The ward is closed.

So, yesterday we found out that our ward was closed due to an outbreak of d&v (diarrhoea and vomiting for all of you non medics....) Now, this is not great news for everyone on the ward, or indeed any unsuspecting medical student who swipes in and inadvertently exposes themselves to norovirus. Its quiteeeee good news for us because it means we cant go in, which means we can lie in instead. Having said that, its come at a pretty good time. I am absolutely exhausted, I've had the same bug twice in two weeks and I spent all weekend in bed- not because I wanted to, but because I had the cold sweats/burning up combo. Not sexy. not productive. I tell you, this is hard work.
Not that I didnt expect it to be, or that I don't want it to be- its nice to feel like youre really earning your knowledge, but bloody hell, 4 months without so much as a long weekend is hellish. Now here we go, you say, moaning away, but seriously, I'm not getting paid and Im working evenings and weekends. I'm in a lecture theatre in Monday morning at 8am, we watch the sun come up during the second lecture.

Having said that- I do love the fact that things are s-l-o-w-l-y coming together in my mind. Snails Pace. But still. Its satisfying to actually get things right when a consultant asks you to list all the things that can cause hypercalcaemia, for example, instead of just wildly panicking and selecting whatever the last disease process that you read and blurting it out complete with wild gesticulations demonstrating whatever other symptoms might come with it and lots of ''y'know, y'know that thing....''s.


And how many people can say that they spent their morning trying to (unsuccessfully) catheterise a plastic penis?!

Exactly.
Medical School is fun.

Madness on the Wards

Well, it has been rather a long time since I wrote, and for this i do apologise. Having said that, it would have been irresponsible of me to concentrate more on this and less on not causing long-term damage to the people on the wards..

Anyway, I have been on my ward for almost 6 weeks now and I have to say, its a million times better than the last 3 years of flicking bits of corpse at each other and pretending to be listening to lectures. (That was obviously a joke...i never flicked anything..)
I am on a gastroenterology ward and everyone's reaction is 'errrrrrrrghh poooo!' but actually there isnt much poo around, or even that much wee... or sick. So thats a nice start. The doctors in who's way we are getting are really good- especially our consultant who says things like ' getting your arm fixed is now our most pressing concern' and 'now youre under our team, you'll be our greatest priority'..Seriously, Ive never seen anyone with a manner quite like his. I aspire to be as liked as him- he's pretty inspirational. Whats more, he actually seems to LIKE patients, which you may think is a pretty basic requirement, but you would be surprised!

We have been taught many things and the learning curve on which i have travelled has been exponential. I can now tell the difference between prostate cancer and benign prostate hyperplasia on a plastic bottom (key skill!), i can take blood samples and i have got over my initial awkwardness of asking people how much they drink and exactly what their diarrhoea looks like. I know youre now going 'ohhh thats gross' but you really would be quite surprised at both how important that question is and how much you can tell from colour, appearance and quantity ( eggcup, coffee mug, cereal bowl-ful?)

The thing about my ward is that we have quite a few alcoholics on there, we have discovered Boddingtons under beds and seen people as jaundiced as Homer Simpson. We had to present an interesting patient on the Student Grand Rounds, which is a hospital equivalent of 'Patient Show and Tell' and we picked a pretty classic case of decompensated liver disease (this is when people who are chronically alcohol dependent suddenly find themselves jaundiced, with massive bellies filled with fluid and rather vile bowel habits. Basically, where the body was compensating for the alcoholic trauma to the liver, it suddenly starts failing...anyway, the gentleman we interviewed was so nice- he was really quite traumatised by his hospitalisation and adamant he was going to give up drinking. I genuinely think he didnt know that his 3 cans of 9% beer a day were doing him damage. To be honest, I was surprised at how little that seems. however, when you work it out- were talking 80+ units a week.
Anyway, he recovered quite well over a period of time and was moved off the ward to another..(i think the hospital just moves patients to other wards nearer the main entrance, until miraculously, one day they get up and leave, instead of discharging them..) He was now under the community alcohol team and seemed well on his way to a new life.
Monday morning we turn up for rounds with the registrar. Bad news, He's back. Were all shocked, genuinely thinking he had made a great turnaround. Whats more- hes gone mad!
You need to bear in mind that he was such a gentle man, softly spoken and happy to help anyone who needed to practice taking a history...he had been rampaging around the wards trying to set off fire alarms and swiping at peoples ankles with his walking stick.
One of the problems with decompensation is that the liver cant help to get rid of all of the toxins you get from metabolising food, so they build up and can affect your brain.
He could have got some kind of spontaneous infection in the fluid in his tummy, which could have affected him...
These are both reversible, he will recover but it really shook us all up I think. We had gotten to know him so well and yet suddenly things took a sharp u-turn. Things could have been a lot worse but it shows how difficult it can be to get attached to patients...

Probably thats lesson 1 of hospital medicine.
Number 2 is to wear shin pads around bed 21 to avoid bruises.




P.S.

Listen to this, its amazing

Starting school.

Today, I started my hospital placement and have been reflecting on how many times i have done something similar to this and how every time i do, its still really scary.
I know that when i first started school I went with my best friend at the time (and we wore matching tracksuit bottoms sets, mine pink and his blue) and my teddy bear, Charlie. Moral support at its best. I assume we did a half day and then got taken home and gradually eased in...within weeks im sure we were all taking it in our stride. including the bear. But then, he takes everything in his stride.
Starting secondary school was probably similar, except i looked like a boy so that was a bit awkward (mainly in hindsight) and i was exceptionally keen in every way and you dont get that far on the social scale when you love homework.
By the time i started university you would think i would be used to the whole 'new people new places' thing..i hated manchester for the first few weeks. And then i pulled myself together and now when i come to this city, it feels like im coming home. a different home, but still, home nonetheless. I'd pretty much got the whole uni thing down, lectures and pbl alllll good. And yet again I find myself out of my depth, in 'The Greenest Hospital in the UK', shiny new building, the chattering of the Future's Doctors and feeling like i would quite like to to do a runner and get back into bed. I know, i know its fine, i'll settle in, soon ill be strutting around like i own the place, but still, its a little daunting. I could have done with Charlie and his bear-like charm and moral support.

Harry Potter on Broadway, and other such delights

New York City is one of the most exciting places in the world. We arrived at our final destination, sweaty and grubby, but in one piece. Devastatingly, i dropped my Obama mug at the Washington bus station and it shattered into a billion pieces, just like the American economy. I was extra specially annoyed because hannah has successfully carried a Harry Potter memorobelia mug all the way from bloody orlando and managed not to break it- typical! I have just searched ebay for a replacement, it is severely lacking in any type of quality tat relating to the US president. Anyway, as i was saying, we arrived and got the metro up to our broadway hostel, annoyed that we had to cash in our Dolla coins in the ticket machine as it couldnt possibly be useful enough to take notes...so we arrive, check in and find our room to be most prison-like of them all, with a bunkbed, sink and window...this is the official title of the room as we did actually spend time ranking them...well thats what you get when you spend two months with just each other for company...we also ranked the craziest people we'd met on holiday, so feel free to ask me about it!
So, we got some pizza from this place called Sal and Carmines, which was just around the corner and it just so happened to be recommended by everyone, including that guy that plays the facebook guy in that film about facebook..anyway it was soo good i think we had a slice a day for our whole stay. Then we had a glass of wine and planned our attack on the cheap ticketing system of broadway.
At 7 am we got up and out to go and get tickets to see a show- its friday today so a prime viewing day, and we go to some theatre and queue up with a load of harry potter nerds (they werent actually, they were quite normal looking) and somehow manage to get standing tickets for that nights performance for a measly 32 dolz. Which is pretty good if you take into consideration the fact that the people sat in front of us would have to add another hundred to their tickets for the pleasure of their view.. Anyway, shortly after that we wander into times square and have a little wander around and then we navigate our way up to the Metropolitan Museum as, joy of joys, the Alexander McQueen exhibition is stillll showing, despite having been scheduled to close just 3 days before. Well, lucky us, we had the pleasure of queueing on 'Closing Weekend'...But that wasnt even the start of it. Museums in America are expensive. we completely take for granted that you can walk into the manchester one near the uni, or the bristol one at the top of park street and check that your favourite mummy exhibition from your childhood, is thankfully still there. in NYC,and indeed everywhere bar washington, you have to pay up to $25 for that privaledge...boo. BUUT, every cloud has a silver lining, some of the new york ones are 'recommended', which means when the snotty looking cashier asked us how much we would be paying to see this world famous McQueen exhibition, we say 'Five Dollars each please'. He was not impressed, but whatever, its culture, were students, he should be thankful were in museums and not out looting and rioting.
So then we queued for 2 hours to get in to see everything and then we queued the whole way around to see everything, (anyone sensing a theme?) All that said, it was wonderful, he was incredibly talented and its sad to think he will never again spray a model with paint on a catwalk.
By now my feet felt like they were on fire, we were both limping around like we'd wet ourselves so we decided to WALK HOME THROUGH CENTRAL PARK. we got lost. eventually made it back to have an hours 'foot rest' before we went back out to see DANIEL RADCLIFFE AKA THE REAL HP on broadway. Our seats were actually brilliant and he was also brilliant. The show was about a guy following a book called 'How to Succeed in business without really trying' or something along those lines, it was pretty funny and hp had a good singing voice too...must be magic! (sorry) anyway, so if any of you are in NYC at any point before december i urge you to get up at the crack of dawn and go down to get tickets. So that was fun, we also managed to fit in a drink at a local bar and chat to some locals who were telling us all about new york in the snow.
The next few days we spent trawling around various shops trying to get presents and things like that...which was fun if not tiring. It was super hot there as well which didnt help matters, and neither did our riding the metro all the time- black crispy bogeys all round!
Hannah and I have both been to NYC before which is why we didnt do 'classic tourist things'...also because theyre expensive and we would rather spend our money on bulk buying Reeces peanut butter cups. anyway, we went to 30 Rock(erfeller plaza) and looked thorough all the NBC tv paraphanalia. I almost bought some House Fridge magnets. . . . . . On our final night we went to this lovely little bar called 'Sip' and drank a massive jug of sangria in celebration of surviving all the nut jobs of america..was pretty good..and on our last day we went to the illusive schnitzel shop which we had been hunting for some time and had schnitzel and potato salad for breakfast....The joys of avoiding wholegrain! Anyway, we somehow got to JFK, it took us 2 hours and checked in about 4 times before we could wander duty free and spend our last, worthless dollars on super reduced alcohol and Key Lime Pie flavoured chewing gum (fyi it was vile)
2 films and 3 episodes of 'Jamies food revolution' later we landed at heathrow and i have subsequently not been able to get up before midday...DAMN YOU JETLAG!

'That White House isnt very white....oh, its the Treasury.'

So, we are in Washington D.C, not Washington State, and its so much better than i expected! This isn't really fair, but we kinda added it in as a filler because New York is so expensive...anyway, were staying in a place called the Loftstel. Its weird. There's some crazy woman who was convinced i was speaking Arabic when i was telling Hannah that according to US Weekly David Beckham was paying Usher to teach his children how to dance. AND, then she had the bloody cheek to tell me i should change my name because the new leader of Al-Qaeda's daughter-in-law is called Lucy. She can do one.
Anyway, to add to this were staying in a room in the basement with no windows with the most sullen, po-faced girl ever, who also happens to run the hostel. A lot of people seem to live here so all her stuff is spread all over the room and there's nowhere to put anything, which is annoying...i feel that using all of her expensive products is the only way to deal with this. (joking)
On our first full day we hit up the Organic Supermarket round the corner which is the nicest place everrrr, and we got a little picnic lunch of ham sandwiches and crisps and went off to the metro to be proper tourists and sight-see!
Once we had communicated that we wanted to go to the mall (pronounced Moll) we set off and popped out the other side in the biggest area of free tourist attractions imaginable. it would be bliss if you had a small and irritating child to entertain for half-term. We firstly hit up the Natural History Museum for the tarantulas, diamonds and originally, the rest-room.. We saw the Hope diamond (yes please) and Han persuaded me to see the Tarantula feeding which was pretty cool, except for all the annoying small children who were getting in the way and shouting out answers. Like, obviously arachnids have 8 legs duhhhhhhhh. idiots. We didn't get to hold the cockroaches but LUCKILY saw on in the bathroom last night to make up for it. I especially enjoyed the dead body/forensic section. mmm.
Next we had our picnic, which was excellent, and embarked upon our epic hunt for the White House, which was more difficult than we originally expected. after mistaking the Treasury for it, we eventually find the shining white building and take more comedy photos, to add to our collection of those taken at the Washington Monument..
Today we continued our challenge to see as many of the free (and educational) attractions as possible, starting with Congress which looks kinda like the White House but bigger, and then the Library of Congress, that is the biggest library in the world..it has 520 miles of bookshelves dontya know!? It was pretty stunning inside, much gold leaf and the likes. Its actually quite strange seeing old buildings over here, seeing as its quite a young country. Nowhere else we've been has had anything like it. After the libe we had lunch outside congress and then wandered into the Botanical Gardens which were beautiful. Had to take temporary refuge in a childs wendyhouse during the rain- pretty comical sight, hands and knees and all! It started tipping it down so we stayed and checked out the medicinal plants section and the primeval section too, did all the sniff tests of spices from around the world which, from the height they were set at, weren't for adults, but whatever. Finally it stopped raining so we went to get some comedy Obama related souvenirs and then headed all the way down the Mall to the Lincoln Memorial, past the Declaration of Independence memorial and the Vietnam Memorial...god they love remembering things here. Anyway, by the time we were looking up at ol' Linc in his giant chair, it was pissing it down and we took shelter there, and in the gift shop where they had fake old money and Martin Luther King's speech (that's where he gave it..full of interesting facts today!) We took on the rain and plodded all the way back to the metro, only to have our journey interrupted by OBAMAS HELICOPTER FLYING PAST THE WASHINGTON MONUMENT AND THEN LANDING AT THE WHITEHOUSE!! OHHH EMMMM GEEE! made my day. i waved. obviously.
So, now were preparing for our final city, which is meant to be mega hot, by washing our pants and drinking hot chocolate..any tips for NYC feel free to contact..

Lots of love, not long now!

Country livin'

NASHHHVILLLLEEEEEEEE! So, here we go. Its awesome here. Our hostel is about a 20 minute walk away from 'downtown', which is where all the ho' downin' occurs. On our first day we just walked there and looked through all the crazy memorabilia shops..took some comedy photos with a carbon fibre Elvis statue and got some lunch in a bar (its the only place to have lunch in Nashville- they seem to have got it right!) There was a band a playin and we celebrated not being tired and ravaged by bugs. The bassist in the band was amazing, someone mentioned something about him being in a film about Elvis, everyone here is trying to make it, in the fame sense..y'know, the old chestnut about every waiter being a budding young star.. well our waitress was a sullen old cowboy boot who didn't deserve the tip that we HAD to give- compulsory tipping defies the point, i think i even made some kind of old lady comment to Han about how she'd get a surprise if she waitressed with that attitude in England.
Seriously, Hannah and i might as well have gone on a tour to Napa Valley, were such oldies. Our favourite phrase is 'one of my pet hates is........' needless to say, if someone had given me a quarter every time either of us had said that we'd be flying to NYC...
Anyway, the second day we decided we must see the Country Music Hall of Fame, (i was secretly hoping for a big busted shrine to DP, nothing of the sort occurred however..) A very nice lady in the ticket booth said she could tell we were English because we were so polite.. (in truth she could tell we were English because when she asked for our zip code, we said we were from England) but anyway, she was nice. The hall of Fame is 3 floors of memorabilia, cowboy boots, fringed shirts and even Elvis's Golden Cadillac (complete with 40 coats of opaque crushed diamond and fish scale paint). It was coooool! i learnt quite a lot about the Hank Williams Clan, there was an extensive display on him, and Han got all elbow bargey excited at the Taylor swift things, small girls HAD NO RIGHT TO STAND IN FRONT JUST BECAUSE THEY WERE SMALLER! (joking, she was nothing like that) they had some of Dolly's stuff and many people enjoyed our little country dance at the interactive Dolly station...We had a good day.
Today we went to Elliston Place, Lonely Planet says its nice, but in fact, its just a row of shops. Most of the streets of most of the places we've been are deserted, but i think its just because noone walks anywhere. well, you know what they say about mad dogs and Englishwomen. We went to an old fashioned 'soda shop' and got the traditional meat n'3 which, we discovered to our dismay, was as close to a school dinner that I've got to in 13 years..but not necessarily nasty. Were all for trying things, so we got some mac'n'cheese, which was disappointingly out of a packet, and some fried okra and turnip greens (quite bitter) and coleslaw, han had crab cakes and i had baked ham. it was all fine, the piece de resistance was the Vanilla Soda we shared, some kind of weird ice cream soda combo that was, obviously, delicious!
Then we got a coffee at this old Frat house called Cafe Coco which was full of those funny triangle flags that you see in college dorms in movies. It was good coffee too for a change. We are bracing ourselves for a longggggggggggggggg greyhound journey to Washington DC tomorrow evening, and then, tea at the Whitehouse!

Love you all, see you sooooooon!

XXXXXXXXXXXXXX

Asheville- yogurt weaving capital of the U.S

So, i havent writtten for a while and im so hot and sweaty this is going to be a short one...Theres a heatwave in the US atm and were not talking weston-super-mare beach weather, were talking 105 at 5pm in the afternoon. Asheville, North Carolina originally made its way into our itinerary after someone told us James Franco (actor) does a creative writing course there. after lonely planet had confirmed it was a nice place to go we went there. We stayed at a really cool hostel that had a suit of armour and a vegetable patch and even hooks in the bedrooms so you could hang things up..which is a rarity over here. On our first day we went for brunch at a place called Sunny Point and i ate GRITS for the first time. apparently a southern delicacy they are in fact just a corn based porridge that is a bit, well, gritty...but nice, with cheese and sausage...and this thing called a biscuit that is in fact just a scone...MMMMMMMMM. SO thats one thing off the list...we basically didnt do anything the whole time we were in asheville because it was so hot...someone told us there was a great 'drumming circle' we could go and join in (someone would probably lend us a drum..) DO I LOOK LIKE ID LIKE TO JOIN A DRUMMING CIRCLE?! obviously i do, but i dont.
We got the bus into town on our second day, and id just like to say, i cant wait to get back to the uk- there are so many weirdos in america. Its like, i use the bus in Manchester probably 2 times a day 5 days a week and have only ever encountered Crazy Bus lady 10 times (the name says it all) and also there was this one weird bearded man who went on about when he was a student in the 70s...but thats it. Han and i havent got on a bus, greyhound or other, without some weirdo bobbing around. GODDDDDDDDDD.
anyway, we went into a weaving cafe where baby yoga was probably compusory and using non biodegradable coffee stirrers was illegal. we had a nice cup of coffee and looked around the town, which is an artists central, then got back on the bus and hid at our hostel for the rest of our time there...We did go out for drinks one night, met another nutter at the bar with his young ukranian wife (he had a massive white beard and i thought he might have been Dumbledore in disguise)...Han had gone to the toilet and he asked me if i believed in crop circles or deja vu, which in my opinion are entirely different, so i said not really, and then he told me that i should because they were real and then started harping on for the entire rest of our drinks which was quite annoying, because it meant we had to get another one after to carry on our OWN conversation. ANd then as we paid the bar tender gave us one 'on him' and we had to drink that so as not to be rude, so i blame my sore head the next day on ashevilles reputation for being the 'politest place in the states' or something.....
anyway, it was nice, but were in Nashville now and im quite happy being in counrty music heaven, at least the nutjobs here have good taste in music...



DOLLY 4EVA xxxxxxxxxxxxxxxxxxxxxxxxxxxxxx