Sunday, 6 May 2012

Because Poppet is the best term of endearment ever.

Well, hello there. We meet again.  I've been expecting you, Mr Bond. Etc :)

It has been a strange two weeks, fluctuating between days where literally nothing has happened and I've come home from the hospital depressed, and days that are so weirdly intense I haven't stopped talking about them. For some background, I am now doing the surgery block, which I had been dreading due to hating the idea of surgery in general, and also the faff of having to change into and out of scrubs etc. So brace yourselves, because I am going to go onnn and onnn, lol .

  • Intensive care
 So the first week of the block was spent in ICU. It was a massive change for me, being on a ward where you can't just wonder round taking histories from patients and being all smiley, because near enough every patient is sedated/comatose/seriously ill. Over the week I became accustomed to their faces, who had deteriorated overnight, and who was improving.

Some patients had their sedation lifted- I found it strange to walk in and find a patient who I'd observed sedated for the past three days, awake and talking to nurses. It was a massive relief, but he had no knowledge of what he'd been through. Just two nights ago, his potassium levels had become dangerously high and his blood pH had dropped very low, and his bed area had been flooded with doctors and nurses, all trying to stabilise him. He had no idea that they were the reason he'd made it to today.

And then there was a patient who had been on ICU for a very long time, gradually deteriorating for some reason that the doctors couldn't explain- they had tried every course of treatment for every possible disease they could think of, but he just kept getting worse. People look so small in hospital beds- he was frail anyway, but it was so sad to see him almost lost in a vast array of tubes, monitors, needles, and venous and arterial lines. We did the ward round with the doctors, and each morning they were at a loss for him. Worse still, his family were unable to accept that in these modern times, a solution could not be found. Who could blame them? The doctors eventually sat them down and explained that they were considering stopping treatment. I passed the family later that day- they were all stood outside the ward, crying. I couldn't even meet their gazes, it was horrible. The patient died at the end of the week, quietly at some point in the night.

It's very hard to detach yourself from cases like these- you're encouraged to be somewhat distanced, because otherwise the amount of trauma you'd take on would likely stop you functioning as a doctor. At the moment though, I'd rather be fully involved, and feel every loss, and terminal diagnosis as sharply as though I know these people personally- because in future that feeling will almost certainly be blunted by a massive workload and sheer weariness of experience. Better to let yourself be affected and sympathetic now, than never understand what patients are going through. And as a student, what can you do for patients but offer a bit of comfort and empathy, anyway? The doctors would if they had the time, but they don't. It's the only way we can help at the moment, and in a way its one of the most important things to offer.
  • Surgery
 So we saw some surgeries for the first time this week. I have always been completely sure that I never want to be a surgeon, and it still stands. I have to admit though, that surgery is pretty amazing in that it literally is butchery. As one of the lecturers said to us, surgeons are causing a trauma to the body in the same way that car accidents cause trauma to the body. The only difference is that they cause it in a controlled environment. You truly appreciate the fragility of life when you see that people can be patched up/sewn/glued/have bits cut out/have bits added/have bits taken from places and sewn elsewhere, and then return to their lives. The first operations I saw were eye operations- just so intricate and complicated that I had no idea what was going on. They were correcting people's squints (where one eye points out in a different direction), and to do this you have to shorten certain muscles that control the eye, or reposition them. But you have to be very precise in your measurements, and how many millimetres you move/shorten the muscle by, because obviously if you're slightly out, they will have double vision. Never becoming an eye surgeon. And needless to say, it required a strong stomach not to be repulsed by scalpels in eyes etc.
I have to admit though, as a sidenote, that it felt pretty damn awesome to walk into the hospital restaurant in my blue surgical scrubs, and stand in the lunch queue. I can see why surgeons are totally high on themselves. It's the same kind of glamour reaction a pilot gets walking through an airport. :D
  • Maternity.
So the anaesthetist I'm attached to spends some mornings in the maternity operating theatres, and so I was there the other day, wondering like a lost sheep until another anaesthetist ran past and told mine that an emergency caesarian section was going to happen. So mine sent me running (yes, literally running. How embarrassing) after him. I helped him draw up a load of drugs that might be needed into syringes (by 'helped', I mean I opened boxes for him and threw away empty packages, lol). We then entered an operating theatre where, it appeared, all hell had broken loose. Fifty different doctors, surgeons, nurses running around, getting monitors and IV drips and surgical instruments ready. Another set of doors burst open and a very scared, very pregnant lady was wheeled in and helped up onto the operating table. She was still having contractions, but they had found that the baby was in distress for some reason (I wasn't sure why myself, as I didn't know her history) and so they needed to operate quickly or its life would be at risk. Within minutes this team of staff had her hooked up to IV lines, had numbed her from the waist down, had completed the safety checklist before proceeding surgery, had put up a set of drapes so she couldn't see what was happening, and had brought in her husband to hold her hand. And they were ready to start! It was pretty seamless, I was massively impressed with their efficiency. And they were all very reassuring with her as well.

I tried to stay out of the way, and watched as two surgeons made a large cut below her navel, then more carefully began cutting through layers of muscle and tissue, trying to locate and make an incision in the uterus. The baby is contained within an amniotic sac in the uterus, and just before its born this ruptures (waters breaking etc). But if the kids in distress (e.g. oxygen deprived), it effectively 'poos' a substance called meconium, which turns amniotic fluid green. When these surgeons cut into the sac, a load of very green fluid gushed everywhere, it was..eww. The surgeons then practically wrestled this poor baby out, suctioning all the muck from its mouth, so it could take a deep breath and start crying. After all that tension, it was the most beautiful sound, and everybody visibly relaxed. Mum and dad were congratulated by everyone, and the process began of carefully controlling any bleeding, then sewing the lady back up. Baby was taken to a corner and vigorously rubbed down and warmed, and tested for reflexes. I was pretty spellbound. Miracle of life and all that. Ahem :')

I left with the anaesthetist after a while, and we began preparing for the next caesarian, which was a planned one. It was amazing to watch- this time the atmosphere was much more relaxed, and controlled. The surgeons took more time since there was none of the urgency of before. And it was twins this time! Just brilliant. My clinical partner and I were practically in tears, both being guilty of over-emotionality at the best of times, lol. We didn't get to see them complete the sewing-back-up phase as we had to leave, but we were on a total high for the rest of the day. Just, how awesome! I am now considering being an obstetrician, despite having only experienced it for three hours, lol. One can dream etc.

So thats it for major things that have happened! I know, I know, she's shutting up etc.
And, finally, in other news... I had to include this picture of a neatly abandoned pair of shoes that were near the door of the train I was on. 

...And of the food I made at my uni house! It's a chicken/red pepper/mushroom/spring onion curry type thing. With salad-ness. It was rather nice if I do say so myself :D I'm just proud because I bought the ingredients and made it myself, as opposed to microwaveing/pot noodle-ing my dinner like I usually do, lol. 

And of course, all credit to Emad-ness for the awesomesauce-ness that is this rainbow slinky :D It is a massive source of cheerup. (Yes, my dressing table is messy, shhh)

I leave you with this, that I was relistening to yesterday (again, thank you to Emadness), and saw a comment that it would be featuring on the Voice, so woo for it being more widely used, despite the guy killing it when I watched the Voice clip ¬_¬ It just sounds so lovely!

(Also, lastly, I promise- ItsComplicated- I watched that slam poetry American guy and was blown away! Favouritest line EVER- "Death is breathless but poetry's deathless". WOW :D )

Oh, and rewatch Mrs Doubtfire, everyone!

In a while, crocodiles!