then - I'm sure he would have had a good gloat. He announced in a meeting that he thinks women are less intelligent than men, which is not the best thing to say when two of our registrars are (very scary and intimidating and) female! I'm trying not to rise to his big-headed comments and just get on with it all. Grrrrrr again.

Enough of my down-on-myself rambling, I'm going to bed or I won't be able to think straight tomorrow let alone cannulate straight!

Boredom and drama in unequal measure

2007-04-12T12:49:00.000-07:00

Sorry for the lack of posting of late people, surgical shadowing is actually busier than I thought!

We start at 8am, do a surgical ward round [read: wave at the patient from the end of the bed and say 'ok today? good, see you later'], do the jobs from the ward round - which is mainly taking the bloods the phlebotomists won't do, which on a breast surgery ward is most of them because most of the patients have had mastectomies and so have oedematous arms and they leave all the bloods for us - then do the admissions for the day.

Because the patients are mostly coming for elective surgery, they are usually pretty well, so they end up looking at me blankly while I ask about lots of symptoms they don't have, then sometime interject 'but am I supposed to have these things, doctor?' I reassure them that no, they are not supposed to have them, and that saying no to all these symptoms is a good thing, then I examine them, find nothing, take some bloods, which are normal, fill in an ECG form (or in fact take the ECG myself) for an ECG which is usually normal, then fill in the Kardex and get someone else to sign it all. Not the most intellectually stimulating job, but it keeps me out of trouble.

There have been two moments of drama though - firstly, an elderly lady who started making funny breathing noises while we were doing the ward round in her bay (good timing!) - she was pretty unresponsive and in her chair, so while we were all rallying round trying to figure out what to do and how to get her onto the bed, when one of the auxillaries runs over and just scoops her off and dumps her on the bed - it was impressive! So no output, we are all getting a bit stressed, the arrest call goes out, we start poking about in the groin looking for a femoral pulse, grab the arrest trolley. We put the pads on her chest, start thinking about chest compressions, and just as we do, she opens her eyes and goes 'oh, hello, I felt a bit funny!'

Phew!

The clever doctors arrive at this point looking flustered, see the two regs, two JHOs, two 5th year med students and about six nurses, not to mention the now-talking patient, and we look sheepishly at them - sorry guys, false alarm. I end up staying with her sticking pins in all sorts of vessels, sometimes successfully and sometimes not - my JHO ended up getting blood out of the brachial artery, it was impressive.

Today on the ward round, she was sitting up eating her breakfast. As our colleagues Across The Pond would say: Go figure.

Second dramatic moment was this morning - we were one doc down so the only one with prescribing abilities was getting autograph-fatigue. He went off to shout at CT about a patient who was having to hang around in hospital for five days waiting for a scan, and while he was away, one of the patients got sick. Let me tell you a tiny, non-confidentiality-breaching something about this guy: he's come in for surgery, but he's really not very well, and we think he might die before he gets to theatre. Not the most cheerful of cases. Anyway, while OnlyDoc was away debating intensely with CT, this man desaturates to 69% on room air. Now, for non-medics among you, this is Not Good. If I were Dr Shroom, I would day that this is not something you want your sats to be.

Unfortunately for this chap, I am the nearest thing to a doctor on the ward at this time. One of the student nurses comes and asks to borrow me for a minute, and I take a look at the patient, and my most insightful first-uttered phrase is, yes, you've guessed it........'Hmmmm'.

I kid you not. Smooth, Joey.

Thankfully, the second thing was 'bleep OnlyDoc', so all was well. Once more, much sticking of pins ensued, again with occasional success. When I left today, he was still alive, so that's good I guess. Think there might be a resus status discussion tomorrow.

So there's a little insight into my life on this block. Ah, crap, I've just remembered I have to create some kind of learning plan to show my supervisor tomorrow, and I'm midway through a great episode of House. Grrrr. Let the creative writing begin.

Rantage

2007-04-09T09:34:00.000-07:00

Sorry folks, has to be done:

Number one: why is it that whenever you have worn your jeans till they are the comfiest thing in the world do they need washing and come out all small and stiff so they are not comfy at all any more?!

Number two: more seriously, I am having Skype issues. I hate the thing, I really do. I use it to talk to my family abroad because it's free, but to be honest I think the makers should pay me to put up with it! It's just decided to cut out completely so I can hear my dad but he can't hear me, and when they can hear me it echos so loudly with whatever I'm saying but with a 2 second delay that I can barely string a sentence together, it's so offputting.

If my parents were oil tycoons as people assume when I say they work in the ME then maybe we could afford to use the good old telephone, but as it is we have to use Evil Skype.

And in case you hadn't guessed it, I HATE THE STUPID THING!!!!!!!!

Right, I'm going to restart this thing and see if it will work then.

Grrrrrrrrrr.

Home again home again quickety quick

2007-04-06T13:15:00.000-07:00

...And boy, did it go quickly! Holidays always do, it must be a relativity thing. I'm missing the family lots now, but my brother lives (mostly) one city away, and I'm going back out to see the parents in June once the exams are dusted.

So now, back to the grindstone for the final hurdles of med school. I have one more block left, which unfortunately is surgical shadowing - I'm not a huge fan of surgery and consequently haven't done much this year, so I have forgotten lots of things that might come in handy in this block...better hit the books tomorrow.

I'm quite looking forward to getting back to a more practical clinical block - the last one (paeds) was clinical, but because it was with kids I didn't get to do anything, so I'm looking forward to getting to do some stuff in this block. Not least brush up my clinical skills - I've not examined a fully-grown patient since before Christmas so need to be better at that also given the speed at which August is approaching!

There are lots of niggling little things that I am worried about starting work - you'd think I'd be more worried about big things like cardiac arrests and stuff, but recently I've been dwelling on the little things. An example: what happens to discharge scripts after I write them?! Weird, I know, but I get asked to write them by the F1, so I do, and put them in the front of the notes, and somehow they get to the pharmacist/GP/filed in the notes, but how?! I'm just worried in case this is going to become my job and I haven't realised it...I keep imagining myself drowning in discharge scripts because I haven't worked out that it's my job to deal with them!

Yes, I realise I'm crazy, but I'm sure it's relatively normal to be stressed about starting a new job of any kind, let alone one where you can screw up really badly and people might die!

There are still some hoops to jump through before the real fun begins, which I'm not going to think about just now to preserve some modicum of sanity.

For now, it's Easter, which is a pretty big deal, so I'm going to try and spend some time over the next few days thinking about that. The pastor at the church my parents go to in Cyprus seems to think that in order to be holy you must be in church, so, this being holy week, he has held a service every day, including a watch-night last night and a three-hour service today, so my parents are feeling rather over-churched - think next year they will try to have a less-holy week!

So have a happy Easter, I hope it means as much to you as it does to me.

Forgot the locust...

2007-04-01T06:20:00.000-07:00

The locust comment on the last post was not totally random, we actually have a 'pet' locust who inhabits the plantpots in my parents' back yard. He's about 12cm long and has stripy legs.

I have named him Ioannis Baptiste - a Greek version of the name of his greatest predator.

It took my dad two days to get it. Ministers, eh?!

Of locusts, sunshine and family

2007-03-30T08:08:00.000-07:00

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!

Countdown Mark One

2007-03-27T12:45:00.000-07:00

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!

Blood, sweat and tears

2007-03-25T12:31:00.000-07:00

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!

Sunshine and flowers

2007-03-23T07:38:00.000-07:00

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.

Wow

2007-03-22T13:32:00.000-07:00

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?

Madness

2007-03-20T07:07:00.000-07:00

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!

Livin' for the weekend

2007-03-16T09:45:00.000-07:00

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?

The youth of today...

2007-03-12T12:33:00.000-07:00

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!

Glass half full?

2007-03-11T13:30:00.000-07:00

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?

Gormless

2007-03-09T09:29:00.000-08:00

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

2007-03-09T03:58:00.000-08:00

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.

Grandma? Moi?

2007-03-08T06:27:00.000-08:00

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.

MTAS - Medicine Torture Application Scam

2007-03-06T08:55:00.000-08:00

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.

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

2007-03-05T14:26:00.000-08:00

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!

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

2007-03-03T09:31:00.000-08:00

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?!

2007-02-28T15:15:00.000-08:00

Man, I am hating this latest essay-hoop that the med school are making us jump through...I left the basic science essay till last, thinking I would be able to spend more time on it, which I have been - I started it on monday, and it's due on friday, so I started a full 4 days earlier than usual.

Unfortunately, I had the bright idea of writing an essay on something I'm not very good at in the hope of understanding it better. Enter the dreaded acid-base balance. Septic patient in metabolic acidosis with dodgy arterial blood gases, and I have to write a 2000 word discussion on it. So far I have written 729 words. D'oh.

I kind of am understanding it better, but I'm so used to the last minute bashing-out of essays on wednesday/thursday nights (it sounds sloppy but I get B's so no criticising!) that I'm frustrated at the amount of work I'm having to do in order to understand enough to write one paragraph.

Tomorrow, I have 2 lectures, then a meeting with my group about an ATLS presentation we have to give on friday. Then in the evening my flatmates and I are having some people round for dinner, and bizarrely, without even offering, I have taken it upon myself to do the cooking. So tomorrow is going to be tight, and I forsee a late night getting this stupid essay done.

Oh, I can't wait for the time when essays will be a thing of the past and there are only 13-hour acute receiving shifts to worry about...

Procrastination time over, back to the grindstone.

MDM, MFG

2007-02-28T04:33:00.000-08:00

Another lecture from the military bloke from the first week yesterday - this time on major incidents. All about organisation and contingency planning. Was pretty interesting, although I was struggling a little bit to believe that the Tay Bridge is a potentially major terrorist target!

The main 'take-home' message (why do people call it that? it makes me think of party bags I used to get as a kid, but they are nowhere near as interesting!) was that attention to detail is extremely important in dealing with major incidents. It was neatly summarised by our lecturer in the mnemonic, 'MDM MFG' - 'Minor Detail Missed, Major F*ckup Guaranteed'.

Again, nice. At least I'll remember it.

Freaky Friday

2007-02-27T02:12:00.000-08:00

Apologies for lack of posts over the weekend, it was a tough one.

Friday was a bit mental - was in A&E in the afternoon. It started off really quietly, so much so that I considered calling it a day and going home, but then it picked up in a BIG way. First was a known alcohol enthusiast who jumped out of a window and broke her pelvis, ribs, tib and fib, both ankles...nice. Then came an elderly lady found unconscious who seemed to have had a massive stroke or brain haemorrage or something - it was just a case of keeping her comfortable, not much could be done. Then came another elderly lady who collapsed in a shop - she was a full resuscitation case, so I got to do some CPR (first time on a real person, I was scared), but sadly she died. So a bit depressing all in all.

Saturday was good - went to see The Last King of Scotland with some friends. It was really well-acted and well-shot, I was very impressed. Not for the faint-hearted though, it's pretty gorey.

Sunday was a crazy day too - am having some family issues, with my grandparents needing support - my grandmother is going into hospital for some surgery tomorrow, and my grandfather is developing dementia and can't really cope on his own. Since my parents are abroad, I feel quite responsible for it all, but my uncle is going to go down and take care of my grandfather for the few days when he would have been on his own, so it's all working out. Pretty stressful though.

This week is full of essays and wrapping-up of this block, so posts may not be too interesting, but I'll do my best!

That's all folks, got another lecture.

Affirmative, SAH!!

2007-02-23T03:35:00.000-08:00

Just got out of a lecture with the blood transfusion dude - he's the guy we call in a panic when our patients are bleeding all over the place and we really really need blood and we really really needed it five minutes ago but we wasted the time panicking! He's magic.

And he's a soldier, has been placed in Bazra and has seen A LOT of stuff. So he was teaching us how not to let your patient exsanguinate, how and what blood to give, how to get hold of it, etc., all very useful because soon this will be us, as we are eternally reminded by gleeful physicians who I think just like to watch the fear creep over our features.

We are listening intently and trying to make notes and take it all in when, breaking the silence, his phone rings with this tune...

http://mywebpages.comcast.net/freewebman/war/ww2/great-escape.mp3

...nice!

Blatant plagarism

2007-02-22T15:20:00.000-08:00

Copied mercilessly from Elaine. Must work on Southern Hemisphere...

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Brain Fog

2007-02-22T08:42:00.000-08:00

Some days, you just don't know enough. Today, for me, was one of those days.

This morning I was in the high dependency unit for the ward round - only 5 patients but still took nearly 2 hours. So it was long, but it was okay, not too many difficult questions.

However, this afternoon I was in the intensive care unit being taught about acid-base balance (yes, non-medical people, it is about as interesting as it sounds) which, I'll be the first to admit, I'm not very good at. Basically we were taught about this kind of stuff years ago and I didn't get it, so I asked for help, but I still didn't get it, and then people got bored of me asking, so I stopped. And now it's not so much a case of failing exams if I don't understand it, it's more a case of people dying. D'oh. It is a fairly confusing subject, but my tiny brain just doesn't seem to be able to figure it out. A trip to the library ensued, and I am nearly at my book-loan limit.

Guess what I'll be doing tonight?!

Jump on board

2007-02-21T09:33:00.000-08:00

At last, I join the realm of bloggers everywhere.

A bit about me...I am just polishing off medical school after six long years of study (I didn't flunk one, I did an extra degree in the middle. I am a self-confessed geek) and will soon be starting work as a foundation doctor. I have no idea where.

I love medicine, but I'm still undecided about the doctoring side of things! I also love travelling, music, photography, and sleeping when I can. I love my family, my lovely friends, and I love God. I'm a Christian, and a very imperfect one at that, but I hope that God likes me anyway.

I am currently studying acute care - a nice module of lectures, the occasional stint in theatre and most of all, long-lies and the wearing of denim rather than smart clothes. Tomorrow I am going to the high dependency unit in the morning and intensive care in the afternoon.

I think that's all for my first post. So long for now!