General Medicine

oooh the most important run of my year… so dreaded but its what good doctors are built upon. It will apparently make or break our first year out as a doc… intimidating

so my first week on general medicine is well and truly here. it is as if the whiffs of vascular surgery were mere lingerings in a past life. I do somewhat miss having a ‘home ward’  – the one and only ward I hung out in for vascular.

its been a quite tough 4 days so far- I have not properly studied in fear for like 6 glorious months – not after my big 5th year exams. relaxing but less mentally challenging and rather stagnant. Thus I am no way ready to face general medicine – where drugs actually matter (mainstay of treatments) and its not about cutting patients open anymore… I am very used to writing at the top of the plan for a patient – NBM/ ‘nil by mouth’ but it sadly no longer applies.

my consultant is an interesting one. quite as anal as most of the surgeons I have met so far but more tame thankfully. no aggressive insults are inflicted. just some milder ones I can swallow most of the time.

self beating up ensues especially after challenging rounds where I get thrown curly and not so curly questions. I do not care if I do not know from memory the bioavailability of oral frusemide. But it does hurt when I can not present test results that I did know in the mists of time but the mists are so thick now it can not be dredged up – it stubbornly refuses to settle out into a usable format. Then I miserably fall to depths of ‘oh god – i am an invalid student having embarrassed myself’ and ‘oh god I am definitely going to fail this run’… fatalist thinking is not healthy for the soul.

it is equally annoying that every time I can not answer and get a mind block – i have this unshifting mental image of a HUGE gloop of green gunk that falls repeatedly onto the consultant’s head – glooop – gloooop – glooop – splat!

– this also does not inspire much intelligent thoughts/ answers to follow …

walking to school today in the rain – i even had silly thoughts such as – when a consultant asks an impossible question and the registrar stands impotently there not helping – i wish i had magical powers of sucking all intelligence out of the registrar – this ‘brain sucking’ technique leaves the target like a drooling 9month old mess of an infant – useless as cherry pie. Then I can triumphantly say all necessary answers!! hurrah. Then I can give the knowledge back to the registrar in a noisy woosh – audible only to me- for the registrar to snap back into sensibility. All of this goes unnoticed by everyone of course.

yeah right – I need to start drinking coffee instead.

After that preamble… I am really driven to write to illustrate my weird and wonderful day. Not really – but u know- I can be just like my funny patient who eagerly says every time we see him on ward rounds: ‘you know I have had many weird and wonderful diseases…’ and these diseases are in fact common ones like appendicectomy, reflux etc. well I guess they are ‘out there’ for him. Unfortunately it is hard to impress doctors with such diseases!

My day was very up and down today. Maybe the fatigue is getting to me? I do get emotional when I am hungry or tired or sick. How lame. Not quite the invincible goddess I should be.

So after being thoroughly sick of failing every ward question of the day (in my mind anyway – it was not that bad), damp with the shame of it all – luckily there were no other student witnesses – getting smashed aint too pleasant- I thought “I can not possibly be a doctor!”

What a surprise! it is the first time I have ever even thought this – On top of “I can not envisage a life of learning crap I am not interested in”. Dont get me wrong I love many things about medicine (but respiratory is not one of them) but I was in a bad mood and this was not helped by my cloud of ignoramous hovering in my vicinity.

I knew deep down it was just a passing thought from frustration – very much like when you are REALLY angry – thoughts of killing yourself passes through your mind briefly – but you only do so as you are angry and never really go back to dwell on the thoughts when the hot iron of anger has rapidly cooled down!

But I could empathise with people who hate their jobs. Man it must really suck. I could also see why doctors who have studied for donkeys years do not go on when they know they can no longer go on anymore. It is just not possible to do medicine half heartedly.

I do know an internist – who hates his job and moans to everyone. I thought him a little ridiculous – but I can now sense on some level the misery he goes through every day…

But being on acute take and having to miss things in my normal schedule was not fun. Nor was getting a grumpy uncooperative patient.

However somehow things swung around for the better. I dont know when exactly it happened – but immersing myself in the patient stories helped a lot somehow. It helped my forget what a crap morning I was having. The mini despair evaporated slowly away like washing waiting to dry on a overcast day.

Getting things organised / clarified and happening for my patients from the reaches of my efforts was empowering I suppose. And getting a run of lovely, funny and just plain nice patients is uplifting to a degree. I had a very interesting case to end my night. I actually was thinking of what their diagnoses will be on the drive home, while I ate some food, washed my hair etc – its interesting and stays with you.

Then I realised – just like surgery with its moments of beauty – it exists for medicine…

I do have two snapshots of surgical beauty in my mind to unleash onto my blog but it will have to wait another free moment in time.

A tip for future patients – if you want good care – make your doctor laugh – its awesome cos you will get a doctor to care even more about how you are managed!

So in summary I was compelled to write about the unexpected thoughts I had today and how it changed so dramatically without my conscious effort. Minds are fascinating entities. I mean how can you logically plan to have a big thought of ‘medicine sucks so bad —> to morph into —-> medicine is so beautiful and inspiring’?

sigh… over and out by almost-doctor-drama-queen-extraordinnaire