Update

Thanks for all the comments on my sciatica post, the good news its much better. The bad news is it hasn't completely gone away and I'm terrified of doing anything in case I make it worse. As I have no idea what caused it in the first place, I can't really rule anything out. Anyway, I'll keep on the diclofenac for the month and pester the GP then if it isn't gone. The plus side I suppose is that the diclofenac is making my knees feel fantastic!

Medicine wise, I have been spectacularly unproductive. I had so many plans for a weeks end of review and revision, and cracking into some anatomy, but somehow it never happened. I blame sidereel.com and my addiction to Desperate Housewives.... I think maybe I'm like Cal in that I need to be under pressure to be efficient. If I don't have loads to do I just mess about.
Also, this weeks objectives in PBL were pretty wishy-washy even by my standards. Hard to get motivated about. . So here's hoping next week is more exciting! Although, by the look of the timetable, I doubt it.

My mum was here for the bones of a week, and actually despite my worries it went really well. I think Lis was right, moving out is the best thing you can do to improve your relationship with your mother. You appreciate each other so much more. It makes me miss home when things are good between us. Well, i guess Christmas will tell. Which is actually starting to get really close (although not so close that we need to see Christmas food in the shops, take note Mr. Marks and Spencers). How can I have been here so long already? I definitely need to get more productive.



Did anyone else see that article in the Sunday Times Magazine today about the school in the US which treats behavioural disorders (anything from severely autistic children to juvenile delinquents) by hooking them up to electrodes and a battery pack 24 hours a day and shocking them whenever they are "bold"? It was unbelievable, and horrifying, and I just couldn't understand why this institution hasn't been shut down!!!! And, they offer NO psychiatric treatment, just a punishment/reward treatment. Crazy.

This week in primary care I saw a 14yr old with diabetes. Onset of 3yrs. They were amazing because they were so ok with the whole thing. If I was diagnosed with diabetes I would completely freak out, and stress about managing it the whole time. But the patient was really relaxed, had good glucose control, and didn't seem to have any problems with fitting it into her social life. That said, the mother was in the room and did most of the talking. I wonder if she would have said anyting different had she not been there.

In contrast, another one of our group saw a girl of 12, also diabetic (diagnosed at 3yrs), who had a very different outlook on the whole thing. She was very upset about it, had no confidence in her future, didn't think she would ever be able to leave home, get a job, go to university etc. The mother was also stressed out. She didn't seem to be letting the child out of her sight, and was pretty paranoid about the whole thing. But maybe that comes from having to deal with it for so much longer. It obviously wasn't nice when she had to hold her child down to inject it repeatedly each day for so long.

Two very different patients with the same disease. Which I suppose is supposed to get us thinking about disease vs. illness (if we haven't enough already). For anyone who doesn't know, disease is what the patient gets, but illness is how they experience that disease and how it affects their life. Which our medical school are very keen that we think about. A lot. But its probably a good thing, because all doctors start out wanting to always see the patiet and their illness, but so many end up just seeing the disease. Maybe all this focus on it will help protect us? I hope so.

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My parents brought me up on a diet of classical music, but as I grew older I naturally drifted into other genres. But from time to time I find myself returning to it. Which is what happened today when I stumbled upon Classic FM. It also helps that what is playing right now is the top 100 most relaxing classics, and not full on opera (which I can't stand). Drift on......


Other fantastically exciting news from my part of the world: I made my second lentil lasagne in the slow cooker, and it was again delicious! If only I hadn't eaten the whole thing..... And coming up soon, stewed apple (with apples that my mummy brought me from the garden)! T'is the season after all, right? I really don't want to do all that peeling though....

Well, think that's my update for the moment, a suitably random and not very exciting post. I'm working on other ideas, I promise!


See you soon!

This sucks.

I have sciatica. It hurts. Really, really hurts. Especially when I sit. Which kinda sucks for lectures/seminars/PBL/studying.....i.e everything medicine related. And the painkillers don't work. So I'm feeling generally moany and grumpy. Apologies. I needed to share.

Excitement

Lis is coming to visit me!!!!! Wooooohooooo!!!!!

Thursday, 11th October 2007

Because I can't think of a better title.

I like this university. That is such a strange thing for me to say, I almost can't believe I've said it. But I've said it to several people. So it must be true.

PBL is good, I think we are ironing out the wrinkles. Sometimes I do think that people are not using the best sources (Wikipedia is fine to satisfy your curiosity, but please don't quote it as a reference), but at least its not too important yet. And my own work is hardly the most astoundingly brilliant stuff.

IPL is a bit more tricky, namely because we're not really sure what the hell we're actually meant to be doing; its all a bit vague. Could somebody give us a big shove in the right direction? Please? We don't quite look like the perfect MDT below.....


Primary care is brilliant, I love it! Its so amazingly different to be sitting on the other side of the door,actually being in the consults. I'm surprised at how happy patients seem to be for medical students to be in the room. I don't think I would like it, but maybe I'm just sensitive. And I HATE going to the doctor, so it kinda figures. They (patients) just completely ignore us and seem totally uninhibited by our presence; thank you patients.



The other thing we do is interview patients in pairs. As we obviously don't have any clinical skills, our "examinations" go as far as talking to them. Despite being told in consultation skills that if we just sat back and listened that the patients would tell us everything, I didn't quite believe it. Well, its true. You can't actually get a question in with some of them! Which is fantastic, because awkward silences suck, and they really presume we know what we're doing, which we really, really don't.



Its interesting to see how other students talk to patients. Some of them seem quite insensitive, and not able to read the situation very well. I was a little embarrassed when my colleague asked a quite blunt question about socio-economic status that didn't really seem relevant or necessary. But I guess we're all learning, and I'm no saint myself. How do you teach yourself to eh stop um going eh.....um.... all the time? In my opinion, people who don't do it are amazing. Tips please!

Sometimes I'm surprised about the things that med students don't know. (Please don't think I'm being arrogant) One thing that shocked (and kinda horrified me to tell you the truth) was that during a lecture on cultural and ethnic differences and the issues that raises with pregnant women was that only about 5 people in a room of 30 knew what Female Genital Mutilation/Female Circumcision was. I would have thought that it would be something that medical students are aware of, especially because its the kind of "hot topic" that people read up on for interviews.

But I've noticed a lot of people don't seem to have a very culturally/ethnically broad "world perspective" of medicine and patients; maybe they think it doesn't matter if they want to practise solely in Britain's NHS (considering the amount of immigrants in the UK though this does seem a little short-sighted). And indeed, all our training is about preparing us to work in the NHS. Sometimes I find this annoying because I have noticed quite a few differences even between England and Ireland, so outside of Western Europe the odds are there are going to be even more. Do we have to be trained only to become "NHS Doctors"? Can't we be trained to be Doctors who are competent at working in the NHS? And yes, I know that it is the British taxpayer who is providing my medical education so maybe I should just shut up and be thankful, but all the same......

Haven't had any "special" cases yet, but at this young and naive stage of my life every patient is fascinating. I hope I won't lose that interest.

The doctors we are working with are very very good at what they do. I don't mean their diagnoses/treatment, because I can't really tell yet (but judging by the high standards they have in everything else, it can't be too bad), but they are so good at listening to what the patient is actually telling them and giving clear advice and good reassurance. I have never been a patient of doctors that acted like this. I very much want to be like them, and am so thankful for the opportunity to get to work with them.

Private Practice

Sucks! Its a far cry from Grey's. And we all know, Grey's isn't exactly the most factually-based medically accurate show out there. But Private Practice just takes silliness to a whole new level. Addison has completely lost her hard-ass surgeon role, and gone all fluffy round the edges. And doing a c-section out of theatre with acupuncture as anaesthetic? In L.A? C'mon producers, how stupid do you think we are?

That said, I'm sure I will be following the series avidly, I can't resist a medical soap, no matter how dumb.