AC1 – Week 9

Monday

In for clinic today. I was happy because I thought I could get the slightly later bus this week but it would give me 10 minutes to spare and with the traffic around Coventry, I did not trust this leeway of time. This is why I found myself standing at the bus stop at 6:50am on a Monday morning. I eventually got to UH and had half an hour to read a book. I’ve been trying to read a bit more lately as I know I have been stuck in a rut so I am trying everything I used to enjoy when I was 15 to work myself out of it. I was reading I am I am I am by Maggie O’Farrell. I was introduced to it by one of my year in SSC1 and I love it. It’s about the near death experiences of Maggie and I am only into the second chapter but I am already on the edge of my theoretical seat. I have also re-uptaken crocheting. Results pending.

I was placed into the Fracture repair clinic and kinda hit the med student jackpot. Despite waiting 40 minutes for doctors to show up, I glued myself to a Reg who happened to be on the trauma bleep meaning he was doing the clinic but would be pulled across the A&E if needed. I joined him as he popped down for 5 minutes. He showed me the scans of the patients hip who he was on the trauma call to. He was a male in his 40-50’s (I do know the age but patient confidentiality means I have to be really careful with my blog). He had sustained a fracture to his proximal (close to the middle of the body) femur. This is extremely hard to do as a middle-aged person as our bones are strong and need high energy impacts to break them, especially the femur however, the nature of the accident made it obvious as to how it was broken.

The patient themselves was conscious when we went to see him in A&E and was orientated which was a good sign of no head injuries. I got to see how patients such as his were managed in the A&E multidisciplinary setting and see how the impact of a hip fracture affects the placement of the foot. It was interesting as the people who normally sustain hip fractures (older women) actually have a better healing rate than their younger counterparts, so in this case, being old is an advantage !

I got to spend the rest of the morning in the clinic meeting patients who had fractured virtually every part of their lower limb. I think the best parts was listening as to how they sustained their injuries. One is so rare that if I described it on here, you would be able to identify them with a Google search so I am sorry, you’ll have to just guess ! I finished clinic early as the Reg had little left to do but he said to come and see him if I want to go into surgery, as if I am going to turn that opportunity down ! We were also chatting about London as a training location. He was a London medical student and found that PG training was better outside the capital as people were not so competitive and cut-throat. This was interesting as I had planned to do my ST training within the London deaneries as they were close to home and I do want to work in the capital one day but this has given me some slight food for thought.

In the afternoon I had cannula training. Cannulas are the small ports to the venous system most hospitalized patients will have inserted. In fact, I had my own a year ago!

It is slightly more tricky than taking blood as the catheter is a two part device but I think I am nearly there. It’s a tad frustrating as the plastic arms are significantly harder than their real human counterparts but I really did enjoy it. I also got talking to Jess in my year about Atypical (Netflix). Turns out we are two of the same human as we had so much in common even down to our love of musicals. Apparently, radio 2 have a musical hour on Saturdays which I now need to include in my life. We are in the same CBL so the med school did well bringing us together there !

In the evening we had our first BIG revue rehearsal of Act 1. Unfortunately, I can’t say any more as I have occurred multiple (alcoholic) fines for accidentally revealing information as I learned the other night so I am super aware of what I am saying right now. We finished at 10 and I was super happy to collapse into my own bed and sleep.

Tuesday

Finally got to the doctors. It’s very weird following the history taking process in your head and I couldn’t help but smirk when she mentioned Ideas, Concerns and Expectations. Essentially mine were:

Ideas: It really really hurts

Concerns: It really really hurts and I can’t stand in front of patients clutching my stomach as if it was going to fall out.

Expectations: Youre going to give me an abdominal exam and push down onto my already sore abdomen.

I’ve been given a blood test for the norms plus thyroid function and a coeliac screen?! I really hope I am not, I love bread, pasta and pizza too much. Matt and I had a joke about later in the day that he should take my blood for me, I’m sure it’s because he is concerned about his friend and not because he wants to finally stick needles in others.

We then had CBL, our final two parter sessions before SSC1. We had a talk from Prof. Patel about themes in Middlemarch and we ended up getting into debates about surgery, training in London and racism in the NHS. Prof said he was once told not to apply for a job because he was Asian and this is as late as the 80’s. We also had the debate about if it’s right for surgeons to be paid the same as their medical counterparts and why people still choose surgery despite the gruelling hours for no extra pay. I became very passionate (no surprise) and said people apply for the passion and the love of that speciality. For me, the 12 year Neurosurgical training programme doesn’t mean a thing to me, I’ll do it because it’s what I want to do. Sure, my friends will become consultants before me, and I’ll be sleep deprived forever, but once I am in surgery, clearing that subdural or even inserting a shut or just cleaning the area because I’ve fought to get in the theatre for months and this is the only thing I can do, I’ll be satisfied because that is what I want to do.

We then had Revue part 2 in the evening and that is all you shall know 🙂

Wednesday

We had a 9:00 start today looking at the mechanisms of cancer and how we diagnose and target treatment based on diagnosis. It was interesting and finally getting to learn about this disease that 1/2 of us will get in our lives is satisfying. We had the return of a WMS favourite – Dr Hopcroft. Now Dr Roebuck has gone, we are all in debate about who is the “new” Dr Roebuck who was a favourite here and Dr Hopcroft is a leader in that race. He went over the molecular biology of cancer which I did a lot of in my Neuroscience degree so it was nice to be on familiar ground. I thought it was lunch after but we were treated to a second old lecture in the form of Prof Tunstall who EVERYONE knows at the med school. It was nice to have these familiar faces in what is a very uncertian time with transition weeks.

We then had group work about the cancer biology we had just learned. Except I believe there was an alternative motive to this to see if we could find obscure rooms behind locked doors we can’t access. I’m not even kidding here, we needed to recruit PhD students and undergrads who had access to both the building itself and the numerous doors inside. I suppose it’s good training for F1?

We then had our CBL session which reflects the CBL we are now going to experience every week. Gone are the two sessions a week, and here we have one mega session once every two weeks. I actually really enjoyed it and I was the scribe for this session. I also got to use my new whiteboard pens I brought back in the summer so by the end, the board looked like a unicorn had thrown up all over it.

We then had a night off from Revue rehearsals where I thought I would get an early night but instead found myself watching Stand Up to Cancer documentaries, crying my eyes out on the sofa, swearing to be the best god dam doctor I can….. Did I mention I am shattered?

Thursday

Cheerful day today. Death and dying. We started with a 9:30 session introducing us to the world of palliative care and then had a group session discussing scenarios surrounding death and dying with our CBL groups. We had a situation about a doctor who got close to a patient (nothing sketchy) and when they died, they took it too hard. We agreed that we do need to maintain some sort of professional boundaries to our patients but we are all going to become too attached at some point and at that stage. It’s important to chat to colleagues for support and reach out for help. We are only human after all. We were also introduced to the blog of Dr Kate Granger who started the #hellomynameis movement that is so ingrained into our training.

https://drkategranger.wordpress.com/

It’s a beautiful blog reflecting on the importance of introducing ourselves to patients at all times from the prospective of a doctor on the other side of the bed rails.

We then had a final lecture before our final communication skills session. I walked in and my favourite clinical skills teacher/ CBL facilitator Jeremy was there teaching and I was rather excited. We had a chat about our summers and how this year is going. We were practising logical thinking about diagnosis. At one point I was acting the patient and we had been told to be difficult. Jeremy was leaning over my shoulder reading my patient sheet and pointed out the dry cough symptom. I said I knew it was there but I was following the instruction to be difficult to which Jeremy said ” aaah but that comes naturally to you though doesn’t it” and sauntered off to the next group. I cracked up in laughter as I did not expect the savageness to come out of Jeremy’s mouth, aah the banter we two have.

Then freeeeeedom ! We had our mega rehearsal for Revue today 5pm-1am. It’s ok though we have pizza to get us through !

Friday

Productive day today. I had a doctors appointment in the mental health clinic as I want to get out of this rut. The doc was lovely and we were discussing my treatment options. I’ve been on every SSRI so we are trying SNRI’s, maybe it’s that extra neurotransmitter I need in life. I had to pay £9 for the privilege of this which was annoying as money is tight anyway and £9 is £6 short of my weekly shopping budget for me.

I then had a driving lesson and I have to say I know fully know why people love driving on country lanes. It felt amazing and I even overtook a couple of lorries on the dual carriageway around Warwick. Maybe, I’ll be driving by January !

Finally, I had a meeting about my SSC2. It was with Lesley Roberts who is the pro-dean of education at Warwick. We had a really productive discussion about my SSC2 proposal and it resulted in that she was more than happy with it and she agreed to supervise me. She did come with a warning (given by herself) that she is very bossy and inside I was doing an air punch, the last thing I need is a ghost of a supervisor. I am really excited for my project, and there a potential for publication and for me to get several posters out of it too! Bring on third year ! (Please *higher power* let me pass my second year exams).

We then had our final rehersal for revue before the big show tomorrow. We normally do it in front of staff who kinda veto it to say it’s ok. The last thing we need is to end up like another medical school :

https://www.theguardian.com/uk-news/2017/jan/25/cardiff-medical-school-blacking-up-play-led-to-feeling-of-segregation

However, all our jokes are good natured and I really can’t wait to show it to everyone tomorrow. I collapsed in my bed at the end of the night shattered, but buzzing for the next day.

Saturday

TODAY IS THE DAY. It is finally here ! REVUUEEEE. I am so excited, actually performing is the first time we get to hear people laughing at the jokes being said so it makes our performing just that much more incredible. One of my lovely friends who I have been getting to know over Instagram and Facebook who is a nurse from Cov uni also came so I was really excited and humbled. I sent her a quick “whos who” of Warwick so she wouldn’t have so many jokes fly over her head. I arrived late because my block doors decided they were all going to run out of battery at 4pm so I ended up arriving an hour late. However, apparently I wasn’t that late as to miss the fines. My punishment for accidentally letting secrets slip was a dirty shot (some form of alcohol with teabags and party rings) and a pie to the face which I let Isobell administer:

I could still smell that cream at the end of revue.

We then kicked off with the performance. My first scene was a dance featuring michael jacksons “beat it”, Mumma Mia, Living La Vida Loca and Teenage Kicks. All lyrics twisted to medical themes. Instead of :

They told him don’t you ever come around here
Don’t want to see your face, you better disappear
The fire’s in their eyes and their words are really clear
So beat it, just beat it

We had:

My doc said I was drinking way too much beer, I always filled my plate, never had no fear. My sugars hit the skies and my pee is running clear, Diabetes, Diabetes.

So you kinda get the gist ! My next scene was me imitating my anatomy tutor where we were SPIKING an old lecturer (the breaking bad news proforma , not the nightclub toilet kind) and the love for our departed lecture was felt all throughout the room. Poor Ricky. However, it was the best part I have ever played and I had so much fun with it. We then went straight into the end of act song “Mr Brightside” which , you’ve guessed it, was medically themed.

Before I knew it, I was powering into the second act with my three scenes back to back. My first scene was the classic Warwick V Buckingham Medical School. It’s always a revue classic and I loved the scene this year. It was played as the first scene in sleeping beauty where maleficent rocks up out the blue to give her gift. I then had a quick change into a dance and then back into smart clothes for my last scene. I managed to speed up my quick change even more from yesterday so was stood in the middle of the stage waiting for the scene to start. I got a couple of (nice) heckles from the crowd which made me grin to my ears inside . Honestly, you could have told me I had to go into hospital from 6am to 6pm for transition week then and I still would have been smiling.

Our final song was a doctored version of “All Star” by Smash mouth in which we all collapsed onto the stage at the end. I was grateful for that collapse. That was it, all over. I’m sad because it is the highlight of my year but this year was brilliant and I shall wear my yellow top with pride. We then headed off into the night to celebrate what has been such an amazing year of revue again. What. A. Night.

AC1 Week 8

One of the things I wanted my blog to be is truthful. I may appear this happy, pocket rocket but it’s hard. Especially when your brain does not exactly work the default way. So , this week was hard. Really hard. Feel free to skip, but I want to show how Med School really is, and that is what I shall do 🙂

Monday

Only had one thing to do today ! My CLO in vascular access which I was really looking forward to. However, I managed to make it to the hospital a full 40 minutes early as I thought we started at 8:00 and not 8:30.

Early mornings can bring unexpected suprises

I eventually arrived and there was only one case for the morning so it would be a quickish morning. I quickly discovered though that this was going to be a complicated case so they had planned to be there for a while. I was to watch a PICC line being inserted for the use of chemotherapy treatment. It was an interesting part of the morning as I got to see ultrasound being used to establish what veins to use (veins collapse when you push the scanner into the skin whereas arteries retain their shape) and an ECG machine (to see if the line is in the correct place). I was really enjoying the procedure until about an hour in. I began to feel nauseous, shaky and faint for no reason. I thought it would be a good idea to step out of the room rather than throw up on the patient (professionalism first and always) so I escaped to the theatre break room. I did feel a bit ashamed. I had done orthopaedic surgery without a problem practically wanting to jump in and help out but this small procedure shook me. The room was rather small and did get quite warm and because I couldn’t actually see the procedure, my mind was left to wander. Which considering Im not exactly having a good mental health month, probably wasn’t the best thing for me to do on a Monday morning. I ended up bumping into Sam and we sat laughing for half an hour whilst he was on a break which did make me feel better.

I was due to go onto the Neurosurgical Ward after but I decided to head home. I was still a bit shaken by this turn so I was not feeling in the best of conditions. We had revue rehearsal so I decided to try to sleep it off before heading to the med school. I kinda got myself into a slump that afternoon. I could barely see past the fog that had entered my brain so I was thankful to have something to do in the evening.

Tuesday

Not the best start of the day, ended up sobbing my heart out mid-panic attack in the office of our dept head of the MBChB programme (to Warwick’s credit, they managed to find a staff member when I went into the support office completely dishevelled and Kate volunteered). I’ve lost my love of Medicine and I find myself dreading hospital days, not really wanting to go into Med School and just completely numb to everything. There’s been a multitude of factors contributing to this. I decided to try and tackle the ones at the med school. I’m terrified of the upcoming transition weeks, it’s a dramatic change and it’s been a heavy burden to carry for 8 weeks, the year didn’t exactly get off to a smooth start and I feel completely alone. I have also been in near constant pain for the past 4 weeks and with everything else. I am exhausted. I don’t like this sudden change in the way I am feeling so I want to get on top of things now. Kate was lovely and I felt listened to, within 20 minutes I was laughing (though it may have been more manic laughter than happy) and ready to get on with the day. I felt listened to and now have a bit of a better prospect on the upcoming changes.

I made it to CBL but I was looking forward to the SSC2 lecture. I do find it confusing why we are being told this when we haven’t even finished SSC1 yet but hey ho. I was listening to the talk and thinking about the recent tweet that’s been making it’s rounds on twitter. IT’s by an orthopaedic surgeon and talks about Med Students like we are vermin in hospitals:

Suppose one of the best things about this is the spelling…..

My lecturer talked about “on-topic” projects are more likely to get published and I had a lightbulb moment. 2 minutes after talking with the lecturer, BAM, I may have my SSC2 project already. I just need to find a time to talk more with my lecturer. It is going to involve medical students so I need to really start sorting ethics now, ethics can be a nightmare.

Wednesday

Lecture started at 10am today (whoop). We had a three-hour seminar on cystic fibrosis and I really enjoyed it. I did feel slightly cheated as the year before us had patients in with cystic fibrosis and got to see some physio used but hey ho. The lecturer we did have though was incredible and it was obvious he really did know his stuff. He also touched upon the recent advancement in Cystic Fibrosis treatment and it was good to know how this drug worked. I also found out there are 4 different types of cystic fibrosis and that this drug only works on types 3-4 where the channel affected , actually gets to the cell membranes surface.

In the afternoon we had a workshop on genetics and genetic frequency. Maths is not my strong point and it appears not my tutors point either. The whole room was sat there looking confused so we skipped the maths, went to the writing and began discussing the upcoming election. We solved how to manage through it by creating a drinking game (non-alcoholic of course in case the GMC is reading though if you let that othopod tweet slide this is nothing). I also had a call from the Nurse who I saw the other day when I was feeling rock bottom to check up on me. It was the nicest thing someone has done for me in a while and we chatted about my medication and she booked me into a GP clinic so I could get it changed. This small call meant the world and I hope one day to have the time to do something like that myself.

We then had CBL which I just managed to keep my eyes open for. This was followed by a revue full cast rehearsal in the evening which I waddled though due to the searing pain in my abdomen which was then followed by an hour of dance. Normally, our lecture theatre is freezing, like subantarctic) except today, when we didn’t need the heating, it was a sauna and we were all sweaty messes by the end of it. It will be worth it in the end though !!!

Thursday

Made it in for my 9am (round of applause please) and managed to get through 4 back to back lectures (abdominal imaging, Epigenetics and Paediatric Genetic conditions) Paediatric Genetic conditions was one of the best lecturers I have ever sat through. It was to the point and the lecturer was so relaxed and made a few jokes along the way that kept us engaged so an hour felt like 15 minutes. The last lecture however, was informing us about our upcoming GP days. I am really looking forward to these despite not wanting to go into GP. We have to run our own student led consultations three times a day meaning that essentially we are doctors for 20 minutes. I can see now why they say you feel like a doctor in second year (first years it does get better!). I am worried about where I’ll be placed due to transport restrictions so although one of my lecturers has said I can come and annoy them for the first block, Nuneaton is a bit of a stretch by public transport !

We then finally got to meet my CPT (clinical personal tutor) who is a surgeon at George Elliot. I was excited inside as surgery but I was a bit nervous as I know I’ll need a lot of support this year with the changes so I do feel a bit nervous rocking up and being like “Help, I can’t see the wood for the trees”. However, he is lovely and told us his entire schedule, and said we can rock up and observe anytime we like so I am excited to basically be a permanent fly on the wall for his surgery.

We then went straight back into a lecture on refusal of consent in child patients with a lecturer who we had last year so it was nice to see a familiar face. However, there was a bit of an accidental joke made due to an unfortunate pause:

“Some of you may be parents of children with illnesses, some of you may have siblings who need higher levels of care, and some of you may have been children yourselves……[pause]

We all cracked up and missed the “…..who have had illnesses needing special care” part of the sentence so I don’t think our lecturer was too impressed with us. However, I feel we made it up in our ethics workshop looking at cases where it was parents V hospital about life support. Essentially, we were looking at the ethics and law behind cases like Charlie Guard. Is it ethical to keep a child on ventilation which can be painful when there is no chance of recovery as they have a deteriorating illness. There are cases to be made both sides and we debated the ethics of “right to life”, “right to exercise parental consent and responsibility” and on the doctors side “to do no harm” and to “act in the child’s best interest”. This made me sad as there is an ethics day at GOSH coming up which would be amazing to go to but I can’t afford the trip to London twice in one month (https://courses.gosh.org/bioethics2019 – if you want to go). I really do enjoy ethics, I think I can see myself sitting on the ethics committee at which ever hospital I end up at.

At half four I thought I was finished for the day and was happily skipping out the door when I remembered I had a society meeting. Damn it. It was useful however, and the team seem to like my booklet for the first years so in the end, I’m happy I went.

Friday

Day off ! I had a meeting up at the Med School about widening participation. The WP person at WMS contacted me and Ollie (PostGradMedic) about what we were doing. Essentially this was about Ollies project (MedSchoolForAll) so I was kinda awkwardly sat there for most of it as I only help out on the day ( but they have chosen me as a speaker this year so I am ridiculously excited) but I somehow ended up at the meeting. It was interesting to see the behind the scenes of this project, but listening to everything Ollie does, I did feel a bit like I was wasting my time here. I am hoping I can be a bit more active over this year now I actually have time to breath and I start to get my head health under control. However, something I have been sat on for a while is how to increase the presence of disability in med schools. I get a lot of messages about teachers telling people they shouldn’t apply for Med Schools because of their disability. One thing that really annoys me is teachers telling people on the Autistic Spectrum that they shouldn’t apply. There is no reason why people on the spectrum can’t be good doctors. Sure, we may just have to work harder with communication skills and getting used to this non-scheduled work but it is possible. In fact, in specialities such as radiology where being able to spot small details is a desirable trait, Aspie are perfect ! However, running an event for disabled people I think would be a bit odd so I was wondering how else to go about it. Turns out Amanda can help me out there so watch this space.

I was meant to have a driving lesson after but it got cancelled so I did some admin and chores before treating myself to season three of Atypical. I have been waiting so long for this to come out and I couldn’t just watch one episode. They have now included a character called Abbie so I got a bit over excited.

Image result for Atypical