Thursday, 24 November 2011

Tips for Junior Doctors part 7: sometimes medicine is really, really easy.

Sometimes medicine is really easy. 

Exhibit 1:

60-year-old lady with ridiculously long medical history and a 3-page drug list (requiring 15 minutes to write prescriptions for upon admission) and UTI is somnolent; family is really worried. 'She's like this all the time now'. 

A glass of lemonade fixed her hypoglycaemia.

Exhibit  2:
50-year-old male with chest pain, nausea, vomiting and a heart rate of down to 36/min. 

Asking the family to keep talking to him persistently raised the heart rate to a safer 45-60/min, while I waited for my labs to return. 

Explaining to him that he is most likely suffering from good old stress, but we need to do a stress test (har..har..har..) and repeat some bloods just to make sure, made him a lot better right before my eyes. He literally stopped sweating and put his (still empty) puke bowl away. Heart rate 60. 

Sunday, 20 November 2011

Such a clean fellow!

Spent my Friday afternoon in Emergencies. I love Emergencies; have I mentioned that? Oh, yes, I have. A few times. My Patient Of The Day wasn't an Emergencies patient, due to a viral outbreak all 112-calls have been forwarded to another hospital and we had very few medical emergencies. I saw a guy with probably a large psychological component in his complaints on the surgical ward instead.

And I watched the hassle-bassle of the Emergency Department going on. There were a few interesting patients for the surgeons. One of them presented with a shampoo bottle up their bum. Bottom-side first, of course. Not only had he managed to insert a normal-sized shampoo bottle into his anus, he walked around with it inside of him for a few days before working up the nerve to go to Emergencies. It showed somewhere in the middle of his abdomen on X-ray. I always thought the colon propulsion went toward the exit... I don't know the end of the story though, I do know that he wound up in the OR.

Gentlemen, should the need arise to insert a bottle into your anus, please, attach a string first so you can pull it out if it 'slips in too far!'

Monday, 14 November 2011

The Return of the Blonde Doctor.

Meanwhile I'm half getting somewhere when it comes to beating my black dog. I'm all drugged up and ready to go.

OK, not really, I'm on the lowest possible dose but I'm having a blast with the side effects.

And really, I feel like there's some sort of taboo on mental health issues in doctors. But really, we're people too, and anything that can happen to you can happen to us. The depression hit me hard, and the resulting relapse into anorexia hit me harder. I am fighting.

And right now, I'm struggling to regain my career, to return to work, to make it work. I've been given the green light to start seeing patients again, limited to one a day three days a week. I see them in the emergency department, the only place where I can do this.

And today was my first day. I was nervous. I went to work at around noon, after having some trouble collecting my medical gear. I was not as much nervous about seeing a patient, I was nervous about colleagues and consultants.

So I got to the hospital, and faced my first challenge: how to get hold of a white coat. I didn't know the autovallet doesn't work between 10AM and 1PM, there's no sign to enlighten me either. It was somewhere betwee 12:15 and 12:30, and I wasn't entirely hoping to sit there and wait, so I went around to the linen room. A very cross lady handed me a coat, in the same size I wore before, and I'm drowning in it now.

I don't know why hospitals always insist on letting us wear ugly coats.

Went to the emergency department. Welcomed by colleagues. Stared at by a medical student. Not-sure-what'ed by nurses. (But I brought them home-baked biscuits, we had too many). One colleague told me 'well, we have dyspnoea, dyspnoe and dyspnoe, which do you prefer?'
Eh, I'll see the one with dyspnoea...
New nurse handed chart to dr Olderguy, Dr Olderguy handed it to me 'It's dr Blondie's patient'.

Old-ish lady with heart failure. Gave her some lasix and sent her to CCU.
On my way out:
Patient: 'Dr HerGP said I have ladies' legs'
Daughter: 'Well, old ladies' legs then, because mine don't look like that'.

And then, actually, I was tired. Need to train that brain a bit.

I have discovered the use of podcasts though. As I'm (more or less compulsively) walking around, I can now study at the same time!