Monday, March 1, 2010

The Hat-trick

It was an awesome day today.
It was also a long day, but we"ll come to that later.
Let us, for now, begin our story from where most stories begin, at the beginning.

I woke up fresh (what does that even mean?) and well rested (vaguely) and kind of freezing. The single sheet I had failed to protect me from the sub-zero (or 14 degrees Celsius) temperatures and thus it was quite difficult finding motivation to leave the bed which was cold-but-not-as-cold-as-not-being-in-bed-with-a-sheet.

After taking a shower and inhaling some cereal (not at the same time), I eventually made it to the RGH (Repatriation General Hospital or "Repat" for short) for Ward Rounds.
 At some point, I remembered that I was following (or is it shadowing) an anaesthetist in attempt to observe the fabled "Pain Round", so I told my Intern (who's awesome) and left to find this anaesthetist. I found him, but he had other commitments so he handballed me to another anaesthetist, which was performing the anaesthesia of ECT (electroconvulsive therapy, an archaeic treatment) patients.

Now, it has occurred to me that almost every anaesthetist I have ever met seems to really enjoy teaching students, whether it be because it takes a certain type of person to be an anaesthetist, or perhaps because all they do all day is sit around watching vital monitors and injecting white stuff into people. Anyway, anaesthetists are good.
This particular anaesthetist told me to put in a cannula and to bag and mask the patients. Since it had been months since I had last put in a successful cannula, I was not confident enough to attempt the first one, but following that, managed three successful one-shot cannulations in a row. Oh, it did wonders for my confidence. The "Pain Round" that followed was less exciting, as there was just one single patient to assess.

Returning to the ward following the "Pain Round" (which was a quick trip because the patient was actually one of our own patients on the ward), I learnt that things had gotten a little more exciting, as a fellow student had managed to diagnose AF (atrial fibrillation) in that patient we had just assessed. I was suitably impressed as our team burst into action, taking blood, doing examinations, writing in case notes and discussing the weather.

Hours (or hour, singular) passed uneventfully (but if you must know, I had lunch) and I eventually wandered up to the patient I had decided to take a history and present to the Registrar the following day (tomorrow). A lovely 80 year old lady, she seemed to be the perfect history. A simple elective surgery following a colonoscopy, how bad could it be? Oh, it could be bad. It was bad. There was blood. In Admiral Ackbar"s famous words:

She was not only a malingerer, but also a meanderer (as in she waffled on). She had much to talk about, some of it actually relevant, most of it describing the unending, diffuse, vague pain she felt, as well as every symptom under the sun. I don"t believe I had a single negative to the questions I asked. I exaggerate, there was one or two.
She was also the first person to have hit upon a positive for the third question in the "SADA" series of questioning. She had 1/2 a biscuit in an attempt to relax, 15 years ago. I was amazed. I felt the same way when we eventually reached the medication questions.

All in all, she was an interesting lady who I found was quite the experience taking a history from. I gained a lot of experience on interrupting and asking other questions, while sometimes repeating the same question I had just asked to see if it actually prompted an actual answer...

The afternoon was quite good as well as I was able to sit in on my CoC (continuity of care, an assignment) patient's outpatient appointments. They involved a follow-up with the surgeon as well as a follow-up discussion regarding stoma care with the stomal nurse.

Upon returning home, I found I had two packages waiting for me, one being the free glasses I had managed to order (which works, but kind of make me a little nauseous) and the other being amazing cookies!

After a quick visit to the university to deliver some things, I went on a run with a friend. We managed 6 kilometres of dangerous, unstable terrain along with the usual mix of push-ups, chin-ups and abdominal-work-outer-things.

A dinner of curry and toast (don"t diss it until you"ve tried it), finished with a dessert of chocolate cake and ice cream. Marvellous.

All in all, a wonderful day.

In the words of my favourite author:
And so, the time has come to close this post. There will be other days and other stories, but this tale is finished.

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