Sunday, 26 June 2011

Tips for Junior Doctors part 2: be not the bearer of good news.

At least, well, just don't.

Mr Grumpy presented with a ridiculously yellow face, and after some tests and an ERCP he got told that it's likely pancreatic cancer.

Enter dr Blondie.

MRCP showed localized inflammation, and my task was to tell him and his family this glorious news: he was going to live.

Mr Grumpy was happy and relieved. 'Thanks for taking care of me, doc'.
Mrs Grumpy and the 4 junior Grumpies however, were mad. Really mad. Mrs Grumpy kept going on about how she's a nurse and how this is not how things are done. The 5 of them verbally attacked me, going on about how I'm unprofessional (because I memorized what I was going to say and did not have the file with me, simply because I was bringing GOOD news) and how this is horrible and then asking me impossible questions only to tell me that I know nothing. Mrs Grumpy had a grain of decency and used the words 'excuse me', while the mini-me's were simply harsh in their 'I'm right and you're wrong'. Then they demanded to see the internist RIGHT NOW. Not going to work, he has other patients too.

And they kept going on; the internist told me they called me a 'twit who knows nothing'.

All because I told them their father was going to be just fine.

On a lighter note:
Patient quote of the week:  It feels like there's a marble rolling around in my head.
(good, that means you haven't lost all your marbles)

Sunday, 19 June 2011

New House

I have a new house. I have a demanding job. Moving house and medicine doesn't go well together...

Today I moved the first stuff. Paint, carpets, linoleum, some other stuff.

So, no, not much time to blog.

Monday, 13 June 2011

A day at IKEA.

As you may or may not know, I've found an apartment. A 3 bedroom apartment (WITH walk in closet) and it's all for me.

That calls for some budgeting (as I need to pay a warranty) and a visit to IKEA.

Today was not the best day for that. I doubt any of the days I have available for such expeditions are the ideal day, but today must have been the worst idea. The entire Holland thought it was a good idea to go there today. I have no idea what they were doing there because I am VERY certain that not all of them were moving or redecorating. IKEA had a sale, and Dutchmen love sales, no matter how lousy they are.

Apparently, for some people, IKEA makes the perfect family day out. I don't get it. I don't find it inspiring. I find it cheap and practical and very unoriginal, but some people find it incredibly inspiring to walk around the IKEA and eat cheap meatballs. Maybe they're the same people who park their cars in the loading zone?

What I understand even less, is why they bring their children with them. I found a little boy complaining to his dad about how boring it is; and the dad said 'I know son, I don't like it either'.
So then why are you here?
And why are your children running around where I'm trying to push my heavy cart?

Another challenge was getting my stuff on a single cart. It's more than I thought it was going to be. Kitchenware takes a lot of space.
So does a full length mirror and the massive framed poster of a red London bus against a black-and-white background. The idea is an entirely black-and-white hall with just the red bus and maybe a red vase sticking out.
I went slightly over my IKEA budget (damn kitchenware, and I insisted on getting the exact rug I wanted, come on, I'm working as a doctor...)

but afterwards I went to CarpetRight and managed to get a really good deal on my carpetins and vinyl, spending 200 euros less than I bargained for, so all in all I'm playing quitte.

Now still needed: curtains for the living room and one of the extra rooms, blinds for the bedroom, a DVD-player, an iron and ironing board, a clothes rack, a stove and a broom. Oh, and the paint.

I'm poor.

Sunday, 12 June 2011

Tips for Junior Doctors part 1: Make sure you have the right patient.

Highly advisable: being efficient and seeing the patients in one room in one go.
Not-so-advisable: getting your patients mixed up.

Friday afternoon, cardio ward. Short-stay room. I have 2 grey-ish-but-not-yet-fossilised males, both returned from a coronary angiogram that morning. There also are slight differences:

Patient A has a wife who has been hanging around the room the entire day, boasting about how annoyingly rich she is. (Seriously, I don't care that you made a bid on a ridiculously famous estate in South-Africa, I care even less that you can compare the most expensive shopping streets in the country; and I'm not as flattered as you think by the fact that you're impressed with my medical school. The main reason I went there as opposed to my colleagues is that I had the guts to go there.). Patient A also had the worst outcome and needed a CABG.

Patient B is younger than patient A, and probably was a good man, your average Joe. His outcome was fine, and he was good to go ahead and get the planned valve surgery.

One of them had an angioseal, the other didn't; both had palpable masses over their femoral arteries.

I mixed them up, went ahead and told patient B that he had several options for his surgery. Then I phoned the cardiologist because I could not feel a femoral pulse, asked him if it was fine to let the patient go home. All this time, I thought I was talking about patient A.

Until at some point mrs A pointed out that that was not her husband.

Trust me, no matter how human such a mess-up is; the patients are not impressed. It's hard to get your stories straight afterwards.

In hindsight, I should not have ignored the fact that I thought that it was odd that such a high class citizen as 'mr A' pulled down both his pj bottoms and his underwear the minute I told him I needed to check the place where they stuck in the catheter.

Sunday, 5 June 2011

I quit running. Or let's make it an intermezzo.

It's not a conscious decision, it's not a permanent thing either. I have just completely lost my motivation to run. The reason? I'm not getting anywhere. I am getting extremely frustrated. I can't face another 5k lap which I can't even fully run. Ever since my IT-band drama (which also is my most-read post on here) I've been slowly, extremely slowly, increasing my running, every time I went a bit faster or ran a bit further, a dull ache in my right thigh reminded me to go slower. I haven't even finished a 10K run ever (the injury happened at 9.5k in the build-up to the 10k race). I'm not getting what I wanted out of running.

Apparently I don't have a body that takes too well to sudden increases in work-out load. Or maybe my body was in worse shape than I thought, years after the anorexia still... because come to think about it, prior to getting really thin I went through years of compulsive exercise. Looking at my body now, I wouldn't know where I lost those extra 10kg from, but well, it had to be muscle mass. I'm a doctor, and I want to understand what is happening now.

I never went up to the amount of exercise I did as a teen. (I had a resting heart rate of 54 at age 15, and I was about the strongest girl in my class). This winter, I still did not come close, but it's the most I've done since the anorexia. There probably was more strain on my muscles and joints than I thought, because I did not take that into consideration. I think my body just couldn't handle it, it was still too weak, and it was probably leaning towards overuse. Combine fatigued muscles, joints and ligaments with the way I cooled down on that fatal day, and the IT band just sort of tore. There is no other way I can explain the lumps on the thinnest part of the band.

In case you were wondering, such an injury takes long to recover.

And now, in prime running season, I've lost all motivation. I haven't run in a week. I can't make myself. I hate how slow I am, I hate how I can't run 5k in one go, I can't bear to face the same laps again and partly, the solitude is too much for me right now. And maybe, at this point in time and place, I was once again asking too much of a still weakened body.

So, I quit.

Here's the most interesting part: I don't quit. Not for good. Never for good. I'm just taking a break. I've been looking at gyms and I've been doing my Pilates (and I'm getting better at it, I'm ready for a new challenge) and actually, right now, my goal is where it should be: I need to get stronger first. I need to not be running ahead of myself; and if I want to be doing the things I want to be doing, I need to get physically stronger. I need to be doing something that does not require level 4 sports bras, as the sports bra level reflects the impact on the rest of your body too. And meanwhile, when the weather is good and so forth, I will sneak in a little jog and dream of long runs.

I'll call it Project Fitness. Maybe this is the last hurdle in my recovery, maybe it isn't. Maybe the last hurdle would be finding and keeping myself a man.