I could not be more relieved that 2009 (academically, at least) is over. This term has been the hardest I've ever dealt with - not in academic content, but in emotional crapola. However, the two days immediately following the end of term made up for that (partially - family incidents aside).
20 hours of Ortho! It was my reward for surviving the term, and after the battle with Dr Granny, I needed it, and I oh-so-earned it. And it was immense.
7 cases
3 assists
1 solo washout & fragment removal (OH YESH!)
1 attempted intubation
1 failed intubation
17 minutes of bagging V-Tach guy
7 patients still alive when I left...
And Isecretlywanttobeananaesthetist - shush! Mainly cos I'm not 'attached' to a dept when I'm in theatres - I'm there on my day off, for fun, for extra experience. So I tend to wander into the gas room pre-op and the gas men (or mostly, darling ladies) adopt me, take me under their hugely knowledgable wings, and teach me. Last time, I got my first real cannulation and intubation, not to mention various induction stuff. This time, I got a ton of ECG teaching (super-great timing!), a masterclass in facemask seals, teaching on the treatment of V-tach, talked through central line insertions, epidurals, intubation (again)... I <3 Anaesthetists. Maybe I could certify in Ortho & Anaes...
Crazy repeated convo's everytime I met someone new (or not new - some of the surgeons remembered me!) - "So you're 4th year?"
"No, second."
"So why are you here?"
"It's the Christmas holidays"
"So why are you here?!"
"Um... I wanna be an Orthopod..?"
Clearly, volunteering to come in on a) your day off, b) a day when we are snowed in, and c) the morning after the Christmas party, makes you a nutcase. I can live with that - I got to touch the talus from inside a leg!
But now, I am off to marvel at sexy cars and contemplate which one my first surgical pay packet (oh, 6 years time, move faster!) will go towards....
Sunday 20 December 2009
Thursday 10 December 2009
Not a black dreamer.
I could kill. I could also hug.
Homicidal tendencies are due to a big error with our electricity bill, making us liable for nearly £200 worth of power. I wish "I'll cut off the direct debit" held as much weight as their "we'll cut off the power" threat.
In other news, my two days in trauma theatres next week are confirmed. EEEEEEEE!!!!! Now the major problem will be keeping it a secret! If any other second years find out that theatre exposure is possible, my lovely reward for surviving the term will be ruined.
Other factors that threaten to ruin the end of term are impending bankaccountemptinessdoom, all of my friends attending a christmas dinner I am not invited to, and attempting to batter my head of year with a small child. Or other weapon of choice.
An assessed clerking was handed in several weeks ago. It was returned yesterday. I got a score of around 50%. Needless to say, I am not ecstatic about this. I'm boiling over with fury at an inept system which punishes the honest and rewards the liars. Certain people (and I can name at least four, so far) did not clerk a single actual patient, yet handed in a full (fictional) clerking and receieved almost perfect marks. One of my friends was marked down for saying he examined the olfactory nerve in his cranial nerve exam. The markers don't believe people could have the ingenuity to bring an orange to ward teaching for this purpose. I was honest about the fact that I didn't examine certain pulses (didn't want to undress patient), reflexes (patient refused) and vibration & pain sensations (there are no tuning forks on the ID ward, nor Neurotips - also, I find it unnecessary to subject the patient to pain, however mild, for a formative assessment). It was also commented on that I did not perform fundoscopy. We've never been taught fundoscopy, and I wouldn't have a clue which side of an opthalmoscope I or the patient should be on. The patient may have learnt plenty about my retinas, but I didn't do it.
This is war. My tutor today told me to "stop trying to fight the system, because you will end up fighting yourself". Surely if it's me vs me, that's a win-win situtation? I know what he means, and I know that the knobs who lie now will lose out later, but the fact remains that... that... yeh, it's not fair. I should get over it.
Homicidal tendencies are due to a big error with our electricity bill, making us liable for nearly £200 worth of power. I wish "I'll cut off the direct debit" held as much weight as their "we'll cut off the power" threat.
In other news, my two days in trauma theatres next week are confirmed. EEEEEEEE!!!!! Now the major problem will be keeping it a secret! If any other second years find out that theatre exposure is possible, my lovely reward for surviving the term will be ruined.
Other factors that threaten to ruin the end of term are impending bankaccountemptinessdoom, all of my friends attending a christmas dinner I am not invited to, and attempting to batter my head of year with a small child. Or other weapon of choice.
An assessed clerking was handed in several weeks ago. It was returned yesterday. I got a score of around 50%. Needless to say, I am not ecstatic about this. I'm boiling over with fury at an inept system which punishes the honest and rewards the liars. Certain people (and I can name at least four, so far) did not clerk a single actual patient, yet handed in a full (fictional) clerking and receieved almost perfect marks. One of my friends was marked down for saying he examined the olfactory nerve in his cranial nerve exam. The markers don't believe people could have the ingenuity to bring an orange to ward teaching for this purpose. I was honest about the fact that I didn't examine certain pulses (didn't want to undress patient), reflexes (patient refused) and vibration & pain sensations (there are no tuning forks on the ID ward, nor Neurotips - also, I find it unnecessary to subject the patient to pain, however mild, for a formative assessment). It was also commented on that I did not perform fundoscopy. We've never been taught fundoscopy, and I wouldn't have a clue which side of an opthalmoscope I or the patient should be on. The patient may have learnt plenty about my retinas, but I didn't do it.
This is war. My tutor today told me to "stop trying to fight the system, because you will end up fighting yourself". Surely if it's me vs me, that's a win-win situtation? I know what he means, and I know that the knobs who lie now will lose out later, but the fact remains that... that... yeh, it's not fair. I should get over it.
Saturday 5 December 2009
Tweeeet.
I was supposed to finish the GI system today. I'm still 2 lectures off. Bah!
I was supposed to wrap the Christmas presents tonight. They're all sat on my bed. Unwrapped.
I was supposed to not buy any more alcohol til at least next week. I have a new bottle of wine in my fridge. Now half empty. Bonus - I did not get ID'd for it. Antibonus - I'm supposed to be over 25 for that to happen. Shit. Boyf suggested that I have gained wrinkles from excessive drinking.
Boyfriend may have said "We shall see" and then "You may get lucky" when I said that I didn't think we would get married in the next decade (his idea, not mine). Am 80% happy and 20% scared shitless. Do not want to plan a wedding in the next five years.
Flatmate has gone out with friend (amid much giggling) so I have the flat to myself. Myself and Sauvignon Blanc are bonding. We are nearly best friends already.
I am out of Oreo's. This is a national disaster.
I am currently discussing my black cloud treatment with a relative stranger, in full internet view of many medics I know in real life. This is my confession.
I was supposed to wrap the Christmas presents tonight. They're all sat on my bed. Unwrapped.
I was supposed to not buy any more alcohol til at least next week. I have a new bottle of wine in my fridge. Now half empty. Bonus - I did not get ID'd for it. Antibonus - I'm supposed to be over 25 for that to happen. Shit. Boyf suggested that I have gained wrinkles from excessive drinking.
Boyfriend may have said "We shall see" and then "You may get lucky" when I said that I didn't think we would get married in the next decade (his idea, not mine). Am 80% happy and 20% scared shitless. Do not want to plan a wedding in the next five years.
Flatmate has gone out with friend (amid much giggling) so I have the flat to myself. Myself and Sauvignon Blanc are bonding. We are nearly best friends already.
I am out of Oreo's. This is a national disaster.
I am currently discussing my black cloud treatment with a relative stranger, in full internet view of many medics I know in real life. This is my confession.
Friday 4 December 2009
*Pharm dance*
2 posts in 2 days - something must be wrong!
So far all that is majorly wrong (ignoring big uni FtP issues, family issues, flatmate issues...) is that I still have two weeks left of term! This means about twenty more hearty lectures, one community session, and two ward sessions. [And two days in trauma theatre, but that isn't confirmed yet, so ssshh.]
And today, on Haematology? The Jelly fire was still a-burning. The Prof finally deigned to teach us himself, and he's a darling. A veritable Theo Paphitis (sp? I like my dragons firebreathing, not just plain wealthy) with a mild sense of humour. Split to the 8 winds, with a list of 9 patients to see, we regrouped an hour later with 5 histories. Maths is lost on medics, clearly.
Beardy presents his case. I don't even recall what it was, but I've got a 33% chance of guessing - everyone has lymphoma, leukaemia, or myeloma. And I know nil about any of them. Yet. Only just into his HxPC, Beardy gets pulled up on some error, suggests that I take over. Queen of the presentation. I like. I decline (having not even gathered the notes for my case, never mind his) and he continues, until the medication list arises. What is... Aciclovir? Ciprofloxacin? Dexamethasone? Omeprazole? Azathioprine? Bing, bing, bing, bing, bing. Somehow, the rest of the group left their Pharm head at home. Or never owned one in the first place. I recommend eBay. After drug five, Theo has given up even looking at anyone else for an answer. Oh yeh! Oh yeh, oh yeh, oh yeh... *pharm dance*
Now what the hell is MAXICHOP? Aside from the latest in machete wielding ballroom styles...
So far all that is majorly wrong (ignoring big uni FtP issues, family issues, flatmate issues...) is that I still have two weeks left of term! This means about twenty more hearty lectures, one community session, and two ward sessions. [And two days in trauma theatre, but that isn't confirmed yet, so ssshh.]
And today, on Haematology? The Jelly fire was still a-burning. The Prof finally deigned to teach us himself, and he's a darling. A veritable Theo Paphitis (sp? I like my dragons firebreathing, not just plain wealthy) with a mild sense of humour. Split to the 8 winds, with a list of 9 patients to see, we regrouped an hour later with 5 histories. Maths is lost on medics, clearly.
Beardy presents his case. I don't even recall what it was, but I've got a 33% chance of guessing - everyone has lymphoma, leukaemia, or myeloma. And I know nil about any of them. Yet. Only just into his HxPC, Beardy gets pulled up on some error, suggests that I take over. Queen of the presentation. I like. I decline (having not even gathered the notes for my case, never mind his) and he continues, until the medication list arises. What is... Aciclovir? Ciprofloxacin? Dexamethasone? Omeprazole? Azathioprine? Bing, bing, bing, bing, bing. Somehow, the rest of the group left their Pharm head at home. Or never owned one in the first place. I recommend eBay. After drug five, Theo has given up even looking at anyone else for an answer. Oh yeh! Oh yeh, oh yeh, oh yeh... *pharm dance*
Now what the hell is MAXICHOP? Aside from the latest in machete wielding ballroom styles...
Thursday 3 December 2009
Trumpet blowing - it's all brass, baby.
Clinical teaching is now every Thu/Fri morning and today: I was on FIRE! Roar, an all that.
We're on our Haem/Onc rotation until end of January, and I already lov- uh, like it! Consultants seem reasonably willing to ignore us completely and make the SHO's teach us, which is fine by me. More likely to show up on time, better versed in current exam technique, less likely to bollock us for minor errors, young, cute...
So, today. We went out in groups of three (dire, I know, but Onc has very few patients well enough to be poked and prodded!) to take a full history +/- pick'n'mix exam (i.e. pick an exam, regardless of presenting complaint). Paired with supermurmurboy (picked up a grade 3 pansystolic mitral regurg last week, almost by accident. Grr) and orangegirl, we had a lovely bloke (bing! DO NOT CALL PATIENTS "bloke" WHEN PRESENTING!) who had a nasty tumour which was met'd on presentation. Sugar sweetie pie, he was. Honestly. History taken, 80% Jelly, 15% orangegirl, 5% supermurmurboy. Win! I do not just talk incessantly. Much. Except in the face of patients who are really willing to chat about their cancer, and be (badly) examined, with 2 fellow students who have their face in their notes. I just find it rude to let silence fall while we all scribble. So I continued with the history. And still wrote twice as many notes as supermurmurboy. Even the patient noticed. Blame the large, doctory handwriting.
Either way. Hx done. I attempted a very bad abdo exam (argh! OSCE in 1 month 26 days!) and completely forgot to start with the hands, or face... straight for the belly. FAIL. Crappy exam still found my first case of hepatomegaly!
Back to the teaching room for barbeque time. Present Mr. Cancer. "This is a xx year old bloke *cough* male with advanced x cancer metastasised to his x and x, admitted for cycle 7 of FOLFOX." Woo, I can name a chemo regime! Bonus points for describing the constituents of said regime. Superbonus points for discovering that leucovorin was a correct answer (shucks to you, Onc Dr). Yes, I geek.
Quickfire round of pharm, causes of abdo pain, symptoms of heart failure, causes of pleural effusion, investigation of frank haematuria... BING, BING, BING, BONUS BING! Orangegirl, pinkgirl, armygirl, supermurmurboy, nobface and beardy all in relative silence. *Inner glow*
Out on the ward to do a group meet-and-greet Mr Pleural Effusion. Nobface does the worst attempt at patient contact yet seen, complete with incoherent mumbling, a straightfromtextbook knowledge but nil practical practise display of a resp exam, and stunned faces from the rest of us.
Causes of tracheal shift. "Pneumothorax". "What kind?" "A big one?" Genius, Jelly, genius. Do not pass Go. Do not collect MBChB.
Turns out Casualty and ER finally win at something. Tension pneumothorax is a real diagnosis, and really fixed by jabbing a cannula dramatically into the chest. I cannot wait!
Despite "big one", OncDoc is still looking at me for all the answers! YAY! I even came home and spent hours reading about sorafenib and other NICE-banned RCC drugs and more FOLFOX stuff! I never thought I'd say I like Oncology. I like curative stuff! You broke bone, me fix. Not, you have a horrific and mostly fatal condition, I'd like to fiddle with this bag of fluid, or maybe that one?
I fail at life, but I heart clinical medicine!
We're on our Haem/Onc rotation until end of January, and I already lov- uh, like it! Consultants seem reasonably willing to ignore us completely and make the SHO's teach us, which is fine by me. More likely to show up on time, better versed in current exam technique, less likely to bollock us for minor errors, young, cute...
So, today. We went out in groups of three (dire, I know, but Onc has very few patients well enough to be poked and prodded!) to take a full history +/- pick'n'mix exam (i.e. pick an exam, regardless of presenting complaint). Paired with supermurmurboy (picked up a grade 3 pansystolic mitral regurg last week, almost by accident. Grr) and orangegirl, we had a lovely bloke (bing! DO NOT CALL PATIENTS "bloke" WHEN PRESENTING!) who had a nasty tumour which was met'd on presentation. Sugar sweetie pie, he was. Honestly. History taken, 80% Jelly, 15% orangegirl, 5% supermurmurboy. Win! I do not just talk incessantly. Much. Except in the face of patients who are really willing to chat about their cancer, and be (badly) examined, with 2 fellow students who have their face in their notes. I just find it rude to let silence fall while we all scribble. So I continued with the history. And still wrote twice as many notes as supermurmurboy. Even the patient noticed. Blame the large, doctory handwriting.
Either way. Hx done. I attempted a very bad abdo exam (argh! OSCE in 1 month 26 days!) and completely forgot to start with the hands, or face... straight for the belly. FAIL. Crappy exam still found my first case of hepatomegaly!
Back to the teaching room for barbeque time. Present Mr. Cancer. "This is a xx year old bloke *cough* male with advanced x cancer metastasised to his x and x, admitted for cycle 7 of FOLFOX." Woo, I can name a chemo regime! Bonus points for describing the constituents of said regime. Superbonus points for discovering that leucovorin was a correct answer (shucks to you, Onc Dr). Yes, I geek.
Quickfire round of pharm, causes of abdo pain, symptoms of heart failure, causes of pleural effusion, investigation of frank haematuria... BING, BING, BING, BONUS BING! Orangegirl, pinkgirl, armygirl, supermurmurboy, nobface and beardy all in relative silence. *Inner glow*
Out on the ward to do a group meet-and-greet Mr Pleural Effusion. Nobface does the worst attempt at patient contact yet seen, complete with incoherent mumbling, a straightfromtextbook knowledge but nil practical practise display of a resp exam, and stunned faces from the rest of us.
Causes of tracheal shift. "Pneumothorax". "What kind?" "A big one?" Genius, Jelly, genius. Do not pass Go. Do not collect MBChB.
Turns out Casualty and ER finally win at something. Tension pneumothorax is a real diagnosis, and really fixed by jabbing a cannula dramatically into the chest. I cannot wait!
Despite "big one", OncDoc is still looking at me for all the answers! YAY! I even came home and spent hours reading about sorafenib and other NICE-banned RCC drugs and more FOLFOX stuff! I never thought I'd say I like Oncology. I like curative stuff! You broke bone, me fix. Not, you have a horrific and mostly fatal condition, I'd like to fiddle with this bag of fluid, or maybe that one?
I fail at life, but I heart clinical medicine!
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