This blog will remain as an archive.
Update bookmarks and I hope to see you over there.
This blog will remain as an archive.
Update bookmarks and I hope to see you over there.
The guy who had had a zit on his forehead for three weeks and then decided, at 11.30pm, that he needed to see a doctor about it.
And the woman who wanted to complain because the cuff on her 24-hour blood pressure monitor had been inflating all evening.
Both on the same night.
I love coffee. It is wonderful. It is the sweet nectar of 6.30am alarm clocks and three hour lectures. My blog isn’t called becoming a doctor one cup of coffee at a time because I thought that it sounded like a snappy title, and my seventy-third thing (people who suggest that I should try giving up coffee [for Lent] are underestimating how much of a raging bitch I would be without my coffee) isn’t actually a joke.
In my world, there are four types of outpatient clinic:
1) The type where they take a proper break. There will be much coffee and a tray of nice things from the wee cafe, and the consultants will try to persuade you to take just one more cake. I have come across only one such clinic (and liked it so much that I went back five times).
2) The type where coffee is inhaled during the clinic. This category is very broad. It includes any clinics where the first question anyone asks when you arrive is how you take your coffee, any clinics where someone brings in a coffee for you halfway through the list, and any clinics where you are simply pointed at the kettle and told to help yourself. In the nicer ones, there are sometimes biscuits. This accounts for almost all of the outpatient clinics I have ever been to.
3) The type where there is no coffee. These are quite often fracture clinics.
4) The type where they take a proper break but are apparently not that keen on medical students. The consultant drinks his coffee and eats his ginger snap while the four medical students are not allowed such things and must sit, coffeeless and biscuitless, and watch him. This type of clinic is also known as the sixth circle of hell.
Now playing: The Hilliard Ensemble – Ave Maris Stella
At Glasgow, we sit our finals in February/March of our fifth year.
I’ve been avoiding our faculty library since September — not too difficult, that, as it feels as if my faculty have been going out of their way to put me in hospitals that aren’t in Glasgow. I was around last year, though, and I remember what the last cohort looked like by February and I remember wanting to give them all hugs and chocolate. I have no reason to think that the current fifth years looked any better by the time their exams rolled around. But it’s over. So far as I can gather, they spent most of last week having a very big and very deserved sleep, and then this week they learned that they really are going to be shiny new doctors.
In many ways, this is absolutely terrifying. It means that we’re next. It means that this time next year, I can expect my bloodstream to have been replaced entirely by caffeine. It means that I am expected to be competent to the level of an F1 in less than twelve months, which, if the passage of time over the last six months is anything to go on, can be fully expected to go by in a flash. And that in a very little bit more than that, I am expected to be an F1.
Mind, it’s not as if the semi-regular emails about FP application dates weren’t already reminding us of that.
In any case, all of those things are for tomorrow.
Because I ran into one of them today and we jumped in the air and hugged and screamed. In public. You might have heard me in Edinburgh.
We’re stupid proud of you all.
Now playing: Michael Ball – If Tomorrow Never Comes
It is a law of the universe that every once in a while you’ll have a day that is a complete disaster from beginning to end. A day that makes you think that you might have been better off not getting out of bed. A day that arouses in you the childish urge to pull the duvet over your head and demand a rematch.
Yesterday, I had just such a day.
It began when I left my travelcard on my desk, which meant £8.90 and a queue at the ticket office and led to the second disaster: jumping onto the train that was on the platform without checking to see that it was the right one. It wasn’t. It was a train that took me into the wrong train station, leaving less than fifteen minutes to dodge through the other commuters and run through town to the station that the connecting train leaves from. I had not planned to start my Tuesday with a half-mile jog across the city while wearing boots and a winter coat. On arrival at the hospital, I came to realise that I had an unexpected girl problem to take care of and this improved my mood not at all.
And so with these various disasters having already transpired to wreck my journey into work, the day began and I went to a meeting with my educational supervisor.
Do you know the difference between a perforated ulcer and a penetrated ulcer?
I had got it into my head that they were the same thing. I was presenting a case of a perforated duodenal ulcer. It went well until I started to talk about the emergency management of acute upper GI bleeds and the prognostic value of the Rockall score. My supervisor realised that I had gone very very wrong and proceeded to grill me on the blood supply to the alimentary tract, as all my anatomical knowledge fled from my brain and left me to sit there looking like an idiot.
The important things from that part of the story are: a) perforated ulcers cause peritonitis, b) penetrating ulcers cause haemorrhage, and c) blood vessels run behind the duodenum.
It is true that you learn more from looking like an idiot than you do from being right. Still, feeling desperately incompetent is never fun for anyone.
Today, a friend offered me a lift in and my commute became an hour of warmth and good conversation and Radio 4. I answered a question on the ward round. I spent some time with my F1, who made me a cup of tea and taught me how to prescribe vancomycin and gentamicin and warfarin. I passed my first nasogastric tube. I was complimented on my examination technique by a consultant surgeon.
And that’s the thing about bad days.
Last Wednesday, I came home from the hospital and watched an old episode of ER while attacking the pile of dishes that had accumulated. Flatmate and I are both on peripheral surgery rotations and seem only to be at home long enough to sleep and eat, and so the less important things have become less important. I was self-righteously smug when I was able to yell out the diagnosis (to the kitchen wall and the dirty spoons) for a high school athlete who presented with tenderness in the anatomical snuffbox. But my smugness was to be shortlived, for I learned that what I should really be doing on my surgery rotation is forging signatures on procurement paperwork, showing up at the clinical director’s house in the middle of the night, and being the first assistant on an LVAD implantation. I suppose all of those venflons and surgical clerk-ins have been a waste of time, then.
Incidentally, I have a non-medical friend who asked once why we watch medical dramas and this is the answer to that question: so that we can be insufferable when we get the diagnosis before the television doctors and so that we can mock the hell out of them.
And then with order restored to my kitchen, I sat down to watch Junior Doctors: Your Life In Their Hands. It’s a good concept for a documentary and one that hasn’t been done since the epilogue series of Doctors To Be back in the 80s, and the evidence from the first episode suggests that the BBC have done it well. I didn’t have the constant urge to say, “WTF, that is the most ridiculous thing I have ever seen in my life!”, although I admit that I’m not quite sure how a person can get all the way through medical school and remain blissfully unaware of the fact that the day job part of F1 will be almost entirely paperwork and bloods. It’s a good show and I’m looking forward to seeing how it all develops over the next five weeks.
The show has the added element for me of being based the city that I grew up in, those hospitals are the hospitals that I visited my family in and was treated for ridiculous childhood concussions in and did all my work experience in. Only not, because the RVI was never that shiny and A&E was at Newcastle General.
It seems as if my family are all watching it too, and so are many of the families of other students. It’s as if this is acting as a not entirely comfortable window into our world. My parents were freaked out by the rectal, but they were more freaked out by the cartoon lightbulb that switched on in their brains and said, wait, she’s going to be a doctor, like a doctor doctor, oh my God when did that happen, but she was only eight years old the last time we checked. In truth, I understand that reaction. It was a lot like my own reaction.