Wednesday, December 3, 2008

Because I am amused by simple things

5FU.

Coolest drug name ever.

So 5FU is just the shortened name, doesn't change the fact that it's still a cool name.

(And yes, I am weird like that, what, you didn't know?)

Sunday, November 16, 2008

Breaking News

Yes I do realise it's 3.22 am. But I felt the need to announce this to the world.

The couple who live in the apartment block which I pass by every time I go to the train station have finally acquired curtains after two years of living there.

Goodbye nights when I'm walking home from the station and noticing a naked man by the window. Farewell days when I see the lady changing in her bedroom.

I guess they have gotten over their exhibitionist stage.

With that said, I shall go to bed.

Night all.

Wednesday, November 5, 2008

The Big Decision

Obama won. Wow.

Anyways.

On to seemingly more important things - after weeks and weeks of putting it off, making up all kinds of excuses, I have finally done it.

I have finally decided that perhaps now would be a good time to switch on the heating.

Damn you Winter, it's only November!

And damn you rising gas prices! *shakes fist*

Monday, November 3, 2008

In loving memory

My first encounter with death as a medical student was 4 weeks into my first year at medical school.

We were still coming to grips with being away from home, making new friends, fresh, naive.

Medicine was simple then, we only knew the basics, how the muscles and nerves functioned, the names of the bones, the physiology of the digestive tract. A bit about ethics and law.

It was all very sudden.

She sat next to me in anatomy class, on Friday she told me how her computer was acting up, maybe it was about time to change it. We talked excitedly about our upcoming anatomy group social - it'll be fun, she said.

On Monday, during our anatomy session, there was hardly anyone there. Some people were at the school office sorting something out. Something had happened. Our tutor told us to stay behind after class. A lady walked in an just blurted out,

"Your classmate was hit by a car yesterday. She's currently on life support waiting for her parents to come before they make any decisions."

Silence.

"She might not make it."

Those words just ring in the ears.

When you hear stuff like that you can't help to think, but well yeah, medicine has improved so much, they should be able to help her.

Before you realise that, the 'they' that we claim can cure just about anything, will be us medical students in the future. We will be the ones armed with the medical knowledge and advancements that should, ideally, save her.

It brings a lot of things into perspective.

She was a medic like us. She had a bright future ahead. I barely knew her. And she did not make it.

I study medicine misguided that I'll be able to save everyone. None of my future patients will die under my care. I won't let them.

Three years down the line and I've seen countless patients die before my eyes.

People die, it's just a cycle of life.

Coming to terms with death is something they don't teach you in medschool. But perhaps they really should.

Saturday, November 1, 2008

On Being Anal

During one of the clinics the consultant came up looking extremely grumpy and announced to the entire room that he was in a very foul mood because he was on call and was rudely woken up at 3am to operate on this boy who had some AA batteries stuck up his urethra (pee hole, to put it bluntly).

When questioned as to how this came to be, the boy merely replied that the AA batteries were lying on the floor, he tripped and fell and the batteries somehow managed to lodge themselves in his penis in the process.

I am told that this is a very common occurrence.

Today's news for example. Clickity click.

A vicar claims a potato got stuck up his bottom after he fell on to the vegetable while hanging curtains in the nude.

Notice the trend here?

This is a very gross generalisation, but if you are ever in A & E and someone presents with a random object stuck up an orifice, the history almost always goes along these lines:
"I was [insert random daily activity here], in the nude, as you do, when I tripped and fell onto [insert suspiciously phallic object here]."
Someone should really audit how much it is costing the NHS to treat people who have the tendency to fall onto random objects which then get stuck in their many orifices.

Although apparently, the American Journal of Proctology makes for an interesting read on what foreign bodies have been removed from the rectum.

The moral of the story here is to never do anything naked lest you get something lodged somewhere you don't want it to be.

I think.

Wednesday, October 29, 2008

Back by Popular Demand

Hello.

I am back again by popular demand.

By popular I really just mean the 15 wonderful people who still read this drivel even though their brain cells shrivel at every word that spews from my mouth.

Uh, thank you for your support? Monetary funds would be greatly appreciated.

Slight side track - Snowing? In October? Wtf?

Anyways.

Because I've just spent 3 hours of my life talking to the loveliest grannies about their cataracts (not their cats, sadly), I feel the need to go indulge in a bit of mindless sword wielding and annoying side quests in the form of Final Fantasy 7.

Catch you on the flip side!

Whatever the hell that's supposed to mean.

Tuesday, October 21, 2008

The poorengineer returns, with a cup of tea!

While the poormedic sorts itself out regarding whether it wants to resume blogging, I have uncovered the following gem!

BS6008: Method For Preparation Of A Liquor OF Tea


For the uninitiated, BS stands for British Standards Institute, who along with DIN, JISC, ISO et al govern the lives of engineers (among many others) with their standards publications to make sure that a screw thread rolled in China will will fit into a nut manufactured in the United States.

Someone must have had ample time on their backsides to bother penning 5000 words over 6 pages to ensure professional tea testers had an unfailing reference in their esteemed professions.

Such dedication. Superbly impressive. I'm sure this was what the chaps at the Ig Noble Awards selection panel thought too, because BS6008 beat a few other wordy entries to claim Ig Noble's literary award for long windedness.

I shall leave you readers with an abridged version to make the perfect cuppa.

  1. Use 2g of tea (+/-2%) for every 100ml of water
  2. Tea flavour and appearance will be affected by hardness of water used
  3. Fill the pot to within 4-6mm of the brim with freshly boiled water
  4. After the lid has been placed on top, leave the pot to brew for precisely six minutes
  5. Add milk at a ratio of 1.75ml to every 100ml of tea
  6. Lift the pot with the lid in place, then "pour tea through the infused leaves into the cup"
  7. Pour in tea on top of the milk to prevent scalding of the milk. If you pour your milk in last, the best results are with a liquor temperature between 65 - 80 degrees Celcius

This is, of course assuming that you are using a pot made of "white porcelain or glazed earthenware, with its edge partly serrated and provided with a lid, the skirt of which fits loosely inside".

Enjoy.

Friday, October 10, 2008

Goodbye

I think I need to get a job.

This whole blogging thing was fun while it lasted (the whole two months, talk about short attention span), but it's not going to put food on the table.

So goodbye and may your kidneys outlive you!

Thursday, October 9, 2008

Translator, at your service

Ah, the many roles of a medical student.

Today's didn't involve gallantly defending testicles from cosmic rays - far from it.

I was summoned to clinic by one of the consultants who needed help translating for a patient who he hoped spoke the same language as I did. Lucky for him, I did and communication was established.

All I had to do was ask if he had shoulder pain, which he evidently did, however that simple question launched him into a very excitable rant in a mix of English and his mother tongue about knee pain and back pain and other various miscellaneous information - everything but shoulder pain.

He then requested that he be taken to the toilet to have a wee, so I pushed his wheelchair to the toilet and recruited a nurse to help out, who then decided that since I spoke the language I could handle it without her help, and left me alone. I can't imagine language to be a barrier to helping someone go to the loo, but what do I know, I'm just a medical student.

So there I was. In the toilet. With this man who whipped out his equipment without so much as a bat of an eyelid.

We then spent a good 15 minutes in there - him on the toilet seat, having a good old rant about his son and his grandson and what they do for a living, his experience in the navy, his wife's job, how everyone complains that he talks too much so he tries not to - like it is the most natural thing in the world to have someone you've just met in the toilet with you while you peed and told them your life story.

Business done, I wheeled him back to the consultation room where the doctor continued his examination, and decided to give him joint injections for the pain.

I held his hand while the consultant stuck needles in his knees and shoulder, explaining to him what's going on. Once it was all over I dressed him and tied his shoe laces and wheeled him to the reception where we organised transport for him to get home.

He was a very nice man, highly animated, and he kept shouting bilingual thank you very much i am eternally grateful for your help everybody in this hospital is amazing, even as he left.

Yet another satisfied customer.

I think NHS should put me on permanent payroll for the amount of times I had to extend my services as translator. And then for doing the nurses' job. And occasionally the house officer jobs. It's a good 3 - in - 1 deal.

Medical student, jack of all trades, for hire?

Wednesday, October 8, 2008

Get a life, seriously

I think I am very privileged to be in medical school in the UK. A lot of people who are desperate to get admitted are rejected every year.

Sometimes, I wonder what the people that apply to medschool and get rejected are like. Especially after hearing what my admissions tutor had to say.

Til this day he is still getting death threats from someone he rejected eight years ago.

Which probably explains the notice on the wall.

But seriously. Eight years? Ordinary people would've moved on by now, gotten a job, got married, settled down and live a comfortable life. Maybe the occasional "my life would be so much more complete if I did medicine" mope. And then when their kids grow up threaten that they should go into medicine or they will be disowned.

Kudos for the determination, but the freaky stalker I will kill you and you will regret not accepting me into your institute needs just a bit of working on.

Probably a good thing he didn't get into medicine.

Monday, October 6, 2008

Pearls of Wisdom

Our lecturer today, who had more abbreviated letters after his name than the entire alphabet put together, imparted to us something of great value and truth.

The key to success in your MRCP, FRCS, or whatever fancy exams you take to advance your medical career - he said - lies in putting your examiner to sleep.

Right.

Apparently that's how he got through medical school and all those other degrees he has under his belt.

"When asked a question, rattle on with the textbook answer, as all the previous examinees would've said it, and the examiner would be so bored of listening to it again that he'd fall asleep. Speak eloquently and fluently on the subject, so as to not awake him from his peaceful slumber. If he's not awake he doesn't know what has happened and therefore has to pass you."

It makes sense when you think about it, all but for two major flaws. Firstly this is only applicable for viva type examinations where you verbally answer questions in front of a panel of examiners, normally one who asks the questions, and the other one (whom you want to be drifting off to dreamland) writes comments about how you handle the question.

The other gaping problem with this whole putting your examiner to sleep business lies in the fact that you really have to know your shit well enough in the first place to just drone on and on about it for 20 minutes.

But I suppose it can't hurt to try.

Sunday, October 5, 2008

Fresh Meat

It's always nice to see wide-eyed, eager, fresh-faced freshers stepping into tertiary education in medicine. They turn up to lectures on time, do all the late night studying of anatomy that is required of them, ask questions in class - basically they are just very, very keen.

Also, it's nice to then break their spirit and drag them down to your level. The level where everyday you wake up and wonder, why the hell did I choose to do medicine dammit as yet another nice old lady vomits on your shoes. Misery needs company.

Sometimes I'd like to tell them to run while they still can. I'd listen to their complaints about the timetable and teaching and tell them the sad truth. 9 o'clock lectures getting you down? Wait till you go to critical care where the outreach team starts their day at 7.30am.

I tell them to quit their whining, they are having it easy because their syllabus has changed and they don't have to do the extra modules and essays that we had to do, during my time.

Nothing says seniority more than those three words. During my time.

Makes me feel old, all these 1990 babies. They are from a completely different era!

Anyways.

Dibs on at least one of these eager freshers switching to Philosophy by next Wednesday. Any other bets?

Friday, October 3, 2008

The Menstrual Cycle

Click to enlarge

I was never meant to mouse draw.

Original, unedited version of the menstrual cycle obtained here.

Thursday, October 2, 2008

The Many Roles of A Medical Student

I think being a medical student can be a very versatile job. You never know what the nurse, junior doctor, registrar or consultant is going to tell you to do next.

During my medical student career I've been a whole lot of things - wallpaper, retractor holder, phlebotomist for an entire ward, kidney dish holder, personal assistant, chart finder, clerking machine, coffee and toast maker, x-ray form filler - you name it.

Today however, I was given a role I never thought could possibly exist.

I was the protector of testicles.

It was an orthopaedic list, the x-ray machine was used, and the anaesthetist who wasn't wearing a lead coat quickly ducked behind me, saying "Ok don't move I need you to protect my testicles."

The surgeon who had taken his lead coat off and left it somewhere while his registrar went on with the hammering soon followed suit, ducking behind the anaesthetist who was ducking behind me - and I can only imagine this to be a very comical sight of two full grown men hiding behind a medical student half their size.

I guess this could be considered a rather noble role of ensuring that there will be a next generation to look forward to. Their future children damn well better be thanking me.

Wednesday, October 1, 2008

Job Satisfaction

A very pleasant 80-ish year old gentleman hobbled into clinic, obviously in a lot of pain. His 2 week old knee replacement gave way and he had fallen on it.

The joint was very swollen and any movement would cause him great agony. He could barely walk or bend his knee, and he lived on his own. Simply put, he was in pretty bad shape.

Plans were being made to admit him for inpatient physiotherapy and some much needed care, but like all NHS hospitals across the country, beds were scarce. So while waiting for the bed managers to sort something out, the consultant decided he'll try this man on a patella stabilising knee brace with hinges to allow flexion.

The orthotics department obliged with a knee brace and it was fitted on the old chap, who lo and behold, immediately was able to stand up, walk, and bend his knee - things he couldn't do a few seconds ago.

It's amazing how such a simple device, such a simple intervention, can make such a huge difference. From having to be admitted to hospital, he was now able to go about his daily life and attend physiotherapy as an outpatient instead. Suffice to say, the man was ecstatic.

It's like one of those rise-and-walk moments, without the choir of angels singing.

I guess sometimes simple is better.

Instant job satisfaction.

Monday, September 29, 2008

Yeah right you fell

A patient walks in holding his hand in pain, saying that his hand has been hurting since this morning. He claims that he just "woke up" with the pain, and on examination there is swelling of his hand along with tenderness around the 4th/5th metacarpal.

It was pretty obvious what had happened, but we asked him again, and still he insisted that he just woke up with this problem.

So we sent him off for an x-ray.

Which, to nobody's surprise but perhaps the patient's own, came back looking something like this:
Pointy arrow says "hello fracture!"

For the uninitiated, this is a distal fracture of the 5th metacarpal, also known as Boxer's fracture, due to the nature of how this injury is commonly sustained.

Despite what patients will have you believe, the only way you can fracture your metacarpal like that is by punching something (or someone, you never know).

In my short A & E stint I've become a bit of an expert at looking at these fractures, thanks to the crazy amount of people who turn up in the department claiming that they fell or don't know where this pain came from it just magically popped out of nowhere or straight out admit they've been punching walls in anger etc etc.

I'd like to see someone try falling onto their closed fist.

You have to give this guy credit for sticking to his guns, even though we told him there was no other plausible way he could've fractured his hand unless he's gone around punching walls, he still insisted he woke up with it.

Perhaps he's been punching things in his sleep? I worry for his wife.

Sunday, September 28, 2008

Why anyone shouldn't be a doctor

In a phone conversation with my parents the other day, my mum asked if I had enough money to survive, after paying the extortionate amount that is my tuition fees.

I will do, if people click on the adverts *hint hint*.

Anyways, one of the FY1s showed us her paycheck the other day. Even the consultant was shocked by the amount, because it was the same amount he used to get as a house officer. Over 30 years ago. The cost of living has most definitely risen since then, but not our wages. Figures.

My friend who is on a placement year gets the same amount. In fact, most of the auxiliary staff in hospital get the same amount, if not more.

I wonder whether it's too late to reconsider another career path.

All you wannabe medics out there, heed my words, the life of a doctor is not all glamourous as it seems. You're generally overworked, unappreciated and underpaid. And hugely in debt.

Back to the phone conversation with my mum, I was half expecting her to say something along the lines of, "If you don't have enough money, you can ask me for some."

Instead she said, "If you don't have enough money, go ask your brother for some."

I suppose this is one of the reasons they are happy he's got a job.

Friday, September 26, 2008

Writings from the A & E

The strangest things walk in through the A & E department sometimes, that when you look at the triage form you think, maybe the triage nurse didn't really mean what she meant.

Some examples of presenting complaints as seen written on the triage form:
  • Swollen finger after repeatedly poking someone with it yesterday.
  • ? Deliberate self harm - has stuck metal can in vagina
  • Fell down stairs, hit both arms and ironing board. Both arms swollen.
People should compile a book about most random A & E presentations. Or is there already one?

Thursday, September 25, 2008

Illegal Transactions

My friend called me up and asked to meet at the train station so she could pass me something that needed to be returned to the hospital.


It looked like we beheaded someone, cracked their skull open, removed the brain and was exchanging the remains in the middle of the street in broad daylight.

I got so many weird stares from people when I walked home with it swinging in my arm. I suppose it's not really usual to see disembodied heads in the hands of some random person walking on the street.

But luckily nobody called the police and accused me of murder.

Wednesday, September 24, 2008

So you had a bad day

Woke up rather reluctantly this morning, went to the car, and discovered that some bird(s) had done some rather amazing diarrhoea all over it - it must've been some really ill bird(s). Never mind that the car is parked indoors.

Drove to GPLand, which is usually about 15 - 20 minutes away, but took a bit longer than expected because of traffic, but managed to reach GPLand on time, only thing that parking at the practice was full so I had to find some random residential road and park up there, all the while worrying about people breaking into the car because it was a very dodgy area.

I hate being in GPLand, so that's already bad enough. GP Tutor didn't look to happy when I said that I had to leave early because I had to go see my supervisor at 3pm. Then she sent us out on a home visit equipped with just the address of this person.

I find that all GPs that I've been attached to expect us to have extensive knowledge of the surrounding area down to every random lane, despite the fact that we do not live anywhere near there. Thank god for Google map.

Anyways fast forward to rushing off to meet my supervisor for 3pm. Luckily we managed to make it in time because he just finished surgery. He told us to wait while he took a quick break, so we waited. And waited. And after an hour decided that perhaps we shouldn't really be waiting anymore. Went off to find him only to discover that he went home. Nice.

Then it took me 50 minutes to get back home because traffic was just crazy.

I wonder if this counts as a bad day?

Anyways, digressing a bit (I tend to this a lot), on my 50 minute journey home down a straight stretch of road I saw 6 ambulances and 2 police cars.

A & E seems to be very busy this week.

Tuesday, September 23, 2008

Saw, drill and hack.

Orthopaedic surgeons are like carpenters.

Their theatre is like a handyman's garage with lamina air flow, and their tools probably came straight out of your standard toolbox, only difference is that it is all sterile.

Throughout the surgery the surgeon kept talking about how foundation is the most important bit when building a house and how you need to have grout and cement to hold the bricks together - all the while drilling holes and sawing and hammering nails into this poor old lady's femur.

I think orthopods would naturally be very good at DIY jobs.

Monday, September 22, 2008

Pre-hospital Trauma Trained

Trauma course weekend is over, now to await the ever elusive results... and then be a fully certified... actually what would I be after I get the cert?

I suppose "qualified" is a bit too strong a word.

Anyways, I can now assess a trauma scene for danger and maintain an airway!

And that's about it really. I can now go buy that hoodie from university that I've always wanted, the one that says MEDIC on it, because at least if someone gets knocked down by a car in front of me while I'm wearing it I would know exactly what to do - shout for help and scream like a little girl.

I'm on A & E all this week, and it's fresher's week, so I'm hoping to see some broken bones and random drunk accidents.

You can probably already tell that I'm a pretty sadistic person.

Saturday, September 20, 2008

Car vs Tree

Today I was told in a lecture that you should never ever crash your car into a tree.

Because trees are horrible things to crash into.

If you have to crash into something, you're better off crashing into a group of small children, or even a brick wall.

I somehow doubt the man who gave the lecture would make a good paediatrician.

Yet another life's lesson learnt on the trauma course. It's pretty good, really.

Friday, September 19, 2008

It's the weekend! Or not.

I have signed myself up for 3 days of pre-hospital trauma course organised by the faculty, whilst they insist it is not compulsory it sure does sound like it - medschool has a way of doing things like that.

Basically it's a 3 day course teaching us the ropes of pre-hospital trauma life support, which cumulates to a written and practical exam on Sunday which would hopefully see me getting a certificate saying that I am trained in trauma life support.

I've picked up the course material and read through select sections of it, actually just the "what to do when caught in a shootout" section, because that sounds like it could be very useful information to know.

And I feel like sharing it with the general public. So! What I've learnt in a nutshell:
In a shootout, never hide in police/ambulance cars because they make easy visual targets for the shooters. Unlike what they tell you in movies, cars make for very bad cover. Bullets can go straight through them. If you need to take cover behind a car, the engine block is your friend. What you really want to be doing when caught in cross fire is to keep as much distance as possible between you and the scene.

Also, police dogs can't tell the difference between good and bad guys.
End community service message.

On a sidenote, I wonder whether it's any reflection on our society today that our trauma course teaches us how to approach a scene of violence and riots.

Wednesday, September 17, 2008

I has mojojojojojo

It is common stereotype that orthopaedic surgeons are big, muscly and love their power tools. There was some mention about intelligence but I won't go there.

So why is it that all the orthopaedic surgeons I've encountered so far are, to put it simply, eccentric?

I sometimes get the impression that they have been sniffing crack on top of having some sort of attention deficit disorder. (Rest assured that is not the case, it's just my personal feeling.)

I didn't quite know what to say when the consultant walked into clinic this morning and excitedly proclaimed to all who were present:
"Guess what? I've finally got my mojo back!"
Which was swiftly followed by two thumbs up, a smirk, and a wink.

I wonder what Austin Powers would have done in that situation.

Monday, September 15, 2008

Case Scenario: Hot Stuff

Mrs. Melaena Stools is a quiet 58 yr old lady who presents to your surgery late on a Friday evening. She is a patient of your partners who is in Japan watching the world cup. Unfortunately her records have gone missing and are believed to be in the back of your partner's Lotus. She has been limping in pain after slipping on a loose grape in her local supermarket.
Mrs. Melaena Stools? Seriously. For the non-medics out there melaena = blood in stool.

And I find it completely random that the question talks about Japan, world cup and a Lotus before telling you that she slipped on a loose grape.

And why is the case scenario titled Hot Stuff?

I really wonder who writes the case scenarios for our tutorial sheets.

Because I want whatever s/he is smoking.

Sunday, September 14, 2008

Cycle. Is good.


Cycle. Get yourself knocked down by a great big red double decker bus, more like.

Saturday, September 13, 2008

In a Galaxy Far Far Away

I am so addicted to this, it is taking up my life.

Star Wars: The Complete Saga

And to think I've only completed, like, 20% of the game so far.

Everyone I've introduced the game to are thanking me for bringing them to the dark side.

Speak
ing of addiction, I may very well be an internet addict according to this criteria.
  • Do you feel preoccupied with the internet (think about previous online activity or anticipate next online session)?
    • I'm online all the time. What's there to anticipate?
  • Do you feel the need to use the internet with increasing amounts of time in order to achieve satisfaction?
    • I need to use it all the time... mmm internet. And using the terminology "achieve satisfaction" just... sounds wrong.
  • Have you repeatedly made unsuccessful efforts to control, cut back, or stop internet use?
    • I've never bothered trying. So I suppose that's repeatedly unsuccessful attempts.
  • Do you feel restless, moody, depressed, or irritable when attempting to cut down or stop internet use?
    • Hahaha... yes.
  • Do you stay online longer than originally intended?
    • There is no such thing as "longer than originally intended". I'm on all the time.
  • Have you jeopardised or risked the loss of a significant relationship, job, educational or career opportunity because of the internet?
    • Uh. Would it sound really pathetic if I said yes? What can I say, I'm antisocial to begin with.
  • Have you lied to family members, therapist, or others to conceal the extent of involvement with the internet?
    • Does anyone really care how involved I am with the internet?
  • Do you use the internet as a way of escaping from problems or of relieving a dysphoric mood (for example, feelings of helplessness, guilt, anxiety, depression)?
    • I have a freaking blog. What do you think?
Although to be fair this criteria is based on the pathological gambling criteria, and internet addiction is not really recognised as being a mental health issue as it is not being considered for the Diagnostic and Statistical Manual of Mental Health (DSM V).

Also the criteria was written in the age of dial-up and 56k modems.

Are you an internet addict? You need to answer 'yes' to five or more of those questions. Tell me your results in the comments!

Wednesday, September 10, 2008

You mean he was born with two hands?

We were at the nurses' station discussing the patients we saw yesterday and what interesting signs and symptoms they had.
The patient in Bed 5? The one with the hands?
Yeah, and the patient in the side room has a good abdomen.
What about that man with the toe?
I know exactly what they mean - we're not excited that a patient has, in fact, two intact hands and some toes, but that his hands have something medically relevant to our clinical learning.

Because I'd be very worried if all those patients were suddenly lacking basic anatomical assets.

I find that nowadays with all the need for patient confidentiality I end up referring to the patients I've seen after their main diagnosis; a few examples being Infective Endocarditis Guy, Diverticulitis Woman, Man with Paper Eating Dog.

I sometimes wonder whether this is a good idea, because in a way it encourages the thought of a patient as a diagnosis rather than a person - a notion that seems rather incredulous but sadly true.

On a completely unrelated note, at least I don't refer to the jaundiced patients as part of The Simpsons family.

Tuesday, September 9, 2008

I think I really need that X-ray

I don't quite know how to describe this, but there is a lump that sits slightly above my left costal margin.

It is only slightly tender, and does not really stop me from breathing or coughing up my internal organs.

I do recall falling on that side when I flew off the bike.

It feels like it's part of my rib cage - probably the 10th rib - I can feel the outline of the rib and the intercostal spaces.

It is a curiosity indeed.

Like a true help-deferring patient I have decided that it is nothing to be overly worried about, and that if it doesn't go away in a week, I shall go to see someone about it. Ah, temporalising.

Somehow I have the feeling that this is probably a bad choice.

Oh well.

I'll keep you updated.

I am a poor engineer

Oh hello. Like poor medic, I'm one of the many tens of thousands (possibly millions) of lowly students currently slogging away at one of UK's many fine educational institutions. Greetings.

As an inaugural blogjack on my part, I shall now announce to everyone that the possibility of all of you dying within the next month (days?) has increased exponentially with the final quadripolar magnet of CERN's Large Hadron Collider has been put into place.

Speculations abound about what happens when the particle accelerator gets fired up. Will antimatter be created? Will a blackhole come into being and the world as we know it gets sucked into oblivion? What about us mere mortals? Will we be spat out into the tenth dimension? Good questions really, this lot...

Luckily, or unluckily, them buffoons physicists responsible for this conundrum are now divided into two camps; one wants to go ahead with the most expensive physics experiment in history, the other don't really want to die.

So yeah. Go ahead and make love to loved ones and make peace with hated ones.

On a less depressing note, lets look over the notion of the LHD being the harbringer of death and pay a little more attention to the wonderful fact that it's a tunnel thats freaking 27km in diameter underneath Switzerland! Oh oh and the cryogenics infrastructure is awesome too! Constant -271 degrees C! I'm like... wtf!

Geeky isn't it?

Monday, September 8, 2008

Empire Strikes Back

I am your father.

The OHCM thinks that George Lucas was a big Gaudi fan.

How else can you explain the Darth Vader lookalike chimneys?

Sunday, September 7, 2008

An Ode to The Rather Interesting Bruise on My Knee

Blue black purple grey
Swollen spots make me wonder
When will the pain go
So yet another weekend has come and gone.

Yet another rotation has come and gone.

Trauma and Orthopaedics tomorrow. Perhaps I really should get my knee checked out.

Saturday, September 6, 2008

Gravity Kills

Today I went cross country cycling.

I probably won't be going again for a while.

To cut a rather long and boring story short, I flew over the handlebars while going downhill in the pouring rain. A lot of things can be said about how I really shouldn't be allowed to cycle anywhere but on a flat dry ground with no one within a 100m radius, but we'll save that for another day.

So.

I was rather apprehensively going downhill when I saw a huge dip, and thought, oh crap, this can't be good.

Next thing I knew - sky, ground, sky, ground, sky, ground, ground, ground - this is gonna hurt really bad.

Gravity is an evil thing indeed.

On a sidenote, it's interesting that while my life was flashing before my eyes (and so was the sky and ground), the first thing that went through my mind was, If my parents found out they are so gonna kill me. 21 years of bringing me up and I repay them by breaking my neck in a forest.

Where was I? Oh yes.

And while I was sprawled out on the muddy ground, my bike decided it missed my presence and skidded and hit me.

Life is good.

So there I was, undecided whether being in a foetal position would involve less blinding pain, when it occurred to me that I was on the ground in the middle of a downhill track.

Great.

I somehow managed to drag both myself and the bike off the track, and thus assuring myself that yep, ABC (Airway, Breathing, Circulation) intact to a certain extent.

Once the pain had subsided slightly I decided that it would now be a good time to survey the damage.

Limbs. Intact. There's blood down one leg but it looks rather superficial. Grazes to the hand and face, nothing serious. Knee is swelling up quite a bit, but that's to be expected. Full range of movement in all joints. Check.

Now what.

The friends came out to help and we decided to go back to the forest centre. Which involved more cycling. In the rain.

And everyone I cycled passed gave me really horrified looks, which worried me slightly because as far as I was concerned I was pretty okay. I was CYCLING back, how bad could it have been. I think it must've been the bloodied leg.

It was bad enough that I had to cycle myself back for some form of treatment, but when we got back to the centre no one knew what to do with me. The staff showed me a first aid box and threw out its rather random contents and sifted through it.

Then he looked at me and said, "I don't know what all these things are for..."

Sigh.

So I said, "Trust me, I'm a medic" and proceeded to mend myself.

Apparently I looked pretty okay for someone who just did a spectacular endo on the fastest section of the trail.

So, not only did I fall and hurt myself (and my pride), I had to get myself back and then self-medicate.

And in true Schaudenfreude style, my friend told me that when I fell he almost whipped out his camera to take pictures of my misfortune, but managed to restrain himself only because I was on the floor moaning in pain.

Good friends like him are hard to come by these days.

And that's why there's no pictures.

Anyways, whilst I am still in considerable amounts of pain, I am alive, and have developed slight paranoia over the possibility of developing septic arthritis or a kidney contusion.

The swelling and pain have gone down slightly, and I haven't been peeing blood, but we'll see.

I'm guessing tomorrow will not be a good day to be me.

Friday, September 5, 2008

Breakfast

Mmm.. OHCM

The Happy Lobster eats OHCM for breakfast.

What do you eat?

Thursday, September 4, 2008

The Square Root of Three

I watched Harold and Kumar Escape From Guantanamo Bay just now. Hilarious shit.

I really liked the poem that Kumar recites in the movie, because it's so geeky and I'm a nerd like that. So here you go, revel in arithmetic geekiness in all its glory:

The Square Root of Three by David Feinberg

I’m sure that I will always be
A lonely number like root three

The three is all that’s good and right,
Why must my three keep out of sight
Beneath the vicious square root sign,
I wish instead I were a nine

For nine could thwart this evil trick,
with just some quick arithmetic

I know I’ll never see the sun, as 1.7321
Such is my reality, a sad irrationality

When hark! What is this I see,
Another square root of a three

As quietly co-waltzing by,
Together now we multiply
To form a number we prefer,
Rejoicing as an integer

We break free from our mortal bonds
With the wave of magic wands

Our square root signs become unglued
Your love for me has been renewed

Wednesday, September 3, 2008

The traveling OHCM

Hola!

The Oxford Handbook of Clinical Medicine (OHCM) has gone traveling!

Send in your pictures of the traveling OHCM to share with the one loyal reader and other imaginary friends that frequent this blog.

Tuesday, September 2, 2008

The Girl Who Leapt Through Time

I watched this last weekend on a whim after reading about it on ANN. Yes, medical students do have time to do other things like blog and watch anime.

In a nutshell, I thought it was amazing.

I loved the art, the characters and how the story flowed so seamlessly. My lack of adjectives hamper me from describing exactly how amazing this movie was, and is probably why I'm a medical student and not, say, a movie reviewer.

The anime is an adaption of the 1965 novel by Yasutaka Tsutsui, and revolves around a 17 year old girl who discovers that she has the ability to 'time leap'. She sets about doing rather odd things with her newfound powers - undoing blunders, eating pudding - without truly understanding the consequences of her actions.

Because there always is a moral to the story when it comes to Japanese anime.

She comes to realise that her little actions in manipulating the course of history have dire effects on the people surrounding her, but is it too late to make everything alright in the end?

RUN TIME: 98 minutes
DIRECTOR: Mamoru Hosoda
WRITER: Satoko Okudera
CAST: Riisa Naka, Takuya Ishida
PRODUCERS: Jungo Maruta, Shinichiro Inoue, Yasutaka Tsutsui

Monday, September 1, 2008

Today in GP Land

I sometimes find that the strangest things happen in General Practice Land.
"What can I do for you today sir?"
"I need an appointment letter for hospital."
"It's written here that we have requested another letter to be sent, you should've gotten it by now."
"My dog ate it."
"Yes, and we asked for another letter for you."
"It came this morning and my dog ate it."
"You mean he ate it again?"
"He's eaten 3 of my appointment letters."
"What kind of dog is it?"
Student-led surgeries, in theory, are a good opportunity to put into practice things that you've learnt in medical school. But the harsh reality is all you ever get in your two hour a week slots are people coming in for repeat prescriptions and people with runny noses demanding antibiotics.

Sometimes it's not just about knowing the diagnosis and treating the patient. Sometimes it really is just differentiating those who really need help from those you can offer reassurance to and send them on their way.

It was a Shihtzu, by the way.

Saturday, August 30, 2008

Guide to Clinical Year

The key to surviving clinical year lies in mastering the art of loitering.

Yes, loitering.

More specifically, loitering with intent.

A lot of time is spent hanging around in ward corridors, in front of the nurses station, outside procedure rooms, in the hallways of clinics, waiting for things to happen.

We're always waiting for something.

The general idea is to loiter around with the purpose of gaining learning opportunities. Most of the time a nice kind soul will see you standing there and take you under their wing.

Hang around the nurses station and ask if there are any jobs to be done, any patients to clerk or anyone with interesting clinical signs and symptoms.

Seek and you shall find, but don't seek too hard, you might end up observing a complicated five hour neobladder construction surgery on a Friday afternoon.

Loitering is all well and good, but sometimes it might take hours before anything exciting happens, as such no loitering medical student is complete without the companionship of the trusty Oxford Handbook of Clinical Medicine.

Why not spend your time learning something new while waiting for the consultant to turn up for teaching?

I'd suggest eponymous syndromes. They are good for impressing people with your extensive knowledge of weird and wonderful diseases. They are fun, random, and more often than not completely useless.

You are now ready to take on clinical year, armed with your Oxford Handbook and newfound skill of loitering.

Friday, August 29, 2008

Seen Outside Medschool

THERE ARE NO MORE PLACES ON OUR MBCHB COURSE. PLEASE DO NOT ATTEMPT TO COME SEE ADMISSIONS TUTOR [insert name here] IN HIS OFFICE TO APPEAL. THANK YOU.
[name of admissions tutor]
Just thought it was rather random to put a sign like that, with his name and position, right outside medschool.

Thursday, August 28, 2008

I wonder sometimes

While being the SHO's clerking bitch the other day on MAU.
"Sorry sir, just to clarify, did you just tell me that you have been passing blood in your water for 13 days?"
"Yes, 13 days."
"Every time you pass water, every single day, for 13 days?"
"Yes."
"And you say it's like passing red wine?"
"Yes, that's correct."
"Any particular reason you decided to come into hospital today?"
(shrugs) "I'm still passing blood..."
Is it just me or does that strike anyone as rather odd?

Wednesday, August 27, 2008

Why Medicine?

It's one of the questions that everyone seems to ask, especially, especially UCAS personal statements and admissions tutors.

It also happens to be one of the questions I ask myself everyday when I get out of bed, which is perhaps not the best way to start your day.

Why medicine?

Oh, well you know, I've always wanted to be a medic, it's my destiny, my calling, my life will not be complete if I do not have Dr. in front of my name.

No, I didn't say that in my interview.

My official answer when faced with that question is simply, I like being challenged to solve puzzles.

I like putting the pieces together, connecting the dots, then sitting back and looking at the full picture glaring back at me. Medicine gives me the opportunity to do that.

Granted, many other professions do, perhaps just about any job you care to think of incorporates elements of problem solving... but I digress.

Truth is, I wouldn't know what else to do if not medicine.

But despite the daily doubting of my ability to survive in the world of health care, the constant confidence crushing at the hands of consultants and the early morning marathon ward rounds, I love every moment of it.

So there.

Tuesday, August 26, 2008

Trust me, I'm a medical student

The inaugural post.

It should probably tell the reader my background, who I am, what I stand for, my motives and my general purpose in life. But it won't, because I'm lazy and I really need sleep.

So why a blog?

I need money to put myself through medschool, doesn't matter how as long it's legit and not overly time consuming. So over the next couple of weeks, months or even years, dependent on when I can be bothered to do anything, expect to find this blog filled with pointless ads you don't want to see.

Hey, at least I'm being honest.

Now that formalities are out of the way, watch this space!