Riding the PEP-Train

I’m on PEP again.

And I’m angry. And miserable. But mostly angry.

Because I’m careful. I am so, SO careful all the time, but others are not. I always make my surgical needles safe. But many doctors I assist do not. I always discard my sharps. And many do not. I never point a sharp at someone. Many do.

Here's a random picture of a zebra I took a few years ago at the Vaal River. Because this post needs something pretty.
Here’s a random picture of a zebra I took a few years ago at the Vaal River. Because this post needs something pretty.

Continue reading “Riding the PEP-Train”

Weekly Whine: Headaches

I am starting to get the idea more and more that too many healthcare workers (particularly doctors) know far too little about headaches.


Having suffered migraines for more than a decade, I started having this suspicion while still in school, but now that I have a smidgen of knowledge myself, the suspicion grows.  Continue reading “Weekly Whine: Headaches”

How To Pass Pharmacology (Part 2)

samfA while ago I shared how flashcards saved my (as yet metaphorical) career. The problem with flashcards – as with any rote-memorisation trick – is the “I studied, I wrote, I passed, I forgot” phenomenon. Because frankly, except for the most common drugs, I really have forgotten most of what I learned two months ago.

Pharmacology is difficult for most medical students, and neglected by many. But I know I would hate to go to a doctor who does not know what to prescribe (or worse, prescribes the wrong thing). I don’t want to be that doctor. So it is important to remember it beyond the exam. And for that, we need to look at it in the long haul (something I did not do, and wish I did). Just like we would not try to learn mathematics from scratch in a few months, we cannot learn pharmacology from scratch in four weeks.

So here’s what you do: 

Continue reading “How To Pass Pharmacology (Part 2)”

How To Pass Pharmacology (Part 1)

This post is in honour of good news received this past Friday: remember those exams I wrote shortly after arriving back in South Africa, and that I surely doubted I would pass? Well, I passed them. I was most nervous about Clinical Pharmacology – reasons being that a) I suck at it and b) I was admitted to hospital the day before the exam. I was ready to accept my fate and write the rewrite.

Pharmacology is a thorn in the side of many medical students. A lot of it is rote-memorising, unless you have the time to delve into the history and mechanisms of each drug (which, frankly, few of us have). So today I share the thing that undoubtedly got me through the exam. Attending class is a good beginning, but since I was sailing around the world, that was lost to me.

flashcards1 Continue reading “How To Pass Pharmacology (Part 1)”

The Girl with the Smile

She is here for a nerve conduction test and an assessment of her Thalidomide regimen.

Thalidomide: The morning sickness wonder-drug-turned-teratogenic-horror that gave birth to deformed and ill babies.

It has some wonderful other uses. Crohn’s Disease and Myelodisplasia run from this drug. And mycobacteria hate the drug too. But special permission is required to use such a potent drug.

She had an IRIs-reaction to starting TB medication a year ago and suddenly had TB-abscesses in her midbrain. Her cerebellar function declined and she neared death.

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In my first year we had quite a difficult Pharmacology course. It was well-known to be the course most often failed by first years and we were freaking out. We asked one of the professors for advice, and in his distinct German accent he said this:

It wasn’t really what we wanted to hear, but it was the truth. It worked. It’s probably the only best advice I’ve ever received from a lecturer.

If only I knew then that basic pharmacology would be nothing compared to Anaesthesia. It’s like advanced pharmacology.

I’ve been applying bum to chair and fared well… I just wish I’d started sooner. I’m still not certain that I’ll get through everything before the test.

Antibiotics: So Now What?

Reuters reports that antibiotics are not useful for most sinus infections. Excessive prescription of antibiotics has lead to large-scale resistant organisms.

Okay, this I know.

But now what? Antibiotics make patients feel better. A frequent sufferer of sinusitis, I know this. So now my patients walk away from a consultation feeling that their doctor doesn’t care about their suffering. I don’t see many doctors being happy with that.

Continue reading “Antibiotics: So Now What?”