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Currently on my second rotation .... at DOME @ WOODEND HOSPITAL
Woodend hospital is a truly interesting place....
as one irritating coursemate said " It's like disneyland without mickey mouse"
Well from that I suppose you could make an intelligent guess that this hospital deals mainly in geriatrics, neuropsychology and neurology and everything else that goes with care for the elderly.
we've been introduced to the MSQ ( Mental Status Quiz ) I think,
which is a short series of ten questions where u humiliate both yourself and the person your questioning.
I've taken to telling the patients " If it's alright with you, may I ask you some ROUTINE questions"
and then I start asking them whether they know where they are, when the were born, and the most interesting questions of all....'' Who's the previous prime minister? (JOhn Major) and Who's the current prime minister?"
So far, the above two celebrities have been referred to as the Good Guy and the Bad Guy...respectively. No commento.
And yes, one little old lady said at the end of my clerking, " I knew what u were doing in the beginning my dear, you were asking me about my political views weren't u? But I nae (didn't) fell fer it" (Dun you just love the scottish tongue?)
watashiwa said .... " Aye mam, you got me there"
Yup, basically it's to see whether their orientated and whether their all there, and to see whether what we've just spent the past hour collecting is a big fat concoction of dementia, alzheimers or psychosis. Oh joy.,,
but it really is very interesting, these past two weeks I've heard the most intriguing and fascinating cases such as woman who spent 3 days in hospital talking to someone by her bed who wasn't really there and she suddenly cleared up on day 4 and little invisible person disappeared, man who slammed his head into a low wall on a sleding accident and believes he is 47 though he is really 53, really nice old lady who went on about her nervous coughs when her actual presenting complaint was pseudogout of the knee ( I loved this little old lady, she really was the sweetest)..... so on so forth.
I've learnt quite alot and through countless questions beginning with the slightly mocking " So Dr. Tan ( me frantically glances and badge, very sure that i had skewed it out of sight of tutor) tell me what other investigations would u be doing for this old gentleman with painless jaundice?" ( for all the med students out there, painless, post hepatic jaundice...differential diagnosis is head of pancreas cancer, impinging on common bile duct. prognosis, around 6 mths even with chemo and radiotherapy)
this whole Dr. business is disarming. It sends all of us nitwits into a freaking state of confusion. It puts added pressure. Please call us by our first names. It relieves some of the weight of responsibility. But of course there will be some shit heads who smile and bask at this whole Dr. business and at the same time give the most ridiculous, stupid, imbecilic answers.
For ur viewing pleasure .... 50yr old man, presents with jaundice and swollen legs
Tutor: " So Dr. M.., what is the most clinically worrying sign this gentleman is presenting with?"
"Dr. M.." ( smiling a confident smile) " His swollen legs."
yes yes, some may argue, swollen legs, right congestice heart failure and all that but! HE's FREAKING JAUnDICed? Does that not ring alarm bells of liver probs, or possible splenic hyperactivity? They are more worrying acute problems if u ask me.
yup...so , don't have high expectations of this graduating batch.
but then again, I have to once again applaud and extend gratitude to our most patient co-stars. The patients.
Thank u for putting up with a whole group of medics stabbing u in the carotids to get a pulse to figure out which is the first and second heart sound as they " molest" u trying to feel ur apex beat, but of course it's not in ur stomach or epigastric region, but that's where we fools will constantly prod u.
Thank you for not beating the living daylights out of us whilst we continuously ask u the same stupid question over and over again.
and Thank you Mrs S, for your words of teachings and ur kind words of acceptance and gratitude for this failing profession. yes, the medical profession has evolved into a more caring and concerned one. It's really sad for Mrs S, cause her MSC ( a more advanced mental test) has put her in high likelihood of alzheimers. FIGHT FIGHT FIGHT!!! Do not lose yourself!!!!
I'll always remember wat u told me when we shook hands at the end of our wee chat
Mrs S " You've got lovely cold hands."
me... " erm......."
Mrs S " Do you have a warm heart?"
me... " Well, I do hope i have a warm heart" ( me more concerned with physioogical implications)
Mrs S " I'm sure u do. as they say " Warm hands cold heart. Cold hands warm heart" "
me... " thank you so much."