Monthly Archives: August 2010

The Less I Say, The Smarter I Sound

I hate those stupid awkward long silences after a lecturer asks the audience a question. One of several things are happening: the question is unclear or incomprehensible, or nobody knows the answer, or loads of people know the answer and nobody feels like being the one to say it. And so the question just hangs there and we all look dumb together.

My exceptionally low threshold for that specific type of awkward silence means I am reasonably likely to stick my neck out and have a go at answering the question, even if the question is bizarre. On occasion I get it right. Sometimes I get it horribly and spectacularly wrong. In those moments, my colleagues are probably glad they are not me. They probably thank their cotton socks they studied something science-y and not some vague kind of arts degree. They probably wonder why I keep opening my mouth if I don’t really know the answer.

And then there are the questions I ask. Lately I’ve been asking questions which make perfect sense in my head, and as far as I can make out, they make perfect sense on their way out of my mouth. However the psychiatrists who answer them seem to hear a different question to the one I am asking. The question they then answer is then something so naive or judgmental that I would be embarrassed to have actually asked it. (I’m on placement in mental health, not a patient, yet). And when that kind of question is answered, it’s just a tad awkward to say “um, that’s not quite what I was asking”, because by the time it’s answered, it’s entirely obvious that the question I didn’t ask should never have been asked. Even though it wasn’t.

So, do I have some sort of expressive dysphasia? Or are they using me as some sort of Dorothy Dix? Or is it a case of people hearing what they expect to hear? Well, you don’t know, because you’re not there. Those are rhetorical questions, and this is not an awkward silence.

Really.

It really isn’t.

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Falling Off The Planet

My Mental Health rotation starts tomorrow in an unusual and personal way. I’ll be taking my Grandma to hear the outcome of her cognitive and memory testing. As an intelligent woman who keeps her mind active tutoring kids and reading the paper, she’s starting from a good baseline. That said, her lapses are more pronounced than they were a year ago, and it will be good to hear an external opinion on their significance.

Tonight at dinner she told me to be careful of my knife as it was falling off the planet. Oh my, I know how it feels.

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Surgical Wrap

Tomorrow at 6am I will attend ward rounds for the last time with the vascular team. I have enjoyed the rotation far more than I thought I would. Surgery is not something I expect to pursue as a career, for several reasons. One, I’m freakin’ uncoordinated. Two, I’m really not that great when it comes to precise vision, especially regarding spatial relations. Best not let me too close to your arteries, too often. I mean, I can make do, but don’t expect artistry with the scalpel. Three, there are too many other things I’m more interested in.

So, vascular. Lots of old people. Lots of poor people. Lots of ischaemic limbs, emboli, diabetic feet, aneurysms. Gangrene and lots of festy wounds. Very, very interesting medical problems. Very, very interesting patients. I liked it. Surgery itself? I am in awe of the work of the consultants, and I admire the tenacity of the registrars. I have an abstract interest in the work, but I really can’t say that I’ve discovered a new passion.

Highlights of the tour? Chatting with patients, learning new things from smart people, and being challenged. Lowlights? The very elderly lady wrapped up in bed with her doll, quietly oblivious to her impending leg amputation, and the look on her face the morning after.

Biggest learning points? Reconciling different approaches to the patient as a person vs the patient as a problem. Balancing clinical distance with empathy is a fine art.

Things I learned about myself? I know very little, I guess very well, I like how I approach a problem, and I need to know more.

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Medicolinguistics

Part of studying medicine is learning a new language, and part of learning a new language is relating new words and concepts to words or concepts which are already familiar. By considering the constituent parts of new words or expressions, one can often deduce the meaning of the whole. A few translations I am especially pleased with:

Syndesmophyte
A plant growing from a synovial joint, much like a rock orchid.

Galactorrhoea
To be shitting stars.

Carpectomy
A surgical procedure in which goldfish nibble bits off you.

Amaurosis Fugax
A brightly coloured poisonous mushroom.

Lap Collie
A small Lassie-like dog.

And now for your added benefit, here are my explanations of some common medical abbreviations:

Patient SOOB: Patient Sitting On Own Bottom.
PUIT: Pees Upright in Tube.
HSDNM: Heard Something, Does Not Matter.
JVPNR: Jolly, Very Pink, No Reflux.
RTA: Read The Armband (while feeling pulse)

Feel free to let me know of any medical terminology, jargon or abbreviations you would like clarified.

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Awesome Career Move #37: The Diesel Mechanic

An extract from Play of the Week.

THE SCENE:
Vascular Surgery Weekly Meeting.

THE CAST:
Surgeon 1, A Man.
Surgeon 2, A Woman.
Registrar 1, A Man With European Accent.
Registrar 2, A Woman.
Resident, A Woman.
Intern, A Man.
Med Student 1, Girl Genius.
Med Student 2, Boy Genius.
Med Student 3, A Woman in Comfortable Shoes.

ACT IV: THE PRESENTATION.
Registrar 1 is on the third slide of his presentation on Compartment Syndrome. Surgeon 1 has commenced a critique of Registrar 1‘s use of the word ‘volume’ instead of ‘space’.

SURGEON 1: I don’t mean to nitpick here, but you’re talking about reduction in compartment volume. That should be reduction in space. It’s not reduction in volume, because liquid can’t be compressed.

REGISTRAR 1: Well… In the textbooks, they are saying reduction in volume.

SURGEON 1: But you can’t compress liquid, can you. [looks around table] Can you?

[REGISTRAR 2, INTERN and RESIDENT look at ground. REGISTRAR 1 looks confused. SURGEON 2 remains impassive.]

SURGEON 1: [looks at Med Students] Come on, one of you must know something about physics. You can’t compress a liquid, can you.

[MED STUDENT 1 looks startled. MED STUDENT 2 shifts in seat.]

MED STUDENT 3: Well, actually, you can compress a liquid. Diesel is a liquid, and it is compression that makes a diesel engine work. You compress the liquid, and it explodes.

[SURGEON 1 looks shocked. SURGEON 2 smirks brightly]

MED STUDENT 3: But if your point is that the compartment space is reduced rather than the volume, well, yes, it’s a confusing way of putting it, but you’re both saying basically the same thing.

Fancy that, an Arts graduate with a minor in diesel mechanics.

I wish you could have been there.

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Protected: I Am Not My Disease

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