During my internal rotation I learned something devastating: the wondrous white coat is simply not big enough. During the four weeks I did not button my coat up once – and I don’t think it has anything to do with the few extra pounds I have gained this year.
1. Stethoscope: The favourite tool of medical students; the day your first stethoscope arrives is one of excitement (anyone who is blasé about it, is just suppressing their joy). Don’t forget it; I have once or twice and felt naked the entire day. I like Littmann, mine is a lovely raspberry colour.
I wear mine around my neck, but med-school lore apparently states that students should keep their stethoscopes in their pockets.
Aside: You can use your stethoscope to test reflexes if you forgot your patella hammer; but if you tell anyone I will vehemently deny any mention thereof.
2. Gestation wheel: we use these in obstetrics, but since we got a few pregnant patients on our Internal calls, I like to keep mine handy. You can get a template to make your own or buy a nice plastic one. Mine was handed out at our campus’ society day – quite a nifty hand-out.
Aside: these are awesome to have on-hand when calls get quiet or boring. We discovered that one of our friends was most likely conceived on New Years’ Eve.
3. Illegal hospital supplies: We are discouraged from taking supplies in the morning to have them ready when we need them. In a private hospital where different wards are owned by different professionals this is completely sensible. However, in our public set-up, it is often necessary. Some staff nurses are lax in restocking their supplies from the storeroom, which is problematic if you are out of 22-gauge needles and your 92-year-old patient needs bloods drawn immediately.
You also often find that in a specific ward, only one glove-size is available at any one time. When I find small gloves, I stock up; as do my clinical partners when they find size 8½ gloves.
The “piggy” in the picture is my own. It’s like a specialised syringe, I don’t know it’s real name.. In our hospitals they are a rare find – even rarer than piggy-needles, which baffles my mind. They are awesome though, especially if you need 20mℓ blood (or more). They are much nicer than syringes. Similarly, butterfly needles are much nicer than normal needles of you need a radial arterial blood gas.
The name tag is what students often use to label their stethoscopes. You should not steal from the hospital though.
4. Tourniquet: In South African hospitals, people often use gloves instead. Avoid at all costs: it HURTS (go on, try it). Once our Intern was helping me with a difficult blood-draw. I said, “You can use my tourniquet, it’s brand-spanking-new.” He laughed and said, “And so it shall remain, because it will be stolen before it ages.”
They are really easy to misplace, but fortunately also quite cheap. Mine is an ugly orange, but I’m hoping to get a pretty one soon, like the one on the side. Patient’s do often call us vampires…
5. Pupil torch: Admittedly this was a bit premature, as it will probably be of more use in trauma. This one is dirt-cheap, but we also haven’t been able to discover how to change the battery or the bulb. I guess you just replace the whole cheapie.
6. Measuring tape: Another thing I acquired for Obstetrics, but quite useful when your patient has a lymphadenopathy (or anything else, really).
7. Reflex hammer: I bought the expensive metal one, although the cheaper plastic ones are much better for the swinging technique required for testing reflexes. The metal one is semi-collapsible, which is why it won. It also has a sharp end for Babinsky-reflexes and a pin on the inside. In the age of HIV and other blood-borne disease we don’t use the pinprick anymore, instead we use wooden toothpicks.
This book is probably my favourite of all medical textbooks – and it fits perfectly in your white coat’s pocket. Learn how to use it with speed and, like the stethoscope, don’t go anywhere without it.
A note on diagnostic sets: they are awesome, but very expensive and they are usually available in all wards. Due to their value you might need to ask the chief nurse for access to it.
I have seen senior medical students pull other gems from their bags: scissors, adhesive tape and breakfast bars. Don’t forget extra pens and paper for notes, either. Undoubtedly, one needs a bag – a satchel. I’m still looking for my perfect one: it should have a sturdy strap that can be worn across the shoulders and have an easy-to-organise interior. And because I’m a girl it needs to look good too.
The search is on!
I saw Janeway lesions the other day. Janeway lesions are rare and elusive, and usually present due to an underlying vasculitis or endocarditis.
Needle-prick injuries
But the fear remains. I don’t need a dream analyst to tell me that these dreams are a mirror of my thoughts and fear, that much is obvious.
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.
