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 🙂
5am and my alarm kicks off. However, it’s ok , I HAVE MY SURGICAL INDUCTION TODAY !! I had to get a slightly chaotic transport route to get there as I was stationed in Rugby and I don’t drive. One Uber from campus to the train station as I was up before the busses started running, a train from Coventry to Rugby and another taxi to get from the station to the hospital because … the busses were not running. So, £15 down and I finally arrived. Cue another 20 minutes wandering around the hospital because I had no idea where I was going (I did a lap of this place) and I finally find the theatres. I got changed into scrubs and a lovely white hat as this is policy for students and soon I was chucked into theatre. Rugby is mainly an orthopaedic theatre so this was the complete opposite of the spectrum I was planning on going into but I felt I may know a bit more about what I was seeing so I was excited.
I got to see the operation from start to finish with the patient being put under general anaesthetic (they were asking him to tell a story and he fell asleep half-way through) and then the operation began. They were doing a hip replacement so I was chatting with the scrub nurse before about the instruments used. There were some cheese grater like devices that were used to drill into the acetabulum (hip socket) which when they were eventually used, put me off grated cheese for a while. Orthopaedic surgery is a whole other world from the Neuro surgery that I was used to. Bringing out a hammer in the middle of the operation was a bit of a new experience and seeing the power behind the technique took me back a bit ! However, it was incredible to watch and the mess was just everywhere. After the surgeons were done rubber gloves were flying everywhere as they were pinging them into the bins and then left. I was so bemused but it was brilliant and I enjoyed watching the hip slowly being put together !
I had to leave early as I had to get the bus back to UH of which I was completely gutted about as there was a knee operation in next 😦
I had bedside teaching in the afternoon and since I was a bit bleary-eyed this morning I forgot my Stethoscope, Well Done Abbie. Thankfully we had mainly Neuro patients that I loved as we got to do cranial nerve examinations. Lastly, we went onto the cardio ward in which I had to awkwardly stand there nodding as I couldn’t actually listen to the organ in question. We also managed to pick up a third member to our group as Matt was hanging around the ward.
In the evening I got introduced to an MS database I said I would help out on and eventually got back home at 7pm. Longest day ever but it was worth the 5am start for surgery.
9am CBL. I am enjoying CBL a lot more from last year but having it two days in a row can make you dread it. However, this session we found out we were swapping over facilitators and then it hit me. I’ve done 5 weeks of year 2 – the equivalent of one block in year one. Normally, I would be shattered after 5 weeks but I actually feel amazing. I guess my new methods are working ! We also had Revue auditions in the evening. This week my two favourite parts of the year begin on the same week with Revue auditions and Doctors and Nurses in the same week !
I was so happy to finally be back in the Revue spirit and I even put myself up for the dance side this year, I was a stiff as a board but hey ho – perhaps my 14 years of dance lessons may come back to me eventually.
Normally, I switch off during infectious disease lectures as it’s not really something that I am interested in but today’s topic about virology seemed to peak my interest and I was engaged all morning.
We then had our final CBL with our facilitator Ellie who made us the most amazing cheesecake as a goodbye gift. It honestly was the best thing ever, however, we kind of forgot another group were also sharing the cake and we ended up eating more than half of it , as the smaller group out of the two… oh well!
I hung around the med school that evening as I had my interview for surgical society. I know I want to go into surgery so I thought being on the committee helping to organize events and speakers would be good experience. I had applied for their outreach officer so I was asked about my experience at one point and of course, I run this blog which I think counts. However, instead of being a tick in my box, it ended up being the most awkward moment of the year:
“Interviewer : So what experience do you have”
Me: Well , lets address the elephant in the room, I run a blog..
Interviewer: I’m sorry, what blog?
Awkward. Should have not mentioned it, should have just pretended it didn’t exist, then I wouldn’t have ended up with egg on my face 😅
I headed back home feeling slightly optimistic about my chances but later got a rejection in the evening- I don’t mind too much. Obviously I was slightly gutted but I guess I am going to be ridiculously busy this year and I have a lot going on with my NANSIG role. So actually , I am slightly relieved. I have my own plans to go along with (doesn’t mean I won’t reapply next year though!
It’s here ! The day is finally here. DOCTORS AND NURSES HAS ARRIVED !! It is my favourite night out of the year. I get to wear comfy scrubs, go out in comfy shoes, and draw on a fake beard. Last year I was completely wrecked before we even got there so the evening appeared to go by in seconds and I had planned to repeat that experience again except this time, I wouldn’t have to be in for a 8am lecture the next day 😀
Most of us convened round one house for pre-drinks and as determined as I was, it seemed I was destined to remain semi sober 😀
We met my medic parents there (my dad wearing the same dress as last year – ever reliable though apparently I have been disowned because I abandoned their pre-drinks) and I also bumped into my medic kids. I am especially proud of my son who went the full mile and shaved his legs for the evening – following mothers footsteps in the effort making. Im proud to say they both made it to their 8am the next day ,:D.
I ended up making it till close and of course finished the night with the cheesiest of chips. The perfect end to an evening out. Bring on next year !
DAY OFF ! Woke up early which was annoying but practically didn’t move. I ended up having a bit of an admin day, sending some emails for NANSIG, uploading photos and writing this blog. I like being able to get everything done in one day. Makes me feel a bit more on top of things.
So I guess that is it. The end of yet another hectic week. I am really looking forward to the first read through of the revue script, finally being able to meet with a neurosurgeon at UH and getting more involved in NANSIG. Here’s to a slightly less hetic week ! (pah, as if I am ever capable of one of them !)
How is it week 4 already? Only, feels like I have been back for about 4 seconds. Though I have the exhaustion levels for 4 months ! Anyway, Monday started with a nice early wake up call as we had the fire drill here in my accommodation block. Let me tell you, 200 odd freshers being woken up at 7:15am on a Monday morning is not what they imagined their first day of lectures would go. I also got to have a slightly delayed start to the day as I didn’t have to be at the Hospital until 11:30am for my TDoc (assessment) in blood taking so I would be able to carry out the procedure on the wards. I left my flat after a lazy morning at 10 to catch the bus to get to the hospital for 11. This plan did not go well. I got on the number 60 which is the bus I need to take, however, we have to get the anticlockwise one (why they just didn’t give the two different routes two different numbers I have no idea) and I ended up on the clockwise one. The driver didn’t alert me and happily printed off my UH ticket and it was not until we were the opposite side of Coventry that I realised what had gone one. I began to panic but because I had left an hour and a half early, I thought it would still be ok.
However, we pulled up at another stop and because I was knee-deep in a book, I didn’t realize we hadn’t moved in a while. It wasn’t until another driver had come upstairs to enquire why I was sitting on a parked bus did I realize what had gone on. The driver of my bus not only failed to give a heads up he was the wrong bus, but had failed to tell me he wasn’t actually going to go the full route to UH and had parked up and gone off. I was fuming, by this point it was 11:15am and I was 30 minutes from the hospital where my TDoc started at 11:30am. I was fuming. I finally arrived at UH at 11:45am but thankfully the clinical skills guys at UH were lovely and let me still do my TDoc. My hands were shaking the entire way through and my head was just not in the game. I ended up getting a borderline pass but the lecturer assessing me and myself suggested I should come back later to re-do it and show I know what I am doing.
I also managed to walk off with a Tourneqy which make amazing fiddle toys so I was just working off my frustration before bedside teaching. Bedside teaching more than made up for the disaster of a morning. We saw 4 patients all with hugely different histories and some interesting presentations. One chap will forever remain with me as he was so open about his past and did have a symptom called gynaecomastia. We have to speak our findings so we were saying that he had minor gynaecomastia to which he shouted ” I know the medical talk for man boobs!”. I completely died with laughter inside as he was just so good-natured and completely clued into our ways. I also got to examine a patient who had a replacement heart valve. It was completely incredible as I could feel the valve from outside the chest and it was fascinating to hear the metallic sounds inside her chest. She also had Lupus and I only knew this because we had it in our mock that the second years had created for us last year (we hadn’t learnt the presentation of lupus) and so picked up her presentation there !
After bedside, I headed back to the clinical skills lab and repeated my T-Doc which was significantly better and I had a bit of a spring in my step. I got in that evening and was immediately on the phone to a local driving school to arrange lessons so I could pass my practical and never have to get on a bus again. I believe I have used all my tolerance up on public transport.
I called it. A rare sick day. I had been coughing all through the night and woke up wit painful sinuses and just feeling generally ill. There was no way I could get through the day so I decided to do what’s best for me and just take the day off. I didn’t even do any work until about 6pm.
I still feel a bit rough but I feel so much better for taking time off to get over the worst of it. I hate taking sick days, but you know what? This was needed and I feel guilty but happy for doing it. Sick days may not seem like a big thing but medicine can feel like an all consuming study/ profession so most of us feel guilty for taking a break and just power through it. However, as my old lecturer used to day, you can’t pour tea from an empty teapot.
So , after I had finished typing for Tuesday, I found out I had been made the Warwick representative for NANSIG ! I was pretty shocked as I thought I had screwed up my application big time but I got it. It is a huge opportunity and is going to be amazing for my CV. I also just believed that I got it by default, but I later found out that others from Warwick had applied. Im expecting a rejection email any day now as I can’t fathom why they picked me and not the other guys who clearly have more expertise than I do but hey ho, I guess all I have to do it just give it my best shot !
Back to lectures today, the cough died down overnight so I was happy just to trod along. In the afternoon we had CBL which included cake of which I had made for missing the CBL session on Tuesday. I also found out my facilitator comes from the same town I grew up in and we were marvelling at the delights of one of my local hospitals which had a bad reputation and was one of the worst hospitals in the country. We were also marvelling at the delights of the said town. I like that we have added another person to a growing group of people in my year that we had established were all born in the same hospital 😀
Thursday brought about the arrival of our first communication skills sessions in year 2. We had small groups and SIM patients whom we had to take a history from. We were given no information about the patient coming in so it was hard to keep on top of things but it was really enjoyable. I was slightly dreading having to listen to the same history over and over again but the SIM patients were rotated around after each history which was brilliant. My SIM patient was a woman with headaches which threw me slightly as I had never really learnt any of my focused history in year 1 (whooops). However, I managed to stumble through and was given good feedback! Honestly, the communication feedback I am getting is surprising to me, Im being told I am empathetic , warm, bubbly and caring and have had no bad comments about bad eye contact. Maybe , I’ll be a human doctor after all instead of a robot!
In the evening I had a Neuro committee meeting before heading off campus (whoop) to see my student seminar team from last year. These people became family to me last year both in a warm cuddly way and also in a medic family way. We just had an evening laughing about pretty much everything, drunk quite a bit of prossecco to celebrate the 100% pass rate in our student seminar, and chatting about how the first years get a week off between blocks now and how the exams have changed for them with the written papers now averaged across. This has brought about much jealously in the upper years as it caused us A LOT of stress with us having to make sure we passed all the written papers. Im glad though that the first years won’t have that terror facing them when they hit exams.
I also was messaging my best friend from UCLan who I was joined to at the hip back in undergraduate (literally when you saw one, the other wouldn’t be that far behind). I love the fact we are still as close as ever and more importantly, it’s nice to know that someone outside the Warwick bubble understands the chaos of Med School. I have found it has been hard to keep up with my friends at home and I can see the distance growing between me and my friends from home, but I know with Rosie she understands and though we go weeks without messaging, we both understand our lives are crazy . I think those are the best type of friendships. Especially, for busy medics who love our friends a lot but can find it hard to keep up with everything all the time.
I can’t tell you how much I was looking forward to my lie in today. I am shattered with whatever the first years have infected me with so I needed a bit of a nap. However, me being me, I couldn’t just have a day off so I ended up going to UH to go to Neuro teaching as well as hoping to bump into one of the Neurosurgeons at UH to get involved with the research and hopefully shadow operations. Teaching didn’t happen but I did meet one of the surgeons who is known amongst us students for being helpful and open to us so I booked a meeting for next week.
I decided that I also wanted to get a bit more out of the day so I went down to Ward 1 where my bedside teaching was last year to take some blood. The nurses were so lovely and I eventually had my first patient. I was terrified inside but tried to not let it show (though apparently she guessed it was my first time) and I successfully found the vein the first time ! However, it stopped bleeding before I filled the bottles I needed so we went for the back of the hand approach (with a beautiful vein) and I successfully filled the bottles I needed and got them labelled and sent off to the lab. I suddenly felt like a doctor in training and had a massive grin on my face for the rest of the day. I also managed to take some blood from a pregnant lady with my technique being a bit less shaky this time and managing to fill all three bottles. We got chatting about names and due dates and I loved every second. I also managed to squeeze in a quick ECG before I had to run for my bus which was also , incredible.
I had my first meeting with my DSA mentor that evening and then headed off to my medic dads house finally for pizza and to see their four new Guinea pigs so I could finally have a cuddle. I’m glad this week is finally over – I am shattered ! (First years, your levels of tiredness do improve I promise !)
Into the big wide world! It feels weird not being in lectures on Mondays, I am so used to dragging myself out of bed to go to 9am’s and now it is completely different. Well, not so different, I am still up ridiculously early to catch the bus to get to hospital for 8:30am, so I guess some things stay the same!
I got to hospital for my first CLO. These are clinical learning opportunities where we shadow anyone but doctors in the hospital. Today I had the REACT team. It was slightly different to what I was expecting, well, a LOT different to what I was expecting but I ended up loving it anyway. REACT is a team at UH which prepares elderly patients for transfer back home and suggests any adaptions they may need. I ended up hanging around in ED and went to see a patient being screened to go home. It was interesting to see how patients are assessed and the gentleman we were talking to was lovely.
After, my tutor had to go and make a call, so I ended up just waiting. I wanted to be pro-active, so I ended up popping back into the gentleman’s room to listen to his chest as he had an infection and I wanted to hear what that sounded like.
After, my tutor suggested I go and see a patient with Parkinson’s who had significantly deteriorated and was severely ill. I went into the room and instead of throwing 21 questions at the wife, I ended up just helping her care for her husband by helping her clean her husband’s beard from custard. The wife looked exhausted and my first instinct is tea, tea solves everything. I dashed off to make her some, so I now know where the tea station is in ED (which I believe will come in handy) and when I came back, she was alone. I asked if she had had anything to eat and managed to find her some (very dry, very crumbly toast). I went to sit with her just to offer some comfort, but I was whisked away by my supervisor, I hope I helped her a little though!
In the afternoon I was convinced I had bedside teaching, so I went to sign in but couldn’t find my name. Turns out, I was meant to be in clinical skills teaching learning how to take blood, starting 10 minutes ago. I raced up to the third floor and collapsed into a chair. Learning to take blood felt amazing, it really feels like a step up from first year, and I am hoping that I will now be more useful on the wards than before. It’s weird, I’ve finally learned the technique I’ve been wanting to learn since day one, but it’s not been the best part of my day. I still wonder what happened to the lady whom I met in the morning, and just getting her a cup of tea reminded me why I want to keep going with my medical degree and why I became a walking textbook in first year.
In the evening Will came around to celebrate him passing his second-year exams and the two of us managed to successfully cook a damn good dinner!
First day in Uni with the Freshers. I’m not going to lie. I am an over excited puppy, so I was excited to get to the med school, but I was also aware of the mountain of work I currently have brewing. We had our CBL finish in the morning and then I decided that I would try to get some work done before afternoon lectures. I ended up just basically distracting myself for an hour and doing 10 minutes of actual work.
In the afternoon we had a lecture on cannulation and the anatomy behind the technique. This was slightly weird as with the first years now here, we got kicked out of our MTC, and we are now in the MSB, haven’t figured out if I am pleased or not about that yet!
In the evening I FINALLY had my first SSC1 session. I am doing Middlemarch – Medical Humanities. The book was written by George Elliott, of whom one of our teaching hospitals is named after. The module focuses on Humanities in Medicine which is a nice break from the pace of normal lectures. I have several ideas of what to do, so I am excited to start putting them into place.
In the evening I finally got to meet my amazing medic kids. I am married to Kat, a fellow Neuro in my year, and we have two kids who are Neuro inclined 😀 It was lovely meeting them and it was our daughters birthday so naturally I had to embarrass her in front of everyone there by getting her a cake and singing happy birthday at the top of my lungs, what can I say, I am OWNING this embarrassing parent lark :D.
I also got to meet some other freshers and chat to them how their week is going, everyone seems lovely and I even got recognized for my blog a few times which felt really humbling. I’m glad I’ve helped others get to where I am!
I got home late and basically collapsed on the bed and was knocked out to the world.
Pretty standard day, we had a 9am lecture on UTI and then a two-hour lecture on Delirium and Confusion… which left us all confused. It was a Neuro lecture so I should have loved it, but I am dreading typing that lecture up!
We then had some free time (sorry to rub it in first years) so I spent the afternoon making rather fetching brain hats and a game to win a cuddly neuron for fresher’s fair that evening. There was glue and Sellotape everywhere, but I was pleased with the result and even my anatomy professor loved them!
We had freshers fair in the evening which was brilliant. We got a lot of sign ups and I am pleased to say that the “pairs” game I had made brought out the competitive med student in everyone. I was exhausted by the end though, so I made it back and again collapsed into bed. The plan is to sell more raffle tickets next week so Freshers, come and get your soaps!
We had a Neuroimaging 9am lecture so of course I was excited. Radiology is beginning to become a speciality I am really intrigued by especially the Interventional side as it means we can fix patients problems without having to operate. I’ve got the contact for a Radiologist at UH so I am going to email to see if I can find out more.
After our morning lectures had finished, I spent the rest of the day following Matt around as he took photos for his Med Project. He is going to take photos of first years throughout their journey at medical school and see how they change and how their perspectives differ throughout the year. Considering Matt is normally behind the lens, he normally does not have many photos of him (despite his cannula porn type arms see the image below) so I used my limited photography skills to take some photos of him taking photos! We also ended up in my Anatomy lecturer’s office doing a mini photo shoot and got talking to her about teaching as I really want to build up my portfolio.
She also has an incredible book called “The Secret Language of Anatomy” of which I believe my medic dad will love and I certainly do. It is a book that tells you the origins of certain anatomical names of the body, I sadly geeked waaay too much over it.
This is what I have been waiting for, a day off!! I let myself sleep in until I naturally woke up, well, until a couple of my freshers rang my door bell.
I had a slow morning, sorting out the To-Do list and eating a perfect sausage sandwich, of which knowing that fact has greatly improved your lives :,)
I basically spent the day catching up on lectures and had to head to Tesco to grab a new flask as mine was taken over move in weekend. Turns out this new flask leaks more than an old tin roof. In the evening I went climbing with Matt and got signed off ! I now feel like a grown up on the climbing wall 😀