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!