In which I get upset about a patient

It's odd how different human beings are. How even two people who can be considered relatively similar may be confronted with the same situation and respond completely differently.

I remember a discussion I had with a friend of mine about our placements at the start of fourth year. She was on neurology at the time, and had seen a patient newly diagnosed with a progressive condition. I couldn't understand why on earth she was so upset by it. She'd gone home, she told me, and cried. Her poor patient was "only 50" and seemed "unaware that there was no treatment". I didn't understand why that was so sad. Sure, progressive neurological conditions are horrible, but her patient was 50. Thousands of people are diagnosed in their 20s - including a relative of mine, who died in her 40s. That night, I phoned my Mum. I was worried, really worried. I'd always thought I was a caring person, but perhaps I was wrong. My friend was obviously extremely moved by something that didn't really bother me. Since then, I've seen probably a few hundred patients, each one with their own (often tragic) story to tell. At most, I've felt a little sad for them.

Last night, for the first time, I was genuinely upset by a patient I'd seen. I was moved to the point of tears, felt nauseated, couldn't focus. I can't explain why it was last night that this really hit me. The patient was a child* I'd seen on my elective who was diagnosed with an advanced malignant condition. He was 3. He'd only been ill for 2 weeks. Something about this child really got to me, and I've found myself thinking of him numerous times over the past few months. Perhaps it was his family set up (older sibling and then twins) being the same as mine. Maybe it was that despite having worked with many children who have cancer, I've never actually seen the process of diagnosing it. Possibly it was that he was just so cute and cheeky. Who knows. Whatever the reason, he affected me in a way I haven't been affected before.

We are all different and we all have different reactions to scenarios we are confronted with. Our own experiences and personalities shape how we respond, but sometimes we can't see any logical reason for the emotions stirred up inside us. As a future doctor, I am well aware that I will shed many more tears for patients. Patients and their friends and families will in turn make me happy, sad, angry, amused and a whole range of other emotions. In my opinion, the important thing is that I care for them all appropriately, regardless of how I feel about them.

When I started medical school, I wanted to know everything. I wanted to be the sort of doctor who could answer any question, who could "solve" any mysterious case, who knewthe solutions to the rarest of problems. I still think that would be great (if unrealistic). But for now? I just want my patients to feel that I care.

*I would hope that by not mentioning where I was and keeping the medical details vague that confidentiality is not broken here but if anyone senior thinks I'm being unwise, please do say something.

I'm A Terrible Blogger!

v note with some shock that it's been 3 months since my last update. Time has flown by pretty quickly and I'm now over 25% of the way through my final year in student-ville. I've been pretty busy so here's a brief update:

- I got back from my elective 2 weeks ago. A couple of months in New Zealand flew by ridiculously quickly. I had a fantastic time there, the people are super friendly, the country is beautiful and I learned loads on my hospital placement. I was based in paediatrics and got loads of hands on experience, including sticking venflons in neonates - something decidedly easier than I'd expected it to be. I'm seriously considering moving out there for specialist training. There were quite a lot of British registrars at the hospital and it's apparently pretty easy to get jobs.

- I have a job!! On 15th September I unfortunately didn't get offered a job in the first offers round, but was placed on the waiting list by two deaneries. However a couple of days later I got an offer for an acamic medical job. After briefly considering what to do, I decided to accept. I've already spoken to one of the consultants I've worked a lot with and he said he's happy for me to do the academic part of my job in paeds, so I'm super happy.

- At the moment I'm on placement in gastroenterology ward. I'm actually really enjoying it and it's been really good for showing me what I know and what I still need to learn. I've also got to do a few practical procedures; last week I got to put in a paracentesis drain which was pretty cool. However, what scares me about this placement is that the first two weeks have already flown by and there are only 6 before the Chr!stm@s holidays, when I'll technically be half was through the year. Terrifying.

Anyway, those are the major updates. I shall attempt to blog more regularly from now on, although no doubt my posts will be more medicine and less job related now the AFP is secured.

xxx

Somewhat Overdue...

Greetings from Kuala Lumpur! I'm currently here for a couple of days en route to my elective placement in New Zealand. Staying in a rather basic (but clean!) hostel, exploring a new city and chilling out so that hopefully by the time I arrive in Hawke's Bay on Friday morning I'll be nicely rested and relaxed :)

The lack of updating recently has been due, in no small part, to me deperately trying to get organised for my elective. However, I also had my last week of work at my job (summarising medical records in a GP surgery - just can't commit a reasonable amount of time to it this year), 2 weeks of uni and an interview for the Scottish AFP. I'm hoping that justifies my silence in the blogosphere!

Having got back from my Sense holiday, I had 2 days at my parents' house before returning back to my uni flat and working for the final week of my summer break. It was quite odd finishing as I've been there over 18 months and actually really enjoyed it. I would happily keep it up, particularly as the money would be handy, but with elective, placements, finding an FY post etc I just don't think it's realistic to pretend I can hold do a job. Once I was done with work, I had 2 weeks of (pretty dull) classes on professionalism, communication skills, careers and all the other dull stuff you have to do at medical school aside from the actual medicine. It does feel quite strange knowing that, after all this time, I'm actually in my final year of medical school and if all goes well I'll be a doctor in less than a year...

As I mentioned before, I had an interview for the Scottish academic foundation programme on Thursday. It was a really difficult interview to prepare for as I genuinely had absolutely no idea what to expect. The interview was in 2 parts, a 10 minute interview with 2 clinicians (in my case a GP and a liaison psychiatrist) on clinical issues and a further 10 minutes with 4 academics on the more academic side of things. The clinical stuff was ok, largely about communication, professionalism, good qualities for a dr to have etc - really quite similar to the kind of things they were asking when I applied to med school, but looking for more specifics as I actually know some medicine now! I did screw up a bit when they asked how I'd treat an insulin overdose because we've never been formally taught that so I didn't have an answer to hand the way I would if they'd asked about, say, DKA or acute asthma or paracetamol overdose, but I'm hoping that I managed to come to the right conclusions eventually, and if not, the fact that I said "call for senior help" will give me some credit! The academic part was really difficult as it's a bit strange trying to talk to 4 people at once, but the questions themselves were easy enough to answer and the panel all seemed really nice. I hear either way on September 15th so just got to keep my fingers crossed until then - although it's not the end of the world if I don't get it, it would be nice.

Right, it's 11.30pm here and I'm hoping to fit in a decent amount of sightseeing tomorrow as it's my last day here, so I'm going to sign off and head to bed.

Hope everyone's keeping well and I'll update about New Zealand once I get there :) xxx

Busy Bee!

Why is it that weekends seem to go by so quickly?! I had so many things I wanted to get done, but am nowhere near through them. My list looks a little bit like this:

1) Finish neurology revision and start on gp stuff
2) Work on application forms for academic foundation programme
3) Complete pre-elective reading, write up findings and send to host supervisor
4) Work on systematic review for home supervisor
5) Clean kitchen and bathroom
6) Do food shop

So basically this weekend I've successfully cleaned my flat, and bought some food. Useful, but not exactly the top priorities, were they?! I have done some neurology (and covered a bit more in clinic this morning), but I really ought to have finished it by now. I've added nothing recently to my AFP forms - I'm struggling to answer questions such as "explain how your SSM or elective demonstrates your suitability to an academic post" - argh! I did do a little bit of my pre-elective work, but ideally I would have finished it. My host supervisor is very relaxed so there's no pressure, but it'd be nice to have out of the way. The systematic review has been largely ignored, but I'm less concerned about that as there's not a lot I can do until I receive other people's information.

I probably spent too much time catching up on Grey's Anatomy - what a tear-jerking season finale! I actually cried more than I did at the end of season 6, which I didn't think possible! Anyway, it's now finished, so I suppose that's one less thing to distract me this week.

Better get back to the books...