Today I’ve decided to write a bit about what my last week has been like. It hasn’t been the most exciting week but it’s been what I’ve come to expect from a typical week in medical school – tiring but somehow still satisfying.
I’m currently in my Adult Medicine rotation. My time is split between being on ward rounds, helping with ward work and bedside-teaching on the wards. See the common theme here? The wards. Every rotation we’ve been through, there’s always a doctor telling us some variation of “the wards are your textbooks and the patients are the pages of those books”.
I was on call last Sunday and Thursday. On call days, whatever units are “on call” are then in charge of the management of all of the patients admitted that day. By our Friday post-call rounds, I think we ended up with over 50 patients admitted under our unit. On call days, I’m expected to be down in Accident and Emergency to “clerk” patients and help with things like taking blood.
Last Thursday, I got to meet an interesting family. Their son had to be brought in for a sickle cell crisis. In sickle cell anaemia, there’s a mutation that cause the red blood cells to be sickle-shaped instead of the usual rounded, biconcave shape. Because of this change in the shape of the red blood cells, the cells don’t flow through the blood vessels as smoothly as they should. Sometimes they get stuck in the blood vessels – that’s called a vaso-occlusive crisis. These crises are extremely painful. This patient had been having pain for the past week despite being on pain killers.
Talking to the patient and his family, I got to hear first-hand the effects sickle cell anaemia can have on patients and their families. The patient had to be hospitalised more times than people four times his age and he has to be on antibiotics and painkillers every day. Before I started clinical medicine, sickle cell anaemia was just something I read about in books: I didn’t hear it talked about all that much. But in the past month, I’ve seen so many kids and now adults coming into the hospital because of complications of sickle-cell anaemia. It’s been an eye-opener. Medicine is becoming more granular – and real.
There’s a lot of walking around in medicine and especially in this rotation because we have patients in all parts of the San Fernando General Hospital – the new hospital, the old hospital and in the teaching hospital. We end up doing most everything on the move – talking, eating, studying (and sometimes even sleeping) are all done while walking. That’s why I spent over an hour last weekend trying to find the perfect pair of comfortable shoes after spending a week with bruised and blistered feet.
We have classes on the wards most days of the week. Usually we have to examine a patient and summarise our findings to the consultant, along with what we think the diagnosis might be. Then we’re drilled with questions around the patient’s particular condition. It’s supposed to help us to think clinically about what might be wrong with the patient and helps us to hone our techniques when examining patients.
Helping out with ward work usually means routine things like taking blood, putting in IVs and setting up things like blood transfusions. There’s also a lot of filling out of forms and running down to the lab for things. Again, more walking.
It’s been a long week, and a tiring one at that. But I’ve ended the week knowing more than I did at the beginning, so all that running around and walking up and down feels worth it.
