Medical Elective- Day 4

Evenin’. Right, where to start with today? Well, I guess if the Beginning is good enough for a mad hatter its good enough for me. This morning we had clinic at a sister hospital. A hospital that, on a map and from my vague recollection of London geography, was about a 20minute walk away. Turns out it’s a 40 minute march away. I had arranged to meet Friend at 9 am and just about made it there by ten past. Phew. We located clinic and were there happily by the designated start time of 9.30am. We then spent a delightful hour and a half waiting for Mr Consultant. Luckily the Reg and SHO had been there since 9.30 and had been seeing patients, so don’t fear NHS customers. It gave me the chance to do an impromptu sketch of Friend, which I may upload at somepoint. Good practice drawing profiles. That’s boring and of little consequence. But it is something I did today. 

Clinic saw a swathe of beloved patients and even a hug for Mr Consultant from a young girl who had had various facial surgeries. I was then quizzed about the national religion of Armenia in a roundabout way of being schooled on the history of plastic surgery in America. Apparently all the big bosses are descendants of Armenians who fled Turkish persecution. I learnt something today. Woop.

Lunch was an MDT but first Mr Consultant insisted that we try out a local sandwich shop. He was bang on the money- Halloumi and veg sarnie. Delish. But that four quid was this week’s budget... Anyway. After the MDT we then went to another clinic on a different floor to the first clinic, and saw patients until around 6pm. The way patients are seen is also a bit alien to me. Basically the most senior person starts to see someone and then in the middle of consultations goes around and sees everyone else and their patients. At first glance it all seems a bit rude, but the patients are patient or politely befuddled, just happy to be seen. After watching this approach to clinic for a couple of days the idea seems to have sunk in, that its evolved as the most efficient way of seeing the hundreds of patients who need the department. 

But enough of all of this NHS related talk. Today was productive in several ways. I have discovered the key to talking to Mr Consultant. First you must understand that at any point in the conversation he could be interrupted by his phone which 50% of the time gets answered. Secondly, he may interject with ideas before your idea has fully come out of your mouth. Thirdly, he may be stolen by anyone else at any time. Thus, I have developed a means of communication whereby I think about what I want to say, form the idea coherently and put it into one sentence. I then wait, poised, with my sentence. Ready to pounce. When he appears to have finished a conversation- Strike! It has worked so far. Mr Consultant reminds me of me in the future. So busy and full of ideas that holding anything down can be a bit tricky. I hope people talk to me in the future with well thought out punchy statements. Possibly with hand actions. Or interpretive dance. 

After escaping clinic and finally letting Mr Consultant leave (after inadvertently walking him to his car) at 7pm, on my way back to the entrance (I had no idea where I had walked to) I ran into the rest of the Team. Reg and two SHOs, one of whom is Old Girl. They accepted the challenge of showing me how to get out of the hospital and on the way I got invited to join them for some dinner. I declined dinner (zero cash) but said I’d come for a drink (sneaky tap water perhaps). On chatting to the other SHO it turns out he is originally from Nottingham and we had a good old chinwag about getting burgled in Radford. Homies! They’re just crawling out of the walls! Anyway, Reg took us to a rather swanky bar full of financial looking types. On admitting that this was possibly the most up market place I’d ever been in my life, Reg insisted that most of them were just wannabes. The City is a strange place. Reg kindly treated us to a bottle of wine, explained that if I wanted to come and see anything in particular just to ask him and then I politely made an exit. Yay! One of the Team!

I’m going to keep the rest of this short as it’s already 11pm and theatre all day tomorrow with Mr C. It’s set to be a whole bunch of interesting stuff. I treated myself to a bus home, via mini supermarket. Reduced cooked chicken equals tomorrows chicken and avocado sarnies (competed and in fridge) and a room that smells of chicken as for some reason I insisted on doing much of the preparation in my room. As per my nightly task, one more self-portrait done. Tonight’s was in biro and this time I tried to smile.

Medical Elective- Day 3

It struck me today that all my numbering is out. This is ‘Elective Day 3’ as I counted my arrival day- but knowing that today is ‘Day 3’ I spent the whole day convinced it was Wednesday. My new friend is not used to me never knowing what day it is (as other friends can attest to) and, after clarifying that today is in fact Tuesday about six times, I’m sure I have now convinced him that there is very little to me beyond the odd witty quip and a good sense of lunch-break timing.

Some good news, I now officially have a friend. There is a nice young man here doing the same thing as me for one week. Good points: He is not adverse to me following him around (he thinks I’m being sensible and sticking together, rather than I don’t know where anything is and I probably wouldn’t remember to go to anything if he didn’t remind me to). He is pleasant to talk to and we have similar interests in Plastics and Facial Surgery. Bad points: He is better than me at EVERYTHING and NOT a douchebag. Bastard. He is more involved with Mr Consultant’s charity: I’m doing a little exhibition- this guy is organising a showing by a professional artist. I turned down a charity bike-ride and this guy is doing the half marathon. I’m now going to have to run the sponsored 10K so that I don’t get ‘out charity-d’. He knows more than me about stuff I have just taken exams in, despite him taking a year out to do a Masters in Research. And as such has way more papers than me and a more legitimate claim to academia. Now, all this makes me sound like a mighty jealous and shallow person. Maybe I am, as all I can think to mention after that is that I’m two inches taller than him. Win! But, seriously, he’s a nice guy and I wish him all the best and I hope he takes it as a massive compliment that I’m very jealous of him.

Having thus resolved to be better at stuff so that I don’t have to be jealous, I am now back in the sauna room writing a ranty blog. Maybe this is why I’m not getting any research published. I don’t think bitching about people who are better than you counts as research. He did give me a bit of advice, though and this evening I resolved to hit the books. It’s now ten past nine and I have watched Dara O’Brien on DVD and had a bath. I tried to read a book in the bath but was foiled repeatedly and with malice by the lighting system. The light in the bath room is based on a motion detector, which was installed about fifty years ago as far as I can tell. You start by walking into the bathroom. After waiting for a bit you wave your arms around experimentally. You then hear a ‘click...click....click...click’ sound of the detector detecting you but being struck with some kind of lighting impotence. After a bit of clicking (come on!) it starts to do an impression of a strobe light (cue discovery of latent Epilepsy) and then the light comes on. So, having run a nice bath, settled in with a book, after about three minutes the light went off. “Silly me” I thought- motion detector! So, waggling legs around out of the bath every few seconds I’m feeling really cunning. Until the light goes out again. Ok, so it seems motion detector is only to switch the light on, not to keep it on. Once on, it has three minute timer, then you get darkness. This was not conducive to reading in the bath as planned. This place just keeps getting better.

Anyway, today was pretty interesting. Handover for ward round starts five floors down from my room. For some reason the first couple of floors of the accommodation is given over to hospital business. Suits me, finally the accommodation is paying off as I left my room at five to eight for eight o’clock handover. Ward round was standard then went to Orthognathic Theatre. One tooth extraction, one BSSO. Saw absolutely nothing. Firstly, because oral surgery mostly involves you being directly over the patient’s mouth to see anything. This would mean you’d have to scrub for surgery. This would not ordinarily be a problem were it not for the six other people scrubbed. One Consultant two Registrars and three SHOs. It has been a learning experience of what it’s like to try and get anywhere in medicine in London. MaxFacs isn’t usually the most competitive of specialities, thanks to the fact that you need a degree in both Medicine and Dentistry (which the majority of people can’t be bothered to do and go into ENT instead). In the Midlands I assisted with Maxfacs procedures as a student, here I could barely fit in the room. 

However, as happens every now and again, it turned out one of the SHOs went to my high school. I definitely feel like an Old Girls Club member. I’ve run into Our Girls in other hospitals, as they all did undergraduate Medicine and are now all F2s. This particular girl was amazing. As far as I was concerned she was the same person I knew from being thirteen. She has a very Ilford accent and she was always a complete Rood Girl. Now she has accepted a highly competitive Core Training post in ENT in Essex. Like, the nice bit of Essex. I almost couldn’t believe what she was saying, I couldn’t equate that Ilford girl with what she was saying to me about her career. Obviously, she’s bright. It was a Grammar School, after all. And I thoroughly love the fact that her accent hasn’t changed one iota.

This afternoon was spent in clinic with Mr Consultant’s Reg and then Mr Consultant himself, who just continued to cement my worshipping of him. I have never heard of an irritable, angry old patient coming into a clinic, threatening to just leave, being told by Mr Consultant that she has cancer and leaving as happy as Larry. And I have it in good faith that Larry is a pretty cheerful chap. She was so enamoured with Mr Consultant, his straight talking attitude and lovely manner that she also didn’t seem to care that his phone kept going off. In all honesty, he wasn’t too chuffed either and if there had been a window I’m sure the phone would have been heading out of it. He warned that the higher up the ranks you get, the less actual work you do and the more phone calls, talks, being chair of things and taking on the EU you have to do.

So, having finished clinic at 5.30pm, we then kept Mr Consultant back til 6pm being all generally interested in stuff and trying to convey this to him (Starfish, Love Me Love Me!). I have gleaned a little information about the future of training in MaxFacs for medical graduates. It looks like the three year training may be on the way out. MaxFacs is also more competitive than I had originally given it credit. Just because no-one in my year at medical school wants to do it, there are plenty of other people in the country that want to do it. Thus I have resolved the following: a, to meet up with mad friend on Thursday and make an actual plan about putting together an art exhibition that is within the bounds of reality. b, ask Mr Consultant just straight out if he has any research projects going on that I can get involved with, emphasising that I will literally do anything. c, sit down and get on with some work. I keep berating myself for not doing anything, but I have only been on elective for two days and have already done one A3 painting, which isn’t too bad going. Just gotta keep the juice up. I will be placing my giant Plastic Surgery textbook under my pillow for osmosis and aim to think of at least one actual, doable, reasonable, not crazy research proposal by the end of the six weeks. And then preferably do it.

 *adopts Rambo-style stance*...


After some thought, and on my way to bed, I thought that I should bust out some work for the evening. I've seen people who do 'one photo for every day of the year' projects. I wonder if I can do one self-portrait for every day of the elective...

 

Medical Elective- Day 2

Ok. Today seemed to go well. Just to update the curious, I’m at a London hospital doing an elective in Oral and Maxillofacial Surgery. Or ‘Dentistry’ as it’s known to doctors. Having gone to bed at around 10pm yesterday (after a bath and a DVD I ran out of ideas about how to pass the time), was up bright and early at 6.20am. Not counting all the times during the night being woken by the delightful sounds of London. Mostly car alarms, drunk people and anonymous buzzing noise. It was either leave the window open or die of suffocation. As I seem to still have a pulse I think this was the right choice. Four years at medical school and I can safely diagnose that I am still alive. Yay!

As the student office didn’t open until 9.30 and I couldn’t do anything before enrolling and getting my ID, this morning was on the whole leisurely. On my way out I met another student (sweet thing from Berlin, here for three weeks doing Obs and Gynae). Nice to know I’m not the only one here. Having negotiated ‘campus’ (or ‘Central London’), student office identified, photo taken and badge collected. It was great spending the day wearing the same outfit as on the badge. Well, I was amused. Possibly just me. Despite pointing it out to people. Everyone’s so humourless in London.

This morning consisted of meeting my consultant, who I continue to regard as some kind of demi-God. Not just because he is a Consultant, and as such this status is conferred in his contract, but because he is how I hope to be when I grow up. Completely scatty and got ‘projects’ coming out his ears. We managed to find each other, he showed me some ‘other students’ (his PhD students and another elective visitor), then pointed me at clinic. I was there for six hours before we all agreed that maybe 2.15pm was time for lunch. Didn't bother going back as it then took me most of the afternoon to sort out my rent payments and other admin. In short, the rent I was quoted was for four weeks not eight (my fault). Re-negotiated for six weeks (acceptable). However the rent quoted initially was eighty squids short of what the rent actually is. So I have found myself in a bit of a financial pickle and plan to spend the rest of my elective prowling the streets of London, eating dropped clementines and potatoes at Borough Market and begging Special Brew on Brick Lane.

Anyone who is actually worrying about me having to sell myself on the streets, fear not for I have contingency plan (thank you Risk Assessment!). I am due some funding, just waiting for it to turn up. But am safe in the knowledge that the Mother is not too far away and visits aren’t restricted to just in case of military coup. Mummy will save me. And anyway, I have a cupboard full of tins of tuna, soup and beans. And I even remembered a tin-opener.

Another pleasant surprise today was seeing an old friend. We met during my first degree in London so it was a bit nostalgic. She normally works from home but occasionally has to make visits to the London office, so I took the opportunity to show her around chez moi. Cue 10 Richmond Menthols and a delightful bottle of wine. London is starting to feel a tad less threatening, but we both ended up reminiscing about why we left and don't ever want to move back. I’m now not quite so much looking forward to doing a dental degree back down here and am starting to understand the ‘let’s go and be a GP in the countryside’ mentality. Jeez, the Midlands has made me soft.

I seem to be spending an inordinate amount of time just staring into space.

After having sat staring into space for a good three minutes before becoming intractably bored, I have resolved to be more productive. As such I have just spent the last few hours painting the most ghastly self-portrait ever. Let me explain; as part of my time down here, what with having arty inclinations and all, I wanted to do something creative. A friend and I hatched a poorly thought out plan about putting together an exhibition. Now, I must hand it to her, she has done it before. Twice. So I am confident that she can do her part and organise it. I have been put in place as ‘Artist’. This is the bit I’m now having second thoughts about. I don’t get much time to do any art these days and mainly stick to doing low-brow obscenities and doodles. We are going to finalise exactly what we plan to do for this exhibition on Thursday, so until then I thought it would be good to get in a little practice. I will try and upload the creation at the end of this post. I don’t mean to be one of those moany ‘oh, it’s so shit’ artists, but in all honesty, this is far from my best work. But, on the flip side (I’m cursed, infected with Positive Mental Attitude), this is just a start. The idea is to improve from here. I have managed to use ALL of the colours. Now I just have to master putting them together into a portrait rather than what I’d see if I looked into a gypsy crystal ball and she started screaming “she-devil!!”

I need to find a life-drawing class down here. Preferably one that’s free. There’s only so many self-portraits I can do before I get permanently sucked up my own bum hole. I also need to organise a Jaffa Cake rationing system that’s agreeable to everyone. By everyone I mean me and hungry me. I also also need to try and pin down Mr Consultant and demand careers advice and possibly art advice. I also also also need to get out more.

SHEDEVIL!

Medical Elective- Day 1

Quick intro: Medical Student, final year (graduate so a little older that usual, but just a little), written finals were a week ago, this wednesday we finished OSCEs, thursday drunk, friday panicking and writing a presentation, saturday delivered presentation, now sunday and have arrived for my Elective. Phew.

Ok. I have arrived in London (kindly dropped, with my kitchen sink, by my Mother et al, traditional student style). I am in a modest room in a building from the 1930s and 1970s at the same time, with built in teak furniture that makes me feel like Poirot would have stayed here. It is boiling hot, as with this kind of accommodation instead of risking complaints from people being cold they just try to boil you to death in your sleep. Dead people don’t complain much. I can hear occasional noises outside hinting to the existence of others, but I seem to have come over all pre-adolescent and don’t much fancy venturing out to meet anyone. Just in case.

There is a 30s style balcony adjoining my room to my neighbour, with whom I share a bathroom. And it literally is a bathroom- no shower. And again, approximately 50 degrees C. No need for a towel, I guess the water will just evaporate straight off me when I emerge from my bath. I’m not sure if it’s a relief that the door to the shared balcony is sealed, due to the balcony being deemed dangerous. On one hand this means I won’t have an awkward encounter with my neighbour whilst in my knickers but on the other hand I’m now unsure as to the structural integrity of the building. Maybe I will move my bed away from the window.

I am on the whole pleased with where I have ended up. Shame that on closer inspection of the paper work I have only booked four weeks rather than eight. Now, the minimum period I have to be here is six weeks, but having only saved the money for four weeks, even if they let me have the room for the mandatory extra two weeks I may have to think of creative forms of payment. Having been accepted for a grant from the Association of Reconstructive, Aesthetic and Plastic Surgeons, I should be home and dry. However there is no actual sign of the money as yet. And the fifty quid that the Medical Womens’ Federation sent me, whilst a lovely gesture, will buy me a mere 72hours more in my accommodation. And anyway, I already spent that money on books. It’s now that I’m starting to appreciate that the Mother is only a bus ride to meet in Stratford, that there are likely to be supermarkets in Stratford and that I have a backpack. I’ve started practicing my ‘starved’ look.

Recent successes include getting internet that works and in theory won’t cost me an absolute fortune. I’m wondering if I could perhaps start writing this as a blog, rather than just an exercise in staving off loneliness (yes, I am essentially having a chat with my laptop right now). Other successes include that I don’t seem to have forgotten to pack anything (famous last words). Taking a leaf from Bukowski I am now having a mug of wine and indulging in a little writing. It is pleasant. With the window open to balance the boiler-room atmosphere all in all life seems ok. Lucky to be in a place where people are at the other end of a mobile phone and I can happily add any thoughts or feelings I have to the existence-vomit that is Facebook. This isn’t very Bukowski at all.

I did a little exploring of the building after the Mother left. There is a basement and I was again pleasantly surprised that it lived up to expectations in the best way. It was super-creepy. Peeling paint, low ceilings, corridors that go on to dead ends and unmarked but heavily bolted doors. The laundry room is fantastic. Two large very new washers and dryers, an old ironing board with no cover, giving a somewhat skeletal impression, all in a concrete lined room full of vents, pipes, massive old ceramic sinks and some smells that could tell stories. Decomposing stories. The best bit of all this by far were the signs on the doors as you exit the clattering lift into the basement: “North East London Foundation School”. Epic near miss.

In a bid to try and do something constructive, I’ve just had a flick through the ‘Elective Study Log Book’. I actually laughed out loud (to coin a phrase) when I read the sentence “We want you to think about what is happening to you”. With the best will in the world I now feel like Bruce Willis in Twelve Monkeys. The rest of the book is some space for ‘what I has done today’ style reflection and advice about not getting Malaria. It has just occurred to me that I have no idea how prevalent Malaria is in London. Not very, I think. You’re always hearing about how East London is rife with TB and HIV and all the exotic conditions. Perhaps my risk assessment should have been more thorough. Ah, the risk assessment. That was amusing. Obviously it is geared at people going to Somalia, but it’s the same questions for everyone. It asked what my planes were in case of military coup. I really struggled trying to envisage a military coup in the east end. But you never know. For all questions in this vein my answer was “Go to my Mother’s”. Mummy will save me. Shit, I swear I just saw a mosquito cross the wall above the desk. Shit, shit, shit I should have thought about Malaria prophylaxis. I don’t have a mosquito net!

Ew, after chasing an imaginary mosquito I just found a dribbly stain on the wall. I am most definitely in limbo between the first and third world. Trapped in the second world. Fuck! I just squished the bugger!! I didn’t imagine it! Just squished a mossie against the wall!! I haven’t been here for four hours and I’ve already contributed a stain to the wall. I’m feeling increasingly more at home. Is it weird to preserve the squished mossie between some sellotape as evidence? Nah, I’m sure this is what they have in mind for us to hand in at the end of this whole thing. God help the people in actual hot countries, their mosquito project is going to be much bigger than mine.

On second thought, my mossie project may well be up to scratch. Just got another one and boy it was juicy. Have pressed them onto a piece of white A4, with a view to eventual binding. Have also closed the curtain as a compromise between Malaria (or just being eaten) and being cooked alive. I have also found a problem with the room. It’s the desk. It’s trying to either kill me or hint something. In order to type I have to rest my wrists on the edge of the desk, which it appears is razor sharp. 

I shouldn’t complain, at least I have running water. And it’s so hot you can make tea from the tap. Good job I’m next to a hospital.