Countdown to 2008

Well 2008 isn’t far away and I’ve been thinking about the future. As time passes, the days, weeks, months seem to go quite slowly - seemingly nothing changes, another day at work, another day in uni, the same old things. But if you take a single point in time, a single day and think about how much has changed since that day exactly a year ago so much will be different.

In the last year I feel I have matured, become more independent and changed for the better. I’ve started and finished things, I achieved things which I’ve worked towards for a long time, I’ve progressed. But sometimes I still feel like a child, I can’t really put my finger on what it is but sometimes I just feel so young.

When I think about my life up to now I realise just how much I’ve really achieved, I didn’t have the best start in life - the first 13 years are a time which I don’t think about, I’ve pushed from my mind, its a time that I never want to remember or re-live, bad things happened in those years which I wouldn’t wish on my worst enemy.

But as bad as those times were they didn’t beat me, I got through it and came out the other side fighting. It was then that I decided that I wasn’t going to settle for just anything - I wanted to achieve, to succeed and to make people proud.

I went to an inner-city comprehensive school where many of my classmates didn’t really want to be there and the emphasise wasn’t always on learning. But I worked hard, put my heart and soul into my education and it felt good, I felt alive. I don’t really remember when I chose medicine but it seems to have always been what I’ve been working towards - I picked GCSE’s and A-Level’s which would give me the best chance of getting into medical school - I had something to work towards and I thrived on it. Exams came and went and things were good. I went to uni, the years progressed and now here I am.

I don’t know where the enthusism went, the drive to succeed just isn’t there anymore. Its gradually faded away and now instead of having a goal and a reason I’m just plodding along on a predefinded path. I need to find my motivation again, rediscover the reason I’m doing it. So I’m taking a year out of medicine from January. I’m intercalating - doing an extra year in a field related to but not wholly medicine - its in a topic which really interests me, a topic which I can read about and feel inspired and enthusiastic to learn. I’m hoping its whats going to push me back into medicine again and give me that reason to continue.

Only time will tell if it helps but I really hope it does. I’m proud of what I’ve achieved so far in life and I really hope I can be proud of whats to come.

All the best for the 2008.

SD

We’ve come so far, we’ve reached so high
And we’ve looked each day and night in the eye
And we’re still so young, and we hope for more
But remember this
We’re not invincible

Duvet day

Today was very uneventful. I essentially just had a duvet day but without the actual duvet. I slobbed around, sorted a few things and explored some xmas presents a little bit. Holidays are great - I love not having to set an alarm or get up for anything. The only problem is that I tend to turn noctural - hence me writing this at 2am!

Is it strange that I prefer to be awake when everyone else is asleep? The problem with being awake at this time is that it gives your brain time to ponder over things which at the current state of play probably isn’t the best idea in the world.

I don’t really have much planned for the rest of the holidays, I’ll probably go back to uni sometime just after the new year - 2 weeks back here is enough for anyone! I might even attempt to pick up some shifts at work if I can muster the energy. I need to send some emails and sort some things out for next year - but I’m putting that off for now.

Anyway, I guess I should at least attempt to get some sleep before sunrise.

Take care

SD

A new beginning

I have no valid reason for why I have not updated this for 7 months other than the fact that I lost interest and gave up.

I have decided that I am going to become a regular blogger and use this for what I intended it - to reflect on what I do and hopefully learn a few things about myself over time. How long this will last and how successful it will be I have no idea but I am determined to try.

Much has happened over the last few months, some important decisions have been made and I’m still not sure I made the right choices. I had a few weeks off in August which gave me time to think about uni and various other things, for a while I’ve not felt that I’m on the right track, I don’t know if I’m doing the right thing and whether I really want to continue. I came very close to quitting medicine and almost walked away. I didn’t go, I’m still here plodding away but it’s more out of fear than because I actually feel any different about my future.

How can I just quit? I’ve been here for over 3 years, I’ve put so much into this, finantially and emotionally, how can I just want to walk away? I don’t know why I feel like I do, I can’t really explain it or pin it down to any time or event it just seems to have crept up on me over a period of time.

How do you tell people that that is it? Friends, family, coursemates? How can I look my friends in the eye who have tried so hard for a place on a medical course and not got in? How can I justify it? What would I do if I left, where would I go, what would I do, what would people think?

Everyone around me seems so enthusiastic, so sure that they know what they want to do and are dead set on getting on there and I don’t really care anymore, theres no motivation to get out of bed in a morning, no desire to do any work, nothing drawing me to read or learn.

I just am, I exist, I function. I don’t live, I don’t thrive, I have no will to succeed. I don’t deserve to be here.

So far I’m still on the course, I’ve just passed the latest set of exams - thanks to last minute revision with a friend.

No one truely knows how I feel and I don’t really know who/how to tell anyone, and I’m not really sure I want to. So I’ll just keep going, head down and trudge on doing the bare minimum and see where I end up.

Your guess is as good as mine as to whether I’ll still be here in 3 or 6 months time, I guess only time will tell.

Stay safe.

SD

Clinic, clinic and more clinic

Today was quite a busy day but I didn’t actually get to do that much. I was in ante-natal clinic this morning which was quite good - spoke to a few expectant mothers and saw lots of US scans. Also got to feel my first pregnant tummy, very exciting! Before this placement, my only understanding of obstetrics was the so called ‘maternataxis’ so commonly written about by the likes of Tom Reynolds. However, today I saw a lady who was completely the opposite to this, this lady had been having labour pains since the previous evening, brought herself into clinic, was examined and told she was 4/5cms dilated and was admitted to the labour ward - she even refused a porter to take her upstairs and insisted on walking!

This afternoon was spent in a gynaecology clinic which I did not really enjoy that much. Its not the most thrilling of clinics as its mainly all menorrhagia and associated symptoms. The most interesting part of this afternoon was after I took a history from one patient and the consultant ended up having to refer her to the rheumatology department as she didn’t really have any gynae problems, but did have something that needed investigating.

You know that feeling you get where you need to cough and you know its not just going to be one but you are going to have a full blown coughing fit? Now imagine having that feeling whilst being sat in a room with a patient, consultant and nurse whilst they are discussing some intimate medical problem. I tried, but I just couldn’t stiffle the coughing anymore - I had to leave and have my coughing fit. The nurses outside were very nice though and got me a glass of water and ensured I wasn’t dieing/choking, which was nice.

Tomorrow is a lazy day, I’m not in hospital so I’m going to have a lay in and then catch up on some book work before next week.

Stay safe.

SD

Breast Clinic

Breast clinic this afternoon was quite interesting, I saw lots of ladies getting good news that the lumps they had been worrying about were nothing more than excess growth of breast tissue, cysts or benign growths. The look of relief on their faces as they received this news was obvious, I can’t even begin to imagine what it must be like, most of these ladies had been referred from their GP so had been waiting at least 2 weeks for their clinic appointment. It must be hell knowing there might be something seriously wrong but being able to do absolutely nothing about it.

I can see why working in oncology must be a very rewarding career when things work out well, I just don’t know whether I would be able to face telling these young women that they had breast cancer. I know there are now lots of things that can be done and many different treatments avaliable but it is still a huge life changing diagnosis. That said, there aren’t many areas of medicine that are easy!

Tomorrow is ante-natal clinic in the morning and gynae outpatients in the afternoon, both with my consultant. So hopefully I should get quite a lot of teaching and practise at examining pregnant ladies tummies (and gynae things). Looking forward to it, clinics are a lot better than wandering around on a ward looking like a lost sheep!

SD

Babies!

Today was the first day of a new module block and I’m loving it already! I didn’t think obs and gynae would be that great but I think I was wrong.

I spent this morning in GUM (genito-urinary medicine) clinic and it was amazing, the staff were really friendly and I was adopted by one of the SHO’s. I observed him take two histories and do speculum exams/take samples on those patients and then it was my turn. The next patient was mine! I took a history, wrote it in the notes, explained what was going to happen next, and then I did the speculum exam and took the samples. All this and it was only my first morning! Then I took the histories for the rest of the patients in that mornings clinic.

Since I started clinical placements in June last year, this was the first time I’ve actually felt like a useful member of the team. For the rest of the time I’ve just felt like I’m getting in the way and not actually serving any useful purpose but this was different and I love it!

Met up with some other students in the canteen at lunch - discussed how our respective placements are going, no one seems to be having many problems, except one who’s consultant is on holiday. I haven’t met my consultant yet but that will happen tomorrow morning in theatre.

This afternoon was spent in the early pregnancy assessment unit (EPAU), watching lot of ultrasound scans, it was very interesting and I saw lots of little pictures of babies. So cute. The best part of the afternoon was when one lady came in with her 5 week old nephew and I got to look after him whilst she had her scan - he was so tiny and so cute!

Early start in the morning for theatre followed by breast clinic - should be interesting but I bet I’ll be exhausted by the end of the day!

SD

What have you done today to make you feel proud?

On Saturday I helped to save a life.

We were sat in the first aid room when the call came in, “male, cardiac arrest”. Hearing that was enough to make me forget the hangover that I was trying to hide from the boss. I rushed to the scene with a paramedic and technician hoping that the info we had got had been over cautious. It wasnt, just by taking one look at this gentleman I could tell that we had a full blown cardiac arrest on our hands.

We attached the defib pads, he was in VF. Shocked. Remarkably the paramedic found a pulse, the defib showed sinus tachycardia, he had a chance! We planned how we were going to get him out and down to the ambulance that was on the way, I moved the crowd out the way so we had a clear exit route, I also got some details of the patient from one of the crowd, name, address etc. As we prepared to move him someone yelled “the rhythm’s changed”, we all turned to the defib screen the paramedic shouts to me “whats the rhythm?”, “VF” I reply and we prepare to shock him again, again he reverts back to sinus - this guy’s not giving up easy.

We got him back to the first aid room and waited for the crew, by this point he was breathing for himself with a good output. Fantastic! The crew arrive to take him off to hospital, he’s got the best possible chance for an out of hospital cardiac arrest, he recieved defibrillation within one minute of collapsing. The crew came back to the event to see us after they delivered him to hospital - they brought with them good news - by the time they left the A&E department, our patient was sat up asking the nursing staff what the football score was!

This is the second cardiac arrest I’ve been to and the first time I’ve seen someone receive a shock from a defibrillator. It looks brutal, to be jumping up and down on someones chest only stopping to force air into their lungs and hundreds of joules of electricity through their body but it really did make a difference today, hopefully our patient will survive this event and go on to have many more happy years, more time with his family, more time to enjoy life - it makes me proud to think that I helped to save his life and that I’m going into a profession where I will make a difference for the rest of my career.

What have you done today to make you feel proud?

SD

Another whoops

Again, I’ve been really bad at keeping this blog updated! Its not that I have had nothing to write, much the opposite infact. Lots of happened since I last posted - including an entire module of my course! Psychiatry has come and gone, much of it was enjoyed, some of it was not. I’ve been on weekends away, conferences and done much work in the past month, and coming up I’ve got trips away, a weekend out in London and a training course that I’ve been waiting for for a long time.

I will endevour to keep this blog updated from now on and yes I know I said that before, but doesnt time fly when you’re having fun.

Carpe Diem

SD 

Oops

Well I haven’t done very well at keeping this blog updated have I?

So what have I been up to over the past week or so since I updated you? Well, my 2 week essay SSC is over - but I haven’t actually written the essay yet, but don’t worry, it doesn’t have to be submitted until 13th April!

I started my current module 2 days ago - I’m doing neurology for 2 weeks. Its really interesting but quite complex. I’m struggling to get my head around all the different aspects, signs, symptoms, differentials etc etc. But hopefully I’ll start to pick it up before these 2 weeks are up!

On Monday we had an intro session and were split into our firms we also had teaching on parkinsonism and epilepsy/blackouts - in which the consultant did a very good impression of a tonic-clonic seizure! We saw a patient on the ward with parkinsons and watched the consultant do a very brief assessment. In the afternoon we attempted to take a history from a lady on our ward, however, after we had got a far as presenting complaint the consultant came round on the ward-round and talked to the patient about her diagnosis and what it was going to mean to her future. After he had spoke to her she got quite upset so we left her to have a cry with one of the nurses and decided that it wasn’t fair for us to make her talk about it all again so we called it a day.

Yesterday we had a pretty pointless teaching session in the morning by one of the consultants, he made us sit on the floor of the treatment room for 2 hours as all the other rooms were in use, and he managed to insult us all a few times - the most memorable being when he was slagging off new style medical courses including PBL and came to the conclusion that we were all glorified nurses. Me and another student attempted to find the on-call SHO so we could shadow them and see some acute neurology but we had no luck with that - no-one on the ward could tell us which team was on-call and the number switchboard had was actually the bleep for the on-call infectious diseases SpR! We did manage to find the on-call SpR at around 3 and we got to take a history and examine a patient with benign intercranial hypertension, then we observed her lumbar puncture, so after all the hassle it was actually quite a good experience. Unfortunately that can’t be signed off as our on-call period so I’m going to have to sort that out another time.

This morning I went to the MS clinic, it was very interesting and I got to see lots of patients including 2 new patients. I also got the chance to do lots of neuro examination which was useful as the consultant gave us feedback as to technique etc. I enjoyed the clinic even if it did run over and I hadn’t had time for breakfast so my stomach was audibly rumbling! This afternoon was made up of neuro exam teaching which was ok, and then we should have had imaging teaching but the consultant didn’t show so we called it a day.

Best news is that I have tomorrow morning off! Lay in plus time to write up some patient histories and try and get my head around some of the neurology I have seen over the past 3 days. Fun times ahead!

Laters

SD

It makes you think

One thing I love about my course and job is that I get the chance to talk to so many different people who have all had a much different experience of the world than I have or will. Some of their stories are incredible, whether its things they’ve done or been involved with or whether its the things they are currently having to live with, I find myself respecting them all.

I love learning from each of them, I love finding out about their conditions and how it has affected their life. Its so much easier to learn the symptoms and specific histories of different pathologies direct from the patient. And when its just one-on-one in the back of an ambulance, with no nurses and other ward staff floating about its much easier to talk.

One of the patients I transfered yesterday made me think, I guess I felt sorry for him really, and I realised just how lucky I am. He was a 29 year bloke that had been involved in a car accident, he’d had a spinal injury and is now paralysed from the waist down. He’d been in hospital since the accident and was now ready to be discharged, but he would need some help at home. However, he had no family other than his parents, and they were unable to care for him due to their own health problems. So this guy was being transfered to a residential home. His whole life has been changed due to one accident, and he’ll never be the same again.

When I’m 29, I’m expecting to be a Doctor, with a settled job and slowly working my way up the ranks. I don’t know what I’d do if something like that happened to me, I don’t know how I would cope. I guess you just never expect it to happen to you. But the scary thing is that it could very easily happen to each and every one of us. One split second and your life changes forever.

I think I’ll remember that transfer for a while.

SD