Sanctity of life

I am not a religious person, but an experience I had made me, for the first time I feel, realise how special we condsider human life.

Was in A&E with my colleague. Whenever we are there, nothing exciting really seems to happen, we see a lot of good medicine and a lot of good care, but nothing really exciting like you see on the TV. There is the red "Bat-phone" that rings if the ambulance people think the case is serious enough to need further attention and it had only rung once before when we have been there.

It rang again. ?CVA heart rate 30. We've seen plenty of ?CVAs before, but the red phone never had rung before. Perhaps the paramedic had a feeling. When the guy arrived, everyone crowded round. The guy was pretty stable, his BP was a bit low, but the SHO had done all she could. She also had a bad feeling, she thought that he could arrest at any moment so we ran him round to resus. Surely his family must have known that this was something very serious.

Anyway, we stood in resus for an hour and a half and the guy had x-rays, CT scans etc. He was eventually stabilised, DNR'd by the consultant and the guy's family and sent to MAU.

Two medical students, three ambulance staff, one medical SHO, two nurses, one SHCA, one medical registrar, one consultant physician, three radiographers. 14 people all making sure that the patient was OK.

I think that is truly special.

First week

Well, the first week of placement went well...eventually. On Monday, it was kind of a "what the hell am I supposed to do" event whereas the rest of the week was enjoyable.

Monday, as I said, just spent the day wandering around the hospital and having talks on all sorts of things, really started to worry about what we are supposed to be doing!

Tuesday, things got better, went to a drug rep free lunch and got lots of post-its and pens. Our consultant had a go at the Pfizer rep for saying that Lipitor (Atorvastatin) is clinically significant at 3 months but statistically significant at 6 months, which he says is impossible.

Then had a free afternoon so booked ourselves into A&E for the afternoon, which must have been the most quiet A&E ever! Only about 15 patients in 5 hours, though the nurses did tell us off for saying it was quiet; they didn't want us cursing their ED. Some really nice people in this hospital, which make a change from the "oh no, not medical students.." attitude that i've come accross many times before in the bigger hospitals.

Weds, thing we observed lots of procedures here, which was a good experience. At one point the consultant shouted at me "quick, get some gloves on and help!" which felt cool. The other member of my group was holding the patient to the bed which I was making sure the wires weren't ripped out of the gastroscope!

Thurs, went to GPs, who modify their surgery to have double length appointments while we are in clinic with them. Saw some interesting cases again, including a young girl who wanted contraception (Gillick competence issues, her mother wasn't there), a woman who thought she was going through the menopause, to which I had no clue what to ask, a man with musculoskeletal/?cardiac chest pain and a young woman my age with otitis externa. A good day our GPs are friendly and really good doctors.

Friday, our Academic half day, not much, but did some more BLS training and learned how to resuscitate an intubated patient and how to use a bag and valve mask instead of mouth to mouth.

So a good week. Have a few days off next week so should be able to get into A&E, theatre, Radiology, etc and have some more fun!!!

Looking after your own

I had an X-ray a while ago, and as a result I have just been diagnosed with a chest condition. Namely Chronic Obstructive Pulmonary Disease. For the medically minded among you, I am not, and never have, smoked. I am not in my late sixties or early seventies.

I am 20.

So why do I have the tell-tale hyperinflated lungs which are so stongly associated with the condition?

I hope to have all these questions, and more, answered when I go to see the thoracic medicine consultant in a few weeks time. But will he look after me?

I read months ago in the studentBMJ an article from a like-minded student who thought that we (medical students or any other health-care professional for that matter) should get preferential health-care treatment - a kind of "look after your own" mentality. And why not? I'm on full time placement - any missed time could cost my learning dearly. I have to travel 20/30 miles to get to the hospital from my placement (which seems ironic, as I live about 10 metres from the nearest hospital). I want to be seen quickly so I can be treated and get this business sorted out.

A few years ago, my grandad had a collapsed inter-vertebral disc. My auntie was an ICU nurse at the time. Lots of anaesthetists work on ICU, so it's fair to say that she knows lots of them. When grandad needed his operation he was fast-tracked through the system because of my auntie's "connections." It could be argued that this kind of behaviour is outrageous. I can see the point that a more needy person may be being robbed of their life-saving operation because people want to get their friends sorted out first. But that's probably because i've been listening to two years worth of "managing resources" lectures.

Do I tell the consultant that i'm a medical student when I walk through the door? Or do I wait until the end-of consultation pleasantries when he/she asks me what my job is? Either could be risky.

Oh well.

Back in Hell

Just got back to a certain lovely city in the north. Went shopping, and now at home in my beautiful new house! It's so much cleaner and generally nicer than the tip that we lived in last year.

However, I don't get long to enjoy it - on Sunday i'm moving to start my first rotation in NDME (basically GI and anything abdominal) at Scunthorpe General!

£££

Nothing much has been happening apart from me operating the lottery terminal at work for the last 4/5/6??? (i've lost count) weeks. Today, finally, after 5 years working there, someone popped in, expecting to lose as always, and had matched 5 numbers and the bonus; she wins £42,000.

She did not believe me.

Good for her.

Junior Doctors; Eat your heart out

The European Working Time directive is old news. Junior doctors are not supposed to work more than 48 hours a week. They, of course, still do. And so do many other health-care professionals.

Including medical students. Especially in their holiday time.

What do medical students do in their holidays? Well, you may go away with the family, take a week or two away with your better half, or if you're part of the lucky few, you'll go travelling. Lots of people in my year group and lots of people in the years above and below me have gone travelling this summer - Eastern Europe seems to be the destination of choice at the moment. And good for them! They will see magnificent, strange and different parts of the world that they may never get to see again.

However, there are those of us who simply cannot afford to do these wonderful things. Some of us are working 64 hours a week in the local supermarket just so we can afford to go back to university in September. This is highly illegal. It is disgusting. When I asked the manager at work he had never even heard of the European Working Time Directive. What a surprise.

The student loans system is a complete mess. The poor are well off under the system. The rich are, as the rich always are, well off under the system. That leaves us middle-of-the-roaders.

One of my housemates at University owns a car. He can afford to run this car and come to University and still pay rent, bills, buy his own food without any support from his parents. He does not have a bank overdraft.

Is he rich or poor?

The Student Loans Company says that he is poor. Therefore, they have given him the full loan available, paid all of his tuition fees and given him the maximum 'higher education grant'.

Another of my friends at medical school does not own a car. She has quite well-off parents who give her a generous £300 a month allowance. She is saving for a car and can easily afford rent, bills, food, new clothes and treats for herself and her boyfriend. She does not have a bank overdraft. Quite rightly, the student loans company says that she is rich, and gives her the minimum loan available to her and does not pay any of her tuition fees and doesn't give her a higher education grant.

I know that I would never be able to afford a car while at University. My father has just been made redundant from 'darn pit' and my mother earns £14000 as a nursery nurse. I can afford rent, food, a good time and not much else. I survived this year thanks to my generous £1900 bank overdraft.

The student loans company says that I am rich. WTF?? My father is now earning minimum wage (compared to his £32000 pit salary), my mother earns about the average for the area and they also have my sister (just starting University) to support. They cannot afford to give me any money.

So here I am, in my summer vacation, illegally working 64 hours a week under immensly stressful conditions just to pay off my bank overdraft. There are many more in much worse a situation than I.

I should not be doing this. I should be in Bratislava with my housemates.

The caring profession(s)

My Grandmother has breast cancer. She had a mastectomy and was given the all-clear. However, something else appeared on her skin and tests have shown that she now has it for good. So she has lots of treatment.

One of the problems that she is currently facing is allergy to dressings (which may or may not be drug induced). She has to have lots of dressings on her arms because of massive lymphoedema (some as worse as elephantiasis) and she simply cannot tolerate some of the dressings. I think it's fair to say that she is pretty fed-up. She now has to have radiotherapy - she went for it the other day to be told be the radiologist/radiographer(?) that the line up for the radiation beam "doesn't look right" so she has to arrange another appointment.

On top of all these problems, she has to put up with the caring professions. Nana is a strong willed woman. She has lots of pride and will stand up to almost anyone and anything. I have lots of respect for her. This is why I cringe when she tells me that whenever she goes to clinic or whenever the nurse comes to give her the Herceptin that's keeping her alive, she has to put up with people saying "ooooh, you poor woman." The other day everything was too much for her. She lashed out. "I'm not a poor bloody woman, i'm fine, i've just got a bit of a rash and breast cancer." True, infact Nana says that at the moment she's felt better than she has at any other time during her treatment.

You may think, in all fairness, that whoever was on the receiving end of that was only doing their job. Of course, any first day medical student knows that healthcare is primarily about the care. But in my short time as a healthcare professional, i've witnessed many other professionals, perhaps even myself, being over-patronising and perhaps even insulting to patients in the pursuit of "good care." Some people don't want to be molly-coddled all the time and told how "poor" they are. They may appreciate a bit of empathy every now and then, but i'm quite sure that they won't want people telling them how bad everything is for them at the moment.

And i'm sure that they don't want nurses a quarter of their age shouting "Oh no...let's get that cleaned up" as if they are young children in their ears when their incontinence has got the better of them like happens in certain wards in a certain local hospital.

I'm surprised that there aren't more lash-outs.