Thursday, January 30, 2014

Ten thousand reasons

Maggot infested wounds
Subarachnoid bleeds
Popping abscesses
Renal colic or rupturing aorta?
Frequnt cannabis users who wont stop throwing up and taking cold showers.
Old people who have fallen down and split their head open.
Trauma and car accidents.
Unexplained blood loss.
And some more disturbing things.

These are some of the highlights from the first few weeks. I've enjoyed it until today when I had my first deteriorating patient, and then it became stressful. Fortunately I didn't have to make the decisions and have become reasonably good at putting biggish jelcos in in a hurry. I'm not sure why I used to have issues, I just seem to have engaged the zone now. I've only had one patient properly defeat me on the jelco front recently - and that's because they literally had no veins left after many rounds of chemo.

So what have I learned so far from ED? The teaching has after all been really good.
1. Don't think about what it probably is - rule out all the things that will kill the patient now.
2. If after doing step 1, all the bad things are ruled out. You can confirm your clinical suspicion.
3. Don't jump to conclusions or get stuck thinking about one diagnosis.
4. Don't feel bad when you fail at all three steps prior to this step.
5. ED doctors do a lot more PRs than GPs. I didn't think that was going to be the case, but i've stopped being phased at least.
6. If I had been in charge of patients I would have missed a lot of serious things. Thank goodness I'm still the student.

Although I feel like I'm progressing and my skills are improving. I just feel so amateur and I wonder if I'll ever be good enough to be a real grown-up doctor. Its a very scary prospect.





Sunday, January 5, 2014

The last cackle of summer

It only seems like yesterday. There's every chance this could be a dream, though I know in my heart it is not. That first day of ashes cricket. It started the day after my exams finished. Joy beyond words. Packing up the Mannum mansion to the sights and sounds of Australia pummeling England.

After a long and wonderful summer of cricket, the five test series has wrapped up. I've spent a lot of time splayed on the couch watching. Engrossed. Such a thrill to see a whitewash. But now it feels as though those carefree days of summer are gone. Almost symbolically, the Aussies have wrapped up England two days ahead of schedule. As if they knew I had to go back to uni tomorrow, and couldn't be on the couch to watch them.

Goodbye summer. I'll miss you!