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.

Medical Elective- Day 31

Feeling better today. Not one hundred percent but better. Got up and head to ward round for 8am no problems, was immediately plucked out of ward round by a consultant and followed him to theatre for a treat. Today was an interesting case, a ‘pioneering’ surgery. Basically they did a dynamic face lift with a twist. A patient with a facial hemiparesis can have a few things done- a static facelift, where the paralysed half of the face is lifted up so that it doesn’t look droopy, or a dynamic facelift with a view to restoring a bit of movement, also known as ‘facial reanimation’, which just made me think of zombies. In this particular case the temporalis muscle was mobilised and attached distally to the nasolabial fold (which in itself is pretty cool- with physiotherapy the patient can re-learn ‘chew’ as ‘smile’) with the added modification of a periosteal flap from the cranium to cover the whole thing to minimise the cavity defect of moving temporalis. It’s going to be written up as a paper by the consultants who invented it. Immensely cool. The un-cool part about it was that I got to see approximately zip. I was really hoping for a good opportunity to illustrate but what with the entire Maxfacs and Plastics departments along with the university film crew being there I was sort of confined to the edges. But still. Was very cool.

Things I have learnt: the scalp is ridiculously vascular. You can bleed out from a scalp wound and heard tale of a patient who died of hypovolaemia from as much. While the Reg was closing the scalp he popped the suture through, caught a vessel (of which there are many) and a puddle quickly formed by his feet. This is why, before any scalp incision, they infiltrate with a special mixture of saline, adrenaline, hydrocortisone and magic.

In my cunning schemey way I plan over the next day or two to try and turn the op into a series of technical illustrations. I know it’s hoping against hope (since there was a lot of photography) but if I present these to the consultant he may want to use them. But even if he doesn’t, it’ll still make for some cool illustrations. Sadly, in amongst all my being schemey and wiley, I have managed to leave my sketch book somewhere. If it’s in theatre I’m ok - I came in today, having not been in theatre for nearly a week, to find a library book I had borrowed, on the side exactly where I’d left it. I hadn’t even noticed it was missing. I need to start hanging on to things a bit better.

I abandoned ship after this op, at lunchtime, due to a combination of headache and needing milk. So I nipped to the supermarket, milk, bread and fruit, then home. Painted a bit, napped a bit, painted a bit. Then was invited out for a pint by some fellow flatmates. Trying not to nurture my antisocial tendencies I accepted and have just come back from a couple of pints at the local. It was really nice to spend a bit of time with other human beings. There are two guys and a girl from Austria and they are all really friendly. The girl’s English is fantastic (I was lamenting over our drink my inability to speak another language and admiring the fact that they are working in A&E in a second language). All in all a really nice bunch.  I also met another MaxFacs elective student today. He seems really nice and also expressed a penchant for scheming and projects. I think there’s a secret bunch of MaxFacs aficionados around the country who need a central organisation through which to scheme together- but that’s a scheme for another day.

Interestingly this evening’s portrait was done before I went out but looks strangely like me after two pints- sort of a bit sleepy. I must be drawing the future again.

Medical Elective- Day 30

 

Not much to report today. I had a sick day. The Man Flu finally got the better of me. Temperature and everything. I do not feel that it’s fair to be sitting still, minding your own business and to be feeling nauseous. So, after having gotten up at midday I went back to bed about an hour later to watch DVDs. I felt a bit better around 5pm. Sadly, I seem to have missed the warmest loveliest day of the year so far. I quite needed to head out too as I’m dangerously low on milk.

No matter. Tomorrow will be different. Today I at least tried to do something constructive and started a painting. Still panicking slightly about the lack of definition to The Project, but I reckon if I just start painting, something will happen.

Medical Elective- Day 29

After a rested weekend with The Mother, I’m feeling motivated. I have been filled with loverly Sunday Roast (both beef that wasn’t dry *miracle* and Mum’s special nutroast, which went wrong, long story about parsnips, but was delish in the end) aaaand home made Yorkshire puddings. The spellchecker just saw fit to capitalise my Yorkshires. Good decision spellchecker. We then watched Tucker and Dale Vs Evil. It was great to see the family, including Adopted Aunty from next door, both Little Brother and Medium Brother (both of whom are looking a bit more like Ticket To The Gun Show Brothers these days) and Sister In Law, who I don’t see enough of. Then bussed it back to London.

I have a dirty confession to make. In the space of a week I have been shopping three times. Three times. Once is too often. I have enough clothes down here with me to last and can probably get by with minimal food purchases for the next two weeks (still have a cupboard full of tins). Iam currently unemployed and living a bit hand to mouth. So why in hell have I purchased a new skirt, two new dresses and two pairs of shoes? (I don’t even usually wear these things! I’m a trousers and sweater and ‘the same pair of boots until they fall apart’ kind of person) Cos I’m a sucker for sales. They were all bargains. But that’s not the point. One pair of shoes originally cost more than the whole spree. But that’s not the point. And everything I have bought is beautiful. But that’s not the point. I don’t have money to be throwing around. I am choosing to interpret it as some kind of subconscious cry for help. No other explanation. And to justify my purchases I have punished myself by wearing my new high heeled ankle boots (uh, suede, oh, beautiful) all weekend and now I have sore ankles. I think that’s penance enough. Well, until I can’t pay my rent.

Other than that the past couple of days have been all but completely uneventful. Fantastic. I’ve been living on The Mother’s couch, watching rubbish TV and films and just eating and dozing until my little heart was content. Now, well rested, I’m back on the case. I realise that I have only two weeks left here and I need to make them count. This week’s tasks are to include:

• Getting on top of this project for Mr Consultant and working out how I will stay involved in the write-up once back in Nottingham. I may have to organise a couple of extra trips to London in the three weeks after I leave to wrap things up and still keep my finger in the pie. 
• Writing up my Case Report.
• Working out this Art Project I’m supposed to be doing. Art Friend has exams impending and so I need to be independent and brave and just make a few decisions. I need to talk to the ladies at The Charity and see what they say. I need to come up with a coherent plan for an exhibition to raise awareness for the charity and what sort of format that’s going to take. Enough Blue Sky Thinking. It’s time for action.
• I need to do more illustrations in theatre and turn some of the illustrations into stand alone pieces. My watercolour technique better buck itself up.
• I have to do a market stall on Saturday (anyone in Nottingham come to the art gallery on St James’ St on Saturday!). I have nothing to sell. So I need to make some things here and now and quickly. Thus, in a cunning but potentially very blasphemous fashion, I rescued a handful of my old comics from The Mother’s place today. Twenty year old copies of The Complete Spiderman. Now, obviously after I have read them again, I will see if I can be brave enough to cut them up, varnish bits and make them into various accessories. Nail biting.
• Finally shake this bloody cold.

So I have my work cut out for me this week. Along with attending a few galleries, catching up with a few friends I actually have to go in and see some patients and stuff. Although I’m thinking that ‘clinical’ attendance can be allowed to slide at this point in favour of getting work done.

I foresee a week of sniffles and reading comics.