Medical Elective- Day 40, 41, 42 and 43...today I believe to be Day 44

SO we have come to the end. I have been very lapse in updating this blog over the past few days but it’s all ended in a bit of a blur. Today (Day 44) doesn't technically count as I guess I've officially finished the Elective. But it's portrait number 44. So will probably just keep counting....

Thursday was technically my final day down in London. As usual it was a long oncology case but was set to be straight forward. Patient with previous SCC, previous maxillectomy and massive gaping hole left in the poor blighters face. So, the plan was to move a free flap to cover the defect and try to reconstruct some of the palate, helping with speech and potentially with regaining a swallow. The first thing to do was a neck dissection to discover the internal jugular vein and the common carotid artery to use for the anastomosis. Then all hell broke loose. The IJV was so friable that whenever the surgeon touched it a massive hole opened up. Three hours later, half the patient’s circulating volume either on the floor or in the suction tub, the surgeon had managed to repair countless little holes and regained control. It should have taken an hour. So we were already behind. Quick break for lunch and then planned the flap- anterolateral thigh (ALT). Raised the flap, almost freed it when the surgeons realised that the pedicle contained the vein but not the artery- the patient had a rare anatomical variation meaning that the artery had dove off somewhere else rather than going into the flap. So they had to bin it. And they re-started working on a latissimus dorsi (LD) flap. By this time the whole surgery should really have been finished but they had just started work on the anastomosis. The rest went without hitches (despite some difficulty doing the venous plumbing to a very bleedy IJV). All done and dusted at 10.30pm.

So, it being my last day I’d said to people, let’s go for a pint after the case to say bye-bye, thinking the case would be over around 5pm. When it ended in the middle of the night I thought we would all just slink off to bed. Nope. Consultant made sure we were in the pub before last orders and all the team had a well deserved drink. Or several. Then about half of us went on to a private members club with the consultant to carry on drinking over a bit of 2am pizza. It was so amazing. Being around these amazing people, at crazy o’clock in the morning, in a club that would normally not let me set foot on its front step. It was quite an experience. I arrived back at my place at I think a quarter past four, and managed to go to bed around 5. Between arriving home and going to bed I appear to have updated my facebook status, done my self portrait and made a general mess of the bathroom. And I don’t remember doing any of it. However, as the old adage goes: Worth it.

The next day I woke up sharply to an alarm which I also managed to set but don’t remember (I know my brain will always pull through for me in the darkest hour). Good job too as I had exactly an hour and a half before I was due to be collected by The Boy’s parents. But oh, oh the raging hangover. Fought through the hangover and managed to get away from London with all my belongings, then enjoyed a really lovely parent-in-law treat of a carvery. Carvery cures all. Got to my coach with one ikea bag (the rest left in parent-in-laws’ spare room), slept back to Nottingham and was greeted by a happy-looking Boy and a trip to the kebab shop. Sweet.

Saturday was mostly spent in bed. We decided to get up around lunchtime and I made us special brunch, then we head to a mate’s BBQ. All round a fab evening even though, having sworn never to touch alcohol ever again in my life, I ended up a little on the sozzled side and we managed to have a blazing row in the car in front of a very embarrassed friend. The next morning neither of us could work out what had happened as we’re not the raging screaming argument types. So, all forgotten and forgiven.

Sunday was another very lazy day. All in all I have barely achieved the basics of my little portraits... and have managed to leave the Friday night one in my little sketchbook in London. But no matter- I can upload it retrospectively in a couple of weeks when I go and collect all my stuff from London. And today I have spent all morning on the couch. A well deserved bank holiday weekend off. Afternoon up to my eyeballs in dust (The Boy can wash up but has no concept of surfaces and accumulated dirt)... and I think we’ll eat out tonight. Bliss.

A long few weeks ahead of me. I will continue to do my portraits but probably won’t update the blog everyday since my Elective is over. I have an awful lot of projects to be getting on with. Not to mention an exam to retake. Let’s see how it all goes. 

Day 41

 

 Day 42

Day 43

Medical Elective- Day 39

I worry sometimes that one day I’ll just stop coping. Bam. Just like that. Sometimes I’m fine and dandy, just like everyone else in the world, happily just getting on with life without really thinking about it. Some days  I have to remind myself to do a lot of things- pick up my feet when I walk as otherwise I just shuffle and get caught on the pavement, look people in the eye when they speak and then remind myself to stop staring at them and listen to what they are saying. I can’t look at people in the street for fear that they are thinking something terrible about me that may subliminally be passed over and then have to remind myself to act natural so that they can’t tell that I know that they think I’m mad. But mostly I just get on. Just sometimes I have to remind myself to stop pulling faces while I’m thinking. And seriously, stop frowning so hard.

Today was once again brilliant but very sad as today was my last clinic day. I just got to know everyone by name and started to get offered tea by the dental nurses. I felt almost like I ought to be there, like part of the set up. So I bought in the obligatory sweeties for the afternoon and made a card with the obligatory stick figure picture of myself waving, with a speech bubble saying “Bye Bye, thanks for having me!” And after clinic at 7pm I finally got some time with Mr Big Cheese- my absentee supervisor. He said we should go to a coffee place over the square to chat and Reg and SHO joined us. We all had lemonade and a bite and a chin-wag about the current state of OMFS training etc etc. Then Reg and SHO left and I updated Mr BC on what I’d been up to for the past six weeks. I bought a show and tell bag. He went through my Uni ‘Elective Diary’ and seemed chuffed that I appeared to have been listening when he was telling me things (I’d written them down in the diary). I also showed him the case report I’d written (he only made two corrections and one was a typo) and told him about my second case report. I forgot to mention all the work I’d done for the other Consultant. I showed him my sketch book and a half-finished painting. I explained that it was the start of a project to raise awareness for his charity. He seemed pleased all round. I was pleased all round. And despite being so nervous I was shaking I felt like I’d made a good impression. It almost felt like a job interview, but the interviewer is your dad. A weird mixture of nerves and a strong desire to make them proud.

I noticed that I was shaking when I had talk to these people. I try so hard to be serious and make witty yet very subtle comments and not say anything that could be misinterpreted in any way. I try so hard to make myself bland. I want to work with these people. I was looking at the Reg thinking, you may be my consultant one day. I may work for you. I want it so much that I worry about the impression I’m making. But then I worry I’ve come across as shy or even aloof. The SHOs have all been really nice and I feel like I’ve been able to open up to them a bit more. But still. It struck me at how good a bullshitter I am the rest of the time. Everyone who knows me in ‘real’ life probably can’t understand the concept of me being shy. I’m normally loud, wise-cracking, outgoing and proactive. But I don’t want them to see through it and think I’m just a massive bullshitter. Instead I think being thought of as a bit shy but kinda jolly most of the time, and with a talent that I’m willing to share (everyone is totally intrigued by an artist in a room of surgeons), is much better than being a loud-mouth who may get on smashingly with some but annoys the crap out of everyone else. Also, I noticed how much easier this would be if I were a boy. I’d be in the boys club. But I’m not a boy and I’m not going to make ‘being a girl’ a selling point. So, here we are. At the end. I hope I’ve made a good impression. I hope they remember me favourably when they are interviewing me for a training post in a few years time. Last day in theatre tomorrow then out for a couple of drinks, with the opportunity to get smashed and destroy this carefully constructed personality by dancing on the table.

Medical Elective- Day 38

I find myself stuck between a longing for simplicity and a strong desire for innovation and a vague conviction that the combination of the two will be perfection but am so far away from achieving this it makes me sad. It struck me today walking in the drizzle to the tube station that not a single person I passed was not carrying a bag. What is it that we feel we need to take everywhere with us? Necessities, that’s what. Necessary things. Wallet, phone, book to read whilst travelling, tablet computer to get some work done on the go, some random item required for work/leisure/whatever it is you do to pass the time during the day or night.  I had: wallet, keys, sketch book, tictacs, chewing gum, tissues, lipbalm, notebook and diary, mp3 player, bottle of water, ID badge, two biros, a bit of ribbon, panty liner and paracetamol, rubber, sharpener and emergency headphones, empty Hello Kitty lunchbox, large brown envelope with documents to be filled out job-wise, book to read whilst travelling, pencil, hand cream, alcohol gel. And that’s a light day for me. I’m not sure if I agree with contingency planning (I used to carry around a knife, fork, salt, sugar, set of screwdrivers and a few spare bits of wire and fuses...) or if this is just a whole lot of unnecessary.

I’ve had another good day. I went over to the Other Hospital today, theatre from 8.30- 11.30, receiving inspiration and wisdom from a ‘savvier than initially expected’ Consultant. Feeling inspired (which was possibly his cunning plan) I then spent 11.30-5pm data gathering. I made 97 phone calls. I broke for 10minutes to eat and read a bit of my book. So, with a feeling of accomplishment and a resolve to come back to London from Nottingham to engage further in this slog, I travelled to the other side of London to meet Dad for dinner. This was the highlight of my week for sure. I don’t get to see too much of my Dad and historically, being Weekend Dad, I’ve always kinda valued time with him. Also we get on really well and talk about everything and anything and really bounce ideas off each other. We went to a random little Greek restaurant and shared some lamb and wine. I was sad when we had to leave. My step-mum had sent me a bag of cool wool down and I managed to leave it in the restaurant. So after arriving on the tube platform, realising, I then walked all the way back, collected it and then came home. 20minute journey dragged out to an hour. Never mind. At least I got to enjoy the drizzle. I felt kinda sad too, but let the drizzle wash it off in favour of a cuppa and some mild pondering.

Communication is something that the modern world specialises in. We are all about social networking, wifi, phones that do everything and go everywhere, neurosis about being uncontactable. And yet we seem to have lost the art of traditional communication. The productive sharing of ideas and thoughts. Why don’t we ever share the important things? I’m not even talking about feelings (although these are obviously important), I’m talking about why Science in the news is bits and bobs, usually scaremongering and yet Football has hours devoted to it. I have so much to say on this topic I’m not going to continue in this space, you’re just going to have to wait for my BMJ article, Guardian article, novel and little box on the street corner where I throw my badly photocopied leaflets at you as you go about your daily business.

Today my glasses fell apart on my face. One of the lenses fell out as I was walking down to the tube station. I have never been more scared in public, panic attacks aside. This wasn’t physiological, this wasn’t cold sweats, gut ischaemia and inexplicable fear- this was cold hard logic. I could not see. I could not tell who was who and I could not read any signs. I couldn’t go anywhere. I tried wearing them with just one lens and was granted enough vision to stave off catastrophe but was immediately met with a searing headache. I made it to the ticket and ‘help me’ counter and begged some sellotape form a very helpful guy who offered to tape them for me. I said it was ok, just bunged loads of tape over the lens and head for the tube. Once on I sat and carefully arranged the tape so that it looked like I was just poor/been in a fight and had broken glasses as opposed to had been attacked by some tape.  And so I met my Dad, looking like a damp cardigan-clad victim of domestic violence.

I was starting to wonder the other day about why I blog. Desperation-fuelled narcissism? Not being able to bear the thought of my stream of consciousness being mine and mine only? The fear that if I do not share the narrative of my existence that my existence will lack meaning? Well, all of that but it started as a way of initially staving off boredom and loneliness and then became a way of telling my Mum what I had been up to that day without a half hour phone call. Since then, it seems to have just become habit. And a way of ensuring I continue with this stupid self-portrait scheme. This will be self-portrait number 38. At the end of this week it will have been six weeks. That’s 43 self- portraits, ending on Sunday. I have been toying with the idea of trying to keep it up for six months. That’d be over 100 more portraits added to the six weeks. If social networking has taught me one thing- it’s that I should not take this decision as an individual, I should canvas for opinion and see what others think. Bollocks to social networking. I’ll see how I feel.

Medical Elective- Day 37

There’s a plate and cutlery gremlin somewhere round here... and I will seek him out. I just walking into the kitchen to make a cuppa and a spot of dinner to find some old guy schmoozing a lady, neither of whom I had seen before, but he pretty much told me off for walking in. I apologised and carried on. What I should have said was- this is the kitchen, I imagine one of you rents here so just go in there and you won’t have to see me pottering around making tea with wet hair and putting you off your stride. Sleazy.

Today was another pretty bog standard, ward round at 8, clocked a pretty interesting paediatric case to write up then went to theatre until midday. By midday I had become so distracted by the increasing list of ‘things to do’ in my head that I just left. I had work to do. So, back at The Accommodation I managed four hours of painting (which seemed to make a little dent in it- but considering it’s gotta be finished tomorrow night and I’m meeting my Dad for dinner I don’t have many hours left to dedicate to it. Sad face). I then took a nap for an hour cos I totally earned it. Tonight I finished writing up a case report and sent it on to the Reg for looksies and made a start on the case report from today. I still haven’t touched the pile of ‘forms that need filling’. Maybe I can do that on the bus tomorrow.

Tomorrow I’m back over at the Other Hospital, the one that’s two bus rides away. Morning in theatre seeing interesting thyroid surgery, then the afternoon dedicated to following up on the project, which involves phoning lots of people. I’m quickly running out of gumption. But Dad is meeting me for dinner (on the other side of London) tomorrow so despite the seven quid cost of a travel card these days I’m actually quite looking forward to tomorrow (even thought I will be exhausted and when I get back I need to paint until I pass out). And I haven’t even started making a gifty thing for The Team. I really wanted to do a painting or something for them but just haven’t found the time. I should have really started my ‘goodbye’ gift when I first arrived... Never mind.

So, it’s all push for the last week in London! Sign off after clinic Wednesday night, goodbye drinks after theatre on Thursday then move-out on Friday. Le sigh.

As an experiment for busy people, this portrait was done with ‘whatever was to hand’, which tonight was my dinner.

Medical Elective- Day 34, 35 & 36

This weekend was mostly spent on the go, so please see below blog entries...

http://jadedladies.blog.com/

Three little mes.

Medical Elective- Day 33

Today was pretty cool. Ward Round at 8 (after actually remembering to fetch my laundry from the laundry dungeon), went to theatre around 9, found New Friend and then spent the day watching what can only be described as a Seriously Cool surgery. There were two Maxfacs consultants and a Neurosurgery consultant. The patient was having an SCC removed from their temple that had invaded to bone. So the skin, muscle and everything else was removed, then the neurosurgeon set about removing a section of the skull and then an area of the dura, down to brain. Today I watched a living human brain. It’s beautiful, like in pictures. In real life brain pulsates. It has two rhythms, one with the cardiac pulse and the other with the respiratory cycle, so it looks rather erratic, as if it had a mind of its own (oh yeah, get in there brain jokes). Pulsating brain is both weird and beautiful and gave me a whole brand new sense of wonder about the profession I’ve chosen. After the dissection, they covered the brain with fakey-dura (that looks like a little brain quilt) and brain glue (which is the same colour as blue washing up liquid) and a big bit of stainless steel mesh. The defect was then covered with a rec fem pedicle from anterior thigh. And we were all done and dusted by 5.30. Early finish!

That was pretty much it today. Although I feel that’s enough to warrant bloggage; chillaxed day with a bit of sketching, bit of photography, bit of banter and brain. Have been back at The Accommodation trying to work up the energy to paint and pack to head back to Notts in the morning. So far I’ve just mostly eaten chocolate.

This evening’s portrait sums up a lot of this elective period- a biro drawing. I got changed out of my scrubs this afternoon and emptied out a pocketful of tabs from doing up peoples scrub gowns. I had apparently been taking the tab and each time just shoving it in my pocket. Bar the one I used to write a note on I came home with six. So I taped them together and did tonight’s drawing on them. Here’s to the end of five weeks of not scrubbing in, in favour of biro sketches.

Medical Elective- Day 32

Trotted over to Sister Hospital this morning for a clinic. I got the bus as usual and as usual had not anticipated the traffic. But was only five minutes late so not too bad. On arrival New Friend was in with the consultant (Mr Bond today), so I was left to chin-wag with the two SHOs who I’ve gotten to know over the past couple of weeks. I made one of them teach me dentistry. After seeing two patients, we ran out of patients. So the other SHO dragged the two students out for lunch in the sunshine. They got some food from a sushi shop (I had packed lunch and, Mum, had it confirmed yet again that peanut butter and cucumber sandwiches are not normal.) I got a little tub of ‘green tea ice cream’. How nice does that sound? It tasted rank. Like eating powdered green tea. Soooo nasty.

Anyway, I skipped out of the lunchtime MDT as I was half falling asleep and half watching the SHO drool over Mr Bond. While both fun, neither particularly constructive. So pottered back to The Accommodation. Via the market. Via ‘everything’s a quid’ guy. Picked up a gorgeous GAP summer dress for two squids and a few remnants of the nineties for a pound. Had a shower, did a bit of case report (which involved ringing the library to chase a journal), bit of painting then back out. Via the library to pick up this journal. The staff in the library weren’t much better at finding things electronically than I am but they were persistently helpful to the end and between the three of us I left happy with a print-out on the house. Yay library folk!

After being slightly kidnapped by the bus, finally met up with a mate on Oxford Street. Having made a very poor shoe choice for the afternoon. I have since resolved to have a ritual burning of all of my high heels. Horrible things. It stops being pain after a while and is just becomes an indescribable combination of nausea and wanting to cry. But we eventually found a pub, having failed to find the gallery we were supposed to nip into. Quick drink, quick chat then back to home-base. On arriving home I managed to consume food, watch DVD and drag myself back to my painting. I had promised myself I would finish this painting by the end of the week. My week ends tomorrow as I’m back off to Nottingham Friday morning. But I have a niggling headache and complete loss of gumption. I’m tempted to take it back with me over the weekend and see if I can make any headway.

This evening’s portrait is also sleepy.