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.