T_T

My first LP was unsuccessful T_T I hit bone on 3 adjustments of the LP needle and my SHO butted me out. As a medical student, I only deserved that much chance.

Some procedures like LP and drains don't come very often for medical students. There's always some F1s around who want to attempt those. So, even though I didn't get it, I was proud that I was brave enough to attempt it.

(Well, actually after two years of sticking needles and venflons in people, there's really no excuse for being afraid or nervous anymore.)

That was probably the next best thing I've done this year apart from the simulation training we had a few weeks ago. The whole flaw of the training was that we were supposed to act like proper doctors on the ward i.e. no running and crying to senior doctors when facing troubles.

But we all know as F1s, that's what we're going to do anyway.

Hey, you gotta do what you gotta do to avoid killing people.

(Btw, the SHO didn't get the LP as well. And they tried again later that evening after giving diazepam to the patient and still didn't get it. That made me feel slightly better. Until the registrar came and did it himself the next day, sigh)

CARE OF THE ELDERLY

I'm just about finishing my Care of the Elderly firm. I hear cheering ^_^

I started off really hating the firm. I've not known myself to be good with the extremes of age. Babies and children - yuck. Old people - eehhh. So even before starting the firm, I was dreading tiny veins, wriggly veins, demented and delirious, septic and dehydrated little old ladies and men who have fractured their osteoporotic bones.

Now, before you start judging me, I didn't know any better then.

Well, when I was in Colchester (the Florida of the UK), I managed to meet a few ladies in their 90's. The very first time I met a 99-year-old lady, I was honestly surprised. I know the medical system sucked back then, so what's been keeping her alive for so long? And I know the medical system now doesn't work so well anyway. Must be something else.

I didn't feel appropriate to ask.

The average patient on the ward is a confused patient secondary to a sepsis complicated by a fall. The average age is upper 70's (when they use the words 'young man' to describe a 60ish man, well... makes you feel like an embryo yourself). You don't clerk a confused patient, you get collateral history from GP and family, which I did on my first day (well, actually you can try and clerk them but you may end up banging your head against the wall repeatedly).

But you still need to speak to them on daily basis because as a doctor, you can't get away without talking to your patients. As the weeks went on, I began to love watching the doctors speak to confused patients. The stuffs they come up can be so random from cats to East Enders to nurses stealing their things during the nights.

Just to be clear, nobody steals on the ward. Except for me *roll eyes* although lately I've been unsuccessful in getting the new BNF.

On the other hand, the ones who are orientated and able to talk don't like to be quiet. They'll tell you their life story if you just sit and spare a few minutes. You can complete an MMSE or a GDS in 10-15 minutes in an ideal setting but never with these people. Some of them have led a wonderful life, most however have had to endure hardships.

It's heartbreaking listening to someone telling you how his wife cheated on him with his best friend 40 years ago and he had been afraid of loving another soul since; and how her mother used to throw pots and pans and verbally abuse her father; and how lonely he feels at home now his children have refused to talk to him.

I am no fan of growing old, even more now than ever. Either that, or I've got to go out and meet jolly and happy happy old people.

On the ward, they make full use of PT, OT, nursing and SW. Unlike other wards, Elderly Medicine looks into every aspect of a patient's life. I've never learnt so much about care packages and homes until this firm. They just don't teach that sort of thing in medical schools. Sending an elderly person back to the community can be a real challenge. You send them home and they fall because you don't ask OT to assess their home first, it's on your head.

It's really inspiring the work that they do. I've never appreciated the need to make the last few (umm) years of someone's life as good and as high QOL as possible until this firm.

Age matters.

I'm still glad to move to a different firm. I don't mind coming back but not in the near future.

RIGHT STEP

I am one of those people who like to step over lines on the floor with my right foot. It somehow feels right when I do it especially in mornings when I set foot at the hospital front entrance. It's not OCD because if I miss it, I don't go back and try it again.

The problem with that is you need to time your walking so that you set your left foot very near the lines and cross them with your right. Often, you end up either having to take a giant step, or you shuffle Parkinsonian-like to make it right. After years and years, you don't even realize doing it.

(This is totally rubbish).

One of the hospital staff saw me shuffling this morning and he gave me a look.

I swear other people do more annoying things in the hallways. For example, talking loudly on the mobile (oh I so want to shove their mobiles down their throats!! Clearly I'm not a morning person).

Ah well.

16TH

We were watching Family Guy and my boyfriend couldn't stop laughing when Peter started singing Surfing Bird (The Bird is the Word!) and until you've seen it, you won't appreciate how annoying Peter was being. Annoying but also stupidly hilarious.

I have been with my boyfriend for 16 months now. That's 13 months more than I thought we were going to last. Somehow, I'm still behaving. A year ago, I would've stopped watching right when Peter started singing. Listening to that stupid song must've killed a lot of my brain cells.

An hour later in the kitchen, my boyfriend said 'Haven't you heard?' and I completely fell for it and asked, 'Have I heard what?' and he started singing the song.

In a way it's like I've gone back to being kiddish. But I'd like to think I've actually grown up a bit =)

SPLASH

It finally happened. I was only being sarcastic about needlestick injuries before but I knew it was coming.

But it wasn't a needlestick injury; it was a splash injury. I was transferring blood into blood culture bottles and I managed to get blood all over my clothes and face. Please don't ask how I did it; it wasn't even funny.

Anyway, I ended up in Occupational Health with a 20-page form and a pen running out of ink. How did it happen? Did I get blood on my skin or mucosal surface or both? What initial interventions did I do? And just about another 100 questions following those. By the time I got to the end bit, I was wondering if getting hepatitis would be easier than finishing the form.

The very last question was how I would do things differently in the future to avoid similar incidents; and boy that was painful to answer. I see that they want people to learn from their mistake but oh I so did not need to feel lectured at the time. Not at least until they tell me I won't end up with HIV or hepatitis.

There was one time in A&E I just sat and talked to one of the patients before he was discharged (he was young and cute and he was a company director so yes, I deserve to be judged haha). He was curious why anyone would want to work in hospitals, A&E especially, considering the kind of people and diseases you come across and by doing so, you can't help putting yourself at risk.

Join the club. Sometimes, I don't know the answer myself.

CRICHTON

Michael Crichton died today. He was one of my favourites.

May he rest in peace.