Cases...

One of my supervisors this block has an unusual way of approaching my case reports. Hew anted them in by week 3 and then sat me down went through them and pointed out some errors, but instead of them giving me the mark, he wants them re-written and handed in by mid next week. This gives me both an opportunity to correct those problems, a second chance to worry about introducing more, and a worrying situation of having to tidy up all my cases in one weekend!

Looks like this weekend will be more book based than last weekend.

In an interesting twist, the Med School, and med School Library are shut for most of the weekend (usually we have 24hr access) as the door swipe card machine is broken. A biut annoying for e, but the 5h years are only 2 weeks from finals and are les sthan pleased to have to use main library and their own textboks.

London

Well a fun weekend in London was had, with Pete, Anna, Jack, Ronnie, Rachel and Jack all being there for part or all the times of fun.












We all started off meeting up... well this was where the fun started. The agreed time was 2pm in 'Lord Moon of the Mall' on Whitehall, or "the wetherspoons near Trafalgar Square" as it was described to me. Despite getting up earliest, traveling furthest and being 20 minutes late, I was stll the first to arrive. Well we all traipsed in one at a time over about an hour, and sat chatting and drinking a bizarre cycle of coffee, juice and drinks. About 4 we decided to take a wander down to the embankment, and along to the South Bank to see the huge book fairs under the bridges. As we walked past Trafalgar Square, we saw a protest of some sort (I suspect gaza related).
The south bank was quite good fun, and we ended up in a small pub near Blackfriars Bridge which was warm, cosy and not too noisy, despite the football on the tv. It took us a while to realise it was cup (itv) and that Car meant Cardiff, nor Carlisle.

Then we headed off, and a few of us went back to Pete's and cooked up some tasty tea. This involved passing through London Bridge, obtaining my very own Oyster Card, and then a wander through the inner east end.

On sunday a more touristy day was planned, with 30 minutes stiuck on a hot tube due to signalling problems. We alighted at Kings Cross, had some tasty lunch, and then ehaded for a wander around Bloomsbury, the british Museum, Soho, the West End, finishing in Leicester Sqaure before I jumped the tube back to Euston for the train. On the way up Oxford St, after passing through Uniqlo, I saw this fantastic shop selling walking sticks and umbrella's. It still had half closing Wednesday and didn't open on Sundays!
For higher quality pics, just click through.

SSM(C) 2

I have another SSM / SSC coming up in March-April. After the fun of my last one at big city hospital in November, I am hoping to do the next one out at DepCat hospital. This one is looking to be an ICU Audit of some sort, and there will be two students doing it. The ICU there is much smaller so hopefully elss records to rake through!

Anyway the two of us students met last night, over coffee to plan our moves from here and brainstorm some ideas on what we could audit - any sugegstions? We have to meet the Consultant, plan the audit, sort out the practicalities, submit it to faculty, get a response to faculty from the consultant and have faculty approve it. All by next Friday.

A strange week

More on London later in the week when i catch up with myself.

Monday was a day of ante natal clinic and then Gynae theatre (of which more later). After this I got a text from Butcher Boy asking if I fancied a trip to Ayr that night as he needed to go there........given my main plans at that point were an evening off, I said I was free and my car was at his convenience if he bought me a Maccy D's....so I picked him up outsode his work at 7.

The roads down to Ayr was empty. just as we rolled round the Ayr bypass, he sugegsted Pizza instead.... so after getting down and him doing what he needed to, we went to get a Pizza Hut atke away.....after not really getting lunch (or breakfast), and late night sudnay, that pizza was good.... and the irony of eating a chicken pizza whilst watching Hugh Fearnley Whittingstall going on about animal welfare was not lost on me.

Tuesday was less fun though. After getting back from my placement to the West End, I had a pre-meeting about my next SSM (more later) and then found that the rear tail-lights were not working in my car..... after a 2hr wait for the AA man (or actually his subcontractor), they don't carry bulbsm, which is what the problem turned out to be. So he put the bulb from reversing light into tail lights so I could drive it yesterday, then I made it home for 10pm for the second day in a row!

Lundun

Slight break in proceedings this week due to Uni work, and tomorrow I'm away for the weekend.... to see friends in London.

Simple pleasure

Friday night: after Uni and stuff, a quiet pint or two in the pub with a few workmates from the past (G star, Butcher Boy and Little Miss P amongst others), chatting, joking and generally relaxing. The pub so quiet that we have to move from upstairs to downstairs as they are sending staff home early and shutting upstairs at 10pm.

Saturday morning : fresh cooked bacon in an oven cooked roll with brown sauce. Behind me the washing machine rumbles away on the third load of the day.

Perfect.

Shame that left the car in the West End, I need it tomorrow and its currently throwing it down and blowing a large gale.

Traveling, traveling, traveling far.....

The hospital where I am doing my Obs/Gyn is about 25 miles away from home. And has 3 main roads into the town. All 3 currently have roadworks, meaning that it can take 30 minutes, or 45 minutes to get to the hospital in the morning. The antenatal clinics are about another 10-15 miles beyond the hospital, which makes getting there lots of fun as well. There is a bus, but it takes 1hour plus a 25 minute walk. May as well just resign myself to a 320 mile weekly commute!

Straightforward cases and ethics!

I'm finding Obs/Gyn a strange block - Obstetrics seems to be a mix of sonography, surgery, medicine, and being a referral service for Midwives. A lot of the consultant work involves initial assessment by sonographer / midwife and then just a quick consultation by SpR / Consultant. This makes trying to talk to people for long enough to get a case study quite difficult.

One day I spent time on the Maternity suite / labour wards, initially shadowing my consultant, but later the Spr & Fy2 who seemed to be doing most of the work. There was less of the competition and agro between Midwives and Medical staff than i had been lead to believe existed, and also less resentment to my presence as a Medical student.

Two cases filled a large part of our day - a young woman who had a C Section and also had HELLP which meant her blood wasn't clotting correctly. She developed a haematoma under the would and was taken back to theatre to have it removed. As they undid the staples, there was a strange sound, and a plume of blood sprayed towards me as I jumped backwards to escape the pool of red arterial blood on the floor. The clot was removed, and the bleeding vessels were sealed. It was an interesting case, because she was at that moment receiving lost of blood products and transfusions, and the situation had fairly rapidly escalated from a post op patient who was a bit sick, to a surgical emergency. Interesting to see, but not very mentally taxing.

The second case left me thinking for a long time about ethics and my opinions. Itw as a patient who had gotten pregnant despite a contraceptive implant, and then decided to have a medical termination. The implant secrete progesterone (which IIRC both 'prevents' implantation to stop a pregnancy, but once one has started, maintains the placenta). The Medical termination pills cause blocking of progesterone receptors, causing the placenta to die and the uterine contents to be delivered following further medicine administration a couple of days later.

In this case the patient had passed the foetus into the vagina, and the placenta was coming out. My consultant used a speculum to open the vagina and said, "Look in there. see the hand and face...." I was quite unprepared for that to be what I saw. Medical termination sounds very sanitised and clean. The actuality is less nice, and quite traumatic on the mother.

This has contributed to a growing ethical dilemma for me over the issues of terminations and abortions, which I may explore in a future post once I get time to read more on the subject.

What is it?

Sadly this rather nice looking spacecraft/firework / whatever is actually some kind of rocket or missile or bomb over Gaza. I don't know which way it is going, or who will be the victims of it, but it occasionally amazes me how something so pretty can be so lethal.

edit: The BBC website now captions it as "Israeli artillery shells explode over the Gaza Strip"

The day the earth stood still

My annual cinema visit was tonight...well I think it was last January when I last went to the cinema. I think we (that is me, little miss P and another of my former work colleagues) meant to go to a mind emptying joke fest (e.g. Bride Wars) or action film, but ended up at a thought provoking version of the Al Gore film....It's a good film, about an alien race who come to earth in 'globular balls' which look something like the planet earth...they have come to save the other species then destroy the humans to allow the planet to recover 'Earth is one of 5 planets in the cosmos suitable for supporting life, we cannot allow you to destroy it'.

The film however ends on a cliffhanger, with none of the 'modern' mechanical or electronic items on earth (from a watch upwards) working. The product placement for Microsoft vista also gets quite annoying, though the touchscreen desk looks quite fun. Mind Keanu Reeves is starting to look quite old........Speed was quite a few years ago....

Thought provoking.

I was listening to Radio 4's PM programme in the car on the way home today and they were talking about Leona Lewis writing her autobiography at the age of 23. they interviewed the author and commentator Matthew Parris, who made the interesting point that maybe we should all write down our views (not feelings) on the world, because we forgetso quickly what we once thought or accepted as normal.

He gave the example of how few of us can remember what we thought when 18, and whilst sat at traffic lights, I pondered on this. I know a lot of teenagers around 16-20, but I can't say that i can think like them anymore, or even visualise their hopes and dreams.

And when I think back to when I was 18, way back in 1999-2000, it is tinged with the actuality of what happened. The dreams of studying medicine and the reality of doing a Biology degreee, the dreams of what I could/would do, and with whom, and the reality which was so different.

It was not just the hopes, dreams, and opportunities that I had, but also the changes to me, to life, and to the world which I could not have forseen which have changed my thinking, changed the world and changed my life since that point - the friendships, relationships, deaths, opportunities, disappointments and such like.

Maybe this is a good frame of mind to start my bnext block, OBstetrics and Gynaecology, one half at least of which is about the hopes, dreams and opportunities , and a child who can be anything it wants to be..........oir it could be like the 'child' today jailed for culpible homicide at the high court, of whom the Judge said:

I accept that the very early years of your life, prior to your adoption, were emotionally traumatic; having been born in Corntonvale Prison to mother then addicted to heroin and a father who had himself died in police custody. He had apparently been physically abusive to you even although you must have been little more than a baby. It is hard to image a more deprived and tragic start to life.

However, it is equally clear that your adoptive parents tried very hard to compensate
for that early start by providing you with a comfortable lifestyle and the potential for a good education and future life.

Whatever the psychological reasons for it, you spurned their attempts to help you
and engaged in a life of substance, drug and alcohol abuse and, ultimately, crime.
This lifestyle culminated in the death of another young man at the start of his adult
life.

What must the views and opinions fo this young teenager be, and how alien to most of society must their thoughts be to do this, and yet, their hopes and dreams may be very similar to many other people - a partner, family, money, job, house.......I guess we can only hope that prison rehabilitates.

Do cashpoints get hungry?

Today a Clydesdale cash point ate my debit card because, according to my bank (HBOS) 'card services' department "The bank which operates that cashpoint was worried about the security of that cashpoint and to avoid a potential fraud it closed down and retained your card"

Ok.....except
1. Why not close the cashpoint before I started my transaction?
2. If there is a skimming device (and I didn't see anything which looked like one) why allow me to put the card in and enter my PIN before shutting down?

These are points I may be raising with HBOS and Clydesdale by letter. For once I even had sufficient funds in my account!

The cashpoint was in a Clydesdale bank wall..... thankfully my bank is now open Saturday's a mile away so I went there to get it sorted over the phone. still takes 7 days for a new card to come (odd given that Play.com can manage next day delivery), but they were able to give me cash based on photo ID and my having a credit card with the same bank.

Happy New Year!

As introductions to 2009 goes, I felt almost Gazanian... the fireworks from City Chambers appeared to be shelling my flat, and indeed on the TV pictures it looks like they were. I managed to be outside from half eleveen and was still frozen when I got back home, and yet sweating and needing Beechams... I think my Chjristmas Cold has returned.

As tonights headlining artistes finish on the main stage outside, I am watching QI under a duvet and waiting for the noise to finish so I can sleep. If this is what 2009 is like, I'm not entirely sure I liek it.

I am however looking forward to tomorrow, and if I had any similarly mad friends (and did not have a cold) I'd be up for doing the Loony Dook at South Queensferry! Havings aid that, I have no plans for tomorrow, and may end up just heading out to wander round the quiet of the city.