Contagion

from riz94107's photostream

It was inevitable. I have succumbed to some horrid little virus and I am laid up in bed.

My wife brought this back with her one day from the school in which she works. Those bipedal plague factories by which she insists on being surrounded. After going climbing yesterday I came down with shivering a blocked nose and sudden urge to clamber into bed. We'd invited some friends around for dinner and I thought would man up and try and play mein host.

We got to the end of dinner and I felt like I had not got better at all. Since I was a child I've known I was getting unwell because my flesh felt like it was crawling off my bones. A bit like a spidey-sense, but not nearly as cool. 

I'm not running a temperature and I suspect by tomorrow I will be well enough to return to school. I doubt my PBL group will have suffered due to my absence and we kinda know what the disease of the week is before the case even starts which is nice. The one thing that being ill has allowed me to do is sleep. I slept for greater than 8 hours last night (waking once for my alarm which I'd forgotten to turn off). And it was glorious. Even with an over-arching crappiness that surrounds me, I can't remember the last time I slept for so long. I don't know when it will happen again.

Uh oh.

A Facebook message from someone in my PBL group:

Wait, what?

Ah. Okay. Guess my notional anonymity has pretty much gone, then. To his credit, my colleague has said he won't announce it to the class, so thanks for that. And, y'know, feel free to comment ;)

How much is enough?

words of wisdom from Wonderella

Today was rectal exam day.

But more importantly, it reminded me how I don't have enough time or energy or ability to be the best.

And how, on a low day, this is really dragging me down.

I don't understand it all, my clinical skill set from nursing is yet to be useful and I am surrounded by over-achievers, Rainman's marginally more socially adept cousin or full-on alpha males. And me, I just want to pass.

I know I can be a good doctor. I know this. Get me on the ward, give me the chance to flex a little communication skill, let me lay hands on a genuinely ill person or something where I can show my quality. I'm tired of the let's pretend of clinical skills where say all the things we don't see (no sign of clubbing, splinter haemorrhages, xanthelasma etc etc) , the PBL sessions dominated by pointless displays of obscure, clinically irrelevant, scientific knowledge, the lectures that wander around the point without actually helping me learn.

I laughed when I saw the entry on Stuff Medical Students Like about "Time". But it's funny because it's true, to quote Homer. I don't feel like there is time enough in the day. It is some small degree of schadenfreude that most people I talk to on the course say this. I think the worst bit of it all is that I feel guilty for any time I spend not doing something to help me with medicine. Go to the pub? Go to the gym? Go to the cinema? This is all time I could better spend learning about Vitamin A metabolism or the pathways of the facial nerve or any number of the myriad little bits of information I need to have at my fingertips, because as one of today's lecturers said:

"One day you're going to be sat in A+E at 3am and not have a bloody clue what is sat in front of you"

And that, I guess, is what scares me the most. That I don't feel I have enough time now to be the best and one day, someone's life may well rest on me remembering that symptom X is a tell-tale sign of disease Y which if not picked up will kill them in a couple of hours.

So I work as hard as I can, but I don't feel like I've covered everything. And it doesn't matter how many times I can answer the lecturer's questions, the one time I can't, some else can - which undermines any sense of confidence I have about the topic. It's sick really.

On the upside, Father's had his angio which showed, to quote the radiologist "pristine coronary arteries", so that's something :)

Because this week is Asthma

Our PBL case this week is Asthma. Which means I know what YouTube clip I'll be sharing in tomorrow's session

It begins. Again.

An Absentbabinski in repose

You win some, you lose some. First day back was more successful than I expected! Second day back was pretty depressing.

I met up with my new PBL group and quickly realised there were quite a few strong personalities which will take some time to start to gel. I figure this is as much about the types of people who go into medicine as much as anything else.

The theme of the week is hypertension, so the practical was cardiovascular exam - allowing me the chance to bust out my new hunter green Littman Classic. I know it's corny, but you drape a stethoscope around your neck and suddenly you feel a bit less ridiculous running through the "Hi, I'm a first year medical student..." spiel.

The comms session was filmed this week which was pretty exciting. We sat with an actor practicing history taking whilst the lecturer filmed the 5 min "performance". I really enjoyed it, partially because I felt challenged by the situation, but also because it gave me a chance to do something I enjoyed as a nurse - talking to patients. If I could be sure the actor wouldn't mind I'd upload the vid to YouTube and give you the chance to rate me!

The downside of the week was two-fold. I had to face up to having not got the best results in my first summative exams. The marking is split into Basic Clinical Science (BCS) and Personal Professional Development/ Community Population Health (PPD/ CPH). My BCS marks were sound (as I expected), but my PPD/ CPH mark fell short. So even though I passed the exam overall, I was called up as a "cause for concern" on the PPD/CPH. I think it was a bit overly dramatic, seeing as how I was told that I would just have to up my efforts in future exams to ensure I keep the mark for PPD/ CPH well above passing in future exams. The head of exams also suggested some materials I could look at to help clarify some of the concepts I seemed to struggling with. So not awful, but still a bit galling.

This was followed up by a lecture on hypertension that forced me to face up to the fact I am pre-hypertensive. I've known for a while, but not really wanted to address it - typical male/ medical response to the notion of illness. I've been feeling pretty stressed about the exam results, money (surprise, surprise) and just generally the future (various things I'll go into in a future post, I'm sure), so having a lecture remind you that you really need to change some aspects of your life, because you are inherently unhealthy just left me emotionally drained. Not great.

I think I need to read Desiderata more frequently:


Nurture strength of spirit to shield you in sudden misfortune.
But do not distress yourself with dark imaginings.
Many fears are born of fatigue and loneliness.

I'm sure part of this is just nerves from restarting the med school journey again, which will subside when I get back in the saddle. The other bit will probably be resolved with me passing my next exams with marks to spare and once I start getting shifts on the staff bank.

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!