One Track Mind

Me, catching a bus to the city: "One student ticket please"

Bus driver: "I'm not going up to the university!"

Me, "No - you're going to the city"

Bus driver, "Oh. Well, yes"

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How to: not get sued

One interesting tidbit that came out of last week's Patient Safety Workshop was a handy guide to "which doctors are likely to get sued".

Apart from the fact that male doctors get sued much, much more often and for much, much more money than female doctors, here are a few of the factors that influence whether or not your patients will sue you:

Doctors who are "late, rude, inattentive, poor/non-communicators, and apathetic" are more likely to get sued.

Doctors who ask questions, laugh with their patients, explain everything, and allow sufficient time for a consult are less likely to get sued. It also helps to be honest and apologise if you do make a mistake, and not just hand the patient to a different doctor.

As one GP told me last year, "if your patients like you, you have to do lots of things wrong before they will sue you".

So now the question is, should we spend more time learning how to be nice, or how to be competent? Or should the less likeable amongst us be trying even harder at med school?

I'm on the wards!

Clinical Pharmacology term is over, Infectious Diseases term has started, which means ... I'm back on the wards! And back amongst all the craziness that will appear if you just see enough humans in one day.

Standing at the nurses' station writing in patient notes yesterday, I observed a patient in a wheelchair zooming along at an alarming rate using just his one arm and one leg to propel himself.

After a few laps, as his anxious face started to become red and shiny with exertion, the nurses began to question him. As he flew past he explained breathlessly, "I've put on a kilo in one day! I have to get it off!"

And therein lies the danger of the Daily Weigh.

Save the ... car?

I almost sold my car this week. Pulling out of a multi-story carpark, I was stopped by a middle-aged man in his tradie ute. 

"How much?" he asked.

I gave him a funny look as I tried to come up with an answer - I couldn't recite the carpark's hourly fee.

"How much FOR YOUR CAR?" he rephrased

I explained that it wasn't for sale.

"Change your mind?" he asked, pointing at the signs in my back window.

I tried explaining, but after several minutes I had to physically pull down the signs so he could read them ...

How to: put your audience offside

Assume they're going to be rude and inattentive, and immediately get defensive and try to counteract it. 

Try saying something like, "I respect your experience and knowledge, and all I ask is for you all to do the same for me please. Thank you."

It should take a good ten minutes before they look at you with anything but resentment.

Mission accomplished!

Patient Safety Workshop

One third of the Year 4 class wasted their entire Thursday at a 'Patient Safety Workshop' - the other 2/3 will do the session later in the year. I also wasted my Wednesday doing the pre-readings and answering thought-provoking questions such as "What are the potential holes in the Swiss cheese?"

Today we sat through lectures, watched videos, split into groups and brainstormed, and wrote on whiteboards. On the plus side, some parts were quite entertaining, it was good to see classmates, and we got morning tea and lunch. But overall it was quite long and tedious and could have been summed up with, "Do your best, but we're only human and we need systems and protocols for the protection of ... well, everybody".

However, I wouldn't have liked to miss the first video. Picture this: a stressed ED doctor had just hung up the phone - "it's not good enough, really. It's -really- not good enough" because the lab had lost some blood samples. In sauntered the ED nurse who got in nice and close to him, flirted briefly and then asked suggestively, "is there anything I can do to help?"

At this point, about 30% of the group was convinced we were about to watch porn.

Highlight of the day.

Journal Club

It was my turn to present an article at the Clinical Pharmacology Journal Club yesterday. This was something I took very seriously and I spent hours analysing my chosen article and working on my Powerpoint presentation. I also prepared a batch of delicious biscuits to bribe my audience into listening attentively.

In hindsight, I probably shouldn't have chosen a review article about a drug  that was written by someone on the payroll of the drug company. And I could have found a more reputable journal than "Swiss Medical Weekly" which, I think, is only published online. But it gave me plenty to talk about, I learned a little about dronedarone (an amiodarone derivative that is less effective but less toxic - unless you count the liver damage), and now everybody has heard of a journal called Swiss Medical Weekly. 

So we all learned something.

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Let's get medical ...

You might be wondering about the lack of medicine-related posts on here. Just to scan through, it would appear that I have switched my priorities to politics, and that's not good for anyone. 

Yes, I am still studying medicine, and my faithful pink stethoscope tags along with me every day. It's just that ... well, I'm doing a Clinical Pharmacology term, and whilst nobody can truly claim to know what Clinical Pharmacologists do, one thing they don't do is see patients. And seeing patients is where all the best stories come from.

No wait, I remember, we did see a patient today. We ventured down to Intensive Care because we'd heard that a patient there had a high Vancomycin level. The levels should be between 15-20 - below 15 the antibiotic is ineffective, and above 20 it starts to become toxic to the body. This man had a level of above 60. After standing at the foot of his bed and staring at his chart, we established that he'd been given a dose last night when it should have been withheld. 

My supervisor chatted briefly with his treating doctor, and then we went for coffee.

Good story.

Save South Australia

South Australia is in a dire financial situation. That is why the Minister for Health is not-so-reluctantly diverting money from several perfectly viable and much-needed country hospitals to help fund a controversial new tertiary hospital in the city. It's justified, apparently, because overall the Government is spending more on Health than ever before. 

It's also spending more on Plasma TVs for prison inmates than ever before, and more on appearance fees for Lance Armstrong. It's spending up big on private parties at Clipsal 500 and office re-fits for MPs. 

Spending money does not equal doing the right thing by South Australians.

Spending money properly would be a terrific start.

The Haircut

If anyone's curious about the outcome of my dreaded haircut at last week's Shave for a Cure, I'll tell you now. I had planned to cut off 15cm of my ponytail, and thought that was pretty drastic. However, my sister and a few classmates made the executive decision that 15cm was not dramatic enough, and promptly chopped off 25cm.

I stayed (relatively) calm, for I'd had the forsight to make a hairdresser's appointment for immediately after the event. I casually sauntered up to the campus hairdresser only to find that he wasn't there! Apparently the med society had given him the wrong time for the event, cancelled at the last minute, and he'd gone home for the day.

Panic!!

On my little sister's advice I went into the city and got an appointment with a hairdresser who was incredibly supportive of the Kitten Hospital as well as the Guide Dog society. After agreeing that curly hair should NEVER be layered because it turns into an afro, she trimmed, straightened, and before I could stop her, LAYERED by hair.

And now, unless I straighten my hair, I look like a pom-pom.

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Country Rally

South Australians may have heard about this morning's Country Rally on TV or radio - especially the traffic report. Some might have seen it first-hand as a large group of vehicles entered the city limits during peak hour, all bearing signs displaying obvious disappointment in the Rann Government's handling of ... well, basically everything to do with South Australia. 

The "Save the Keith Hospital" group was especially prominent, clearly upset that Rann can justify spending  (amongst other things) $500,000 on a VIP Clipsal 500 party for MPs, $2million to convince Lance Armstrong to compete in the Tour Down Under, but refuses to back down on cutting $300,000 from Keith Hospital's funding.

Most passers-by were sympathetic to the cause, some even jumping up on the steps of Parliament House to join the group as they paused for photos and interviews. My boyfriend and I were accidentally interviewed - accidentally because we had no intention of being interviewed, and because the newsman thought we were innocent road-users who got stuck between the protest vehicles. Next time I'll put signs on both sides of the car!

The purpose of the rally was to raise awareness of the issues facing country people right now - and there are many. To those whose mornings were spoiled by the delays, think about your friends in the country whose way of life is being genuinely threatened by the current Government. And if you see a group supporting a cause that strikes a chord with you, I'm sure they'd  love you to join their fight - make it yours too!

Not all those who wander are lost

I saw someone today with a "not all those who wander are lost" T-shirt and felt compelled to go and look up this poem from J.R.R. Tolkien's The Lord of the Rings. A bit nerdy of me, yes, but it's a good poem.

 

All that is gold does not glitter,

Not all those who wander are lost;

The old that is strong does not wither,

Deep roots are not reached by the frost.

From the ashes a fire shall be woken,

A light from the shadows shall spring;

Renewed shall be blade that was broken,

The crownless again shall be king.

 

 

Good drugs, bad drugs

She presented with weight gain, amenorrhoea, and a noticibly "round" face. 

She looked like she had Cushings ... but all the tests came back normal.

What could it be? Was she on any medication? No ... oh, except for the cream she'd been using for her psoriasis - a potent steroid cream, which she'd been slathering on her skin many times a day.

Sure, it had stopped her itch - it had also made her bloated and unrecognisable, stopped her periods and made her panic about early menopause.

In the same consultation that all this was eplained (and a dermatologist referral organised), she mentioned a sore throat and asked if the doctor could "give her something for it". 

Because medications can't do harm, right?

Save the ...

I've been wearing a "Save the Keith Hospital" powerband for weeks now. Unfortunately, millions of people wear powerbands for a miriad of different causes, so people tend not to read them anymore.

Last Friday, however, I had a winner. My hairdresser spotted my powerband and read it aloud, "Save the ... kitten ... hospital"

"Save the KEITH Hospital" I corrected her hastily.

"Cute!" She replied, oblivious, "I donate to the Guide Dogs"

<facepalm>

World's Greatest Shave

I've done it. I've joined the Leukaemia Foundation's "World's Greatest Shave".

No, I'm not quite "brave" enough to shave my head, but I will be chopping off 15cm of my precious, precious hair for the cause. Or, correction, the highest bidder will do the honours. And it's happening this Friday. And I'm regretting it already.

Some might say that it's a bit of a cop-out, "just getting a haircut". Maybe it's not a big deal for some, but it's a big deal for me. You see, I haven't been to a hairdresser for 12 years, when I went in for a trim and the hairdresser cut off more than I'd anticipated. For the last 12 years, the only person I've trusted to cut my hair has been my little sister - because I know where she lives and she knows how upset I'd be if she cut it too short.

My mum, who's been urging me to get a proper haircut for ... well, probably 11 years, freaked out a little when I told her what I was doing. Maybe she mean that I'd hypothetically look better with short hair. She's warming to the idea now, I think.

If you'd like to support the cause, head to the World's Greatest Shave website,   http://worldsgreatestshave.com/. You can click "Donate" on the bottom of the page, or click on "Sponsor" to find individuals to sponsor. Me, perhaps?

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Politics

I really have to apologise for the political posts that have been occasionally cropping up here. I'm sure you don't come here to read about the failings of the South Australian Government or Minister for Health. You probably get enough of that from television, radio, newspapers, your friends ... actually, you probably see enough of their failures for yourself on any given day.

I don't like reading about politics. I don't like to get angry when thinking/hearing/talking about politics. I don't like caring about politics. But at the moment I do care, and this bothers me greatly. I want to say, "Premier Who? Health Minister Who? Never heard of them. Now let's stop talking politics, it bores me".

When people like me start thinking, caring, complaining or talking about politics, there is something very wrong.

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Mundulla Show 2011

The Moot Yang Gunya Festival (Mundulla Show) continues to grow and develop as one of South Australia's most unique festivals, adding new attractions each year whilst somehow maintaining the feel of an old-fashioned country show. I regrettably missed seeing the Gravel-Shovelling Championship, which by all accounts was a real crowd-pleaser. I did however manage to squeeze into the packed marquee to watch chef Simon Bryant give one of his live cooking demonstrations with local ingredients including lamb and free-range turkey.

Utes from the ute muster filled up the cricket oval, the ambulance was called several times to the motorbike area, a live band blasted out covers of classic songs from the back of a semi-trailer, and I ... wandered around taking photos. Here are some of my favourites:

Above: Simon Bryant during one of Saturday's cooking demonstrations

Below: Greg Willoughby, showjumping convenor and newly-inducted Life Member of the Mundulla Show Society

Above: Sydney Olympian Jeff Bloomfield and the beautiful stallion Anton

Below: Sprite, the cutest dog in the world

Above: spectators for the Junior Championships

Below: The traditional "Blessing of the Horses" on Sunday morning

Above: the cutest pony in Sunday's harness competition

Below: Clydesdales resting between classes

Above: Jasmine Dawe and "Rip It Up" competing in the Junior Championships

Below: Junior showjumper having a bit of a "miss" on Sunday

Above: Paige and "Hendrix", winners of the Junior Championship

Below: Matt Afford, winner of the C Grade Championship

Above: Kristy Bruhn and "Belcam Cosmic" competing in the A&B Grade Championship

Below: Anthony Thomas, winner of the A&B Grade Championship

It was great to see the amazing showjumping horses that we have in South Australia jumping at their very best over the weekend. Mundulla Show is renowned for its quality jumping surface (thanks to the Mundulla Football Club for maintaining such a beautiful oval) and coursebuilder John Wilsher made sure the fences were at maximum height to properly showcase the ability of the horses and riders. I never thought I'd enjoy a show where I didn't bring a horse of my own, but the competitions at Mundulla were inspiring to watch. Congratulations to all involved.

Mystery Spider

Does anyone out there fancy themselves to be a bit of a spider expert? Because I found this fine specimen last week and can't for the life of me figure out what type of spider it is. If you need a bit of size context, that thing he's eating is a bee. Click for a (slightly) larger picture.

Save the Hospital, Save the World

On Pens

I am a good medical student because I always carry a pen. True fact.

If my supervisor needs to sign a form (as so often happens), and finds himself searching frantically for a pen (as so often happens), I will hand him mine. And he will say, "that's a good medical student" even if I have botched everything else all week.

But despite that glowing feedback and the lingering sense of accomplishment, I do not like lending my pen to doctors for two reasons:

1. A doctor will never voluntarily return a pen
2. Doctors will occasionally often chew on a pen, regardless of whether it belongs to them

Two reasons for not lending, and two reasons that make it very hard to ask for my pen back.