Adventure, mistakes and successes; in varying proportions.

Interviews

2011-12-20T03:13:00.001Z

So, having completed my CT applications only 2 weeks Ago, today I find that my England/Wales/NI application has reached interview stage. All applicants are guaranteed one interview. So in January I have to head to Torquay!

This is not as easy as it seems. Interviews are on Monday's, and the easiest seems to be to fly to Bristol, then hire car to Torquay. But it all depends what time they give me.

30th birthday present!

2011-12-15T03:08:00.001Z

It's here and I now have wonderful proper coffee!

Clinic week

2011-12-15T03:07:00.001Z

This job has a very odd Rota. Lots of weeks with 7x13hr shifts or 5x12hrs and then to counterbalance it all, clinic weeks which are 3 clinics plus teaching session totalling 2x8hr days.

This is one such week, and thus gives some free time to catch up on MSc reading, write case reports and audit reports from last block, and even do some Christmas shopping, cleaning and catch up on sleep.

However this does mean that the end of December and into January is a busy month of 12hr shifts. Still that's a week away and we have Christmas first.

Impending birthday

2011-10-29T15:55:00.002+01:00

Last night was a friend's 30th Birthday. This isn't the first, second, third or even fourth of my friends to reach this milestone but with my own 30th less than 7 weeks away, I felt this one more than the others.

Discussion flowed as the meal progressed and we came onto the issue of Bucket list and things to do before reaching 30.

I have thus started making my Bucket list but I'm not sure I have the right idea......

1. laundry
2. buy christmas presents for family & friends
3. finish my deep cleaning of the kitchen...

More interesting alternatives welcome, though I'm not sure I have any free Saturday's between now and then in which to achieve them!

Mobile blogging

2011-10-20T02:55:00.001+01:00

This is my test to see how the mobile blogger app works!

Back to it, even if 'it' is a grindstone.

2011-10-17T22:01:00.003+01:00

Today was back to work after my 2 eeks off, and after 6 weeks away from my base ward. Some patients remained the same, and the seniors haven;t changed. We now have a new FY1, who is a touch scatty especially regarding chasing blood results though.

Today was odd as I started the day in clinic, which is at a different site. This was then followed by our department meeting, so I didn't get to the ward til 2pm, then saw 5 patients on a ward round, made a couple of referrals, checked some bloods and got a new bleep battery. Thus a nice re-introduction to ward life.

Clinic was interesting. It was the general Geri's clinic, which focussed today on people not eating, weight loss investigations and the stubborn-ness of the old. People who find cooking boring, don;t want microwave or packaged meals, refuse family help but look at you and say - 'you need to stop me losing weight before i fade away' adding a cursory 'Doctor' at the end.

Thankfully the Consultant was taking this patient, and I just had to watch and start writing the pile of referrals - the poatient also has poor mobility (catabolism of muscle to provide energy?), a swollen leg with prominent veins and painful shoulder arthritis - thus referrals to dietician, physio, OT, orthopaedics, DVT clinic, Radiology (shoulder Xray) all needed writing.

Then tonight I got home via Tesco, and found that I need to get a grip on my online MSc work as I let it slip when on receiving and holiday. Thus 4hrs so far of paper analysis and reading about good papers and statistics. I will miss this week's online discussion group and paper critical analysis, so I ahev submitted my online review. i also need to start worjking on the statistics MCQ and this week's case of the week - also at internalmeded.org

I also need to make a start on more cleaning of my flat. I have made step one - buying cleaning materials!

Holidays are restful?

2011-10-16T21:21:00.003+01:00

Well the past two weeks were leave, which has involved driving almost 2000 miles, traveling a further 500 as a passenger, visiting Newcastle, Edinburgh, Perth, Motherwell, East Kilbride, Belfast, Aviemore, Manchester and Kinross.

Manchester was the most geeky part of the whole trip, to see a recording, for radio 4, of Infinite Monkey cage, hosted as ever by Prof Brian Cox and Robin Ince. This live in Manchester episode goes out on 21st November in the afternoon. It was odd being involved in the media production system though - multiple applauses at the end for them to run under the edits as the show as recorded went on for over an hour, and needs to be 28 mins by time of broadcast.

The rest of the holiday was altogether more restful, but even so, I;d still liek another week off before going back into work.

Nights... my thoughts

2011-09-26T20:02:00.002+01:00

So we are hear again - the 'staying up late the night before'; the 'lying in as long as you can'; the 'fill the day with stuff that relaxes your brain'; the 'eat healthy food with carbs for long release energy'; the 'go to tesco and hoard sugary stuff'; and finally the 'large strong coffee as I head to work' - nights!

I like nights - it;'s when you as a junior get to make most of your critical decisions. You have less hassle of ward rounds etc (until morning). It's you, the patient and your clinical skills. It's very much dealing with what happens, very little planning and very adrenaline fuelled seat of your pants stuff.

In the simple world, when I am first on I deal with GP calls and A&E referrals of new patients, I clerk them and present them to ward round. The range of investigations I can get overnight is more limited than during the day, as are the senior opinion options. This is the relatively easy side, the part that relies on working through each patient, deciding what is wrong and commencing treatment. It's just like days, but with a bit more stress of not knowing how many you will need to see, and there only being 1.5 doctors, no FY1's and such like.

Being second on means ward cover. This is more daunting. 11 wards doesn't sound many it;s about 400 patients, including HDU, CCU, Renal, Haematology and such like. These are the complicated patients on huge list of drugs and for whom 'getting them to morning' may be the best your management plan can achieve. The specialist nurses on these wards frequently know far more about these patients than I do, and even more about their conditions. Their guidance whilst reassuring can also put you off the scent though.

We also have to act as a referral centre for regional services in some specialties where doctors at other hospitals will call and ask to refer a patient to us. We then call the consultant on call for that specialty and relay the info that the other doctor gave us. The consultant then gives us a list of more info they want and a game of phone call tag goes on with us as the centre!

All in all, where's that coffee!

Careers

2011-07-25T00:47:00.002+01:00

I am pondering the latest volumes of careers advice to hit my inbox from NHS Education Scotland. I can imagine some of you shouting "You've got a career, remember the 5 years at Medical School....." before wandering away muttering. As ever with the NHS, it's not as simple as all that!

The idea is that after Foundation Training, you pick a specialty or group of specialties to train in. Some have Common Core Training (eg Surgery, medicine); some is more specialised from the start (Radiology, Obs/Gyn, Paeds). Anaesthetics is unusual in having 2 ways in - Pure Anaesthetics, or Acute Core Anaesthetics - this second option involves a common core of 3 years alongside Emergency Medicine and Acute Medicine (so some A&E experience) before popping out into year 3 of Anaesthetics training (cunningly meaning that one has two 'year 3's' for added confusion.

One also needs to have a strong CV to support the application, in terms of audit, commitment to specialty, other learning etc. So more work, more exams and more stress. Just when you thought it was all over....

Update

2011-07-08T22:21:00.004+01:00

So after various thing have happened at work, I now feel compelled to blog again. I think I blog when I have some free time, feel strongly about stuff and most likely when unsure of the future, some or all of which are coming into play together at the moment.

Basically, I have been pondering work and such like and lloking at some fine blog posts by other medical / para-medical professionals online and pondering about stuff. Also this week I have had 5 week nights in the flat in one week for the first time since some time back in March....maybe even February.

In that time I have changed hospital, twice, changed specialty, completed the FY1 e-portfolio of CPD learning, and decided to take the plunge and apply for an MSc in Internal medicine (online distance learning) so I may get a student card again, but hopefully no student loan.

It's fair to say that I have found surgery challenging. The consultants seem more remote a lot of the time, and senior support on the wards is often spartan - but often contactable by Pager.....the ward rounds happen whenever, but daily and are usually as brief as can be, even in HDU. So I think part of me misses the support of Medicine and the ease of contacting a senior. Also working for only one or at most 2 consultants made life easier and 2-3 days between ward rounds did allow some time for completing tasks rather than the 24hr time periods.

Sorry for the delay

2011-03-03T12:05:00.002Z

And the blog returns, a mere 6 months after the last post. a safe interval has now elapsed for any tales of work i tell not to be easily related to specific patients or staff or indeed wards.

With almost 7 months of general medicine behind me, it is a little daunting to consider that when I come to make my career choices in a year's time, this will be all the acute medicine I will have done. as I spend 3 out the next 4 blocks in surgical or related specialties.

The job

2010-09-03T19:28:00.003+01:00

Well the wee hiatus of the past 4 weeks has been largely so that any stories I post cannot be linked in a time-wise manner to any specific patients etc, and also because adapting to the job of an Fy1 takes some time.

Firstly, time:

You start at 9 and finish at 5 most days, or as most of us do, 8.40-6ish (6ish meaning between 5.30 and 7). It' snot just that we are relatively inefficient as we are new to the job, but also because the boring mundane jobs tend to get left til last, like printing blood forms for the following morning, printing out radiology reports to stick in notes etc.

Secondly, food:

Being able to survive without food during working hours is a skill worth mastering. You may be lucky if you took lunch with you, and get to eat it over your PC whilst on hold to switchboard, accessing results etc on the PC and signing off filing. This however doesn't help digestion, and you may not want to read this report or this report about the cleanliness of NHS keyboards if you do eat lunch this way.

Thirdly, support:

If you are lucky then your ward SHO won;t have too many patients to see on other wards; clinics to attend to, or be on nights / receiving. under these circumstances they will help you with some of your tasks. if not, the prioritisation of what needs to be done now, today, or even this week is essential. achieving the list of jobs requiring doing between successive wardrounds is a skill, especially if there are only 2 days between ward rounds.

Fourthly, referring:

A skill not taught in medical school. How to present you patient in 3 paragraphs and explain to another specialist why you want them to come and see your patient and what you want them to do when they do so. This is often followed by a phone call from them wanting 200 bits of info - 50 of which you don't have and half of those are such that you cannot bluff them. this may necessitate ordering more blood tests, radiology etc, prior to the specialist coming to see your patient. This is especially difficult if the specialist is based at a different hospital as you need to obtain a phone number for the person, and then maybe a fax number to send the letter, and they always page you back when you are not near the notes for the patient concerned.

Finally, ward cover:

After 5pm, and at weekends, you may suddenly go from looking after one ward to looking after 7 or 8. Each nurse assumes you have an encyclopaedic knowledge of their patient, and as such may not use names when referring to 'my wee man in room 3'. You may also start to hate your colleagues who have left 'the venflon no one has managed to do all day' or 'they need some fluids writing up but they have a special regime which isn't written down'. But you are fully aware that you may have done the same on nights when you just wanted to get away...

But in your first month all these can be forgiven on the day you pop into the medical business centre and find in your pigeon hole, a small self sealed perforated envelope with your name on it. Upon opening you see that the NHS has decided to reward this work, which is much like an onward progression of your final year med student shadowing role with a sum of money.

Growing pains?

2010-07-28T01:33:00.003+01:00

At lunchtime today we had some small pondering about when was grown up - 21, 22, 23, 24 or is it not age related?? This discussion included the 4 pillars of grown-up-ness - car, live in life partner (we are very PC), mortgage, proper job.

The main reason for the discussion was that most of us are now approaching having 3 of the above, some lucky ones having all 4. but we don;t necessarily feel properly grown up. Maybe this all changes next week when we get paid and we have responsibilities....or maybe its a gradual process or morphing from students to adults.

Thoughts?

The Hospital

2010-07-27T21:45:00.003+01:00

Running on Monday night on C4 at9pm.

It's factual, accurate and sadly likely to end up reflecting a chunk of my life from now on....

See here on 4OD (until end of August)

http://www.channel4.com/programmes/the-hospital/4od

It's also annoying enough to make you want to shout at the TV.

Bridging a gap

2010-07-24T18:36:00.001+01:00

DSC02525, originally uploaded by djw1981.

On Thursday I was across in Fife seeing a friend for a meal, and on my way to kill time I stopped off at North Queensferry, and took this picture of the Forth bridge.

A Saturday off

2010-07-24T17:21:00.003+01:00

Today is an interesting day. The first Saturday in ages when my diary was empty all day. i had a few 'could do' things but nothing I 'had' to do. I then checked back to find this was my first free Saturday since the end of revision, and going back before that, thus my first free Saturday since October 2009. So almost nine months.

And what have I done with this bonus thus far? Well.........I fell asleep reading the Saturday paper, woke up, listened to the 'Now Show' live instead of on podcast; went for a wander round Glasgow and the Merchant city festival, had a nice coffee and am contemplating what to have for tea at a sensible time.

Normal service is resumed next Saturday with doing sound for an event, the following week is the Fringe, the one after I'm at camp, then working my first weekend and at the fringe again to round off August!

Time to move on

2010-07-22T03:12:00.002+01:00

The first part of moving on has happened i guess.

Graduation has happened, GMC numbers and certificate have been received, induction dates and details have been receved, and I am slowly turning my flat into something more like ahome after 18 months of being an extension of a library.

After getting a safestore unit in june, i have moved all my notes from my first degree and years 1-3 of medicine togetehr with old receipts, camping stuff and even my christmas decorations into the safestore box. This has left me room to get all my books onto my bookshelves and leave my desk and table free to eat from!!

I even bought my first CD racks, after ten years of owning CDs (I thought I'd see if they stuck around before investing in a storage solution) and was so happy with it I even bought one for my DVD's. this tidy up and organisation hopefully makes my flat look less like a students work area and more like a relaxing living room. i can;t help thinking though that when I sort out my new fridge freezer and some new kitchen flooring the flat will look a bit more homely and less studenty.

Still one step at a time.

Holidays and delays

2010-07-22T02:53:00.003+01:00

I thought I had posted this last week but it seems i clicked 'save as draft'
=======================================================
Just back from holiday in Gibraltar. Though the journey back seemed almost as long as the holiday. going out we were beset by a 4hour delay at Edinburgh airport due to Spanish and French air traffic controllers strikes. they don't actually walk out, just reduce the number of planes they control so they cause inconvenience but still get paid (please note BA cabin crew etc). This meant a whole 3hrs sleep at Gatwick before getting up for the early morning flight on to Gibraltar which was a mere 45 minutes late (same reason as above).

Gibraltar was nice and surprisingly for a small peninsula half filled with a huge rock there was quite a bit to do, including a chunk of sitting in the sun on a beach or by a pool reading a book. We even spent some time on top of the rock watching planes coming into land and the connected road closures - the main road runs across the runway at the airport. Whilst up the rock, one of the resident apes also stole my brother-in-law's ice cream, much to his displeasure.

The day we arrived had been misty and muggy but the Sunday through Friday were clear bright hot days. there must be something to do with travel for the Saturday we were coming home dawned overcast and windy. We got to the airport early (Dad aims for 15 minutes before check in opens) and checked in before heading through to the small departure lounge, which rapidly filled up with passengers for three flights back to the UK - easyjet, monarch and BA. all were showing a 40 minute delay. Just at the time the first plane was due down, we got an announcement saying that due to the wind and poor visibility, the easyjet and BA flights were diverting to Malaga airport.

15 minutes later they announced that BA would be attempting another landing in 30 minutes but that Easyjet had cancelled their flight and we should all queue up for a new flight. a rapid sprint back to the check in area saw us join the long queue to rearrange flights. We managed to get seats on the 2230 from Malaga (it was about 1300 at this point0, but with self arranged transport to malaga airport. the airport staff advised that the express bus did not run on Sundays so our choice was a taxi at 150Euro. This we did and arrived after visiting a Spanish cashpoint and being forced to decide if my debit card was 'Current account', 'savings account' or 'credit account'. Turned out that it only gave me money if I clicked 'credit account', so I assume that is what I have.

Malaga airport is soul-less devoid of character, devoid of shops and aimed solely at budget airlines and the charter market. As was becoming a common pattern, the 2230 flight left at 0030 next day allowing me some time to book a room at the Gatwick Hilton - their last remaining room. The minor issue being that I wanted it for 3 - myself and my sister & brother-in-law. The room was allegedly a 'compact family room' with a double bed and 2 bunk beds, but Hilton said it could only sleep 2 adults and adults could not use the bunk beds. Aye right. After checking in around 3am, we found that the lower bunk suited me fine.

Next morning we headed over to the terminal to check in for the Easyjet 1500 flight to Edinburgh. Which suddenly flicked on the online departure screen to 'contact airline' whilst still being open for check in at the airport. a quick sprint to the airline desk confirmed that it was in fact cancelled. The next Edinburgh seats were Wednesday, but they had Glasgow seats at 2100 but no guarantee that the plane would run. As we pondered the cost of rail tickets or car hire, I called BA and managed to get us 3 seats on the 2100 BA to Edinburgh (where the car was). After another 8 hours in Gatwick, we took off almost on time and made it safely back to Edinburgh.

Time to dust down my travel insurance claim forms now and write the story with supporting evidence for them.

Budget

2010-06-23T10:02:00.003+01:00

I just ran the BBC Budget calculator and it gave me a slightly surprising result; the only problem is that this takes no account of the effect of the VAT rise. I think my VAT bill will rise by more than £87 thus I will pay more, c'est la vie.

The indications are that you will be £85.75 better off.
Breakdown of difference

2010/11 £ 2011/12 £ Difference £
Income tax 5975.00 5775.00 £200.00
National insurance 3012.35 3126.60 £-114.25

Spam, spam, spam, spam, spam, spam, spam, spam, spam, spam, spam, spam, etc

2010-06-17T00:47:00.002+01:00

Tonight I went with butcher boy and the tattooed drinker to see Spamalot at the kings in Glasgow - a great show - good acting, some cracking songs and good comedy laughs - some scripted, some not!

The show really needs you to gfo to enjoy it fully - but there are some great audio clips at http://www.spamalotontour.co.uk/media/

Parliament

2010-06-16T11:27:00.002+01:00

I was reading Tom Harris' blog and tweets yesterday - he's a nice guy it seems, though quite institutionalised into Westminister. http://www.tomharris.org.uk/2010/06/15/carry-on-ipsa/#comments set me thinking

One thing I do wonder about is why MPs do casework. Would the transfer of this to CAB style organisations, and MPs concentrate on passing laws, debates and select committees improve our level of scrutiny and accountability. We seem to have confused the role of being our representative in parliament with being our highest representative to the executive organs of the government.

I guess this started, as in councils etc, when an elected member had a word on behalf of one of their friends / family with a civil servant in a bid to sort out a difficult situation or area of maladministration. However it has now progressed to the regular advice surgeries, which are to sort out housing, benefits etc not a forum for discussion on policy. Thus MPs seem to spend more time dealing with the fall out from poor legislation that debating and scrutinising to prevent poor legislation being written.

Personally I am amazed that a bill can make the statute books when it has not been picked over by all MPs clause by clause. With fewer public meetings and such fora for the constituent to tell the MP what their views are, how can the MP represent constituents - the answer I feel comes down to manifesto & pressure groups.

Manifesto - you vote for a list of national pledges and policies put forward by that candidate / party. This tends to mitigate against people standing up for their constituency interest where it conflicts with national party policy unless they are a seasoned and strong willed MP, but as party machines tighten their hold on seat selection etc, this may be waning.

Pressure groups - he who shouts loudest gets to influence policy? The postcard campaigns, emails, Fb groups and petitions etc which are undertaken to push a particular issue are the ones more likely to get an MPs attention perhaps especially with their high profile media and lobbying - most have a parliamentary officer, whom I am sure is doing more than just monitoring hansard for relevant comments.

Ah well back to BBC parliament to watch the IPSA debate!

Decluttering?

2010-06-16T00:14:00.002+01:00

I have decided that to make my flat more homely for starting work, I need to move all my old Uni notes into stopre so that I can have the current ones in the cupboard and then clear stuff out the living room to where the current notes live.

Thus I have been today measuring up at my Safestore Unit, and providing butcher boy with a temporary storage facility for his stuff. packing stuff up however tends to lead to some values judgements about the worth of the item being packed - can it be binned? thus so far; 3 bin bags of rubbish as well as 5 boxes of stuff have been sorted - this I think is about 30% of the stuff sorted!

hopefully this will free my living area to be a living area now i will have less work to do!

Holiday

2010-06-15T23:57:00.003+01:00

Sorry for the radio silence, I was away this past weekend down in london, meeting good friends, and family and such like. It was generally sunny and such like (it rained on Monday) and quite warm though nothing like the awful humidity last august.

On Thursday, after arrival I checked in then went down to Oxford St to buy some new shoes - to replace the ones i bought there last August - somehow I only find time to buy shoes when in London! I then picked up some other essentials and an extra phone charging battery thing. Then wandered home via the amazing St pancras Station; on the way passing the National Homeopathy Hospital and other medical stuff .

Friday saw me visiting the Imperial War Museum, and the London Bridge area for some lunch before jumping a train out to see my cousin & family. I haven;t seen her for almost 2 years now, so it was good to catch up with her and her husband over a curry and some beer watching the football; and also meet her newest daughter and renew acquaintance with the older daughter. they have just moved into a new house, which is pretty big (IMO) for inner London - nice sized rooms and a good sized garden, and very close to a station, allowing a quick trip back to the hotel.

On Saturday I was due to meet school friends Anna, Rach and Pete at tate modern in Southwark at noon. This was interesting due to some strange combinations of tube lines being closed; but we all made it, except Pete who had life delays. So we went for a nice walk around the Tate, seeing modern, impressionist, abstract and pother art forms - some was very good, some was interesting and some was a bit 'Huh'; we then headed over to St Paul's for a nice lunch and met up with Pete before wandering along for some drinks in a nice Samuel Smith's pub with its own ales and ciders - very tasty. Rach had to leave us but Pete invited Anna and I back to his flat for some tea - sausage and mash, a Pete classic - by combination of Tube and bus we reached his enclave in North London - with a view (just) of Essex. The day roudned off heading back into London, me to my hotel and Anna onward to Slough

Sunday was my big adventure; at lunchtime I headed to paddington to get the train to Slough to meet Anna and we headed for Windsor, after commenting (like 2 old people) about the dress sense (or not) or the Slough teenagers. In Windsor we picked up some tasty lunch - a roast beef dinner no less, in the Carpenters arm - a nice eaterie bar with a great view of the 'Crooked house'. the afternoon was really warm, so we started with a walk into the the 'Long Walk' of Windsor Great Park, and then back to a park for ice cream and a walk along the River, passing what we dubbed 'the Queen's kebab shop'; for it is opposite the back door to the castle! An early departure for London saw me walking from Paddington back to my hotel - approx 3 miles, through touristy boits of London which were becoming quieter as evening fell, including the University College Hospital which looks more like a bank headquarters, the Guardian building, British library and such like.

Monday was a touristy day, I dropped my case at the station and went to the British Museum, out to the Olympic site at Stratford, back via London Bridge to Picadilly, and then up Regent Street to the BBC and up to Regents Park and the Zoo, before heading through the rain to the Wellcome collection and then the train home.

The end is nigh

2010-05-20T21:14:00.004+01:00

That's it, that's done. My final Uni sign off is done, and following a 2hr lecture tomorrow and a drinks reception and after handing in my P for p workbook, full time Uni will be over, finished. As I left hospital today, the radio station played some Sinatra:

"And now the end is near; And so I face the final curtain
My friend I'll say it clear; I'll state my case of which I'm certain

I've lived a life that's full; I traveled each and every highway
And more, much more than this; I did it my way

Regrets I've had a few; But then again too few to mention
I did what I had to do; And saw it through without exemption

I planned each charted course; Each careful step along the byway
And more, much more than this; I did it my way

Yes there were times I'm sure you knew; When I bit off more than I could chew
But through it all when there was doubt; I ate it up and spit it out, I faced it all
And I stood tall and did it my way"

So now i head on towards my last long summer of work, weddings, holidays, fun, friends, and academic presentations and writing up papers containing some of my research from SSM's and electives.

Mum's big birthday

2010-05-03T21:19:00.003+01:00

The day that my exams finished was Mum's big Birthday celebration weekend away - her birthday having been mid exam period!

We headed up into the wilds of Scotland and stayed at a very nice hotel with minimal phone reception and a nice spa sauna place as well as a nice restaurant, great grounds and even a giant chess set!
Evenings after dinner were spent sat by a roaring fire playing board games. It was a great end to exams!

The main highlight of the Saturday was quad biking - dressing in hi vis suits, wellies, goggles and crash helmets....followed by an afternoon of swimming in the pool and using the gym and a nice tasty dinner.

Sunday was a nice massage and then lunch before heading home for a sleep prior to heading down to Cornwall; see previous posts

Cornwall

2010-05-03T17:01:00.004+01:00

March involved a nice week break down in Cornwall with Mum & Dad

Sorry!

2010-05-03T15:38:00.002+01:00

Apologies for the 2 month absence.

News.....
1. I passed my finals
2. I start as a Doctor in August
3. We were doing preparation for practice lectures which redefine the word dull.
4. I spent 3 weeks on a GI medicine ward as a junior FY1 type role.
5. I have spent evenings and weekends doing all the things I didn't have time to do between September and the end of exams....seeing friends, doing some work, seeing films, going to comedy shows etc.

Anyway more detailed updates will follow soon :)

Goodies

2010-02-27T14:36:00.003Z

After butcher boy doing me a favour yesterday, he emailed yesterday - I suppose it saves him having to do any real work, and asked if I was free to help with a short trip to Costco today to buy exciting supplies.

We also took his flatmate, who used to work with us all in the days of supermarket land and is now working in another branch of the public services. The summary:

huge tin of pretzels,
lots of juice
random foodstuffs
and of course tasty pizza and coke in the canteen whilst we divide the bill

All in all a good Saturday morning.

The Will to carry on

2010-02-26T09:37:00.003Z

It seems I am a hard person to get hold of.......last Summer - Augusty time, I drafted my will and poewer of attorney, as advised by the solicitor when I bought my flat in 2004. Anyway, having gotten round to it, I have at various times since been on Bute, busy, and studying, so it was today before the completed Will and I coincided for a signing. Now I just have to get a doctor to sign to say that I am of relatively sound mind, and get my sister to sign the Power of Attorney and it's all go.....

Opticians at 11 as well.

Because the will guy, and Butcher boy as the witness of my signature on the will, were coming round at 9am today, after yesterdays OSCE, I spent some time tidying the flat - well tidying as in putting all notes in a big pile; and hoovering and mopping the floors, doing all the dishes and wiping the benches, and moving anything to big / annoying / strange to be tidied easily, into the bedroom, which now looks like the storage yard for a junk shop.... Can't decide if I am running out of room, or just running out of sensible storage ideas. There is a big yellow storage place not far away.... I wonder......

Scores and next year

2010-02-23T17:53:00.003Z

Well, last week the UKFPO published the jobs online. I got my 6th choice - moral don't choose popular choices because with a mediocre score you should not aim too high! So next year I shall be in Glasgow and Lanarkshire. I thus spent the end of the week ranking in order the 18 individual rotations (this is the 3rd or 4th level of ranking to get a job!) and thus know that I will be doing a combination of medicine and surgery and very little else.....

Then later in the week they published the scores breakdown for our questions (each section scores out of ten points:
1 - List previous degrees, papers, posters etc - 8 points

2 - Describe a case from your clinical experience that you have observed in the first 24 hours from hospital admission. How did members of different professional teams interact and how did this contribute to effective patient care? What did you learn from this that will influence your future practice as a new doctor? (200 words) - 8 points

3 - Describe a case from your clinical experience that you have observed in the first 24 hours from hospital admission. How did members of different professional teams interact and how did this contribute to effective patient care? What did you learn from this that will influence your future practice as a new doctor? - 4 points

During a ward round on an ICU placement, a consultant was teaching me about ventilator function and the various modes available for use in a patient with pneumonia. The consultant organised a tutorial where, having established my background knowledge of respiratory anatomy and physiology, he used diagrams and patient scenarios and asked me to explain the pathophysiology of each patient, and choose a method of ventilation, justifying my choice. I found this tutorial approach very helpful.
As a middle grade doctor, I could be called upon to explain some of the clinical features of a disease, such as diabetes mellitus, to some junior colleagues. I would adopt the above approach with the colleague in a one-to-one situation and start by establishing the level of the colleague’s understanding of the relevant disease. From this, I would then lead them through any areas of poor understanding, before reviewing a number of selected cases so they can see why the disease leads to the presented clinical features, and the effect these have on a patient’s life. Finally I would present them with new cases to establish their understanding after the teaching, reviewing their answers with them.

4 - You are one of two foundation doctors on a ward round. The registrar identifies a minor error made by your colleague and makes inappropriate critical comments in front of the patient and the healthcare team. Your colleague is visibly distressed. What actions would you take and how would you prioritise these? What actions do you believe your colleague should take in relation to these comments? How might you address a minor error made by a more junior colleague in the future? - 10 points

As this is a difficult situation, taking place in a semi-public arena and involving a senior colleague, I would ask my distressed colleague if they were alright to continue or if they needed some time out to compose themselves. Before moving on I would reassure the patient regarding the minor error, and would check that the ward round notes were written up correctly, such that patient care was not adversely affected by this incident. After the ward round, I would approach the registrar and politely suggest that whilst errors need to be corrected, they should consider how they present their comments in front of patients.
My colleague should discuss this error with the registrar in order to learn from it, and request the registrar to discuss any failings with them privately rather than in front of others.
Were I to be the registrar, I would correct the error to ensure patient safety and good treatment. After the ward round I would discuss the matter in private with the foundation doctor explaining why the error could have caused problems. I would offer appropriate help e.g. individual training or tutorial to improve their understanding and prevent recurrence of the error.

5 - Describe one example from your medical training when you received feedback on an aspect of your performance. Explain how that feedback altered your subsequent practice. How will you use this experience to develop a specific aspect of your foundation training?- 6 points

Having observed the procedure several times, I was, under supervision, taking my first blood for culture, using aseptic technique. My setup was less than ideal. I contaminated equipment and had to replace it and start afresh. The supervisor took me aside and discussed the problem, emphasising the need for thorough preparation. They suggested that I plan carefully, listing the equipment required and checking I had collect it all prior to starting. They also demonstrated techniques for putting on sterile gloves without contaminating them. Overnight I read up the procedure and consulted the local protocol. The following day, the registrar asked me to repeat the procedure on another patient. I referred to my notes and the protocol, collected the required equipment, double checked it, and completed the procedure successfully without wastage or contamination.
I adopted this approach of observation, pre-reading, reference to local protocols and making notes for common procedures in this and subsequent placements, and have found that it increased my confidence and success at performing procedures. In foundation training I would continue with this approach to new procedures, consulting textbooks, familiarising myself with local protocols and carefully observing senior colleagues practice and amending my notes accordingly.

6 - At times, the patient and the medical team have different ideas on the management of the patient’s illness, because of personal, social or cultural views held by the patient. Describe a clinical case where you have observed this. Identify the factors that contributed to these differing views. Why is it important to understand these differences in your practice as a foundation doctor? - 4 points

The summary of this is that I am rubbish at questions I work hard on and quite good at ones I drafted once.

Interestingly, due to an academic score of 34 (repeat a year) I made my academic score almost with part 1 which brought me to the same score as many of the academically gifted members of my year who did not have a degree. Thus the scoring discrepancy, and thus the first choice is jobs is based on ability to answer those questions.

The questions for 2009-10 were quite different to previous years and I am not sure if that helped or hindered.

Oh and as a PS - I know what to do if someone shouts at me - I got 10/10 above for that!

Theoretically half way

2010-02-15T00:15:00.002Z

The written exams were Thursday & Friday and featured a bizarre selection of questions old and new - STI's, testicular masses, febrile convulsions, pelvic fractures, postural hypotension, hair loss, and more.

The Short Notes were again unusual - the ethics one being absed around adults with incapacity and the rights of relatives with 'welfare guardianship' rights; the public health one related to smoking prevalence.

Either way they are now both finishged and OSCE revision starts in earnest tomorrow!

The hoodies are gathering

2010-02-08T11:56:00.003Z

I am surrounded by hoodies, most of whom look as if they'd happily receive a hug......though not from David Cameron.

Yes, on level 5 of the Study area in the med school, the buzz of tension mixed with the swish of pages turning, the click of keyboards and the hum of the aircon is stifling conversations. The neat piles of empty coffee cups, M&S sandwich boxes, salad tubs and fruit salad trays are growing near the bin, and the dress code is heading from normal to comfy and homely - started with hoodies and jeans, now slippers are creeping in.

The earphones are in, and a selection of online music sources, podcasts etc are providing the soundtrack to our lives. Yes, we're heading through exam season, and as we all struggle with the same past papers, and identifying which antibiotics cause cholestatic jaundice; and debate the answer to mock EMQ 1.8 from the XX past paper etc, we are heading towards a camaraderie - those of us who choose to revise here and developing something of a bunker mentality/ blitz spirit.

And when it all comes down to it, we are all in it together.

Wish us luck!

Pivotal month?

2010-02-04T20:57:00.003Z

Far be it from me to declare any month as more important than it's colleagues, but.... Feb 2010 is pretty important to me - career-wise at least.

Finals
These pretty much fill February - writtens w/c 8th and OSCE w/c 22nd & 1st Mar. Nuff said - they decide if I graduate, if I have resits etc etc etc. This means that much of the rest of the month is built around revision.

Last Med Student Block
.........................Hopefully! This should be signed off tomorrow, again hopefully with a 10/10 pass. The coursework is all uploaded so everything on that side of things looks ok.

Programme details
Hopefully I find out which programme I will be on next year for Fy1 jobs. This is step 2 of the 3 stage 'find me a job' process. Step one assigned me to Scotland Foundation School, and Step 2 will allocate me (hopefully) to one of my top ten choices of programme (or I go into 2b where I have to re preference the remaining vacancies).

Much of the above is tentative and 'hopefully' and just to tempt fate I am planning as if I will pass!!

The last thing we needed.....

2010-01-26T09:39:00.003Z

It seems that someone from my year at Uni has posted somewhere on t'interweb that they have seen the 2010 finals paper.

This seems to have sent faculty chasing their own tail in circles with panic, and thus we have received an email saying that they will now be re-writing the exam paper to ensure no unfair advantage etc whilst saying that they think it unlikely that anyone has actually seen the paper.

Whether re writing means merely swapping the title page on the 'main' and 'resit' papers or long evenings of feverish activity in the admin end of the Med School as well as the library end is to be seen.

After all, all we need at 16 days to go was another minor panic!

Catching up a bit

2010-01-22T11:09:00.003Z

After my SSM at DEPCAT hospital (see here) I wrote up the results of my project, and we submitted it to a scientific meeting. Due to my SSM being in Intensive Care stuff, this means that most of the other posters were written by senior registrars, researchers and consultants.

I was thus quite lucky to be one of the 50 chosen to be assessed in the poster competition at a conference in St Andrews yesterday. This did necessitate an early start, but was a really interesting day with some very interesting lectures on H1N1 and the medical responses to it, and then some research presentations from across Scotland - it was also a chance to catch up with staff I had met on SSM and elective over the past 2 years. This networking surely can't be a bad thing when I get to ST applications in 2012!

However back to earth with a bump, and sat revising in the (boiling hot) library of one of the hospitals, and wondering whether my tiredness despite 7 hours sleep is in anyway related to lack of vegetables and fruit in my diet at the moment.

Being in SL in the evening doing past papers and revision does tend to make you a snack food addict - subway, greggs, ready meals, coffee, tea, irn bru, crisps, chocolate ....and hospital food is not much better - the average sandwich contains a bit of lettuce!

The joys of online shopping

2010-01-04T13:38:00.000Z

3 call centres, 25 minutes and 3 regional accents later I have discovered that my new vacuum (Samsung) is in East Kilbride at the depot as they could not deliver on Thursday as my road was closed. I thus have to go to EK one day this week between 9-5 or 9-12 on Saturday.

Call centres
1. Sainsburys direct - Belfast - amusing irishman and loud colleagues - I could hear the guy next to him talking to a woman ordering a washing machine for SK11 postcode
2. HDNL - Liverpool - very friendly girl, who because their computers were slow, had a 10 minute chat in broad Scouse with me about life and the world and what had I done for new year. her name was Emma.
3. HDNL - East Kilbride - blooming heck, tech them about customer service, the guy belched whilst on the phone.

Resolved to make a resolution?

2010-01-03T09:03:00.003Z

Psychologists at the University of Hertfordshire say it is quite normal for nine out ten of us to give up giving up/cutting down/working out in the first few days of January. Those who do keep on keeping on never make it past 77 days anyway, according to the insurer PruHealth (‘Death of the Diet Day’ is March 18, if you’re looking to pencil dinner dates in to your new dairy). But those who don’t bother at all end up healthier, mentally, as they avoid feelings of failure and worthlessness, according to the charity Mind.

Source

Hmmm 5 weeks of work and 4 weeks of exams takes me to just shy of the new years resolution deadline which does imply that any resolutions related to studying may outlast the exam season!

5 star hotels

2010-01-01T08:52:00.003Z

This next few months will yet again see me visiting some fancy hotels - working, Uni Graduation, Uni Conference, Mum's Birthday, Weddings and such like.
This is the location of the conference in January and it looke very nice, but I worry that it will eb cold and dark when I arrive and likewise when I leave and for all I see of the facilities, woe could have helf it in the old Ruchill hospital.

This is allegedly the location of the 2010 Grad Ball. Looks rather nice and I hope we get fireworks like that, but I fear that they may cost more than the ball will. We were discussing the other day the issue of having to pay now for a Graduation Ball when we an unsure of passing let alone Graduating in July!

End of the year!

2009-12-31T06:29:00.002Z

Hmm we appear to have arrived at the last day of 2009 all of a sudden. I must complain, no-one told me this would happen. Only yesterday term was finishing for Christmas (ok so technically it was 18th December), but this leaves me now with a major issue of trying to complete all the tasks I promised / am obliged to complete by the end of the year.

The main task are registering for a conference in January and completing the text for a poster for said Conference so we can send the poster to the printers and get it printed in time. I have technically been onto this since June but not really done much about it.

Subsiduary tasks include going to the bank and tidying my flat. Then comes the big decision of the day - Edinburgh, Study Landscape or my flat for new year?

The end of the year is also the Queen's New Years Honours list. For the first time in a wee while, I don;t know anyone on the list, though in second year I was a research subject for a trial for which one of the lead authors got a gong! In previous years, Uni lecturers, Scout Leaders, ex-colleagues, Charity people and even people at Mum & Dad's church have received a gong of one level or another.

It does make me wonder how many of the class of 2010 will be OBE / MBE / Sir / Lord before retirement.

My flat on tv

2009-12-30T22:28:00.000Z

Story of a christmas in pictures

2009-12-28T11:16:00.003Z

Sleep

2009-12-23T06:36:00.003Z

Hmmm couldn't get to sleep last night

Possibilities include
a) not burned sufficient calories / done enough exercise. Unsure how this works, but trying to get to sleep after lazy days is harder.
b) finals fear - not feeling particularly fearful as yet, but it is building.

So at 5.30 I gave up trying to sleep and have a large cup of 'Taylors of Harrogate Lazy Sunday' coffee at a fairly strong level and am contemplating my day.

Either way, I should sleep very well tonight ahead of my trip down to Newcastle on Thursday complete with Thermos flask and camera for the snowdrifts, tailbacks,m jacknived lorries and 'christmas roadtrip' film scenes from airplane, home alone etc.

WINTER 2009

2009-12-23T04:03:00.009Z

Random recent pictures

2009-10-10T15:25:00.004+01:00

Does this count towards the 5 a day?

The almost finished conversion of the old GPO in George Square.

Again, ground-breaking science being published. This is real science, this is what people need to know - in a bottling will a full or empty beer bottle break easiest?

2009-10-10T15:24:00.001+01:00

Chaos

2009-10-09T22:26:00.002+01:00

This block has started strangely. There are a 2 cohorts doing Paeds at the same time. This translates as 45 of us in one hospital (of 12 wards) and thus cases are under extreme pressure at the moment, with about 5 med students on each ward looking for suitable cases. Hopefully this will calm down over the next few days else it will be near impossible. The teaching programme however seems more robust and has a fair ammount of tutorials, teaching ssessions and clinics, as well as soem free time. This makes it much ncier than most hospitals.

Recycling, it just goes round and round

2009-10-03T12:06:00.004+01:00

I noticed as we got home yesterday lots of people had brown wheelie bins out, so when playing the car shuffle this morning so Mum & Dad could go out, I pointed to Mum that theirs wasn't out. Mum said it was the Garden Rubbish for recycling. It seems the council collect people's garden rubbish and convert it into compost for the council to use on flower beds and parks etc.

One of the houses with such a bin had a car outside out of which people were unloading compost from B&Q.

The irony and additional cost of this struck me - if people had their own compost heap, then they would save money, the council would save money, and they would be taking a pro-active approach to recycling...this may not work in flats etc, but in deepest suburbia with decent sized gardens then it should be obligated!

End of block

2009-10-03T10:15:00.003+01:00

Another block over, 9 down, 3 to go, revision now cranks up another gear, hence I am sat in my old room at Mum & dad's writing revision cards about dementia at 9.20am on a Saturday, and wondering why I don't remember some of this stuff from the actually teaching blocks.

Today's revision topics are all psych related which fits well with some of the GP stuff I saw - depression, distress, anxiety, psychosis, dementia and addictions. In fact that probably made up about 1/3 of consultations, especially anxiety disorders.

It is strange being back in my old room - It hasn't been painted since I was last here for any length of time, in 2004, and thus looks pretty much the same, including my high school desk, but the bed has been changed - sister getting married required a double bed in the guest room - and the bookcase us now covered in Mum & Dad's books not mine. On the other hand, being at the coast means it is much much windier than Glasgow ever is - mind that could be an east coast thing, as Edinburgh was always very windy........ Either way, it is now very windy today and rain is crashing off the windows - and 2 couples I know are getting married near here today - hope it dies down a bit.

On the way down last night, it was raining rather heavily - after Mum house sitting all week to wait for the dishwasher people - see another post for more info on that - Mum and I met Dad at Longtown for a meal in a rather surprisingly nice cafe/restaurant then drove back along ' the military road' from Greenhead to heddon - the road is as the name suggests right next to hadrian's Wall, and follows the roman route on the south of the wall for most of the way. It is pretty straight and thus quite hilly, which adds to the fun of driving a small Ka with 3 adults and luggage on board.

Island life

2009-10-02T00:51:00.003+01:00

My time on the island at Gp is finished and I am back to stable internet connections, and coffee shops! the island community was relatively small, so blogging was always going to be tricky as by their nature some thinsg i saw would be very identifiable, and recent media coverage has been banging home the message about confidentiality and anonymity for patiients in blog / facebook etc posts.

The intersting things included:

surgical emphysema and pneumothorax in someone who fell at night
managing to palpate a breast lump
student led surgeries
phlebotomy
friday night in A&E
the various skills fo the GPs - extracurricular
the ward rounds and community hospital next door
childhood injections

The next block is child health, and is the start of a run of 3 blocks back here in the city. This is very strange as I had 1 block in the city in the whole of 4th year. Without a 30 minute commute, how does one prepare for the day?

New year, new ways to avoid revision

2009-09-07T22:57:00.003+01:00

Well it is here, 8 days into final year at Med school, only 150 something to finals. One Five Oh...................as in 5 months.............as in argh!

Anyway Block 9, at least I think it is 9, or maybe Year 5 block 1 - yes that is easier, is GP. GP blocks have a reputation for being very boring, very quiet and drinking lots fo tea, much like Psych but with less depressed people. My block is turning out to be anything but...I am on an island for starters, which means no ferries after about 7pm until 7am. This means no ambulances to big A&E and city hospitals. Thus the helicopter (more later)!

This also means that there is no GEMS/Deputising service for Out Of Hours - so the duty GP covers GP emergency, A&E, Minor Surgery, OOH cover and Maternity, as well as Police Surgeon duties. All these have my phone number so I am wondering how many 1am phone calls there will be......

The practice is the only one on the island and covers about 7000 people, 25% are elderly, 14% are kids, and almost 50% appear to have a long term chronic disease of one type or another. So all in all life is not exactly super-quiet here, except after work..... the rush hour is very proportional and seems to focus around ferry arrival and school start / finish times. After about 7pm, the town gets very quiet and up where I am staying, I can hear cars passing on the road about 100 yards away. I can even hear the cows in the adjacent field, though I have not yet noticed the deer which apparently roam the field behind my accommodation.

The practice staff are all friendly, the nurses and receptionists slightly more so than some of the medical staff, who due to their work patterns haven't really seen me much - the on call person ahs the enxt day off, so I only saw my supervisor one day last week - hoping to catch up with her tomorrow to arrange some Phleb sessions with the reception staff on 'study' mornings or where my timetabled stuff doesnt start until 10 or 11.

Considering staying over here for part of a weekend to see how busy A&E is. But looking at diary, doctor on duty rota etc, the only possibilities seem to be staying this Friday night, or coming back on Sunday afternoon this week.

Anyway this week is a right mess. I am back at Depcat hospital to present my SSM research stuff on Wednesday so I need to (gale force winds permitting) head back to the city tomorrow, then meet registrar (who has moved to anotehr hospital) on Wednesday morning, then onto depcat to present the findings, meet Mum and Dad for a carvery meal, then back to the Island on Thursday (5.45am start) til Friday night or Saturday morning.

Shouting Lager, Lager, Lager, Lager, Lager, Lager

2009-08-27T18:10:00.003+01:00

Tennent's accounts for 55% of lager sold to Scottish pubs and clubs and around 30% sold to off-licences and supermarkets.

Source

This made me wonder.... is price what drives drinking habits. Are half of the people drinking Tennent's in pubs just doing so because it is cheap, and spending 'more' for higher quality lager's to drink at home?

Holiday pics.

2009-08-08T17:08:00.002+01:00

2009-08-01T10:01:00.000+01:00

It's a long while since I last travelled first class. And this time I
am doing it for less than the cost if a normal ticket. Twenty minutes
into the journey and I havd coffee juice and a croissant and a man is
collecting the breakfast orders! I know it is all very boringly
normal if you travel first class and stay kn nice hotels all the time
but fir me as a holiday it's a nice change from nescafe on a ward round

Blog test

2009-07-31T21:26:00.001+01:00

Mobile blog posting test

David Wright 07773 797 253

Tidying up

2009-07-04T18:27:00.002+01:00

Ah..... after 25 weeks of Uni, and various busy weekends, I am left with a very large pile of stuff to file away... all sitting in neat piles... or at least they were neat piles when I laid them out.

Anyway today is the perfect chance to do them, as after a week when I have hardly been home, today is the annual Orange Order parades through the centre of Glasgow. This morning there was a heavy Police presence, include Butcher Bo, and a large crowd of Orange order fans and protesters. This evening there seem to bbe large crowds of drunk protesters and supporters going round town shouting at each other, traffic, and the world in general.

What we need is a very heavy rainstorm to send everyone home!

First Day off

2009-06-30T02:00:00.003+01:00

So today was my first proper day off of the summer. And I haven't done much/anything of use.

As in real;ly, I woke up 18 hours ago, and i canl;t account for much of the intervening period. I slept a bit in the sun, cat like.

Bang!

2009-06-29T02:37:00.002+01:00

I was sitting here about 20 minutes ago just on MSN and doing some emailling, when I head a bang. I got up and looked outside.A van has crased into the side of a taxi at teh traffic lights outside my flat. The van has kinda stopped dead, and the taxi has been shunted ovver into some roadworks - outside the building opposite.

It all went very quiet for five ninuites. I could see the van driver was on the phone, so didn;t feel any need to call the emergency services. Sure enough, within 10 minutes there was an ambulance rapid response car followed by a normal ambulance on the scene, anoither 5 minutes and the fire brigade arrived, and still no sign of the Police.

Meanwhile the 3 roads which empty into this junction are starting to back up and traffic is having to do U turns oin one way streets to get away - sounds like a recipe for disaster the way some people drive round Glasgow at night.

H O L I D A Y

2009-06-27T23:56:00.002+01:00

I have booked my summer holiday.

First week in August, to London for 6 nights staying in a (hopefully nice - well it looks ok on trip advisor) hotel in Kensington.

Plan to see some school friends who live down there and also be very touristy - Science Museum, Kew Gardens, some shopping maybe, John Soanes house, Wellcome Collection etc.

Then I have the third week in August working at the fringe, and seeing a few shows as well, so that gives me two weeks in August to relax, see family and such like.

Boiler saga

2009-06-27T23:49:00.002+01:00

Well, 5 visits, several hours of workman trime, 4 weeks and a few hundred pounds later, my boiler has a new pump,m new valves, a new PCB, and will soon have new temperature sensors. Hopefully it will then work properly.

Currently I obtain hot water by opening the front of the boiler and wiggling one of the temperature sensor wires, which then causes the circuit board to realise that the water in the 'out' pipe is cool and thus starts heating teh water. This works for a variable period of 2 days to 20 minutes. Thankfully when not working correectly, the LED flkashes constantly, so it is fairly easy to tell.After 10 plumber call outs in 5 years, my admiration for the boiler manufactuirers is immense. I habve no idea what the pourchase cost was, but I feel I have paid them at least the same value in out of warranty parts, thus maintaining their income!

If only there was mains Gas into the building.

Score!

2009-06-27T23:37:00.002+01:00

Well that is term officially over. 25 weeks, or 175 days or....well you get the idea. 5 blocks, from ICU to psychiatry via Obs/Gyn and Medicine. It;s been a long term with lots of good bits,, and some boredom.

I managed to get to the end of term by getting a score of 2 for every module this year. With some complex maths which gives every piece of assessment from years 1-4 a score, I now know that I have achieved a score of 38 out of 70; the main reason for the low score being exam resits in years 2 and 3. So now faculty will rank the whole year group by these scores; and sort us into quartiles. The 4 quartiles then get a score of 34,36,38 or 40 points which counts towards the MTAS ranking. So for all mys core is not that great, it only penalises my a maximum of 6 MTAS points.

The MTAS score however will give me 5 points for having a BSc First Class; and I can get 1 point for a presentation at a National level, and 1 for a publication. Sadly I fear that my SSC Audit may not be written up and submitted in time. However I do have a paper from my BSc Hoinour project, so I can win back 6 or maybe 7 points there.

The rest of the Foundation Programme MTAS form is so awful and boring I am goiing to forget about it over the summer.

Choices, choices

2009-06-07T21:40:00.004+01:00

Today I was thru in Edinburgh and once I had finished my ususal stuff, and been to an 18th Birthday lunch BBQ, I went to see a friend from my BSc days. She was a genetics geek and then went on to do a PhD and is working as a post doc researcher in cancer-y genetics in Edinburgh. She gets to go to all sorts of exciting confeerences in Prague, and Crieff......

It was very interesting to compare stories as to what could have happened if instead of choosing Medicine in 2004, I had chosen to do a PhD and go into biomedical research.

I had applied for medicine and a PhD and got back acceptances for both on the same day, thus meaning I had 24hrs before I had to reply about the PhD offer. Except by the time I got the email it was midnight and I had until 5pm to reply. I also had a really busy day and ended up only snatching moments to think about it, and came to the decision "You can do a PhD as part of research as a medic, but you may not get another chance to study medicine". Wheher accurate or not, that is how I made the decision!

The boiler saga episode 2, part 2

2009-06-03T10:40:00.002+01:00

Now that the boiler engineer has been, I am left with the knowledge that a valve has leaked, dripping water into the pump, which is shorting. He has dried the pump, but even so, it seems I need a new pump and new valves. Even then there could be microprocessor problems, though apparently these are unlikely.

Either way the parts will arrive Friday so it will be Monday before they can come and fit them, which means another half day off placement. Monday teaching is officially at 1.30, so I would hope to make it in for that.

Now just deciding whether to go in this afternoon and find my FY1, or whether to stay home and finish off my case write up, boil water for a shave and shower and just head in for 9 tomorrow morning.

Head says the latter, heart just doesn't know.

Welcome back to my crazy life

2009-06-02T16:24:00.002+01:00

The first part of this post has come back to haunt me.

The boiler died again last Thursday with a strange burning smell.... So I phoned the company, who said they would find out whether they could still obtain spare parts since it seems that Pulsacoil may have gone bust / reformed / stopped making the boilers. It turns out they wrote the phone number down wrongly. So they didn;t call me back, so then I called them yesterday and was told they did have the parts available, and there would be an engineer available this week. I requested that they come out. I am sure they said that they would come today........

But after a no show until 4pm, I phoned them and apparently they are sure it is for tomorrow....morning at 9.30. Which coulkd be interesting since I have hospital teaching at 11am, a 50min drive away! I am hoping they can fix it the first time, as a second visit will mean missing more of this placement and also I wnt a warm shower!

I also have a broken dishwasher, but cannot book their engiuneers only a day in advance, and also they can only commit to a day not a time, so i may have to survuive without that until end of term in July.
I need a dentist appouintment, so might try to ring one of them as I have cracked a filling....
I need to arrange an MOT for the car before the 17th.
The wooden fascia of the dishwasher needs refitting to the dishwwahser unit

Sometime I think I need a PA!!!!!

Sorry!

2009-05-23T23:47:00.002+01:00

With many apologies for my absence. I should learn in future to remember my passwords and not let my PC remember them... cos when I change my PC user area then I lose my passwords...

So anyway life has been fun and busy and I shall recap these areas soon, probably the M onday holiday on.....Monday..

Technicalities of life

2009-03-29T23:42:00.002+01:00

Having got my car back, and then been away to see Mum & Dad last weekend, I spent the past week gradually coming to terms with life and several busy evenings, including uni, comedy, friends visiting, winning a music pub quiz (as part of a team obviously). I also found time to get a new phone as the old one died. I was also out for inner tonight, which was especially nice.

I am thus now part of the iPhone 3G group... first impressions are very good but it did require iTunes, which for some reason my laptop wouldn't install due to a 'corrupted user area. Thus I backed up all my stuff and created anew user area on the laptop, only taking about 5hours. I also tidied my contcat lists, and sorted out my files on the PC whilst all this was happening, so it wasn't wasted.

Having found out how to copy my mail settings across, I can now sync my diary on the pc with the one on my phone...which is kinda cool. I still need to work out how to use teh full functionality of the iPod part of the phone, but that requires an understanding of iTunes.which may have to wait for another day.

This week looks to be another one with several late finishes, with an 'academic meeting. tomorrow, the music quiz on wednesday, an ICU night out on Thursday and then an invitation to Cheesy Pop on Friday night. The quiz doesn't start til about 9, so is a useful post uni, midweek chance to catch up with friends, and demonstrate our lack of knowledge, and eat/drink our winnings from last week.

Happiness and regrets

2009-03-17T15:24:00.003Z

Well today my 04 intake got their exam results, and everyone I have heard from passed. If I had passed 3rd year the first time around I'd be with them, and looking forward to becoming a Doctor in August, a career, money, success and a long summer holiday. So I;m really pleased for all them, twinged with a slight regret that I won;t be with them, and that I have another 12 months work and graft until (hopefully) I can also add MBChB after my name.

I hope they are nice next year when we students are on their wards.

Graduating a year early?

2009-03-16T18:10:00.004Z

You might think that of all the people to keep track of what year of a Uni course a student is in, that the University registry might be pretty clued up.

And yet, myself and other students who have either missed a year, repeated a year or taken time out due to illness, and thus despite an 04 (or 03) matric number, will be graduating in 2010 not 2009, all received the following this week.
As yet they have not responded to my email. I wonder if i can graduate this year and thus avoid having to sit exams in 2010. Thought not.

Housekeeping or the house and uni

2009-03-16T17:08:00.003Z

Well in this weekend between blocks, I tried to be productive... after taking the car to the garage early on Saturday (such a short night) I decided to start cleaning the kitchen, including scrubbing the hob, scrubbing, hoovering and mopping the laminate floor throughout the living area, cleaning my desk, scrubbing the bathroom, and then hoovering the bedroom and tidying everything away from the bedroom surfaces I felt that things were going better, so on Sunday I printed all the Uni notes I did not recollect printing and found the matching lecture notes from this year and started filing them. Despite lectures only once every 5 weeks, the pile already almost fills a ring binder.

The notes on clinical skills are less organised because due to the nature of this year, they become more integrated into normal notes... I need to work out how to formalise and organise the notes from placements as well into a form from which I can revise when the time comes.

SSm starts tomorrow

2009-03-16T17:01:00.002Z

In a follow up to this, tomorrow I start my SSM at DepCat hospital in ICU.

It is an audit, and now I have a title, a topic, and a pile of reading at tall as a house! I also have a questionnaire I composed to gather the data and now need to design a spreadsheet to put it all into. In some ways a database might be more useful, but I;m not sure how to extract data from that and this needs to be more about the data than the process. It is essentially a 'paper' audit with no actual changes to practice in the unit until we reach some conclusions, but could involve going back through 720 patient records (or 300 patient notes) hopefully though this might be nice and easy and come in a spreadsheet itself from the labs.

Although I did my ssm in ICU before christmas, thatw a s abig city ICU with tertiary centres, and high level professorial input. This next one is a much smaller unit, with more paper based recrds, so it may be something of a change. For a start not all the staff wear scrubs....and I might not get to either.

The exodus continues

2009-03-16T16:58:00.001Z

well in the past 2 years, since I left my lace of work the first time, the rats have been leaving the sinking..... sorry other colleagues have been leaving. First Stefan, then Gstar, Chris, Sarah, and now Butcher Boy. This leaves the tattooed drinker and little Miss P holding the fort, although they have now been joined by some new people...

So Friday night became Butcher Boy's second leaving night...he is maintaining a watching brief by getting his flatmate to work there though.

Time to recharge the batteries

2009-03-16T16:54:00.004Z

My car is ill.... on Friday a red light came on indicating that I had ignition problems... I managed to keep it going until Saturday morning, as the lights got dimmer and dimmer, and then managed to coast it to the local Ford dealer on Saturday who said they would look at it and get back to me, but most likely the link from alternator to engine had gone - apparently this is common in Ka's. However the Ka has also done almost 12000 miles since I got it in August (see here) and needs a serrvice.. so this little episode may not be cheap........

Ethics in psychiatry

2009-03-16T16:47:00.002Z

Wow well Psych turned out to get a bit busier towards the end than I had anticipated. I ended up completing all 4 case sin the final week, and had to adapt one of them to fit the demands of the Uni ethics case.

However, like many others I worry that I have done the ethics case wrong. The guidance notes seemed to refer to patient safety stuff and us seeing staff doing things wrong and how this could affect the patients prognosis and outcome.

Mine focuses more on the issues to do with a 17yr old with prodromal posychoses and self-harm but who contninues to abuse large quantities of illicit drugs, and for whom pharmacotherpay is bcoming elss effective as he takes more drugs to achieve the high he wanted.

I linked this to teh situation of heart disease, and the fact that medics and GPS continue to give statins and anti-hypertensives een though people continue to eat badly, exercise poorly, and drink and smoke mroe. Thus I reasoned the illicit drugs were only different ebcause they were illegal, but that such isuses shuould not affect patient care.

However from the otehr side, if the pharmaco-therapy is meaning that the patient is taking more illicit drugs (with no quality control sapling etc) then it puts him at greater risk of adverse side effects and making his psychiatric condition worse, so maybe in the interest of non-malifience we should cut back his treatment.

In the end I came to no clear view........but in my experience psychiatry was all about discussing the options and not coming to a decision......

Sorry for being away

2009-03-06T19:51:00.001Z

Where did February go?

Mostly in a haze of youth group stuff, psychiatry at Uni - of which more later and sleeping - for some reason I am absolutely shattered this block!

generalness

2009-02-07T10:21:00.002Z

This is lining up to be a nice quiet weekend. Yesterday was a bonus day off, when my supervisors signed me off from the ObGyn block on Thursday, and since they had no clinical activity on the Friday, i decided to have a study day, and i did a bit of the pre-work for a tutorial on Monday, and did the laundry and tidied the flat.

Today is a freezing morning, and we are promised some -5 ish frosts over the weekend which will be fun, so some time today i need to top up on screen wash and de-icer to make sure I can get through the weekend in the car. Today should have a leisurely feel - some shopping, gym, about it until late afternoon, when there is rugby to be won - we can't afford to lose the first match, because with Scotland playing Wales tomorrow, an english victory today would only spur the Welsh on, knowing that they was one team less in the contest for the Grand Slam.

Postal shenanigans

2009-02-03T19:15:00.003Z

I live in an area covered by the XX1-4 delivery office. I'm expecting a parcel - too big for a letter box.
I was expecting a 'card' and then I;d have to go to the local delivery office - about 10 min walk away, which is open 7.30am-5pm 3 days a week, and 7.30am-12.30pm on the other 3.

But today I got my 'sorry we missed you card' asking me to go to the XX45 Delivery office in Ned-estate. And even then it is only open 8-12 each day! Seems ridiculous.

It is on my way to hospital (kind of, but I risk being late, and I need it asap. It seems stupid that they did not try to deliver it from my local Post Office. So I need to leave 30 minutes earlier, and may get there late!

Clank clank bang bang

2009-02-03T01:37:00.002Z

What a way to be woken up at 6.31 on a Monday morning. A smattering of snow on the ground, and people building a crane outside your bedroom window (and yes, I am 4 floors up. It seems that the site opposite has now reached a stage when the 'new' building inside the 'old' facade is strong enough to allow the mecanno which has been holding the facade up since August 06, is being taken down - in a very different way, and with a much smaller crane than when it went up. Also, Uni prevents me sitting watching them all day....which was a fun way to revise for the year 2 resits.

This also means that the building is almost finished, meaning my road with return to 2 lanes each direction, allowing for 'off peak' (i.e. 6pm-8am) parking outside my front door once again. This will also later this year see the office block being available for a tenant, the 'upper floors' with their glass walls towards me potentially being occupied, and the ground floor shops, and restaurants opening. Except this is a recession, and a conversion of a similar building in Edinburgh about 2003 left them waiting 5 years for a tenant - and even then they only took one floor of the building.

OOOh this is post 401.

Cases...

2009-01-31T14:06:00.002Z

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

2009-01-29T17:36:00.003Z

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

2009-01-28T23:21:00.003Z

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

2009-01-28T21:33:00.002Z

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

2009-01-23T22:17:00.001Z

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

2009-01-17T19:21:00.004Z

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.....

2009-01-17T18:41:00.002Z

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!

2009-01-17T18:29:00.004Z

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?

2009-01-10T12:00:00.002Z

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

2009-01-09T22:18:00.004Z

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.

2009-01-06T21:57:00.004Z

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?

2009-01-03T15:47:00.001Z

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!

2009-01-01T01:30:00.002Z

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.

2008/9

2008-12-31T17:37:00.003Z

Well 2009 is now a little over 6 hours away and in common with my general state this year I made no plans for tonight and now end up with no actual evening as such. Most of my friends are quite apathetic for new year this year, with a large focus on 'staying in'; 'doing nothing'; 'got no money'; and 'meh'; when I surveyed them.

I have the car so could go to one of the gatherings I know are happening, but that involves going all the way down in Newcastle, or Reading, both of which are a long way. and would cost lots of patrol. I have my House series 3 from Christmas, a warm flat, lots of tea and wine, and a huge pile of ironing, so it could be that I have an interesting evening, unless I get a better offer by text soon. I also have a large street party and concert outside, which if I open the window I can hear perfectly, and should I want to, I could go to with the 2 free 'inconvenience' tickets I get from the organisers.

Looking ahead, 2009 should be a good year:- my last holiday as a student, elective, and SSM, my Child Health block and for the first time in (at least) 12 years......a summer with no exams!

Looking back 2008 was a year of some highs (passing 3rd year, my ICU SSM, my block at seaside hospital - including chicken sewing and fireworks, passing driving test, getting a Car, my Sister's wedding) and lows (death of close friends, death of grandfather).

I liked 2008, it was a good year, but I am looking forward to 2009 so much more.

Random photos

2008-12-31T17:21:00.004Z

I was in the West End of Glasgow yesterday and took some unusual pictures......

Icicles!

2008-12-31T17:20:00.000Z

It was quite cold yesterday!

Any ideas?

2008-12-31T17:17:00.001Z

Does anyone know what this thing on top of a post box is for?

Ann On A Mouse

2008-12-14T08:47:00.001Z

Faculty have sent out an email this week reminding us of the need to remove all identifying patient information from case reports when we hand them in. They have then requested that we do not use initials either.

This causes minor issues in referring to the cases with educational supervisors, and also with supervisors checking the patient details to ensure that we have got the interpretation of investigations correct.

It would also seem to me that 3 blocks into the year is maybe a little late to tell us!

Busy weeks

2008-12-11T00:35:00.002Z

The past fortnight have been quite manic so far and seem to have one ongoing pattern...in fact most of this ICU block has focussed around dying. It is a common thing, given that 33% of all ICU admissions die in ICU and 50% before leaving hospital. Also this month has been the one where I had to write a Palliative Care case, and work on a Palliative Care plan for the patient.

As you will have seen from past blog posts, the perceived unfairness of who dies has been something I have been thinking about a fair bit.

Also mixed in with all this has been a variety of random non-Uni stuff, tech for a CMF conference weekend away (where end of life issues, euthenasia, and assisted suicide was one of the main discussion topics - some interesting views and opinions); Origin events in Princes St Gardens - where I kept warm by handing out flyers and shaking an orange bucket; and in St Cuthberts in Edinburgh last weekeend. Then this Monday I was at the launch of a CD recorded at a concert we did in the sumemr, and on Friday is another gig, in Grangemouth. So I''m so looking forward to Saturday for a long lie!

A change of scene

2008-11-29T10:08:00.003Z

With one thing and another, I haven't really been home in daylight since well....October, and noticed this morning that the new 'roof extension' to the building opposite seems to be well underway with structural floors and supports in place and the outer skin being put in place. This is to be covered in glass apparently.

Continuing the cheery theme....

2008-11-27T19:28:00.001Z

The new Barnado's campaign is on TV and cinema's. It is hard watching, and a telling reflectiuon on an aspect of society today... for a media obsessed at the moment ith child rape, child murder and hoodies, knives and teenage gangs, what about looking at teh root causes. Are the former linked to the latter. What is cause, and what is effect......

Should we get annoyed?

2008-11-27T17:39:00.003Z

a.k.a. Why do good things happen to bad people.

Over the past few weeks, a common pattern seems to be emerging - often young, previously healthy patients with wives/husbands, young families, and who are working and contributing to society* are getting very sick, and or dying, whilst chronic alcoholic, IVDU's end up recovering from their alcoholic encephalopathy, seizures, and coronary events*.

*the above are composites of different patients.

It seems unfair that people who were doing good, and are only a little older than myself are dying, despoite all the treatment we can offer, and yet people who are on their second or third ICU visit are recovering, but not reforming and going back out to continue their downward spiral.

I am not suggesting that some lives are more important than others, but there does seem a fundermental unfairness about the fact that those who contribute to society are the ones to die, and those who sponge/take from socety are the ones who survive.

As one doctor put it today "those with a rough paper-round have just become so tough that it takes more than a bit of alcohol and an MI to kill them".

Sorry

2008-11-26T23:07:00.002Z

Sorry about the lack of posts recently, but I seem to be really tired after my SSM days, which is worrying as I now have to work on the essay etc!

Skills....

2008-11-26T23:00:00.003Z

This has been a week of firsts.....................

My first pleuritic tap...maybe next time my hand won't shake so much..... and the patient will have less excess soft tissue so I can feel the top of the rib - the tap needle must go along the top of the rib not the bottom because the neuro-vascular bundle runs along the bottom of the rib.
My first 12 lead ECG which I managed to set up, record and then have a go at analysing myself....though I did need some leading through it. ECG's are one of my bogey areas.
My first Arterial blood gases (sterile procedures) and blood cultures.
My first dead body in a mortuary...technically it is my second, since I saw a PM during my BSc Honours year in 2004, but this was the first where I had known /met the patient.

Many of the patients this week seem to be either very, very sick, or alternatively just bobbing along getting better slowly...more to follow later.

	2010/11 £	2011/12 £	Difference £
Income tax	5975.00	5775.00	£200.00
National insurance	3012.35	3126.60	£-114.25