Short calls

Asked to see patient: needs pain relief

Patient admitted with shortness of breath, treated for exacerbation of COPD.

Currently denies any pain.

Patient states he is thirsty - "all I want is a drink of water".

Plan: patient may drink water

Signed, Dr S (medical RMO)

Grumpy RMO

Night shifts make me grumpy.

I have updated our handover board accordingly.

Holistic

Tonight on night shift I refused to give two people Temazepam, and prescribed a heat pack as an adjunct to somebody's pain relief.

Oh God.

I'm becoming some kind of hippie.

Simplify

Speak slowly, use small words.

Preferably diagrams.

Happy Workday

I'm in the middle of a three-month term of medical nights. Seven 12-hour night shifts in a row, followed by a week off. Rinse, re-adjust body clock and repeat. It's not so bad.

But today is my birthday. At midnight I had a celebratory cupcake (thanks to my little sister) and the nurses all said happy birthday. And after I've slept the day away today, I'll come back for another 12 hour shift and it will still be my birthday. The prospect of working twice on my birthday does not excite me.

There had better be more cake.

Sputum

I hate sputum. It is definitely in my top 5 least favourite bodily fluids. Somehow though, patients are especially proud of their sputum. They will endeavour to produce a sample right in front of you, showing it off like a new baby. They will dig through their rubbish bag to find you a particularly interesting sample from last night.

I even had a patient who apparently collected it at home. "I fill up *that* much of a coffee can in a week", he told me.

That's a lot of commitment to sputum.

Catching fire

"Was it last year we had someone catch fire? That was in the foyer here"

- senior medical consultant on why we can't give home oxygen to smokers

Pillow talk

This almost broke my heart today.

Poor, helpless folder.

Lady Godiva

My uncle's horse was part of the Fringe parade, but I don't think anybody saw it.

More on love

"Ok Mrs P, looks like you're ok to go home today"

Mrs P: "Really?? Oh, you're so good! I love you very much"

Me: "Oh! ... ... Thank you"

O?

I don't know what I was thinking. 

There's not even a 0th of February.

Man of mystery

We have a patient at the moment who I am really struggling to get my head around. I think he came in with diabetic ketoacidosis because of sepsis, but I'm not sure where the sepsis came from.

It doesn't help when ward round conversations go something like this ...

Registrar: "do you have pain in your chest?"
Patient, "sometimes but then we bought a special bed"
"Does it feel like someone sitting on your chest?"
"No its a special orthopaedic bed"
"So ... No chest pain recently?"
"If you ask my wife she'll tell you what sort of bed it is"

Yup, he's a real mystery.

Medicine and Love

Last year, my boss busted an elderly female patient reading this trashy hospital romance novel on the ward.

At first he thought it was terrific because this book featured a handsome physician rather than the brutish surgeons our patient usually read about (my boss was a cardiologist). He even photocopied the cover, hence the black and white pic above.

Then he discovered some sage advice on the cover. From that day forth, whenever we came across an attractive fellow medic (it might have happened twice), he would stop and wisely remind me, "medicine and love do not mix".

Wouldn't find that in a textbook.

To Mr S

You came from home, a fit old man who had lived on his own for three years after his wife went into a nursing home.

You were as deaf as post, even with your hearing aids in. Deaf, but not silly. You had loved your school days, although they were cut short because you needed to work to support your family. You told me what you knew about the heart, how it pumps blood to the body, how it pumps blood to the lungs to collect oxygen. You weren't silly.

I could almost pronounce your name right - you corrected me until I could do it, and you liked that I tried.

You came to us because you had trouble breathing. The X-ray showed the fluid in your lung space, and before we could drain it your old heart gave out. By the time we discovered your cancer the next day, you were gone.

Gone too soon perhaps, or gone on time to save yourself from more pain. Either way, may you rest in peace. I liked you.

My student

I love having a student on the ward.

For the first week, I used him as a tour guide because I was new to the hospital and he'd already been there a week.

And I appreciate his presence on ward rounds because the consultant always bombards him with medical questions, which leaves me to act very busy because usually I don't know the answer.

And, like many of my colleagues, I love teaching. It's not entirely altruistic. It makes me feel smart.

Like today.

He'd never taken blood before, so after going through the theory I let him practice on me before setting him loose on a patient. Ego-boosting success all round, and he barely left a mark.

I also took him with me for the solemn task of verifying a patient's death. I told him my most important tip (turn on the lights), and let him see for himself how hard it is to say for certain that a patient has absent breath sounds.

As I drove home from work, I thought about how good I'd been,  taking this young student under my wing.

And that's when I got his text message: "I reckon I might go home now if that's cool. Anything for me to do before I leave?"

Oops.

Dog Tears

Tetley the teacup chihuahua loves our Mum.

In fact, Tetley loves Mum even more than it loves my sister, its rightful owner, which of course breaks my sister's heart.

Yesterday Mum came to visit and after she left, Tetley sat by the door waiting for her to return. Sat there for hours as the sun went down, in an ever-growing puddle of dog tears and sadness.

Rejection all round.

Lost: one female doctor

Day 3 of my new job today. I've gone from "intern" to the far more responsible-sounding "RMO", and from a small country hospital to a much larger hospital in the northern suburbs.

The job is going well so far ... except I keep getting lost.


I feel like a mouse in a maze, but not a mouse that's good at mazes. I'm the mouse that gets lost every single time and spends half its time back-tracking and turning around on the spot, trying to figure out where it is.

I can imagine the posters ...

Lost: one female doctor.

Last seen on ward 2B wearing pink stethoscope, said she was going to staff cafeteria. Not answering pager; possibly unable to locate phone. Approach with caution a may become more disorientated if alarmed.

Kindly return to medical team.

Cencent

I really wanted it to be "concert", but no ... it's just a bunch of consent forms.

New Stethoscope

I've had my trademark pink stethoscope since my first week of medical school, when my Mum took me shopping for supplies. I've carried it through clinical skills tutorials, ward placements, OSCEs and overseas electives, and it had seen me through the first half of intern year.

Still, with a rotation in general medicine approaching, I felt that the old pink Spirit Classic wasn't going to cut it anymore.

Choosing a replacement was not easy ... I needed a quality steth, without compromising and choosing a boring colour.

My solution, the Spirit Cardiology, has been great - and comes in bright pink. It works, too - my supervising physician was impressed with my ability to hear and differentiate murmurs.

Still, if he ever found himself in need of a stethoscope, he would hastily bypass mine in favour of a lesser model from a student or worse, the obs trolley.

Pink is not for everyone.

Moving Vehicles

No I don't regret buying a sports car before moving house, why do you ask?