Thursday, February 28, 2008

I'm all yukky

PC: horrid coughy cold

HPC: 1/52 coryzal symptoms, 4/7 productive cough, 3/7 complete and utter pissed-off-ness at life

PMH: several previous episodes of pissed-off-ness, usually coinciding with bad placements

DH: paracetamol and cough mixture

SH: fed up of stupid hospital placement, non smoker, drinks within accepted units

O/E: pt appears grumpy, apyrexial, obs stable

Diff diagnosis:
- TB
- Pneumonia
- Medstudentitis...

- Continue cough mixture and paracetamol therapy
- Sleep
- Hang on til the weekend when everything will seem better. Hopefully...

Wednesday, February 27, 2008

Earthquake Update

I really wasn't making it up. A tiny bit of me did wonder if I was mad or not, but the Beeb have kindly confirmed it for me.


Oh yes. I was sat in bed reading, should have been asleep, and suddenly the room shook, firmly but gently, for about 5 seconds. I was like 'holy crap, what the hell?' and disbelieving to be honest. And then scared, cos I realised it was definitely not the housemate above me having sex. It was a flipping EARTHQUAKE.

So then I my on my dressing gown and stuck my head out to see if anyone else felt it, but no such luck, all asleep.

I turned to the internet, but there was no record yet. I found a likely page, and refreshed a few times, and then there it was:

12:56:46 AM UTC
England, United Kingdom ( 53.32N, 0.31W )
Magnitude 4.7
Depth 6 miles

Holy crap!

Tuesday, February 26, 2008

The Yearbook or Why is everybody just the same?

After (nearly) five glorious (mostly... well, sometimes... alright - hardly ever) years at Medschool the time has come for the Yearbook. Ah yes, where each of my peers distills 5 years into one page of soundbites and a single photo.

I'm horrified by the identikit nature of said yearbook entries. In 10 years time, everyone would like to be a GP in the country and, if female, making babies. I did not put this, because right now I don't know what I'll be doing where, and I'm enjoying the freedom. Maybe I will be settled in 10 years, maybe I won't. I don't know. And the 'how I want to be remembered' question? Everyone has put something along the lines of 'a fun-loving, easy-going, loyal friend'. Ha! No-one's put anything mean, even the really bitchy girls.

I would like to point out that my friends have done me proud on this - there's a few identikit answers, but everyone's pulled out at least one interesting/funny/bizarre answer. Mine is of course a paragon of wit and poise, just like moi. Yeah, ok, so the picture I chose is ridiculously safe and doesn't really look like me, but at least I don't look crazy (as I do in many many photos on Facebook. Damn Facebook and it's mass photo sharingness).

I guess the Yearbook really just proves one point. We're all pretty much alike. At least in the way we think of ourselves, the way we want other's to think of us. Maybe it's just that there simply isn't that much originality in the world. Everybody wants to be unique, but how many truly special people do you know?

I don't know many people who can 'light up a room', but I have many many friends who are all completely unique and special, but would all look the same on a piece of paper. And some friends only became friends after a long acquaintance, because it took me that long to find the 'special'. Some people in my life are special because of the memorys and genes that we share.

I'm really glad I have them, you know. Even the ones who want to remembered as 'easy going' or (shudder) 'fun loving'.

Monday, February 25, 2008

Jumping through hoops

Being a medical student is not all sweetness and light. It's hard work most of the time, although I think most of us adjust to the level of work required and consider it normal. When I lived with non-medics, my work-life balance was just set at a completely different level. I went to lectures everyday, all day, because that's how it was. One ex-housemate attended just 4 hours a week, because that's how it was for her. Neither was wrong or right, it was what it was.

I accept, nay, embrace, all this. Medicine is hard, and I didn't walk into with my eyes shut, expecting an easy ride, or even a 'normal' student experience. But I am beginning to have some serious issues with the level of rubbish we are expected to do on top of our medical education. The stupid hoop-jumping for the sake of it stuff.

Take this term for instance. It's our final block before graduation, leading up to our last set of exams. We're trying to consolidate and revise everything useful from the last 4 and a half years - and its hard work. So the Medschool decides to set a couple of pointless and ridiculous projects just to add to the fun in our lives.

Firstly it was the patient information leaflet project. As in, critique and rewrite one. Yes, because that will be an important part of our role as doctors, something we should definitely know how to do. Because it's not like the NHS spends a considerable amount of money of paying people to do this stuff. The Medschool's argument is that we need to understand how to communicate to patients. Eh? Have we not just spent 4 years having sodding communication skills lectures and practicals? Surely the obligatory patient counselling stations we have in every single OSCE will have shown up the idiots who have no people skills? No?

(There is a conspiracy theory doing the rounds: any good leaflets are passed on the NHS to be used in the real world. I wouldn't put it past the Medschool, I really wouldn't.)
And now we have an ethics project to complete. In order to prove that we take notice of the world around us and understand ethical issues in the media, we have to summarise 25 articles (at least 15 from broadsheets) to show that we read the papers. It is a pointless exercise. All of mine have come from my once-weekly perusal of the Sunday Times, supplemented by BMJ News articles. Its taken me all afternoon to do the summaries for 5 of them. A whole afternoon when I could be learning something useful, say, how to read an ECG.

I have endured the hoop-jumping up until now, but now I'm reaching the end of my patience. I want - need - to learn medicine, not write summaries of newspaper articles. I feel like throwing the bloody hoop back.

Gratuitous pretty countryside picture taken on my lovely walk last weekend with Zombie. You'd never believe we were only 30 minutes from the centre of Birmingham... Alright, we were just into Worcestershire - oh yeah, I'm moving to the country in the summer!

Sunday, February 24, 2008

The Enormity of it All

So, last night was my first middle-of-the-night-I'll-never-pass-this-module panic. I think this is the record earliest affliction of said panic. Unfortunately, it's probably justified. 'Medicine' is a huge module, and I'm going to have to know a serious amount of stuff. Oh, and be able to read accurately and diagnosis from an ECG. After almost 3 years of clinical work, it still looks like a goddamn squiggly line on pink graph paper to me. Task for the next week: learn something (anything!) about ECGs.

I did attend some extremely useful teaching on Friday about prescribing - not what, but how. Oh yes, the actual nitty-gritty of putting things on the chart, things like sliding scales, digoxin loading doses, fluid regimes, and acetylcysteine for paracetamol ODs. It was very enlightening. Enlightening as to how to do these things, but also as to how ill-equipped we final years actually are to hit the wards in August. Our theoretical knowledge is there (in theory...) but our practical knowledge? Medical school has been tough, but nothing like the curve we'll all be climbing come August...

It's going to be a loooooong summer.

Wednesday, February 20, 2008

Somebody wants to employ me?!

This summer (finger crossed, and wood touched) I will become a doctor. Frightening stuff for both me and the good people of Britain. I'm still unsure as to how I got here without being kicked out...

The first two years out of medschool are called the Foundation Programme, F1 Aand F2. Each year is split into three jobs of four months each. During F1, most rotations include one surgery job, one medicine job, and one other, which may be another med or surg, or something entirely different. F2 is a bit more random in job rotations, and usually they're geared towards a future career, but not always.

To get onto the Foundation Programme, you must apply to a Foundation School (FS). A 'school' is a geographical area with one central office in charge of training. Some are huge and some tiny. My Foundation School, Hereford and Worcester, is one of the smallest, only containing 3 hospitals under 2 trusts. There are approximately 70 F1s there, compared with 800+ in the largest FSs.

After being allocated to a FS, we had to rank the different job rotations in our FS. This was a particularly long and arduous process (and I only had 25 jobs to pick from...) again online, on a very poorly designed site.

Anyway, today was the Big Day when F1 job allocations were released, and we would all know exactly where we'd be spending the next year of our lives.

I got my first choice. Hurrah!

Next year, my rotation is (again, fingers crossed and touching wood):
- Trauma and orthopaedics
- Medical Assessment Unit with general medicine and elderly care
- Accident and Emergency

I'm so ridiculously excited! And scared too. But mostly excited and disbelieving. It's going to be a big big change, but I really glad to have got rotations that are going to test and improve my diagnostic skills and also teach me some real-life patient management skills. Yay!

Most people in my FS were pretty happy with their jobs. Lily, my soon-to-be housemate, also got her first choice job at the same hospital as me, and Mirabelle got her top choice too, which will bring her to our hospital for one 4 month block. Not that I think getting first choice was typical - Lily and I had gone for a rather maligned little DGH, that we love but is considered somewhat dull by others, and Mirabelle has an unfortunate passion for psychiatry (I don't hold it against her, she's my best friend). I don't know anyone who was desperately disappointed though, so the system is apparently working. Seems madness, but is clearly true.

Oh, it's just so big, I can hardly get my head round it. But at least I can really start planning the next year of my life.

And I must also pass my medical finals. Mustn't forget that one last rather important step...

Tuesday, February 19, 2008

You know you're spending too much time in hospital when...

On passing a random SHO in the corridor you are told:

'I'm beginning to see you round here more than the house officers paid to be here'

(Jobs are out tomorrow - eeek!)

Saturday, February 16, 2008

Trippy goodness

So, me and my two good friends (I forget their names, but you should know that one's a lovely human guy and the other a beaver-person-type thingy) cross-country ski down to the train station. On skis made from bark. There's no proper snow but the icy slush makes the perfect surface to slip and slid on.

We reach the station, an old fashioned place with a pre-war feel. The train's waiting for us, so we get on. I don't know where we're going, but that's no problem. There's a minor tussle over seats, but all three of us eventually get sat together, and the train sets off.

The track begins to rise up from the ground, and suddenly we're travelling throught the tops of giant horse chesnut trees in full blossom. The creamy blooms are pushing through the windows, and we lean out to touch them and revel in their freshness.

Then the trees end, and we're travelling past icy mountains, with a foamy sea lapping at their feet. The sea is close and powerful, yet I feel no spray on my face, and have no sense of danger. This changes when I realise the train is headed straight towards a cliff, and isn't going to stop. I panic, and my companions reassure me - the sea is not all it seems, in truth it is the entrance to another world.

We plunge into the sea, and instead of wet and cold, I feel warmth and light, as the train becomes a dragon flying through an orange coloured sky. Riding on the back on the dragon is marvellous, but I know I am nearing my destination. We have reached the home of the beaver people. The dragon drops me and my companions on the back on a giant golden beaver, a statue I think, in the city, and we slid down its back to the ground. There I meet the leaders of the beaver-creatures, the same as my companion, and find out I am part of a task force to win a war for them.

Sadly, before I can find out more about these fascinating people, and perhaps formulate a plan to save them from the terrible war which has already maimed so many of their kind, I wake up.

The End.

*readers should note I was not under the influence of any substance, legal or illegal, at the time of this dream.

Friday, February 15, 2008

Medical Wards

You've gotta love 'em.

This week has been a good week in the land of general medicine. I skipped the post-take ward round on Tuesday morning (well, I hadn't really been on take, so what was the bleeding point?!) and instead headed to an excellent cardiology teaching round. I listened to a number of leaky hearts - including a patient with 2 mechanical valves, which sounded like a wristwatch from the end of the bed. How you would sleep with that clicking away inside I do not know! But it was excellent OSCE practice and made me realise I have to go and revise my murmurs to get them really slick. At the moment I have to think about it all a bit too much...

My own firm's ward round have been pretty good too - we've got an interesting mix of patients. Including one who's 98 years old, and damn sprightly with it. When asked by the reg 'How are you feeling today?', she replied 'I'm feeling old' with some feeling... The 3rd years have also been on the rounds this week, and its good fun. And I enjoy being trusted with jobs. I like being useful, even if my uses are somewhat limited - keeping a jobs list, re-writing drug charts, finding lost notes, doing lying and standing BPs. Not ground breaking medicine but better than standing around!

I also managed to successfully take blood cultures this week, using a syringe. I'm generally a bit rubbish with syringes. Having originally trained with vcutainers, I'm a big fan. They make life neat and clean and easy, and when you've got a patient with shocking veins (as on my surgery ward last year) a little green or blue butterfly is a much easier option to take multiple blood bottles. But to do blood cultures you need a syringe full of blood not neat little vacutainer bottles. I've not have much luck with syringes in the past, but yesterday all went extremely well and I was very pleased with myself. It's silly really, but achieving something concrete and practical always makes me feel happier with the world. Again, it's better than standing around doing nothing...

Most brilliant entry in a patient's notes: 'Fan therapy commenced' - roughly translated means the nursing staff put a fan in the bed area of a patient who was feeling hot. Genius.

Tuesday, February 12, 2008

On Take

Well, I should have been... Except the SHO thought that either I should observe clerking or take historys from patients after he'd clerked that. WTF!? I left early, unsurprisingly, because I was bored out of skull. I'm going to be a house officer in 6 months (touch wood), how can I practice clerking skills without actually doing it? Even the 3rd years can take a history and do a reasonable examination for goodness sake!

I did spend a productive half an hour on the Royal College of Radiologists' website though, while sat in the doctor's office. I am very taken with the idea of radiology. And it has absolutely nothing to do with the really quite delectable radiology consultant at the local hospital, who I happened to see in Sainsburys today... Honestly, nothing at all.

Oh, and how glad am I to see Skins back on TV. Its brilliant. Shaky start to today's first episode, but it picked up and by the close I was enjoying it as much as ever. Especially the crazy outfits, Bill Bailey as a West Country builder ('alrigh', my luvverr?') and Maxxie, the gay dancer. Me and houseamtes (congregated on the sofas to watch) were debating whether fancying him is right or wrong, considering how young he is - quick check on and he's 18 - but I think that's part of the charm. He's an amazing dancer with a wickedly toned body, always a plus, but I think his relative youth completes the attraction. He's a newly minted man: clean, fresh and undeniably hot.

Hmmm, you can't tell I'm in the middle of a man-drought at all, can you?

Saturday, February 09, 2008

New Toy

I'm on the new laptop! Woop woop!

So far so good, will fully update on how cool it is when I stop playing with all the buttons...

Tuesday, February 05, 2008

I feel bad for my lack of posting of late...

My laptop died last week, which has been rather traumatic. Especially as the hard drive is probably bust and I may have lost everything on it. I'm rather upset - and cursing myself for not having backed up the important stuff. Including a wee project that was due in last Friday... Thankfully it wasn't a difficult project (critique of an existing patient info leaflet and writing our own) so I managed to knock another one together in time for the deadline!

However, what with a new placement and no laptop of my own, it's curtailed my late night internet forays somewhat, and so I have not been keeping up with my blog reading or writing. But I am fortunate to have the best most wonderfullest parents in the world, who have bought me a new one that's going to be ready to be collected at the weekend. I am going all the way home to do the collecting, approximately 320 mile round trip, but it'll be worth it. So worth it. And then I shall catch up on all my reading and maybe write some interesting posts on the things that have been swilling round my brain of late. Or not, as the case may be.

In other news, my new placement is 6 weeks of medicine at the large and dreaded hospital where I spent 12 weeks as a 3rd year hating every moment. The very place that drove me to start writing this blog... I'm attached to a general med/elderly care firm, and so far it's been ok. Not riveting, but not too dull. I've been writing out drug charts, doing TTOs and radiology forms, and being a very good general dogsbody. The firm also has 5 3rd years, and I quite like it. Not when they witness me getting a dressing down by the consultant for my utter lack of knowledge, but when they ask me questions I can actually answer! It does happen, I swear.

And finally, I submitted my job choices tonight, and I find out what I've got on 20th February. Not long, not long... I really want my first choice, it's an awesome rotation. But I'll be happy with any of the top 10, and if I don't get those, well, I'm fairly easily pleased. I'll find the bright side.