Gearing up for my 10km

Instead of ranting, for a change I'm going to chat about an upcoming event in my life, my first 10km race tomorrow.
I love the way the organiser chose to call it a race, it leads people towards the wholly untrue conclusion that I will be racing, and therefore running fast to try and beat other runners. This is bollocks.
I will be firstly trying to finish the course without collapsing into a sun-drenched pile of huffing, puffing sweaty pale mess on the course. My secondary goal is to run the whole thing, not taking any walking breaks. I have done an 8km training run, and it wasn't too hard, but you never know, the last 2km could kill me. My final goal, and the one that I will forget about quickest when the start gun goes, is to finish in under an hour. A respectable runner's time would be under 50 minutes, a great one under 40. But despite the misleading facts that I am young, and do quite a bit of exercise, I simply can not keep running that fast for that long.
Because I naturally have the ego of an 8 year old, which needs constant reasurring and compliments from my parents, my mum and sister are coming along to cheer me on. I have devised a list to help them find me in the pack. It will help them spot me as the runners come home.
From first to last, the groups of finishers will be-

1. The elite runners.
2. The highly trained part timers.
3. The social runners with a bit of natural talent.
4. The average social runners.
5. The poor social runners.
6. The people who signed up for a dare last night.
7. The fatties.
8. The concurrent walking race leaders.
9. The under 10's race leaders.
10. The race marshalls that were keeping the road blocks in place.
11. Pedestrians who happen to be walking the same course by coincidence.
12. The litter they've dropped that has been blown by a gentle breeze around the course.
13. Next year's winners.
14. Me.

The fact that my right shin has had a nasty bruise next to the bone for 3 weeks now isn't helping, so I guess I'll be gritting my teeth and throwing myself over the line.

If I don't post tomorrow, I died trying.

Patients are Liars

During a history-taking session with a 35 year-old male patient today, I asked him the routine question about his previous operations.
"None", he stated firmly. I am curious.
"Are you sure?" I reiterate. He looks at me like I'm calling him stupid.
"Yes. Positive." I finally decide to show my hand.
"Only I've looked through your notes and they say you had a kidney transplant in 2005".
He is nonplussed- "oh, does that count as an operation?".

This is typical. Medical people don't expect their patients to know much about their problems, or remember the finer points of their treatment for later, but we have to draw the line somewhere. Strangely enough, putting somebody to sleep, cutting a big hole in their side, tearing out a vital organ and stitching in somebody else's counts as an operation. It's crazy, I know.
I've had worse though. I once chatted to a man who swore blind that his lungs were working fine, never any problems there. He only had one, the other had been whipped out last week for his apparently minimally irritating lung cancer.

"What about allergies, to any drugs or foods?" I continue on down the path of foolish questions.
"Oh, no, definitely not. I'd remember that."

Well guess again jackass. Your notes say you're allergic to all kinds of penicillins, and the most common way to find that out is to have them given to you and watch as you blow up like a anaphylatic hot air balloon and almost die from airway obstruction. But I guess it's easy to forget, you know, that time you nearly died.

So, my conclusion is that some patients are extremely forgetful, plain stupid, or my own personal theory, they are playing games with me and creating a whole new character every time somebody with an ID badge speaks to them.
Anyway, my patient has asked me to kindly tell the surgeons during the operation tomorrow that it is his right testis that is cancerous and needs removing, not his left. Well now, how good is my memory?

Me vs. Stephen Hawking: Gameshow Challenge

We all know Professor Stephen Hawking is one of the leading minds of our time, but how would he fare in a duel with me? My chosen weapon- pistols? No. Swords? No. It's game show time.
Round One- Countdown
It's pretty obvious that Hawkers would shit on me at this. Not only can I never manage more than a 4 letter word when I play it at home, Hawkers probably has Google on his computer and could pretty much come up with a perfect score.
Hawking 1-0 Me
Round Two- Mastermind
It's not looking good for me here. I'd have to choose "rare symptoms of hangovers" as my specialist subject, whereas he could probably take "the life and achievements of Stephen Hawking" and get away with it. Unless I get asked 20 consecutive questions to which the answer is "pass", I'm done for.
Hawking 2-0 Me
Round Three-Big Break
Although this one seems a bit physical, if you remember correctly it's only the professionals who play the shots, while the contestants sit in their chairs and answer questions. It was looking like 3-0 until I realised that at the start of every episode the contestants have to choose a snooker ball from a bag to determine their partner. Hawking has a problem here-disqualified.
Hawking 2-1 Me
Round Four-Bullseye
Hawkers doesn't seem like much of a darts man to me, and I see no projectile-firing devices on his chair. So even though I can only hit the board about once an hour, I win by default.
Hawking 2-2 Me
Round Five- The Weakest Link
Despite being the smartest sod in the line-up, Hawking wouldn't fare to well here because he'd get voted off towards the end due to some tactics by the other surviving contestants. It was all going well for me here until I realised that I'd probably get thrown off first for forgetting how many days there are in a week, or what colour grass is.
Hawking 3-2 Me
Round Six- Stars in their Eyes
Steve probably can't knock out much of a tune, I have heard. Apparently he lacks pitch or something. I, on the other hand, can get through a Frank Sinatra without having anything thrown at me. I don't murder them, just assault them.
Hawking 3-3 Me

Well well, looks like good old Hawkers can conquer the world of theoretical physics, but can't put me away in a good old fashioned round of game show marathon.

Top 5 Famous Surgeons

Seeing as today was the first day of my new surgery rotation, I thought I'd look at a few famous butchers (sorry, surgeons), and judge them in a manner ill-fitting my status. I've listed them in a Top of the Pops-style chart, with the crappiest being number 5 and the least crap (notice my judgemental tone?) being number 1. Enjoy.

In at Number 5-

• Robert Liston (1794-1847).

One of the most revered surgeons of his day, Liston was renowned for his lightning-quick amputations. He was widely reported to be able to take off a limb in less than 30 seconds, which was necessary because the lazy 18th century chemists hadn't bothered to invent anaesthetics yet. That said, when they finally got off their fat alchemy-addicted arses and actually invented ether, Liston did the first operation under anaesthetic (the patient, not himself) in the UK.

Unfortunately nobody is perfect, and Liston had his faults. He once removed a patient's limb so fast he took his assistant's fingers with it, the poor git dying later from infection (because the lazy chemists hadn't invented antibiotics yet either). He also removed a man's testicles along with his faulty leg once too. Whoops.

Oh, and he was Scottish. Win some lose some.

New entry at Number 4-

• Dr Karl Kennedy

"He's not a surgeon!" I hear you scream. Well, you are wrong and I am right. He is a surgeon, a GP, an obstetrician, an A+E doctor and a psychiatrist all rolled into one, in short, he is the world's best doctor. He actually saved his own son's life by keeping his airway open by cutting his throat open and pushing in a straw. He also gets extra brownie points for seemingly being the only bloody doctor in Australia, whenever anyone gets admitted to his hospital they end up under his care.

Alright, I admit, he has his bad points. He seems to be knobbing some different random bird every 2 weeks, and his grovelling apologies to his wife/ex-wife/re-wife are just nauseating. Also, his interpretation of the confidentiality rule is fairly liberal. By that I mean he divulges information to whoever the fuck he wants, whenever the fuck he wants to.

And yes, he's Australian.

Toptasticly bouncing in at Number 3-

• Dr Samuel Mudd

A firm believer in the Hippocratic Oath, Dr. Mudd was certainly not going to divulge information about the identity, condition and whereabouts of the nice young man whose broken leg he had set and splinted recently. Unfortunately, the authorities seemed fairly keen to find John Wilkes Booth.

Mudd escaped the death penalty for conspiracy to murder by one vote, and instead got life imprisonment. He was confined to a dungeon after a failed escape attempt, but still helped to quell a substantial outbreak of yellow fever in the jail. He died of pneumonia (lazy chemists) shortly after being pardoned.

Sounds like he was a nice bloke. Loses points for having a stupid name though. Oh yeah, and he was American.

Rocking and rolling to Number 2-

The more observant readers may have noticed that this is not a surgeon, but a sturgeon. I have my reasons for this unexpected new entry-

1. Surgeons in general are basically hackers and there aren't that many famous ones.


2. I am getting bored and tired.


3. Sturgeon is a pretty cool word.


4. I'm pissed off that I didn't save Karl Kennedy until last, and I can't be bothered to move his section down.

For those of you that care, the sturgeon is a bottom-feeder that uses a wedge-shaped snout to dredge up the water bed. On the down side, fish suck.

And finally, in at Number 1-

• Dr Frankenstein

If you didn't know that Frankenstein was the name of the doctor and not the monster, then your ignorance is insulting and makes me feel ill. Please resit your SATs at once.

Who can hold a candle to Frankenstein? Nobody. Who the hell else has managed to bring parts of corpses back from the dead? Have you? No? Then don't argue with my choice. Well, until we get proof that Prince Charles honestly did construct himself a new bride using only chunks of horse meat and a bolt of lightning, there is only one winner in my book. Plus, Frankenstein worked "freestyle", without so many of the hindrances of modern medicine, like having to wash your hand in between rectal examinations, and having to actually ask before we dig up your gran's body for research.

A true professional. Oh, and he died of pneumonia. Lazy, lazy chemists.

An Open Letter to Professional Footballers

Dear Professional Footballers,
I enjoy watching and occasionally playing football, and admire your talent for the game. I find it to be a wholly interesting and enthralling sport, one which I am happy to be associated so closely with my country and culture. Well done for rising through the swathes of amateurs ranks and becoming professionals, an achievement only a few aspiring children will ever obtain.
However, I think I can be of assistance to you. I enclose a list of advisory points that you may find useful in gaining the recognition of the public and your peers to a greater extent. Feel free to use them as you see fit.

1. Shut the fuck up. When the referee says it's a red card, it's a red card. When he says it's a penalty, it's a penalty. No amount of crowding around him and shouting abuse at him will make him change his mind you classless bunch of chavs. In fact, if I was in charge, I would book any player who spoke to me ever, unless he was telling me that I'd dropped my wallet, in which case I'd give him a final warning. Referees turn up every weekend, run twice as far as any of the players, get paid a pittance and don't even get on the team sheet, so give them some respect. In rugby, whose players could, by the way, beat the shit out of you, the 20 stone blokes cower in respect of the 5 foot 2 bald guy who runs the show. Learn from it.
2. Don't be such a pussy. When you're dribbling along, you have a remarkable tendency to fall flat on your highly paid arsed as soon as the nearest defender farts in your general direction. I don't care if you think that it's your prerogative to go down if you're touched, it's a man's game so act like a man and stay on your feet. If Bobby Moore had brushed Cristiano Ronaldo and he'd fallen over, Bobby would have kicked him in the nuts as he lay faking an injuring on the ground and told him "now that's a foul, get up you fucking girl". Again, rugby players seem to do okay when they have 3 international forwards hanging off them, but you fall over when someone throws a coin at you. Get over yourselves, I'm embarrassed to watch it.
3. Stop whining about money. Don't you dare ever ask for a pay rise, or blow all your money on the horses. If some moron wants to pay you a million pounds every time you take a piss then there's not much I can do about it, but don't go crying about it if you suddenly can't afford the repayments on the small country you bought, or the mafia want that money they lent you for that naughty little crack habit. Not my problem. 100 years ago players played for nothing, in between 16 hour shifts down the mine. And they loved it. And they still managed to stay on their feet, and treat the ref with respect too.
4. Keep your knuckles off the ground. I know your IQ isn't very high, I know your missed your GCSEs because "you couldn't be fukkin bovvered", I know you share half your genes with angry confused gorillas, but for some unknown reason, kids look up to you. So don't chin another player in front of a crowd including the local primary school, because they'll think it's okay. It isn't. For the amount of luck you've had in life, you can afford to not be a twat from time to time. Anyway, you fight like girls, any decent rugby team would murder you, and apologise to the ref afterwards.
5. Stop crying you little bitch. I know it sucks to get knocked out of the World Cup, because we all get knocked out, not just you, whenever you finally play a team not bad enough to lose to your slow, passionless drivvel. We line the pubs in our thousands to watch it, every four years, and we never cry. We go back to our crappy jobs in garages and corner shops and offices. You get to kick a ball around again, for 100 times what we earn. So don't cry, little girl, it'll be okay. For anyone who cries when they lose a playoff/cup final/league, then there's no hope, you're just too much of a pansy, Bobby Moore wouldn't waste his time kicking you in the nuts. He'd just laugh, and wave his World Cup medal, taunting you.

Thank you for your time, I hope you can take some of this on board.

Regards,

The Rising Medic

p.s. The following footballers can disregard this letter-

• Gary Lineker
• Alan Shearer
• Bobby Moore (rest in peace you legend)
• Pele (good work on bum cancer)
• Gary Neville (illiterate)

God and Me, Chatting it Out

I'm not a religious guy at all, never have been. To me, religion at best seems ill-fitted for modern times and at worst comes across as one giant hilarious farce designed to delude honest people into giving up their own personal sense of morals for a pre-written list of platitudes and lies.
I could poke holes in religious arguments for ages, but I won't. But I'll give you a taster of my cynicism- here is how I think it might pan out if I get hit by the proverbial bus tomorrow and shimmy on up to the Pearly Gates. Beware, I may need to have had a few beers to get the most testing lines out, but hey, maybe me being drunk led to me being hit by that bus.

God: Shame on you my son! You have ignored my eternal message and strayed from the path of Christ! It is unending damnation for you!
Me: Hang on a minute. Let's be honest, you didn't make it that easy did you, blessing me with a logical mind and a curious personal nature? Come on, was I really going to believe a 2,000 year old book with a tenuous plot, or some rather sensible modern theories?
God: Good point, but it's in the faith you see, trust without proof.
Me: Right. That's the thing isn't it, it's not really very fair is it? Punishing us for not believing in something without proof? Thanks a bunch.
God: Ah, but I work in mysterious ways. I sent my only Son to heal your sins.
Me: Yeah, great job, healing my sins two millenia before I was born, in a country 3,ooo miles away with no accurate method of recording events apart from world of mouth. Wasn't the best idea was it? If you'd had another son inWeston-super-Mare in the 1980's then I might have gotten the message. And as for mysterious ways, Bristol Rovers beat us in the cup this year. What the fuck was that about?
God: Sorry, I thought I should give them a bit of hope after such a shitty league season. Don't worry, they'll be losing in the final to Doncaster.
Me: While we're at it, what's up with the multiple religions? Do you just automatically send all the Muslims and Jews to hell then? What about all the undiscovered peoples of the Amazon?
God: They all worship the same God. It's the thought that counts, like socks for Christmas .
Me: Well good job telling us. We're been knocking seven shades of shit out of each other about whose God is better for a bit of a while now.
God: Well, I created a perfect world, it is you who has tarnished it. If I interfered I would be infringing on your free will.
Me: Give me a break. You created a perfect world, but we tarnished it? Did we create cancer and bacteria and earthquakes and plane crashes and Dale Winton? And for your information the world isn't perfect, we're far too close to France for my personal comfort.
God: Yeah, bit of a design flaw there, France had to go somewhere.
Me: And don't you think you could make following you a bit more enticing? We only currently have a choice between chanting stuffy old hymns with the oldies, or being young and socially typecast as strange deluded altruistic weirdos that like to spend Friday evenings choosing their favourite Bible sections and being gutwrenching nice.
God: I'll admit, I do have a bit of a cult following. Maybe I do need to make it a bit more street.
Me: Street? Act your age God.
God: Sorry, too much MTV. Pimp My Ride is whack. Sorry.
Me: Listen, I'm actually not that bad of a bloke. Either we can keep arguing like this or you can send me back down there and you can have another 50 years to think up a decent argument. Deal?
God: Fair enough.
Me: Oh, and give me one of those dramatic resuscitation scenes like on Holby City. That would be great.
God: Don't push your luck.

My Ethics of Animal Testing, Basically

Firstly, let me start off by commenting on The Sun's portrayal of the tax rise on cigarettes and tax cut on nicotine patches as a bad thing..............grow up you fuckwits.
That's that done then.It's that kind of ignorant attitude that stops the genuinely conscientious people who want to quit from doing so. I thought you had to have a vague amount of common sense to work for a national newspaper. My mistake.
Okay, rant out of the way. Moving on, my summer elective application was accepted today, in spite of several glaring holes I left in my proposed schedule, including the fact that I only applied to do four weeks of work in India and not the "compulsory" eight. I suppose that the School of Medicine is sympathising with us and our tough third year course, and recognises that we deserve a summer of relaxing, and not one involving work in another hole in a third world country. Either that, or they couldn't be arsed to check my form thoroughly enough.
Also, today I got a brief view of what I'd be doing for the majority of my fourth year. I'll be spending quite a bit of time in sole charge of a rather expensive, rather complicated confocal microscope. Basically, it shines a futuristic type laser at slides and churns out pretty colourful pictures that tell you where all the different chemicals you injected your mouse brain with are. Yes, that's right, mouse brain. For want of a more humane method, my project involves mice. I won't say we kill them for science, but they're alive when we start and when we finish, they're, well, not. We send them off peacefully (I think, is being injected with formaldehyde and heparin painful? Shit, it doesn't sound that nice actually), but that's a bit of a cop out.
On a sensible note, and to stop my house being fire-bombed by mad tree-hugging hippie warriors, I'm not a big fan of animal testing at all. I'd much rather it could be done using another method, but it can't. However, given the choice between a load of mice dying and eventually curing Alzheimer's, or being lovely to mice while our grandparents and parents die in droves (and it is not a nice disease), I know which side of the fence I fall. Again, I'd rather we didn't have to do the maths and calculate which form of life is more worthy, but nobody said life would be fair and sometimes we don't have a choice.
Moving on, if the research turns out to be any good, which with me and my infantile knowledge of neurology as a main driving force is a remote possibility, I may have to chance to do something nifty like bugger off abroad and present it to people who actually understand. Or, it might get published in a journal, which would increase my chances of getting a non-shit job by quite a bit. Plus, my name on a scientific paper which would be totally incomprehensible to the general public might at least make me seem to be fairly brainy. Here's hoping.

Weighed, Measured, and given a C

Today I had my assessment for my previous 12 week's work. It entailed only, thank God, a 30 minute chat with my consultant. She had developed a nasty habit of liquidizing my pride into pet food sized chunks, but luckily today she seemed to be in a hospitable mood. Possibly something to do with her having to postpone our first attempted meeting after her pushbike broke down on the way to work last week. What kind of battleaxe consultant rides a pushbike?
I'm not entirely sure if offering to meet her in the D Level coffee shop was a good idea, as I spent the majority of our supposedly mature conversation with 2 slices of Marmite toast hovering around my face, nicely washed down with the staple black coffee.
I started with my opening gambit, suggesting that she couldn't possibly have an accurate picture of me as a student because she only saw me for an hour each week, and even then hardly ever in the presence of patients. Surprisingly, she conceded that. Bingo, I thought, at least it won't be a straight F.
Anyway, she highlighted a few of my more noticeable shortcomings, including my rather crap ability to take 3 or 4 minutes to answer questions that Richard and Judy would find too easy for their quizzes. Apparently I'm also too apologetic at times, although I think my self-dissatisfaction at times has been misconceived as this. I do not like myself very much when I do a shit job at something I'm meant to be good at. She also reinforced the message about having thick skin, something I thought I was developing quite well.
Also, she reminded me that quick thinking and decision making was a key factor not only in my current speciality elect, A+E, but also in most other fields of medicine.
As she signed my form off, a lovely big C, she asked me for the date before mumbling "hang on, I should know, it's my wedding anniversary".
"Congrats", I said, "which one if you don't mind me asking?", I bantered.
"Fifteenth". She answered. "And don't I bloody know it."
And it was back to work for the both of us.

Recognition

MyHeritage - share black and white photos with facial recognition technology">
Oh yes, I am famous. Well, at least my face is famous, bits of it anyway. I have no idea how accurate this software is, or how many viruses it gave the Uni computer, but at least it's interesting and it got me out of another 15 minutes of studying.
Apparently, I share the features of my mug with a Chilean biologist, a Mexican soap star, a Finnish metal guitarist and an American solo guitarist, a top Hollywood actor and, most interestingly, 3 members of N'Sync. This is surprising as I think there were only 5 members in total. So, either I am the disastrous genetic creation of a cliched 90s boyband, or the software has a very small database of photos.
Either way, at least it didn't tell me that I look like Elijah Wood, just for a change. Even the crackpot patients on the Psychiatric Ward shout out along the corridors I'm that bloke from the Lord of the Rings.

Ranting About Lectures

Every student worth their salt knows what it's like to sit in a boring lecture. I think "boring" is an understatement for some lectures though, especially those on certain subjects like statistics and administration. Which is unlucky really, because that's what we have to do for the next week. Sit in a lecture theatre while some mindless clone recites incomprehensible jargon at us in a monotone voice, for hour long stints. All day. All week.
I don't hate lectures in general, but it's certainly pretty easy to make a lecture boring. For instance, some lecturers have that kind of voice, that low, droning, semi-soporific crackle that either sends you soundly to sleep or makes your skin itch unbearably with the urge to run down to the front and tell him to shut the hell up. Also, lecturers who insist on abbreviating every possible three word term should be shot on sight. I listened to a full 45 minutes of some bloke talking about R&D today before I realised that I had no clue as to what it stood for. Actually, in his defence, when I found out that it stood for Research and Development, I was interested even less.
Also, people who lecture in patronising detail about something we already have to know are fairly irritating. Luckily I fell asleep for the hour on Ethics today, I did all that rubbish at A Level. Everyone still awake was pleasantly reminded that you have to ask the patient before turning them into a guinea pig, and they can even say no if they like. Crazy revelations.
This whole week has been prompted by the School of Medicine's conclusion that we are incapable of writing a good scientific paper as part of next year's assessment, so we should be subjected to 5 days of lectures telling us in great, superfluous detail how it should be done. We actually have sessions on how to do spreadsheets, which will no doubt involve sub-modules on "where the on button is" and "efficient development of mouse-clicking learning outcomes".
I suppose it wouldn't be half as bad if I actually learnt something useful. All the speakers stand up at the front, reel off their piece about ethics, protocol or the Human Tissues Act 2004 and sit down with satisfied smirks. Unfortunately, we have no idea what the hell any of those things has to do with us.
For God's sake, just give us a 10 minute talk with a bullet point list of forms that need to be filled in and who has to sign where. We can deal with the rest. As they should know, we're not totally stupid.

Ash Cash

Last week we had a Palliative Care lecture that was touchingly entitled "And Now the Patient is Dead". Although I won't be making an extra special effort to create corpses in my professional career, I suppose it will still be necessary to know a few things about them. I'll pass on my new wisdom to you.
Firstly, it isn't legally possible to own a dead body. You can be the guardian of the body and be responsible for disposing of it, but you can't actually own one. Obvious, you might say, but it stops the occasional crackpot from going into total denial and still dressing their dead great grandmother in the morning for 4 months. It's happened....
Secondly, if you get permission from the proper authorities, you can bury the stiff in the back garden. Our lecturer says you have to get confirmation from the water board about pipe lines, and from the council about changing the specs of the house, but basically it's fine. It might drop the asking price when you come to move out though.
Next, you could donate your birthday suit and it's contents to medical science. I'm not talking about that weird German bloke who splays organs all over a box and calls it art either, I'm talking about education. This is composed of me, and other assorted halfwits cramming themsleves around your severed limbs and torso and saying things like "why can't your nerves be like in the textbook?". The maximum time you can spend doing this as a dead peron is 3 years, about the same time I could spend doing it as a living person. Then they box you up for a proper send off.
Getting "repatriated" is also a choice. If you choke on your crepe or get poisoned by your San Gria, you can get flown back to the UK. Careful though, get good insurance, because you have to get certified, embalmed, shut in a double metal coffin (less leakage), and crammed into a cargo hold. Not the cheapest thing in the world, especially as airlines are lovely people and wouldn't ever dream of putting any other bags on top of the coffin. They put the coffin on the floor of the hold and make you pay for the airspace above it too.
Also, you can get buried at sea. It's dead expensive (hilarious pun), because you have to get a insanely heavy coffin with holes bored into both ends, but again, if you're a bit eccentric, go for it.
Lastly, it might interest you to know that when the doctor completes and signs the Death Certificate and the Cremation Form, which takes at most 20 minutes, he gets paid. And not a negligible sum either, it's actually around £70. We lovingly refer to it as ash cash. You wonder why Shipman got addicted to doing away with old dears don't you?
When I found out, a part of me was horrified and I promised myself that I'd donate the money to charity, in some wonderful gesture of applied karma. But, given the time to think, for the amount of responsibility you subject yourself to when you sign the bloody things (if things suddenly go tits up in a criminal way, it's your name on the summons), it's actually worth keeping the cash. Doctors. A selfless bunch.

Poker

Seeing as I'm in the mood (eleven JDs), I'll write a short section about the fortnightly Poker Society nights at the student union. Last year I was President, and so I had the wonderful job of getting plastered and still having to usher people around, and count tiny little chips as they flew through my increasingly intoxicated fingers. This year, one of my good friends has taken over my duties so I can now feel free to once again get absolutely wasted and play some cards. In all honesty, I play better when I'm pissed. God knows I chat at the table, my banter is probably almost unbearable for some people, but that's the point, I incessantly ask about what hands people have, why they're playing the way they are, and why they don't give me their money quicker. After a load of practice, all this nonsense info I'm given begins to make sense, and in my drunken haze I can actually file it into useful an non-useful info.
For my sins, I'm not a bad player, and am proudly in profit, much to the delight my bank account and my benefactors. I currently hold the record for most final tables at the Uni poker nite, althougth my most wins record has been eclipsed. My meagre overdraft continues to get supllemented by poker takings, although I must admit that the game tends to drag and that a "real" job would be fine by me.
Over the past 2 years I've not done badly. Of course, I've been in and out of love with the game more times than a Shakespeare character but I've pulled off some useful triumphs. My first big win was turning $6 into $1000, and buying my beautiful girlfriend a plane ticket to Nepal with me 10 minutes later. I've also been lucky enough to win $1500 as a first prize in a weekly tournament, two weeks in a row. Apart from that, I supplement my tiny finances with the odd hundred quid from time to time, eked out on the increasingly boring, increasingly slow tables of the electronic superhighway.
It might not be glamourous anymore, it might not even be cool, but it pays the bills until I can cure people.

Yawn

The last 2 days I've only managed to get in to the hospital for about an hour, for a haematology session. They finally replaced the haematology registrar who knew nothing about haematology with a consultant who actually does, so we even learnt something too. Bonus.
Apart from that, the closest I've been to doing anything useful is finding a mirage-like post office in downtown Southampton. I had a recorded delivery envelope arrive, and nobody was in to sign for it, for I had to trek down to Shirley and hunt for the sorting office. It took me the best part of an hour to find the place, cleverly hidden behind a gym. In an even more cunning stroke of genius, they had at some point decided to stop selling stamps there, so I had to find another post office just to get rid of a different letter. Just another one of those hours....
Except for some light reading today, that's been it for the last two days. Shockingly boring, I'll admit, but I never promised to write about life saving operations every day, did I?

Running Off A Bad Day

It's final, the entry form for a 10km run in 3 weeks is in the post. Which means that in just 21 days I have to get from being a panting, semi-trotting hunched up old git to a striding athletic Adonis. Well, enough of a runner to get around 6 miles anyway. The 3 miles I did today seemed comfortable enough, although my right shin hurts like buggery and my posture makes me look like I've just nipped down from my bell tower in Paris. However, 6 miles is an altogether different prospect, not least because I've promised myself that if I can't drag my sorry carcass around in less than an hour I will publicly declare myself a big girl.
Actually, I'm lucky I have running to provide a vent for me when I have a crap day, like today. Everything started fine, I even saw an interesting ex-alcoholic with Wernicke-Korsakoff Syndrome, in which sufferers can't remember everyday words and memories so they fill in the gaps with total nonsense. Our guys asked where his butters were when he had actually lost his shoes. I vaguely recall it being shown on House, so it must be a proper rare disease.
Anyway, I digress. After I left the hospital I went to Tesco's and tried to pay for £20's worth of shopping with my debit card. Unauthorised. The joy. So I tried my credit card. Unauthorised. Double joy. It turns out that the hundreds of pounds that I am owed by friends, poker sites, online bookmakers, uncleared cheques and intermittent employers have caught up with me, and my overdraft is temporarily maxed out. And as for my credit card, I didn't pay a bill of £20 on time and now they've withdrawn my cashout privileges. Wonderful.
So, I rushed home..no, wait, I crawled home in snail-paced traffic and transferred some money from one of my savings accounts into my current account, and then crawled back to Tesco's to sheepishly pay for my now thawed shopping.
Honest, I haven't blown my student loan on poker and the horses, I'm actually just a bit careless in putting £50 on a poker site, withdrawing £75 after a few wins and then repeating the process the next day. Each withdrawal takes 5 days so I get a bit short sometimes....

Learning by Humiliation

In the good old days, medical students used to get "taught by humiliation". The consultant would cram as many students around the patient as possible, and then unleash a machine-gun tirade of impossible questions that even the registrar might find difficult to answer. The point was that the students would be so overcome with humiliation and guilt that they would rush home and spend overnight sessions crushing as much information into their heads as was humanly possible. I have it on good authority that the doors to the student slums were locked until everyone in the room could recite the 300 causes of clubbing off-hand.
Nowadays, we have it easy. In comparison, anyway. Although our consultants occasionally throw their arms in the air and do little irritated dances demonstrating their abject horror at our ignorance, we are generally treated with a fair amount of respect. In my opinion this is a good and a bad thing. I'm pretty sure medical students are generally happier and more secure in themselves than they were before, and they might even feel a little more in tune with the thought of becoming doctors one day. But on the other hand, the lack of bollockings might serve to make us a little too complacent, and may even remove the drive to work hard altogether. I know for a fact that if I was told that I was shite at medicine 5 times a week I would work harder, although I might just jump off the Civic Centre tower instead.
The old system certainly sorted the wheat from the chaff, and would no doubt get rid of a few of the shall we say, less aspiring members of our year. I remember earlier this year when an SHO looked straight down his nose at a weak-voiced girl in my group and boomed "what antibiotic do you give for a viral infection?". Obviously, antibiotics treat bacteria and not viruses, so it's a trick question. The SHO was actually kidding and pretending to be a hard-arsed bastard, but the girl shrank to the size of a pea and let the ground swallow her up nonetheless. She would never have guessed how much thicker her skin would need to get to be a good doctor, but she learnt that day.
In the meantime, I'm glad to be pottering along, managing my own learning, as we are so often encouraged to do. The occasional ball-blending session keeps me on track, but I'm just glad I don't get squashed to a pulp on a timetabled basis.

My Reasons For Doing Medicine

Nowadays, thanks to our wonderful education system, for all intents and purposes kids have to choose what they want to do with their lives when they're 15 years old. I had to pick my A Levels when I was 15, and if I didn't choose the right ones then the universities wouldn't be interested in me when it came to applying for medicine. In reality, doctors are in their jobs right now because they acted on skewed naive uninformed desires when they were young. So, having been on the planet for only one and a half decades, here were my reasons for wanting to become a doctor.

1. People have to call you doctor. This cool because it makes you sound superior.
2. If World War 3 breaks out, I won't be conscripted to the front lines to get vapourised.
3. You makes bucketloads of cash. This will be useful for the following-
4. Getting a 1976 Dodge Challenger like on that film.
5. Pulling birds with big boobs.
6. Buying a fuck-off massive penthouse in Florida.
7. It will challenge my swollen ego, and provide ammo in Uni arguments about who's degree is better.
8. Helping people is pretty good fun, and might get me a Times obituary or a knighthood.

I'm not kidding, why else would a 15 year old want to be a doctor? The shitty hours, the mediocre pay (and trust me, it is)? The occasional bollocking from a random colleague or patient? The sporadic weekends of vomiting and diarrhoea from ward infections? And certainly, no 15 year old wants to be a doctor for the reason I now want to be one- some honest need to do a bit to push the balance between good and bad back up in the world. I'm lucky that my childish aspirations faded away to leave some sediment of actual truthful benevolence. I'm still looking forward to being called doctor by hotel receptionists and flight attendants, and a Dodge Challenger would be fairly sweet, but basically I'm in it because (halo appears) I'm actually quite keen on picking up my broom and sweeping away a bit of the crap that washes up on our doorstep every day. I'm not going to save the world, I'm not even going to try, but every little bit helps.

And besides, I'm too slow to play professional football, and not enough of a bastard to do law.

Pull Your Fingers Out Guys

You know what? The NHS would have a lot more time and money to provide a better service if you lot started taking some responsibility for your own health.
We'd be happy to treat you if somebody smashed into your car and now your leg is hanging off. And similarly, if you're pregnant and don't know much about obstetrics then we'll be more than happy to pop the kid out for you. Basically, if it's not your fault, then it's cool by us.
But it's you lot that waltz through life ignoring all the thoughtful little messages we give you that piss me off. Like the notes on fag packets or on alcohol adverts. The little clues that should say to you, "hmmm, maybe this isn't such a great idea, I'll probably get ill". Unless you happened to smoke before the 1950s when the research linking it with lung cancer got published, you've got pretty much no defence against an ear deafening bollocking from your consultant about how silly you're being. You can't say you're not getting enough warning, but you still hammer down the A+E doors coughing up blood with that "it'll never happen to me" look on your faces. And booze too. Didn't you get the idea that drinking 40 pints might be a bad idea the first time you did it and punched a paramedic? Why do you do it again and again and keep on playing the innocent? And why do you blame us for not warning you about the risk of liver cirrhosis when your insides finally pack in?
As for getting fat, I know it's a slow process and it's hard to pick a time to make a change, but how hard would it be to skip the take-away just once a week? And maybe take a walk during lunch? That's all it takes to keep us happy and to stop you waking up at 3am every night because your neck is too fat to hold your airway open.
Sigh, I know you're heard it all before, but that's the point, you never learn. I suppose at the end of the day you aren't trying to get ill, you're just too naive to know any better. We don't mind taking care of you because you couldn't get the message, but we wish we didn't have to. Modern medicine is actually doing surprisingly well at taming rare disease like MS and HIV, but it's being mauled to death by preventable things that would only happen once in a blue moon if you guys just stopped being so naughty with your habits. And we might even have some left over money to give everyone a big bag of Herceptin, or whatever other drug you have been conned into thinking cures everything outright.
Come on guys, take some responsibility for yourselves. Everybody wins.

A Balanced Opinion on Teamwork

"In pairs....." the Rehab Consultant begins her sentence, and there is an audible sigh. Oh, how I hate teamwork. How we all hate teamwork. She can stick her team building up her highly trained arse, and her bonding exercises can get stuffed. We sit around in groups of our own mates, mumbling vague suggestions to each other, until our attention is called back to the flip chart and the oh-so-obvious answers are written up. It is a perfectly good waste of energy at 9am in the morning. Why can't she just write the bloody answers to start with, because we all know them? I'm learning nothing new by "bonding" with Mike, who I know pretty damn well anyway. Surprise surprise, a stroke can make you hemiplegic (paralysed on one side) and can affect your speech. In then end, we did learn something new about rehab, namely that the wheelchairs they have are perfect for doing wheelies down corridors. Oh, and that the snooker table in the common room of the Rehab building slopes slightly to the east.
In the first two years, we had the joy of spending two weeks per semester doing the grandly titled Interprofessional Learning (IPL) course. We were split into groups of 12, each group included not only medical students but nursing students and trainee physios, podiatrists, social workers, and so on. We were then assigned a totally pointless task that took bloody ages, and was meant to demonstrate to us that we could all work together as a "multidisciplinary team". I will never forget the activity in which we were asked to make paper models of planes and swans and to then get them critiqued by our mates to teach us about constructive criticism. I have a constructive criticism for you, IPL- bugger off. Once we were asked to do an audit of a government funded child health initiative, and when we suggested some changes we were wholly ignored. Unfortunately, the sheer pointlessness of the task only banded us together into a battalion of severely pissed off students. The course co-ordinators forgot that we can't teach each other about our respective professions, because we all know jolly fuck all about them. I couldn't explain medicine to a nurse, and she couldn't explain nursing to me. They should have just given us two weeks off to "bond" together in Jesters.
So here's a plea to any Medicine course leaders out there- if you're thinking of putting in some new liberal, tree-hugging, empathetic, team-building, hand-shaking initiative to waste more of my precious time, then just, please don't. What use are team building skills if I haven't had enough time to learn about asthma?

Interpreting ECGs, My Way.....

Here is a normal ECG. I am told that despite it's first appearances, it is actually possible to translate these lines into electrical activity in the heart. Each line represent a different angle from which the heart is looked at. If you're one of the clever people then you might even notice when something is going wrong. Doctors, usually, can understand these squiggly lines.

Here is what magically happens to a fairly inconspicuous ECG when it is handed to me by a consultant and I am asked "what do you see here?"

As far as I can tell, this happens for a few reasons. Firstly, I have a nasty habit of choking under acute pressure, forgetting everything I know about everything, including when my birthday is, and how to keep my bowels closed. Secondly, it is because, after six or seven identical lectures entitled "How to understand an ECG", I still cannot understand an ECG. Thirdly, it is because the little elves in my head who turn the cogs are extremely easy to distract and would prefer to think about sarcasm, boobs, Bristol City and Jack Daniels, in no preferential order.

So, I have devised a foolproof algorithm for answering the question "what is wrong on this ECG?"

1. Pick a letter from P, Q, R, S and T. These, I am told, correspond to specific squiggly bits.
2. Pick a word from "inversion", "elongation", "elevation" and "absence". These are a few of the things that can go wrong with the aforementioned squiggly bits.
3. Pick a number from 1 to 6, or if you're feeling smug, pick aVF, aVR or aVL. These are the different lines with the squiggly bits on.
4. Report our answer, for example- "Q wave elongation in lead aVF".
5. Sit back and soak up the glory or, in the rare case of a wrong answer, say "oops, did I say aVF? I meant lead 3...".

Don't go spreading my technique around though guys, or everyone will end up being great at cardiology and I'll never get a job.

Medicine, get out of my Head

I just caught myself reading about heart sounds for fun. I had nothing else to do on a quiet Saturday afternoon so I sat back and pulled out MacCleod's Clinical Examination. Although it's an excellent learning resource, the fact that I am now revising my auscultative technique on lazy weekends is quiet worrying. The fact that I absent mindedly do it by choice and for enjoyment is even more worrying.
I've seen this downward spiral before in older medical students- one minute they're throwing up on their shoes at 10pm on a Thursday night after a quick ten pints, and the next minute, before you know it, they're getting up at 6am on a Sunday morning to go down to A+E and beg the SHO for teaching when it's more quiet.
As a preventative measure I will now be forcefeeding myself social activities, possibly involving intravenous alcohol administration. Ah! Even my comments about booze are now medically based- I'm in trouble. There's only one thing for it, I am going to have to viciously sever my work and social lives, before I end up like that doctor that got crushed by a helicopter on ER. No family, no friends, just a pokey office and a crapload of knowledge about impossibly rare diseases. Oh, and a ginger beard.

Work Hard, Play Hard

Maybe I've been a little harsh in my portrayal of the schedule of a medical student. Sure, the work is copious and difficult, but we do get a fair bit of time off as well, and being experts at efficient time management, we have learnt to cram in as much relaxing as possible into the evenings and weekends. Throughout the university world we are generally renowned for our zealous drinking regimes, rarely missing an excuse to get completely battered. In the first year, on the night after a deadline day, we went to the Student Union in droves and drank ourselves into the ground. We had just spent 2 months writing essays on alcohol abuse.
Our sports teams like to kick back too, the rugby team are probably the most voracious drinkers with nudity, urine and incomprehensible swearing playing an important role in their weekly rituals. It's so bad, in fact, that the Uni has tried to enforce compulsory "non-alcoholic socials" into every club's calendar, for the sake of the safety of our livers as much as political correctness. Needless to say they weren't too popular, or very well attended, if they were even organised at all.
Last night we descended on the local High Street in vast numbers to celebrate the halfway point in our course with an extended pub crawl, from the Union Bar all the way through the suburbs and out miles further, eventually finishing at the revered temple of dirty alcohol, Jesters. About 100 of us trawled the streets for 5 hours dressed up as what we wanted to be when we were kids, hitting pub after pub. We eventually came to the most run-down, cramped, dangerous, unhygienic, cheap, tacky sweatbox in the south of England. But Jesters is home, the venue of our passing from quiet little freshers into fully grown incompetent doctors. Only last week one of my mates broke her arm there by falling on a well placed unmarked step in the middle of nowhere, but she was back, accompanied by her cast, boozing away.
Crammed onto the dance floor, flailing away to total cheese mixed with modern dance and rock, playing impromptu games of "pass the chunk of polystyrene from mouth to mouth", all the week's stress and new knowledge float away on a cloud of cheap vodka and sour orange juice. And, after 8 consecutive hours of boozing, we stumble home, retching attractively every few hundred yards. Suddenly our Jesus and astronaut costumes look a bit out of place, but it doesn't bother us as we moon walk, or bless passers by.
Friday mornings are semi-compulsory lectures (obviously nobody attends), so we get a few hours kip before the cogs of the daily grind start turning again. That's the thing about medics, they will happily relieve you of your alcohol supply, but if you leave the Times crossword lying around, it will mysteriously get finished. We're a multi-faceted bunch.
Sure, we work hard, but we also play hard, and even if I say so myself, we're damn good at it.

50% Doctor

Three weeks ago we crossed the invisible demarcation line, the halfway point in the middle year of the course. We are now, chronologically at least, 50% doctors. I had assumed that by this point I would know more about western medicine than a three year old who has just spent half an hour on Wikipedia, but no, I am still generally clueless. If you put a patient under my care right this second, they would expire quicker than a frog in a blender. This is because a little knowledge is a dangerous thing. There are more than a few scenarios in general medicine in which doing the obvious thing is in fact lethal. For example, a patient in type II respiratory failure requires the need for oxygen to stimulate breathing, so if you do the cuddly paramedic thing and shove a mask on them as they gasp for air, they'll conveniently stop inhaling. Likewise, you can easily give someone too much fluid after they lose a lot of liquid, dilute their blood and make their brain swell up and die. Lovely. Even slightly overfeeding a starving patient could do them in. Basically, it's a total minefield.
This is why I wish I was one of the smart ones. One of the psychologically balanced, popular kids who sits back and lets everyone else guess the answer before lazily chipping in with "primary sclerosing cholangitis?" like they hadn't known it the whole time. The kind of student who the junior doctors are too proud to ask questions to even though they know they're secretly outwitted; the type of student who will be promoted straight from final year medic to consultant whilst simultaneously starting a charity for disabled babies and letting down three or four offers of marriage gently.
Unfortunately, although my quickly deteriorating brain power has gotten me this far, I am now safely lodged in the middle of the pack, doomed to another three years of chasing the tails of those better informed than myself. Slowly, I'm coming to terms with meeting the ceiling of my academic ability- I won't be winning that Nobel Prize that I always thought would be quite a nice icebreaker at cocktail parties. It's unlikely that I'll ever have my life portrayed in film or book, unless I do a Shipman, or actually get Shipmanned myself. In honesty, I don't mind it, I actually quite enjoy the challenge of passing the year, but I wouldn't half like knowing the odd answer now and then just to keep my spirits up. It seems like yesterday I was throwing a fit about missing my A Level grades by one shitty mark (they let me in anyway after the Irish all failed too), and now I'm halfway to actually becoming the barrier between life and going home in a box. And I still can't really explain what flu is, and I haven't really "done" the spleen yet either. I take solace in small things. Today at home when the phone rang (never for me, I have a mobile) I answered with "operating theatre three?". The poor girl on the other end final mumbled "sorry, wrong number" and hung up. Ah, I may not know anything about medicine, but at least I have the mentality of a overworked doctor.