Monthly Archives: August 2009

Icarus, Going Down.

Sadness… Olympic Airlines is closing down their frequent flyer program at the end of September: goodbye, Icarus Club!

Reminding people of the first plane crash in history was such an excellent way to encourage us all to fly more often.

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Breathtaking Honesty

I have been reading other med-related blogs and I am humbled and amazed.  There is some extraordinary writing talent out there, and huge generosity of spirit.  Some posts I read resonated so strongly with me, or were so compelling, I realised I was reading with my breath held.

I’m not ready to induce hypoxia.  For now I’ll stick with random contemplations and vague attempts at humour.

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Free Air in the Abdomen, Part II

Clinical Skills session with Superdoc.  I am staring at the ‘normal’ abdominal x-ray wondering how the heck anyone is supposed to be able to see anything in there, other than the obvious bones.

Superdoc: First, look for the colours.

My brain: Um, it’s black and white.

Superdoc: There are hundreds of colours between black and white.

My brain: Fair enough.

Superdoc has an incredible ability to impart knowledge in a memorable way.  I can now look at an abdominal x-ray and pick out not just the bony structures and a slightly disturbing phantom sacral face, but I can also make a fair stab at whether the patient is young or old.

I can make out kidneys and their associated fatty bits, the psoas muscle, the bladder, calcium deposits like kidney stones, gall stones, porcelain gall bladder, and the phabulous phlebolith.  I recognise the shades of grey and distinctive striations representing large and small intestine.  I can see bubbles of gas.  If there is a metal object in your x-ray, I can find at least three explanations for it.  And if you’re really crook, I can see free air in the abdomen.

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Free Air in the Abdomen, Part I

It turns out that your insides are not, in fact, your insides.  The gastrointestinal tract is a great big tube full of the external environment.  Sure, it passes through you, but from the in-hole to the out-hole, your body is busy squishing, mashing, mixing and digesting foreign substances – absorbing some and protecting itself from others.  We are well set-up to soak up the bits we need.  We have even invited some special guests to help break down things we can’t handle.  These little bugs munch on stuff and let off gas.  And so do we.

What do I mean about the external environment?  Try thinking of it this way:  Imagine it is the early nineteen eighties and you, your three kids, your sister and a cousin are crammed onto a small fishing boat with forty other refugees, heading to Australia.  Pirates board the vessel and so as not to lose the last trace of your husband, you grit your teeth and swallow your wedding ring.  Where is it now?

You swallow the ring and it’s inside you, but it never enters your bloodstream.  It’s not going to lodge in your heart or shoot off down to your big toe.  It won’t become a part of you.  It’s in a tube, and it’s going to come out in your poo.

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All right! All RIGHT!!! I’ll write about Med School.

Further evidence that I am President of the Procrastinators presents itself in the form of this website.  I was supposed to be blogging about being a med student.  Instead, I vaguely mumbled something about golf and bad packing, then set about doing other things.  So here I am taking the first step toward something like what I said I would do.

Today is Monday and I have not had much sleep on account of being up quite late mostly writing an essay.  Mostly writing because I decided it would be better to finish it while fully awake.  I actually spent the best portion of the weekend mostly writing this essay, and it was really not very interesting.

What was interesting was last Tuesday’s clinical skills session.  We learned how to insert a nasogastric tube into a plastic dummy.  I hope that this bears some resemblance to the process required for insertion of a nasogastric tube into a human, because I seem to have a bit of a knack for it.  I’d hate to get on the wards and discover that the anatomical divergence between plastic model and warm human is such that my dummy-tubing skills are irrelevant.

I can’t speak from experience, but I’m pretty sure that having a plastic tube stuck up your nose, down the back of your throat, past your epiglottis and into your stomach is not a particularly nice sensation.  Then the thing gets attached to your nose with a bandaid, and there you lie, a tube connecting your stomach to the world via the end of your nose.  I’m cross-eyed just thinking about it.

Of course, by the time you need one of these, it’s probably not going to be your biggest worry.  Still, you don’t need some cack-handed junior doctor (or worse, med student), stuffing around getting it wrong with the tube and your nostril, or worse, your lung.  So if you’re not built like a plastic dummy, best you steer clear of me and the tube.


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