Sunday, 28 November 2010

Stopping to take a breath

Wow, what a busy week!  Since student finance don't seem to be sorting themselves out I updated my CV and a cover letter and dropped them round the local GP surgeries and luckily was called in two days later by one for an interview a couple of days later and started work the next day.  It's nothing terribly amazing - I'm an administrator on a zero hours contract, so I work when they need stuff doing and when I have the time.  At the moment I am working through their backlog of letter dictations and I'm having the best time!  I find it really fascinating to be able to combine my administration know-how with medicine, and I'm hoping that immersing myself in medicine a bit more might make it easier to learn.  I would also really like a dictation/transcription foot pedal that works with Real Player so I can type my lecture notes streamed from the online uni portal faster.  The one at work is amazing!  I have descended into a whole new level of geekiness from which I fear I cannot be saved.

Asides from paid work I have sat my clinical competency exam in basic life support, taking blood pressure and examination of the pregnant abdomen, and am happy to say I passed all three with top marks.  I have been to lectures both boring, interesting and extra.  One which I found fascinating was some new theories being tested about treating septic shock patients.  The macro-circulation vasodilates but the micro-circulation (the capillaries) vasoconstricts, so although you can oxygenate patients the oxygen doesn't actually get to where it is required, so although the sats appear normal (because we can't measure oxygenation of the microcirculation) the septic patients still die.  They have been able to visualise the blood moving through the capillaries and in normal, healthy people it flows freely, in anaemic people you can see the lack of red blood cells and in septic patients the blood moves slowly and gets clogged up and stuck.  The theory being that now researchers should look for drugs which target the capillaries and vasodilate them.  I found that I really missed going to lectures where the material comes straight from the lab.  I love the clinical lectures that we do, but I miss hearing about the exciting new research.  It's great to be taught by someone who is so passionate about their work, and the way they explain it makes the science sound so elegant.  Hmmm, maybe I'm already to geeky to be saved :)

I also donned my fancy dress and sparkly shoes for the Medsoc Winter ball which was fantastic.  The committee did a great job.  We all got these free insulated travel mugs printed with the Peninsula logo which will make morning PBL session so much more bearable.  We have finished the last case unit of the year and now move into three weeks of SSU (student selected unit), but seeing as it's a formative SSU, I don't think we have much contact time so most people are treating it as an extension to the two weeks we get off for Christmas.  There's just an SSU essay and a portfolio analysis essay to do and that's me done for the year.  It seems to have gone very quickly.

Because the next three weeks will be so slack, it sort of feels like Christmas is a lot closer than it actually is.  This isn't being helped by how cold it is.  We don't have any snow down here, but when I was rowing this morning we were having to break the ice with our blades to get them in to take the stroke, and there was one terrifying moment when I went to put the blade in and it bounced straight off the surface.  We were going round a corner at the time, so if we can't row we can't steer and we were heading straight for a bank.  Luckily there were no accidents.  Every time splash came up it froze on us, the blades and riggers had icicles hanging off them and I was wondering why I wasn't warmly tucked up in bed.  I really should start Christmas shopping....

Saturday, 20 November 2010


I am adding to the list of animals which have been sacrificed for my education.  Starting with flies, maggots and sheep for the IB, moving through frogs, mice and hamsters for my first degree I can now add pigs to the list.  Thursday afternoon/evening saw me taking a scalpel to a pigs trotter so I could learn how to stitch it up again.  I'm not sure I've ever felt so guilty but had so much fun in my life.  If I'm being totally fair, the sheep and pigs were just bits left over from a butcher, the frogs were saved from being frogs' legs and the mice are specially bred to be lab mice.

We have various societies here which, instead of organising socials, organise extra lectures and workshops, and this was one of them.  There was only one other first year that got a place, and only ten of us at all, and otherwise us first years don't get to learn suturing until the end of the first year when it will probably be a 30 minute session before being whisked off to learn something else.  This was two glorious hours.  My theory was that I am pants at sewing, utterly pants.  As in, I sewed patches on my jeans because I had holes where a lady probably shouldn't have holes and try and get away with calling it fashion, so I bought material, made a patch and sewed it on.  Half way through a trip out to town all the patches fell off.  Embarrassed bean.  I figured therefore, I would be a good idea to get as much practice in as possible, and I am still on a mission to collect skills that show yes, I am actually training to be a proper Dr, not just doing another science degree.  I can now do plain interrupted sutures and mattress interrupted sutures and the facilitator said my stitches were excellent :D

Mum had great fun telling my aunt I got 8% in an exam and watching her squirm before explaining how our exams work.  My aunt has always been very supportive, but has also always been the first to point out to mum that medicine is very hard, and only the cleverest get on, and wouldn't I rather do something else instead.

I also went to a careers event in the week - Women in Surgery which had some amazing speakers.  There was a Dr from the GB health team that went to the Beijing and Athens Olympics, an amazing Romanian Plastic surgeon who was terrifyingly brilliant - by the time she finished med school she had 55 poster, 30 papers and had spoken at loads of conferences.  She figured if she tripled the entrance requirements no one could tell her she wasn't good enough.  Apparently, although at medical school the gender balance is equal, only 8% of the Consultants in Britain are female.  I can't remember if that's all Consultants or Surgical Consultants, but it's not good either way.  All the speakers were great, with fantastic sense of humours and I got free food, it was a free event with free transport and a certificate :)

Finally, congratulations and commiserations to all the people who got their GAMSAT results yesterday.  It seems all the people I was rooting for didn't pass so I really am gutted for you.  It is a ridiculously hard exam, no matter what anyone says.

Wednesday, 10 November 2010

First AMK Result

AMK results went up this morning......... I passed!!!!  I got 8%, which counts as a satisfactory pass, and I am above the cohort mean of 7.5% so I am a happy bean.  Unfortunately it doesn't count for anything, but I was happy to see I answered correctly the questions on the topics we had done so far, and I even beat some second years.  It's a good score to work on I think.

Tuesday, 9 November 2010

Acrylic eyes

Tar barrels was amazing, although I got much closer than I was expecting.  I had anticipated being on the edges of the crowd, watching from a distance, but instead on several occasions I found myself right next to the gaping, flaming mouth of a huge barrel with a crowd surging behind me, trying to push to get closer because they wanted to touch the barrel.  Both amazing and terrifying.  Apart from that, it was a nice, relaxing weekend with mr.

Monday was my community placement, this time with the national artificial eye service.  It was pretty cool, I have to say.  This one man travels around hospitals covering all of the south west - Dorset, Devon and Cornwall, with a case full of trays of prosthetic eyes; mainly blue, since apparently one type of eye colour is more prevalent in certain areas than others - and the west country is blue.  An impression is made of the eye socket and one of these temporary eyes he carries with him is selected based on best colour match to the other one, cut to shape and fitted.  The impression is sent to Blackpool where a bespoke eye is handmade and hand painted with oil paints, with the veins being made of individual red silk threads laid on.  Every six months to a year the patient can come back in to have the eye sanded down, buffed and polished to get rid of the build up of proteins from tear fluid and to check the fit to see if a new prosthetic is required.  We met a patient in his 60's who had lost his eye in an accident when he was a little boy.  It was really nice to see how well adjusted and happy this man was.  The prosthetist and the patient spent a good 15 minutes chatting about the man's life in general - his family, work etc which was great, that he had that much time to really build up the rapport, and he'd obviously been seeing this man for some time and remembered details about his family life.  The prosthetist was a history graduate, and it was great to see how much he enjoyed helping people and the continuity of care.  We were told about how few healthcare professionals know about the service, which is a real same since it's free and it can make such a difference.

Unfortunately, and rather embarrassingly, I nearly fainted twice in my placement.  It wasn't because I was grossed out, because I found it freakishly fascinating to be honest and the things we were discussing at the time were perfectly innocuous.  I just started to get really hot, sweaty, dizzy and my vision blurred and I got the sense I'd fall down if I couldn't sit soon.  It even happened when I was with the patient which was seriously embarrassing for me.  The rest of the day I didn't feel right - really weak, too hot, too cold, fatigued and then really achy.  So I am typing this from bed where I have been all day bar a quick trip to the Dr's who thinks I have some sort of major viral infection emerging and that I should stay in bed and keep away from sick people since I am immunocompromised.  I missed clinical skills today, which was pants.  I hate missing things, especially awesome things like that, but I'm not too sure I could get to clinical skills and back without falling down.  That and the fact that tonsillitis and freshers flu round two is currently going around the medics, although I seem to be showing symptoms in the opposite for either of those - everything hurts and is stiff, swollen lymph nodes make it feel like I'm swallowing rocks every time I try to swallow and a fever but no cough or runny nose.  I guess it will get worse before it gets better, but I hope it goes away soon.

Friday, 5 November 2010

Busy Busy!

Wow, well I'm not sure what happened to that week.  I survived the AMK.  I answered 22 questions, so I have somewhere between -4.4% and 17.6%, which I'm happy with.  There were probably some questions I could have guessed at - I got a few down to a 50:50 choice that I really couldn't pick between so I left.  Equally there were some where I didn't understand any of the answers, so I sensibly left them too.  There were a lot of Don't Know answers, but I find I'm not as freaked out by that as I was expecting to be.  When I left one of the guys who finished at the same time as me only answered 2, and I've found someone who answered 122, so the odds of me being somewhere in the middle and therefore passing seem pretty good.  The top 5% get excellents, the bottom 5% fail the next 15% up from that get borderline and everyone else gets satisfactory.

I promised some information on my placement.  I was shadowing a community midwife in one of the roughest, most deprived areas of my city.  This was a really big culture shock to me, and the first time I've had my views really challenged.  We went on a home visit to an 18 year old girl with a 7 day old baby.  The baby had been sleeping fine, but the night before was up crying all night and the mother didn't get much sleep.  She was sobbing on the phone when we said we would come round and she continued to cry almost constantly throughout the visit.  Her mother was there and was being really supportive, although her two younger sons (around 7 and 14 I guess [7 years old and an Uncle!]) were running around being noisy which possibly didn't help.  The mother was telling us how she had fed the baby every time it cried, but still couldn't get it to settle.  The baby was a little grisly when we got there, and didn't like being weighed, but when the midwife held him it was like she knew a special off-switch, the baby was instantly silent and sleeping.  The midwife explained that babies need other things besides food, and at that age they don't know what it is they want exactly, just that they aren't happy.  The biggest thing for me was how young she was.  Inside my head was screaming go back to school, you shouldn't be having to deal with this, you poor thing.  I kept thinking of my housemates who were 18 and how they couldn't look after themselves, let alone a baby.  I know that at that age our bodies are most prepared for having a child, I guess it's just that it's so incongruous with my upbringing, where the focus has always been on education.  The second girl we saw was 20, with a two year old running around and a history of miscarriages.  She was living in a one bedroom flat paid for by the council, and her partner was living with his mum so the council continue to pay her rent.  She had had a big argument with her boyfriend the night before, had no job and her previous successful pregnancy had left her with post natal depression, which she was still being medicated for two years later but had stopped the pills immediately when she found out she was pregnant, although the pregnancy was planned.  Again, I just couldn't help thinking this is no environment to raise a baby in.  I'm not saying she shouldn't have kids, I'm just saying she should get a bit more stability in her life first.  She did come out with a gem though: when asked if she had any heart problems she said "No.....Though I do have a heart murmur, does that count?"

My my am I looking forward to Christmas when the PBL groups swap over.  I really like PBL, I get a lot out of it and prefer it to lectures (especially since a lot of this is revision for me, which is nice).  My problem is the closed-mindedness of my group.  I get the impression that because I look the same age as them, they aren't going to take anything I say seriously - if they haven't done, it can't be true.  When it was explained to me, Peninsula like grads because we can bring our prior knowledge to the group and help out a bit.  My group just shoot me down and get really arsey with me.  Now, normally I can stand up for myself, but when it's 8 against one ad it happens every time, I'm seriously losing patience and am thinking of just shuting up in class and let them do it the hard way.  But I can't really do that, because we get judged on how much we talk in class and how much prior knowledge we bring, so I'd just end up shooting myself in the foot if I'm quiet.  An example being in our case unit this week.  It's on immunology and they decided one of the questions they wanted was when is it not appropriate to give antibiotics (the stimulus being a mother wants antibiotics for her child who has a respiratory infection and you as the Dr don't want to give them because they won't help).  Now, I don't know the A-Level syllabus, but I said well, antibiotics wouldn't help if it isn't a bacterial infection, so only give it if it's bacterial.  Would they believe me? No.  Another was what was the age of consent for medical treatment.  Now we covered this in the first case unit with what age can you get an abortion at.  We should also have looked it up for interview prep because Peninsula is hot on ethics.  Apparently they only looked up rules on contraception, and thought it might be different for everything else?!  So I explained Gillick's competency and Fraser guidelines and so it's 16 normally or minimum 13 with Fraser guidelines but still they wouldn't listen.  We ended up with questions about what is a respiratory infection, and what does a practice nurse do?  Seriously!!!  They are smart people, why the stupid questions?  And I don't even think it's just making questions for the sake of it to pad out the number we have to make it look more impressive.  Any paper evidence I bring to class is shot down and I'm made to feel like I'm disrupting class, being deliberately difficult or something.  Arrgh, rage!!!!  In any other setting I get on really well with them, because we are together for quite a lot of things, it's just PBL.  I guess it shouldn't bug me really, because it just means I have a really easy question to answer, I just get frustrated that I don't feel like a group equal, that my knowledge doesn't count for anything and that they can be so childish and un-accepting.  Meh, maybe this is just the storming part of group dynamics and it'll calm down, but somehow, I don't think so.

In more exciting Dr news... I learnt how to take blood.  Eeeee!!!!!  It's actually real now.  I am bean the medical student, and no one is going to say they made a mistake and I shouldn't be here.  Tomorrow I'm going here :)  Us Devon folk are right nutters!
Tar Barrels!

Good luck GAMSAT people, not long to wait now.
Bean x