Another Pair Of Eyes

Morningwin

Well, it’s 7:37 as I start this and I’ve got nothing left to do before I leave for the hospital, because this morning has been such a whirl of efficiency it’s amazing. I’ve prepared or eaten all three meals for today (delete as appropriate), done a load of washing, and washing up, finished section C on my essay and I only got up at half 6.

AND today I’m not going to my usual ward round with Dr. See-no-students but instead I’m going on the neuro rehabilitation unit ward round, which is fascinating and has a brilliant consulant at its head. and then I shall come home and use my enormous pile of textbooks to finish my essay, submit it, and never think about it again. I will be free to focus on learning and revision for the intermediates, and it will be a strange kind of freedom.

Can you tell it’s a sunny morning?

No, that is not my gold car in our driveway.

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.

Living

Life at the moment can only be described by the phrase ‘crazy busy’. I, on the other hand, do not seem to be as crazy busy as I need to be. Sure, I’m writing a couple of A4 pages of notes a day, and I’m out the door at 8am and back through it somewhere around 3 every day, but I’m just not as busy as I should be, and I know it. I’ve got a LOT to learn this year, and I’m not even kidding – our exams at the end of the year are the most serious we’ll get before membership exams in however-many-years time. Even finals pale in comparison, or so I’m told. The Intermediates are synoptic; they can contain anything we’ve learnt in the first three years from molecular cell biology and theoretical physiology through to hands-on clinical skills and diagnostic knowledge. It’s a lot to know, to link together and hold on to when more learning threatens to tear the older stuff away.

I could go on and on about all the stuff I have to learn, but I won’t because it’s boring.* Instead, I shall leave it with a pictorial representation of how much there is for me to know. I need to know, basically, the information on every single page of every single on of these texts:

There’s a bit of overlap, but that’s basically it. The top one I need to know at the drop of a hat, the others need just a working grasp of their contents. Should be interesting.

That, of course, is not the only aspect of living at the moment. There’s the social side of things, which currently is adequate but far from perfect. D and I are no longer together, due to circumstances beyond our control resulting in her being a good three hours away on a constant basis for the forseeable future. I’m sure given the opportunity to have a solid basis the whole LTR thing might have worked, but seeing as we’d only really been together for a month and a half when the challenge presented itself we decided to let things lie rather than risk seeing them fade into obscurity. Life is full of fun surprises. No doubt.

Anyway, I’ve written enough and I’m tired and I’ve got a load of washing to take out and a lot of Spanish to do. Basically got to sit down and learn the whole module. Terrific.

If I’m not about much, the above is all why!

Hasta luego.

*the going on about it, rather than the actual stuff which is brilliant.

Resolute

Actually, not very resolute, but so be it. Point being, it is the new year and for the first time I’ve got to make resolutions and keep them instead of having to make resolutions to satisfy people that I am, in fact, resolute. This year, I am forced to try and use resolutions to facilitate my learning, my fitness, and my finances.

Fun times. As such, I have proposed to myself the following:

1. I will spend the equivalent of at least 1 hour for every day in the week in a library, with the exception of days upon which I am working the night shift. This will double after Easter.
2. Monday nights after spanish, it is time to go to the gym. I will go swimming/to the gym before or after every badminton session, or three a week, whichever is the greater.
3. I will start running and cycling places, starting very low-intensity and building up.
4. I will stop going to one stop and buying shit I don’t need because I am bored.
5. I shall not spend more than £20 on going out in any one week, with the exception of the first and last weeks of any term.

Right. I’m not feeling particularly resolute, but if I want to pass this year with a half-decent %,  I will resolve. Anyone got any resolutions of their own?

Also, just because I am proud of it, here is a picture of the creation of our new years costume for an Alice-in-Wonderland-themed party. It took hours longer than we thought it would and tested the not-particularly-expansive limits of my sewing skills, but it did let me hug people with six arms at the stroke of midnight. I give you, in shockingly poor mobile phone quality, the birth of the Caterpillar.

And yes, the arms all moved in concert with mine.

Home

I am home.

And there are no builders, and everything is quiet and finished and the view from my room is beautiful.

16 weeks is a long term. I’ve got a lot of work to do. Instead, though, I’m just watching the snow fall.

Interest

Revision, eh. It’s a bitch and everyone knows it – nobody wants to sit and relearn things they kind-of remember (or never learnt) in the days before an exam. Even now, when outside there’s a biting wind which cuts through just about everything, it still seems a bit like being chained to a desk. This revision is slightly different to that stereotype, somehow. It’s still manically hard to actually bring myself to start, but once I do I just get lost in it. It’s, horror of horrors, interesting. Even though the thought of opening textbooks still appalls me, once started I find myself enjoying it, which is a thoroughly alien feeling.

Speaking of interest, someone has been interested in the progress of other, non-examined parts of my life recently. I trust the following, relatively hot off the presses, is answer enough.

Paediatrics

I never had myself down as someone who likes kids. Especially babies. Why should I? After all, they vomit and piss and spread their stool liberally about the place, and howl and cry and bang things together in a 24-hour cascade of sound interrupted only by bottles and sleeping.

Last night, I went out for dinner with my family, and in the general medley of conversation I ended up relating how my attachment was going. It was only after I’d been talking with enthusiasm and without pause for about 10 minutes solid that I realised that actually, I don’t hate kids at all. I love kids, I find them fascinating. Their development is just phenomenal, the way they think and learn, the changes month by month, year by year. I love the variety, the psychology, physiology, family dynamics and sheer vitality of a child, and as a direct consequence of these things, I love paediatrics. It seems so obvious now, not sure why I didn’t see it before.

It’s a strange change. I think the only reason that I ever became irritated with children, especially babies, was because I didn’t understand. I do now. I see a child banging the top of a bin to make a sound, and I understand why, and actually instead of annoying me it makes me smile.  I’m not saying that all children are saints and that they can never drive someone up the wall, just that I find it far easier to tolerate and value kids than I did before.

That’s from a personal standpoint – from a medical one, paeds is also brilliant. It has variety – a broad range of systems and problems over a broad age range. It has follow-up – children you see and treat will often come back to you at least once, and in that there is the reward of seeing how they have been doing, how they have grown, how the interventions you made (potentially) have changed that life.

I guess that leads me into the darker parts of paeds though. Despite the best efforts, children still die. Illness and defects and rare syndromes can strike down a child, sometimes literally while you watch. Not only that, but they are beaten and abused, neglected and bullied and mistreated by their families, by friends. You have to keep an open eye. I remember we had a particularly shocking moment in the middle of a diabetes seminar where we were asked what it might be when a type 1 diabetic child (can’t produce their own insulin) presented in A+E with hypoglycaemia and high levels of insulin in the blood without a corresponding increase in c-protein (meaning the insulin causing the hypoglycaemia was injected rather than produced). We came out with abuse, accidental overdose, neglect, a host of similar answers, some possible, some not.

The answer was attempted murder. Don’t be afraid to think the worst, was the message. Child protection is one of the only things that whoever first sees or suspects it is responsible – if I see a patient and I think there are child protection issues it is my responsibility, not that of my consultant or SpR. Sure, I can and should discuss it with them but if they disagree and I am still convinced, it is still my obligation to do something. Obviously this doesn’t really happen, but it is a disquieting thought nonetheless.

Anyway, I’m still going on about paeds and I should be doing work for it right now. I could talk about this for a long time, but I won’t say anymore. Point is, this is something I’d very much like to do, something I can picture myself doing for many years, and it’s nice to have that feeling.

We’ll see if anything else jumps out at me like this has, but if not…