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Monday, October 18, 2004
5th year started with Emergency Medicine, after a week's break (on the pretext of waiting for results). Over the past 2 weeks, I've had A&E Medicine, where we had to attend seminars in the morning, and in between, groups of 2-3 of us are allocated to various 4-hr shifts, so that there aren't that many at one time. The group in George's is pretty small, about 12 people, and we're divided into 4 small groups for our shifts. I've realised that A&E is so much more practical, in the sense that there's procedures to be done. I've had the chance to currettage an abscess. Got to plaster casts and immobilize joints, suture, manipulate joints, got certified for BLS/ALS/APLS. Clerked lots of patients mainly in majors, minors and resus (!). Had the chance observe and follow up on a status patient (status epileticus), lots of chest pain patients, one who had SAH (sub arachnoid haemorrhage), acute appendicitis who turned out to have liver and lung mets. Had great teaching from various consultants, Regs, SHOs, and even ENP (Emergency Nurse Practicioners).
I've even had the pleasure(?) of being a patient of the NHS, courtesy of the A&E department. I came in on a Saturday morning, after calling my GP and being advised that the subungual haematoma (blood under the nail) required help but not from him, so he advised me to go to the A&E department to get it look at. So in I went, and surprise surprise, in spite of being attached to the A&E during that fortnight, and being a 5th year medical student there and all, one would think that the wait would shorten a little? Nah... I wasn't expecting to be treated differently anyway. =P And so, I waited. After a 2 hr wait, I was shown into one of the cubicles in Minors (the area which I'm oh-so-familiar with) by an A&E SHO. Think there might be a code on the cover sheet of the triage notes, coz he knew that I am a med student (from the past week, i've not seen any weird codes appearing on other patients' notes.) Anyway, it was the fastest consultation I've (personally) ever had so far. I knew my diagnosis (self-diagnosis), I knew the options available, so it took all of 30 seconds to cover the rest such as past medical history, meds and allergies, of which there were nil. And so, more waiting for the nurse matron, then after that, an attempt to drill a hole into my nail (after heating it under a hot bunsen burner-like apparatus) then squeeze the blood, only it wasn't as effective at all. So now, all that remains is a maroon-coloured underside of the nail, a hole in the nail, and no blood. Wonder of wonder, I managed to get a second opinion from an A&E Reg on Monday (when I went to Minors for my shift), when I came into Minors, which he modified my diagnosis to be a subungual bruise (since no blood came out). Haiz...
On the last day, we had an A&E assessment (it was supposed to be an OSCE, but it's actually MCQs plus ECGs and CXRs. After that and getting signed off (which is what you have to do to satisfactorily pass the firm and not be asked to repeat it again), my partner and I were so keen that we actually went in in the afternoon, and becoz of our keenness, we were rewarded with a whole flopping tutorial on ECGs in the resus room with this clinical fellow who had a folder of ECGs. And so we were quizzed on that. Fantastic stuff. =D
A&E's been a blast, and now that it's over, I'm sad. =( I kind of like it actually, coz it's a here-and-now thing, immediate resus or treatment. No follow-up, unless u take the initiative to. You rotate and treat all sorts of people, and not just limited to the elderly or children, but everything under the sun. You get to wear scrubs and sports shoes for the whole shift and no one is gonna say anything. The downside - very un-sociable hours, esp if you're stuck with the late shift (4pm-1am) or the night shift (9pm-8am).
It has confirmed something for me - A&E is in my list of choices to specialize. =)
Went to Stonehenge after an invitation from JV. Thanks to mis-information from me, we went to Wimbledon to take the train (instead of Clapham Junction). Nevertheless, we reached there in one piece, after a train ride to Salisbury (where we wandered around the city centre for a bit to get lunch), a 20 min bus ride (which costs a flipping 6 quid), and another cost for admission fees to see the famous stones. Thank goodness we didn't have to pay more for the audio guides!
It was an expensive DAY trip, but it was worth seeing the stones at least once. =) And when there, I saw something that would be perfect for Stan's birthday present, and so I got it! In the midst of some other knick-knacks which I also bought, of course. =P
English Chess and Table Tennis
I've had a game of English Chess and won it! After my last stint in A&E on Friday, I met Darren while scanning photos in the school library, and so we went up to the bar for a drink. Ended up him teaching me Chess, and with Palani's help (or rather, endless questions of thinking of my moves), I won my first ever game, after close to 24 years of not knowing how to play. =) I've played chess before, but that was the chinese version, and I was never good at it in the first place. After that, we proceeded to table tennis, and it was really fun playing with Susanna, D's gf. =) Haven't played since year 3, and I was really rusty.
After that, Palani and I went to Chef One for dinner, and just ate and talked. Michelle joined us later. Then we headed back to my place for more talking and chilling. And there it was, another 4am session. By the next morning, I was up at 8am though, did household chores, watched episodes of Charmed series 6/Smallville Series 3 (I finished Alias series 2 + 3 already), then went to the gym and played a bit of badminton with the usual people (Palani, Michelle, etc). The first time in a long time that my badminton racquet has come out of the closet, in 3-4 years I think!
This weekend, on a Sunday, Stan came over to the house, and he drove us to Guildford where he's not doing his Surgery shadows. We decided to brave the unknown area of Guildford and bumble around together to explore the city centre, and boy did we really bumble around. It was a really long walk from the hospital accommodation (where he's staying at the moment) to the city centre - a long 45 mins!). Thank goodness it didn't rain that day. So we spent a couple of hours browsing the high street after lunch, and I ended up choosing a shirt for him in FCUK and I went on to shop at NEXT (bought a top and skirt which was just gorgeous, only I don't know if I really need it, or when I'm going to actually wear it, considering I don't wear skirts here coz it's a hassle to run around in them). *dread to think about my credit card bill this month*.
Then we went to watch Shark Tale, and boy was it hilarious!! Just like 'Finding Nemo' but it was both adult and childlike at the same time. Great movie to watch! Will Smith and Robert de Niro are real comedians, man.
By the time the movie finished, I had 5 mins to run to the station to get my train. While getting my ticket, the board said that the train hadn't left yet, and yet when I ran in, there was no train in sight. Apparently it had already left, while the board said it was still there! Damn... And so I had to wait half an hour for the next one in, and during that time, the passengers had to walk from one platform to another due to various announcements that the train was going to land up in a different track. Bleah... Not to mention, the wait for the bus from Clapham was so long that by the time I got home, it was well past 9pm! (And I had left Stan at 7.20pm, the train only took 20-30 mins, and the bus ride itself took like 15 mins.) haiz... Nevertheless, it was a good weekend. =)
I've just started on a fortnight of Anaesthetics, and it's not exactly very appealing. =/ Oh yeah, on another note, I've started training for the ladies' squash team. =)