Thursday, February 25, 2010

Great Exceptations

I typed the title of this post last night intending to blog about stuff, instead I ended up changing it and leaving the below post. Now I forget why I wanted to use this title.

On new housemates:
My unit is now a bustling suburban bedroom mini-community. From the first year aquaculture/marine biology students to the first year health science student to the German exchange psychology student, we"ve got it all! A friendly bunch indeed, mostly away from home for their first time, getting used to not having the roving parental eye of control over them.

On a failure of a Monday:
For the second time this rotation, a certain consultant has been away and unable to give us our eagerly awaited lecture. This is getting to be quite annoying, as they get their lecture times in advance by quite a few weeks, certainly enough to tell someone if a conference happens to be on that week...

On free food:
Ahh, O-week. With the new students coming in, the great annual welcome begins, with BBQ lunches, dinners, morning teas, afternoon teas, ice cream... All free! All it requires is a few omitted truths or small lies, and you"re free to munch away! Alternatively, you can do what I do and make use of the most important piece of information I learned on the wards: Look confident. As long as I look as if I should definitely be doing this and that it would be pure stupidity on anyone else"s part if they were to interrupt and question me about this, I can do (or eat!) just about anything.

On the gym and associated activities:
The annual free week from the gym, a time to stock up on exercise and activity to make up for the lack of these over the remainder of the year... I don"t know where I was going with this topic. All I really needed to say was that I"ve been going to the gym for the last week and now I will stop due to outrageous membership prices. Outrageous.

On surgeries and complications:
So being on the Surgery rotation, it would be expected that I should be going into theatre and seeing some interesting surgeries. Yesterday was one of those days with a laparascopic anterior resection. The initial preparation of detaching peritoneum (sigmoid mesocolon?) from the colon went smoothly enough, until the surgeon started exploring higher and managed to nick the splenic artery. This obviously wasn"t quite too big a problem as the surgeon deadpanned "Oh. No no no, don"t do that." and proceeded to clamp off the artery and asked for sutures, prodding on the nurse with an equally unexcited "Sutures, sutures, we have a bleeder." As I then expected the surgeon to cut open the abdomen due to the complication (which we were trying to avoid due to the patient being quite old and having an open surgery would make recovery a lot longer), I was very impressed with what happened next. The surgeon proceeded to suture laparascopically, which looked very difficult (much like trying to have dinner using 50cm cutlery) but it was done and the surgery was continued with no further complications. The patient looked well and in good spirits this morning. Wow.

On the musculoskeletal workshop:
Now, I don"t expect this to reach anyone that this will matter to, as I don"t believe I know of anyone placed locally in the course that actually reads this blog... I could be wrong of course, but judging by the lack of hits and the rare comments only by fellow bloggers in other areas, I"m probably quite accurate.
We had a musculoskeletal workshop yesterday, lead by a doctor who I believe gave us a spine examination session during GP week last year. It was brilliant. The notes given would have been worth their weight in gold (and a significant weight indeed) had they been given to us last year for when we were doing musculoskeletal clinical skills last year, but for now, they are just incredibly useful. These notes cover the various musculoskeletal and rheumatological examinations and include a DVD with clinical examinations. We"ve also been given an almost definite OSCE station, so that"s a good start too. For anyone who has yet to sign up or go and was considering skipping it, don"t, it"s well worth the four hours it takes (unless you"re a physio, then you know everything anyway...) and a lot of good practice too.

On expectations:
I"m not sure what I wanted to relate regarding this topic. It probably had something about the need to be in two places at once, but the consultant this week (the proper consultant, not the evil substitute one, mentioned previously... or not, that seemed to have been on a power trip as the main one was on holiday) was cordial, in fact I would say almost soft drink.

We had theatre this morning (a simple stoma reversal) followed by a tutorial on evaluation and causes of post-operative fever and presenting a surgical history. The consultant was very good actually, pushing for knowledge but not criticising the lack of it. I"m quite sure that I am seen as a moron as after a few seconds of silence and possibly a look of fear in my eyes, the consultant proceeded to answer the question given moments earlier. This consultant is also the first one to have given a set system for presenting a surgical history to a surgeon. In a nutshell (Oh help! I"m in a nutshell!): keep it simple. They don"t want to know all the "crap"* physicians care about, they just want to operate, "because honestly, its a lot of fun"*. So they just want "a history, not a bedtime story."*

All in all, an interesting week and it"s not even Friday yet!

Oh darn. SMS from Intern says Ward Rounds will start at 7:30am tomorrow. Not a good start.

* Indicates actual words/quotes from the consultant. Wonderful!


Lesleyfish said...

Someone around here is reading occsionally..not sure if that's good news or bad, but there you have it. And I thought the workshop was great too. The other English were jealous of our shiny folders full of precious notes. And i've learnt that my shoulders don't like the apprehension test.

Vonbon said...

Oh my! A little fish is reading my blog! :)
I"ve also started reading yours...
Seems like a stalemate, neither of us can really write anything too bad about the other now, right?