Sunday 20 January 2013

The one where bean is a little [all right, a lot] frightened


Week 8 was right sided weakness and was focussed on neurology.  Constant reader will know already that I hate neurology.  I don’t understand it and to be honest it baffles me.  Tuesday did not start well.  The consultant we were told to report to was away on annual leave, as was every other consultant we were then told to find.  Eventually we were told to go and find the ward round and shadow them.  This involved following a team of doctors around the hospital seeing all the new referrals to their service.

We were sent down to the clinical decision unit to see a patient who were told had seizures each night and would be post ictal when we saw them having spent the whole night on CDU so that his wife could have a nights peace.  We congregated around the bed and pulled the curtain.  The consultant sat on the bed and leant across to the patient sat in the chair to shake his hand and introduced himself.  With a broad grin the patient stood up, exclaiming “Oh yes, I know just what to do with you” and promptly punched the consultant squarely on the nose.  A little bit shell shocked I was acutely aware that I was stood right next to this patient, who suddenly seemed very large and very imposing.  The ward orderly ran around the corner and asked why the patient had done that, to which he replied “Because I want to go to hell!” and went to punch him too, thankfully, unsuccessfully.  Luckily, at that point Security came around the corner and we were able to escape to the corridor.  It turns out that the patient wasn’t having seizures, he was psychotic and our consultant had to be admitted to the ward for stitches in his nose, disbanding our ward round.

On the stroke ward I was pointed towards a patient I was told who was suitable for me to clerk and introduced myself and what I was proposing to do.  It quickly became clear that the stroke had left the patient unable to speak and that I was not going to be able to get a history from this patient.  This then left me in what I found to be a really awkward and embarrassing situation, having to explain to the patient that I had just asked to sit down and chat with that I was going to have to go without taking the history.  It felt so transactional, that all I wanted from them was one thing, and they couldn’t give it to me because of an illness.  From the look in their eyes, they probably would have liked a bit of company and I didn’t have time to give it to them.  I felt so guilty, and a little upset with the Junior Doctor who told me they would be good to talk to and put me in that position.

I passed my competency that week in testing motor, sensation and co-ordination, but the rest of the week was a write-off for me as I came down with a horrible ‘flu and had to take to my bed for the rest of the week.  I can’t say that there wasn’t a little part of me that wasn’t a tiny bit glad that I skipped the rest of the week.