My PBL this week involves describing and differentiating acute and chronic inflammation. Unfortunately, to understand the million abbreviations and processes described, I basically have to learn the entire rest of the immunology book.
But, it is fascinating and I am enjoying it. Beats ortho anyway.....
However, I'm afraid I don't know much about it at all, and sometimes its hard to get my head around it. I keep getting questions popping up in my mind, especially when it comes to HIV which particularly interests me.... Can anyone help?
1. Is it possible to culture and then infuse a patient with NK cells, and thus treat viral infections?
2. Hepatitis can be treated with interferon, why not HIV?
3. Would it be possible to introduce free artificial CD4 receptors that would irreversibly bind HIV to "mop up" the virus in the system?
4. Is it possible that COX and LOX inhibitors e.g. paracetamol and other NSAID's actually dampen immune response enough to prolong infection?
5. Does HIV affect expression of MHC's in any way? If so how?
Showing posts with label med school. Show all posts
Showing posts with label med school. Show all posts
Tuesday 4 March 2008
Monday 25 February 2008
Monday 25th Feb 08
Woops I got a little behind on the blogging.
So what's happened over here at my super-fun-happy-time medschool? Not much. We're working our way through ortho and rheumatology (yawn). We had our first proper cadaver anatomy session last week, and I didn't wuss out even a little. But the smell reminded me so much of vet, vile.
Haven't really been doing much work, for which I do feel rather guilty... All the same, I've been doing my bit when it comes to PBL. Unlike some members of our group. Its getting kind of bad, there are a few who just don't care, or keep using the same pathetic excuse that we are all sick of at this point. So we'll have to see how that one pans out.
Don't think I have any news. My crazy friend has now effectively eloped and is going to marry the immigrant after all.....*sigh* And I have a cold.
I think that's it.
Oh dear. How frightfully dull.....
So what's happened over here at my super-fun-happy-time medschool? Not much. We're working our way through ortho and rheumatology (yawn). We had our first proper cadaver anatomy session last week, and I didn't wuss out even a little. But the smell reminded me so much of vet, vile.
Haven't really been doing much work, for which I do feel rather guilty... All the same, I've been doing my bit when it comes to PBL. Unlike some members of our group. Its getting kind of bad, there are a few who just don't care, or keep using the same pathetic excuse that we are all sick of at this point. So we'll have to see how that one pans out.
Don't think I have any news. My crazy friend has now effectively eloped and is going to marry the immigrant after all.....*sigh* And I have a cold.
I think that's it.
Oh dear. How frightfully dull.....
Friday 8 February 2008
Tuesday 29 January 2008
Saturday 26 January 2008
Saturday 10 November 2007
Consultation skills
This week we had another round of consultation skills. We have it about three times a semester I think, and we've been building up our history taking etc. gradually. This weeks' title was "dealing with emotions and feelings in the structured consultation" or something like that.
Woopee I thought. After the last dire 4hour session, I was NOT looking forward to this. But, I was hoping that it would be useful in dealing with patients, as there had been a few sessions in Primary Care where we had sensed that there were emotional issues under the surface, but too afraid of a meltdown to go near them.
What I was not expecting was the harrowing, draining barrel of emotional turmoil (tears n'all!) that we got. And I mean from us, not the "patient".
For our consultation skills classes we have our PBL group, one or two tutors and an actor who plays out the role of different patients.
We had had a lecture earlier in the week on dealing with emotions. Here they stressed to us the importance of being empathetic, but not necessarily sympathetic. Now I do understand the difference, and I do know why it is important. One of the tutors gave us a nice little picture to illustrate it. She said "imagine you are at the top of a cliff and there is someone stuck at the bottom in great distress. Sympathy is climbing down to comfort them, but not bringing anything with you to get you both back out. Empathy is recognising the problem and the distress, and going off to get a rope to pull them up with." which I though was pretty neat. But my issue is this: is it really possible, as a feeling human being, to deeply empathise with someone and feel nothing? Is it just a question of time and experience that will teach us to see pain but distance ourselves from it? Another thing that confused me was that they said it is possible to learn to be empathetic, that you can know what to say and do with someone to appear empathetic, but not to fake empathy because the patient will always know! Now what's the difference between using formulaic empathy and faking empathy? Not much as I see it. Anyway, there wasn't much problem with a lack of empathy in our class, but probably an excess of sympathy....
The scenarios that the actor played out were all very sad. The kind of awful upsetting things that happen every day, and that you as a doctor, or anyone, can do nothing about. I know that they say just turning an ear can be enough, but don't you hate that feeling of desperately wanting to make it better, to do something, to fix the pain, and not being able to? And for some reason it all felt completely real. Initially I thought I was just being "sensitive", but when I talked to the group a lot of others felt the same. I wasn't the only one who welled up.
The other thing that was a little distressing was that 2 of the scenarios played out almost exactly what had happened to 2 people in our group. It wasn't something I expected, but it made it extremely difficult to be "professional" and distance yourself emotionally when what the patient is saying keeps giving you flashes of your own past. But strangely enough, I found it was easier to be in the position of "Dr." and directly involved in the consultation than it was to watch someone else. I guess the latter was a little bit like a sad film.
Afterwards, I felt drained, flattened, worn out the the way you do when you have cried until your eyes are raw. But I was glad we had done it, because I now feel much more able to deal with any emotional situations that might arise in consultations. Before there was a terrible fear of the unknown; of being unprofessional, of saying the wrong thing, letting the patient down. I guess its one of those "fear of the unknown" things; its never as bad as you imagine it.
Man alive, what am I going to be like when we do our "breaking bad news" class?????
Woopee I thought. After the last dire 4hour session, I was NOT looking forward to this. But, I was hoping that it would be useful in dealing with patients, as there had been a few sessions in Primary Care where we had sensed that there were emotional issues under the surface, but too afraid of a meltdown to go near them.
What I was not expecting was the harrowing, draining barrel of emotional turmoil (tears n'all!) that we got. And I mean from us, not the "patient".
For our consultation skills classes we have our PBL group, one or two tutors and an actor who plays out the role of different patients.
We had had a lecture earlier in the week on dealing with emotions. Here they stressed to us the importance of being empathetic, but not necessarily sympathetic. Now I do understand the difference, and I do know why it is important. One of the tutors gave us a nice little picture to illustrate it. She said "imagine you are at the top of a cliff and there is someone stuck at the bottom in great distress. Sympathy is climbing down to comfort them, but not bringing anything with you to get you both back out. Empathy is recognising the problem and the distress, and going off to get a rope to pull them up with." which I though was pretty neat. But my issue is this: is it really possible, as a feeling human being, to deeply empathise with someone and feel nothing? Is it just a question of time and experience that will teach us to see pain but distance ourselves from it? Another thing that confused me was that they said it is possible to learn to be empathetic, that you can know what to say and do with someone to appear empathetic, but not to fake empathy because the patient will always know! Now what's the difference between using formulaic empathy and faking empathy? Not much as I see it. Anyway, there wasn't much problem with a lack of empathy in our class, but probably an excess of sympathy....
The scenarios that the actor played out were all very sad. The kind of awful upsetting things that happen every day, and that you as a doctor, or anyone, can do nothing about. I know that they say just turning an ear can be enough, but don't you hate that feeling of desperately wanting to make it better, to do something, to fix the pain, and not being able to? And for some reason it all felt completely real. Initially I thought I was just being "sensitive", but when I talked to the group a lot of others felt the same. I wasn't the only one who welled up.
The other thing that was a little distressing was that 2 of the scenarios played out almost exactly what had happened to 2 people in our group. It wasn't something I expected, but it made it extremely difficult to be "professional" and distance yourself emotionally when what the patient is saying keeps giving you flashes of your own past. But strangely enough, I found it was easier to be in the position of "Dr." and directly involved in the consultation than it was to watch someone else. I guess the latter was a little bit like a sad film.
Afterwards, I felt drained, flattened, worn out the the way you do when you have cried until your eyes are raw. But I was glad we had done it, because I now feel much more able to deal with any emotional situations that might arise in consultations. Before there was a terrible fear of the unknown; of being unprofessional, of saying the wrong thing, letting the patient down. I guess its one of those "fear of the unknown" things; its never as bad as you imagine it.
Man alive, what am I going to be like when we do our "breaking bad news" class?????
Monday 5 November 2007
All I want for Christmas....
Is this.
Just look at the beauty of that 3d pelvis!!!
And I'm kinda annoyed that my Uni doesn't provide it, because I've used the free trial, and its AMAZING. And other Uni's do (ahem, Peninsula, ahem) Oh well, its only 155eur, looks like I might have to go back to the 'ol job...
On another note, I am very excited about the possibility of seeing Vieux Farka Toure in London.....if I can get a ticket.
Fingers crossed!
Just look at the beauty of that 3d pelvis!!!
And I'm kinda annoyed that my Uni doesn't provide it, because I've used the free trial, and its AMAZING. And other Uni's do (ahem, Peninsula, ahem) Oh well, its only 155eur, looks like I might have to go back to the 'ol job...
On another note, I am very excited about the possibility of seeing Vieux Farka Toure in London.....if I can get a ticket.
Fingers crossed!
Sunday 28 October 2007
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.
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!
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.
__________________________________
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!
Saturday 29 September 2007
Things are good.
Not my usual tone of title but that's how I feel!
I've managed to get over my induction week freak-out (haha, they were just trying to scare us), and I'm feeling well settled in.
We had our first PBL case this week and I think it went pretty well. I definitely haven't done enough study from it, but, hopefully, I will, and apart from that the seminars and wrap-up and all that stuff went fine which suits me just dandy!
A lot of people are complaining that the course isn't challenging enough, and it is a well known fact (the course directors even spelled it out) that our first semester isn't exactly open-heart-surgery stimulating kind of stuff... But, having been through part of a course where I was completely shattered from the workload of the first semester, I am ok with this. I know it will get a lot harder ( and only after Christmas, come on people, its hardly 3months!) soon enough. And I think its good that we get to grips with how this course is structured before the work piles on.
Had "consultation skills" this week. Now I know a lot of med students and doctors bitch about these classes because they think its all too touchy-feely, namby-pamby and completely pointless in the practice of clinical medicine. Well, I don't think it is. Ok, some of the stuff does seem silly (there is an awful lot of "how does that make you feel?", and personally, if a Dr asked me what I "was hoping to get out of the consultation today" I would have a very low opinion of their competence). But on the whole I think its a really good thing. And the weird thing is (even though the interview process was supposed to weed these ones out) you can already see who are going to be the hard ass "people-are-diseases-so-treat-them-that-way" kind of doctors. And I think consult skills will do them a lot of good. And they do teach you some useful stuff that will really make it easier for us I think. So, so far so good. Plus, roleplay is all about the acting which I LOVE!!!
Not so excited about having to read scientific papers, but oh well I suppose its good to get us started young......
And next week, I get to go and poke real live people......woot!
Possibly the best thing about this uni though is the fact that it has an olympic size swimming pool. Swimming makes me happy. And I just went this afternoon, which possibly accounts for my overly cheery & optimistic tone.
Watch this space for a return to form....
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