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.

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