Achilles' heel

Everybody has one. What's yours?

Working in health-care, there will always be one particular kind of human leakage that gets to you, even if the others don't.

I love to watch a good drainage, and I am looking forward to squeezing/cutting/draining the pus out of things. Blood doesn't bother me any more, and neither urine nor faecal matter phases me in the slightest. As long as it isn't moving in my general direction with any kind of velocity, I don't care.

I don't mind bile at all, and find the colour interesting. I love watching an ERCP when they cut the ampulla slightly so that the stones and bile come gushing out. Fantastic!

The noise a patient makes when they are struggling with the fluid during a bronchoscopy does make me wince. But it is out of empathy.

But dribble. Ugh.

I'm not talking about the dribble from a baby, or an adult with poor oral control. Hearing and watching a patient spitting heavy phlegm into a cup makes me mildly uncomfortable. But stringy spit makes me dry-retch.

I can see the most awful things in ED. But that scene from Big Daddy where Adam Sandler dribbles out his own spit and sucks it back up makes me gag. Typing about it makes me gag. I'm sorry if you are like me and reading about it makes you gag. Ugh.

It is funny, the little things that get to us.

Temper tantrums in adults

Why do some people never seem to grow up?

Why is there always a certain percentage of the population that persists in being completely ego-centric and having the mindset of a two-year-old, thinking that they can have a temper tantrum because they are not happy about something and that nobody else will be hurt of affected in any way?

Perhaps they enjoy the power and manipulation that it can bring when people cater to your every whim and do what you want when you do your nut. Perhaps they enjoy seeing that people are hurt by their actions but have to keep them happy. I suppose knowing that you can get away with doing something awful is one hell of a power trip to the right kind of person.

A long time ago I thought that they were probably ignorant, and that they carried on like fools because they weren't aware of the effect it had on people. There might be a very small percentage of people like that in the world. But I don't think that most cruel and unthinking people are like that any more.

In general, they are jerks because they are jerks. Perhaps it simply comes down to that. (We won't go into nature vs nurture here. I'm simply having a rant. A temper-tantrum of my very own, if you will.)

The ol' ticker . . .

. . . my bodyclock, that is.

I am an early-riser. Or at least, I was before I started shift work. I function best when I can get up early in the morning, get a lot of things done and then relax and go to bed at a reasonable hour.

When I started shift work some five years ago, my body clock had to be put on snooze permanently. I could be at work at any time of the day, and would have to sleep for eight hours straight when it was light outside and there were children playing in the park. (Grrrr, damn kids playing loudly! I wave my imaginary walking stick in their direction.)

Thank goodness I also seemed to be able to manage sleep as a shift worker. Unfortunately, this also meant that any alarm clock going off would catch me very unprepared. I would often jump half a foot off the bed while reaching for the alarm and kicking one of the cats into launch, all simultaneously. I think it is one of those things that you can only manage to do while being semi-conscious. (Like sleep-walking face-first straight into a wall and waking up crying in the hallway with no idea where you were, how you got there or why your nose hurts like hell. But that is another story.)

Anyway, this was just a brief celebratory post to herald the fact that my body-clock seems to have made a valiant return, and over the past week I have woken up at the same time, around one minute before my alarm actually goes off (at 5.30am). God bless you, body-clock. I plan on enjoying you for the next four years until I have to send you packing again.

The nose knows

I have something sad to report. This afternoon during anatomy the off-button on my nose failed me completely, and I have gone from anatomy buff to complete anatomy phobe (almost) in one session.

One of the anatomy demonstrators cut open the abdomen of a cadaver in front of the class, and we were in the front row. I was slightly nervous as I have never seen cadaver cut open ("scalpel-to-skin" if you will) but wasn't too worried. After all, last week went so well! As soon as he cut into the abdomen of this poor cadaver, the room filled with the most revolting smell that I have ever, ever, ever encountered in my entire life. I have smelt a lot of bad things (including burns victims), but this affected me much more.

Normally I can ignore anything that I smell but this was very special. I couldn't decide whether to breathe through my nose or my mouth. I tried wedging the safety glasses further down onto the bridge of my nose but it was to no avail. I occasionally found myself feeling quite dizzy as I was subconsiously holding my breath, so I had to take a couple of deep breaths. Thank God that this wasn't as bad as I feared it would be.

We are not allowed to chew gum or do anything that would make the smell better, which really really doesn't help. There is a theory floating around that the fellow who cut into the abdomen accidentally nicked the colon, and apparently this would explain the smell.

I feel terrible about this, as this person donated his body to science and I feel very priviledged that I have the chance to learn from his cadaver. I don't think I learnt as much as I could have if the smell hadn't distracted me so badly. If you'll excuse me, I need to take a long, soapy shower and cover myself in nicely-smelling things.

Eureka!

I have worked out what seems to be an effective study method for myself - pictures! (Not this one. I found this one on flickr.)

Now if only I could find "The Big Giant Picturebook of Medicine" I would be able to sail through this degree with a nervous bone or two still intact.

If I could draw well enough then I could make one myself. I like to imagine that it would be the most popular learning resource on the market for drunk or mentally depleted medical students. It would have a fun cast of characters, with medical-sounding names.

The first chapter: Steph the friendly staph, in "Let's Have an IDC Party!"

It would be followed by a scratch-and-sniff book entitled, "Smells I Have Known." This would be part of the hospital acclimatisation of the course.

Ah, the possibilities.

"Suitable ward attire"

I am very happy to be getting away from a profession in which we are required to wear a uniform day in and day out, but this introduces the option of personal taste and preference. Generally making your own mind up can be an area in which some people seem to struggle.

In a recent lecture we were told that we were to look, act and dress the same way as the real doctors in order to fit in and give patients confidence in our ability. Having worked with real doctors for several years, I am not quite sure how to take this. You see, real doctors get it very very wrong as well.

I have seen a young female doctor in a tight designer dress with fishnet stockings and killer heels. In the emergency department. I would have loved to see how she went if all hell broke loose.

I have seen another female consultant wearing a low-cut top and tight leopard-print miniskirt. She could have gotten away with it if she had worn the ensemble once, but it was a regular outfit, clearly in her pile of "workwear". I doubt this would pass for suitable student attire, but you could argue that you were dressing like a real doctor.

The men don't quite seem to get it as wrong as the women, probably because it is hard to get it so incredibly wrong when you get to wear men's clothing. Your average clueless male can get away with a striped collared shirt with navy pants or jeans (on the weekend) and not put anybody offside.

However, I have seen a male doctor running around the hospital with clothes that looked strikingly like the uniform of a male nurse. His pants were the same colour, his shirt was the same colour (although obviously not hospital-issue) and a lot of nurses run around with Littmann steths around their necks these days (as does everybody, it would seem - even the vet students at uni!) so that didn't even make a difference. However, seeing as how most male nurses tend to get mistaken for doctors I doubt it would have caused him any issues.

Milk & Two Sugars has already written a great post on student-wear in the hospitals, so I won't repeat what she has said. However, where we are in the world, a lot of our female doctors run around in business pants and dress shirts that don't need ironing, and for me this is an incredibly attractive option! There is also the issue of the cost of a nice collared shirt for women - the same brand of shirt with the same material for a woman will cost twice as much as the same shirt cut for a man. Not cool.

However, you won't catch me dead wearing a leopard-print skirt or fishnets anywhere, so I think I am pretty safe. Better to concentrated on becoming the best doctor I can be without spending energy fixating on clothing. If I do fixate on clothing, it will be in a happy way. :)

Add a dash of inspiration . . .

Awwww! Just when you think you have it tough, never underestimate how helpful a little (or a lot) of resourcefulness can be.

When I grow up, I wanna be a . . .

Shrink!

In case you haven't read this, the posters at Shrink Rap have posted some wonderful comments about why they love their jobs as psychiatrists. If you are at all interested in the field (or are wondering why the hell somebody would want to work in psychiatry) then it is well worth a bit of a read.

Psychiatry is up there as one of my top areas to work in when I finish medical school. It is an area that has always interested me, ever since I read Tell Me I'm Here by Anne Deveson about her family's experience of schizophrenia when her son develops the disease. Mental illness is a fascinating and terrible thing, and I love the idea of helping people who are suffering from it's debilitating effects, finding some way to return them to a normal and functional life.

Yes, I am well aware of the reputation psychiatric staff have. "When you go to visit, you aren't sure which ones are the staff and which ones are the patients," and "No sane people do psychiatry" are two of the typical things that people say about psychiatrists. The other one I hate is that people who go into psychiatry supposedly do it because they are either no good at any other kind of medicine or that they are in it because it is an easy life. We'll see.

I'm not going to go in starry-eyed, expecting to love every minute of it. (Honestly, there is no job like that in the known world.) If I find I hate it, that is ok too. I'm not doing a medical degree because I want to specifically become a psychiatrist. However, it has a lot of the things I am looking for (being able to schedule your day a little better than ED, some continuity of care, reasonably regular hours, the opportunity for meaningful interaction with patients - I love listening to and talking with patients!) as well as being an area that I have always been fascinated by.

Time will tell. But as I go further into the medical course, the prospect of actually being able to become a psychiatrist is getting more and more exciting for me.

(And as a completely different side-note - I recently received a request form from an ED doctor with the word "pleaz" written at the bottom. Seriously. God help us all.)

Teamwork and showers . . .

When I started medicine, I knew it would be difficult. However, I had no idea just how completely overwhelmed both I and everybody I know in the course would be feeling just a few weeks in. (Except for those of you who either don't study or who know it all already. But you are few and far between, and because you are either not going to be here much longer, or are clearly not human, you don't count. Sorry.)

Here is a rather creative (aka far-fetched) analogy: imagine you are told you have to familiarise yourself with every drop of water that comes out of a tap. That's ok, you think. If I work hard, I will be able to keep up. Suddenly you realise that it isn't a tap but a shower, one of those high-pressure ones with a million jet streams of water. And nobody is turning it down or off any time soon. And they still expect you to know the drops of water, even the ones that are down the drain and far, far away into the sewer of life.

Ok, so that was silly and rather badly-written. If I had more time and energy I would pen a haiku on the topic. In fact, here is one that I clearly didn't prepare earlier:

I stand in the rain.
Drops pouring down past me, scared.
Too much too fast - d'oh!

Enzymes and t-cells
are like Dutch or football games.
Some love them - not me.

If you're still here after that little bit of pain, congratulations.

Thank goodness there is a core group of us (well, I dabble in a few groups!) who are banding together and helping each other out. Many hands make light work! After all, I would consider it good practise for when we are out in the big bad world working as doctors. There are some people in the course who are, at times, silly. But the people I mainly work around are people I will be proud to call colleagues in a few short years. Thanks, guys.

If you do a similar thing for people you study with, thank-you, too. You clearly rock.

How not to be seen . . . to be a dick

Sorry for the amount of days between posts - things are crazy at the moment as I am having fun working out how to fit everything in. Anybody who would like to post their study suggestions in the comments would be more than welcome. My latest trick is using flashcards, courtesy of an excellent suggestion of one of my friends at uni.

Anyway, back to the topic at hand. It has come to my attention that several of my classmates in medicine need instruction in how not to be a dick. In theory, this means that there will be people exactly like this in just about every other medical school on the face of the planet. One of them might read this post, and become slightly less like a dick. Yes, I am a philanthrope.

It is pretty simple:

1) As medical students we are all issued with hospital ID tags so that when we are running around the wards creating havoc and asking questions, people know who we are. They are like our version of a staff ID, and are very important.

However, it is not vitally important to wear this ID tag clipped to your shirt or pants/skirt while you are at the university campus attending lectures/tutorials/sports games, in your normal clothes around your normal university friends. You know you are a medical student. Your friends know you are a medical student. Nobody else really cares. Except if you wear your ID tag. Then they will care that you are clearly either imbalanced or misguided, and will want to avoid you. Now that you have read this, you cannot be the latter.

The med students several rows away will laugh at you. The other uni students will begin to dry retch in front of you. It won't be pleasant.

2) We are all beginning to learn new things, however we all have undergraduate degrees, so naturally some people will have in-depth knowledge that nobody else has, or franky, wants. During the introductory lecture for the subject that is your forte, please resist the urge to stick up your hand and ask a question that would immediately identify you as somebody who either did a research paper in this area, or who has no life. Or both.

Nobody cares. We are all having enough of a hard time grasping the basics being explained to us by the lecturer. We need all of the time during the lecture to be spent pushing these concepts into our aforementioned cheese-like brains. The lecturer, even if he or she is an expert in the field, will know that a left-field and exceedingly difficult question asked in front of the class is meant to make the questioner look clever, or the lecturer look silly. They won't like it either way. Everybody else in the theatre will think you are a dick. Don't do it.

If you can't resist the urge to ask a question, please talk to the lecturer down the front at the end of the lecture. You might both be interested in the same thing and strike up a friendship. Bonus. If you don't want to do this because nobody will see or hear you being exceedingly clever, you are too much of a dick for me to help you.

3) More on the question-asking. (Seriously, what is with medical students and asking questions? Somebody should do a study. Anyway.) If you are an expert in the field, please do not ask excessively simple questions that are also slightly irrelevant at the end of the lecture. Did your parents not pay you enough attention as a child? Was your brilliance not recognised in primary school? Everybody else wants to get out of there. Go down with the other experts and talk to the lecturer at the end. If your question is too simple to ask on your own, don't ask it in front of everybody. (I'm not saying people who genuinely don't understand shouldn't ask questions. What I am describing here is a VERY different phenomenon. Other medical students will know exactly what I am talking about.)

4) Clapping. It's for seals, concert-goers and children singing along to songs. Breaking into spontaneous applause at the end of a lecture on the basics of anatomy is both embarassing for yourself and highly confusing for the lecturer. Can't you just read their minds?

"Why are they clapping? Are they glad it's over? Are they being sarcastic? Did we just let a whole lecture theatre full of dicks into medicine?"

Don't spread the clap. If it is a brilliant lecturer, sure, applaud a little. But like all things, moderation is good. Please.

5) This will be my last and most contentious point. I HATE it when people get up and leave in the middle of a lecture, right in front of the lecturer. Especially when it is an interesting lecture. I just feel so bad for the lecturer when this happens. Seriously, imagine how you would feel if somebody did this to you.

You can turn the tv off at home if something stinks. Your tv doesn't have feelings. Your tv isn't an educated professional who is an expert in their field and has taken time out of their very busy schedule to teach a group of young upstart medical students the basics of their field.

All of our lectures have been excellent so far. Of course, their excellence varies, but I can be confident in saying that none of them have been marginally near awful.

If you don't want to go to a lecture, don't be there when it starts. If you want to get an early start to your weekend on a Friday afternoon, don't go to the start of the lecture. If you are there for the start, you really should stay until the end, unless of course you: go into labour; have a partner who goes into labour; begin to dry retch at the people wearing ID tags into lectures; or you are about to wet yourself laughing at a stupid question. Leaving during the lecture is just disrespectful and rude. Sorry to say it, but it is. You are inadvertently being a bit of a dick.

So that is what I have learnt after my brief time in medical school. Perhaps I am a dick in my own way. But if I am, it won't be for any of the above reasons!

The Procrastinator

It sounds like the title of a wonderful movie from the 80's, doesn't it? I am a master procrastinator in my own way. I can be busy but not actually memorise anything much, and because my brain is vaguely cheese-like, I need to sit down and memorise things (or pace the room and memorise) rather than just listen in lectures and have things magically pop into my brain.

My procrastination techniques include:

- Looking for and buying/borrowing textbooks rather than concentrating on the subject matter at hand. I somehow reason that if I have the book with me, I will magically understand the information it contains. Ha! I might as well sleep with it under my pillow.

- Avoiding the actual memorisation and writing out lecture summaries. I'm not quite sure how effective this one is. I learn by physically pacing the room and practically stuffing the words into my brain. Writing things out gives me a vague idea, but I don't learn it as well as I would want considering the time invested in this one. I'm considering memorising from my lecture notes, testing myself on the Learning Objectives at the end of each week, and looking to some of the premade summaries that are doing the rounds for any further reinforcement/quick revision.
Mental note: printing something multiple times does not equate to learning.

- Finding pictures of things on Google image. I love Google image for histology slides and diagrams of processes. Being a visual/tactile learner, these things really help me. Plus, many of them are just damn cool.

- Blogging! (No, if I felt it was interfering with my life at all I wouldn't do it.)

So while not being entirely negative procrastination techniques, I'm not sure that I am doing things as effectively as I could. However, as tea-at-ten says on her wonderful post entitled "mantra": medicine is meant to be hard. Whenever I start to feel overwhelmed, I just remember that I am studying Medicine, and nobody in their right mind expects it to be easy.

I would like to be more philosophical or interesting, but I have been lacking in sleep due to the aforementioned fact that medicine is hard. But I'm enjoying it.

Speaking of cool movies from the 80's, I bought a copy of the Dark Crystal on DVD the other day. (Yes, all of you sad people like me who are getting excited, you can now reminisce about your childhood, muppets, and the sad fact that Jim Henson died at the young age of 54 with so much still to give.) I'm keeping an eye out for Labrynth. I doubt that David Bowie's purple tights would get past any kid's movie censors these days, but none of us were too badly scarred by the sight. Perhaps we were distracted by the hair.

My own portable zoo

I am hideously busy at the moment due to the fact that we are covering a bit of microbiology/immunology/completelynewology and I am having to play catch-up. I am finding microbiology hideously interesting, and the more I look at these things the more I wish I had done them as an undergraduate degree. However, had I done these in undergraduate I would have probably gone on to do research and not progressed to becoming a medical student, so you see, things work out as they are meant to be.

Up until now I was wondering how all of the people from a non-science background would be going in the course. This week I am finding out first-hand, as I have covered next-to-none of this week's content previously. Yes, it is incredibly fascinating. However, as I don't know any of it already, I am having to start much of it from scratch.

Thank God I have two years of anatomy under my belt! This week it isn't making a huge difference, but I am grateful for any kind of relief.

I found this article today and felt that it was strangely appropriate. Before now I would have read it and thought that the guy was a few short of a dozen (and then some), but now I can see where he is coming from.

Human skin populated by veritable zoo of bacteria

Yet, as interesting as they are, I now understand why many surgeons seem to be completely OCD.

Me and my overheated brain

We're halfway through the weekend and I still have to study all of what we covered last week. How on earth am I going to keep up with everything as we move through?

I guess I'll just have to do my best, focus on the main things and try to stay sane.

And it's a stinker of a day again. I'm getting tired of the summer. Let's just say I'm slightly jealous of MedStudentGod and his snowy weather. Years ago I lived where it snowed in winter. It was lovely. I would walk home in the dark from the busstop, scoop some fluffy snow from the bushes beside me and puff on it, to watch it react just like I had done the same thing to a handful of bubblebath. Priceless. (I choose to forget the muddy slush as the snow melted, or the harrowing bus trips through the dark as the bus skidded along the icy roads.)

I hate sitting at my desk trying to study in the heat and humidity. My only trick is to roll up some icecubes in a towel, wet the towel and drape it around my neck as I sit there trying not to melt. The fan helps slightly. My poor brain just wants to go to sleep, but I keep poking it to get it to learn. (Mentally. I poke my brain mentally. Just thought I would clear that up.)

Enough whingeing about the heat - I am off to the shops to spend some of the gift vouchers I got for Christmas! I hope the air-conditioning is exta cold!

Staying healthy while studying medicine - "The Girl's Quest For A Hobby!"

Yes, it's that time of year again - time for the Girl to find a hobby! What will it be this time? Ninjitsu? Macrame? Trainspotting?

But in all seriousness something that keeps getting stressed to us is that we need to have a life outside of medical school. I'm not a demanding person normally, so I would settle for sleeping, eating and a couple of other minor activities. I have to look after my cats, my fish and my husband (in that order - kidding). And work, occasionally.

I went to the gym again today, for the first time in a couple of months. It actually felt really good afterwards. Note to self - remember that gym feels good. Forget scary men with large weights and the fear of being looked at in shorts. Gym = goodness.

We have also made a deal to have Tuesday DVD and Takeaway night every week, to catch up and relax. Why Tuesdays? DVD's are $1 and takeaway is usually cheaper, so now I am a student we just HAVE to take advantage of these things!

I figure that if I get together with friends, relax, read, play the piano, exercise and watch a movie regularly I might just be able to stay slightly balanced through this whole adventure.

Come to think of it, perhaps I should become a ninja. Just imagine - the world's first female ninja doctor!

Small child: I don't wanna getta needle Mummy! I'm scared!
Mother: It's alright, child. I'm sure it will be fine.
Nurse: You can go now, the doctor is finished.
Mother: How can that be? Doesn't my child need an injection? Don't we need antibiotics?
Nurse: Observe the band-aid over your son's arm. Also, if you look in your handbag you'll find the prescription already there.

I would go to a lot of classes to be able to blend into the wall when somebody comes looking for me to clear out a faecal impaction. Ah, the possibilities.

This old dog has a couple of teeth left

I HAD written a nice long post about how bullying is horrific, how there was no excuse for it ever, and about how I would not tolerate it happening to myself or anybody around me, particularly at university, where it is easier to tell somebody to go to hell than in an employment situation, particularly if you are a lowly worker and they are a big scary uber-boss.

I had talked about how there are some times when some minor things must be borne, but in a university situation when we are all supposed to stick together and support each other (or at least not openly attack and belittle one another) there was no excuse.

I said that we should not only ensure that we ourselves don't bully, but be confident, strong and empowered enough to stand up for those around us and let them know that we are there and that the person who bullied them is well and truly in the wrong, and back them up if they need it.

However, adding the picture of the dog onto this mildly thoughtful and emotional post, I managed to somehow select the script I had typed and replaced it with the code linking to the dog picture. Never mind. The dog picture somehow says much more.

Just picture a group of uni students discussing something. It's deep, meaningful and complex, with lots of long chemicals involved. And possibly the kidneys. Somebody says that they don't understand, at which point they begin to be mocked by another group member. Let's make it two. Suddenly, this scary dog appears, and with her scary dog breath, tells them to pipe down, grow up or get out. They are at university for God's sake. If they can't manage respect for those not as "perfect" as themselves now as students, we all already know what they are going to turn into when they become consultants.