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Care of the Medical Patient Week Four

Got to be honest, been putting this one off as I didn’t want to relive last Thursday considering I made an idiot of myself.

Monday

Since the disaster of the lost weekend thanks to my vaccine, I decided to make this a half say. We went in for a morning of teaching which was meant to be face to face but found it all to be moved online.

I am so grateful to have the teaching as we barely had any last year but the trip to the hospital is 23 miles round so we could have been saved the journey. Projectors are also not amazing at reproducing X-rays of lungs so it took away some of the teaching. However, it was a much-needed review of asthma, COPD and TB. TB was something which I sort of knew but needed a review so it was good to go over this condition in detail.

After, I went home supposedly to do work but that didn’t happen. Stopped off at the new Aldi on the way home (I am re-converted) and joined in for a peer teaching course. They started running this course last year at Warwick and it’s designed to make us better peer teachers which is something I want to upskill on and I know it will make me look better when it comes to Medical Education Fellow jobs (something I know I want to do when I leave Medical School). It was really enjoyable however, I started to bang my head against the wall. Why does no one talk in teams?! It makes the session go on for longer and makes it painful to watch.

I then went straight from that to sort of getting some work done that evening but I am struggling so much with getting work done at home. I am tired most of the time and I think I have worn out my study space. I need to mix things up when I have the time but I never seem to find this time.

Tuesday

Today we decided to get some clinic time in Gastro. The car park was a nightmare so I sent K in early to get into the clinic but we were already beat, by some of the consultants own students. It is a bit hard to argue with that. We wandered around and thanks to some lovely HCA’s and Nurses, I managed to get into Foot Clinic.

I had braced myself for a morning of uclers (which wasn’t helping my already feeling ill because of not eating breakfast and sensitive to smells state) but actually turned out to be a really useful and informative morning. I spent the majority of my time with the podiatrist who was answering all my questions, and we got on well.

To my surprise, I actually coped well with the uclers as they were all really well maintained and healthy. That’s my own bias kicking in really. I do feel ashamed for having that initial reaction to the clinic, but I am so glad I did join.

I was shown how to examine uclers, how to care for them, and then unfortunately, what to do when the foot was in danger. I even got to try and do a foot Doppler. I was asked “do you want to do one?” and may have said “Yes” a little too quickly.

i really enjoyed this morning but had to go before the end as I had teaching at 12:30 on frailty. We had a PA who delt a lot with strokes, so I was in my element. Even on her exit she said, well I’m going to see a patient at home now so if anyone wants to come? I replied ” Don’t, because I will follow and come with”.

I don’t know what’s happened recently, I feel like I have suddenly come into my element and this confidence has come out of nowhere.

We then had THE BEST TEACHING in radiology ever. No PowerPoints in sight (+1000 points to Ravenclaw) and a doctor who was funny and told us to PUT DOWN OUR PENS.

They then proceeded to pull out lots of PHYSICAL X-ray graphs and we played spot the diagnosis. I learnt so much and it was so engaging. This is teaching we need, and I took a lot away from just listening to a lecturer who was engaged.

After the lecture I attended a meeting with some staff and students to organize our disability away day. We are finally making progress with the scheme and I am really excited with what the potential this scheme has.

Wednesday

Manage to wiggle our way into a Neuro clinic today of which I was beyond excited about. We got to sit in with one of the Neuro’s from UHCW as they saw patients with movement disorders.

I was so happy to finally be in a clinic of something that normally gets such a bad rep at Medical School. I love Neuro and we do not get ANY time in rotation in it. I’ve had to learn all of medicine these past few weeks on a cardio ward.

We got to see the SLICKEST upper and lower limb neuro exam ever (the reflexes were incredible and that is the exam I aspire to be able to pull off one day). We were also taught the specifics of Parkinson history taking and specific tests we can do to look for Parkinsons in patients.

We also found out our teaching in the afternoon had been moved to 3:30pm as was online! Cue K and I high tailing it home. Well, when I say home. I had some important filming to do first:

Yes, it’s the return of everyone’s favourite YouTube ASMR doc! This time it was the ear exam which is ironic considering I have stuffed up ears and am currently waiting for my next ENT appointment to figure it out. I’m telling you, the concentration I had to pull for the hearing exam was hard as the recurrent infections have affected my hearing.

Thursday

Here we go, not my finest moment. We decided to head to breast clinic in the morning as it was a highly rated clinic, and it lived up to its reputation!

I ended up hanging with the radiographer who in between converting me to radiology, spent the morning teaching me how to read Ultra Sounds, Mammograms and the process of taking a biopsy. It really was a good morning and they were so encouraging of me even when I pointed out something obvious like a “rib”. As they were so lovely, I let the fact they kept calling me Abigail slide…….

Then we had a palliative care comet. I was actually pretty excited about this as I missed my surgical comet thanks to a COVID-19 quarantine. I was in the corridor waiting (it works like an OSCE but gets you to learn on the spot things and has no bearing on your grade) and joking around with everyone. I love the team at Gelliot, and I am gutted to be leaving them next week. However, I got into the second station and fell apart.

We had to talk to a “patient” about their wishes for their last few days to weeks and fill out a RESPECT form with them. It could not have gone any worse than it did. I completely forgot how to structure a conversation, and it threw me when the patient responded with “Call me Mrs Smith please”.

Suddenly I became incapable of getting words out. I froze and lost any capability of making a sound. I was offered to re-start the session but I just completely lost it and came out of the session a bit shaken.

In the next session it was a bit more straight forward, but I was still a bit shaken from the previous session. I was asked the first question, and it all just came tumbling out. I became a blubbery mess, and it wasn’t because I just had to talk to a “dying person”.

The finalists had started their finals this week, and it just hit me how near we are to the end. Next year I will be a doctor and suddenly have responsibilities. Now, not knowing something wasn’t a case of a few marks, but could be potentially lethal. I didn’t feel ready for that. Now, I was so ashamed if I didn’t know something. I’ve been trying to work at night and feeling like I am getting nowhere because of the sheer amount of work. I’m sat here trying to remember things and just can’t retain any material.

Thankfully, I had amazing staff sitting there with me and I tried to pull myself together to carry on the session. It really wasn’t the situation, it was just the straw that broke the camel’s back.

After K and I stopped off at McDonald’s to get milkshakes because we deserved it after all that. I took time to myself that evening. It took me 4 hours to recharge to speak again and in that time I just sat sewing my scrubs getting them just the way I like them, covered in neurons and stars ……

Friday

Academic Day. Nothing huge to report. Sat behind a computer all day. I had tried to go for a swim in the evening but my hip literally allowed me all of 10 minute in the pool. I had to get out and take 45 minutes to get changed plus an extra 30 minutes to do a 10 minute walk home. The takeaway was a ‘I’m feeling sorry for myself” treat ,:D.

One more week to go.

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