What happened to yesterday!?

I'm not even sure how to describe the day in a single word. So here's tale and maybe you can summarise it for me

Well the day started off fine, assisting in lumps and bumps and getting first dibs on ED patients. And then quite unexpectedly I was off with the veteran doctor and in to the suburbs. One of the frequent fliers, indeed a gentleman I was talking to just yesterday had been found dead. I was off to see my first certification.

I'm not sure why I'd thought this person would have just died in bed asleep. It came as a bit of a surprise to find that it wasn't the case. It was very weird to see the person come cadaver still awkwardly in situ at the site of transformation.

Outside I joined in on a quiet joke with the ambos, the policeman and the undertaker. Asked how I found the scene I gave an unguarded 'disgusting.' Instantly regretting my choice of word. The friendly ambo and undertaker were kind enough to put 'disgusting' in to perspective for me by comparing other scenes. I guess it wasn't that bad then.

I jumped back in the docs car feeling ever so mildly nauseated. Fortunately we got in to a good discussion about how you survive in a small country town as the heroic doctor and how you avoid getting involved and ultimately emotionally destroyed.

I think I learned a lot. Not about medicine though. It was another one of those 'learning things about life' days.

After a few moments of pondering it was back to clinic work. I was left to make contact with the orthopods at the kids hospital to transfer a broken distal humerus to them.  I got absolutely drilled by the ED consultant I spoke to about my apparent lack of anatomy knowledge and inability to describe the fracture. Arrrr! All I wanted to do was send the pictures. I mean, how do you describe a chunk of bone that is pushed in two directions and rotated.

Well I found a way: Badly.

After my botched explanation of the two x rays, and because this doctor obviously thought he was hilarious, he finished with a 'what year medical student are you? Ah I see, well 'posteriorly' means backward.' Then started laughing at himself. He did give me some tips though, which was very nice of him.

Luckily he put me through to the orthopod and I got a real doctor to do the speaking. *rubs hands*

Better touch up on the old anatomy. But there is a difference between inexperience and idiocy.

I think I learned a lot. It was another one of those 'learning things about medicine' evenings.

A door to the face? But a window opens.

Got to sew up a mans face last night. Was very exciting. Luckily there was a real doctor working further down the face on the ugly looking lac, while I got the little straightforward one. Still, was nice to get some facial suturing in. Luckily the patient couldnt see the fine trembling of my nervous hands as the blue sheet was draped over his face. I actually thought I did a good job in the end. Good apposition with nice eversion of the edges. And all my knots on the same side...

Then today my streak of discovering murmurs continued. Found a mitral regurge today, my first! I've really only been able to find systolic aortic ejection murmurs before. So maybe my ears are finally dialing in. Was good too, as it happened to be a patient that I'd decided to get assessed on.

Suffice to say, I'm having an 'up' day today.

Polyp ahoy!

Spent the whole day in surgery today. A scope list in the morning, where I got to see lots of polyps, proctitis, haemarrhoids, skin tags, stomach ulcers and hiatus hernias getting explored. Interesting in parts, but didn't get to do anything. Which kinda sucked if I'm honest. But the surgeon seemed to think that all of the stuff I was seeing was novel and that the scope list was usually a lot more boring. Thankfully he was realistic enough to say that one session was enough and to try avoid ever having to see another scope list as you won't learn anything new. Good bloke.

Then it was more hernias and gallbladders in the afternoon. It's the kind of stuff that would be really interesting if you were involved. But watching it from beyond the blue zone is kinda boring. The videos on youtube are often just as good.

I have a suspicion surgery might not be for me. It's all so confusing!

Parasympathetic overshot

Have had a spate of the doctors and nurses becoming patients lately. Quite amusing.

I'll make an honest evaluation here. Doctors are much better doctors than patients. Which once again reassures me that its perfectly normal to vasovagal after having a cannula put in yourself and yet be able to happily put them in to others.

"Knowledge brings fear."

Yesterdays Jam.

Bit of an emotionally trying/draining few weeks. Very up and downy. Forunately was warned to expect this. Having no boundaries is certainly proving a formidable challenge. I might elaborate on that at a later date. But not today.

A little while ago, I was reasonably fortunate to be standing on the other side of a curtain, whilst a patient misinterpreted their benign diagnosis to be much more severe than it was. As funny as it sounds, it's not often that you actually see people appreciate their lives. It's a very real emotion and a great chance to hold a mirror to your own life.

As the introvert that I am, I'm often stuck in my head wrestling with things. I guess that's why I enjoy when things are brought back to basics. All that's left is the clean cut, where things are or aren't and reality is at its most appreciable.

I guess its ironic that I'm about to segue from reality to religion, because for many they're quite contrary. And yet...

Here is a song. I originally liked it for its punchy kick drum and mellow toms, but I've grown to love the lyrics. Mostly though, it's what I needed to hear today.

Fairest Lord Jesus, Lord of all creation
Jesus, of God and Man
You will I cherish, you will I honour
You are my soul’s delight and crown

Fair are the meadows, fair are the woods
Robed in the blooms of spring
Jesus is fairer, Jesus is purer
He makes the saddest heart to sing

Fair are the flowers, fair are the children
Beautiful in all their youth
Yet is their beauty, fading and fleeting
Lord Jesus yours will never fade

Fair is the moonlight, fairer still the sunshine
Fair is the starry sky
My Jesus shines brighter, Jesus shines clearer
Than all the heavenly host on high

All fairest beauty, heavenly and earthly
Jesus, in you is found
None can be nearer, fairer or dearer
Than you my Saviour to me bound

Words by German Jesuits, English translation by Joseph A. Seiss, 1873;
Music by Alanna Rodgers, Richard Fenton, Greg Cooper, Andrew Judd & Garage Hymnal.

Sorry about that!

A quick blah from the phone.

One of the things I find interesting is about how people judge they are sick.  Most people seem to have a fairly good idea when they are sick and to what extent.  But some times there are people at the ends of the spectrum who are either desperately anxious or seriously sick. Often the history comes across initially similar. Its only when you look at them that the patchy story resolves as an exaggeration or an understatement.

I managed to diagnose an infective endocarditis the other day.  I was pretty happy to be able to deduce it from the history and have it ultimately be shown to be correct by the egg heads in town.

Some times I think I could do this doctor business.  And then I go stick a sharp thing in to someone and blood goes everywhere in an uncontrolled fashion and it looks nothing like how the real doctors do it.

Practice makes mess.