On things to come...

Because everybody else is doing it, I thought I might as well too.

So most people in my year have just found out their rotations (well, "just" being 2 days ago) but I"ve been one of the totally lucky ones who knew over a week ago. I was one of many who was left with a missing term 1 due to the totally fair and perfect algorithm the magical School of Medicine computer uses to allocation rotations. Working fast, I managed to get what I thought was the best of the worst, but others were not so lucky. My heart weeps for the two people who had to do Chronic Condition Self Management, and my Respected Associate who had to do Neurological Rehabilitation.

Outlined below is what I like to call (for the first time) The Grand Plan:

Term 1: Musculoskeletal Rehabilitation
Location: Repatriation General Hospital
Probable job description: Fractured hips, femurs (heads, necks) and knee replacements I should think.
Personal thoughts: Could be hit or miss but its ok, I have company for this term and we"ll make the most of it. *sigh* At least the year can only get better...
Career opportunities: Physiotherapist, Masseuse

Term 2: Urban (Legend) General Practice
Location: My new favourite GP's practice. 
Probable job description: Being Awesome!
Personal thoughts: Very excited about this one, I"ve been having my GP placement here and from previous posts, you can probably tell I enjoy it very much.
Career opportunities: GP, Batman

Term 3: Critical Care Medicine
Location: Flinders Medical Centre Intensive Care Unit
Probable job description: Watching and waiting. Then waiting more. Also watching. 
Personal thoughts: Should get some good physiology and medicine knowledge here. Maybe do some management things.
Career opportunities: Intensive Care Specialist, Dr Robert Chase

Term 4: Emergency Medicine
Location: Flinders Medical Centre Emergency Department
Probable job description: Running around like a headless chicken.
Personal thoughts: If rotation quality was proportional to number of people wanting to do it, this would probably be the best rotation ever. It should hopefully be exciting. Alternatively, this could be so much work I might lose my mind. We"ll see.
Career opportunities: Alcoholic, George Clooney

Term 5: Unconfirmed
Location: Hopefully, Singapore General Hospital
Probable job description: Messenger boy
Personal thoughts: Hopefully I"ll be doing anaesthetics and general surgery.
Career opportunities: National Service, Ending sentences with "la"... la.

Term 6: Cambodia
Location: National Pediatric Hospital
Probable job description: Picking on little kids, stealing pocket money, etc.
Personal thoughts: This one should be fun! I like paediatrics :)
Career opportunities: Paediatrician, Nobel Peace Prize Laureate

Term 7: Vacation
Location: Asia
Probable job description: Being on holiday
Personal thoughts: This will be a lot of fun, aiming to go to China, Hong Kong, Taiwan and Japan.
Career opportunities: Dumpling King, Communist

Term 8: General Surgery
Location: Mt Gambier
Probable job description: Generally surgerising. Some surgery on generals?
Personal thoughts: Surgery is the topic I"m least excited about, but who knows, rural general surgery may be more exciting than urban general surgery (which consists of hernia, hernia, laparoscopic cholecystectomy, hernia, colonoscopy, colonoscopy, colonoscopy, colonoscopy, endoscopy, endoscopy AND colonoscopy).
Career opportunities: Obnoxious Pretentious Twat Surgeon

There we go. The plan is out.

So who"s excited?

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

RGH day two

Another overall good day, which is surprising because I don"t usually have two good days in a row...
An interesting ward round with some nice patients, a good mix of simple and crazy super complicated. A nice fun chat afterwards over coffee and cake (a black forest style birthday cake, yum!) and then some paperwork.
Managed to survive another scrubbing tutorial session (just because the RGH seems to prefer one of their nurses teach how to scrub, despite everyone already having done it at FMC...) without too many mishaps, and ended it all with an uneventful afternoon. Of course, I"m not sure of that last bit, since the afternoon is still going, I"m just getting ahead of myself.

Oh, exciting news! I have a new housemate! From what I"ve determined from a phone message from the Associate Dean of the Village, she is a 22 year old German student. From what I"ve determined from items in the fridge, she like anticoagulation.

I really should probably clean up the place...

The Repatriation General Hospital

First day at the repat, and it was a good one!
Great intern, friendly and very willing to teach! She taught me and a fellow student to put in a NG tube which was an experience... Especially with the 315mL of lime green aspirate...
Great RMO, friendly and laid-back! Was very relaxed and welcomed us and explained how things worked (before the intern arrived).
Great registrar, friendly and with a good sense of humour! Also very willing to teach and has already organised a teaching session with us.
We haven"t met the consultant yet who, from what we"ve heard, may be quite scary and intense, but also a good teacher.

Overall, I"m looking forward to the next four weeks, especially with the free coffee (which will be a bit of a change from FMC) and occasional breakfasts and lunches that will be provided to us!

Friday! Finally!

4 weeks done, meaning that next week, I start on General Surgery at the Repatriation General Hospital.
This could be a good thing or a bad thing, I haven"t quite worked it out yet.

Today was a good day though, waking up for the first time in 3 or 4 days not feeling like absolute crap. I think this cold is finally moving on, so in the next few days I should be all good.

Made it to ward rounds on time, which is always a good start, especially when you"ve missed the last two days (illness, breast clinic) and it being the final day on this ward. The Senior Fellow was really cheerful, and usually in these cases, its a trap.
And it was.
She had decided that we would do a mini-CEX (or "mini sex" as she pronounced it) after ward rounds. Oh hooray.
Surprisingly, I did quite well. Sure, it didn"t feel like it when I was under the spotlight, with her firing question after question at me during the history. But afterwards she gave some very good feedback and gave me good marks! I received a 6, which is quite a surprise because in our introduction lecture when they explained the mini-CEX, they told us to expect the initial few to be very bad...

So I"ve been pretty happy.