You are not a unique and beautiful snowflake

This is not you

Just a quickie, but I just thought I'd share an experience I had yesterday that has really helped me deal with the self-doubt and associated shit that this week has brought to the surface.

I have a very good friend with whom I go drinking and she has a good friend who has just taken his entry exams for the Royal College of Surgeons.

Apparently the night before his exams, he too was wracked with self-doubt, suggested it was all too much, how could a person remember all this, he should chuck it all in now etc. etc.

My friend, Hazel, opined that this was just how doctors (and by extension, med students) are, full of self-doubt, neurotic and constantly feeling overwhelmed by the volume of knowledge they are expected to have.

So, in one respect, yay! I'm not behaving in an abnormal way, my negative emotions are validated and guess what? It doesn't mean everything is doom and gloom, it's probably just a emotional survival strategy.

In another respect, boo! I am not a beautiful and unique snowflake and hey, guess what? My emotions really aren't anything special!

*sigh* I jest, I'm feeling a lot better and more capable. And maybe just a little bit apprehensive about the future ;)

Have you got what it takes?

So it feels like I need to work on my clinical self-confidence.

I'm finding the transition going from senior staff nurse to wet-behind-the-ears-med-student hard. It's hard going from being on top of your game, in a comfortable place - the go-to guy full of how-to and confidence - to being uncertain and feeling vulnerable. Before I started this course, I didn't realise how fragile my ego is.

It's compounded by being surrounded by a group who are effectively the top 10% of the class. Imagine the equivalent of a class filled with the girl who has a dozen different coloured highlighters and does extra reading for fun. I know I've earned my place here, but it doesn't make me feel any more comfortable. I know this is all in my head and I should just deal with it and crack on with the work...

It's pretty tragic that this is taking up so much of my run-time, as the course is full of work I need to do and is more than capable of giving me stuff to worry about. I think I just feel like the fact I'm an awkward nerd who tends to make friends on his own terms, is being thrown into sharp relief by the naturally gregarious and socially-engaged behaviours of med students in England. Why that is the norm, I don't know, but it's just helping me to relive a whole bunch of shit that I thought I'd dealt with in high school but apparently really haven't.

Good grief, this is a wee bit self-indulgent, isn't it? Hopefully telling the internet my deepest, darkest worries will help me get a handle on them. It would be really nice to be over all this kind of nonsense so I can really focus on worrying about how much I need to learn in four years!

This medicine thing takes a lot of time

In space, no-one can hear you be a massive nerd

I can't believe it's taken this long to find the time to do another post. Even worse, I can't think of a cohesive topic for a Friday night, so I (and subsequently, you) will have to make do.

Here's some thoughts:

1) I'm pulling 8 hours a day, a couple of hours in the evening and I don't think this is going ever let up. I'm not complaining, just sayin' is all. I'm balancing it out by knowing that you have to make sacrifices to get what you want. And any time I feel I'm a bit stressed by it all, I watch a little Randy Pausch and get a bit of perspective and a renewed eagerness to work harder.

2) My uni seems to think that one lecture on pharmacology per quarter is acceptable, but we have 3 comms sessions a week. This is the kind of thing I'm just going to have to address with a "suck it up and walk it off" mentality. I can't change it - we've had an opportunity for feedback, but I don't feel like The Man really wants to address this kind of thing. Whatever, I'll play the game, pass the tests and try and do more individual learning to make up for this.

3) Channel 4 do a good line in getting Britons to show off their embarrassing bodies. (Apologies to people who 

4) This week was a good week. I felt like I was on top of things for the first time in a long while. With PBL it seems very easy to cover just the Learning Objectives your group agrees on and not go much deeper. Then you rock up to the next PBL session and realise that other people have pulled out the lead a bit more than you and have gone deeper. Then you feel stupid and lazy and it means you feel at a deficit for the next round.

This week, however, I went deep enough and really nailed the issues we discussed in group. I feel more comfortable with the menstrual cycle than I have done for aaaaages. I feel like learned a lot and had plenty of positive input in the group sessions. My group of friends is getting tighter, too, which is awesome. I'm hitting the gym with one of my PBL homies on a regular basis and really lifting weights, on top of my prep for the Hastings Half-Marathon - so that's all good.

5) I may have also reactivated my EveOnline account. I'm not going to apologise - I need to indulge my nerd a bit and if by playing at being a spaceman every now and then, so be it!

Another space filler

Urgh, I am having trouble finding the time for a proper post, but here's a little something for this evening: The Differential Diagnosis

There as many ways to do this as there diagnoses (PRO TIP: It's never Lupus, but it might be TB) but the one my PBL group has settled on for the next few weeks is the acronym, Investigations - a like so,

Idiopathic/ Iatrogenic
Neoplasm
Vascular
Endocrine
Structural/ Mechanical
Traumatic
Inflammatory
Genetic/ Congenital
Autoimmune
Toxic
Infective
Old age/ Degenerative
Nutritional
Spontaneous/ Social

And as for history taking, I'm yet to find a good one, so I just end up humming...

Entertainment, journal style.

I have a proper post for this week, but I've just stumbled across A Good Poop and it reminded me that people write medical papers because sometimes life is just too bizarre.

It doesn't look like it's still being updated, but it does have a some intriguing papers and now I've got my BMA membership, I might well celebrate by hunting through the BMJ archives for more oddities...

One thing I have in common with Don Draper

Last night was a night out at The Blues Kitchen in Camden which was pretty awesome. It's quite boutiquey and didn't get crazy busy which was nice. There was some great food, proper American Southern fare and some great drinks particularly the Old Fashioned that I spent most of the night drinking. And unsurprisingly the music was blues, which makes for good background noise when you're eating, drinking and chatting.

I'm quickly beginning to realise that this kind of thing will have to be a once in a blue moon event as I am now coming to the end of my last paycheque. From here on out it's student loans and whatever I can get from the occasional shift - although I'm still yet to actually get on the staff bank.

The first of many

Another week down, first exam out of the way.

This week we covered a topic that I'm pretty familiar with, both from many years studying it and from having to care for patients who have had it. I hate being so cagey about the topic of the week, but our school teaches by PBL - problem-based learning and repeats the cases each year, so in the unlikely situation that someone from next year's group reads this they might get a feel for what cases they will see and I will get in trouble. Or something.

Gah.

Anyway, the PBL case was pretty cut and dried, compared to last week, so it was just a case of nose-to-book and sucking up as much information as possible. I think it's a little ironic that the course dresses up learning with so much back story, patient depth and the like, and it all just leads to going to the library and opening a book and IRL ctrl+c, crtrl+v. It's the self-directed aspect that I guess we do have the onus on us to work at learning, but still, I think my point stands.

Our exam this week was BSL (or CPR, depending on where you come from). It was a nice reminder for me that I still know it to a level considered competent. Inside a hospital CPR is a strange beast that doesn't involve "rescue breaths" and counting to 30 for the chest compressions, invariably because you're being led by an anaesthetist who is keeping track of everything for you. But for the sake of the exam I did my counting, I noted the lack of chest movement from Anatomical Annie and called for help in a suitably loud voice. I passed but was chastened for winking at the examiner on the way out. It wasn't a creepy finger-guns kind of wink, just a friendly gesture. The examiner didn't see it that way, but they didn't fail me either, so I'm not too bothered. Especially seeing as one of my course-mates failed AND got yellow-carded for swearing at the manikin.

And now the weekend, in which our intrepid hero tries to fix his bicycle so he can save a few pennies in train fare and lose a few pounds in excess body weight.