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!
Showing posts with label deprivation. Show all posts
Showing posts with label deprivation. Show all posts
Friday, January 22, 2010
Thursday, November 27, 2008
Should we get annoyed?
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".
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".
Tuesday, September 30, 2008
How long have I got?
Leaving aside any politics or debates about the pro's and con's of our welfare state, and pension system (which in fact predates the welfare state - the random facts you get from watching BBC4 documentaries, or was it QI?) , this makes interesting reading. If we lay all the economics and social policy stuff about pension pot, and actuarial scales...something I don't even profess to comprehend let alone understand, one table hit me:
Copy and paste directly from BBC Website on 30th September 2008
Note how the bottom 5 are all in the area covered by my beloved Medical school. One factor that those of you not familiar with the West of Scotland can be seen in this map
Sitting squarely between Glasgow City and North Lanarkshire, and adjoining West Dumbartonshire is East Dumbartonshire, and area which one might except to have a similarly poor life expectancy for its 65 year old residents. Except that it does not. If we look at other statistics in teh full report (here) we see that East Ayrshire adnd Clackmannanshire also have poor life expectancy figures. And yet, East Renfrewshire does not.
There seems to hjave been some nice games played when the old Strathclyde region was divvied up in the 1990's, to create the unitary authorities you see on the map above. The two areas I identified, East Dumbartonshire and East Renfrewshire also have very high (for West of Scotland):
The local health profiles designed by the ISD of NHS Scotland are interesting reading (unless you are a Glasgow First Year Medical Student doing Block3/4 Community Diagnosis coursework, or year 2 Family Project coursework). Similar are available in England. They also offer tobacco atlases! I can't stand doing statistics but I like graphs and maps... Maybe epidemiology is worth understand after all, but I still don't think I could deal with a career in public health.
| Lowest Life expectancy at age 65 | |||
|---|---|---|---|
| 432 | Glasgow City | Scotland | 13.8 |
| 431 | Inverclyde | Scotland | 14.9 |
| 430 | North Lanarkshire | Scotland | 14.9 |
| 429 | West Dunbartonshire | Scotland | 14.9 |
| 428 | Renfrewshire | Scotland | 15.0 |
| 427 | Knowsley | North West | 15.3 |
| 426 | Manchester | North West | 15.3 |
| 425 | Liverpool | North West | 15.3 |
| 424 | Hartlepool | North East | 15.4 |
| 423 | Cannock Chase | West Midlands | 15.4 |
Note how the bottom 5 are all in the area covered by my beloved Medical school. One factor that those of you not familiar with the West of Scotland can be seen in this map
Sitting squarely between Glasgow City and North Lanarkshire, and adjoining West Dumbartonshire is East Dumbartonshire, and area which one might except to have a similarly poor life expectancy for its 65 year old residents. Except that it does not. If we look at other statistics in teh full report (here) we see that East Ayrshire adnd Clackmannanshire also have poor life expectancy figures. And yet, East Renfrewshire does not.
There seems to hjave been some nice games played when the old Strathclyde region was divvied up in the 1990's, to create the unitary authorities you see on the map above. The two areas I identified, East Dumbartonshire and East Renfrewshire also have very high (for West of Scotland):
- school exam results,
- owner occupier,
- car ownership,
- house prices,
- health indicators
- incomes.
The local health profiles designed by the ISD of NHS Scotland are interesting reading (unless you are a Glasgow First Year Medical Student doing Block3/4 Community Diagnosis coursework, or year 2 Family Project coursework). Similar are available in England. They also offer tobacco atlases! I can't stand doing statistics but I like graphs and maps... Maybe epidemiology is worth understand after all, but I still don't think I could deal with a career in public health.
Friday, September 26, 2008
Introducing Suburban Seaside Hospital
This weekend is the Monday Holiday in the Health Board where i am currently on placement, so a 4 days weekend!
I utilised today by a period of meditative activity (i.e. a long lie) then started to scout out my next placement location. From Depcat Hell, I will be at the Suburban seaside hospital. Well it's not on the prom, but its a darn sight closer than my flat is.
I decided to find someone with some knowledge of the area I'd be going to, and indeed who knows the road very well. Step forward the ubiquitous Butcher Boy. the tattooed drinker also knows the area well, but he had films to see and drink to drink. We set off shortly after lunch and had a good journey down, despite the obsessive changing of the speed limit every 5-10 miles, The trip takes about 50 minutes, so is almost commutable - although we do get accommodation at the hospital if we choose to use it.
The biggest surprise was the fact that there's no two ways about it, the hospital is bright yellow. Most around here are Concrete or Stone. This one is yellow brick and looks both quite nice and quite odd at the same time.
We then went for a rather nice lunch in the Boot of the old town, near the courthouse and beach, before heading for the 'burbs, where I dropped butcher Boy at his parents house and he did some carjacking, and I drove back up to the big smoke.
Who said public holidays were restful?
I utilised today by a period of meditative activity (i.e. a long lie) then started to scout out my next placement location. From Depcat Hell, I will be at the Suburban seaside hospital. Well it's not on the prom, but its a darn sight closer than my flat is.
I decided to find someone with some knowledge of the area I'd be going to, and indeed who knows the road very well. Step forward the ubiquitous Butcher Boy. the tattooed drinker also knows the area well, but he had films to see and drink to drink. We set off shortly after lunch and had a good journey down, despite the obsessive changing of the speed limit every 5-10 miles, The trip takes about 50 minutes, so is almost commutable - although we do get accommodation at the hospital if we choose to use it.
The biggest surprise was the fact that there's no two ways about it, the hospital is bright yellow. Most around here are Concrete or Stone. This one is yellow brick and looks both quite nice and quite odd at the same time.
We then went for a rather nice lunch in the Boot of the old town, near the courthouse and beach, before heading for the 'burbs, where I dropped butcher Boy at his parents house and he did some carjacking, and I drove back up to the big smoke.
Who said public holidays were restful?
Monday, September 8, 2008
Life in DepCat hell
One thing I have learned on my first Surgical block is that DepCat matters... Given that they invented Carstairs Indices6 & 7 for Scotland, and Indices 7 for the area I am in at the moment in particular.
This informs the patients we see...
Being a surgical block, we haven't seen much respiratory stuff, since most are to far gone for any curative or palliative surgery. Many of the operations are not curative, and the people accept this as normal.
Many of the population in the area served by the DGH moved from the East end of Glasgow in the 1970's-80's and brought their health with them. You may remember the East End from the recent by-election and news headlines (see here, here, here, ad infinitum).
It seems that down in the lower indices, where deprivation is at a level which is hardly ever seen and which some in the UK would like to pretend does not exist, then you can expect to die young and they accept this. They view their lot as a poor one, and aim to make the best of it, but the vices of the poor are generally alcohol, food and tobacco - who can forget a local MP's comments in 2004.
Lest you think that it is all depression and gloom....the sick man of Europe as its uses as a Medical student, and since we cannot change the health we are presented with in the here and now, it gives many great opportunities for understand behaviours, trendsm, and also to see lots of pathology and cases in a relatively short block.
On a related note, I am writing up my first portfolio case and discovering
a) I forgot to ask about half the information I ened
b) I forgot to look in the notes for the other half
c) I have no idea why the patient is on some drugs
d) I have no idea what the 7 GMC themes are
e) I am now worried due to the above....any support anyone - the email link should work :)
This informs the patients we see...
- Pancreatitis (West of Scotland favourite)
- Cancer - bucket loads of it, of almost all known organs - oropharyngeal, gastric, colorectal, pancreatic, prostatic, bony met's....
- Obesity
- Traumatic orthopaedics
Being a surgical block, we haven't seen much respiratory stuff, since most are to far gone for any curative or palliative surgery. Many of the operations are not curative, and the people accept this as normal.
Many of the population in the area served by the DGH moved from the East end of Glasgow in the 1970's-80's and brought their health with them. You may remember the East End from the recent by-election and news headlines (see here, here, here, ad infinitum).
It seems that down in the lower indices, where deprivation is at a level which is hardly ever seen and which some in the UK would like to pretend does not exist, then you can expect to die young and they accept this. They view their lot as a poor one, and aim to make the best of it, but the vices of the poor are generally alcohol, food and tobacco - who can forget a local MP's comments in 2004.
Lest you think that it is all depression and gloom....the sick man of Europe as its uses as a Medical student, and since we cannot change the health we are presented with in the here and now, it gives many great opportunities for understand behaviours, trendsm, and also to see lots of pathology and cases in a relatively short block.
On a related note, I am writing up my first portfolio case and discovering
a) I forgot to ask about half the information I ened
b) I forgot to look in the notes for the other half
c) I have no idea why the patient is on some drugs
d) I have no idea what the 7 GMC themes are
e) I am now worried due to the above....any support anyone - the email link should work :)
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