Crash Report

At first I thought, cool, that's new - I've never had this error message before!

But now I can't open Firefox. Time for a virus scan?

Oven Master

On a happier note, I seem to have finally mastered my dodgy electric oven. The secret? Switch oven on, go do something else for an hour or so, and then return and do your baking. I also leave a baking tray on the very bottom shelf so that my food isn’t burnt to a crisp from the bottom up. I consider it a win. Mmmmm, cake.

Post-Holiday Blues (reprise)

I got a lot more response from yesterday’s post than I expected –not in the comments section, but in personal messages and chats both in person and online. It seems that it’s not just me, it’s not just the students in my region, and it’s not just the rural students who are feeling isolated and overwhelmed. Even the city-based students can lose contact with their peers, miss out on social events and have trouble getting to the extra-curricular talks and events. From the friends who call me frequently, to those I chat with online from time-to-time, to those who interact mainly via Facebook, we are all lacking in friendly human contact and suffering from fractured social circles since basically the start of Year 3.

Should this be comforting? Possibly. At least I’m not alone in my aloneness. But I find it more worrying than comforting. Why didn’t they warn us that this would happen? That the close friendships we’d forged during the stressful first and second-year would be torn apart as we were thrown into different rotations and geographical locations for the even more stressful third-year. That the people we’d come to rely on wouldn’t be around to help with homework, make you dinner or give you a hug when you needed it most.

And here I am whining because I’ve been sad and it’s all the School of Medicine’s fault. I think I need a dog. And a hug. What do you need?

Post-Holiday Blues

I have been feeling a bit sorry for myself since the holidays. During the three-week break I managed to spend a lot of time with my family, my horses, my little dog and my friends back in the city. I had a birthday, I got presents, I went shopping, and I felt loved. Then I came back to my placement - back to work and back to the reality of assignments, exams and other assessments.

And I was lonely.

I know that a lot of the other rural students are feeling the same way. It doesn’t help to know that the student society is running events that we can’t possibly attend, and that our city-based friends are carrying on with their social lives, attending trivia nights and having group dinners and breakfasts. It did help marginally to see our classmates on the big screen during a whole-class video conference, to sneakily chat on Gmail and to wave at the camera.

But the only thing that really snapped me out of my little funk was a 3am phone call from some old showjumping buddies, inviting me to the casino. They didn't know that I'm placed 500km from said casino, but they have no idea how much it helped to know that old friends still think of me occasionally.

We probably all have a few old friends who could do with a phone call ... some of them might appreciate being called at a more respectable hour, but it's always nice to be remembered.

(Photo stolen from www.bluesbrothersgallery.com)

8 months

He’s “just in for a checkup”, his mum tells me as she brings the happy little 8-month-old into the room. I ask about his history ... he had a low birth weight, he’s been lying on the 3rd centile for all growth parameters, he wasn’t feeding well at the start and he’s had a hydrocele. Sounds like there’s a lot to “check up” on.

He’s picked up a bit lately though – started feeding well, he’s been putting on weight and he’s obviously pretty happy about life. I do his weights and measures, and we note that he’s now in the 50th centile on the growth charts, so he’s caught up well. The doctor examines the testes – everything is normal and the hydrocele is gone. And then he has a listen to the boy’s lungs. It tickles and the boy starts a little staccato laugh.

The doctor then tickles the boy’s tummy, and chuckles when the boy bursts out laughing again. And then they just keep setting each other off, the baby’s bleating laughter like a little lamb and the doctor’s deep chuckle. They keep it up for a few minutes and then the boy keeps looking at the doctor with his bright eyes and big smile, kicking his legs and waiting for the laughter to start again. I’ve never seen anybody have so much fun in a doctor’s appointment.

Beautiful ... necks

Because distended neck veins and goitres are all the rage this season.

Picture with thanks to Facebook ads.

The day that wasn't

All I had scheduled today was a GP tutorial from 2-4pm, and a video conference of the fourth-year elective presentations at 5pm. So technically, I had the morning to study and become an expert on all things tutorial-related and otherwise. That didn’t happen.

The tutorial was postponed until 2.30pm, so I did have time to read through the case and prepare some notes. Our GP is usually a few minutes late, so my classmate and I wandered in just after 2.30pm to find his office still empty. We both got out our Oxford handbooks and continued our medical education while we waited for him, until after an hour when I started to wonder if he was coming at all. My classmate wisely suggested that we wait another half hour since the doctor had patients booked in for 4pm. He did struggle in a bit after 4pm complaining of a terrible headache, so we gently excused ourselves and jumped in the car to travel to the next town for the video-conference.

At first I had been rather annoyed to find that our students’ society had scheduled the fourth-year elective presentation on a weeknight during term, because the rural students had no chance of attending. So I was pleased to hear that it would be broadcast to at least one town in our region, and I was keen to attend – especially because elective preferences are due in a few weeks. So imagine how irritated I was when we arrived to discover that the video-conference had not in fact been organised, and since it was after 5pm none of the IT staff could be contacted. Luckily somebody in the audience thought to record the audio, so that should be thrilling listening if we ever get hold of it.

And then we went to McDonalds and they had run out of commemorative World Cup soccer glasses.

Can we rewind? Please? I think this day could be done better.

Dog Parties

Saw this in a bookshop in Melbourne ...

I didn't want to flip through it in case somebody saw me, but I imagine the title is fairly self-explanatory.

Jersey Boys Fan

My Mum has been wanting to see “Jersey Boys” the musical for years - so when we checked into our Melbourne hotel and discovered that it was playing just around the corner, we went straight out and bought our tickets.

We managed to score some special tickets in the Dress Circle, which caused Mum much angst as she then had to find an outfit suitable for such seats. So it was a great moment when we arrived to discover that she was dressed exactly like everybody else, and we could relax and enjoy the show.

Jersey Boys is about Frankie Valli and the Four Seasons, a 60’s rock band, who were inducted into the Rock and Roll Hall of Fame in 1990. The story basically follows the band from their formation in the 1950s to today, and the actors perform some of their most successful songs throughout the show.

After seeing the performance, I only have one regret: I didn’t enjoy it as much as the stranger on my right. She would start clapping before the singers asked us to, she would sing along to all of the songs, she was marvelling over her purchase of a Jersey Boys hoodie, and for the whole performance our entire row of seats was literally rocking as she danced in her seat. Somehow now I don’t think you are getting the full experience unless you see a show with such enthusiasm. I might try it next time.

Journey

I don’t watch much television any more, mostly due to the whole having-to-study-so-I-don’t-look-stupid thing. But when I did tune in over the holidays, I was horrified by the abuse that was dished out (mostly on reality TV), time after time, to a poor innocent word – ‘journey’. I make a conscious effort to not use this word on a daily basis, believing (don’t stop) that maybe I can make a difference, and that eventually this word will have some kind of meaning again.

But I am just one person, and I have yet to see things improve for this poor overused word. I hear it used on television, in lectures and in “motivational speeches” (don’t get me started on those). It is time for us all to join the fight, and endeavour to protect ‘journey’ for future generations of word users.

Examples of inappropriate use include:
“It’s been such an amazing personal journey”
“Her journey does not end here”
“This is the beginning of a long and arduous journey”
In any other sentence heard on Masterchef, Australia’s Got Talent, Australian Idol, Today Tonight, and well, television in general.

Examples of more appropriate use:
“Let us journey forth to the cafeteria!”
“Journey’s version of Don’t Stop Believin’ is much better than the Glee version”
"Nobody in the band 'Journey' is particularly attractive"

Try and count how many times you hear this word in one day (I personally can’t be bothered) - you might be surprised. And let me know if you hear it used appropriately, so that I too may be surprised.

Cherry Ripe Slice

I went out to breakfast with a friend the other day – his shout, because my birthday is sometime this month. I waited at the table while he went up to order, and then we chatted while we waited for the food to arrive. After about 5 minutes the waitress came up and said, “firstly, you didn’t say what type of coffee you wanted, and second, we don’t have cherry-ripe slice today.” So I re-ordered my coffee and, wondering why my friend had ordered us dessert for breakfast, told her that we probably didn’t need a cherry-ripe slice this morning.

When she left I made sure my friend wasn’t upset about missing out on the slice. Sure he was, because he hadn’t ordered it. We chased down the waitress, who then realised that she hadn’t gotten a drink order for my friend. “So what would you like?” she asked, to which he replied, “Chai latte please”. “Vanilla or spiced?” “Spiced.” “So a chai latte, spiced ... ohhhhh.”

Band Heroine

I am truly no musician. I did learn piano for a few years in primary school, but now my keyboard lives under my bed at home. Still, whilst visiting some of my city-based Med friends during my break, I decided to give Band Hero a go.

I sat in front of the plastic drum set and set the difficulty to medium and we rocked out our first song. Paying heed to my friend’s advice that “drummers don’t think”, I managed to score 86%! A High Distinction!

Having found my true calling, I stuck with the drums for the next song, then became thoroughly confused when the guitarist started playing my solo. “Which side am I on?!” I demanded, and was surprised to learn that my part was actually on the right of screen, not the left as I had been playing previously.

I didn’t even get close to 86% for the rest of the evening.

Vet Trip

We were all dozing in the lounge-room after dinner the other night, when an ad came on TV for the show Border Security, and the sniffer-dogs were searching people’s bags looking for drugs. Suddenly my Mum sat up and said, “you should take Doggers tomorrow – see what’s in my purse”, and then when back to dozing. Upon further questioning I discovered that she actually meant, “take Doggers to the vet for his vaccinations, and check if there’s enough money in my purse to pay for it”. Which is lucky, because I wasn’t sure how he’d do with sniffer-dog duties.

So I took him and Sprite (my dog) for a walk to the vet’s office. We didn’t have an appointment, but luckily it was a slow day. I stopped Doggers from peeing on things until the Vet was ready, then led them both into the small surgery, which smelt very strongly of antiseptic. They weren’t too bothered about the whole thing, sniffing around the surgery and trying to say hello to the groggy cat which had had an operation earlier that morning.

I actually had to hold Doggers down for his injection – not because he didn’t like it, but because the vet’s assistant came in halfway through and he started wagging his tail and tried to jump up and say hello. It was all very quick and painless really.

Later that night when Dad came home, I mentioned that I’d taken Doggers to the vet. “Oh good” he said, “so he’s got his microchip?” Ohhhhhh. That’s what I was meant to do?

The "Volunteer"

I spent my entire afternoon at the hospital yesterday. Mum works there, you see, and she thought it would be A Good Thing for me to come and help tidy up a few of the rooms for the up-coming accreditation visit. Sure, I thought, it’s raining, and what else am I going to do with my holidays?

But of course it was a Saturday, and footy was in town, so in the end I only ended up dusting one of the back rooms. The rest of the time (5 hours, all told), I was looking at X-rays. Before lunch, Mum was called in to X-ray a footballer’s thumb. We couldn’t see a fracture, but when the doctor came in he gave me a mini-tutorial. Which bone are we concerned about in this type of injury? (scaphoid). How long before we X-ray it again? (10-14 days). We had a chat about electives and medicine and he taught me how to reduce a dislocated shoulder (morphine and midazolam to relax the patient, then externally rotate the shoulder, pull it downwards until it pops back in, then place that hand on the opposite shoulder).

After lunch Mum was called back in – to X-ray a dislocated shoulder! How perfect! Well not so much for the patient, because he was in a lot of pain, but I got to cannulate him for the medications and watch as the doctor reduced his shoulder. He did it exactly as he’d explained, and it was very quick, very neat, and very much appreciated by the patient (“f--k yeah!” He exclaimed when he felt the ‘pop’).

It must have been a rough game, because we also X-rayed an ankle (probably ligament damage), and a thumb which had an obvious fracture. I did a bit of dusting in between patients, but in the end I really didn’t get much done. Mum probably knows now not to bring a med student to do the dusting – they’ll just wander off and find patients.

Dog Karma

My sister's dog ('Doggers') really enjoys shirt-fronting the chookyard fence and barking at the chooks. In turn, they fluff up their feathers and try to peck his nose if he gets too close. This is all well and good, as long as there is a fence between them (my sister recently reinforced the fence - not to protect the chooks, but so her poor little dog didn't get pecked).

Today, one of the chooks was on the wrong side of the fence. Doggers saw this as 'open season', and promptly chased after it - they ran into the bushes, and over my own yelling I could hear the skwawking chicken and thought it was all over for the poor thing.

But it managed to fly back over the fence and Doggers emerged from the bushes ... disappointed, a little bit sorry ... and with a large chook poo splattered across his back. Dog karma.

Elmo's Hospital Visit

I rode my horse to the hospital this morning. The hospital in my home town has a large aged-care component, and Friday is excursion day for the residents. Today they excursioned to the grass area near the hospital’s heli-pad to meet Elmo.

And Elmo loved it. There is nothjing he likes more than the adoration of a large crowd, and being a large, black, shiny horse, adoration is what he got. We cantered a few circles but spent most of the time moving between the residents so that Elmo could have his nose patted. Here are some of the comments he received:

“He’s very black isn’t he – even his darn legs are black!”

“Oh you’re beautiful. You should have Princess Diana riding you”

“Your dressage is world-class”

“Look at him in his fancy clothes” (he had his show bridle on)

“This is the most exciting day of my life”

“How old is he, I wonder?” (3 times in the space of two minutes, and yes, all from the same resident)

“Come to mummy. You’re a good girl for mummy, aren’t you Elmo?”

“You’re such a good dog”

"Forgive me - I'm a little short-sighted - what's his name again?"

The Cut Lip

The three-year-old had fallen off the trampoline and cut his lip quite badly. The doctor had some trouble assessing it – “No no no you can’t look at it, it hurts!” but his Daddy held him still. It was his lucky day – the GP proceduralist and the GP anaesthetist were both on duty. They decided to give him intranasal Midazolam before injecting the local anaesthetic into his lip ... this was also quite difficult – “No you can’t put that in my nose, I don’t want it!” but his Daddy held him still again. It was worth it – within minutes the boy was laughing and pulling faces at everyone in the room (see diagram).

As we were preparing the suture trolley, the boy looked over at me and asked, “is that lady going to do it? Is she going to fix my lip?” After being told that the man doctor would be sewing his lip, he spied my stethoscope and exclaimed, “Daddy look, that lady has pink on her!” I came over and said, “that’s my stethoscope, I chose it myself”. He asked if I liked pink – I told him I loved pink, and then asked what his favourite colour was. He thought for a moment, “ummm .... pink!”

He wasn’t too happy about having his lip sutured, but with the nurse, the anaesthetist and his Daddy holding him still, it was all over in a flash. As his Daddy was finalising the paperwork, the boy started pulling at his lip. Everybody in the room drew in their breath, anxious to stop the boy from destroying our hard work. When his Daddy told him not to pull the stitches, he said, “but there’s a bit of dirt on there!”

He was adamant that he should walk out of the trauma room and not be carried. His Daddy carefully shepherded him out as he drunkenly weaved his way towards the door, barely avoiding crashing into the doorframe on his way out. Looking after a drunken toddler was probably not the Sunday morning anyone had in mind for this family ... but at least they can remind him about it at his 21st.

Paediatrics Presentation

I’ve been working on this assignment (or at least thinking about it) for weeks. I’ve been through all the textbooks, printed out, highlighted and annotated all the latest articles, and written and re-written my handout. Last night my Mum and a workmate came and stayed at my house, and I subjected them both to the 12-minute speech. Time limit is 10minutes, so I asked which parts were the most boring so that I could cut them out. Unfortunately I had bored them into stupor and they couldn’t help, so I cut out the sections that I could get away with.

This morning I did everything right – I printed my notes and emailed my presentation to myself, just in case my USB failed. We didn’t get our usual few hours to prepare our presentations this morning, so I double-checked my Powerpoint (and added an extra picture) at lunch time. We all drew a number from a pile, and for a terrifying minute I thought I might have to go first – until somebody agreed to swap with me and I became second-last.

And I’m glad I did. I sat there and listened to my classmates’ fascinating presentations (no sarcasm, they were very impressive presentations). Then I got up and delivered my speech and blitzed the questions/discussion. And then I realised that I am now PRACTICALLY ON HOLIDAYS! What a wonderful feeling. I’m sure that actually being on holidays will be so much better, and I can’t wait.

Study-brain

Three days until holidays! Excitement!!1! Paediatrics assignment (mine’s on scoliosis), PBL, progress reports, tutorials, all due this week? Not quite so much excitement.

It’s been a long year so far. I came down for orientation in early January, and apart from the odd weekend away or a lucky day off, I haven’t had a holiday yet. I’m not getting sick of it, but it’s a long time to be consistently eager and on the ball. This is why my brain retired for several days the other week – for a couple of sessions I could not answer even basic questions (example, the organ responsible for breaking down red blood cells is the spleen, NOT the liver).

I have managed to regain study-brain for the time being, but it’s a tenuous hold, and I can’t imagine it sticking around after Wednesday’s mass of deadlines. I hope nobody asks me a question on Thursday ... unless it’s about scoliosis, because I’ll have a three-page handout all ready.

New Favourite Patient

A two-year-old girl was brought in last night with an asthma attack brought on by a viral infection. I didn't get called in, but the duty doctor gave me the history and asked me to examine her on this morning’s ward round. She’d obviously responded well to her Ventolin nebs – she was running around the room jumping on the chairs, grabbing her dad’s legs and then taking off to run about the room again.

I called her over and asked to listen to her chest. She really liked my stethoscope, so she approved and lifted up her singlet so I could have a listen. All clear, no wheezes this morning. I told her they were good lungs and she smiled and ran a lap of the room. I called her back and asked to look in her mouth, and she opened nice and wide and stuck out her tongue for me, even though she thought it was pretty funny. And then I asked, very nicely, if I could look in her ears. She came over and actually knelt down next to me, brushed her hair back and sat quietly as I looked in her ear. I was so impressed that I just sat there and smiled after that, until she looked at me and said, “udder one?” Then she turned around and sat nice and still while I checked her other ear. What a great patient!

Later on we returned with a ventolin puffer, a big spacer and a paediatric mask so we could teach mum how to give asthma first-aid. Once she had a good grasp of the procedure and understood how to wash the spacer, put it together and check if there was ventolin left, we called the little girl over to practice using it. She was happy to stand there and breathe quietly as her mum held the mask in place and counted her breaths. So very cute ... my new favourite patient.

Laughter

Laughter is not always the best medicine. Sometimes we use a smile or a laugh to create a bit of a rapport with the patients and prove that we’re not just robots trained to poorly recite the Oxford handbooks. Sometimes it’s nice to get a patient to smile after a tense or teary consultation. Sometimes a patient will tell a joke of their own accord, and it’s only polite to laugh then.

But sometimes, it’s just not appropriate. When a patient is expressing their distrust of the medical profession and says something like, “the doctor ignored my shoulder pain and it turns out I was having a heart attack” ... well, then it’s probably time to put on your empathy face.

Turns out, there are people out there who don’t realise this.

Micro Horses

We had a patient transferred back from a city hospital today who’d had a microdiscectomy for treatment of Cauda Equina syndrome due to L4/5 disc herniation. She was “my” patient, so I spent a fair while looking up her long and complicated history, but I finally got my head around it all. The nurses didn’t. I sat there listening to their handover as they tried to remember what this lady had - “So, she hurt her back ... while riding a micro horse ... and holding a quarter”. Close enough.

Quoteblog #7

“There are surgeons out there who I wouldn’t let operate on my pet gerbil” – anaesthetist
“I didn’t know you had a gerbil!” – student
“Not anymore, somebody operated on it” - anaesthetist, sadly

“It’s bizarre how much the patients value putting a face to the person who’s about to render them unconscious” – anaesthetist

“I don’t want to be cooking. Or cleaning. No, no, no, no, no” – student

“The good thing about the Australian medical system is that none of us trust each other” – GP

“You’ve gotta remember, nobody really cares!” – GP after we corrected him on statistics

“An idiot can ask more questions than a smart person can answer” – GP

I Am The Yoyo

As I left the GP tutorial this morning, the doctor told me that we had blood results for the patient who’d come in with subfertility. I’d seen this lady on my own first, and she’d burst into tears as soon as she entered the consultation room because she so desperately wanted this baby and it just wasn’t happening. The blood results showed that she wasn’t ovulating, and the doctor sent me away with my morning’s homework – go read up and see what course of action we should take next. So I spent a few hours with the O&G, gynaecology, women’s health and medical books, came up with a few more tests and a treatment plan. I went through them all with the doctor, he agreed with some of them and we decided on an action plan. He told me that she had an appointment this afternoon and that he’d call me when she arrived.

I was with a different doctor that afternoon, but I knew she’d understand if I ducked out to see this patient. I arrived early and sat in her office so I could inform her of this. 5 minutes went by, then 10 ... the intern wandered in, also looking for my doctor. I mentioned that maybe I should check she wasn’t at the nursing home, but he said no, she was supervising him, she’d be in the clinic. 10 minutes later he was called away, and I snuck over to the computer and checked ... our doctor was doing the rounds at the nursing home.

I hurriedly informed the intern as I ran out the door, and drove hastily to the nursing home. The doctor was there, completely understanding of the situation as I explained ... and the next minute one of the nursing home workers knocked on the door and asked for me. The clinic receptionist was on the phone ... the GP from this morning wanted to speak with me. I was put on hold, but I remembered immediately that I was meant to be seeing that patient, my doctor was hurrying me out the door, and then I was driving back to the clinic.

When I arrived at the clinic I knocked on the door of the consultation room and was greeted by the doctor who cheerfully informed me that my patient had come and gone, but that he’d started her on the treatment plan we’d come up with. Oh, good. Nothing to do at the clinic, so I headed back to the nursing home.

The GP was still sitting there doing paperwork, and she laughed when I told her of my adventures. We had a little chat about how I was going – I mentioned that I was looking forward to holidays, but still had a massive assignment (Paeds presentation, for those in the know) before I could relax. She asked more, and I told her it was due next Wednesday and I mentioned who the markers would be. When she heard their names (a physician and a paediatrician), she gasped and told me “go study!”. I laughed and said I was happy to spend the afternoon there, but she told me no, she was serious, I had better go study right now.

So I marched back to my car, which probably would have shied and run away if it could, and drove back to the clinic to hide myself away in the study room for a few (very productive) hours. Yes, I am the yoyo.


Here is a totally unrelated link, you should click it.

Car Space

The people of this town are used to driving long distances, used to driving in tough conditions, used to driving every day. But they are not used to driving in tight spaces. The roads here, even the back residential streets, are wide enough for a Rodeo ute to do a U-turn (maybe I’m exaggerating, but the roads are wide). This is apparently necessary because most people believe that their cars are several metres wide.

If there is a car parked on the curb, leaving oh, say 10 metres of free space next to it, most drivers will veer across to the other side of the road to make doubly sure that they clear it. Cars coming in the opposite direction will wait patiently and only drive forward once the other car has cleared that unnatural obstacle. And it’s ok, because nobody here is in a hurry.

Compare this to the city, where they cram in as many lanes as possible, cars park so that they take up half a lane, everybody does 60-70km/hr and cars miss each other by millimetres (or not). A certain relative of mine was driving in the city on her learner’s permit, concentrating hard so that the cars on her right didn’t clip her. Her passengers noticed a strange clunking noise, and after searching the car and turning off the radio, somebody finally looked out the window. In her effort to avoid oncoming traffic, she had been clipping the mirrors of all the parked cars to her left ... clunk, clunk, clunk, not missing a one.

Stories like this inevitably make it back to these country towns and become legend, and I believe this explains everybody’s wariness of parked cars. I can’t think of a better explanation.

Code Blue

We had another training session with the Sim Man (simulation dummy) this week. The aim is to train us to cope with a patient whose condition suddenly deteriorates, so we know what to do in an emergency.

Even though it’s “just a dummy”, the pressure is on to save that life and look good in front of your classmates (and the Emergency doctor and other tutors). In one scenario, the students in the room could call a Code Blue and have other classmates come in as the “code blue team”.

The ED doctor was preparing us for this role, and gave us the instruction, “when you come in you’ll say ‘we’re the code blue team, how can we help?’ and they’ll say ‘ablablablabla’” So we were ready to rescue them from that inevitable disorganised panic.

So what happened in practice? We burst in, said “we’re the code blue team!” and saw that the situation was perfectly under control. After a few minutes of watching, my classmate helpfully suggested, ‘have you guys called Code Blue? Maybe we should do that”.

I wonder who would come.

Recovery

I found Recovery Room fascinating in first-year. Patients were wheeled out of theatre as comatose bodies and left with the nurses until they woke up. The nurses would call each body by name as they took obs, pulled the slimy laryngeal mask out of the body’s throat and wiped sticky phlegm off the body’s chin. And then, like magic, the body would suddenly transform into an actual person who could see and understand and communicate - it was amazing!

After that, I presumed, they were released back into the wild.

Last week, I saw what happens AFTER Recovery Room. One of my classmates needed a bit of facial reconstructive surgery following a ferocious netball match. Another classmate, as her “next of kin”, was too scared to leave her alone after surgery and so she joined us for tutorial.

She wandered into the room, a dreamy expression on her face, sipping chocolate milk through a straw and smiling vaguely at everyone. It was difficult to concentrate on tutorial, and we continually stole glances at our loopy classmate as she happily munched on a chocolate biscuit and stared about the room, stopping every 10 seconds or so to give the ceiling a good perusal.

It was hilarious watching her. I wonder if I could specialise in post-recovery room care ....

Immunisations

I am sent to check a 12-month-old before her immunisations. I kneel down next to her in the treatment room and get a bit of a history from Mum and Grandma. The little girl wrinkles her nose and gives me a cheeky grin. She’s been well apart from getting ‘the snuffles’ last week, but she’s over that. She reaches for my stethoscope and I hand it over (they’re unbreakable ... right?). She’s feeding well, eating solids as well as formula, and she can feed herself but not with a spoon. She demonstrates by placing a good portion of my stethoscope’s tubing in her mouth – it makes her drool. Yes, she’s feeling well in herself, she’s a very friendly and happy girl. She reaches up for me to hold her, reaches for my ID, my pen, my earrings. I need to check her over. She is happy for me to take her temperature, listen to her chest, look at her tonsils. She is all good for immunisations.

And now the horrible part. She needs three injections – one in each arm, one in the leg. There is only one nurse at the clinic today, so I offer to help out, and after being coached thoroughly in paediatric immunisations (don’t go in to the bone!), I give one of the arm injections. My happy little girl screams, cries, and then looks at me accusingly, and I feel like the worst person in the world.

Then she is given a jelly snake – she actually licks her lips before eating it – and everything is right in the world ... I am forgiven. And as I’m wiping drool off my stethoscope, I’m glad we’re ok.

Med Ball 2010

So ... Med Ball 2010 was fantastic. I’ve been looking forward to this year’s med ball since just after last year’s med ball, and whilst not everyone from our group was able to make it, we did manage to put together a table of 10 really ridiculously good-looking people for a night of mayhem.

I made the 400km drive up and made the best decision ever in staying with my sister at the same hotel as the ball. All 5 girls from our table congregated there to get ready, and my sister had a little production line of hairstyles going – and might I say she did a brilliant job! Champagne had started at 2.30pm, so we were all fairly cheerful and ready for a party by the time the boys arrived at around 6pm.

There were no tickets, so nobody had much idea as to when the Ball officially started, but we decided as a group that sometime between 6.30 and 7pm would be an acceptable time to arrive. On arrival I reached for a Coke, hoping for a bit of caffeine, but had it wrestled from my hand by RT who declared that my first drink at Med Ball could NOT be a soft drink and that I was to drink champagne instead. And that was the last glass of soft drink I saw for the night.

The ballroom looked magnificent ... I’d had some concerns about an “under-the-sea” themed Med Ball, but it didn’t look at all like a school formal or a 16th birthday party; it looked very classy. And everyone looked gorgeous (apart from a few young ladies who misinterpreted “black tie” as “dress like a hooker”, but they might know better next year). So many beautiful dresses and sharp suits! Well done Flinders Med – you’re a very impressive bunch!

The awards were very well done, although most were focussed on the first- and second-years (such as “McDreamy award” and “Walking Harrisons”). This meant that our last year’s McDreamy, MT, went unchallenged and undefeated – reigning champion of McDreaminess for our year level, congratulations! One of the third-years from a different table presented the “best dressed” awards for third-year (congratulations JG and MM) after reading the following medical poem:

“Your love is like bad medicine
Bad medicine is what I need
Shake it up, just like bad medicine
There ain’t no doctor that can
Cure my disease
Bad, bad medicine”

Profound, and I think it really struck a chord with all the med students in the room, especially those at our table who later on were up circle-dancing and air-guitaring to numbers by the same artist. The dance floor soon filled up, and the completely random music selection and occasionally malfunctioning speakers really got the party going. And I’m actually not complaining; I was happily dancing under a crackling speaker for a good portion of the night.

The hotel staff started to usher us out at midnight, and so the crowd straggled across the street to the after-party. Our table was a little late, as we reconvened in the hotel room to discuss the night’s plans over another glass of champagne. And so by the time we ventured across the street, one of our classmates had already been arrested ... the story is a bit vague, but from what I gather he was refused entry and took a swing at the bouncer. To his credit, he usually gets kicked out hours before the party starts, and so midnight was a good effort. The party was thinning by the time we arrived, but we found a number of people who’d skipped the Ball itself and gone straight for the after-party. We enjoyed a couple of hours there, dancing, drinking, deciphering drunken gibberish and occasionally arm-wrestling.

All good parties must come to an end, and in the outer suburbs this happens relatively early. The bars closed at 2am, leaving us out in the cold with no place to go. We met up with our eloquent classmate Anonymous, who despite missing Med Ball and most of the after-party looked most resplendent in a three-piece suit. I think the policemen were quite disappointed that he did not end up breaking out in dance right there on the street – they had offered to sit back and watch while he did so.

And so ended the night, with Med Students huddling in the street before dispersing into the darkness. My sister, one of my classmates and I headed back to the hotel to fall asleep surrounded by champagne glasses and bobby pins, with a sparkling view of the city out the window. An excellent night.

The Couple

I saw a gorgeous old couple in the nursing home this morning. As I followed the doctor around, we would pass them sitting in the communal lounge, watching everybody go by and commenting in what they probably thought were low voices. They would sit there and make insightful social commentary such as, "that man is very tall", and "oh look there are three of them now", all the while eyeing us to make sure we hadn't heard.

I passed them again when I was sent to assess a patient ("that one's on her own now"). It took maybe 15minutes and when I passed their way again they were sitting in their same chairs, heads lolled back and mouths wide open, both of them snoring away. So cute.

Tom

I met a cute little Asian boy in ENT consulting this week. He was just so happy to be there - he dragged his mother into the consulting room, climbed up onto the chair and sat there beaming.

The ENT specialist started reading from his notes, "and now we have Tom. Tom is a mouth breather ... and he snores"

Tom beamed proudly back at us. So cute.

Out of Pocket

The patient started to shift uncomfortably towards the end of the specialist consultation. "How much is this going to cost? The bills are really coming in, you see"

"Well I'll bulk bill you, so you won't be out of pocket for this one" he says kindly.

"Oh, I don't pocket them - I have to pay them!"

The Photo

It’s been a long day. After hours and hours of ethical discussions and two PBL tutorials, our little med student cohort joined up with a few other medical students and pharmacists to play a game of netball. This involves a lot more running around and puffing than I remember, and after playing two quarters (not in a row), I was rather fatigued. And so, it was time to head for home – a 50km drive which I quite enjoy.

I was driving along, singing loudly and badly to music I don’t play in public, when I noticed that the local factory looks very pretty with all its lights on. I thought you might enjoy seeing a picture, so I pulled over and took a few shots before turning to climb back into my ute ... only to discover that it was locked. Keys in the ignition, radio blaring, doors locked.

I immediately called my sister, who’d been in a minor accident today, and she felt much better about her day. And then I started making a series of frantic phone calls to classmates and friends in the district before sitting in the back of my ute, wrapped up in my sleeping bag and hiding from the rain until friendly help arrived.

No cars stopped to offer assistance. At first I was disappointed, and then I realised that a mean-looking ute (such as mine) parked on a country road at night does not really attract passers-by. I sat there for maybe half an hour, shivering in the cold and listening to the music blasting insolently through the cab, before the first help arrived. It was the boyfriend of a girl I used to ride horses with, and I had high hopes that he might be able to break into my ute. Out came the coathanger, but no amount of manipulating would make it lift the lock.

Soon another friend arrived with a warm jacket and a torch, and we dismissed the boy with many thanks and sat in her car to keep warm. Eventually two very dear classmates arrived from the neighbouring town, bringing with them a spare key to my house, and we ventured there to retrieve my spare car key. I will be forever in their debt for making that 100km round-trip – pleasant drive that it might be, they had originally planned to go to the pub.

The photo? I don’t think it was worth it.

Convenient

Today, the whole class heard a lecture about the massive end-of-year examinations. The lecture was delivered via teleconference so that all sites could watch it at the same time. The year-level coordinator gave the lecture from the very building in which our cohort was congregated for our weekly study day, so it would naturally follow that this would be very convenient for us.

Well that’s not quite how it turned out. While the rest of the class was watching the year-level coordinator deliver this very important lecture, we were in a separate room continuing on from the morning’s long* ethical debate. We will be able to watch the lecture on DVD in our own time at a later date. That’s convenient.

* Words can describe how long the debates were … but I would need a lot of words.

Quoteblog #6

“High jump was my absolute low point” – Student

“It’s a very sexy cough” – Student
“and [my husband]’s not here to enjoy it” – Other student, disappointed

“That item on the high-left is a nipple, in case you’re wondering” – Lecturer
“Aha! I’ve seen one of those before!” – Student

“Michael Jones, where are you??” – Student looking at blood-gases

“I now follow the guidelines, like a good boy” – Lecturer

“Some of them are really really bad at it and they have no idea how to get pregnant” – O&G Specialist

“In relation to the chap, I must admit I’m not an andrologist” – O&G Specialist

“The trick in General Practice is to get everyone out the door as quickly as possible, but still make them feel special while they’re here” – GP supervisor

“I was just thinking, how quick you’ll learn to be a doctor when there’s no such thing as a 5-day week!” – elderly patient I looked after over a weekend

“I just made it!” – elderly lady walking back from the toilet. She was so proud.

“I had an operation for a defibricator” – patient in heart failure

Grumpy

The RN on duty is in a bad mood. The few patients on the ward are time-demanding, and she’s trying to get everyone their medications. I cop her wrath when the doctor sends me to request maxalon for a patient. Doesn’t the doctor know she’s busy, all these other patients need their medications too, everyone needs something right now ... but she obliges, after I’ve listened to her lecture.

Later on I am sent to assess a patient who presents with acute chest pain. She beats me to the room and persists with taking the history, firing away with disjointed, demanding questions, blocking me from reaching the bed. She is not keen to help me with the ECG – it would be faster to do it herself, but “you’ve got to learn somehow”. It’s a struggle, but I keep smiling.

Around midday we are both left behind in a room after the patient has been transferred. She huffily begins cleaning up. I pick up a pillow and change the pillow case. She looks up, smiles, “thank you!” And for the rest of the day she is lovely. If I’d known it would be so easy, I would have changed a pillow-case first thing.

Yes

"Why are you in hospital today?" I ask the little old lady

She looks up at me, smiles, makes eye contact, and says, "yes"

"But why are you here?" ... "yes" she smiles

"WHY?" ... "yes"

I smile, lean in close, and shout in her ear, "WHY ... ARE ... YOU ... HERE?"

"Oh, I got up after my afternoon nap and I was shaking all over, I just couldn't get warm" she says in her soft little voice.

And I thought she was confused.

Skills

We are discussing a PBL case with one of the GPs, when he begins a little speech: There are a lot of skills, peripheral to your examination skills and your history taking skills, that are really good to work on. And here at this clinic and this hospital, you will have more opportunities than your city colleagues to work on these skills.


Whatever it is, I’m sold. I must work on these skills.

One of these skills is changing colostomy bags.


I look up. As far as I can tell, he is serious. I recall that we have a patient in the hospital who is seeing the stoma nurse next week to learn all about his colostomy bag. How fortunate!

Sandwich

“You can only have one roll each, otherwise there won’t be enough”. We’re not used to these restrictions here, and I’m pretty hungry, but I acknowledge that it will probably be enough. I select my roll, and I make a good choice – chicken and lettuce, plenty of butter on the roll and generous with the pepper. I am impressed with the first bite and go back for another but there, millimetres from my previous toothmark ... is a fuzzy little caterpillar. The poor little thing must have feared for his life for a moment there. I show my coordinator, and she flicks the poor caterpillar into the bin and attempts to confiscate my sandwich. No thank you very much - with the very hungry caterpillar out of the way, that sandwich is all mine. Om nom nom.

Gastroenterologist

We had a session with a Gastroenterologist for one of our study days. He sure was a good teacher. What did I learn?

Gastroenterologists are not like most surgeons. In contrast to the “If in doubt, take it out” mantra, the gastroenterologist declared, “If it’s in a bucket you can’t put it back”.

Gastroenterologists are not haematologists: “This is a bone marrow. Who knows about bone marrow? I don’t”

Gastroenterologists can be generous: “Everyone deserves an ultrasound”

Gastroenterologists can also lose their train of thought: “Now where was I leading? Heh heh.”

And they can be a little strange. Student: “Do you just have naked large lady on there?” Gastroenterologist: “Yeah, I’m a bit like that”

Small Pleasures

• Suturing
• Early minutes
• Cups of tea
• Finishing assignments
• Long weekends
• Real mail
• Hugs
• Sunshine
• Sitting with my dog
• Playing on a playground
  
• Classmates getting excited about my shoes
• Correctly answering a specialist’s question
• Sleeping in
• Successfully cannulating a patient
• Patients who refuse to see students (= coffee break)
• Old ladies complimenting my hair
• Patients who make jokes
• Doctors who make funny jokes
• Discovering that people read this blog
• Hearing that some people actually like this blog
• Eating chocolate like it's actual food
  
• Getting dressed up
• Or putting on my pyjamas as soon as I get home
• Hearing from faraway classmates (they’re all far away)
• Going home to see the family
  
• Eating someone else’s cooking

Sometimes, I'm easily pleased.

My Old Lady

“I’ll let you see this lady. She’s pretty much a ... I’ll let you decide what she’s like” – and with that the doctor is gone, leaving me to see his 9am patient. It quickly becomes clear that she’s a lot of work. I’ve been in hospital, I’m better now, they’ve changed my medications, no I don’t need a script, I’m 87 you know, I’m meant to see a specialist what’s his name, no I already have a referral, and an appointment, look at these hands, no can’t you see that one’s weaker, I’m left-handed you know and I write with a special pen, oh, what am I here for? My leg’s red.

So I look at her leg. She’s had an ulcer for about a week but it’s going well, I’m just worried that the redness is cellulitis. She’s quite happy to scratch at it with her long yellow fingernails, but I ask if it’s painful all the same. Look at me! she exclaims, pointing to her (tear-free) eyes. But is it sore there, on the red bit? Oh, no, just the ulcer. The doctor agrees that it’s probably red from scratching and she should use a cream, but wants me to prescribe antibiotics just in case.

What is she allergic to? Oh, lots of things, I have a whole list but I left it at home, I can hardly take any medications, how could I remember what happens, it’s years ago, I’m 87 you know. I look up her recent prescriptions – they are many and varied, so we take a chance with Cephalexin.

She needs an ankle-brachial index done. I ask if she’s ever had her blood pressure taken on her leg? No. Ultrasound of her leg veins? No. Doppler, that sound familiar? No, none of that. I look up her notes. She’s had three colour dopplers on her left leg, but now we need to check her right. The nurse gives me a warning look when I request it, “she probably won’t let me!” But we have to try. As the nurse slips the sphygmo cuff around her ankle and begins to pump it up, my patient begins to howl. This old lady must hate me by now.

I have been despairing over this lady for almost an hour, and I must be getting a little terse. She doesn’t really like doctors and nobody likes medical students, so she must be eager to be rid of me.

But as I stand to usher her out the door she smiles and says, “when that nurse was pumping up that cuff on my leg I could feel my boobs getting bigger!” I suggest that maybe she should wear pressure stockings just for that reason, and she breaks into a hacking laugh and pats me on the arm before toddling out the door.

That 30 seconds was the best part of the consultation.

I'm glad she saved it for last.

The Hand

He’s doing a silly little job at work, nothing difficult, nothing laborious, just putting up an antenna for the break-room television. The drill bit slips and attacks his hand, drilling a hole in the webbing between his thumb and forefinger, angling down towards the wrist. His mates take him straight to the medical clinic - it's an emergency - but the nurses only glance briefly at his hand before sitting him down on a bed to await the doctor. Screaming children are given injections, old ladies’ leg ulcers are dressed, and he sits there bleeding. He probably wonders why he’s left to wait.

Finally some girl comes and introduces herself as the medical student. She quickly inspects his wound, asks him to wiggle his thumb around despite his pain, and starts drawing up injections. She looks him in the eye and tells him the local anaesthetic will hurt. He flirts a little, realises it isn’t helping, and sits back and grits his teeth. When his wound is properly numbed he watches, fascinated, as it is first rinsed and then scrubbed with antiseptic. He dabs at the blood running down his wrist.

Like many of the local patients, he asks whether she’s going to be a doctor or a nurse, and seems fairly impressed when he discovers that she will one day be a doctor. He is quite proud of himself when she puzzles over how best to suture his complicated-looking wound. And then the actual doctor arrives with instructions, “you’ll want to put one suture from the outside part here, to this part, and then ... actually I’ll do this one, you watch”.

He is much relieved.

Quoteblog #5

These are all courtesy of the pain management / musculoskeletal doctor who gave us a whole-day tutorial yesterday. Whole day tutorial, and it didn't even get boring!

“Students like food, pens, and testing reflexes”



“Every OSCE I mark, you get 10% for being a human being. That means you only have to get 40 out of 90 to pass”



“You don’t expose, you fail”



“All you get from stroking the insides of a patient’s thighs is trouble”



“And I don’t give a stuff about her breathing of course, unless she stops and then it just gets messy”



Neck exam on student:
“Ooh that feels nice” – student
“You’re not supposed to say that to your teacher!” – Lecturer, then, “Why don’t you come lie down”
“You’re not supposed to say that to your students!” – other student
“Face down please” – Lecturer



“A Trendelenburg gait looks like a constipated swan”



And one from dinner: “You’re asking orthopaedic surgeons to walk and chew gum at the same time?”

Red Herring

A patient comes in with chest pain.
"Have you had any paracetamol?" asks the nurse
"No, I took some Herring" patient

Bad Doctor

In my humble opinion, all of the doctors who I’ve worked with here are exceptional. Not every patient will like every doctor, but that’s to be expected, and most people can find a doctor that they really like. It kind of increases my confidence in the medical profession to hear how highly some patients regard their chosen doctor.

So it’s disappointing to hear about people’s bad experiences with doctors. Take my friend in the city, a gorgeous girl in her early 20s, who was sent home from work with a bad cold. She went to see a GP in her suburb, and the consult went something like this:

Young male doctor: “So when was your last PAP smear?” My friend sheepishly admitted that she’d never had one, and he offered to do one that day. (Note: most of the doctors here will offer to book a later appointment for this procedure, and the male doctors will give the patient the option of seeing a female doctor. And they never begin a consult like this). My friend was a little shocked, and firmly declined this procedure. After that he decided to finally ask, “so what brings you in here today?” My friend informed him that she felt unwell with a headache and a sore throat.

His next question? Try and guess from the choices below:

a) How long have you felt unwell?
b) Is it getting any better or worse?
c) Have you tried anything for it?
d) Are you sexually active?
e) What's your favourite colour?

You probably think I threw in the last couple for a laugh, but no, this doctor chose option D. My friend says that during the consultation, the doctor asked her a total of seven questions relating to sexual activity, when all she had was a sore throat and a cold.

He ended up prescribing her antibiotics, but as he handed over the script he told her, “I wouldn’t be in a hurry to start taking this – you’ll probably just get thrush”.

She called me a few days later to tell me about it, and then asked if I thought it was weird, from a medical student's point of view. I think it would be weird from anybody's point of view.

It's All Relative

I'm chatting with a friend online on a Sunday afternoon.

He's had the week off. I had last weekend off, but I had a big assignment due so I used it to study.

He spent his Saturday at a football match with a friend. I spent 10 hours at the hospital.

He slept in this morning and is wondering what to do for the rest of the day. I snoozed my alarm once and then went in for ward round, and I'm hoping not to be called back in this afternoon.

When I tell him that I only spent three hours at the hospital this morning, he replies, "oh. Easy morning then".

Yeah, sure.

Concussion

A family brings their teenage son in with “delayed concussion” from football on a Saturday afternoon. The younger brothers and sisters, Mum and Dad are all crowded around, anxious to help out in any way. I struggle with his history in so many ways. For starters, I’m a bit of a novice with head injuries at this stage. And then there’s the casualty nurse occasionally popping in to interject my question with a similar but wordier one before the patient can answer me. Not to mention the boy’s mother, who is worried about her son and tries to answer all the questions for him. And then there’s the boy himself, who obviously has amnesia and can’t remember anything of the game or afterwards. As we wait for the doctor to arrive, I ask him a few questions.

“Who did you play today?” I ask

“I can’t remember his name” announces the boy after lengthy deliberation

“Do you know where you played?” I ask, wanting to know which town the game was in

“It would have been the wing” – the boy hazards a guess at his usual position

Hard to say whether we would have this much trouble communicating without his head injury, or if he is trying to compensate for his amnesia, but it's pretty serious and the doctor doesn't waste much time before calling an ambulance to ship this boy off to a bigger hospital.

As we're waiting for the ambulance to arrive, the doctor sends me back into the room to assess the boy's lower limb reflexes. He has a lot of trouble with the instruction "just let your leg go loose", and we struggle for a while as he first lifts his leg straight up and then forces it down on the bed, but eventually I manage to bend his knee for a patellar tendon reflex. Everything is normal until we get to the Babinski. I turn the tendon hammer around and use the scratchy end on the sole of his foot. As his left big toe curls upwards his girlfriend, who has just arrived, mumbles, "that's so weird". She has no idea.

Viral Infection

We had to give a PowerPoint presentation a couple of weeks ago on a selected cardio topic. I chose 'cardiomyopathies', and although I was nervous about presenting in front of the big-shot cardiologist, I think I went OK. But I was shocked and dismayed when I took my flash drive back to my computer afterwards and was rewarded with the following message:

The shock came mostly from the fact that SOMEBODY ELSE had given me a virus/worm. I am normally quite capable of destroying my own electronics without any outside assistance. In fact, once I managed to shut down the entire university intranet while I was living on campus. Don’t believe me? No, you know me too well. It was twice. Twice, I single-handedly shut down the university intranet by inadvertently picking up a virus in my travels. I was banned from connecting for quite some time, and I had to study using books, just like the olden days.

I have since learned all about anti-virus programs, so don’t worry – I’m pretty sure this one’s no longer contagious.

She Was Mine

There aren’t many patients in the hospital, but they are all demanding our attention this morning. Ward round is disjointed, and the doctor sends me to assess patients and report back just so we can get them all seen. There are patients coming in and patients being shipped out – the one pair of ambulance officers seems to be constantly marching our halls.

An obese woman presents to casualty with 9/10 retrosternal chest pain. She came last night and was given antacid and sent home, but the pain has returned and now nothing is helping. The doctor is busy, very busy, so the patient is mine. I take her history and discover that, but for the fact that she’s never had heart problems before, she has EVERY SINGLE RISK FACTOR ON THE PLANET for a heart attack. Diabetes, hypertension, hypercholesterolaemia, obesity, family history, and of course she’s a smoker. Still I’m not sure – she has a long history of gastro-oesophageal reflux, and she says her pain is alleviated by sitting up and (eeew) burping, so maybe it’s the same old thing?

I ask the doctor what to do but he is still very busy, and he tells me to do the full workup and then come back. So I examine her and find nothing remarkable, place the most beautiful cannula (I'm so proud) and take some bloods, and do an ECG. Her troponins come back borderline, but the ECG shows ST elevation in the posterior leads. The doctor sees this and suddenly she’s not my patient anymore, she’s Priority 1, she gets morphine and maxalon and clexane and she’s sent away with the Flying Doctors to the city.

But for that brief moment, she was mine.

More or less anaesthetics

I have a “Pain and Anaesthetics” tutorial scheduled, which sounds pretty serious, but my classmate assures me that it’s just a regular theatre session with the anaesthetist. So I turn up a little before 8.30am, change into scrubs and wander out to theatre to find the nurses frantically drying condensation off the walls, windows, equipment ... everything. The air-conditioner has mysteriously broken overnight and the operating theatre has turned into a warm humid cave.

The doctors haven’t arrived yet, and eventually the girls make an executive decision to move theatre into our trauma room, and we wheel trolleys of sterile equipment, linen etc down the hall. Our hospital is not exactly state-of-the-art, but trauma room, as one nurse put it, is “like operating in the third world”. There is barely room to fit all of the equipment, and we are claustrophobic before the list even starts.

The GP surgeon eventually turns up a little after 9am, and speaks to me briefly before walking off in an unknown direction. One nurse tells me not to worry, “you’ll never work him out”, but I tell her it’s ok - I’m with the anaesthetist today. And that’s when she informs me that there will be no anaesthetist for today’s list, and suggests that I run away now.

But it’s too late. I’ve already been seen.

Quoteblog #4

“Cataract operations last 15 minutes. You can duck out 4 times an hour to go to the toilet if you want to” - Opthalmologist

“And just remember when you’re answering these questions and you can’t think of any more, just say idiopathic” - O&G Specialist

“And if you forget one, you’ll have so many others, the examiner won’t even notice” – O&G Specialist

“I had an operation on my appendocyte” patient

“Oh God ... footballers” – Orthopaedic surgeon

“Oh my GOD! That’s very very small” – clinical tutor inspecting a student’s skin ‘lesion’

“Enjoy your oddity” – Pathologist’s advice to medical students

“Their urine will be radioactive for a few days after ... it’s a β-emitter so it won’t even clean the toilet properly for you” – Pathologist re: diagnostic test

“The second tray is for the religious – vegetarian, whatever you call it” – Lunch lady segregating the sandwiches

“I like dots. Dot, dot, dot, dot” – Student showing off her PowerPoint presentation

“Whether she’s got a shed of a pelvis, doesn’t matter” – O&G Specialist on the value of pelvimetry

“You can decide whether you’re an intelligent doctor or just a poor donkey eating grass” – O&G Specialist gives us some options

“There’s no person – male or female – without any problems, and they’re not all PMS” – O&G Specialist

How do they know?

How do they know I'm ridiculously intelligent and HOT?

That's it, I'm covering up my webcam.

Orthopaedic Consulting

The patient is waiting in a separate room, his X-rays already up on the viewer. The other student and I hover behind the orthopaedic surgeon as he inspects the images. I know that I should be looking carefully for the pathology – after all, the surgeon might ask for a student’s opinion, and I wouldn’t want to look silly. But something keeps catching my eye. Just below the pelvis, where one would expect to see only ... well, soft tissue, there is a cluster of bright white rings and bolts. This man is pierced. And not just once, no – there must be at least 10 of the things, creating a rather distracting focal point of the image.

Fortunately, the surgeon doesn’t ask for our assessment right then and there, he just goes through the consultation and sends the patient on his way.

Later, in the privacy of the surgeon's office, we have a look at those X-rays. The surgeon points out some discrete lighter patches around the hip joint, and asks what we think they are. I’d honestly not noticed them before, and the other student can’t answer either. The surgeon informs us that they are clips to stop bleeding arteries, indicating that the man has had surgery in the area before – probably a hernia repair. Oh, right. How boring.

The surgeon then waves his hand vaguely at the image of the man’s crotch area, “and what’s ... all this?” “Piercings”, I announce confidently. The surgeon briefly ponders what possessed the man to get this done. I point out that the man had a wedding band, and suggest that maybe his wife made him do it. The surgeon gives me a blank stare, and I know I’ve gone too far – I probably shouldn’t be speculating on a patient’s intimate life with a prominent surgeon who I’ve only just met. He then says, “there are a lot of things I don’t understand about ... life”, ruminates some more on the issue and then blurts out, “could a wife REALLY make you do that?!”

Later in the session we have a short break between patients and the surgeon reflects on the morning. “We’ve done a fair bit today” he says, “we’ve done acute knee injury, supracondylar fracture, axillary nerve, rotator cuff injuries ... and piercings”. Clearly it’s had an impact.

Computer Genius

She’s making a newsletter for work, and she’s run into some computer trouble.

“It won’t type in this box, look!” as she bashes random keys.

The cursor tracks along the screen, and a red squiggly line slowly grows, but there is no text. I lean over, change the font colour from white to black, and save the day.

For almost a minute, I am a genius, and the failures of the week fade to the back of my mind.

Small victories are still OK.

The War

There was a war on, and all of us were required to fight. I didn’t know many of the other 'soldiers', but I know a few of my classmates were there, so that was comforting. We had a few drills, where we had to run to the store room, take up a mask and a rifle, and line up on the hill ready to shoot. On command we would lie down on our bellies and army-crawl forwards towards the “enemy”.

The masks were all standard, but there were three types of rifle – some with a golden butt, some with a wooden butt, and there were a large number of completely plastic rifles. On the day we were finally required to fight, I was one of the first to reach the store-room and had first choice of the rifles. I immediately picked up a golden rifle and realised it was terrible, so I selected one of the wooden ones, but took the time to pick one without a wonky sight. Clearly the plastic ones were not first choice.

And as we were in the midst of the battle, I turned to one of my classmates who just happened to be there and said, “this would be a great excuse for an extension on Wednesday’s assignment”. And she laughed.

Crazy dream. Point of the story: if anyone wants to start a war with our cohort, let me know by Wednesday.

Image from http://trombonestuff.blogspot.com/2007_06_01_archive.html
Not sure about original source

Big Scary Student

I’m in theatre with my GP supervisor today, and he’s got a full list of skin excisions to do (our day ends up running from 9am-8pm). Somebody switched the on-call roster, and he’s been on call all night, so he’s sleep-deprived, grumpy, and late. Adding to the general awkwardness, he’s injured his foot and has to limp around in a giant moon-boot. I do my best to be helpful, drawing up local anaesthetic, cutting sutures and generally staying out of the way. And I’m doing well – we all are; eventually he starts to smile.

During a break between patients, he ducks across the hall to radiology to have his foot X-rayed. I’m in theatre preparing to draw up some more local anaesthetic, and I realise we’re out of 1% xylocaine. What to do? I ask the nurses, and their advice is to go ask the doctor.

So I venture across the hall to Radiology and see my doctor leaning on a chair strapping on his big moon boot – obviously he’s just had his X-ray. He seems to catch my eye, so I stick my head around the corner and ask quietly, “we’re out of 1%, is 2% ok?”

He looks up in surprise, loses his balance and topples over backwards. As in, completely over backwards, and the next minute he’s lying on his back with arms and legs sticking up in the air. I can only look on in dismay – he’s going to be furious, the rest of the day is going to be hell, and it’s all my fault. So I am much relieved when he dusts himself off and laughs, and then proceeds to tell all of the theatre nurses about his accident. Very much relieved.

Although, I must have look quite terrifying when I approached him, because he asked me later, “were you wearing a mask?” For the record, no, I was not.

Relaxed

He's a regular to minor surgeries. Today he's here to have three of his skin lesions excised - one possible basal cell carcinoma in the crease of his nose, another behind an ear, and a possible squamous cell carcinoma on an eyelid. He doesn't seem too concerned, but then he's taken his hearing aid out so I can't really ask him. He doesn't even grimace as the local anaesthetic is injected, although I'm sure it must sting his nose at least.

Before long, there's an area sheet over his face and the doctor is working on him with a scalpel. As the doctor excises the second lesion, the nurse hears a strange noise. "Is that ... is he ... ?"

Yes he is. He is asleep, and snoring.

Medical Specialty Aptitude

I took a "Medical Specialty Aptitute Test" a little while ago, just because I thought it would be interesting. It's quite slow to load and has hundreds of questions on many pages, so it took quite some time to complete. And after all that, the results weren't what I was hoping for and so I have decided that it's a load of rubbish anyway. Since my hopes and dreams (currently) involve me becoming a GP and maybe also doing anaesthetics, I was rather disappointed with the following results:

1. Radiology

2. General Surgery

3. Thoracic Surgery

4. Pulmonology

5. Haematology

6. Radiation Oncology

7. Infectious Disease

8. Nephrology

9. Nuclear Medicine

10. Obstetrics / Gynaecology

Where was GP? Number 33. Anaesthetics? 28. I'm probably mostly puzzled by Pathology appearing at number 17.

I suppose the quiz has some sophisticated method of determining your aptitude based solely on your personality type. And if you're the type of person who gets fed up with slow-loading million-question quizzes, maybe you should be a surgeon or a pathologist, and stay away from too much patient contact.

Not happening. Look out, patients!

Tracker

It’s amazing what I've discovered by installing a tracker to this web page. I may not know your name, home address or favourite colour, but I do know that you use IE 8.0 / Firefox / Chrome, and your computer is running Mac OS / WinXP / WinVista / Win7 and that you visited my site for 0 seconds/ 4min 13seconds / multiple visits spread over more than one day. It’s nice to see that some people, not limited to but including my Mum, make return visits. And I seem to have been visited by somebody on every continent already, which is nice, although I’m pretty sure most of them arrived here quite by accident. Here are some of the Google searches that have led to my occasionally peer-reviewed (PTR, Puddle, Vonbon) and vaguely semi-informative page:

“schoolgirl had chest examined with stethoscope for sore throat” – UK

“pinkstethoscope Champ” – UK

“champ pink stethoscope” – New Jersey, US (is there a champion pink stethoscope out there somewhere? Is it mine??)

“cystic fibrosis stethoscopes” – California, US

“dirty stethoscopes” – Utah, US

“urologist nurse gown” – Florida, US

“which way do you insert the stethoscope” - Massachusetts, US (more than once, and then they tried “insert the stethoscope”. I hope they found what they were looking for)

“which way do stethoscopes go in your ears” – California, US (at least they know it goes in the ears – good start)

“pink urine scrub solution” – Israel

“stethoscopes ashamed” – Iran

“Thomas Jefferson stethoscope” – Philippines

“anaesthetist rocks” – Cape Town, South Africa

Thanks for visiting! I'm sure that you don't find all / any of the right answers here, but I hope you have some fun along the way.


“We’re supposed to do that, when we find what we're been trackin!”
Copper, The Fox and the Hound