Posts filed under ‘med school




“Red!”

Today I witnessed a registrar tear strips off a colleague of mine. Scratching the surface, he wanted to do some surgery which was done by another, and was pissed about it. Colleague was in the wrong place at the wrong time. I often feel like medical students are easy targets. It’s not like we’re in the same place for very long, so it doesn’t matter if we complain and placements are short enough to think it’s fine to just grin and bear it. We all have bad days now and then, but it’s hard to be at the brunt of someone else’s mood when you already feel like you’re in the way and would like to feel a little more useful.

I wish I had been braver and said something. I’m not sure what or what the hell it would have achieved, but I hold my own more at the gym. Perhaps that’s because I feel like the gym is my territory and I have a lot of confidence about it. I still feel like an outsider in medicine. Not so much in obstetrics, but certainly general medicine and surgery.

There’s no safety word in the hospital. I wish there was.

Add comment March 11, 2009

Poly-gone

Monday sexual health seminars have been interesting to say the least, but not really enjoyable on my part:

Another medic [in the context of finding out if patients are having sex in parts of the world where HIV is highly prevalent]: “So are we meant to ask if couples go on Safari and swing with the African tour guides? Har har!” God, you’re so funny and profoundly insightful, let me go and rip my sides off, they’re splitting already.

Towards the end of the session, the tutors had a list of ‘alternative lifestyles’ listed up on the board as an example of how we as doctors should be aware of and non-judgemental about. I was surprised to see Polygamy on the list, which the registrar addressed: “And some people choose to have more than one relationship, sexual or otherwise at a time.” I wanted to ask whether they meant polyamory rather than polygamy, as the latter is more familiar and controversial among people and tends to be associated with marriage than relationships as a whole.

Instead, I kept schtum. Mainly apathy and tiredness. And partly because I don’t want certain assumptions made about me by the likes of Safari Boy. Then again it might make classes more interesting if he did.

2 comments February 19, 2009

C U Next… Wednesday?

Before I started Obs & Gynae I was expecting to be thrown out of the consultation room a lot, or be told in the labour ward that the patient doesn’t want any students. Luckily this didn’t happen and the vast majority of women I saw were happy to have a student present. Come sprog time, I’d definitely consider having a student midwife or doctor present; I’m the type of person that does better with continuity (and lots of attention), and in the last delivery I followed, I was there from the beginning to the end: in that time, there were four midwives handing over.

It was also nice to feel useful for once (Protestant ethic, much?) whether it was helping out the anaesthetist (who very kindly did some one-on-one teaching with me), fetching towels, changing linen, doing basic observations, fanning down the mother (and father) during transition, dressing the baby, getting it latched on and making cups of tea. Some of my collegues were really offended by stuff like this – they wanted to see the labour and deliveries and how dare anyone ask a medical student to make a cup of tea – which I guess is fair enough if this isn’t the speciality you want, and you just want to get to grips with the basics. I like to feel useful, simple. My grandmother constantly told me as a child in Italian, “Do your schoolwork, do your homework, then come and help with the housework.” Maybe it’s less of the Protestant ethic and more of the Italian Catholic grandma factor.

Anyway, the reason I really wanted to post was that seeing a lot of women in that context made me realise that it was about time I stop using every excuse in the book in terms of keeping everything tidy in the vicinity. Before I met B, I used to live about 7 minutes away from Selfridges, and behind the store was a rather awesome beauty salon which did really good waxing. I’d see Otylia, a Polish lady in her 50s who could get me done in about 10 minutes while discussing matters concerning her boyfriend. After meeting B and moving to Sarf London rather quickly, out of sight and out of mind, I forgot about it. It came to August and I decided to venture into Clapham to find somewhere cheaper for the Hollywood treatment.

I found a salon and waited in the rather odd paper pants they had given me. To my naive horror, I then realised that the wax was going to be done with strips and not the hot wax I had been used to. Needless to say that pain was excruciating and the hair wasn’t coming away well enough, cue more wax and more stripping. The woman who was waxing me told me halfway through that she was very inexperienced with Brazilian waxing and that they offered the waxes as they knew they were very popular among women. Probably not the kind of thing you should tell a client. The wax itself took about 40 minutes, half of the hair was still there (putting my narcissistic hat on, after waxing I would always touch myself more, not even for masturbation, it just felt ever so nice.) by which time I resolved not to look at the damage for at least a fortnight. Suffice to say, it was enough to put me off having it done for a good [whisper] 2 years [/whisper]

Recently, I decided to have a little image makeover, starting with my cunt (not the kind of feature you’d see on Phil and Fern). A very lucky find bought me to Holborn where a very cheerful Essex girl defuzzed me in 10 minutes with minimal fuss and pain. I spent the rest of the evening at home with my hands down my pants. In addition to this,  I have been thinking about getting a vertical hood piercing, although I’m still umming and ahhing over it. It’s an area I consider to be pretty and pink – do I want a piece of metal going through there?

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After a very painful recovery from last week’s gym session, I had mustered up the courage to go back to start with Turbulence Training for abs. Cept I had forgotten that my gym was closed this week to install new cardio equipment. Which is fair I guess, they had put in new weight equipment last year. Somehow I can’t see kettlebells on the agenda anytime soon. Think I may as well bite the bullet at and get some of my own.

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Baking my own bread is proving dangerous. I’m making a wholemeal loaf later on, and made a lovely onion and pancetta focaccia on Tuesday. It had disappeared by Wednesday, and I can’t blame B or the flatmate for that.

Add comment February 19, 2009

Nights

I haven’t slept since Wednesday night and I’m kinda enjoying the buzz that’s coming with it. Although the feeling I’m getting could have been due to being utterly floored by witnessing a shoulder dystocia during one of the births I saw in the early hours this morning. The registrar looked so cool and composed, even with the sound of, “Doctor, it has been 2 minutes now.” I on the other hand, felt like a complete tool, the midwives were talking to me but they could have been speaking the language of planet Zog, it wouldn’t have made a difference.

Despite the shock of that, mother & baby (and father) were ok. I think I needed a stiff drink.

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Blood oranges are in season again, yay! Flatmate has recommended a blood orange jelly with orange pieces and a dollop of lemon curd on top.

Add comment February 6, 2009

Every night I toss and I turn and I dream of what I need

It was a pretty and clear day in a drab London teaching hospital, and I was sat in the office of a very nice consultant. He was about to give me some of the best advice to take me through medical school: find a role model in medicine, someone you can look back on in your training process with admiration and use them as a guide.

 Looking back on the years I have been tallying up, I still think fondly of this doctor who gave such good advice. There’s often such a lack of continuity in training – from the quality of teaching (if we get any) to memorising the route from theatre to the changing rooms. Most often, it’s something to deal with, but sometimes it can get you down, especially if the staff members you’re dealing with are not always as professional as they should be.

I keep short vignettes of former lovers so that when I’m old and senile, I can look back fondly on my youth and remember intricate little details that I had forgotten. That is, if I can remember the password that I used to protect those documents. I’ve started to do the same with great doctors (and other health professionals) I’ve encountered as a ‘constant,’ (see Lost season 4) to remind me when times are though that there are decent normal people out there.

I’ll start with Dr H who gave me this initial advice.

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It was my second module and I was really struggling with clinical medicine. At my lowest point, I spent an hour in the evening, crying in the ladies loos. The weather was dark, depressing and cold. I was coming home to a mouldy house which was falling apart, and our landlord had just informed us that he was selling up. The same week, B and I were driving home and we saw a woman being mugged on our street. Company loves misery.  

I had to get a form signed off by Dr H, so I rang his office. He was about to do some teaching on x-rays and invited me up for the session. I had been having a lot of confidence issues, but had really made an effort for the last 3 weeks of MAU hoping that the team would notice. After the session he signed my form off and we had a chat. He told me that from what his staff had told him, they had absolutely no worries about my competence or clinical performance. He told me that if I ever wanted to spend more time in the department, he would happily have me back, and all I had to do was email him – this included if I was in my final year. I spent the afternoon dancing on endorphins.

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It wasn’t necessarily what he said (although I still think it was important) but it was the first time in clinics where I had really felt a bit of human kindness from a superior. When you’re feeling low anyway, the other insignificant snippy stuff gets to you, and up until then I had still felt the sting of the previous module: the eye-rolling registrar who expected me to know as much as he did, getting very little teaching, having a locum hang up on me twice, and no meetings with my mentor as he outrightly said in front of the team he didn’t give a shit about that and the professor I had to meet with several times throughout the year to get a form signed – our first meeting and I was tallying up times he was looking at my breasts. Don’t think we don’t notice.

Having someone to look up to and think back on fondly makes the insignificant stuff so wonderfully insignificant. Of course, medics will all have views on what makes a good role model. One of my pre-requisites is, “Seems relatively normal, wouldn’t expect them to tell me they were a doctor if we met in public.” Maybe that’s a little unfair, dog knows what people think of me!

Add comment February 1, 2009

Salsif-eye or salsif-eee?

Reasons to smile:

Big snowflakes at the farmer’s market this morning. Leaving and seeing a random guy out in his boxer shorts giving the weather a raised eyebrow.

The mysterious appearance of a large toy alien in the entrance lobby of our building.

Smugly making our own coffee than popping out to get some.

The feeling of cutting a garlic bulb in half and sticking the whole lot in the oven.

Picking out the perfect bottle of Riesling. (German, I have a sweet tooth when it comes to wine)

Landlord agreeing to rent reduction!

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Salsify is a pain in the arse to wash, peel and prepare. It’s also very sticky, but no one tells you that (rather like the Things That No One Tells You About Childbirth). Luckily it’s a joy to cook and devour. Pan-roasted in olive oil = win.

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Since being in Obs & Gobs, a lot of people have asked me about the numbers of men in the field, and what could possibly attract them to it, revealing the horror that they could possibly be turned on by it? Answer – I’m a bisexual woman – there is nothing to be turned on by in gynaecology. Staring inside someone’s vagina trying to visualise their cervix is as mundane as filling in prescription forms by hand – maybe mundane is the wrong word. It could just be me, but I have a hard time getting aroused by simply staring at someone’s genitalia in the cold harsh light of day.

I remember the sweet irony of reading on a feminist site (from a feminist) that a lot of men are attracted to ob/gyn – not because of teh patriarchy – but because it’s ‘easy’. Here’s a cluepon – think about all of general medicine as applied to women, the diseases, the meds, and throw a pregnancy into the mix. Bet cardiology isn’t looking too bad now, eh?

Add comment February 1, 2009

“Freedom is deciding whose slave you want to be”

I am still having issues with the fact that I qualify as a doctor next year. For so long the prospect of qualification was a blip on the horizon and life as a student drowned away any potential musings on the subject. Except now, it’s real and I’m constantly thinking about deaneries, paying off debt and if it’s what I really want to do.

I have danced with the idea of going to law school, essentially a year of rote learning – could I even deal with that after medical finals? I have thought about doing courses in journalism, or teaching scuba diving somewhere in the pretty pacific. All these ideas have given me some degree of comfort about the uncertainty of what I want to do. Except something happened. Obs/gynae happened, and as I predicted; I am absolutely loving it. This is despite the looks of horror I am getting from staff members as if I’m suggesting I like to self-flagellate before breakfast each morning. If I had hated obs & gynae, it would have secured my decision to eventually leave medicine, but on the contrary, it has made me think – horror of horrors – that I would enjoy being a doctor, and a hospital doctor at that.

I had assumed that once I got to the stage of qualifying, I would feel less constricted by my career choice, but as it seems now, the handcuffs are getting tighter. B often tells me to close my eyes and think of what I’d enjoy doing the most, but my subconscious distracts me with food and fond memories of previous sexual encounters.

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To curb my anxieties, I have been collecting discounted cookbooks from a bookshop in Lambeth North. As the flatmate says, “You can never have too many cookbooks.” I am determined to eat more seasonal fruit and veg and I am trying to make the most of the autumn/winter harvest. The tiny greengrocers on the high road is in abundance of Jerusalem artichokes, blood oranges and salsify. I made a rather delicious soup with some Jerusalem artichokes and white truffle oil, which I sat down and consumed while watching some dismal cooking on Masterchef ensue.

Hat tip to a certain cheese sandwich; B got me the Decadent Cookbook for our anniversary. As well as recipes there are some very interesting stories and information on cooking techniques e.g. how to prepare a dog for slaughter – not sure how the RSPCA would feel about that one. (For the interested, a dog should be tied up for 24 hours, and beaten with small sticks to get the adipose tissue moving.)

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Another hat-tip, but I am immensely enjoying “Family,” a web series sit-com about a MFM triad based in Seattle. The clips are short and I’m finding them highly entertaining.

1 comment January 28, 2009

OSCEs for the uninitated

OSCEs stand for Objective Structured Clinical Examinations and they usually start to happen when a med student hits clinical medicine. It involves a series of 5 minute stations and you get to do things like take a history, something practical or cry while an examiner marks you. When it’s the first evar OSCE, it’s daunting and terrifying, especially as you can be ‘pink slipped’ for a number of things i.e. hurting a patient, wearing inappropriate dress etc. Out of everything, I was more anxious about getting all flustered or going into a panic, so my get out clause was just to say calmly to the examiner, “I need to take a minute.” I did this several times.

Rather like a wedding day, you have to assume that somewhere down the line there will be a cock-up. Here were mine:

Station 6, fluid balance (permanently etched into my subconscious). I do the usual, inspect the patient, look for any obvious signs of dehydration or fluid overload. Then came the blood pressure check. I have checked blood pressure more times than I can count. Only on the day of my OSCE, the universe decided this was the time I was to be tested. The cuff wouldn’t inflate. In my nervousness I started to fiddle with the metal adjuster hoping that I hadn’t tightened it enough, then the examiner (who I’d like to add, was completely deadpan and unfriendly, unlike hip examination man) said, “You’ve got it on the wrong way round,” with no attempt to mask the contempt she had in her voice. 2 minutes to go, and I turn the cuff around, thinking internally, “Fuckity fuckity fuck,” then started fiddling with the adjuster again. And with stunning, effortless timing, almost in slow motion, the little metal screw flew off the monitor and landed on the floor, as if it’s entire lifetime ambition had been to live for that moment. I accept that I may have failed that station.

My medical school told us there was *always* an opthalmology station, and that we would have to examine the eyes of a plastic dummy. I walked in and read the instructions: “Please examine this patient’s ear.” Thanks a lot!

Airway management: it takes me about a minute to realise a patient was in cardiac arrest. I say rather too loudly, “Oh… riiiiight!”

Hip examination: the patient looked exactly like one would if they had been doing the same thing at least 50 times previously that day. My examiner was a dream, Eastern European good looks and eyes which seemed to twinkle everytime I answered a question correctly. I’m sure I giggled like a schoolgirl every time this happened.

Ethics and Law: Rather than stipulate what the law was, I just told a patient what they wanted to hear. Oops.

Taking a patient’s basic obs and recording them. Most bizarre station ever in terms of the dynamic of the examiner and patient.

Examiner: Right, that’s the O level stuff over with, now lets do some medicine, it’ll be like cricket!
Me: I don’t really watch cricket *WHY DID I SAY THAT?!*
Patient: I like football
Me: The patient’s respiratory rate is 14 breaths per minute
Patient: Ok, you need to write it down here *points to part on paper*
Examiner: Excellent! Ok, now take the patient’s temperature.
Me: *reading instructions*
Examiner: Now tell me what you are doing
Me: Erm… I’m going to take the patient’s temperature

Examiner: Excellent! One mark!
Patient: *takes thermometer out of my hand and puts it in her mouth*
Examiner: If she was pyrexic what could you do?
Me: I could give her paracetamol, fluids and…
Examiner: … yes? And?
Me: erm
Patient and examiner (looking at me wide eyed): turn around!
Me: *thinking what the hell upon seeing a fan* erm, there’s a fan there?
Examiner: Yes! Well done!

That night I fell asleep before B did. He said I was out like a light as soon as my head hit the pillow. I got 10% over the pass mark which I was pleased about, I’m just about getting to grips with the fact I will be doing this again in just over 10 weeks…

1 comment September 24, 2008

On the couch

I’m a few weeks into my psychiatry placement and it has proved far more revealing than anticipated. I always knew that dealing with mental health issues would always bring back some memories of my own flirtation with depression (one less subject to revise, hurray!) but I feel like I’m on the cusp of stepping over the boundaries of professionalism.

I have always been able to do empathy, while keeping any sympathies to myself. However, on occassions in talking to depressed patients and hearing their own experiences and how closely they mirrored my own, I’ve noticed my eyes start to well up, and I find myself pulling out all the stops to avoid making it known that I might be starting to blub. Luckily I’m a medical student and for the most part I’m invisible so no one notices.

We had a patient come in to discuss his experiences of bipolar affective disorder and he described his depression as ‘the world being grey’. This was very close to my own perception at the time, although I’d say it was more like the world being misty, and that daily life was a compromise between accepting the wade through the mist, and the fight to get out of bed every morning when I felt there was a heavy weight bearing down on my chest.

I generally have no problems with the way my treatment was handled: meds (citalopram + propranolol) and CBT. My first few days of citalopram were interesting. A small wave of nausea passed over me, then 20 minutes of absolute euphoria – a couple of times I turned the radio on loudly and danced. My dreams were hugely vivid and I would sleep like I was experiencing sleep for the first time in my life. After a few weeks, getting out of bed no longer became an issue, I don’t think I even noticed it happening.

I do wish I had started exercising sooner. When I first presented to my GP, the depression was not mild enough to be treated with exercise, but I think I would have benefited greatly further down the line, especially when I was on the line between being well and relapsing (I had one relapse where my meds were increased – 2 weeks after that, I saw a different GP by chance who was very keen on knowing when I was going to stop and she thrust some leaflets in my direction. I take it she hadn’t paid close attention to my notes, I’d be more worried if she had). These days exercise works wonders on my mood, and the day I stop getting pleasure from it, something would be wrong.

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Yesterday at the gym I saw a man spray his bench with Dettol wipe it down. I was shocked.

All the new freshers have started to have a look around. I don’t think the girls would take kindly to a sweaty yours truly dragging them to the freeweights room and evangelising on the benefits of resistance training.

Gubernatrix is back! *does dance*

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Now that I’m in year 4, the NHS has started to throw large sums of money at me. I don’t have to pay them back either. This could prove rather dangerous, especially as I have taken the attitude that I should be rewarding myself with pleasure at least once a week (masturbation not included). For me, pleasure involves spending money, or gardening. I should probably buy an allotment.

Add comment September 24, 2008

Mini-musings

The frantic sensory overload of flicking through Gourmet Nutrition caused me to lose my appetite.

My appraisal went well. The consultant recommended I don’t spend too much time in theatre as, “When you’ve held one retractor, you’ve held them all.”

Apparently the rising number of female doctors is ‘bad for medicine.’ Oh noes!

Add comment April 4, 2008

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