I swear, I am still on 1/2 speed since my return to school (I won't say Christmas 'holidays' because it really wasn't much of a holiday at all, and I don't feel like sullying the term).
I just can't seem to get my thoughts together and concentrate, AT ALL.
Things are slowly starting to ramp up, study group is starting to meet again this week, USMLE prep course starts again next week, anatomy group is back at it, my own USMLE prep is *cough* ongoing, I am supposed to be playing music for this fundraiser thingy but have to dust off my vocal chords before the event, etc. etc. But I don't feel like my brain has checked in, just yet.
Our case last week was a patient with Graves' disease, this week it is inflammatory bowel disease.
Thyroid. Yawn.
Bowels. Double yawn.
I guess I can cross endocrinologist and gastroenterologist off my list of 'possible careers'. Sweet. Now I am down to only 47 options.
Maybe it isn't the gastrointestinal tract I hate so much. Maybe I am just getting a little burnt out by this whole PBL process (hence the new countdown screen on right margin). Apparently this is a common finding among medical students around this point in their studies.
I know, this too shall pass!
On the upside--I am going to see both Ray LaMontagne and Iron and Wine in Dublin! Very stoked! And also excited that my good friend Cathy Lee will soon be here visiting (in time for the Iron and Wine concert). So some things to look forward to.
Tuesday, January 18, 2011
Monday, January 17, 2011
Wordpress vs Blogger
I am thinking of moving to Wordpress...has anyone else done the swap or have some thoughts on this?
I just like the layout on Wordpress better.
Do I really need to do that though, or am I just trying to find a way to kill a HUGE amount of time rather than study inflammatory bowel disease?
In other news, today I realized that my new haircut no longer allows me to look like a normal woman at the gym.
Nope. Now I look like a woman who is trying to look like a 5 year old girl.
This completely destroys the months of attempts at gaining street cred in the gym here where 99.9% of the time I am the only woman lifting weights, surrounded by testosterone-crazed-bowling-ball-headed-whole-chicken-eating-febreeze-spraying rugby players.
Gone, in the snip (or two) of a scissor.
I just like the layout on Wordpress better.
Do I really need to do that though, or am I just trying to find a way to kill a HUGE amount of time rather than study inflammatory bowel disease?
In other news, today I realized that my new haircut no longer allows me to look like a normal woman at the gym.
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| Note ridiculous hair nubbins poking out the side of my head. |
This completely destroys the months of attempts at gaining street cred in the gym here where 99.9% of the time I am the only woman lifting weights, surrounded by testosterone-crazed-bowling-ball-headed-whole-chicken-eating-febreeze-spraying rugby players.
Gone, in the snip (or two) of a scissor.
Sunday, January 16, 2011
Heads Up
Based on descriptive cellular pathology terms...if you ever look through a microscope and see this:
Your patient has papillary thyroid cancer.
Go figure.
That representation of Annie has always creeped me out. Now I know why.
Go figure.
That representation of Annie has always creeped me out. Now I know why.
Saturday, January 15, 2011
Saturday Morning Thought Invasion
Tobie has been in London for the week, and I have been missing his sweet face. Yesterday he and his parents returned (yes, they are still visiting). It is lovely to have him back. I never sleep well when he is away.
I woke up early this morning, just a little of the gray light starting to illuminate our bedroom. I looked over at Tobie, his face silhouetted against the window and thought,
"no signs of exopthalmous".
How romantic.
Being in medical school seriously fecks up the way you look at the world.
Like yesterday also, I was sitting in my histology class and I noticed my prof had a long, surgical looking scar running along the lateral aspect of her leg. Her voice turned into a drone as I pondered, "did she need surgical repair of her fibula? I wonder how she broke it? Maybe she needed a fasciotomy for compartment syndrome? Wrong side for the usual vein harvest, maybe she had bad varicose veins?"
Then I realized, it was a run in her pantyhose.
I really need to get a new hobby.
I woke up early this morning, just a little of the gray light starting to illuminate our bedroom. I looked over at Tobie, his face silhouetted against the window and thought,
"no signs of exopthalmous".
How romantic.
Being in medical school seriously fecks up the way you look at the world.
Like yesterday also, I was sitting in my histology class and I noticed my prof had a long, surgical looking scar running along the lateral aspect of her leg. Her voice turned into a drone as I pondered, "did she need surgical repair of her fibula? I wonder how she broke it? Maybe she needed a fasciotomy for compartment syndrome? Wrong side for the usual vein harvest, maybe she had bad varicose veins?"
Then I realized, it was a run in her pantyhose.
I really need to get a new hobby.
Thursday, January 13, 2011
Narrowing Down Future Career Paths
I was going though some old files on my computer today and came across a document named, "Things I Know". Naturally, I wanted to jog my memory and see what it was that I once thought I knew about something.
This is all that was written:
Things I know:
Well that about settles it then.
*Facepalm*.
This is all that was written:
Things I know:
-I don’t want to do a job where volume is key, i.e. that I need to see 60-70 patients a day to meet a quota/keep the tofu on the table
-I like quality, not quantity
-I do like fast paced, hard work, unpredictable work
-I like doing, not thinking or watching or waiting
-I like skiing.
Well that about settles it then.
*Facepalm*.
Wednesday, January 12, 2011
Medical Jargon
When a health care worker becomes a patient, is it lame or appropriate for them to use medical terminology when talking to their care providers?
I am (as usual) on the fence with this one.
A part of me finds it borderline irritating sometimes when people present to triage and say things like, "I've had some discomfort beneath my xiphisternum for the past three days, not sure if it is from the NSAIDS that I've been taking or if it is a hiatal hernia, or what.." Or "my nephew has just fallen skiing, I am pretty sure he's torn or partially torn his ACL, his drawer test is positive and he's not weight bearing".
Naturally the thoughts running through my head will include; "are you telling me this as a secret hint that you are a HCW and therefore should be seen more quickly than the sicker people in the waiting room?", "are you using medical language because of it's precision and beauty, or as an attempt to make my assessment easier?", or "are you having a difficult time accepting that you are a patient and are trying to desperately hold on to your normal power position in this setting?"
And then I realise that I am probably over-thinking the whole thing. Yet the feeling of vague annoyance lingers.
Of course, when I went to the sports med clinic with my shin splints a few years ago I wrote, "bilateral anterior tibial pain" under the chief complaint box. Why didn't I write "shin splints"? Well partly because I didn't know for sure if that is what it was, "leg pain" seemed too vague and I could perfectly describe the area of discomfort using those words. I am pretty sure the MD who saw me thought it was douche-y (the only explanation for his terrible assessment and treatment).
Since then I try to just let go, accept that I am the patient and write things like "knee pain" in the chief complaint box when I go to see the orthopod. Even through it is "midline, subpatellar discomfort on palpation and with weight bearing exercise".
Thoughts?
I am (as usual) on the fence with this one.
A part of me finds it borderline irritating sometimes when people present to triage and say things like, "I've had some discomfort beneath my xiphisternum for the past three days, not sure if it is from the NSAIDS that I've been taking or if it is a hiatal hernia, or what.." Or "my nephew has just fallen skiing, I am pretty sure he's torn or partially torn his ACL, his drawer test is positive and he's not weight bearing".
Naturally the thoughts running through my head will include; "are you telling me this as a secret hint that you are a HCW and therefore should be seen more quickly than the sicker people in the waiting room?", "are you using medical language because of it's precision and beauty, or as an attempt to make my assessment easier?", or "are you having a difficult time accepting that you are a patient and are trying to desperately hold on to your normal power position in this setting?"
And then I realise that I am probably over-thinking the whole thing. Yet the feeling of vague annoyance lingers.
Of course, when I went to the sports med clinic with my shin splints a few years ago I wrote, "bilateral anterior tibial pain" under the chief complaint box. Why didn't I write "shin splints"? Well partly because I didn't know for sure if that is what it was, "leg pain" seemed too vague and I could perfectly describe the area of discomfort using those words. I am pretty sure the MD who saw me thought it was douche-y (the only explanation for his terrible assessment and treatment).
Since then I try to just let go, accept that I am the patient and write things like "knee pain" in the chief complaint box when I go to see the orthopod. Even through it is "midline, subpatellar discomfort on palpation and with weight bearing exercise".
Thoughts?
Monday, January 10, 2011
New 'Do
Warning: Girly post regarding hair. Normal posting will resume again next time.
So I chopped my hair off. It is not the dramatic inch-long version that I did 11 years ago when I went to Asia the first time, but it feels pretty dramatic to me right now and I find myself waking up and touching the back of my head going, "really?"
 |
| Tundra tresses à la Canadian Arctic. |
After the Asia incident grew out I kept it pretty long. But I loathe having hair in my face so 98% of the time I wear it in a messy bun of some sort. Especially at work following a nasty catheterization experience wherein my hair fell from behind my shoulder into the dark, dank, yeasty thigh crease of a morbidly obese patient. I then had to sit in the ambulance transferring that patient for the rest of my shift and I can tell you I came pretty close to an ambulance hair cut on the way back from that drop-off!!
 |
| The permanent expression on my face in the hospital. So the odd, odd time I'd wear it down, I didn't feel like it had any pizzaz to it. Mind you that might have had something to do with the fact that I spend about <1 minute getting myself ready to hit the town usually. |
 |
| To be fair, I was caught in an Irish rain storm that day. |
Ok let's be honest. I wore my hair like this. Almost. Every. Day. For probably the past 7 years.
 |
| My, what a dazzling bun you've got there! |
And once in a blue moon I'd mix it up with the Robert Palmer music video look.
 |
| It was, in fact, a coincidence that we all wore stripes to the final exam in December. I think we all felt an underlying 'imprisonment' vibe which we needed to express. |
So Tobie's sister is a killer hairstylist and she happened to be visiting over the holidays. Her take on style is that you should only keep one hairdo for 5 years and then you have to let go and mix it up or you'll end up looking dated.
I let her at it. Still easing into it and deciding if I like it. I tried to take some nice photos to show y'all but every one makes me look like a complete tool. Ah well, here they are anyway!
 |
| Tool: full frontal. Black and white unsuccessful at making me look less "tool-ish". |
 |
| This is how it looks from the side when I am staring passively off in the distance. |
 |
| This is how it looks when I am self-consciously pawing at it and suspiciously staring to my right. |
 |
| This is how it looks when I've been doing CPR for 40 mins and can't push it out of my face because there are questionable fluids on my gloves. |
Sunday, January 9, 2011
North West Passage
One of the enjoyable things about studying in a different country is learning the local twists and turns of culture, specifically medical culture and language.
To me, the Irish have a musical lilt to their speech which I adore. I find my own voice and accent sound harsh to me now, to the point where sometimes I catch myself wincing when I speak. The North American prosody seems halting, staccato, and brusk where the Irish manner of speaking is sing-song, soft, and rolling (with some exceptions, naturally).
To add to the charm, they have an immense vocabulary of slang (the particularly entertaining ones are usually some sort of insult--like wagon, spanner, minger, puck, tosser, dosser, knob, wanker, scobe). Hmpf. Might have to make up my own version of Santa's eight reindeer next year.
Anyway, one expression that slays me every time is the euphemism "the back passage" for rectum. This is actually used even in our clinical labs, profs saying things like, "d'you know now, if someone has a low BP and has a history of ulcers, he may be bleeding out the back passage". To which I have to hide my snicker and "did anyone else find that hilarious" expression. Call me childish. Call me Beavis. But it is beyond my control.
So a few days ago we get a call for a woman who has elevated blood sugar and decreased consciousness. The two paramedics I am with go into the bedroom (which I have found is always up a narrow flight of stairs and/or the smallest room in the house). I physically couldn't have fit in there even if I had wanted so I stand outside and talk to her sister. The sister is a right proper older Irish lady who is shaped like a refrigerator box on sturdy legs with her hair in a bun, and a thick cable knit cardigan slung over her shoulders.
I was asking about medical history and specifically diabetes history to which she informs me the patient has none. She very sincerely started telling me about the patients meds, and about a 'bad turn' she had last year when they gave her some medication up the back passage which sorted her out immediately.
In my state of sleep deprivation and dangerously high levels of caffeine I was borderline giddy as it was, but she had just struck my professional Achilles. I bit down on my lip and looked at my gloved hands.
"Mmmmhmmm", I say, thinking, arrange face in serious, concerned manner.
"Yes, I am not sure what it was but they gave it up the back passage and it really seemed to work!"
"Okaaayyyy. Well I am not sure what that might have been but they'll have that info at the hospital I am sure." Please don't let her say that phrase again or I'll lose it.
"Yes, now that I think about it, she'd never been given anything up the back passage before..."
I felt my face uncontrollably twist into a semi-grin and I tried to mask it by faking a twitch and then a cough. I mumbled something about needing to fetch some gloves out of the ambulance and bolted, pretty sure that I was the most horrible, unprofessional, medical student/nurse that had ever responded to an EMS call.
I just can't help myself. Especially after working in the Arctic. All I can see in my minds eye is Cabot or Amundsen with a fortified ship and compass trying to negotiate their way up the back passage. A journey no man had undertaken before, one they may never return from...heh.
Beavis. I know.
To me, the Irish have a musical lilt to their speech which I adore. I find my own voice and accent sound harsh to me now, to the point where sometimes I catch myself wincing when I speak. The North American prosody seems halting, staccato, and brusk where the Irish manner of speaking is sing-song, soft, and rolling (with some exceptions, naturally).
To add to the charm, they have an immense vocabulary of slang (the particularly entertaining ones are usually some sort of insult--like wagon, spanner, minger, puck, tosser, dosser, knob, wanker, scobe). Hmpf. Might have to make up my own version of Santa's eight reindeer next year.
Anyway, one expression that slays me every time is the euphemism "the back passage" for rectum. This is actually used even in our clinical labs, profs saying things like, "d'you know now, if someone has a low BP and has a history of ulcers, he may be bleeding out the back passage". To which I have to hide my snicker and "did anyone else find that hilarious" expression. Call me childish. Call me Beavis. But it is beyond my control.
So a few days ago we get a call for a woman who has elevated blood sugar and decreased consciousness. The two paramedics I am with go into the bedroom (which I have found is always up a narrow flight of stairs and/or the smallest room in the house). I physically couldn't have fit in there even if I had wanted so I stand outside and talk to her sister. The sister is a right proper older Irish lady who is shaped like a refrigerator box on sturdy legs with her hair in a bun, and a thick cable knit cardigan slung over her shoulders.
I was asking about medical history and specifically diabetes history to which she informs me the patient has none. She very sincerely started telling me about the patients meds, and about a 'bad turn' she had last year when they gave her some medication up the back passage which sorted her out immediately.
In my state of sleep deprivation and dangerously high levels of caffeine I was borderline giddy as it was, but she had just struck my professional Achilles. I bit down on my lip and looked at my gloved hands.
"Mmmmhmmm", I say, thinking, arrange face in serious, concerned manner.
"Yes, I am not sure what it was but they gave it up the back passage and it really seemed to work!"
"Okaaayyyy. Well I am not sure what that might have been but they'll have that info at the hospital I am sure." Please don't let her say that phrase again or I'll lose it.
"Yes, now that I think about it, she'd never been given anything up the back passage before..."
I felt my face uncontrollably twist into a semi-grin and I tried to mask it by faking a twitch and then a cough. I mumbled something about needing to fetch some gloves out of the ambulance and bolted, pretty sure that I was the most horrible, unprofessional, medical student/nurse that had ever responded to an EMS call.
I just can't help myself. Especially after working in the Arctic. All I can see in my minds eye is Cabot or Amundsen with a fortified ship and compass trying to negotiate their way up the back passage. A journey no man had undertaken before, one they may never return from...heh.
Beavis. I know.
Friday, January 7, 2011
Monday, January 3, 2011
Oh right. Patients!
Just getting ready to crawl into bed after a long and harried day with the ALS crew. Oh and what a day it was. The glory of emergencies!
I mean, real ones...not the 'I saw an old guy going slowly down the street with his walker so I dialed 999' [true story that happened on my last shift].
I even managed to make myself useful and do a good thing. After a day of trailing with a kit bag it was nice to feel useful instead of useless for a moment. But that is a story for a day when I don't have to wake up again in 6 hours.
A nice reminder that I am learning applicable things! Information that is making my differentials more astute, my understanding deeper, and my realization that 'holy crap I don't actually know anything' crystal clear. It's always good to be reminded of the light at the end of the tunnel and what this is all truly about--patients! Not spotters, or papers, or OCASE's.
It is also good to realise that wow, I'd never want to work as a nurse in that hell hole of an emergency department. I thought the situation was dire in some of my previous Canadian haunts but, well, it was the Hilton in those places compared to what I saw today.
Sleep time.
I mean, real ones...not the 'I saw an old guy going slowly down the street with his walker so I dialed 999' [true story that happened on my last shift].
I even managed to make myself useful and do a good thing. After a day of trailing with a kit bag it was nice to feel useful instead of useless for a moment. But that is a story for a day when I don't have to wake up again in 6 hours.
A nice reminder that I am learning applicable things! Information that is making my differentials more astute, my understanding deeper, and my realization that 'holy crap I don't actually know anything' crystal clear. It's always good to be reminded of the light at the end of the tunnel and what this is all truly about--patients! Not spotters, or papers, or OCASE's.
It is also good to realise that wow, I'd never want to work as a nurse in that hell hole of an emergency department. I thought the situation was dire in some of my previous Canadian haunts but, well, it was the Hilton in those places compared to what I saw today.
Sleep time.
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