Morning off today. Not that I did a huge amount with it. We had ABG training in the afternoon which I was looking forward to as we know the ins and outs of ABG’s including how to translate the results (in theory, in practise I’m still second guessing everything) so I was keen to get to grips with the practical side.
A helpful tip for the year below – DON’T WEAR WHITE OR LIGHT CLOTHING . The blood went everywhere. Jacob had the pleasure of fake blood down his light pink chinos whilst my kind clinical partner managed to get blood on his housemate who was stood the opposite side of the table from him. I’ve now seen a dark side to klaudio.
I headed back home after that night and tried to get an early night. I knew I had to be up at 5 the next day as I had my very first labour shift.
Here it was! My first day on labour ward. I was thankful it had arrived as it mean’t I was in scrubs all day which is like wearing PJ’s to work. I turned up at 7am, got changed and waited. Labour Ward means a lot fo waiting around. I was in Lucina that morning but the ward was eventually closed as there were no patients. The Lucina ward is a ward where low risk births happen. The rooms are beautiful with huge bathtubs, and ceilings with lights in them to simulate the nights sky. All I could keep thinking was how nice it would be to have a bubble bath in there.
I went onto Labour ward with the midwife I was shadowing in the Lucina ward. We ended up in a room with a mum in labour. There was also a student midwife in there. Labour ward is one of the wards where medical students aren’t really the priority in teaching terms. The student midwifes need to supervise births and catch babies for their degree requirements. We are the tourists of the labour ward. However, the lovely student in there took me through the CTG (the machine that produces the funny lines during labour) and how to interpret it. It took me a while but in the end I began to see the lines for the scribbles and slowly understood what was going on. The CTG shows the mothers contractions and the babys heart rate. You’re mainly looking at the heart rate of the baby when you’re monitoring the CTG looking at the rate, accelerations, decelerations and how they correlate with the contractions.
Eventually, mum gave birth to a beautiful baby boy and I was ecstatic, I had just seen my first birth. I stayed to see the newborn checks, see the measurements of the new baby and resist every inch of my fibres to pick him up and give him a cuddle.
I spent the rest of the afternoon doing odd jobs with the midwife. Taking blood, doings obs and even putting the CTG machine on ! I felt a complete part of the team which was great because it made the time fly by and I was enjoying my time of the ward. I left round about 5ish and headed home with a spring in my step. I was pretty exhausted as I had done 10 hours on my feet but felt pretty pleased with how the day had gone.
GP day! I love these days as we get to be as Independent as we can be at this stage and I found I just love talking to patients. I had a good mix of patients that day. Some pain presentations but we later found out they were a heavy drinker (time to deploy the intervention skills I had learnt via an e-module) and I wanted to check how they were doing so I advised them how to slowly decrease the alcohol levels and gave them a two week follow up. I also had a lovely human come with with suspected carpal tunnel. I did the two checks that are drilled into you in first year aaaannnddddd nothing. I asked them to describe the pain and it turned out it was more to do with the radial nerve rather than the median nerve which is normally affected in carpal tunnel. They had been referred to us as the consultants at the hospital as they thought they had carpal tunnel. Med Student 1, Consultants 0.
We also got to stay for the contraceptive clinic in the afternoon. It was interesting and I got to see a implant being put in and taken out. My eyes watered at how much the skin was stretched with the device but thankfully, the lady had been given local anaesthetic so apparently didn’t feel anything! I also got to see (a different one) being taken out as the woman was hoping to get pregnant. So, a nice happy end to the day!
Sneaky day off today as the clinic we could go to only allowed one student in and the workshop in the afternoon was part 3/3 and I hadn’t been to the first two due to illness. I decided to catch up on work and go climbing as I hadn’t been since the week before and Im working to build my callouses up so I can climb for longer in less pain #priorities.
Academic day! I like these as I actually get to see everyone in my year and my friends who I actually begin to miss during the two weeks away. However, I spent more time running around campus than actually seeing others. In the hour we had for lunch I had to go and visit the doctors, return an Amazon package, meet my clinical personal tutor and have a meeting regarding my absences at the beginning of term. Safe to say lectures after were a working lunch. IT was paediatric week so we had lectures on child development with the person who happened to be the lead for paediatrics at UHCW. I managed to grab them at the end of the lecture to talk to them about catching up on the paediatric week I had missed due to the ear infection at the beginning of term. I’m planning on catching up in the last week as I have two weeks of peri-op and even Warwick agreed I can miss some of those to catch up on paediatrics. Turns out it won’t be a problem and I am going to email later on to arrange my visits.
End of the day I spent finally working on my home comforts project. I had ordered 45 new mugs to replace the ones that had gone missing from last term. I had to nail varnish these with WMS to try and stop people taking them away and then find some way to put all the blankets in the box. I lead a very exciting life.
Finally, I got to go home and basically collapse into bed. I had also realized this week that I have 14 more weeks till my glorious week off in May. I can not wait for the glorious dog walks I plan to take my scruff mutt on 🙂
Psychiatry week! Well, sorta. Warwick scheduled us with a doctor who was on annual leave so we ended up being passed around. We headed for the caludon centre which is the mental health hospital at UHCW for 9am to meet a consultant who had agreed to take us on for the day. We ended up walking back to UHCW to see some patients who were waiting for beds or needed a psychiatric consultation. It was extraordinary to listen to their histories and stories and I could feel my heart breaking for them as they explained why they were at UH. We saw three patients and were extremely grateful to be allowed into the consultation with them as talking about mental health still has a bit of a stigma attached to it and it can be hard to talk. I can’t say much more about the consultations but I came away with a new found appreciation as to how layered mental health can be and it’s not all easily explained away like physical health can often be.
The consultant told us to have the afternoon off and I went back to the medical school to chat with my deputy tutor about how my medication was making me ridiculously tired. I am coming home and struggling to work and practically falling asleep standing up in hospital so I just wanted to chat to her about it. However, there was a bit of agg beforehand so I ended up being a blubbering mess in her office for an hour and a half trying to work through it. Well Done Abbie, Well Done.
In the evening I met with my fellow blogger and med student abi for some hot chocolate and a chance to work through everything that was going on. It was great to have a chat with a good friend and I think the hot chocolate both let us work through everything that was going on that evening. She had just come out of a CBL meeting and I was still working off the back of what was going on earlier that day. I’ve also decided to set up a “hot chocolate therapy” group with another of the medics on campus. I’m looking forward to all the hot chocolate to come !
Day off today. I used it to try to get a doctor’s appointment to sort out my ears. Turns out Im good and healthy, they just seem to like causing me agg. It was nice to have a day off, I used it to catch up on sleep as I was exhausted and get to work on the presentation list for that week. It wasn’t the most productive day, but sometimes that’s ok. I ended up just binge watching TV programmes that evening in an effort to try and switch off from everything going on.
Wednesday we were at GP and IT WAS THE BEST DAY EVER. In the morning I shadowed a GP just sitting in on their consultations and we had so many paeds cases! I was in my element. We had a 6 year old who had an ear infection in which the ear drum looked like it was about to burst. I could relate to them except they were running around and happy as larry. Apparently, kids cope really well with these types of things ! I also got a milestone that consultation, my first GP doodle:
I also got lots of cuddles from them and when they left I felt the happiest I have felt all week. Yup, I think paeds is for me! I also got to see a little 9-month old who had big brown eyes and a head full of hair so that morning was a highlight.
In the afternoon we had our own student lead clinic and I saw my foot patient again and I think just about managed to do a successful consultation. However, it was my second patient whom made the day for me. A mum came in with her three year old and her new baby. I was in paeds heaven. The mum was worried about a rash on her three year old so I got to take their temperature. Turns out mum was a doc herself so this three year old was an expert in this field! Kaludio entertained himself with the baby whilst I examined the toddler with the GP as my rash knowledge is well… non-existent. There wasn’t anything to worry about but I made the toddler a glove balloon anyway, I could not resist.
I came out of that day beaming. After everything that had happened, this day had been amazing and I knew that dropping surgery and going for paeds probably is the best thing for me, even though it was hard to admit it to myself that I was better suited away from the theatre. In the evening I had a pizza catch up with one of my friends who I hadn’t seen in a while. It was nice just to catch up and by the end of the day, I felt the most me I had been in ages.
We were summoned to the Caludon centre for 10am and we had some teaching on AKI from an F2. It was really useful especially as although I love the physiology of the kidney, I don’t get on with the diseases associated with them. We also had a skip and hop through addiction, particularly that of alcohol which I could relate to a patient I had seen earlier on in the block so it solidified a lot of the information for me.
In the afternoon we got to sit in on a clinic which had a good turn out rate (something that does not normally happen in psych clinics) and I was able to sit in on patients consultations about their symptoms and medication management. Even though the majority of psych week had been quiet I really enjoyed getting to grips with treatment for certain disorders and was privileged enough to see the “word salad” symptom. It’s incredibly rare to see it and I was incredibly grateful to the patient for letting us sit in on their clinic.
Friday/ Satuday / Sunday
That pretty much summed up the week. We had nothing on friday so I spent the day prepping for teaching the next day. I was teaching the basal ganglia at anatomy day which is one of my favourite aspects of block three. I had nicely set up in a room with my swanky 3 slide powerpoint (as I draw most of my lesson on the whiteboard) and Ollie came and shifted me to a room where the computer nor the powerpoint decided to work. Cheers Mate.
As it was anatomy day, I focused on getting the first years to be able to draw it from memory with the help of some slightly odd mnemonics. I really enjoyed being able to go back to block three and realize that I still had the same passion for Neuroscience as I did before I gave up perusing Neurosurgery. I still find the brain amazing and oddly, I still find Neurosurgery incredible and I will never turn down an opportunity to go and observe. At the end of the morning in my final session I got a hug for my teaching which meant so much to me. I’d gone from thinking about taking a year out of Medicine on Monday, to feeling like I could conquer anything I wanted to after that hug on Saturday. I still am so grateful to be here, yes, some mornings I curse under my breath that my alarm has gone off at 5am because I need to be in for 7am (spoilers for next week) but, then when I get to hospital, I get to see babies being brought into the world, or comfort a patient who’s had to be isolated but has dementia. I keep thinking more and more about when I graduate and become an F1, then an F2 and hopefully one day, a consultant at GOSH (yes I’ve skipped a few steps).
On Sunday I went with my friend Will to IKEA in an effort to have one last plate of meatballs and exercise extreme self-control. The one in Coventry is closing down so we decided to have one last bit of fun. A qoute from Jacob in my year pretty much sums up IKEA after talking about the Corona Virus:
“Coventry can’t have Corona, We’ve already lost IKEA, do they want to hurt us even more?”
Came down with a killer cold over the weekend so I decided to avoid sniffing over pregnant mothers to be and go in later for the clinical skills session at 1pm. I found out that actually I had chosen wisely as the clinic were only letting one student in so 2/3 of the students there got turned away, so I would have gone in early to spend the morning sneezing and feeling sorry for myself.
We had our oxygen clinical skills session in the afternoon essentially looking at what we would give to a patient based on their oxygen needs. Each oxygen delivery system has different flow rates so need to be selected based on the patients needs. We also got to learn about inhaler therapy using different techniques and learnt about equipment to test if the patient is able to use inhalers. This included some weird party blower type things that check the patient has the strength to use some types of inhaler. It was hilarious and we created our own New Year’s Eve in the room. Safe to say we all reverted to about 4 years old at this point. We then moved onto the peak flow instruments and that also turned into a bit of a competition. I was pleasantly surprised by my results, apparently I have the lungs of a 6 foot man….
I guess my classical signing lessons for virtually 4 years of my life payed off. (Yes, I can belt out a phantom song if it takes my fancy).
It felt like a really long afternoon and I was happy to just get back and nurse my cold. However, I had to make a quick stop as I had to pick my new phone up ! A better phone, more data AND a cheaper contract?!?! I was ready to collapse in bed when I got back , and that is exactly what I did (after a helping of my mums chilli).
I had been looking forward to this day as it was my first community midwife shift, this meant babies and lots of them. Well, I thought that, turns out I saw two. Our first stop was a beautiful two-day year old of which it took every fibre not to pick them up and give them a cuddle. I got to help out and take mums temperature and blood pressure which came a little out of the blue so I mentally had to check I could remember how to take a blood pressure (it’s OK, we did remember). It was apparent they had appeared before mum and dad were ready but apparently that’s how all babies arrive. I also got to see a 5 day year old visit where the baby was weighed and the heels pricked. The heel prick test looks for sickle cell, Cystic Fibrosis, congenital hypothyroidism and some inherited metabolic diseases. Amazing considering it’s all done by 5 drops of blood on a bit of paper. This house also had a bird in the corner who kept whistling the Adams family theme tune whilst we were in there providing a comedy element to this check up.
I then got to escape to Costa for 4 hours as the midwife was just doing paper work and I have to say, doing work in a coffee shop made me feel like the Instagram cliché I ultimately am. I hadn’t packed my laptop so I was working all off my phone which was annoying but the antenatal care learning objective is huge and I really needed to get started on it.
After wandering round the road system there (it was an industrial park which aren’t really catered for pedestrians) I found my way to the surgery and spent the next couple of hours seeing lots of baby bumps. I got to do the urine dipsticks (a task I can imagine the midwife was more than happy to give me) to check for protein in the urine which is an indicator of pre-eclampsia that can lead to deadly seizures in pregnant mums. Thankfully, all were good. I also got to feel some abdomens for baby and I think I need to keep practising this as I am a bit hesitant about pressing too hard on the mums tums and could only just about feel baby. I also got chatting to the midwife about the channel 4 documentary on mental health that was showing a mum who had gone through serious post-partum psychosis.
It was a pleasantly surprisingly good day and I could see myself working in obs and gyne which was extremely weird as I swore I would never go down this path and for someone who can’t see kids in their future yet, I became extremely broody……
First day of school again! It was our first day in GP which is something we start in phase two. I’m based at a surgery about 40 minutes away from campus which is brilliant as these practises can be flung far from Warwick. I arrived at the surgery at 10am (something which I also loved about them) and we were immediately made to feel so welcome and wanted. Something, I was worried about not happening. I was put in to observe a nurse in the morning and got to see a little one having their first jabs which got us on the topic of anti-vaxers. It’s becoming a sadly growing trend even here in the UK. Vaccines have been shown time and time again to be safe, effective AND LIFE SAVING. Autism does not develop from vaccines. I did not become who I am because my mum decided to save my life from measles, mumps, rubella, polio etc. In fact that paper was retracted exactly 10 years ago this week. Anyway, rant over.
In the afternoon we got to meet our mentor Dr O who would be supervising us through this 7 week block in GP. I expected the first session for us to just be observing her and watching but nope. Immediately we were chucked in front of patients. GULP. It was actually amazing and showed that we’ve reached that stage in medical training where observation isn’t enough for us and we want to get involved with everything that was going on. I really enjoyed it but I need to learn to direct my consultations. I did over-run partly because I was dealing with a condition where I wasn’t sure what I was doing and partly because my patient liked to talk. They were lovely, I just need to be a bit more assertive. In fact, they are coming back next week so I am gong to read up on their condition so I have a better idea of what to do next.
Me and Klaudio left that day feeling accomplished and like we were progressing on our medical careers. I dreaded this clinical learning but you get so much more out of talking to patients and getting involved than a thousand lectures could ever give you. Kaludio mentioned thinking of GP as a career but I am going to need a bit more convincing.
It’s currently 9am and I haven’t slept since Wednesday morning. I was up in A&E all night and basically just went straight to my 8am lecture at the hospital (luckily) but halfway through I had hit the wall and basically called it a day. I was annoyed as I needed the day to get sign offs but I guess luck isn’t on my side today. However, I did make progress in trying to meet my consultant so I guess I got one thing out of today.
Academic day! A slight lie in and I’m off to the med school for CBL. I have to admit, I get so tired during CBL that it is hard to stay focused. I am also a bit tetchy about CBL at the moment as the learning outcome list is huge and often the points seem leaps and bounds away from the case. However, that’s more my agg. It paediatric week and we got treated to a lecture by one of the lecturers who restored my faith in medicine during AC1. He was Irish and training to become a GP but makes his lecture just interactive and enjoyable.
However, I had to scoot early as I had a GP appointment to talk about my SNRI’s. I don’t think they are working as things had happened that week outside the medical world that had caused me to come crashing to the floor and question everything I thought I knew, I was also still shattered from the Thursday so I wasn’t coping. I had my meds upped in the evening just to see how I am with the side effects so I am going to see how I cope for the next two weeks.
I then high tailed it back to the MTC as my personal tutor had come to Warwick to check in on us. I said that I was just tired and a bit stressed but I was kinda coping, which was true. I still loved my course and I’ll just see how everything goes. It was a quick in and out meeting (plus a quick 5-minute vent to a friend) as I had a THIRD meeting that lunch about my absence at the beginning of term. It was not anything bad, I had done everything the Med School wants us to do but it was just to see how I was doing catching up and if anything else needed to be done. I took the opportunity to mention that sign offs here can only be done by ST3 or higher rule was annoying and seemed excessive for year 2. Other med students (yes, I network!) can be signed off my any grade doctor and band 6 and above nurse so I wondered why Warwick was different. The reason was to prepare us for F1 which I can see the logic, but I am only a second year medical student at this point.
At the end of the meeting it was time to run to lecture as I was slightly late and ended up having a working lunch due to having been in meetings all afternoon. Lectures on academic days are becoming a bit of a cause of chuckle with me. My year isn’t exactly the model year for showing up to lectures but now our lectures are sign in, the lecture theatre is constantly full.
The afternoon lectures looked at paediatric development and I got to chat to the doctor at the end about making up my paeds rotation which I really want to do as it’s not only a sign off but an area of medicine I love. I’ve got two weeks at the end of the block of peri-op that will be a good time to slip two days of paeds in so I am hoping to do it then.
That weekend I also was teaching for Block Three physiology day. I had chosen to do the basal ganglia as it was a part of medicine I loved. It’s the first time it’s been taught at a physiology day so I was keen to split apart the anatomy from how the system functioned as I was also teaching it on anatomy day. I really do love teaching, I know there is going to be Med Ed in my future career and I know in F1 I will be teaching those from KCL and the new Kent and Medway medical schools so I am keen to build up my teaching skills from day one. Here’s to more knowledge imparting on unwilling victims !!
I never thought I would see the day when the word surgery didn’t make my heart flutter and my face turn into a big grin. Yet, here we are. I’m sitting here looking at the brain light that Henry Marsh signed for me and my heart is breaking to know that I simply don’t want to follow the path that I have loved and dreamt about since I was in six form.
It sounds like someone has told me that going down this career path is simply not possible anymore. However, it has been a revelation through my own reflections and thinking about what I want from my career. I posted a lot about GOSH in the summer and how the director said about making the speciality fit you and not you fit the speciality. However through events that have happened over this year and simply thinking about what I want for my career I realise that it would literally be putting me in a square hole when I’m a round peg..I wouldn’t ever fit in anywhere properly and I would rather have a career where I fit in and where I love my job the entire way through, rather than struggling for upwards of 12 years to get to a point where I’m happy.
I partook in a national audit this year which has been the main source of why I don’t want to pursue the speciality anymore. I am completely new to the research side behind medicine and had managed to set up this entire audit in a week. However the people I was running the local audit for were not happy enough with my progress and we are blaming me for people not replying to emails and for general blockages in this audit.At times it was more stressful than my medical degree and I felt like I was doing wrong when in fact I done everything I could physically do. I also began thinking about the surgical conferences that I’ve been to.Everyone is so professional and seems to want to elbowed people all the way to get to talk to people or to answer questions. I’ve heard of tales of surgeons in London who will virtually backstab other people to climb the career ladder. I know not every surgery is like this but I’m not that type of person. I’m very informal I’m very silly and I don’t take myself seriously at all I’m not very academic and I’m just that little bit quirky.
My mental health has been an extreme problem for me for the past year. The academic stress from the only first year exams but The added pressure of making sure that you were preparing your surgical portfolio from virtually first year of Med school. You feel like you’re never doing enough. The audit, greater exposure to surgery, new interests, complete loss of old ones and of it it’s got to the point where I now have to sit down and think what is more important to me at this stage. Burning myself to the ground but coming out with a amazing portfolio or enjoying med school and pursuing a career path which is become more and more appealing to me.
I still want to go down paediatrics Route, that is never going to change. I still want to one day work at GOSH, and I’ve been thinking about specialties allied to surgery. I like the constant environment the small team and the low patient to staff ratio. This has led me to 2 specialities. Anaesthetics and intensive care.￼￼￼
Every anaesthetist I’ve ever met has been lovely especially the ones at gosh who couldn’t teach me enough. I like the idea of being able to both administer medications and take charge of your patient in surgery but also being called to assist in other areas of the hospital with things like difficult cannulations or airway assistance. Intensive care has also caught my eye because it’s very low patients to staff ratio But provides the mental challenge that I love. ￼
I don’t feel sad about giving up the pursuit of a dream of which I was so passionate about. I’m happy that for once I’m putting myself first and my needs ahead of my career. Part of me still loves the brain, The anatomy is just amazingly complicated and the physiology baffling. But there’s just something amazing about an organ we still have pretty much no idea how it works. I still enjoy neurosurgery I find aneurysms fascinating and watching them being fixed is just amazing. However I just can’t picture me fixing them anymore.
So I guess that’s a big revelation from last term, then do you know what, I am so much more happier for it.
Dictated but not signed (that’s why there’s so many grammar errors!)
So, back at it. Thankfully it’s a 9am start so it’s not too bad for getting up and on the bus for. We are on care of the elderly this week and to be honest, I wasn’t expecting too much out of it. (I was to be proven wrong). Got to the ward for 9am and we sat in the board round which is where they discuss every patient on the ward (essentially a ward round in one room on steroids). It was great to be sitting there because I was taking it on myself to pick up the lingo being used and decode abbreviations.
As we went along we were included in the discussions and I have a feeling I was being watched by one of the docs because I was scribbling like mad making notes and because I had my tablet – I was able to google and answer my own questions.
After we were assigned to a consultant who took us to see a patient. Since there were three of us we each did one of the history, general exam and focused exam. The consultant was also interested in the use of tablets (I’m single-handedly revolutionising the NHS). I had to do the general examination so was having to dust off the chest of OSCE knowledge which I don’t think has been properly opened since May…. It was ok, remembered most of what we had been taught. My main problem was getting the patient to answer the questions I had asked rather than going off on tangents. I felt too bad to keep interrupting so I’m hoping I develop this skill over time.
He then took us into the office and taught us important skills to remember in OSCE’s as he was an examiner (and I am half convinced he was my examiner for my abdominal station) so we were taught common mistakes and how to avoid them. I couldn’t beleive my luck, first day there and we had already been given amazing teaching.
We then were handed over to Another doctor who has one of the best reputations in my year for being a good consultant for medical students. We were pretty keen to get sign offs done so I had asked to take bloods which qualifies as a mini-cex (yup, second year brings it’s own new language). I was told to take bloods off a lovely old lady who I found a good vein on, inserted the needle and nothing. No flashback, no anything. I sighed. Obviously , I had done something wrong. I withdrew the needle apologising and then before I knew it, BLOOD EVERYWHERE. I panicked getting the flow to stop and silently cursing because apparently, I had indeed hit the vein.
I felt awful but I decided to hand the bloods back, the last thing she needs is me causing more pain. I had to leave after that as I had to get home for my driving test but I was still kicking myself on the train home three hours later.
Back again and after failing my driving test, I wasn’t exactly in the best of moods. However, we turned up for half nine and immediately jumped in to reviewing new patients with the doctors. The first patient I saw was someone who had collapsed at home and was suspected to have a bleed in their brain. It was interesting examining them as they had a positive babinski sign (a way to identify upper motor neurone lesions) which I had never seen before. My heart really did feel for her as she was alone (visiting hours were a while away) and unable to respond to any of the doctors questions or instructions.
We continued going around on the ward round and then after were treated to some F1 teaching. Our F1 was also an ex-warwick grad which is great because you do feel like there is hope at the end of the tunnel for us !
We then asked to do a case based discussion which I led as being off for two weeks, I was severely behind in my sign offs. We talked to a lovely lady who was admitted after a fall with low blood pressure but otherwise well. She had some liver, pancreas and bone problems and we were chatting about her family, her job and her medications. I was surprised as she said she was only on one which puzzled me slightly but I guess that’s medicine.
We finished off the history with a abdominal examination (as she said about her liver) and a quick chest just to check for heart and lung sounds. There was nothing really of note so we said thank you and goodbye and then toddled off to see the notes. Her daughter caught up with us at that point and asked if we had seen her notes. We replied no as I wanted to go in blind like I would do in an OSCE and the daughter filled us in with the correct history which changed a lot. I felt bad for the patient as she had hidden things from us for reasons which I could understand but having the full history made everything so much more easier to work through.
Over lunch Kaludio and I discussed her and went back to the ward early to go through her bloods and work out why there were the abnormalities there was. I loved learning this way as I know it’s going to stick and I can feel the improvement in learning in comparison to death by powerpoint last year. I guess clinical life is for me after all.
We then attempted another blood but this time we had the flashback, but no blood decided to go into the tube. It was frustrating as we had a lovely man but we slumped back to the desk annoyed. What was going wrong? Our F1 appeared behind us and we were telling him about the constant unsuccessful blood taking but he reassured us saying that elderly veins were difficult, you could find a good vein and it would wander out of the way before you got the needle into it. We were taught some techniques to get the blood to flow so Im hoping that I can practise this technique one more time before the end of our time on the ward.
We also received the result of the brain scan our patient had gone for earlier and it was the worst possible news. There was a tumor growing and my heart dropped. Im being careful what I say so I can’t say much else but it led to my consultant having to break bad news to the family and discussing future care with them. Whilst our consultant was there, we were waiting at the desk when all the doors in the ward were shut and a blue metal trolley was rolled into one of the side rooms. We both knew what this meant and went home that evening reminded of just how serious flu can be.
Arrived back on the ward earlyish this morning to catch up with what was going on with the patients we had seen yesterday. I was intrigued to see if anything had changed with the three patients we had seen yesterday. It turns out not much had but we had some new bloods for one of our patients so I spent 15 minutes working through them as I was presenting the case today. It was a interesting case and there was a lot to get our brains going. It was also a bit of a difficult day as they were understaffed so we were asked to come back – perfect excuse for a mid morning tea.
We arrived back to do our case based discussion with our consultant which went well. We had managed to identify everything he wanted us to catch and then we had a discussion about further management. So, sign off done. We then were sent away again and to come back after lunch as there wasn’t much to do so came back and then managed to watch a cannula being inserted as we were both a bit apprehensive about inserting them before some quick teaching on hyperkalemia. The ward was ridiculously busy that day however so we left after to allow them to get on with their roles and to allow the 4th years to get sign offs done before their finals in a few weeks. I tried to get work done in the evening but I’ve got a feeling I’ve got a cold coming so I just went to bed hoping to be better for tomorrow.
Brain decided to get me in an hour earlier than I needed to be today, as if I wasn’t tired enough already. We decided to buy some treats for the ward as they had been so accommodating to us during the week which we checked before we left the ward at 12 and had been hovered up in the two hours we were there #beststudentsever.
We had tried to get a OSLER done but with the busyness of the ward, we thought it would be best to just leave it. It’s not fair to nag the staff when they are running around trying to get patient care done. I did meet a patient who was on the ward though who had learning difficulties. They needed some comforting and it was nice to sit there and talk to them as it reminded me of my uncle back at home. I’ve grown up surrounded by adults with learning difficulties so it’s second nature to me and I really enjoy it when I have the chance to talk to patients with these extra needs.
We then left UHCW early and I was keen to get back to do some of my presentation list. It was nice to be back in my flat , in comfy clothes just working through what we need to do. I much prefer this solo method of working. I am retaining everything more easily and I actually feel like a medical student instead of just learning information off a powerpoint slide for the sake of an exam.
I’m also making progress in improving my mental health. I’ve managed to pass on an audit which was causing me a lot of stress (even though it would have been good for AFP applications) and I am making sure I keep some of the day to myself away from Medicine (even though I may be spending too much time away from Medicine at the moment as I am so tired). I’ve got a doctors appointment to review my meds and I just feel a lot more fufiled in what I am doing.
So here we are, back in the swing of things , ready for clinical life to begin.
You may be wondering why I have not written here in, well, months. I was due to start CCE1 (core clinical education one) on the sixth on January. This meant I was flung out into the Hospital to start my clinical teaching , except my immune system had other ideas…..
Moved back to Warwick today. Woke up with a ear ache (please note the word ache here) and shrugged it off with some paracetamol and ibuprofen and moved back. I wasn’t amazingly happy to go back, I’ve been apprehensive about going back and failing my driving exam two days before did not help matters. However, I got my miserable arse back to Warwick and waved my mum and grandad off after they moved me in and went to do the dreading unpacking stage. I was a bit dizzy wandering around my flat but I again shrugged it off as I had a lot to organize on Sunday such as my notebook, materials for the audit, materials from Wilko I could not get the day before and just general cleaning to do before making sure I got one final good nights rest.
I went to bed after watching Dracula but was rudely awoken 4 hours later with pain radiating from my right ear. I quickly took some more paracetamol and ibuprofen and went back to sleep.
4 hours later (I’m not even joking) I woke up again. This is when I panicked. I’ve had this type of pain before (Block one Week 2). I ended up calling 111. I could see my pain relief was not going to last the time I needed it to (I had 10 hours left of the 24-hour paracetamol limit with one dose left). I was told that I would be called back by a health professional so I took my last dose and some codeine from my last ear infection (yes, I know it’s bad to self prescribe but I had climbed the WHO pain ladder and this was the next step), and tried to get some more sleep. I could tell it was going to be a long day. I woke up 4 hours later with no call (and no missed calls), I was in a lot of pain. More than I had during the night and I had to bite the bullet and take some more paracetamol. Pain level 7/10
I called 111 back to check I hadn’t been forgotten and casually mentioned the 5th dose. Things blew up, it was like I had downed a whole bottle of paracetamol rather than the one innocent dose 4 hours before my 24-hour limit. I know paracetamol has a really high toxicity level, but I had no choice. I eventually got to 111 health professional and they said go to the walk in centre. I sighed. Here we go again.
I dragged my sorry arse over into Coventry. I had some new earphones for Christmas that were wide so I could cover my ears. I found my right ear had become completely deaf meaning that something, somewhere was either closing off my ear canal or stopping the signal going through the ear drum. I got to the walk in centre (pain 9/10) and was triaged and put on urgent. The Dr saw me and only prescribed antibiotics with no pain relief. I was told the only way I could get stronger pain relief was to go to A&E. So, guess where I high tailed it to.
I spent 4 hours waiting in A&E (pain 10/10), one cannula inserted and blood taken (and split all over my jeans) and was eventually seen by an ENT doc. She said that I had an infection of both my middle and outer ear. I was impressed with myself, how I managed that I have no idea. She was lovely, but slightly unsure what to do so we discussed oral antibiotics and I hopped home with oral antibiotics and more codeine. My lovely friend rosie came and met me at A&E bless her with some goodies as I think we were anticipating being admitted due to how illI was, however I was discharged as she arrived and I got a ride home- so thank you rosie !
You maybe thinking I am a bit of a drama queen. However, the point was that my tablets were not lasting long enough for me to take them at safe levels, I needed longer/stronger pain relief, and did not get it. I was at the highest level of the pain ladder I could be at with the materials I had and not tolerating it well. I could literally time when the pain would hit again and it wasn’t psychology. I was sleeping whilst the pain relief was present and waking up when it started again.
I’m sure we have all stuck an ear bud in our ear. We’ve all had a good wiggle meaning some of you have inevitably hit your ear drum (or tympanic membrane if you want to be fancy). That pain is bad isn’t it. Now imagine that, but constant at the highest arc of the pain you feel. Imagine it radiating to your jaw so you can’t move it. I couldn’t eat anything but a cookie from Sainsbury’s because it was thin and soft enough for my jaw to cope that entire Sunday. Every time the tablets stopped working, I was back in the pain with it getting worse and worse with every return and of course, I could not take any pain relief. Every time the pain returned I called mum to see if I could distract myself, I held my ear over my radiator as I couldn’t put a hot water bottle anywhere near it without causing additional pain. I tried holding my head at different angles trying to see if it was fluid in my middle ear pressing on the ear drum that was causing the pain, that did not work. I tried freezing a water bottles to see if cold would work but again, I could not get it anywhere near my ear. I tried sleeping upright, holding my head upside down. Nothing.
By 7pm I was on the floor in agony, I hadn’t eaten all day and dreading the 3 hours of agony I would face after the pain relief wore off after the 3 hours it worked (yes we are down to three hours now). I considered going back to A&E but the thought of even sitting in a taxi for 15 minutes to get there made me nauseas. I had been everywhere I could, seen everyone I could, done everything I could to try to cope and now was the time I wasn’t coping.
You’re going to read that and think how pathetic I am. I sat there for half an hour in the pain I was in trying to not call, I had no other option however. I was at the end of my wit and at the stage where I was thinking about how to knock myself out to try and escape the agony I was going through. I had messaged a friend of mine who is a F1 in Manchester to ask if I was being pathetic, I felt so ashamed. 999 is meant for heart attacks, strokes, people fitting, not for pain. I had no other choice though, I was done.
I had taken another dose of tablets and two hours later, I had a knock at my door with two lovely paramedics and campus security. I felt so ashamed because I was pretty level due to the tablets working when they arrived so it looked like I was being dramatic. However, they came in, lovely as ever and immediately spotted my stethoscope on my desk still not packed away. ” You’re a medical student aren’t you?!?” Great- now they are going to think I am a complete waste of time. However, they were still lovely and took my vitals, Temp 38, Heart rate 134, high blood pressure. The paramedic looked at me ” You know what this means don’t you Abbie?”. Sepsis. Great, again.
They said they were going to take me in because of this, but before they were going to give me pain relief. Second cannula of the day inserted and 3ml of IV morphine inserted. Here we go.
I was sat in the ambulance with my blood pressure/rate still high but temp falling (it was cold and I was in my PJ’s and a baggy shirt). I was able to just chat with the paramedic about training and TV crews etc and just felt better being there. I think it was the prospect of finally getting this pain sorted that calmed me down and I knew I was going to be treated and cared for. We got to A&E and 10ml of morphine later, I was back in minors slumped against a pillar, half asleep in the morphine haze.
BAM. On cue the pain was back. This time , I had no pain relief with me. I had gone to the desk to ask if they knew when I would be seen – an hour to go at least. Thankfully, I still was pretty sleepy from the morphine so I could managed until about half an hour later when I had nothing. I had tears streaming down my face trying to hold back from screaming. Someone had spotted this across the room and came and checked if I was OK. She was lovely and understood but I did feel embarrassed, that should be me comforting people.
I eventually got called in 4 and a half hours later since I arrived and was relieved to think I was finally getting some treatment. I’m not going to go into details about what happened because I am in education at that hospital and I don’t want to get into trouble for moaning however, half an hour later, I was turfed out with no further pain relief given (apart from the dose of tablets that I was due anyway and some oramorph as a compromise) and feeling like I had been abandoned by the trust and system I love more than anything. And that hurt more than the infection.
The only thing I was offered (as i had explained what had happened before) was a visit by the ENT consultant who said I could get IV pain relief but I would have to go back to the waiting room once the IV had finished. This meant three hours of agony in the waiting room, struggling to get attention for more pain relief for an unknown amount of time till a bed became available. Three hours sitting in that minors waiting room, in agony with no idea how long I would be there, in a top I have had on for two days now, alone (despite the numerous offers of people coming and waiting with me, but it’s bad enough one medical student there). In the end, with the things that had happened to me in A&E during the time I was seen, I could not face being there any more.
I eventually got back home at 3am and went straight to bed. Looked like uni was out of the question so I decided I would take the day off, grit my teeth and try to get through it. The cycle of pain was horrendous, I was becoming exhausted and add to the fact that I was feeling nervous about the prospect of jumping into clinical teaching without the prep on the Monday at uni. I still could not eat, I could not cope and now the pain was down my neck, and I was now feeling twinges in my left ear. My warden (essentially my boss) popped in as she had seen the Ambulance report and reported on how awful I looked and told me to go home, I later checked in the mirror, I could have passed as Frankenstein’s bride.
I made it to 5:30pm when I gave up, I could not manage on my own any more. I knew I was going to get nothing in terms of treatment from A&E in Coventry and I didn’t know where else I could turn. I was on the phone with mum and she decided to come and take me home. My superhero of a mum drove 150 miles to Warwick and back that evening to rescue me. It was the worse 2 and a half hours of my life in the car. I had tried to not take any more tablets as we were heading straight to my local A&E at home but an hour in I had to give in to some Ibuprofen, and a further half an hour later, some codeine which did a good job of sedating me so the pain was still agonizing, I was just a couple of GCS points lower from reacting.
We got to Darent A&E at 11:30pm and within half an hour, I had another cannula (3rd one in 24 hours) and was receiving IV paracetamol and IV saline. Unfortunately, the pain was still there, we were breaching 11/10 pain scale and two hours later I was given further IV morphine, IV antibiotics and anti-sickness through my cannula. 4:30am rolled around and we were sent to Darent’s sister hospital in Medway (15 min drive) as that’s where the ENT boffins lived.
I was in trouble though, IV morphine was having no affect on the pain. The pain was breaching the strongest pain relief that was on offer and I was exhausted already.
I was quickly triaged at Medway but made to sit around again. The morphine was wearing off and the pain was rearing up yet again (12/10), I was exhausted after battling this for 48 hours now. I was deaf in one ear, hadn’t eaten and probably put my liver through more battles than what it coped with the night after we finished first year exams. According to my mum, I was rather loud in my cries of exhaustion and agony. I was quickly given IV paracetamol and oramorph (probably to shut me up more than anything) and I ended up chugging ibuprofen as I couldn’t cope. Finally, the pain started to drop to 10/10.
I was seen by a lovely F3 who took the time to look at me and gave me extra treatment and finally, put me on track to getting over this thing. The worst part was where the wick was put in (a cotton tampon for the ears essentially) my already inflamed and tender ear. She had also given me stronger oral pain meds so I was able to cope with everything which was the greatest blessing.
We eventually got home at 6am and I collapsed into bed and told my mum she was not allowed to go to work (thankfully her work were really understanding).
I spent Tuesday and Wednesday in a haze of drugs, pain and sleep, thankful that I was soon going to actually have my immune system on my side as well as the antibiotics. I woke up Thursday to go back to Medway and have the wick taken out, but it had fallen out the night before which is a perfect thing. This meant the inflammation had gone down meaning there was no “grip” to keeping the wick in place. The docs and nurses at Medway were slightly relieved as my ear drum had not burst in my right ear but I had developed a polyp in my left, so some suctioning and 4 wicks inserted later, I was back at home, deaf but better than the Monday.
The next 3 days were annoying as I couldn’t hear anything, and I could feel the wicks in my ear but I was on the mend and more importantly, able to eat !!
We ended back at Medway on the Sunday to have the wicks removed and to see how I was recovering. I was so happy when the wicks were removed (even though there were traces of blood on one) but it turns out the infection was still there. I was discharged with my antibiotics that day though which was great!
I know this has been a long moan and dramatic. However, when you tell people “I had nearly two weeks off for an ear infection” it sounds pathetic to me, but it was the worst pain I have ever felt in my life. When you think about it, the ear is served by 7 cranial nerves. All seven of those nerves would have been screaming at me all at once, sending pain impulses. So, hopefully, you’ll be able to understand.
I decided to not go back to Warwick until Wednesday this week because I am a bit nervous about going back and ending back at square one. It’s Monday today, and I still have a few aches in my right ear (not to mention itching in both ears) which are making me nervous but I can’t hide at home. I’ve already missed my paediatric week which I am gutted about and I am not too sure about if I am going in Thursday as it’s the neonate ward due to infection control. I am also a resident tutor and I feel I have let my team down enough so I want to be back doing the job I am meant to be doing.
So, that’s it. I wanted to explain what had happened mainly because I want to show I was not taking liberties and over reacting to a slight ache. I have regular ear infections so I know what an “ache” feels like and trust me, this was no ache.
Well, that’s my infection done for second year, (not) looking forward to my third year one !
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.
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 🙂
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?
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.
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 !
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 :
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.
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:
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
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.
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 🙂
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.
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.
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:
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.
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 !!!
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.
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.
Whoop whoop. LIE IN ! First time in weeks that I haven’t had to be up before 6am. It felt AMAZING and I woke up ready for the day instead of practically falling out of my nice cosy bed. I had airway teaching at 10:45 so spent my time slowly getting ready and actually catching up with what is happening in the outside world. It’s easy to forget the world still carries on outside of Medicine.
I arrived at my airway teaching and it was actually fun. We were taught the basic principles of airway management so we were taught head tilt, jaw thrust as the non-equipment techniques. Then we were introduced to the maze of tubes and suctioning things in front of us. We first used some tongs known as Magill forceps which are angled allowing for removal of objects. We successfully removed Halloween sweets using these (and got to eat them for our efforts).
We then went on to use the more technical items that you see in medical dramas learning how to measure and insert them. The only thing we didn’t get to use was the tracheal tube which we get trained to use in phase three. I am actually really excited for that session now . I really enjoyed this session, clinical skills have the potential to be dragged out sessions but the higher level learning and new skills is making these sessions the highlight of my week.
I also decided to get my flu jab done that day. This meant walking to the other end of the hospital but at least I now have it done !
After Airway management we had resus training. This was basic so it was what to do if we found someone without a pulse around the hospital. We got to practise using a fake AED on a dummy which had a monitor attached which tells you how good your CPR is. CPR is most effective when you are at the right depth, rate and allow the chest to fully recoil after each compression. The machine speaks to you if your compressions are not good enough and has a metronome to check you are going at the right rate. There’s something odd about being praised by a machine ….
When we went to do it , I forgot to check if the patient was actually breathing , turns out this is important – who knew ? (DISCLAIMER – I KNOW THIS IS IMPORTANT).
Finally, the moment I had been waiting for. SCRUB TRAINING. I was so excited, well, what do you expect from me. We did the process from start to finish learning how to wash our hands with the sponges and iodine and then moving onto scrubbing. The gloves were a bit fiddly to get on as you can’t use your hands outside the sleeves so we were all fiddling around trying to get them on, safe to say I need more practise.
In the evening we had revue rehearsal, I am now off script which is handy and then just collapsed on my bed. Monday Completed.
My friend Tash had also surprised me with some little wooden bumblebees from her paediatric play session which vastly improved my day:
Second group for CBL today ! Mind you, ended up going in early because I needed to do some SSC1 work for our mini bazaar later. CBL was good as we were finishing up from the week before meaning I only had to be chair for 2 more hours, however, this also meant we had 15 minutes for lunch before the next lecture. This meant I was happily munching away on my pasta during a lecture on airway management with some gruesome images. Guess I’m fully immune to grossness now.
We finally got to SSC1 session and I got to speak about curious incident. I looked at how the book changes the perception of “normality” by telling the tale from Christopher’s eyes. I also looked at the last scene of the play and how they portray that even though people with disabilities can technically do anything, we are still in the position that this is not possible. We still see disability as an inconvenience and with the lack of adaptations, people really can’t do anything:
In the evening we had a huge revue rehearsal doing the big whole cast scenes. It was fun to get back to acting etc but it was a long evening. I was pretty grateful to get back home and just collapse in my bed.
Decided that I was too tired for the 9am but thankfully it had been cancelled anyway (whoop). I made it in for 10am when we had some safeguarding workshops. Both me and Matt had failed to actually do the online courses before they were due so we quickly completed them before the session. We had Cornelia who was one of our Anatomy tutors last year so it was strange to not see her in an anatomy setting. We just have to remember that people have lives outside the STC .
I really enjoyed talking about this. It’s a shame that we have to talk about it, no-one should ever have to be put through it but we do live in a world where safeguarding is a valued framework so it’s important to learn.
We then had a lecture about glucose regulation but I could barely hear the lecturer so I made my own notes off of websites in the back. At least I was productive ! Wednesday afternoon brought a diabeties workshop, with a twist. We were locked out of the room that we were meant to be using so we ended up having a al fresco lecture sitting on the floor in a werid circle, filling out the worksheet. Locked rooms shant ever stop us.
We also had new CBL case. It was diabetes this week and one of our first paediatric cases. It was also one of the first cases where we could not have guessed the diagnosis from the opening page so it was nice to debate and delve into the case.
I took a 40-minute nap before rehearsals as I was in a lot of pain (seems to be the common thing at the moment). Then came the moment of truth. We had a three hour dance rehearsal and I’ve not danced since I was 14 when I gave it all up for school. Despite me having two left feet I managed to get through it and I really enjoyed the evening ! I can’t wait for it all to be tied together – but towards the last ten minutes my abdomen was in agony so I decided to just walk through the last ten minutes.
It was 9 by the time we finished so I was pretty relieved to dive back into bed safe in the knowledge that our 9am had been cancelled the next morning.
We started with a lecture on concordance and then onto what to do when a minor refuses consent. I really did enjoy this as ethics seems to be becoming a love of mine here so learning about the ethics behind paediatrics was a brilliant session. We also had a debate about real paediatric cases (obviously changed for patient confidentiality) and it was interesting to see how the minds of my year works. I love interactive sessions like this as you can almost imagine yourself in these situations when you qualify. GOSH have actually got a ethics event coming up which I wished I could go to but I can’t get the time off or afford the train as I am going down the next week for their conference.
We also had some group work to do in the afternoon but shortly before I had managed to scald my hand on the boiling water tap filling up a water bottle to try and ease the abdominal pain. So this session turned into a mini first aid session. I wanted to go climbing but I ended up just coming home and doing some light work. This pain has just completely wiped me out these past couple of weeks.
Day off ! Spent the day getting ready for Family Meal ! It’s a tradition here but I have been panicking about cooking as I am really not known for my cooking skills. I ended up just going with a simple rice and curry dish (which I managed to not muck up). It was a lovely evening and it was really nice to catch up with my medic kids. It’s nice to see how chilled out their year are compared to us. They actually seem to be enjoying their degree and having a decent work life balance. The kidneys seem to be causing problems again and I do feel sorry for them not having Dr Roebuck teach them. We were gutted when Jamie left, he is the top lecturer here and it does feel weird knowing he isn’t here. All the lecturers are brilliant , but Jamie just had that extra something. Me and Kat decided that we should run an extra session about kidneys as we actually quite enjoy them, so watch out for that! We ended up finishing early though as we were all pretty shattered and they had anatomy day the next day.
Weekend post ! I actually did something on Saturday ! My friend Matt from UCLan was around in Coventry so we decided to meet up. Rosie my bestie was also around so we had a mini reunion. Rosie, Matt and I lived together in second and final year. I miss it so so much and it was nice to see that Matt had not changed at all with his card tricks. It was so nice to catch up and see everyone. It can be hard here, seeing everyone lead amazing lives and with half of my group still together it can be very isolating.
I ended up in a bit of a slump this evening. All I wanted to do was go home, there’s a lot of worrying me at the moment and for someone who loves this degree, the fact that I keep wanting to drop out is scaring me. So in the middle of this slump I receive a random message from one of my other friends (sally) and within a good 10 minutes I was crying with laughter on the floor. It wasn’t even about anything funny in particular but I just appreciated that bit of a break from the cloud that was hanging over my head.
Med school can be incredibly isolating and hard. It can make you feel on top of the world one second, and the bottom of the heap the next. I do try to keep these things positive, but there are weeks when I just want to write, yup this week happened, and leave it at that. However, part of the anxiety I am feeling is due to the unknown, and the point of this blog was to tackle the unknown for others. I am struggling with my mental health, I am trying to fight back against it but not even wanting to do work is completely against what I normally am like. I know it’s ok to feel this way though. That’s important to recognize. Instagram is filled with accounts showing off pretty notes, insane working schedules and super star medics. It’s so important to keep in mind though that these accounts are only showing part of their life. I try and show everything, the ups and (most of) the downs. I hope that is good – and I hope that somewhere, this taking away of the unknown, is helping someone get through the uncertainty of this insane medical world I love so much.
Hospital again, and thankfully my last ridiculously pre-6am wake up call. Today I had to be in the hospital for 7:30am which does not sound too bad but the bus from campus was at 10 past 6 so it was an early morning for me! I arrived at the paediatric ward and it is now my favourite place in UHCW as it was covered in decoration and had a completely relaxed feel to it despite it being quite as it was so early.
I was taken to the day surgical unit on the paediatric bay where I met my supervisor for the morning. She was a cheerful human so I knew it was going to be a good morning. I had a quick tour around the place and she explained how the paeds bay works on that ward. We only had 4 patients there today so it was a quiet day and 3/4 of them were in for tonsil removal. It was a slow start to the day as they began to arrive for their surgeries and in my exhausted state I was struggling to keep my eyes open. However, we ended up doing a coffee run for the staff on the paeds bay so I managed to get my hands on an amazingly strong coffee – bliss. The surgeons then started to take the kids off for surgery. I got to see the role of the play specialist here who was providing comfort to the kids before their operations. They had a small kit which contained everything the kids would be experiencing in their operation. The cannula , the stickers to hold the cannula in place, the air mask. It was all in there and I really like the concept of this. I think if I ever do end up in Neurosurgery (of which I am yet again doubting myself if I am actually good enough to do) I want to bring this into my practise if it isn’t there already.
This happened throughout the morning and I was kept well supplied with biscuits which again was great ! At one point I entertained myself for a good 20 minutes blowing bubbles for a little one whilst they were waiting for surgery, not sure who was having more fun though, me or the patient.
I was also lucky enough to go into the anaesthetic room to watch them being put to sleep and my surgical heart just wanted to follow them into the operating room but alas, I’ve had my surgical fix already. I also got to try some numbing cream which was the weirdest feeling but it did mean my hand didn’t belong to me for a good 6 hours afterwards 😀
In the afternoon I had my final bedside teaching with our clinical education fellow. It was an amazing session as we got to see several patients on dialysis and several kidney transplants. The brilliant thing with transplants is that you actually get to feel the kidney. As part of abdominal exams you have to feel for the kidneys except you will NEVER feel the kidneys. Consultants will tell you they have probably felt one or two in their entire career, so getting to feel the transplanted kidney was useful as it shows us what we need to be feeling for.
I ended up going home pretty sharpish after, I’ve been feeling pretty rough all day so I just wanted to get back despite having some database work to do. Sometimes, you just need to do what’s good for you.
Worst of both worlds for CBL this week. 9am on the Tuesday followed by the last group session on the Wednesday. It’s slightly annoying as I could have used the late CBL starts from the beginning rather than now as I had all my stupidly early mornings in the first week. Im so tired not even surgery got me hyper last Monday. We finished off our HIV Case from last week looking into the impact of HIV on family and friends and debated where the doctors duty lies in informing partners if the HIV positive patient refuses to do so.
In the afternoon we had a a lecture from McDoogle who we have seen once at the beginning of the course and not since 😅. It was interesting as we were talking about allergy and how it is diagnosed in clinic. I did not realise that allergy could be non-immune system regulated , so I suppose you learn something new every day!
I had SSC1 in the afternoon and we were picking our favourite quotes from middlemarch and digging deep into them. I am loving this as I used to dive deep into my books. Literally, I believed the curtains were blue to reflect the characters mood rather than because the author picked a random colour.
Then , the thing we had all been waiting for. REVUE read through. I can’t say too much. If I did then my fine would be a shot and I am dancing in revue so I prefer to be able to actually stand up. However, I can say I was giggling all the way through and even the cast songs went down a storm ! We headed to varsity after and we got chatting to the first years about how they were doing. Im still jealous they get a week off between blocks but we found out they took a week off easter and I treasured all my 4 weeks at easter so I am happy with our years arrangement!
Did not managed to make my 9am. My eyes were so heavy when my alarm went off and I just did not have the strength to get out of bed. I think I have some infection as my abdomen was in agony all evening so I decided just to go to the 10am. I guess it’s just that point of the term where the tiredness just hits. It also didn’t help that we have near on 4 hours until CBL so I was practically falling asleep in the computer room instead of doing work.
When CBL eventually arrived we had a new facilitator who was lovely. We ended up going around the group telling everyone our past lives before Medicine. Turns out Jess in my group would have made 17 year old me green with envy having been IN SHERLOCK and casually watched TV with Benedict Cumberbatch. I stood for 14 hours to watch 30 seconds be filmed 😅. I ended up being chair for this case and for once I enjoyed it. Maybe the leader inside me is emerging.
Again, missed the 9am lecture ( I swear I am normally a good student). We then had a renal dialysis seminar which was interesting but because I’ve mainly seen these patients on the wards through bedside teaching, it felt a bit of a repeat. In the afternoon we had our phone communication skills session. We were essentially phoning SIMs in the room below us but it did feel rather real. I had a bit of a curve ball as we were told to take a history but my patient was having a heart attack so I wasn’t sure what to do. I ended up stumbling through a quick history and then ending the conversation by shouting please call 999. Not my finest moment 😅. However, we learn through stumbling so I felt I took a lot away from this situation. We also practised handovers and because me and Matt seem incapable of taking anything seriously during clinical skills, I ended up taking a handover from a Texan GP.
This was also the day Adam Kay’s new book was released so I made the trip down to main campus and back to retrieve the book and sat in the MTC giggling to myself for the next hour. I devoured the book in one evening, it was as amazing as his previous one was.
My first Coventry driving lesson today. I definitely am a lot more confident driving and I even managed to drive inside UHCW ! I went in to try to chat with one of the Neurosurgeons about getting involved with research but he was pulled into theatre. I don’t mind, I’ve been feeling off all week so I was happy to get home. I finished off the week by going to watch the Joker in the cinema. It wasn’t something I was keen to see but at the end I was hanging off my seat. It was amazing !! Now, a nice weekend at home treat to myself 🙂