So that was third year

Well, I'm finished. I found out this morning that I have taken my last ever exam for medical school.

In a good way.

As it turns out, I somehow got more than 65% in the rather horrendous multiple-choice exam on Monday. By how much, I may never know ... but that's fine with me. I'm finished!

I celebrated by ordering new contact lenses, helping my friends study for tomorrow's short-answer exam, and then having a beer with my sister before refusing to go out to a pub.

Party central, right here. Happy Wednesday everybody!

Pick-a-Box

Then there was the MCQ exam. I'd prepared well for this, by doing other multiple-choice exams and trying to remember the answers. The day before (on a beautiful Sunday), I'd huddled in a tutorial room with some friends and we'd worked through several of the past exams. We couldn't agree on all of the answers, and some of them we decided were ridiculous questions, but at least we tried.

I started out the day by locking my shoes in the bedroom and finished it by pouring popcorn all over my lap in public, so it’s hard to say how the middle bit went. But I can tell you that all of the questions we weren't sure about in practice were repeated verbatim in the exam, and all of the questions we thought were easy had been changed slightly so that they became tricky.

If I got more than 65%, then I won’t have to sit the second written exam on Thursday. Given my success in practice exams (50% on a good day), it’s most likely that I will be sitting the second exam.

Of course, I won’t find out until tomorrow, so today is to be spent in ... I’m going to call it purgatory.

Who smiles during the OSCE??

PTR does. PTR smiles during the OSCE. I followed him around, station by station, and became more and more perplexed as he would read the instructions, give a big grin, and enter the room. And as each station ended, out he would come with a big smile on his face as if the station was not only easy, but also funny. Then it would be my turn, and I would read the instructions (nothing funny there), I would do the station ... and I can assure you, none of them were particularly humorous or easy.

The OSCE was strange. In 20 five-minute stations, we were to be assessed on the clinical skills we have obtained over the past three years, and prove that we are doctor-like enough to pass through to fourth year. Armed with only a stethoscope and a biro, we were to face off against the unknown horrors behind each door, ready to prove our knowledge of obstetrics and gynaecology, medicine and anatomy, psychiatry, pathology and perhaps pharmacology.

Well as it turned out, most of the stations were about counselling. I used my stethoscope once, and that was on a dying mannequin. Sure, I’ve been tested ... just not on anything I’d prepared for. Can I read an ECG or an X-ray? Can I do a proper cardiovascular or respiratory examination? Can I suture or cannulate? Can I perform a Pap-smear or a DRE?

Probably. But the school of medicine will never know.

Maggots

An 86-year-old gentleman I saw at the hospital came out with this charming quote:

“it was the maggots, I reckon, gnawing in there and giving me all the pain”.

I was going to share it without context but you might enjoy his story as well ...

He’d been burning off his paddocks in readiness for summer when he noticed that there was a bit too much smoke, so he jumped in the F-100 and went to investigate. Partway there the smoke became so thick that he couldn’t see at all, and he ended up crashing into a fence and bailing out of the truck.

“What happened to the truck?” we asked out of curiosity
“Oh, that went up. So did the petrol tank next to it” he said.
He escaped with only a scrape on his shin, probably from a metal dropper.

The scrape he ignored for several weeks until the maggots moved in. Even then he didn’t want to see a doctor, but his wife insisted – apparently she was sick of having a maggot-infested wound in her bed.

The doctor at the clinic sent him straight to the hospital for proper wound exploration. The poor on-call doctor managed to pick out more than 100 maggots from a deep hole on the man’s shin which, on the surface, was only as big as a 10-cent piece. They had eaten their share of necrotic tissue and then started invading the healthy tissue underneath, creating a large pocket under the skin.

I saw him the next day when his wound was being re-dressed. The hole in his shin was significant, but it all looked healthy and the doctor had managed to scrape out all of the maggots. I asked if there was any pain and he said “no, not today – it was the maggots, I reckon, gnawing in there and giving me all the pain”. Good to know.

Cat Poo

Going through my PBL notes today, I found this:

Alcohol: no alcohol is best
Pets: don’t eat the cat poo
Caffeine: 1 coffee max. Reduce soft drink intake

It must have been a funny joke at the time, but now I have no idea why I felt the need to add the line about cat poo. Do pregnant women have cat poo cravings?

And I thought the famous "pickles and icecream" cravings were disgusting.

Vampire

She was referred to the general surgeon with non-specific abdominal symptoms.

She was playing with her daughter one day and suddenly became nauseated, and since then has had nausea on and off.
My brain: nothing. No idea.

She’s been feeling exceptionally cold
My brain: ooh - maybe she’s a vampire?

She’s been off solid food and can only drink liquids
My brain: she’s probably a vampire

She’s suddenly repulsed by the smell of garlic. She even feels like vomiting when somebody says the word ‘garlic’
My brain: she’s a vampire she’s a vampire she’s a vampire

The surgeon wasn’t sure about a diagnosis and booked her for endoscopy. After she left he turned to me and asked what I thought.
My brain: vampire vampire vampire vampire vampire
Me: I, um ... I really have no idea

Quoteblog #10

“I’ve seen Arachnophobia and Charlotte’s Web as well” – Clinical Educator on why he doesn't like spiders

“Oooh, hello, that’s my bum!” – Surgeon, overly excited about his phone ringing in his pocket

“I like firm things!” – female student ... then, “ohhh, I shouldn’t have said that”
(She was referring to her firm jeans)

“You were tickling them, you weren’t blowing them!” – female student on how to blow whistles

“You can eat me under the table any time you want” – One male student to another, hopefully talking about food

“No, no – my waistline is outside the Australian Heart Foundation’s recommendations” – Cardiologist after being offered a cupcake

Do dogs eat cake?

I made cupcakes tonight for tomorrow’s PBL day.

Sprite was immediately convinced that dogs could eat cake. I fed her sausage and she was like, “No ... dogs don’t eat sausage. They eat CAKE.”

So I let her try some. She took the cake delicately from my hand, set it on the floor, and contemplated it for a while. But she couldn’t back out now – she had to eat it. And that’s when she realised that maybe dogs aren’t meant to eat cake. Mlup, mlup, mlup, she worked her jaws as the cake turned soggy in her mouth and stuck to her teeth. But she battled on bravely and choked it down.

She went off for a drink and I thought she wouldn’t come back, but a minute later she sidled up to my chair and looked up as I ate another cupcake. More? I don’t think so Sprite. But she turned her head, dialling up the cuteness until I couldn’t resist, and I fed her more cake.

And now she is an expert on eating cake. She doesn’t even go “mlup mlup mlup” anymore, she eats it like it’s food.

Even when I was out of cake, she wasn’t fooled. She could see the stack of patty pans on my plate.

Dogs can eat paper.

Cardiac Revelations

Aortic stenosis murmurs sound different to mitral regurgitation murmurs!

I discovered this last week when I listened to a gentleman's heart and heart not the "whoosh whoosh" of mitral regurgitation but a little "vrmmm vrmmm" which happened to be aortic stenosis. It sounded like a little motor trying to start up between every S1 and S2 (because we all know that both AS and MR murmurs are systolic).

I was so amazed that I told the on-call doctor (who already knew this amazing fact) and she made me go and listen to everybody with a heart murmur. And I excitedly hurried off to do exactly that because heart murmurs are now amazing.

God help me, I'm becoming a nerd.

Orrina

"I have seen fomme in my orrina" says the Italian man

"Your ... orrina?" I reply, puzzled. Between his thick accent and ill-fitting false teeth, communication has been a struggle.

"My orrina" he gestures vaguely at his abdomen, "You know, with the toiletta"

"And how long has there been foam in your urine?"

Accommodation

I have my accommodation sorted for next year. The original plan was to share a townhouse on the university campus with my boyfriend, but then he told me how much rent cost these days and I changed my mind. Sorry.

It’s been four years since I’ve paid rent – this year my rent is free because I’m on rural placement, and for three years before that I worked as a Residential Coordinator on campus and hence rent was incredibly cheap. But I remember how much I struggled to pay rent as well as buy food every week back in the day when I paid full rent on campus. Taking into account the fact that rent has increased alarmingly each year since then and Youth Allowance has not, I was terrified at the thought of trying all that again.

And so my little sister, who has an actual job and lives all on her own, offered to take me in. We came to an agreement in a series of long phone calls interjected frequently with important information such as “my dog is so cute! She’s laying down” and “so is my dog! He barked at somebody today”. The agreement is fairly simple ... I just have to pay a bit of rent and make a lot of food.

Mum thinks it’s a terrific idea. She hasn’t said so but I know it’s because 1 – I can ‘keep an eye on’ little sister and 2 – I won’t be living with a boy. Little sister thinks it’s a great idea because 1 – Food, 2 – Oh my God we can share clothes, and 3 – I think she’s sick of living alone.

There are many potential disasters, and I know this, but it still seems like a pretty good option because we get along really well in between fights, and also I’m on Youth Allowance and she isn't charging too much rent.

Things look all too simple at the moment because both of us are living alone and have forgotten how annoying house mates can be. But I have been responsible and produced this list of possible cons:

1. Little sister’s house is miles away from uni. This will probably start to annoy me after a few weeks or months.

2. “Sharing clothes” means different things to different people. Little Sister is already prone to sneaking items out of my wardrobe and not returning them for months or years, so I hope this new arrangement means that she’ll return them sooner because they’re legitimately borrowed.

3. I don’t particularly enjoy cooking, especially “real food” such as is expected at dinner time. I do, on the other hand, excel at making cakes and biscuits, which I enthusiastically pointed out. Little sister’s reply was “um ... we’re going to ... we kind of need to eat vegetables sometimes”.

4. I’m going to have to hide my chocolate stash REALLY WELL.

5. I'm adding "arguments over the bathroom" because this is inevitable.

Stay tuned next year to hear how we get on!