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.

Thorsday!

Sometimes I wish I had a big magical hammer I could use to smash things and throw around a bit of lightning.

Today started as any other day (any other day where I wake up while its still dark anyway...) with a trip to the RGH and ward rounds. Following the ward rounds I managed to acquire the signatures necessary to lock in a patient as a CoC patient. This was exciting for a while, and I spent quite a while talking about all aspects of his care.

After hours and hours* of chatting and various examinations, I decided that I had probably done quite enough on the wards and decided it would be a good time to go home for lunch. I decided to call this "good time" lunchtime. I thought it seemed quite apropos.

Our PBL was uneventful, though very informative as one of the consultants shared a little bit of the amazing amount of information that senior medical practitioners seem to pick up along their careers.

The trouble came afterwards when I happened to bump into the registrar from the ward I am attached to at the RGH. He was quite surprised to see me, wondering why I was even at FMC. I told him we had a tutorial from a consultant. He told me that they (the RGHers) wanted to give us tutorials but could never find us. I was amused at that considering I had not seen him since midway through ward rounds. I told him that we had our scheduled classes to be at. He told me that one of the consultants at the RGH wanted to give us a tutorial, tomorrow morning at 11am. We were also to prepare a patient to present. I asked him if there was any way we could reschedule, as we had an orthopaedics tutorial at FMC at that time. He repeated that the consultant would give us a tutorial at 11am, as if there was nothing to contest, and then walked off.

I stared off into the distance, with a slightly perplexed frown which deepened into a full blown contorted look of horror as I realised I had to somehow bring this subject up with a consultant that I personally thought was more than a little frightening.

Tomorrow will be an interesting day.



*With slight error from a time dilation effect

It"s been a long day

Ah, Matchbox Twenty...

Where was I?

Oh yes, blogging. Just to switch things up, lets Tarantino this a bit. I"m going to start with the end of this story:
I had a nap. This morning. Before lunch.

Now lets flash back to the beginning:

-fzztwhirkdsafh;gssssssooooooooooooooooo-

Waking up at while its dark is not good.

Ward rounds was uneventful, though there were some quite interesting patients (with one a possible CoC subject!), the fact that it was bloody early kind of toned down my interest.

We then attended a presentation by our very own registrar, who was amusingly anxious about the whole thing, though us students didn"t really mind, we were kind of more interested in the breakfast that was provided...
A very impressive breakfast spread it was, with sweet pastries, mini quiches, a large variety of fruits and what I"m going to call "slices of closed pizza" (otherwise known as toasted focaccia).

Afterwards I went to have a chat with one of the interesting patients, taking a history and performing a basic physical examination of all systems. As a random point of interest which came up during our conversation, we found out (despite the over 40 year difference in ages as well as residence in different states) that we had previously shared the same GP! Small world indeed...

Such a long day, in fact, I"m quite tired...

-ooooooooooooooooossssssg;hfasdkrihwtzzf-

Wednesday, fin.

Still sick, ginger tea is starting to annoy me, but butter menthols (with honey centres!) are as delicious as ever. They also kind of help my sore and irritated throat.

So I made it into the CoC (teeheehee) introduction/tutorial.
Not the most exciting, or informative of sessions, but nice to find out that I won"t be in the state for the 2nd tutorial.
I still have to do my work though, just submit things early and liaise via email.
At least I vaguely know what to do now, just have to find a patient with a chronic illness, get consent from them and follow him/her as they are treated and attend follow-ups for 5 months. This includes visiting them in their own home, as well as visiting their GP, preferably while they are there, with a maximum of 6-8 meetings.
I take this to mean that I have to improve on my stalking skills, raising them to a comparative level of a ninja or perhaps Batman. I"ll have to hide in bushes and on stone gargoyles and the like, hoping that my patient is just like every other person in those movies and that they never look up just as I"m somehow holding myself in the upper corner of a room. Luckily the SoM has understood that we"re not all as physically active and able as others, and have given us the leeway of a maximum of 6-8 meetings. I assume that we"ll start with 6-8 credits (I guess they haven"t decided yet) and when (or if! HAHA!) we get "caught" by the patient, we"ll have to hand over a credit and continue from the last save point.

You know, now that I think about it, Continuity of Care could be quite fun, and besides, I still have that imaginary cape.