Another Pair Of Eyes

Pauses

You may have noticed I’m not here so frequently as I might have been before. The workload is stacking up rapidly – I’ve taken today off from placement to finish my essay and a bunch of cardio notes, and been up since half six doing the same. Day off, pffft.

Not, you understand, that I’m complaining. The more I learn the more elegant everything is, and the more I can link things together, understand the consequences of things and the cascade of consequences consequent of those consequences. Why can alcoholic liver disease cause catastrophic haemorrhage in the throat, or swelling in the ankles, or rupture of the spleen, or kidney failure?* I know I’m endlessly banging on about medicine but it’s increasingly an integral part of my identity, for better or for worse. Probably for worse, but hey – in some ways it changes me for the better. Currently I’m on a one-week-on one-week-off routine in sync with Helpful Teaching Consultant’s morning ward rounds. Next week it’s back to Dr. See-no-students-hear-no-students so I’ll revert back to going to a bunch of random stuff, neuro and GI and endocrine and phleb clinic, if I can swing it.

We’ve got some new neighbours, postgrad nurses-to-be; in number, three. We were worried first that there was a family moving in, but they were just the landlords. As of last Sunday we are officially surrounded by students on both sides, which is good news. And we invited them over for cocktails, and they are pretty chilled out, which is nice. That, the discreetly unmentioned valentine’s day and a couple of sunny days and nights with sleep in have cheered me no end, life is better again.

Now, I need to crack on with my essay. It’s a bit of a strange reflection that I want to finish this essay so that I am finally free for the remainder of the year to get down to working on medicine proper. Who’d've thought that the homework-hating me of yesteryear would become so driven…

Essaytime.

*don’t get alcoholic liver disease, kids.

Displaced

I am, in three words, not quite right. I can’t quite put my finger on it – I’m more tired because I have to get up an hour earlier now I’m on cardio, I sleep very lightly in the early hours as a result of endlessly getting up early.* Vicious cycle. When I sleep, I dream vivid, repeating dreams. I have a complete loss of interest in cardiology, which reflects on to my love of medicine as a whole and hence my work output. Luckily I have found another notebook which has endocrinology notes in it and a lot of spare pages, so I’ve fallen back on thyroid function and adrenal crisis for today and will turn the other notebook back to front and start GI scribbles tomorrow. I just can’t get excited about something which by virtue of starting half an hour earlier (and that for no explainable reason) requires me to get up a full hour and fifteen earlier in the mornings. And isn’t very gripping, either.

I think I need some sunshine, and a week off. Roll on Easter.

*last night a text woke me up. my phone was on my bedside table, on silent, and I was woken up through closed eyes by the light that the screen cast on my ceiling.

Romance

I found this during my research for my essay:

Hippocrates wrote “Some men have constitutions that are like wooded mountains running with springs, others like those with poor soil and little water, still others like land rich in pastures and marshes, and yet others like the bare, dry earth of the plain.” Today, we describe these observations as interindividual variation in disease risk manifested as gene-environment interactions.

Tell you what, the modern interpretation might be more succinct and scientific but it certainly isn’t as accessible or elegant as the original description!

Also, Valentine’s day could not come at a worse time this year.

Yes, I’m aware it’s the same time every year.

Stalling

I watched an episode of scrubs once and during the episode, Dr. Cox came out with a phrase (the exact wording of which I cannot remember).

“Everything you do in medicine is a stall.”

And it is. Every disease you treat, every symptom you manage, every wound you stitch or tumour you excise; it’s all just stalling for time. It’s a pessimistic viewpoint, but the universal truth is that everyone stops bleeding one way or another. Fight as hard as you like, but in the grand scheme of things you lose. The bigger picture is a grim one.

The other day on the ward, a patient arrested. Staff performed CPR, successfully, and he was resuscitated. Three hours later, despite the best efforts of everyone involved, he died.

At first glance, we lose, death wins, but there is one more thing to this story. Three hours was long enough for his daughter to come and see him, talk to him, say goodbye to him. Before that I kind of agreed with Dr Cox, but actually sometimes, despite the worst, we still pull some semblance of victory from the jaws of defeat.

And I think that’s enough.

It’s not always about the bigger picture.