BB boredom

E4 have done it again. Their summer schedule is now in place, which means large chunks of their schedule devoted to Big Brother. I thought that the pre-series 1 documentary (in 2000) about BB in other countries was quite funny, series 1 was interesting, series 2 was ok, but series 3-8 were starting to look like grasping at straws with the people becoming more eccentric, and the
tasks becoming ever more bizarre and attempting to grab headlines.

The people this year seem very odd, slightly fake and not that representative of Britain, or even any subset.

Maybe I am just old and grumpy, but it only ever gets interesting on Friday's and the final 2 days. Regular readers may notice that I made a similar rant last year.

If you always come late what does that mean

I have yet again come late to a TV series. I was late to ER, late to Scrubs, totally missed Lost, 24 and Grays Anatomy, and tonight I saw House for the first time. It was much better than I thought but I still can't get over Hugh Lawrie's american accent, which seems to be English but more gravelly than. House does seem to be very good and his character appeals to me in the was the Dr Cox from scrubs and Dr Pratt & Dr Lockheart in ER. Eccentric doctors with crazy personal lives seem to act as some kind of Icon for me - Dr Patch Adams also fits into this category.

It is a strange situation where you want to be like a fictional character in a fictional situation which was written purely for dramatic intent.

Anyway the break is over, so back to the final part of House.

Elective - day 2 (maternity)

Today was my first ever visit to a labour ward. I was there to see what the anaesthetists do, although I also got to see 2 C-sections as well. It's much more umm, well, eerr, brutal than I thought. However, either way, 2 7lb babies were born fit and healthy so it can't be bad for them.

I don't know if today was a slow baby day, or if it's normally quiet, but there were only 4 ladies required anaesthetic intervention - either for a C-section, or for epidurals, so I got 3 or 4 tutorials on different aspects of anaesthetics. I got to spend time with an SHO, SpR and Consultant and got to see their different styles but also the high degree of teamwork they have.

1. The difference between a spinal and an epidural anaesthetic.
2. What the things to look out for when anaesthetising someone who is fit, healthy and awake.
3. How they manage a patient who has an 'allergy' to one of the commonly used drugs.

The most useful one, long term!!! How to be a good JHO - all about being organised, knowing where things are, what tests to request, how to request them, when to take them down personally and when to just put a card in, remembering to check up on results, knowing how to do all the minor jobs - ECG, venflon, taking blood before you become a JHO etc.

SHO Teaching & careers advice
The SHO I was with for that part of the day was really helpful at explaining why these things are important and why it is good to pick them up as a medical student, and not wait til you are a JHO. She also explained some of the simpler things about anaesthetics and the anatomy of where the different needles go. She also gave some advice on why Anaesthetics is a good choice as a career and also how to manage your FY1 choices and accepting that you are an admin clerk and spend most of your time monitoring things, checking up on things or ordering test fro other departments, She also said about knowing the patients on you ward because more senior staff are off at clinics, research etc, and it is down to you to know who slept well or didn't, whose birthday it is, whose family members are away and haven't been to see them, and things like that which help you to explain things to the consultant. Also getting to know some patient history and circumstances is important.

Seeing tomorrows patients
In the afternoon we were a bit quiet, so the SHO took me over to see the 2 patients who are being operated on and whose anaesthatist I am with tomorrow. Both are having heart surgery, so I had a look in their notes and noted the drugs they were on and went to see them so they would know who i was and why I would be in theatre tomorrow (if they care at that point!). Upon coming home and checking the drugs they are on, one patient is on Clopridogel, which is a drug which aims to prevent your blood clotting (an anti-platelet). The BNF and other textbooks recommend stopping it 7-14 days prior to surgery unless it is needed for anti-platelet reasons. So that case may be a little interesting anyway. When I went to meet that patient, who is having an aortic valve replacement, and potentially a CABG - the consent sheet and referral letter said different things! - I had a listen to her chest and the murmur was really loud and obviously diastolic. Even the SHO said it was one of the best she had heard.

Elective - Day 0

Hmm night before elective and the nerves are kicking in

• Can I find it?

I know where I am going - theatre X in building Y.

• Will he remember?

Well he sent an email confirming the details so i guess it is more about what else may come up tomorrow morning.

• What do I do with money keys phone etc?

I assume there will be lockers, else stuff it in a rucsac and hope. I could leave the phone and change at home and just take a ten pound note or something

• What money will I need for lockers?

This goes against the idea of just taking a ten pound note.

• What hours will I be doing?
• Where will I be working?
• Will i have time for revision?
• What do I need to take with me?

Textbook guide, notebook, pens, ?stethoscope?

Oh well I find out what the world of Anaesthetics is like in 8 hours, and I still haven't sorted most of my to do list from yesterday yet.

More Scrubs

More Best of Scrubs clips again stolen....

Dr Cox

The man known as the alchie of Ayr has asked to be renamed as The Tattooed drinker... he also has a Dr Cox fixation, so here goes:

Big Brother

I tend to ignore BB, and have only a very minor interest, and in exchange it normally happens without affecting my life.

Until now.

E4 schedulers have decided that "Big Brother Live" should start at 0015 each day running through until 6am. They appear to not have noticed what used to be in the 0015-0115 slot - Scrubs.

Now I am able to understand that they were having to repeat Scrubs, since there are only 6 series, but to replace nit with BB8 for the next 10, 11, 14, 18, or however many weeks is criminal.

My only hope is that BB flops and gets pulled.

Janitor

As a tribute to butcher boy, 3minutes of the Janitor.

The colour of blue, reminds me of you.....

Ok, ok enough of the S-club 7 song lyrics!!

It would seem that a large proportion of my female friends have weird fantasies. Involving NHS property.

Ever since I started telling people that my summer elective would be in anaesthetics and i would be spending the summer in operating theatres, wearing scrubs (I must learn that it has a lower case S!), no fewer than 4 of my friends (all female) have asked me to steal them a set of scrubs to use a pyjamas.

When I pointed out that if you are so desperate, you can buy them online, they all said "No, they must have 'Hospital property' printed on them". The world is full of some strange people, but if all my friends start appearing wearing blue scrubs, you know my kleptomania got the better of me over the summer.

Personally I blame e4, JD and Elliot. But there must be a reason why guys don;t want to sleep in scrubs?

Surgery (2)

WOW!!!!!
It was a great day!

I loved my day in theatre. It was an early start to get there on time, but we arrived a wee bit early and watched te two cases prior to the one we were supposed to be seeing as part of the SSM. The surgeon, and thhe registrar were both very helpful and epxlained a lot about what they were doing, and even turned the microscope and TV on for the earlier cases which were adenoidectomy and grommet insertion and draining of glue ear.

Implant
We then got to watch the Cochlear implant, and it was great to see the things that everyone else viewed as normal, such as the care taken to make the incision as small as possible, and the neat and detailed drilling so that the implant would sit comfortably under the skin and slightly recessed into the skull. It was not like surgery is reputed o be and was in fact very gentle and the staff didn't seem arrogant at all - maybe ENT surgeons are different?

Wearing blue scrubs was in fact kind of cool, and got me some interesting looks when I went for lunch - all 8 minutes of it.

Scans and Anaesthesia
We were offered the opportunity, in the afternoon, to watch a child having an MRI & CT Scan as well as evoked Auditory Brainstem Responses (ABR) to assess their candidature for a Cochlear implant.

The little girl (M) needed to be anaesthetised for the scans, and it was amazing to see how she went from being happy (if deaf) 18 month old, to being a floppy mass of wires and tubes, with her life entirely in the anaesthetists hands. Because of the big paedatric hospital, little DGH like the one we were at don't do much paediatric anaesthesia, s there was an hour wait before M was sedated, allowing the registrar to pick my brain in a one hour tutorial on ENT, hearing impairment and my course. It turned out that he was friends with a Doctor who had done an MD and been Mr Tiddlywink's (a friend of mine) supervisor for his BMedSci project in my Honours Year.

The scans were successful in demonstrating that M had an intact auditory nerve. The EBR results were a mass of lines on a graph, and I couldn't even get a handle on them, but the Clinical scientists seemed happy that they had a result.

DIME
Of course me being me, a long uni day was not enough! I got the Bus to Train to Bus combination to be at DIME for 8pm, 110 miles away, since they were 2 Leaders short for DIME 3. Thus I got home 19 hours after I left!

O S C E (to the tune of YMCA)

Exams are over!

Well for the moment, I might have a recall exam for my OSCE, if I was in the gap between PASS and (PASS + 5%). Hopefully I am not. I would like to think that the OSCE went well

1. Ethics station - a man with a sickline which says Alcohol (10 min)
2. Blood Pressure measurement
3. History of a jaundiced patient
4. History of a suicidal patient
   
5. Peripheral vascular examination of lower limbs
6. Respiratory examination of the back
7. GI examination of a jaundiced patient with hepatomegaly
8. History of a rheumatoid patient
9. Difficult circumstances with pregnant woman drinking alcohol
10. Comms Skills station - woman with a cough - followed by information giving for bronchoscopy. (10 min)
    
11. Neurological examination of upper limb
12. History of a woman presenting with headache
13. Resus with a Defibrillator
14. History of a woman with weight loss.
15. Breast examination of a manekin.
    

And another 1 I have forgotten since this afternoon, and 2 5-minute rest stations.

Scrubs

Tonight E4 was showing the end of Series 3 of Scrubs (for those of you not paying attention, this is the episode where Turk and Carla are supposed to be getting married). JD has persuaded Elliot to leave Sean and go out with him, and then told her that he didn't love her.

Elliot was doing the whole jilted-girl-at-a-wedding thing or appeared to catch JD's attention then storm off, anyway, it all went from looking all positive and hopeful of maybe two romances, to 2 singletons and a marriage in a side-ward the day after the wedding. reception.

That hopefully means that E4 will be showing the first 2 episodes of series 4 tomorrow night. This should be good. I was very pleased with tonights timings - 2340-0040. Towards the end of last month, the scrubs double bill was slipping towards not starting til 0030, which is a touch late to watch if you are in Uni at 9 next day. Anyway it helped postpone the exam stress a little.