Sunday, 18 April 2010

Stuffed.

I am.so.full. Im back in Mtown and i went to dinner with those housemates that are in the country. (screw you boys in canada/ prague..'boohoo im missing my exam'- shutit) Im back in student-mode. eat EVERYTHING you can because you never know when your next meal may be. (entirely an exaggeration. mine will be at 7.30am tomorrow). The cupboards are full too though (thanks mum) and the car was full on the way home as ive tried to half move out to save giving myself a hernia in a few weeks when i actually have to decamp from Number 35....
I have been at home for 3 WHOLE BLISSFUL weeks. I have done practically no work except for a few afternoons in the park with my 'integrated pharmacology' textbook for company. This is a guilty pleasure of mine and it is my internal snob that admits this....i kinda love people looking at me with my textbook sunning myself while all the crusties are dossing around with their circus skills...
Anyway...i think my mother at least would contest that i have not learnt anything- i challenge you with this-
NEVER INJECT VASOCONSTRICTOR DRUGS (epinephrine) into YOUR PENIS FOR FEAR OF GANGRENE. boo yah. i know that fact offf.by.heart. mainly because i sent it as a text to all my friends that would understand it because i thought it was funny.
The easter holidays are actually a horrible invention- They create a false hope of summer even though theres this nagging in the back of your mind reminding you that you have 4 weeks left of lectures and 3 weeks of EXAMS before you can truly bask in the glory of the english summertime.
SO, what have i done in these 3 weeks then? well, been out 3 whole times. Ive (re)discovered that a cider hangover is probably the worst sort of hangover that there is. and (re)drinking on it the next day in order to (re)go out is an awful idea.(except for if going out involves 8 banterous boys. then its a great idea and a lot of fun) Ive been to the dentist- (LUDICRISLY OVERPAID). I re-read a book called 'Trust Me I'm a Junior Doctor' that has re-scared me about my FY1 year.
I got to catch up with my homegirllllssssssssss.
I watched UP. Its my favourite film ever. After The Crimson Pirate. And The Holiday.

So basically, im sat at my desk attempting to digest, checking to see if my timetable has reduced in the 20 minutes since I last checked. It hasnt. 9-5 tomorrow. booooooooo. (yesyes, i know, in the REALLLLLL WORLD everyone does that every day blah blah. well by signing up for uni you expect to bypass the real world for up to 5 years so shhhh!)
At my left hand is my physiology manual. Tomorrow were learning CPR so DONT WORRY if your heart unexpectedly stops in my prescence (after tomo) i will be able to break all your ribs, slobber on your face and hopefully keep it pumping until someone comes along to tell me that you merely fainted.
At my right hand side a bag of ground coffee with extra caffeine (how is that even possible??) that i was given as a gift...i think i may have let slip to the people who gave it to me that my trips to the park werent THAT effective....apart from the gangrene thing.


Im just going to make myself some kind of digestion promoting drink as i feel like a beached whale.

And check my timetable one last time.

So until next time kids, watch where you stick those needles.

Wednesday, 17 March 2010

Hanging with Benton, Ross and Carter

For old times sake I've been hanging out with the E.R boys tonight. Ive got a bug that means I'm really snotty in one nostril (green) and have a mucus-sy cough and I'm tired. Its SSC week. what is an SSC you ask- Ive realised medics lives are entirely full of code- pbl, ssc, etc, lol....
SSC is the 'Student Selected Component'..i think that name is some kind of legal clause that means when you complain about it they remind you that you chose to do it in the first place...that's right STUDENT selected. Its a 15 page essay on a title you have chosen and been allocated. I 'beat' 20 people to what i thought would be a brilliant idea to look at 'Should Euthanasia be legalised in the UK?'...what a barrel-ful of weasels that is...I'm looking at morals and law and legal precedents and human rights and self-determination and autonomy and the 6 different types of Euthanasia and physician assisted suicide and normal assisted suicide and the law in Belgium and in the Netherlands and religion and oh my god I'm so in too deep. but that's right folks, i CHOSE IT.
the main drag is the referencing. do i reference a person who has paraphrased something from an original piece of research if i have paraphrased their interpretation? or do i reference the original work?
Can i just write 'YES' in 172 font and submit that instead?
So anyway we have a couple of weeks off normal lectures and seminars to do this and is horrific.id rather be in at 9am every day listening to detailed accounts of rectal prolapse than i would being able to lie in and knowing that i have to get up and face 'Euthanasia & The Law, Dying with dignity' (i dint have to reference that because i made it up but you get the gist)
So anyway its going alright and what i was really going to write about is that I'm annoyed because my housemate Paul has gone out for dinner.
This is annoying because he has my Grey's Anatomy Season 2 Box set in his room. What is even more annoying is that I gave it to him so i couldn't watch it because i have become absolutely addicted to it and it has taken away all my productivity and my perception of what working in a hospital is really going to be like!!! so anyway this evening i went old school because Paul didn't expect me to turn back to clooney and wyle now did he?!?! mwahahaaaa. and I'm ill so I'm allowed.
The thing i love more than anything in these drama series (more than the faces of noah wyle and the cloonster and dr mcdreamy)is the fact that I'm actually beginning to understand what they re on about.
I know what a bilateral haemothorax is. And what a pulse ox measures. what cyanosed is. i know that tachycardia is an accelerated heart rate, i know what a normal BP should be (hell if you gave me a sphygmomanometer and a stethoscope i could measure it myself. i know about angioplasty and i know about beta-blockers.
It is so satisfying to have these words no longer drift by your subconscious but actually have your brain grab them out of the air and process them and start to think about their significance within what is being presented to you.
This is a medical code even med students don't comprehend fully and its nice to be slowly cracking it.

Now I'm going back to ER in the hope that I'll be feeling better in the morning ready to be Euthanised once more...

Monday, 22 February 2010

Satisfactory.

This is the grade I got in the exams i thought I'd failed. it isn't even like 'good not great, could try harder', or 'better luck next time'. 'Satisfactory' is all you need to get through medical school. 'Satisfactory' is a PASS.
And thank god i satisfactorily gauged the amount of work required over Christmas, turned up with satisfactory Biro's and managed to satisfactorily work out which little box corresponded to a satisfactory answer.
Fair Enough. they don't want to start telling us were 'good' or anything. Heaven forbid you compliment anyone in my year for fear their heads may grow to a size that wont fit through the double doors that lead into the medical school...
BUT. Surely 'pass' is OK? i mean i know I'm getting picky about terminology but who wants a doctor that did what basically is 'o.k' at medical school? Were talking 'alright', 'adequate', 'not outstanding'..'unexceptional'....??
After satis comes Honours, then Distinction. You get honours points every time you get one of those and then at the end of your degree you get even more letters to put at the end of your name...Dr Doug Ross (par example) MbChB(Hons)...
I was in a lecture this morning and an HONOURS STUDENT was TALKING in the row behind me about how 'in the handbook it says honours points count even from the progress test even in first year even though the progress test doesn't count for anything'.
Firstly, SHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH!!!!!!!!!!!!!
Secondly, jeez Louise, you've only just STARTED. Its like collecting gold stars when the teacher hasn't even put up the chart.
Ive encountered many doctors in my 21 years. There were many present at my birth i believe. One was dragged from sleep and required to give my mother an epidural because i was taking my time entering the world (theres a theme here....birth, getting up at the weekend, getting a degree....all so long in coming..)
Mr P.J Witherow. A man who has morphed into someone who kind of resembles my uncle Pierre and father Christmas performed surgery on my club foot. twice. My GP Dr Spence is someone i have visited my entire life, he wrote the sick note when i had tonsillitis during my final A levels, he always asks about my family in England and abroad before he asks why I've come to visit, and he always sends his regards to everyone as i leave the door. This isn't to mention the many doctors I've encountered in the Accident and Emergency department when I've thrown myself off my bike and knocked my teeth out, slipped on some leaves and broken my wrist, caught a hard ball at netball and broken the other one, and this isn't even to mention the many Ju-Jitsu related injuries...
I encountered a very young lady doctor in A&E who saw my GP and announced that she had just moved there, but on some days she works a rotation in the hospital. Dr Janssen is so nice that i make a point of seeing her if spence isn't around because she seems like she cares.
The other doctor i remember from A&E is a guy, i don't remember his name or what he looked like, but i do remember that he was HOT. so lets imagine its doctor carter from E.R. I went in with the most disgusting, gammy, infected ankle from scuba diving in Thailand. Id caught some bug and it wouldn't go away, and whats more it was eating its way up the scar Mr Witherow had so beautifully made so indistinguishable on my left ankle. Dr McDreamy asked where I'd been and how the diving was and la la la if id enjoyed myself etc etc. This was 2 years ago. And yes, i don't remember all of the names, but i do remember their kind manners.
Equally, there are people that i remember who were horrible and dismissive and made me feel like i was time wasting, so thanks doctor so and so who said that my loose joints were something i had to live with. I KNOW theres nothing you can do about it but you could have been nicer. And thanks to the doctor who missed my vein 4 TIMES before admitting it had been a 'while' since he'd taken a blood sample. i GET that you don't do it all the time, but i was only 14 and that needle bloody hurt.


The thing I'm getting at here is even if i can remember the names of the doctors (sorry Mcdreamy, i wish i could cos id probably look you up on facebook if i could....!) i haven't a clue whether they were (Hons) or not. In fact if Mr Witherow was 'Satisfactory' (or even 'Low Pass') at med school id give him (Hons) just for his needlework, and Dr Janssen can have (Hons) for just being really easy to talk to, and McDreamy can have (Hons) in the looks dept......
If i come out of med school being nothing more than satisfactory, and i manage to go most days acting in a way that me personally would like a doctor to act, that's all i care about.....

Maybe I'd ask about the patient before the extended family. that would be satisfactory.

Thursday, 11 February 2010

Marinade.

I got a text at 3am the other day. I was getting up at 6 to go on placement and NOT.IMPRESSED. it was my housemate Tom announcing they had found a rabbit in the road on the way home from wherever they had been intoxicating themselves, and had decided to 'rescue it'.
It’s in a box in our living room awaiting its collection by the RSPCA. They named it Gulliver because of its travels. I’ve named it Marinade.
I’ve done the hunter-gatherer thing before, set rabbit traps, watched my uncle ‘dispose’ of them (I say ‘dispose’; it was quite a lot more brutal than that. I’m pretty sure there was quite a lot of eye bulging going on…and that was just on his part.) And eaten said fluffy things in a stew...
On Monday I crunched through quite a few ribs (not mine obv...) and chopped out a human lung with my own hands…










Marinade’s days are numbered.

Blue 2, Bay J, JR

I never thought i would be disappointed at a fire drill that evacuates the library. It was 7pm and i had been fidgeting for all of 2 hours trying to engage brain with partial pressure gradients and the Laws of Doyle, Henry and Fick...I was actually getting on with it when the alarm went off and my friend Neelesh said it usually takes 40 minutes before they can let everyone back in. BOOOO.
It was snowing outside so i fought my way onto the rush hour bus heading home and did absolutely nothing for the rest of the night...
I don't know whats suddenly happened, maybe its going from having a case for the weekend, to having one Monday to Thursday but i seem to not have any time any more. It feels quite nice, i feel proper. if that makes sense.
I sit on blue 2 in bay J by the floorlength window so i can see everyone coming in and out...John Rylands, whoever he was, has had the library named after him, is referred to as though he were still alive e.g.
'Where are you going?'
'To see JR'..
http://en.wikipedia.org/wiki/John_Rylands
I spend monday afternoons, all day tuesday and wednesday in John's company. Ive started noticing regulars and everything. Lammmmeeee!

Apart from that, Ive started French which is good but i have to admit its hard getting back into it after 4 years and realising that you really arent very good anymore. Especially when 1 of the girls in the class speaks 5 languages, including French, pretty much fluently. WHY IS SHE THERE???????????

Today in Labs we got to be 'lab rats'- totally got to take loads of Salbutamol (aka asthma inhaler)...had to have full blood pressure/pulse etc checked by a doctor before i took it- my bp was 94/72, very low..and then we all got the shakes and thought it was really funny...Realised i take my inhaler totally wrong. whoopsss!!

Other things going on in my life include:

Glee- Sue Sylvester is AMAZING!! Theres something about that saccarine all american program that makes me happy.. Mondays at 8:55 involve me running down from the top of the house shouting 'GLEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE!!!!!!!!!!!!!!!!!' and then all 7 of us cramming onto our 3 2 person sofas to watch Mr Schu and the rest sing and dance and ruin their ever so comlicated lives. Its pretty much the only thing that brings the house together...our love of Fin and the other guy who plays football and who looks like he has had his hair waxed into a brazillian. on. his. head!
(ive got both soundtracks. im not even ashamed to admit that)

14 Tatton View, our house for next year. Seriously i trawled around 7 houses and i was pretty fed up and at my wits end when we stumbled across this little slice of perfection! its got a garden. with grass! not just a giant gravelly litter tray. in the garden is a bbq pit and a pagoda and trees with fairy lights and a sofa?!
Its got a rave basement with UV paint everywhere and one of those clothes racks that you hoist to the ceiling of the kitchen that reminds me of (very) happy times at my grannys. Its even got working fireplaces. not sure what genius decided that was a wise idea for a student house but anyway, i cant wait to move in!!

The Summer! Its ages away, but im going to central america for a month with my housemate Paul who is going to be in belize on a Zooooooology field trip ( they say field trip, i say holiday...we get 'trips' to hospitals. def not the same thing!) SO im going to meet him. i just bought a guidebook. eeeeeeeeeeeeeeeeeeee!

Also the Bestival line-up has been announced! VERY EXCITING ALSOOOOOO.
so apart from being so busy and tired i dont know what day it is (i constantly hope its friday) all is dandy in MTOWN.
wooooooooooooooooooooooooooooooooooooooooooooooooooooooo

Wednesday, 3 February 2010

Definition of Gerstmann-Straussler-Scheinker syndrome

A rare familial form of progressive dementia inherited in an autosomal dominant manner due to a mutant prion gene on chromosome 20pter-p12. Abbreviated GSS.



medicine.net
not me.
not yet.

Making Progress....

I have previously mentioned the progress test. dun dun duuuuuuuuuuunnnnnnnnnnnn.
I don't know whose idea this was, but i think they need their head looking at. Basically the idea is that the ENTIRE medical school, all 5 years, sit 1 exam at the same time. The same exam.
So for a first year you are basically going to fail. and the 5th years should be passing. and if the next time you sit it you havent made progress, they consider throwing you off the course! WOOOOO!!
It turned out to be the most fun exam Ive ever done...this is what the questions are like:

A 43 year old woman dies after a long and debilitating illness. A post mortem examination is carried out, and a neuropathologist notes that the brain shows well-defined areas of demyelination on naked-eye examination
What is the most likely diagnosis?
A Alzheimer’s disease
B Creutzfeldt-Jakob disease
C Gerstmann-Straüssler-Scheinker syndrome
D Multiple infarcts
E Multiple sclerosis

The thing is with these questions is that the first years are meant to get SOME right, so despite the fabulous yet confusing red herring that is 'Gerstmann-Straüssler-Scheinker syndrome', we do all know that demyelination is generally a sign of E, Multiple sclerosis.

However, it is tricky to spot the ones you know from the ones that are in fact ridiculous, because we have no clinical training and the presentation of each question as a clinical case is slliiiightly offputting.

Others include-

You are a senior house officer on call when a 40 year old patient who is suicidal and known to be suffering from paranoid schizophrenia threatens to leave the hospital.
Under which section of the Mental Health Act can you detain this patient?
A 2
B 3
C 4
D 5
E 6

Trick to answering this one, Pick your favourite number.........
(answer: D)

I did take the exam seriously, and i did quite enjoy it because the lack of clinical now makes the end result of you being a doctor seem very far away. There was a point where my University Learned Knowledge failed me, and all i have to fall back on was 7 Seasons of E.R, Meridith Grey and Her Anatomy, House, my secret addiction that is BODYSHOCK (half tonne son/mom etc...) and when totally clutching at straws....Scrubs.
CSI wasnt at all useful, not even when dealing with BLUNT FORCE TRAMA....oh Horatio!

And when desparate and having to choose a drug to prescribe I picked the one that would sound best when screaming it across a trauma room with blood spurting in every direction.

I can see why they choose to examine us like this, but at the same time, it is incredibly demoralising to know you are going to sit an exam you cannot revise or prepare for and are expected to do badly in...

My favourite questions begin 'You are a senior house officer and your consultant calls you to prescribe...' because this is a little indication that IF you get through the exam, and all the subsequent ones, you WILL get there, and the medical school believes it, even if sometimes you dont.........