Boredom and drama in unequal measure

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

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

...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...

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

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

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

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!