In 2010 I shared this picture via Youth Journalism International of a skeleton in our faculty dressed up for the Fifa World Cup. (Click the link and scroll down to the middle-left.)
Today we had a rather long clinical skills session for our anaesthesiology block.
This little guy met us there. I laughed:
I had fun with this 9gag ish.
No, I do not have too much time. But with Internal Medicine over (for now) I at least have some time. I know I will miss it soon. Hence the inspiration for this:
I’ve been told before, “You’d be a better doctor if you weren’t so emotional about life.” I don’t consider myself a superbly emotional person in public, but yes, I am touched by stories. If you scan through this blog you will see that stories of compassion or triumph are dear to me.
I’ve always believed that as long as it does not affect the way I treat a patient, it will be okay.
But maybe not.
If I am touched by the mother who brings her teenage rheumatological daughter pink milk and a favourite blanket to hospital, then I am also affected by the injectable drug-user who shouts at me for drawing blood “incorrectly and from the wrong vein”. Or the patient who tells me to “hamba” (leave) when she sees me entering the room with a drip-set.
And if I am happy because of a compliment given (probably without second thought), then I will easily be saddened when the same doctor is rude because of something I presumably did wrong. Or the nurse who is in a bad mood and tells me I will “just have to do without a blood culture bottle.”
I begin to understand why doctors are disillusioned about their jobs. I begin to see why they choose to change careers. I begin to see why they feel unfulfilled.
Sometimes, “helping people” just isn’t enough. When other healthcare workers are rude, and when patients are moody, and your employer (in this case the State) does not look out for you, and working conditions are terrible… it’s difficult to remain positive.
I’m not even qualified yet, and I feel like this already. I used to promise myself I wouldn’t become dulled to this work, that I wouldn’t become one of those sad, dissatisfied doctors.
But I don’t know if that’s possible anymore.
Yesterday was a bad day.
It’s been a bad couple of weeks, emotionally; me being weaker than I ever thought I could be. I’ve been able to retain my composure mostly.
However, during ward rounds our consultant looked up disinterestedly while I was presenting a rather interesting patient and said, “Today is your last day, isn’t it? So why is it that you can’t calculate the feeds of these children?”
© Jill Greenberg, “End Times”
At the beginning of our rotation my partner and I had asked the sixth years to teach us the formulae for feeds. They tried kind of half-heartedly and told us that it wasn’t part of our outcomes. The registrar agreed.
So I responded, not in a sarcastic tone, “I’m sorry – I was under the impression it was only part of the sixth-year outcomes.”
And she responded, “I’m sorry, how old are you?”
She then went on a tirade of how even if it wasn’t in our outcomes we should have learned it. Her tirade consisted mostly of personal insults.
We committed to reading it up and moved on to my next patient. And then my eyes started tearing. And my voice got all husky.
And out I went. In tears. They were big violent sobs.
It was kind of embarrassing. I don’t let people who don’t know me get me down. I’ve never cried in a clinical setup, not even when a patient died. I wait for the privacy and security of my room.
I don’t know why this affected me so much. I guess it doesn’t help that for the past two weeks, we have been mainly ignored by the rest of the team. Our (valid) questions go unanswered. Our input into difficult diagnoses is ignored. We had three OSCEs today, and not once were we told what to expect. Not once were we tutored in anything except breastfeeding and X-rays.
So after really going the extra mile for a team that seemed to be inconvenienced by our presence, I guess I didn’t feel they reserved the right to scold us for not sniffing that we were expected to know something.
I managed to calm myself down, but every time somebody made eye-contact with me the hot tears welled up. I have cramps in my jaw today from clenching my teeth so much.
It didn’t get better after hospital. I was teary for the rest of the day.
It was weird for me. I don’t cry a lot. Ever.
Consultants are mean, and often. I don’t mind being grilled for answers. I find it thrilling, actually. But personal insults in a professional environment are just so… unprofessional. Here’s hoping I’m stronger next time.
Today (a public holiday) I went to Stellenbosch, in the Winelands District of the Western Cape. The medical campus is far from the main campus, so I don’t get to go to Stellenbosch very often. But today I met Nazirah.
Yes, the tree has to be in there. It's pretty, and I was having a bad hair day
Nazirah and I are both medical students – she in Malaysia and I in Cape Town. She’s doing her elective rotation in Cape Town. We met via our blogs. And no, we’re not the kind of people who readily meet people over the internet.
Because I don’t know Stellenbosch very well myself, one of my friends, Dee, joined us for the day. She gave us the royal tour and it was lovely. And a royal tour must of course start with some lovely tea. We went to The Birdcage, a quaint little coffee shop with the most amazing teas. I had French Vanilla tea, Dee had Raspberry and Blueberry, and Nazirah had Rooibos tea – the endemic and famous “red bush” tea of South Africa. And she liked it!
Dee's tea is pink, Ni's is reddish. How lovely are the tea sets?!
We learned a lot about similarities and differences between our countries in terms of healthcare, politics and infrastructure. It was amazing. It was a chilly – but not cold – Autumn day, and the town was simply beautiful.
And I got to meet an international friend, and that with the aid of WordPress.
Earlier this week I saw this fun experience occurring right before my eyes. And for once I had a camera on hand and snapped away shamelessly:
There were three kids from my campus who were collecting some boxes and things (for what I don’t know). Problem one was that for everything to fit, only two of them could sit in the car. The other problem was that everything couldn’t fit- they needed the roof. But they didn’t have rope to tie it.
So they made a plan. Without a helmet. I hope they didn’t get a fine, because considering I haven’t heard of an accident I assume they arrived at their destination safely. Perhaps their destination was somewhere on campus.
Anyway, I laughed.
Kelly just wrote a post about her prom (among other nights) that inspired me to do the same.
Tonight the girls who were in grade 8 (first year of high school in South Africa) when I was in Matric (last year of HS) have their Matric Farewell – our equivalent of Prom.
We nicknamed them little tadpoles, symbolic of the years of growth ahead of them. And now they’re getting ready to fly. In a few months my little sister will have her Matric Farewell.
The theme was Titanic and we rolled our eyes. We wanted elegance, not cliche. But we were surprised – never before or since have I had such an elegant night.
I’m not a dressy-uppy person. But I saw my dress at an expo and knew: that was it. I made an appointment for my hair the day before the big night, leaving everything to the last minute as usual. I wouldn’t have had my nails done if Mom hadn’t made an appointment for me.
The date was my boyfriend at the time. Of course he made me feel beautiful. Our relationship was good then. It didn’t last, but that’s okay. I’m happy.
It was a beautiful night. All my friends looked stunning. None of the disasters I anticipated occurred. We went out afterwards.
Do you know that on that night in 2008 I had not even considered submitting an application to study medicine?
So much has happened since then. I’m a little wistful tonight, I suppose. I know my little tadpoles are going to be gorgeous.
This is a Langerhans cell. Langerhans cells are dendritic cells found in the epidermis (that is, the uppermost layer of the skin) and should not be confused with the Islets of Langerhans found in the Pancreas – and incidentally named after the same person. Langerhans cells are antigen-presenting cells – in other words, they form part of the body’s protection against antigens, and present these to the immune system.
This is Paul Langerhans. He discovered Langerhans cells at the tender age of 21 (that’s younger than I am now). He did mistakenly believe they were part of the nervous system due to their dendritic appearance – but whatever. It was not long thereafter that he wrote a paper on the anatomy of the pancreas and referred especially to the Islets of Langerhans, which we all know and love.
Upon further reading up, I found rather disappointingly that Langerhans did not really have any ideas what either of these structures did, just that they existed. That’s less remarkable… and somehow I doubt that these days anyone will be so acclaimed for similar discoveries.
But again… he did make a fairly cool discovery at a young age. I suppose maybe those days you weren’t considered a dimwit or a baby at 21. Also, life expectancy was considerably lower those years, and Langerhans went on to develop Tuberculosis and eventually die at age 41.
A few times every year I see on Facebook, blogs and Twitter how high school students consider their options for life after school.
There was this boy I dated in high school. He was not a genius, but he performed as an above-average student. He did well in Maths, Science and Biology. He was good at interpersonal relations.
In short, he was not meant to be a candidate for struggles later in his life.
But he had a family job lined up and decided, despite advice from people who cared for him, not to study after school. After all, he was the heir to the family business.
But the family business has now become insolvent. He, his older brother and his parents have no means of an income. His little sisters are still at school. And he cannot find another job, because he has virtually no experience and no qualifications either.
I am sad. I can’t offer him much help. And I am a little disappointed, because this needn’t have been his situation.
There are many unemployed people the world over who have qualifications and still cannot find a job, I know this; but I think his job-hunt may have been a little easier had he had some form of CV.
My heart breaks for the many people who cannot find jobs despite their best efforts. My biggest wish is that all young people (even the “trust fund babies”) will consider the long run and prepare for tougher times.
During a visit to Oncology…
“People will tell you that cancer can’t be cured. But I’ll tell you this: Cancer is about the only disease that can be cured.
By and large, most diseases are not cured, they are managed. And there is nothing wrong with that.
The question is, can we cut it out? And, more importantly, can we put the patient back together again afterwards?”
“Of course we would love to blast the tumour with a lethal dose. The problem is the patient’s in the way.”
“There’s no such thing as a man – we’re just a woman who’s gone horribly wrong.”
