From one madhouse to another
The last three weeks of rural GP has been great fun. There was no assessment apart from my consultant marks, so I could just turn up each day and enjoy the attachment without the stress of having to do annoying presentations or study for tests. It was close enough that I could drive out each day. Going against the traffic, it didn't take very long at all!
When I arrived, I was able to do all kinds of things. Seeing patients and sitting in on consultations took up about half of my time there. There was also a GP there who focussed on dermatology so I got to see lots of skin stuff. I found that really helpful since I find derm quite difficult.
There was a lot of down time, especially in the afternoons since patients preferred to come in the mornings. However that gave me the chance to gain other skills that I hadn't expected to learn. While I was there, the practice staff were doing a major spring clean. They had lots of documents that needed shredding. So whenever there was nothing to do, I sat at a desk, took staples out of the papers and fed them into the shredder. Unfortunately the shredder was unable to keep up with my efficiency and frequently overheated and went on strike. Then I would go back to a consultation room and browse the web.
In the last week, a handle broke off a drawer. I went over the road to the hardware store and bought some supaglue. Then I returned and supaglued the handle back on. That was so fun! You don't learn skills like that in hospitals!!
Alas, the fun can't last for ever and I'm now back in hospital for General Medicine. Today was my first day and having been away from hospitals for three months, it certainly was a rude shock to the system!
Firstly, I forgot to set my alarm and overslept - I have to wake up an hour earlier for this attachment. Then I had to put on a long sleeve shirt and tie! I could barely breathe. Then I got on the motorway, and as I was driving along, I was struggling to remember how to drive to the hospital. When I got to the offramp I normally take, I found that I had to take a detour because of roadworks! That made me really late so I parked my car and rushed in as quickly as possible.
When I got to the meeting place, I found that I was still 20 minutes early because I hadn't read the arrival instructions!! It never occured to me that our orientation book would tell me when to turn up. The orientation never happened because the orientation person was in Australia.
I proceeded to join my team and got plunged into a consultant ward round. Then I found myself writing in the notes of a patient when I had no clue what was going on. Then I began to write super duper brief notes in a surgical style. My house officer reminded me to pan things out a bit more appropriately for medicine.
After the round, it's time for ward jobs. I was asked to put a luer in a patient. Things were going smoothly - I managed to get all of the bits and pieces ready, lined up my target vein, donned my gloves and feeling all ready to go. Then I opened up the luer pack and held up the needle. Then I looked at the needle. After three months of not looking at a needle, these things look huge!! I stared hard at it and thought, "$#^! do I have to stick this in someone's arm??" I checked the pack to make sure I had the right one. I did. Then I started shaking - this was not a good look.
After a few seconds of internal screaming, I managed to pull myself together and got the luer in without spilling a drop of blood! Feeling rather proud of myself, I proceeded to secure the luer with one of those sticky thingies (whatever they're called). Then I totally stuffed it up and got the sticky stuck to itself. That's when you say to yourself, "L-O-S-E-R"
Well, that's day 1 completed! Six weeks, 4 days to go! Let the fun begin!!
SARS is more prevalent than you might think
I was playing interclub today and one of the balls I was playing with rolled behind the neighbouring court. I waited patiently for the rally on that court to finish. The guy at my end hit the ball in the net and I went to pick up my ball. Then I heard him scream out in his native language (he was from Eastern Europe) and a split second later heard a massive WHACK as his racquet hit the fence and then deflected off and hit me on the leg! How spastic is that!?!? Thank goodness it didn't hit me before it hit the fence.
That guy had serious anger issues. In the first set he threw his racquet and cracked the frame. In the third set he cracked another frame and then proceeded to totally destroy his racquet on the ground. I heard from one of his team mates that he broke a racquet last week too! That leads me to several conclusions
His mummy didn't hug him when he was a child
He can afford to buy tennis racquets every week
If he runs out of racquets, don't lend him your one
He has a notifiable disease: SARS (Spastic Abuse of Racquet Syndrome)
I'm certainly glad I didn't have to play him. Instead, I had to play a 13 year old kid. He also had SARS but to a lesser extent. I drove him up the wall by playing soft lobby shots which got him really frustrated. This caused frequent exacerbations of his condition. Unfortunately he was able to control his symptoms in the community setting and he ended up beating me 7-5 6-2. I really feel old now!
I'm also annoyed now because this was going to be a non-med post, but somehow I've managed to spoil it with this stupid SARS thing. Oh well, better luck next time! Tata for now!
No pain, no gain!
Well my community psychiatry attachment is over. Once again I have mixed emotions. Happy because that's another attachment out of the way. It was also a little tricky feeling so lost most of the time just floating around trying to observe stuff where ever possible. I'm also sad because the staff were all really friendly and I did get to see a lot of interesting patients. The OSCE was a complete nightmare and I'm not even going to start talking about that!
Over the weekend, we had the introductory BBQ for YACMA. It went really well but the turnout wasn't quite as big as we had hoped. It's funny how things unfold differently each year. There must be some deep and meaningful psychological factors which influences whether people are motivated enough to turn up for events such as these. While our advertising campaigns does contribute, I have the feeling that there are other factors beyond our control.
The kebabs went down really well at the BBQ! I'd like to claim credit for making them, but WW donated the recipe, YH mixed the ingredients and I didn't really do anything particularly useful. However I would like to say how much pain and suffering I went through to make them possible. I had to chop two whole bulbs of garlic. Do you have any idea how much it hurts when garlic juice soaks into your fingers for 30 minutes!?!??!? I was in such agony while chopping and later that evening I had to soak my hand in a bowl of cold water! Three days on, and my fingers still stink of garlic. Also, my fingerpads are now numb where they were stinging on Friday night. The sacrifices I make for YACMA! Forget about claiming expenses! I'm going to claim physical disability!!!!!!!! Oh well, at least I am safe from vampires for the next few nights. Buffy can have a holiday from watching over me while I sleep.
Today marked the start of a new attachment - rural GP! As you can probably tell, it must be in a town not too far away from Auckland City if I'm still posting on my blog! In fact, it's hardly has a rural feel at all. There are at least 4 GPs working there, a physiotherapist, a pharmacy and a brand new x-ray machine! Basically I just had an orientation day so I didn't get to do much. However it should be a nice and enjoyable three weeks ahead!
Gosh this is a boring post. Sorry about that. I can't think of anything really interesting to say right now... Actually that's a lie. There's heaps I want to post but it's hard to talk about things that I see in clinic and not break patient confidentiality. I really have to figure out a way of telling stories without saying stuff that I really shouldn't.
