Friday, February 13, 2009

Gastro updates

The score so far:
  • Runaway patients: 1
  • Birthday cakes eaten on ward: 1 (yay Woolies)
  • Practice long cases done: 0 (arghhhh final week soon!! where did the month go?!)
  • Ascitic taps done by me: about 3-4, lost count
  • Traumatic ascitic taps done by me: 1 (so not my fault, patient was sat up....)
  • Ascitic taps removed by the patient themselves: 1 (see: runaway)
  • IV cannulas inserted: 1
  • IV cannulas attempted: 3
  • Patients presenting with alcoholic livers, GI haemorrhages, or combination of the above: ALL OF THEM, it feels like.
  • Liver biopsies seen: 2
  • Colonoscopies seen: 2
  • Colonoscopies in which patient semi woke up: 1
  • Emergency gastroscopies in which patient melaena'd on bed and had to be held down by three people: 1 (too many)
  • Attempts taken to do a MMSE on a grumpy old lady: 2, with much cajoling.
  • Patients successfully discharge-counselled: 1 (take your drugs, go to your appointments, stop that drinking, limit fluids)
  • Longest stretch without seeing consultants: 1 week
  • Pathology forms filled out: 127836987236874 (we are the intern's bitch)
  • Items carried at one time: too many. OHCM, clipboard, notebook, steth, pen, mini handbag, charts
  • Free food: less than expected. WTF, hospital?
So, acclimatised to ward life now. Got a decent rapport going with the team, who are quite friendly - gastro dudes are definitely nice, none of the (overt) personality disorders seen elsewhere. My main problem is that we've become too useful to the JMOs, so the time's been a bit heavy on scut and minor procedural stuff and light on hardcore pimping (also known as learning). Just did a shitty short case today. Not because it was difficult, because I suck. What is it with med and my brain? Oil and water, sans surfactant. I blame vivas...what, they expect me to think without pen and paper?! It's not that I'm slacking either, probably am more motivated than usual for this point in the semester. I dunno. Feeling dumb is not fun. Chris and I were reminiscing about high school when we felt smart the majority of the time. Where did that go? I think the prob is that I STILL have not figured out "learning widgets" for med...processes to churn and integrate the info. Whereas for, say, French - even at uni level - it was relatively simple: memorise vocab, practise both by writing and speaking, expose self to francophone sources. Lather, rinse, repeat. Badabing.

Despite the moaning and nervous breakdowns, I'm nostalgic for last year. Armidale was awesome, VN quite fun, and even academic semester was satisfying cos I was knowledgable for a whole three minutes there before it all drained out the other ear. This year hasn't been bad so far, but there's the vague undercurrent of DESPERATE PANIC from being in 4th year and expected to, er, know stuff. Somehow 4th year sounds so much more almost-doctor than 3rd year, just as being 23 is uncomfortably close to "mid 20's" and ensuing QUARTER LIFE CRISIS (part the umpteenth).

But all is well. I now know how to stop a nosebleed in a sheep. We had an ENT session with decapitated sheep heads (is that redundant?) at the morgue - this involved practising stuffing gauze up their noses. Should come in handy in rurality one day.


Anonymous said...

lol at the sheep. That's so weird. As is the patient waking up(!?!) but that's also just a tad bit disturbing...

GL with the rest of the year. What are you doing next?

Dragonfly said...
This comment has been removed by the author.
Dragonfly said...

What - not tampons?? Will never forget that episode of Sex and the City, much as I cannot stand the show...
A patient sat up while you were tapping their ascites? I would have thought that the ascites and needle would be independently enough to stop someone moving too rapidly, but how often i can be proved wrong...