Blonde medic moment: number 1

Blonde medic moment: number 1

Ok, I've been thinking about how I can make sure I blog more even when I'm busy, and I've come to the conclusion that sometimes it might be better to write short posts about amusing moments even if they are not necessarily recent events or coming in chronological order with my main longer posts...


So here starts a new series of posts that I will slot in whenever I feel like it (and whenever they happen) "Blonde medic moments".


So, yeah, I'm pretty blonde in both a literal and metaphorical sense (however much I argue against the blonde stereotype when everyone else suggests it..), so sometimes on the wards I do some pretty stupid stuff, bad times perhaps but good blogging stories? Maybe :).

Blonde medic moment: number 1

An elderly care teaching ward round in third year...

So we are round an elderly lady's bed being taught by the consultant, there are only three of us and one of the other students is examining the patient who is sitting in her chair; I am the only student standing on the far side of the bed.

Now unfortunately the elderly care ward has a tendency to be very hot and whenever we  stand around a patients bed with the curtains pulled on that particular ward for some time I suffer from feeling really faint and like I'm actually going to faint or be sick (neither would probably be deemed particularly professional!).  So whenever I can I try to lean/ prop myself against things on the ward (eg. half sit on a radiator), perhaps not particularly professional either but when I feel like I'm about to faint I'll go for anything that might ease the faintness slightly! This ladies bed was unfortunately lacking in anything I could lean against and was incredibly hot and I was feeling awful, which is what lead to the first blonde moment (and probably chronologically was my first on the wards though certainly has not been the last!)....

As the patient was sitting in her chair, I decided to subtly lean slightly onto my hands which were on her bed (and yes I know, infection control wise I probably shouldn't have been but I promise that a) I had used alcohol gel on entering that patients bed area and b) It was that or potentially be sick on her bed..the greater infection control risk!).  Now what I hadn't realised as I did this was that firstly the patient had a special air mattress (not sure what her reasons were but special mattresses tend to be for reasons like stopping bed sores) and secondly that the valve was right near where I was standing...

Yes, you guessed it, suddenly there was a loud raspberrying sound and the bed started deflating rapidly before our eyes.  The other students were not touching the bed...

I didn't actually even try and say this... that probably wouldn't have gone down well!

The consultant was actually a very nice consultant and looked at me with a mixture of amusement, exasperation and pity as I turned beetroot and frantically (and unsuccessfully) tried to fiddle with the valve and stop the bed from deflating.  In the end he continued teaching and I had to sheepishly ask a nurse to re inflate the patients fully deflated bed after we were finished.  Not my finest moment but probably not my worst either... more to come in the future :p.

Patients bed didn't look dissimilar by the end...

Physician don't heal thyself

Physician don't heal thyself


As well as having hospital rotations this year, I also have 8 morning GP practice visits.  A couple of months back one of my visits was postponed a week before it was due to happen because the GP was ill which I remember thinking was quite worrying because to be able to give a weeks notice of illness the GP was clearly suffering from more than just a mild infection.

When I did have my visit with him I wasn't going to ask what had been wrong with him but he quite happily told me what had happened of his own accord and it was a good warning story about the dangers of self diagnosing when you are a medical professional...

Basically he had been having a very stressful few weeks and had been feeling quite tired and rundown and noticing periods where his heart skipped beats but as he didn't really have time to get checked out he just ignored these until one day at work when he got angina like pains.  So not feeling he had time to get to his own GP surgery (and fortunately doctors cannot prescribe medication for themselves) he asked his gp to fax him over a prescription for GTN spray (the reliever of angina) and said he would get to the surgery for an appointment later in the week.  His GP quite rightly refused to do so unless the GP came in immediately for an ECG.  So the GP moodily agreed to do this but was annoyed at having to when he was so busy.  A good thing he did tho......

On having the ECG it was discovered that the gps chest pain was not due to the traditional cause of angina (the hearts own arteries getting "furred" up with fat gradually over the years causing a narrowing artery and so reduced amount of blood being able to get through causing the hearts muscle to not always get enough oxygen especially at times when the hearts muscle is having to work harder eg when the patient is stressed or exercising) but because he had such severe bradycardia (slowing of the heart) that his heart was simply beating too slowly for enough oxygen to reach the hearts muscle for it to undertake even this reduced level of work.  He was having up to 7 second gaps between beats. GTN spray works on angina by dilating the constricted arteries to an extent, as this was not the priniciple cause of the GPs pain it was unlikely to relieve his symptoms and bits of his heart muscle will have started to die off (not to mention the fact that other vital organs such as the brain will also have been depleted of oxygen).   So thanks to the GPs own GP refusing to be persuaded to prescribe without seeing him, the GP was rushed in to have an emergency pacemaker fitted, something which actually would fix his heart problem, and now he admits he feels better and has more energy than he has for years.

Whilst doctors undoubtably have the knowledge to technically diagnose and treat themselves, when it comes to their own symptoms they can be blinded and biased by their own beliefs about themselves and health agendas.  Self diagnosis...not a good idea!

Interestingly I've noticed that when it comes to adult doctors they are likely to be quite dismissive of potentially serious symptoms whereas medical students are the complete opposite (at least based on my housemates, close friends and self) and even a simple  2 second itch is proclaimed to be pruritus secondary to kidney failure.  Honestly we've all probably used our stethoscopes more times to listen to our lungs  when we have a cold than to actually examine patients!  Sometimes we do get it right tho..or at least describe our symptoms in such a correct way that persuades the doctor we are right or leads them to treat us accordingly just to shut us up!

  I wonder when the hypochondria wears off and the apathy sets in ?  

Halfadoc x

The eternal struggle to get into clinic

The eternal struggle to get into clinic

Everyone knows getting into a secondary care clinic as a patient can be difficult, what with the occasionally massive waiting lists etc. But sometimes it feels like its just as hard to get to sit in a clinic as a student!

One of the main problems is often persuading whoever is sitting on reception to allow you to even find out from the doctor if they are happy letting you sit in on their clinic. My year at medical school is massively over sized because lots my orginial year intercalated like myself but very few of the orginal year below intercalated meaning that when we dropped back down into the year below the new year group was suddenly massive. As a result the medical school had to find a way to squeeze us all in to clinical sessions somehow.  The result of this has been having clinics that are further away, clinics which have more students in than ideal and some lectures where we have literally had to share seats! 

The doctors running clinics have agreed to take a given number of students per a clinic which is higher than normal in order to try and prevent us losing out on clinical experience, so this year clinics that traditionally only took 1 person now take 2 and some 2 people clinics now take 3 students.  Unfortunately news of this either hasn't reached nurses/ person manning reception desk or they just don't approve of so many students in one clinic and make it difficult for us to get in there anyway.  Its a difficult position for us to be in because on one hand we as medical students to do not want to get on the wrong side of the nursing staff and they do have the power to stop us from getting to clinic, on the other hand if we don't get into the clinics we are timetabled for then we will fall down on attendance as it is very difficult to get into another clinic as a different student will be timetable for that one (and whilst there are an irritating subset of students who will happily steal a clinic from you by turning up a lot earlier than the scheduled time meaning when you get there on time you get told "No sorry theres already too many students here", I am proud to say I am not one of them).  


So clinics become an exercise in diplomacy just to get into them, and then if after all that struggle you end up with a doctor who doesn't teach you and entirely ignores you, it certainly doesn't leave you in a particularly great mood by the time you've wasted a multitude of hours learning nothing....


I've just started ophthalmology and so because its not a particularly sensitive area, I have been scheduled to sit in a clinic every wednesday morning for four weeks where there are 3 students in the room.  The corner where us students were crammed was tight (i was quite literally hugging up to the sink) but the patients side of the room was still spacious and none of them seemed to mind us being there and the doctor was more than happy to have all three of us and said he was used to having so many students on a wednesday morning. Yet you wouldn't have thought this was a weekly occurrence from the response I got from the nurse when I turned up 5mins before the clinic was scheduled (and standardly 30 mins before the doctor actually appeared!):


Me: Hi I'm a fourth year medical student, i'm due to sit in a clinic with Dr x *winning smile*
Nurse: *Impatient shake of head* No there's already two students here, you will have to come back some other time.
Me: Oh ummmm we are timetabled to have three of us here every wednesday.....
Nurse: *tuts* That too many.
Me: Oh ummmm err its just thats what we are timetabled...* apologetic look*
Nurse: *sigh* Do we really NEED three of you??
Me: Resists urge to say that we are students and the department never really needs us but we need to be here for our education and are due to be here and the hospital recieves extra funding for taking students and being a teaching hospital
Me: ummm errrr timetable errrr errrrr ummmm :/ 
Nurse: SIGH, fine follow me, will see if the doctor lets you stay when he arrives.
Me: *scuttles after*


Fortunately this particular clinic ( if I had a pound for every time I had had this conversation this year I could probably stop renting and buy my own house, sadly sometimes we never get into the clinic we are meant to be attending) was good (I finally managed to see the Optic disc through an ophthalmoscope, wooooop!) and the doctor very kindly taught us lots despite being busy.  Good thing it was good as I predict the same struggle this wednesday, and next and next and then it will some other poor group of students turn :p.  So spare a thought for the poor student (s) huddling in the corner next time you see the doctor they may have had more of a struggle to get to be there than you! 

I'm not saying I think there should be quite as many students in clinics/ theatre as shown  here mind you!