The lowest of the lot

"They know they are making you nervous. It is so typically male."

"I know you're a medical student when.....

a) You look eager to learn.
b) You seem sheepish about being here.

and

c) You are afraid to invade people's personal space," said this cute resident to me in theatre after which he introduced himself and kept smiling at me. Gosh.

I am loving it at the Alfred. While it's intimidating and nervewrecking, I feel that all the expensive fees that I have pay to do medicine here has been really worth it.

Having the Head of Surgery as my clinical tutor has got to take the cake. Followed by the Head of Anaesthetic at Maroondah Hospital for theatre and Head of Radiology for radiology tutorials (did i mention she's got a whole library named after her?) and the prize winning female surgeon as my permanent tutor just adds to the worthiness of paying 34 000 bucks each year.

I am truly surprised by how interested the consultants are in our medical education.

And I quote, "We want you to have a really good time in this rotation. You need to be involved in every aspect of the ward from admission to discharge to unit and audit meetings, clerking the patients, following them into theatre and CT scans and sitting in with the consultants in the outpatient clinics. You can even write down your own notes in their medical files. Make sure you see a colonoscopy and rigid sigmoidoscopy before the next tutorial and learn the technique. Also, when possible, stay with the residents during their weekly night shift. They would love your company."

Full on.

Needless to say this barrage of extra activities are to be done during our free time. And yes while I admit I return home tired everyday, I also return home immensely satisfied that my day in the hospital was full of learning and wasn't wasted.

Being in the surgical rotation has made me realise how wrong society is today. Practically every patient that was in theatre had facial surgery for motor vehicle accidents (MVA) due to drink driving. And don't forget the stab wounds, gunshot wounds and being bashed in the head with a baseball bat. The drug users that destroy their own hearts and the lonely forgotten patient who has no visitors.

It was yet again another patient in a MVA. The anaesthetic registrar under the watchful eye of the Head of Anaesthetic was nervously trying to intubate the patient. The scrub nurses stood around enjoying the situation silently while the plastic surgeon shared a private joke with his surgical trainee that only surgeons understand. The melancholy sounds of Coldplay filled the theatre.

The Head turned to me.

He looked at me questioningly. My heart began to beat faster. Oh no he's going to start quizzing me again on sedatives and anaesthetics. Shit.

He opened his mouth, paused and then said, "Now tell me. Why do people have......."

He paused again. My heart is having palpitations.

"Tell me why do people have tattoos?"

Geeeez.

There is nothing more intimidating than having Heads and senior consultants as my tutors. Or so I thought.

It was at the weekly consultants' meeting. Four senior surgical consultants including the Head of Surgery, sitting opposite you. They are dressed in their finest suits sitting lazily on their chairs while sipping gourmet coffee. Occasionally they joke around, jokes only the priveledged understand, while the registrars and residents scan their notes.

The subtle aura of power and knowledge occludes the senses.

The male surgeons lean back in their chairs and spread their arms across the armrest, crossing their legs. They eye you in silence deciding what kind of doctor you will make. They know they are making you nervous. It is so typically male. The fifth year medical student is quietly rehearsing her presentation. She is about to present her patients' progress.

In the corner of the powerful circle sat me and my colleague, the lowest of the whole lot. Mere third year students in their first clinical year. Babies.

My resident had warned me before the meeting that unit meetings are really the time when the consultants quiz medical students. The fifth year medical student received the brunt of their questions sparing me and my colleague. Whew.

But the whopper had yet to come.

The Head turned to us. I felt that all familiar thudding of the heart.

"Today we are letting you off. By next Thursday, I want each of you to find three patients and present them to us. You need to know what's going on with the patient, their histories and their issues. Whether they are febrile or not and who lives with them. Do they need the OT or physio and who will arrange it. You need to know them inside and out. In other words, you have to spend most of your time here in the wards tracking their progress."

By this thursday's 7 am meeting, I need to familiarise myself with every sort of surgery that can be performed in the abdomen. And know everything about my patients. As Wendy said, if they ask you who will she return to when she is discharged, you need to know if her husband lives with her and how many kids she have and whether they can care for her. You need to know everything.

The patients in my ward are post-operative patients and many tend to run fevers and require frequent pain assessment. This means that I have to see my patients before the meeting on that day to make sure that I have their vitals correct to the last minute as they may change overnight.

Yay. Another 6.30 am start for me.

This will be my first time making patient presentations to doctors and it does not help my nerves one bit that I have to do it in front of ten of them. While this is all good for my learning, and for that I am not really complaining, the thought of having to do this every week is a tad stressful.

But hey stress and me are long time friends. We can't live without each other.

I'm loving it at the Alfred.

Comments

Anonymous said…
man...im soo envious of u...wat ure learning and goin to do is so much more worthwhile than wat im doin..i'll kill to be doin wat ure doin... ;)i noe ure gona do great even wif all the stress.. :)keep on rockin' at Alfred gurl..
Anonymous said…
oh ya...are u gonna have a sem break or sumtin now that ure at Alfred? wondering if u can join us in may at GC... ;)
Ryu Arashi said…
yah man, it'll be cool if u can join in the craze. anw, sesungguhnya lah, aku tak faham many many terminologies dat u use here. sesungguhnya.
zarawil said…
moonie: thanks gerl but you are doing worthwhile things to gerl. it doesn't matter what we do in life; teach, research, bringing up kids etc..we just need to do it for Allah swt. and i have to remind myself that everyday whenever i feel myself become defeated or complacent. :)

btw, i finish my first sem on the 16 june. so that's like mid june. my break ends 14 july. so yeah if you all tak dapat tix for that time takpe..i'm cool with it. :)

rahayu: haha i do apologise for my terminology. i was just reading thru my post and i do agree that unless one is familiar with medical terms, my post would just be jargon haha.

sigmoidoscopy: they stuff a camera thru the anus to have a look at in inside

colonoscopy: they stuff a camera too but they push way deeper till you appendix

OT: occupational therapists. they're the peeps who help int he rehab of patients when at home like building support holders in the shower so that they won't fall.

febrile: having a fever

scrub nurse: nurse who assists the surgeon. "Scalpel." Nurses hands over scalpel. just like in the movies :)

resident: doc who just graduated, finished internship and has no particular specialty.

registrars: more senior than resident. usually training under a specialty before they become junior consultants.

think that's pretty much it. :)
Anonymous said…
Now that's better. I was in my grey-anatomy-mode while reading ur post. veru enriching though. =p
Anonymous said…
haaha..same here..was so visioning u in grey's anatomy and even Scrubs..have u found ur own janitor? ;)
Ryu Arashi said…
haha!!! the janitor!!! lame guy!
zarawil said…
haha no lame janitor here unfortunately....it would really make my days here more fun...but the many cute docs around here are enough to keep me humming! :)))
gammaraysky said…
"drug users that destroy their own hearts"... what did they use eh? interesting bit of fact there. :D
zarawil said…
xaph: i am indeed. except when the consultants start grilling me, that's when things get scary :)

han: hey! well the patient i saw was an IV drug user who used a non-sterile needle that infected his heart causing him to have endocarditis. he needed valve replacement surgery after that because his valve in his heart was damageg by the infection. but most illicit drugs tend to have effects on the heart. heroin etc.