Medicine "oop North"

[M Clayton]

I have a ridiculous cough at the moment - I may very well die.

I hope you're all feeling a lot of sympathy for me...

[M Clayton]

It would seem that I'm not dead - in fact, I am very much still alive and breathing, although there's more of a Darth Vader vibe to that aspect of my current existence than I'm entirely happy with.

I've been coughing pretty much non stop all day - advice from friends seems to fall into two broad categories "Go home to bed" and, "Stop coughing or I'll kill you!". I chose to ignore that advice on the premise that, if you can't make yourself feel better, it's always nice to make someone else feel worse. After all, if I've got SARS (whatever happened to that anyway?) or Avian Flu, I want to share it with all my bestest friends.

Today's delightful lectures involved some stuff on germ cell tumours. Just how gross are teratomas, sorry, non seminoma germ cell tumours? All that tooth, hair and cartilage action. Nasty stuff.

This evening involved me giving a talk on the completion of the patient report form to the Newcastle LINKS people, after which I had to answer a complaint letter. The joy of it.

Now I'm coughing again, so I have to go before I get blood in my keyboard. Ciao for now peeps

[M Clayton]

At last! It has arrived!

A week of IDHD that I might enjoy. Praise be to the angels of boring lecture based medicine - with such delights as "Bioterrorism" and "Nerve Agents", this week might just be a little bit interesting!

[M Clayton]

Oh heck, it's been over a month since I last posted in this thing - I've been so lax that I've even dropped off the first page! The shame...

Crikey, there's so much to tell you about that I'm not wholly sure where to start. If I start where I left off, it'll be a month long narrative that'll take me forever to write and even longer to read. Maybe a summary of some kind will be appropriate.

I'm currently having my brain melted at work via the combined efforts of a festive CD (oh hooray, Jingle Bells for the 6th time today!) and inane female chatter (sorry girls, but it you do talk some crap) - it's aural torture! So, please excuse me if I drift off topic into a christmas ramble at any stage.

Medicine:

The final two weeks of lectures were great fun. As well as the lectures on terrorism and biowarfare already mentioned, we learnt all about forensic pathology and medicolegal aspects of death. Doesn't sound interesting? Believe me, after 10 weeks of the same topics delivered in slightly different ways (everyone repeat after me: abnormal test results may not mean anything... but, they might mean something), the delight brought on by viewing images of depressed skull fractures and car accidents was without limit.

We were then given a generous 10 days to do some crash revising for the coming exams. I, of course, went home to work at the surgery and earn some cash.

Total cash earned over the week = £165
Total revision done = 0

What worried me more than anything was my total lack of concern. Frankly, I couldn't care less about exams - I didn't feel a need to revise and, actually, I probably got more out of my relaxation time than I would have done had I feebly attempted to revise. I think, if I'm honest, I have to say that I don't really know how to revise - oh yes, I know what you're supposed to do when revising, but I don't seem to be able to do it when the need arises. Up until now I've always just learnt things as I've gone along but, at some point, I'm sure I'll come a cropper.

So, exams. Wednesday and Thursday of last week saw the whole year decamp to Eldon Leisure centre for the joy of 2, 3 hour multiple guess papers. In all honesty, it's a bit tough to call really - lots of people came out of the exam commenting on just how hard the paper was but I didn't think it was anything more difficult than I expected, so who knows? With a bit of luck, January will bring good news and that'll be it til finals!

"Life in general":

Life has actually been pretty darned good recently. I'm quite sure you're not interested, but I'm actually in a decent relationship with an awesome person that feels the same way about me! Yay The bad thing is that said fantastic person is now 120 miles away from me

[M Clayton]

Ohmigod!!

I have just returned from a "quick dash" to the supermarket for bread and milk - this quick dash took me over an hour and a half! Discount the 10 minute round trip and I'm left with an hour and twenty minutes to purchase bread and milk! I'd have fared better had I found a cow and milked it myself - I'm sure there was a session on it during obs and gynae...

What is it about the festive period that means that every person on Planet Earth descends on the local Asda/Morrisons/Kwik Save/*Insert Shop name here* in order to purchase enough food to survive a nuclear holocaust? For the love of god people (hehe, see what I did there?), the shops will be shut for precisely 2 days! There is no need to buy everything on the shelves! Seriously, I despair...

[M Clayton]

Ok, it's a new year already. How did that happen? :/

Meh, however it came to pass, Happy New Year to you all. I hope you have good ones and all that jazz, blah blah.

What have I been up to lately? This, I feel, is a good question; I may use it to start my blog entries in future. Or, more likely, I may not.

I've been busy. You might have guessed that much by the lack of blogging. Then again, you might have come to the conclusion that I was just being a lazy git - let's be honest, this is quite likely and has frequently been the cause of missing blogness.

First off, there was that whole Christmas thing. When you've got to choose between eating copious amounts of unhealthy food whilst watching crap TV in an overheated room with the detritus of a morning's present unwrapping surrounding you, or getting online and spending time actually thinking about writing something coherent... well, there's no contest there! So that, at least, accounts for some of the absence.

What else?

Well, there was a New York trip in there somewhere too.

What? Oh, yes, a little trip to New York. New Year in Times Square, sightseeing, and shopping. Beyond that, there's not too much to say really.

I got back to the UK on Monday afternoon and had to endure a 4 hour drive back from the airport before crashing out at home. I would have had quite liked to have spent Tuesday in bed recouperating but, alas, it was not to be. In their infinite wisdom, the medical school decreed that we should all be there for an 8:45 lecture. Honestly, who in their right mind thinks that making students travel from the four corners of Earth (ok, all over the UK at least) for an early morning lecture is a good idea?! I had to get up at 5:30 to catch a 6 o'clock train! Madness. What made me more angry was that the lectures they gave were nothing new and, to add insult to injury, were made available on line! Grrr.

That leaves us with what I've been doing more recently.



This is my new home ^^ Hull Royal Infirmary A&E dept. (off to the right of the pic)

So far, I've spent most of my time in EIT (Early Interventional Triage) where we do the initial clerking and early interventions (ABCs, cannulation, analgesia, bloods etc). I've seen shed loads of chest pain patients and done a load of ECGS - I almost sound as though I know what I'm doing in that respect!

What else have I done? I've run 2 teaching sessions for the doctors (SpRs and SHOs so far) on why we should scan all head injury patients over the age of 65 - just one more to go. I was surprised at just how not scary they actually were - a room full of middle grade A&E docs is less intimidating than our clinical supervisor from last year! Fancy that.

I've also done a couple of ward rounds on the A&E short stay ward - my god, how depressing! The ward's only got 12 beds, but they're full of the ODs, alcohol intoxications and other joyous cases that really don't have anywhere else to go.

And, finally, I've spent some time in majors. Participated in a resus and puzzled over the case of a 89 year old with hypothermia (and J Waves on her ECG!!!).

With a bit of luck, tomorrow might just be as much fun.

[M Clayton]

Crikey O'Reilly!

It's been a while, hasn't it?

I'm currently in Darlington doing my 6 week Paediatrics SSC (awwww, kiddies) and, owing to the fact that there are about 3 working computers in the hospital (just kidding, it's not that bad), access to t'internet is somewhat restricted. I wish I could blame that for my exceedingly poor efforts at keeping this here blog up to date, but I've only been here a week... hmmm.

And that's where I'm going to leave it for the time being. I've got a million and one other things to do before I can even think about relaxing, so I should get to it!

Laters.

[M Clayton]

It's been a while hasn't it?

As promised, I've been exceedingly poor at updating this thing whilst at Darlington - it's just such a bloody effort to leave my lovely warm room and traipse across the car parks in the snow and hail in order to type a few words that nobody will really read anyway...

Paediatrics, after a slow start, has picked up recently and I'm having a lot of fun. With their being so little to actually do in my free time, I've turned into one of these people that spends every waking minute on the admissions unit/ward. Generally, I get under the feet of people who have work to do () but sometimes I actually make myself useful and clerk the kiddies in. I also eat a lot of toast with seedless raspberry jam, but that's neither here nor there.

I've also spent a fair bit of time on SCBU and have to remind myself that these babies are unusual rather than the norm - I popped onto the post natal ward this morning and was shocked at just how "fat" normal babies are!

In real life (TM), the saga of the elective rumbles along. I'm having my chest x-ray for the visa tomorrow and will be relieved of the princely sum of 66 pounds for my trouble. When that's sorted, I can finally get the bloody application sent off and book some flights. After that, there's the simple matter of trying to find accomodation at a time when there's a great big festival going on (read: accomodation prices will be vastly inflated)... Frankly, I wish I'd decided to stay in the UK.

What else? I've finished analysing the data from my A&E audit and I was really pleased to note that my basic intervention doubled scanning rates for over 65s (woo!). Yes, it's still below 50% but saying it's doubled sounds ace, don't you think?

Anywho, I'm boring myself, so that doesn't bode well for you guys.

With luck, it won't be a month before I post again... <doesn't hold breath>

[M Clayton]

Oh heck, this thingy-mi-blog is still here. I'd sort of assumed that it'd self destruct if I kept putting off posting here, but apparently that's not the case. Well, you live and learn eh?

Give me a second to see when it was that I last posted and what I actually had to say (although I suspect that it wasn't an awful lot...)

**reads through piffling entries**

Yep, pretty crappy half posts for a little while really. I think this whole relaxed 4th year thing has spilled over into my free time too - I just don't feel motivated to write about all the oh-so exciting experiences in my life. If life were boring, I'd have an excuse, but so much has happened lately that I can't really pretend to be lacking material. Again, if it were the case that I had no free time, I could use that as my excuse but that's not the case either. Simply put, I've just not been arsed to update this thing. Nothing more complicated than that.

I had intended to move on at this point, but I'll have one last word. In mitigation, for the 6 weeks I was in Darlington, my internet access was next to non existent and there was a lot of server downtime to contend with.

So, paediatrics in Darlo… I suppose I should post a picture of the hospital, as is traditional (yes, I am aware that previously posting one picture does not a tradition make);

Tada! Darlington Memorial Hospital (aka DMH for those of us "in the know"). Check out the 1950s architecture - I believe it's called "Prison Camp Chic". Would you believe that the buildings are owned by a PFI? You’d sort of expect nicer surroundings with all that private cash… Anyway, it’s decent enough inside and I’m straying off the point a little. Actually, was there a point?

In the absence of any clear direction from above, I’ll give a brief overview of my time in paeds and what I’ve been up to since then shall I?

...
...

Damn my easy distractability (is that even a word?) I've just spent an hour and a half playing Spider Solitaire. Yes, Spider Solitaire. Kill me now. I'll continue...

... just as soon as I manage to win one game on the difficult setting!

Anyway. Like the other placements during the SSC period (the others being A&E and anaesthetics respectively), I spent 6 weeks in Darlington and the vast majority of my time was spent on the Children's Day Unit (CDU - Acronym-tastic!). Essentially, I took on the role of dogs body and did all the initial clerking, bloods and cannulation for the unit - I should probably explain that all kids who were sent to the hospital by GPs/Walk in Center etc were seen by the CDU staff rather than A&E (except those kids that were involved in accidents - they were seen in A&E first). The unit was scheduled to close at 7pm but I never got away before 9pm - it was just that busy!

Aside from the CDU stuff, I also attended the daily ward rounds where I was constantly reminded of just how little I actually know. It was a rare occasion indeed for me to get something right when put on the spot. We live and learn though.

When I wasn't busy on the ward, I had to put a bit of effort into preparing and producing an A0 (!) poster of my A&E Head Injury Audit as well as writing the complete report. I thought I'd make my life easy by producing the poster using PowerPoint - apparently that's how the professionals do it, so why not me? The poster looked great once I'd finally worked out a layout I was happy with ... like it?

Unfortunately, I'd not taken into account of the fact that I'd no way of printing an A0 poster in one go. I've only got a black and white laser printer, so what on earth I thought I was doing when I decided to make it in one piece I don't know! Simple, I thought, I'll pay a printer to print it for me.

Sixty Quid!

This, believe it or not, was the absolute cheapest quote for one printer at the lowest paper and print quality commercially available. I wanted to get a good grade, but not that badly! In order to avoid a total disaster which would require a major rethink (oh, did I mention that this all occurred with 4 days to go before the deadline?) and muchos effort on my part, I prostrated myself before the feet of the lovely people at medical imaging and asked, nay begged, them to find a way to print it for me on the cheap. They were a little reluctant at first but, to give them credit, they managed to print it for me. Yes, what should have been a single sheet came out as 12 A3 sheets which I had to stick together, but I was over the moon. Ok, not literally over the moon - that would require several tons of highly volatile rocket fuel capable of generating millions of pounds of thrust. Then there's the need for a space suit of some sort... so, in all, not worth the effort or cost involved... Argh, off topic again! Bad Mark.

The finished article (ignore the funky duvet);

Total cost to me: £24 (inclusive of whacking great card boards to mount it on), quite a lot of sleepless nights and, very nearly, one very pissed off other half. (It's not my fault he's no good at sticking things to my satisfaction!)

In addition to the ridiculous effort required for the poster, there was also the little matter of an assessed oral presentation to prepare for. Not wanting to cast off my "Mr Last Minute" mantle just yet, I held off doing any work until two days before the presentation (which brings us to a week last Wednesday if I'm right...)

I'll hold off finishing this tonight - I don't want to bore you all to death!

[M Clayton]

Apparently, some of you do actually read this (and have messaged me to say so!). Frankly, I'm amazed. I've often wondered why anyone keeps a blog - there's something just a little bit self indulgent about the whole process don't you think? I'm sure my year 1 PPD tutor would be mega impressed at all the reflective nonsense that goes on here and, dare I say it, ranting can actually be theraputic!

I suppose I had better finish yesterday's entry then eh?

I think I'd just started waffling on about the assessed oral presentation thingy (I could probably just scroll down the page and actually read what I'd written but that feels too much like effort for my liking...) so I'll carry on from there.

I had 2 days to prepare 15 acetates for a 10 minute presentation on a topic of my choosing. This should have been a doddle - I can ad lib for ten minutes on pretty much any topic without pausing for breath but I couldn't come up with a topic that I was sure would fulfil the requirement to demonstrate my worth as a reflective practitioner (seriously!). To summarise, I'd gotten myself into a bit of a pickle (Not a bad phrase, that) and only one thing would save me - yes! I rehashed a presentation I'd given previously and adapted it to fit the marking criteria as defined in the course handbook.

Of course, with a whole day and a half to go, I wouldn't have finished - I had to purchase something to actually print the slides on. Why we couldn't just use PowerPoint, I'll never know - all the bloody rooms in the med school have digital projectors after all!

Long story short, I ended up buying acetates and printing the slides about an hour before I was due to get a train up to Newcastle. This would be fine if I lived next door to the train station and had a fast yet high quality printer for printing acetates and had packed everything I needed for the next day. Those of you whose brains haven't been turned to mush by the Hollyoaks Omnibus might be able to guess where this is going.

I obviously don't live next door to the train station and my printer isn't very fast when I want high quality and no, I hadn't actually packed anything. Not surprisingl, I missed the train by a good 10 minutes.

"Fear not! I can probably drive to York faster than the train and still make my connection", I thought to myself. (Interestingly, I do think with punctuation.) This obviously necessitated getting hold of a car (no, I didn't steal one! I borrowed my sisters) and sat nav. Why sat nav? I here you ask. Well, York is silly with its masses of one way streets and blind, death filled alleys. Maybe they're not death filled, but the whole city confuses the hell out of me. So, sat nav would save the day and deliver me to the station in good time.



Satnav is great! Her sultry voice guided me the right way. Well, she would have done had I chosen to listen to her and not go my own way (which is better, for reference sake) to York. Once in York, of course, I did the gentlemanly thing and listened to what she had to say. Revenge, as they say, comes sweet. Mrs Satnav directed me through some lovely cobbled streets to the very heart of old York. At any other time, I'd be glad of the trip but I had a train to catch and was now stuck in the warren of one way madness that is York. Oh, and it was snowing. The old Y chromosome prevented me from admitting defeat and asking for directions and so, predictably, I arrived at the station much too late to make the connection.

Bugger.

Fifty minutes and £12 later, I'd finally gotten onto a train to Newcastle.



That's not my train. Obviously. Otherwise I'd have been on it and not stood on the platform taking a picture. Duh

Arrival in Newcastle passed off without further incident and I had only to run the gauntlet of Helen's driving before retiring to my old bed in Gateshead. We only hit one fence and stalled long enough to run through one full cycle of traffic lights. Good going, I thought.

The oral presentation itself was ok. I spent my ten minutes explaining how we're not sure what causes minimal change nephrotic syndrome in kids only to have the assessor ask once I'd finished, "So, what causes minimal change nephrotic syndrome in children?". I had to work very hard not to leap across the room and claw off his face while screaming "Were you F@!*&g listening or not!?!". It didn't matter in the end though, because I passed the assessment with two Ms and an S. Go me.

Here endeth the bloggery.