The Hippocratic Oaf

[thehippocraticoaf]

Open for business

I’ve been back for over two weeks now. The transition from lackadaisical, tardy, pre-clinical student into someone who appears on a superficial level to resemble a respectable member of society, and in the correct setting, occasionally mistaken for a real doctor has commenced.

The third year kicked off with the usual suspects; paper work, timetables and introductory talks. The hall was packed out with familiar faces, and a number of fresh ones – the Oxbridge transfers, the graduate-entry students, the MaxFax dentists and a few who failed to progress to the fourth year. So with our over-subscribed year swelling to around 300, then commenced the first clinical demonstration. A man wheeled in suffering from an acute exacerbation of his COPD, accompanied by a respiratory consultant demonstrating...

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[thehippocraticoaf]

And so it begins

Attention dear readers, I regret to inform you that unfortunately the Oaf has taken a turn for the worse. Acute pharyngitis, submandibular lymphadenopathy, nasal coryza, otitis media, myalgia and conjunctivitis. Yes, vitals remain stable, but I suspect a mild pyrexia and neutrophilia. The diagnosis? Man Flu. To the non-medically trained friends of the Oaf, all this sounded rather alarming for what in layman’s terms they described as ‘a cold, if that, even’. However, I shall remain adamant that the world as we know it has stopped turning and vigils shall be held throughout the land as my health hangs in the balance by a mild viral agent.

In other news, the medical school in its infinite wisdom...

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[thehippocraticoaf]

Living the dream

Life inside the hospital is quite unlike anything I’ve ever experienced. The previous two weeks have hammered home the role of a doctor; the complete lack of glamour, the endless rounding, the tireless adjustment of medications, the utter disillusionment of previously held misconceptions, and the repugnant odours that only the new medical students seem to be bothered by. Ironically, it seems our oxygen saturations fluctuate as frequently as some of the patients as we hold our breath from bed to bed...

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[thehippocraticoaf]

Into the abyss

Back in bedlam, the chaos ensues. The ward I am currently working on has a number of different types of patient; some transient cases - fresh faces recently admitted and soon to bode farewell, whilst others have been lying in their beds for far longer than I have been in clinics. As I tag along on the morning rounds, I notice we become a point of interest. They lay there helplessly chained to their drips, watching silently as we continue the daily ritual. I carry on listening to the doctors, occasionally picking up an obs chart or scribbling an unnecessary sentence on my patient list in order to look preoccupied, all the time acutely aware of the row of screaming eyes only metres away.

Later on I am summoned to take blood from a patient down the corridor. Fearing failure ...

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[thehippocraticoaf]

Anything can happen

One of the perks of being a medical student is being able to sit in on the free lunches provided courtesy of big pharma. I speculate; am I selling my soul, sitting there devouring piles of moderately priced sandwiches and sausage rolls, gratis, as I listen to a drug rep hail the wonders of their latest snake oil? - “Peptic ulcers getting you down? Bleeding into your GI-tract? Lansoprazole still not touching it? Kick that ulcer into submission with our latest proton pump inhibitor – Mansoprazole. Are you MAN enough??” Part of me thinks perhaps not...

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[thehippocraticoaf]

Cough, please

Oh dear, I did not realise so much time had passed since I last posted. But, to be frank there was very little of note over the holidays and I did yearn for some much needed downtime. However, I am now well into the second placement – in a different hospital, and a different city. The contrast between here and my last hospital is apparent, for here seems far more organised and indeed, busy. A plethora of pathology to feast upon, and once again I am slowly finding my way around a labyrinth of seemingly endless corridors in a concrete matrix.

I am in fact, the only medical student attached to my firm. Initially I felt quite happy about this, as I know all too well the perils of spending nine weeks with just one other student whom may occasionally drive you to insanity. Although I must admit, being a lone island in the hospitals archipelago has its own draw backs. I am attached to a respiratory team, a very busy and understaffed unit...

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[thehippocraticoaf]

The Pickwick Capers

Clerking is a term used to describe the process of taking a full history and performing a full examination on a patient – cardiovascular, respiratory, abdominal, nervous system, musculoskeletal, the full works. If done thoroughly it can take well over an hour, especially for the inexperienced nubile, such as myself. I have recently discovered the best place to gain such experience is on the acute medical unit, as punters arrive at A&E are assessed and diverted to this medical purgatory full of doctors and students alike.

So brings last weeks attempt at playing doctor. Upon arrival I introduced myself to the medical registrar, who with a telling smile suggested I clerked bay 4. I dutifully made my way down the corridor to find myself staring at a patient who was regrettably described in the medical notes as “morbidly obese 69 year old female discovered collapsed at home covered in faeces”....

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[thehippocraticoaf]

Pleural plumbing

Wednesday morning, post-rounds and cue the moment I had finally been waiting for. “Mrs Johnson requires a cannula put in, do you think you can handle it?”

Thinking to myself... “I can-nula give it a go”, I smile and nod obligingly.

Down to side-room 7, I see the patient and request permission confessing I had not done one before but have seen them done many times and am comfortable to go ahead if she agrees. Consent is forthcoming and the hunt for a suitable vein begins. Unlucky first time, and second. Feeling the pressure a last ditched attempt at a small vessel popping over the dorsum of the left hand. Flashback. Success. Crack open the IV gentamicin, as the Oaf is in the mood for celebrating. First cannula, done...

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[thehippocraticoaf]

Life on the coronary care unit

Cardiology continues to inspire, confuse and exhaust both patients and students alike. I was placed on the coronary care unit and general cardiology ward spending much of the day rounding and attempting various tasks delegated to us by the SHO and consultants. The morning began with a bleary-eyed 8am ward round in which we use our combined medical expertise acquired over the past two and a half years to repeatedly open and draw the curtains around the bedside. Our consultant...

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[thehippocraticoaf]

General practice

I must confess that I have never really been that keen on general practice. The medical school has sent us to various GPs since day one and these have all been so far, thoroughly enjoyable experiences consisting of non-acute, bread-and-butter medicine. The GPs themselves have all been excellent in my experience and are amongst the best teachers (and certainly most approachable) I have had so far in my medical education.

It seems rather odd then, that like so many of my peers I have no intentions of following this career path. Perhaps it is far too early to write off such a specialty, and maybe I will have to eat my words in a decade or so. When statistically speaking approximately half of us will go on to general practice, and so many of us seem to almost vehemently refute the prospect of such a career it leaves me wondering at what point will we see a shift in attitude?...

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