6 Years old

I wasn't actually sure my mental arithmetic was correct, and childishly had to whip out my fingers and count to be 100% certain. This blog is 6 today ^^

Back in 2007 i was scribbling my journey through Biochem. at KCL, and now 6 years on, I'm a 4th year at BL, scribbling my way through medical school.

Hopefully next year i'll be scribbling my way to finals! - but for that to happen...let's get on with some revision!

PS - i don't actually drink as much soya milk as i did 6 years ago.....!

Sounding stupid - Ophthalmology Chapter

Consultant: "Tofu, look at these glasses and tell me about the prism, and the direction of his double vision"
*consultant takes the glasses from the patient and passes them over to me*

Me: "okay"
*okay...he probably just wants me to tell him if the patient is short of long sighted*
*takes a look at the pair of glasses*

Me: "i think he is long sighted"

Consultant: "Yes, he is, but tell me about the prism"

Me: "okay"
*okay, damn....that's not what he wanted!
hmmmm he definitely said prism...and as far as i know, a prism is long and triangular shaped with a light shone in one end, and a spectrum of colours beaming out the other.... and these... well... these are definitely just a pair of glasses....*

Tofu's Prism

Me: "well, er.... these are glasses. I'm not sure if they're a prism or not *mumble mumble* ummm, i mean, a prism is triangular and long........ er..er....  Dr... i'm actually not sure what you're asking me"

Consultant: "okay, never mind"
*continues with his consultation*

----------------------------

Yep, unfortunately when i had both the patient and the consultant sitting and staring at me, expecting an answer... i did the foolish thing of just saying anything i had in my mind to fill the silence.

Luckily i admitted i didn't have a clue about what he was asking me, and i didn't embarrass myself further by going on about the spectrum of light and all....

As it turns out, almost every other patient turning up to the clinic this afternoon had these prism lenses, which corrected for their double vision, and unfortunately with every question that came firing in my direction, the impression i left with the consultant sort of just went from "she needs to revise" to "how the hell did she get into medical school?".

At one point he blurted out something Latin sounding, and was asking me what it meant. Lucky i didn't start guessing the patient's condition, as it turns out, he was asking me about medical ethics (!!!!!!!!!)!

So yep.. it was a very long afternoon clinic.

I best go and do a bit of reading before i turn up to the remaining clinics.

Consultant's Prism

Neurosurgery Placement

NEUROSURGERY

I LOVED this placement.
- i have never considered surgery as a career, but if i had to do any surgery, this would probably be it.

From my experience so far, as a medical student you don't normally get to feel as part of the surgical team as much as you would if you were doing a medical rotation. This all changed with Neurosurgery.

On my very first day, my reg was on call and we went straight to theatre to put in a VP shunt. This was already quite exciting, as I had literally just done that lecture the night before so it all seemed pretty relevant, but perhaps this was the first time the entire theatre team were so keen to have a student scrub in.

Reg: "Tofu, have you ever scrubbed in before?"
Me: "Well I did in 3rd year.... *mumble mumble*"
Reg: "Okay, get one of the nurses to watch you scrub in and come stand next to the head"
Me: "OKAY!" *tears of joy*

*okay i didn't actually have any tears of joy.. but I was pretty happy with having such an enthusiastic reg.

The head was fixed in place, overlying hair was shaved off, the scalp cut into, and using power tool like instruments, a hole was bored into the skull.

For the very first time i saw the human brain in a living person, it quivers ever so little, almost like a pulsating movement. A long metal shaft was shunted through the neck, over the clavicle and into the abdomen, where one end of the catheter was inserted. Whilst the valved end of the catheter was shoved into the brain and into the ventricles, and you can instantly see the valved area fill up with CSF.

That was my first taste of neurosurgery. I had to come back!

I went back to theatres for my consultant's surgery list, and it was awesome! As soon as i walked in, the nurses remembered me, and already asked if I wanted to scrub in today, i nodded with a big smile.

The list was rather short, but I was lucky to get to see a good mixture of procedures, from spinal surgery and brain tumour biopsy to sub-dural haematoma extraction. Managing to scrub in for every procedure, as the day progressed I got to go from standing by the head, to given the suction, helping with the sutures and stapling up the scalp at the end.

The only down sides from this placement, is that it was only a week long... and that from now onwards, i will never be able to have any grass jelly drink or dessert, without it reminding me of a sub-dural haematoma!

Found this picture online, not sure if it makes me want to eat it anymore.

A difficult few months

It's been a while since i've updated my blog, and it's been a pretty emotional and difficult few months since then.

Back in 2009 my mum had a traumatic fall and fractured her spine, that was fixed with a few screws and plates, and i thought that was the end of that. However, sadly i've learnt over the last few months that it's not quite the end of it. After a year or so of neurological symptoms which has gradually worsened with time, my mum finally had a MRI followed up very quickly by an urgent MRI.

The good news being the mass in her spinal cord doesn't seem to be a malignant mass, and the main differential at this point, is a post-traumatic syrinx. Referred to the neurosurgeons, we're now just waiting to see what's going to be done; but i was told at my mum's appointment, it's almost certain she will need some form of surgery pretty soon.

Seeing my mum's eyes red and close to tears as she sat at her appointment worried that she had cancer really was very difficult, thankfully it's not that. I know it could be a lot worse, and there is always a better way of seeing what could be seen as a bad situation, but it was difficult trying not to worry wondering what it could have been, and what it may mean in the future.

I've found it pretty hard to sleep at night, and that sort of led to not being able to concentrate and i sort of just slept or day dreamed my way through my paediatrics firm, my last ICA and the week of neurology, opthalmology and psychiatry lectures; and i'm worried with how im going to cope with my upcoming firm.

Starting with neurosurgery and neurology in a weeks time is a little difficult for me. I am generally emotionally quite weak. I know i'm probably worrying myself more and predisposing myself to being upset, but I know i will find it hard to see patients in a similar situation to my mum.

At the same time, i think it's making me want to work a lot harder now; and naive as it may sound, i just want to work really hard and be the best i could be, and one day be able to help others, knowing that every patient is important to someone else out there.

With a week to go before uni and my firm starts, i'm going to start with revising year 1 and 2 B&B lectures, and then move on swiftly to cover as many of the 4th year neurology lectures as i can before i start my short 1 week of Neurosurgery, and 2 weeks of Neurology.

O&G - GP Week

This post is a little late, in fact an entire week late as I've become extremely sleep deprived and tired from my O&G firms...! But yes... my GP placement 2 weeks ago...

There is no set timetable from the medical school, just a simple set of learning objectives, and the GP can make what they want from it. So essentially.. GP sessions are as interesting/dull or long/short as the GP in charge wants to make it... and it's simply a matter of luck if you get what you want.

I'm not going to complain about my O&G GP placement this time though, as it's been pretty good!

Smear Clinic

It's perhaps a little immature and silly to find these things awkward and scary... but I admit... that was exactly how I felt the first time I had to insert a speculum. The awkward part came from being slightly startled by the very energetic, loud and possibly too friendly patient; and the scary part owing to the fear of inflicting any pain whilst carrying out the smear.

< Just look at the thing, you warn the patient it's going to be "uncomfortable", and I'm sure it probably would be just that.. if not worse!

The smear was pretty easy to perform, and particularly as I had the nurse with me to teach me step by step (Nurses tend to be awesome at teaching clinical skills).

We donned our gloves, lubed the sides of the speculum, making sure none got onto the tip, parted the labia, grabbed the speculum and pushed and rotated it, got the cervix in view, locked it open, inserted the brush thing, twisted it round in the same direction for possibly 10 times, and then just removing the whole thing, making sure the cervix doesn't get trapped! (Ouch). Quick few violent swirls of the brush in the solution, labels on and ta-da.. done!

It wasn't actually as bad as I thought it would be.

...... oh yes.. I forgot the mention the bit where the cervix starts bleeding whilst i was twirling the brush around.. the nurse warned me this happens quite often... but it didn't stop me from feeling a little bad. 

Vaccinating children and babys

Thankfully the children and babies were probably too young to remember me and hold a grudge against me for injecting their tiny thighs. We were taught to ask the mother's to hold their babies in a specific way, and then it was all stations go go go, trying to get the vaccinations over and done with as quickly as possible.

Innocently, all the babies would beam their little smiles at you, and as soon as the first needle went in, the crying would start, and it was a matter of trying to get the other vaccination into the other thigh as quickly as possible to get the ordeal over with.

Examining Baby Bumps

I'm the youngest in my family, and I was too young to remember any of my aunts being pregnant, and having not had any friends or relatives fall pregnant in my 2x years of life.. I felt my first baby bumps this week! We had a number of pregnant ladies come in to have their checks, and we were taught how to examine.

I was again a little nervous of hurting the mother, and it was made pretty obvious to me that I was pressing far too gently, when the pregnant lady herself looked up from her supine position, and told me not to worry, and that I could press harder on her! So yep... now i know they're pretty resilient, and I can put a bit of pressure on their baby bumps.

-----------------------

All in all, I can't really complain about my GP week, as I've been quite lucky with the placement with lots of hands on opportunities.. and no longer can i complain about far distances to travel, as a small group of students got sent to Southend for a week of daily GP placements.. despite being attached to a London hospital!

Now for a few weeks of hospital based O&G!

Starting Obs & Gynae firm

An intro week (which could have probably been compacted into 2 days), and a week of O&G lectures later... i'm now ready to start the firm!

It's a 5 week firm, the first week in the community (GP placement) and 4 weeks at the hospital.

This will be the first time in 3 years that I've had a complete week at the GP practice (from year 1 -3 we would attend on the same day, once every other week), and so instead of just experiencing what the GP would do every Tuesday, I now get a flavour of the entire week. It also means I don't get the disruptions from the hospital part.

Now no post about in-firms will be complete without my travel moans.

Living at home has its perks; it's cheaper, I have the company of my lovely parents, and.. the list goes on. However, as my hospital placement is an IN-FIRM, I've been placed rather far from home, and it means 4 weeks of leaving the house at 07:17am to get to the hospital by 09:00am...

I will be needing that morning cup of coffee (or 2)!

But for now, it's a week of GP from tomorrow! (and a far short travel distance)

Year 4: Day 1 of "The Hardest Year"

Introductory Week

So it was a pretty mix of excitement and fear today, probably more of the latter.

Excitement - well, it's the penultimate year! 3 years ago, around this time I had left my HCA job, received my Barts welcome pack, and was eagerly awaiting  the start of medical school.

And today? Well, i'm a tad over half way through, and approximately 1 Year and 8 Months from the finishing line (according to the informative lecture this morning, and with fingers crossed for all things going smoothly). I'm not quite sure how the last 3 years manage to pass so quickly, and now there's just the two left.

This sort of leads on to the Fear part. 

It's pretty scary for a few reasons. 

1. I've been told it's going to be the "HARDEST YEAR!" .. and looking at the timetable.. i believe that.
   There's a lot to cover this year, with less time to cover it all... and I will have to start from scratch, as a lot of these subjects i haven't touched since year 2.
2. It's the last year to work on the rankings (we're getting a talk on Friday for this), and if the weighting works how i currently think it does.. then this year's exams count for a meaty chunk, and more or less dictate how many points i will be getting for my Foundation Programme application.
3. It's my last year to get anything impressive down on my CV... and it was drummed in this morning, that leaving it till 5th year is simply too late.
   At this moment in time I honestly don't think I have anything for my CV, and don't really know where to start.

On a less serious note, we had a really funny talk today by a 5th year medic, who pretty much gave us the do's and don't for 4th year. I was also inspired by her to try and predict the modules i'll enjoy this year, and those i won't, and at the end of the year i'll see if i was correct... so here goes:

Obstetrics and Gynaecology - Like

Paediatrics - Like

Neurology - Like 

Psychiatry - Like

Opthalmology - Dislike
Orthopaedics - Dislike

Rheumatology - Dislike

Care of the Elderly - Like *

Dermatology - Dislike

GP - Dislike *

*When asked by doctors or others which speciality i'd like to pursue, I tend to either say care of the elderly, or GP... which is surprising, seeing as i don't think i will enjoy the GP component of 4th year.Only time will tell if these change by the end of the year ^^

However, for now.. it's a 9am lecture tomorrow, and time to sleep.