I have a question

So.

I watched a movie yesterday which involved a member of a triad sticking a shovel into someone's forearm and effectively severing it.

My question is, how easy is it to amputate someone's limbs? With a shovel? Or even a knife?

In movies all they seem to do is swipe a shovel/long sword/knife/hell even a claymore through it and voila. Operation complete.

During my trauma attachment (the whole one day of it) someone came in who required his entire arm amputated thanks to IV drug use, but I never got to see the operation, let alone see the man, because he was too sick and arrested a couple of times.

And I never quite got round to asking the butcher on the psych ward how he self amputated his finger. Because, how do you ask someone, "Hey there, how did you go about trying to cut your pinky off?"

Personally from experience from orthopaedic surgery you require a lot more than just a plain sword and biceps of steel to cut through flesh and bone in a single swift swipe. A lot more hacking is required.

And it's helpful to have an electric saw or a guillotine maybe.

Anyways.

What is your take on on-screen amputation? Plausible? Complete lies? Don't really care?

I'd like to know.

Mentally Disordered Video Game Characters

Am I the only one that finds this hilarious?

12 Video Game Characters With Undiagnosed Mental Disorders

It all makes sense now.

And that's my psychiatry revision done for the day.

Holy smokes, I am still alive!

Contrary to popular belief that I may have gone underground as a black market organ relieving surgeon, I am actually still here, doing - of all things - psychiatry.

When I'm not surrounded by depressed, "Oh no dear, I don't drink any alcohol, just a bit of sherry in my tea 6 times a day along with the occasional red wine, good for my health, they say" little old ladies, I chat to really crazy people with very bizarre ideas and grandiose delusions which is all well and good until they flash their teeth and tell you the only reason they are chatting to you now is that you actually look quite pretty.

I am enjoying it, really.

But it's not quite medicine, is it?

Everyone has an underlying personality disorder in this neck of the woods.

Anyways.

The only reason I'm blogging now is because exams are in 2 weeks and I needed some distraction from the classification of Hodgkin's Lymphoma or whatever it is that I need to know for finals.

It's not like anyone reads this crap anymore. Or do they?

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?)

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.

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*

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.

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.

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?

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.

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?

The Menstrual Cycle

Click to enlarge

I was never meant to mouse draw.

Original, unedited version of the menstrual cycle obtained here.

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.

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.

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.

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?

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.

That something was this:
Adam, Rouilly: Opthalmoscopy Training Head

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.

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.

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.

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.