30 Day challenge: Day 2

from m22+'s flickr photostream

Day 2: Where would you like to be in 10 years time?


I was going to start this post with a fatuous statement about wanting to be a doctor in 10 years time and leave it at that, but then I realised this question is one that has a dozen different angles to it. So I will try and answer it from a few of them.

Career in 10 years time? Well, I would hope that I will be well into my Specialism Training (for the non-Brits in the audience our doctors spend 2-3 year post-qualification on the Foundation Year programme before entering specialist training or the "ST" years. This leads ultimately to the role of Consultant in a specialist field). I don't know now what speciality will take my fancy, but I want it to be one where I make a real difference to as many lives as possible. And one that satisfies my desire to learn and develop skills. And hopefully a speciality that pays enough that I can help support my family and give them as many opportunities as possible.

Location in 10 years time? I've talked with my wife about going back to America (she being an American) - It's something I think would be very exciting and would offer a lot of opportunity to me and would, I think, make her feel more comfortable than living in the UK does. We've also talked about the possibility of moving to Australia or New Zealand - both places I think would be interesting places to live and would have similarities to the UK, but enough differences, too. I'm not really desperate to stay in the UK.

Physically in 10 years? I want to be faster and stronger than I am now. There is a line in Hagakure that states (and I misquote, probably) "a man should gain strength until the age of 50". Now read into that what you will, but it sounds like a pretty good aim to me. I want to run a marathon before I'm forty and work to gain a black belt in a martial art. These seem like reasonable goals to me.

Mentally in 10 years? I want to be happy with all that I have achieved and all that I have planned out. I figure if pursue my goals with good spirit and punch just above my weight, these too should be reasonable goals.

Right, introspection over, my pasta is pretty much done.

Laters~

30 day challenge: Day 1

Estelle Darling over at Word Lust introduced me to this notion and I was looking for a fun way to increase my output here so I thought I'd give it a go.

Day 1: Your current relationship

Mr and Mrs AbsentBabinski

I have been married for the best part of a year now and it has been a lovely development in my relationship. We lived together for a couple of years before we got married and it felt the natural progression and to her credit my wife is one of the major reasons I can pursue my medical career. She has been the bread winner since we started dating and will continue to be so for the next 10 years I suspect. She is also long suffering and knows just the right thing(s) to say when I have my regular "Why did I leave nursing? This is crazy! I should be earning money for us!"

She is my confident, and my best friend. And the person I hope to spend as many years of my life with as I can.

We have totally different tastes in so much, but we make it work. In fact we have the dubious honour of annoying my wife's friends by not arguing about... Anything, really. I think that's why we work, we might have different tastes and views but we respect and love each other.

Someone once told me that when you apologise, you're not admitting you're wrong - you're stating you respect the relationship you have with the other person more than being "right" (whatever that means). And that's what guides me through the harder bits of being married.

Do not look for patterns. Look for patterns.

George would be proud :)

Inspired by a bit of med school doublethink. On Tuesday afternoon last week we were told "Do Not Look For Patterns!" when it came to ECGs, by one of our clinical skills lecturers.

Shortly afterwards, we had a consultant cardiologist state "You should be able to identify around 20 different patterns on an ECG by the time you qualify".

So in a bid to upset no-one, I present a link to a cheat sheet I found whilst finishing off this week's LObs (Learning Objectives, it's a PBL thing)

ECG cheat sheet from ECGpedia

I've bookmarked ecgpedia for future reference. I think we shall become close friends over the years.

Why does my heart, feel so bad?

Actually it doesn't. But I thought of that title for this post and couldn't come up with a better one.

Clinical skills this week was ECGs, which I have done hundreds of times as a nurse, not really understanding what I'm looking for, sticking the dots on, pressing go and calling the doctor. I know what a QRS complex should look like and that lead II is my rhythm strip but that's about it.

To be honest at this stage of med school, we're not expected to know much more than that, but we have been given a bit more knowledge and explanation for what we should expect to see on which lead. It feels great to have a little bit less mystery in my world and a bit more knowledge that I can apply. I'm sure it will take the remainder of my course to really get to grips with ECG's, but I'm happy that I've understood everything they've explained so far.

yup, I think I'll live

I've been told that ECG's and CXr's are the hardest things to analyse, but the most useful. So I guess I might spend a bit extra time with this, even if it's not going to be an OSCE station, I think the clincal application warrants it.

(P.S. Anyone else see a bit of the old exercise-induced left ventricular hypertrophy? :P)

Boom

Now I know I shouldn't be too full of bravado but yesterday was a very nice surprise:

I'm really hoping whatever damage I did to my hip has resolved itself. This means I could still, *just*, be on for my half-marathon in March.

Maybe.

Nurse, med student, patient

Last week was all about Asthma and as an asthmatic I had the opportunity to fill the role of expert patient for my PBL group.

"Expert patient" was a phrase I heard bandied around during my nursing training as a kind of gold standard of educated, engaged patient - someone who "knew more than the doctors". I found by and large patients just wanted to be told what to do and those that knew their condition inside out were more of an annoyance "I don't take my pills now/ do you even know what you're doing/ why can't I keep my tablets on my bedside table?" than a useful resource.

But here I was, telling my group about the ins and outs of asthma, medication and emergency care. I've never really thought of myself as someone with a chronic illness - I've never missed work because of it, never had an ED admission because it, exercise as well as anyone on my course (110% of predicted lung function and capacity, what up). But in my backpack is my salbutamol inhaler (just in case) and I take beclomethasone 50mcg BD, so I guess I am chronically *ill*. It was the main reason I didn't get into the RAF after my nursing training. It gives me pause for thought when it's really cold out. I know what it feels like to have your bronchial smooth muscle contract, leaving you fighting for breath. It's terrifying.

My mother was a stickler for me knowing my condition, I used to read her BNF in high school and learnt early on about corticosteroids and beta agonists. Then as a nurse I learnt about nebulisers, anti-muscarinics, how to read a blood gas and how to correct it and what to do when the shit hits the fan.

The week really pushed two thoughts to the front of my mind:

1. There is value in the expert patient. I am one - I know how to manage my chronic disease and I would kick up a storm if I thought a healthcare professional was treating me incorrectly
2. Respiratory medicine is something close to my heart. I'd never even considered when, sat with coursemates and coffee, the question is asked "What speciality do you think you'll get into?"

Food for thought.

Keep death off the roads. Drive in the cycle lane.

I have become a cyclist.

Which is to say, any given weekday morning 0800, I don my Hi-Viz orange jacket and trusty skid lid and take my life in my hands battling the half-awake drivers of South London.

I spend 30 minutes practicing my defensive cycling (generally involves pointing at drivers poking their noses out of side roads and into *my* cycle lane), working up a sweat and a sense of modest superiority.

It does generally mean that PBL mates and lecturers alike see a little more hairy calf than anyone wants to see, but hopefully I'm burning off the Christmas calories.

And I've discovered that to be a cyclist on my course is to join a clique I didn't know existed. People are coming up to me asking how my ride in was, suggesting websites to buy gear and generally giving me props for riding in whatever the weather. What other mysteries will this lifestyle open up to me?