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Dissection Recollection 2008-02-28 12:47:00 The final day of cutting is over. We spent it looking at the hip, knee and ankle joints. I eagerly jumped in at the start, keen to find and remove the head of the femur from its socket. With what seemed to me like a rather careless approach I managed to do so in ‘record time’ according to the instructor, and apparently not a bad job either. Synovial fluid spat out as I tried to sever the ligaments, and as the head rolled out of the socket I smiled coyly at the smooth white contours of the joint. I was a little disappointed there wasn’t an artificial hip joint, as there occasionally can be. As in the nature of medicine, there’s always far more information than anyone could possibly remember, and the torrent of fact from the instructor’s explanation went way over our heads.With the Read more:Dissection
No title 2008-02-27 05:56:00 The lower limb is a little easier to dissect. For one, the face is out of view allowing for us to slip into a less personal sense of thought and just get on with the task in hand… or foot. Secondly, the muscles in the leg are much larger and easier to separate than those in the arm. Finally, there is no need for twisting the limbs into place, as they have been fixed in the anatomical position. Needless to say, the lower limb has proved a little easier to deal with.We started with the posterior - the gluts and hamstring muscles. Once again, we found ourselves with the rather unpleasant task of cutting out chunks of fatty tissue, but eventually the anatomy became clear. Following on from this came the femoral triangle. It’s odd poking around near the cadavers genitals, but as is the nat
Bad to the bone 2008-02-24 10:53:00 As the week drew on, the nature of dissection changed. In the beginning, after the initial shock was overcome the cutting process became fairly routine. By Thursday, things started to get a little messier. In order to fully dissect the joints, we ended up doing what can be described as effectively skinning the arms. Needless to say, the week ended on a fairly drained note, most of us glad for the weekend.I think the best part for me was dissecting the palm. The method itself was quite challenging, the skin and facia stuck on tight. It required a lot of patience and hands on precision to make a half decent job of it all. Eventually we penetrated the carpal tunnel, something that I’d put as a highlight of the week. The instructor explained to us how the anatomy related to carpal tunnel syn
Dissection 2008-02-19 17:23:00 Just a quick request to start with, that is if you are planning on donating your body to medical science then it would help a great deal if you could end your days laying in the anatomical position, arms supine.One of the hardest things about dissection is trying to move a body into the necessary accessible positions. A fair deal of force is required that, for a first year medical student with limited exposure to death can prove exceptionally tough to overcome. It is undignified, especially when it comes to rolling the entire cadaver over onto its front to dissect the back, it is also messy at times, but still we persist.The general atmosphere is quite jovial. There is no need for it to be solemn and there are the usual light hearted jokes and comments needed to overcome the mental obstacl Read more:Dissection
Feel lucky, punk? 2008-02-17 14:28:00 Friday’s exams proved on the whole to be much more challenging than the FunMed cohort, as you can see:FUNMEDWhat type of image is this? A. CTB. X-rayC. MRID. Contrast media X-rayE. Ultrasound(Website was left on the image)CARDIORESPIRATORYName A.A. Anterior papillary muscle of the right ventricleB. Septal papillary muscle of the right ventricleC. Posterior papillary muscle of the right ventricleD. Anterior papillary muscle of the left ventricleE. Posterior papillary muscle of the left ventricleAs you can imagine, this has a significant impact on results. In fact they went from this:FunMed Class Average: 60%To this:Cardiorespiratory and Metabolism Class Average: 49%Over half the class (~150 people) failed.Thankfully I did not, though I didn’t score as high as before which is a bit of a Read more:lucky
Introducing: The Medical Student 2008-02-12 10:49:00 As it has once again reached that time of year when an exam is looming, I felt it appropriate to compile a list of exam personalities that I have witnessed over the past few years. Please note, they are not a reflection of the students at my school (although some will invariably fit the description).The GunnerA classic personality. These high calibre front row revision jockeys are at the forefront of every year. They are walking textbooks that seem to run off self-satisfaction. To the Gunner, a pass is a fail unless they are right at the top of the year. They are ridiculed by the pack but always come off best.The SpongeSponges have a seemingly unnatural ability to turn up to lectures and remember volumes of information without effort. Revision time is brisk for a sponge as they are already Read more:Introducing
, Student
Withdrawal 2008-02-10 18:44:00 One of the best things about medicine is getting away from it all. Particularly the fascination and regard your non-medical friends have towards you. Friday night I ventured off to Carnaby Street in the heart of central London for drinks with some old friends. Every time I see them I get asked that same endearing question “how was school today?”And so would follow a short spiel of whatever amusing story I can think of that they’d appreciate. Many of them are still finding their feet and subsiding on the same disposable income they had when they were students. Though, with time modest salaries will increase, promotions will come and lives will move on. I am aware of this, a feeling which fills me slightly of dread. I will still be in school, living off my pocket money, revising for ex
Hard to stomach 2008-02-07 13:21:00 When in the anatomy lab all notion of time fades away and hours can pass unnoticed. What does not fade away, is the smell of formalin. It seeps through the gloves and clings to your skin. No amount of washing is able to cleanse the scent, I am sitting in my room two hours after I’ve finished and can still smell it. This makes eating dinner a little unpleasant. Every forkful of food I put in my mouth brings with it a reminder of the days events.Lasagne was a bad idea.It is far too structured a meal, far too familiar. After a day spent pulling apart and prodding abdominal anatomy, the thin slightly tarnished and burnt-edge layers of pasta remind me of the layers of peritoneum and anterior abdominal wall. The béchamel white sauce browned by the oven, thick and gloppy from melted cheese is
No brainer 2008-02-05 18:00:00 I heard from a hall mate that during his PBL, two students turned up 20 minutes late and had to take the only spare seats left in the room – on either side of the tutor. Both then proceeded to take out their PBL notes, which happened to be the exact same printout of the relevant wikipedia page. Imagine the tutors delight!Still it begs the question, what kind of anencephalic bint would do that right next to their tutor??Surprisingly, my PBL session this morning went fairly smoothly and dare I say it? I actually enjoyed it, to a degree. Perhaps as I went in with absolutely no desire to be there or prospect of enjoying it. Expect the worse and never be disappointed, half empty and all that jazz. I’m not holding my breath for Friday’s session.Recently I have been trying to work out what
Please Note: 2008-02-05 12:13:00 It is not anemia, it is ANAEMIAThey are not neurons, they are NEURONESIt is not edema, it is OEDEMAIt is not cecum it is CAECUMIt is not esophagus, it is OESOPHAGUSIt is not hemoglobin, it is HAEMOGLOBINIt is not norepinephrine, it is NORADRENALINEThey are not determinants, they are EPITOPESIt is not microanatomy, it is HISTOLOGYYOU NAUSEATING TEXTBOOK!!
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MBBS (Wiki) 2008-02-03 10:49:00 Whether it’s a bachelors in Google or doctorate in Wiki
pedia, the use of such online resources is abundant in medical education. For me, science and efficacy of data has been drilled in during my biomed years. Yes, I used the internet, in particular PubMed which I have spent many hours refining search options and looking for papers of relevance. Much of the time, the university hadn’t subscribed to the journal articles I wanted to view. Yet, with persistence and effort we all managed to become scientists who knew how to obtain and analyse information as it was published. It was thus possible to be cutting-edge, on the brink of fact.Then I started medical school. PBL sessions in particular seem to be a fairly endless onslaught of Wikipedic drivel. At the risk of criticising some fellow
Not quite Werther's Orignial 2008-01-31 16:04:00 GP day again, bit of a weird one. We spent most of the morning discussing eating habits with the practice nurse. She was a lovely lady, and I actually quite enjoyed the anecdotal nature of the morning’s discussion. After a cup of tea we all got to take a dipstick test on samples of our own urine. I did wonder just how awkward it would be if there happened to be say, a positive test for a urinary tract infection in one of us. Fortunately it did not transpire and they all came back as normal. By a quirk of coincidence I have to do exactly the same thing tomorrow as I’ve only just got round to registering with the local GP practice.We calculated our BMIs and mine came out as 19.5, officially classing me as underweight according to the UK, or normal in the eyes of the world health organisa
The Lax Approach 2008-01-30 08:20:00 I’ve had diarrhoea all afternoon, spread right across my bed sheets. Just to clear up any misconceptions, that be, I’ve been reading about diarrhoea. It’s been an exhaustive few hours and I didn’t stop for lunch, but can you blame me? I found out that there is however, a lot more to diarrhoea (besides proving an absolute bitch to spell correctly) than just the usual bullshit. Diarrhoea essentially comes in a variety of flavours, I won’t bore you with the details regarding those. Still, there was one cause that caught my attention - factitious diarrhoea.More commonly seen in women with eating disorders who binge on laxatives to lose weight. Not a nice thought, but you can understand the mindset. Rarely however, you will come across patients who dilute their stools with water or ur
Tummy Ache 2008-01-28 11:46:00 “Muscles of the anterolateral abdominal wall”Qué?Still a stranger in this town, the anatomy textbooks have once again come into play. I’ve spent most of this afternoon a tourist trying to locate the few basic muscles and fascias that comprise the abdominal wall. The rectus abdominis seems the easiest to understand. These strap-like muscles run vertically down the abdomen and are separated by the linea alba – something I remembered reading about in surgeonsblog over the summer. Together, this simple arrangement is better known to you and I as the six-pack. Aaah…layman’s terms.Then comes the headache. Internal and external oblique muscles that run antiparallel and perpendicular to one another separated by various fascias and overlying the transverse abdominis, all ultimately ove Read more:Tummy
And breathe... 2008-01-27 09:18:00 Cardiorespiratory is over, with only exams to look forwards to now. It was on the whole, far better than the first term crock of shit that was FunMed. Hell, there were times I actually felt like I was in medical school. A slightly turbulent third week has ended with a fairly placid, Oasis-filled Sunday. Just like old times.Tomorrow sees the start of a new block of teaching, kicking off with my favourite subject delivered by one of the most famous editors in the world of medical textbooks. Shame there’ll probably be the usual complete lack of respect from the wank-stain that makes up some of my year. I’m no gunner; I don’t ask countless questions or suck up to lecturers, or try to use an overly sophisticated verbatim when I do speak up. I don’t go around asking everyone what they go Read more:breathe
Human Canvas 2008-01-23 09:00:00 Something you don’t think about when starting medical school is just how much you need to play patient to aid each others learning. Of course, we do get on occasion to meet real patients. Sometimes we even get to listen to their breathing, or take their blood pressure. In the past eight days, I have had to play the topless patient four times. Once for a cardio exam, once at the GPs, once for a respiratory exam and once today for…body painting.Surreal. That’s how I’d describe standing around topless for over an hour in the anatomy room. Just behind me, rows of preserved specimens in jars on display, to my side, two tables with cadaver shaped sheets covering them and in front, ten (seriously, ten) eager young girls wielding paint brushes eyeing up my chest.It was heaven.So they set a Read more:Canvas
Yr1 SSMs 2008-01-21 14:53:00 SSM Allocations:1a – Dissection (Limbs)1b – Neuronal and pharmacological control of body functionDissection starts in about three weeks, and is the one I’m looking forwards to doing most. Pretty pleased I didn’t get assigned any random goal setting bullshit.Been a long day, will blog more tomorrow.
Blood Brothers 2008-01-19 09:25:00 For years they lived in the same house together, cohabiting, existing but never talking. Related by blood was all they seemed to have in common. Like ships in the night, they would wander past one another in ghostly passage. Of course, it wasn’t always like that, but growing up and growing apart and accepting the silence was just the way it went. He was quiet, an introspective person whom did not have many friends, housebound by free will, afraid of the world, neglected by himself.Years gone by, a recluse suffering in silence, so guarded, secretive and withdrawn. In passing months, he became overwhelmed by anxiety. Turning to the internet out of sheer desperation. To those sites that prey on the meek, a few e-mails, some false reassurance. He began self-medicating with powerful tranquili Read more:Blood
, Brothers
Blue Bloaters 2008-01-17 12:23:00 General practice, only for the rule breakers apparently. You see, bespoke treatment can only be provided by the most defiant of doctors. Not like those hospital specialists, those conformists whom must fall in line and follow protocol. These are the words of our practice doctor whom I have great admiration for, though I do not necessarily agree with that statement. Smoking was the topic for the day, which turned out to be a real revelation.The morning debate was pretty dry, it seems we are all rather too straight-laced to spark any passionate moot point. At one moment, we were discussing the effect of a strict upbringing correlating to an increased rebellious phase during adolescence. I personally agreed with the GP, in that often those whom were subservient to an authoritarian parental fi
Hits the fan 2008-01-15 09:18:00 If you throw enough shit at a wall, some of it is bound to stick.Guess how my day went…Let’s start with the usual PBL fume. It was horrendous, not because no-one had done the work, or I got something embarrassingly wrong. It was because the tutor seemed to be on the war path. I have never witnessed such a highly critical, deconstructive teacher in my nearly four years at university. The session, I agree wasn’t the most dynamic, and there was a need for some prompting, but the endless torrent of generally unhelpful comments directed towards the entire group only served to isolate the tutor. My back was literally soaked in sweat by the end of it (and the room was freezing) just because I felt so uncomfortable working with this individual. I’m sure they’re very good at their job and
Touched for the very first time 2008-01-14 15:56:00 A double dose of medicine today, once again piercing that undergraduate hymen as we are introduced for the first time to ECGs and a chest exam. To add to the fervour of the event we are informed that the worlds first ECG was in fact the innovation of a physician at our school. If only he could see us now...So after a briefing explaining the equipment and technique to taking an ECG reading, we were let loose on each other. The first five or so readings were not so useful, as the ECG machine decided our classmate was in asystole despite his apparent ‘aliveness’. Upon much deliberation and reconnection of the limb leads we managed to wrangle a steady pulse. Unfortunately for us, no-one really understood just what the hell the different leads meant, especially the augmented ones and so fin Read more:Touched
A day to remember 2008-03-13 16:03:00 We met in a church hall, after the briefest of introductions I sat in the spare chair next to her. She seemed delighted, as the other lady’s gently teased “Oh look after that one, you’ve got a looker there, Emily!” She would then reply, “None of your business!” laughing and flirting harmlessly as older ladies do and I would sit smiling bashfully, as young men do.Emily has Alzheimer’s, quite how advanced I am still unsure. I was handed a children’s puzzle to go through with her. At first I felt awkward, trying to treat her like an adult whilst piecing together a cartoon farm. To make it worse, she was unimpressed and reluctant to take part. “Shut up, not interested” she would keep telling me. At this point the carer would explain that she is a particularly hard client to
Cranial Nerves 2008-03-20 11:43:00 Easter has taken a rather rostral turn from the spine to the twelve cranial nerves. It would seem this is a part of medicine where a mnemonic will come in useful. So far I’ve heard two good ones.(Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Vestibulocochlear, Glossopharyngeal, Vagus, Accessory, Hypoglossal)Only One Object Transcends Time And Foams Vivaciously: Glorious Vagina! All Hail!Ohh, Ohh, Oh, To Touch And Feel Virgin Girls' Vaginas And HymensIt always seems much easier to remember with the added charm of smut. Well, I suppose it beats the more conservative mnemonic:On Old Olympus Towering Tops A Finn And German Vending At HopsDoes anyone even understand what this means??!Once I’ve finally managed to remember the names and spellings of the nerves let alo
Apologies for the late running of this service. 2008-03-30 10:30:00 Once again I find myself neglecting this little patch of cyberspace in favour of less pressing matters and general idleness. March has been a fairly dry month, with little of interest to report. Saying that, I have spent the past two weeks arsing about as it was the Easter holidays.A brief visit home and a slightly overbearing mother pushing me to spend more quality time with my brother is more than enough ‘family time’. It ain’t gonna get fixed that easily. I still haven’t managed to find any form of housing for next year, or job for the summer. Instead I received two rejections for some summer research applications as I’m still a first year medical student, despite the fact I have a fucking degree in Biomedical Sciences. Looks like a few dreaded months of agency work is on the Read more:running
Blind Man's Bluff 2008-04-03 17:56:00 ‘Blind
people don’t see blackness’A provocative afternoon at the hospital as we’re given an awareness workshop by the Royal National Institute for the Blind. Later on we’re to discover that a person born totally blind sees with their other senses. For those who lost their sight in later life, they may see different patterns or the same one permanently. When they dream, they can see – all in the eye of the mind.It’s a philosophical question, and something that is not fully comprehensible to someone who is able to read this blog. Of course, they are not ‘seeing’ in the sense you and I can as there is no visual input into the visual cortex. Occasionally when some people lose sight, they experience hallucinations – a condition known as Charles Bonnet syndrome. We’re told
Clinical (s)-Kills 2008-04-09 14:09:00 There’s nothing like a long clinical skills session to demonstrate how much you’ve forgotten when it comes to cardiovascular, respiratory and abdominal exams. Fundamental, keystones of good clinical practice these theatrical displays of competence are right now, at best shabby. I can’t for the life of me remember the order, and signs we’re instructed to look out for. Come the summer OSCEs we will be given perfectly healthy patients with none of these pathological features, yet we will need to say what we’re checking for and remark on their absence.A respiratory exam should start something like this:“Hello, I’m Harry and I’m a first year medical student. Would it be alright if I can quickly look at your chest and listen to your breathing?” Said as I wash my hands and stand Read more:Kills
Stroke Folk 2008-04-13 19:14:00 I spent some time last week at the hospital, on the stroke rehabilitation ward. Upon arrival we were greeted by various members of the team, later we would be introduced to a man who’d recently suffered a cerebellar stroke. This is where the medicine learnt in a lecture theatre translates into something completely different. No longer is it as clear cut as ‘a cerebrovascular occlusion of the posterior inferior cerebellar artery resulting in localised ischemia.’ It is instead, a man who has difficulties walking, standing, co-ordinating his hand. I watch for a moment as he tries to place a red counter into a connect-four grid.The occupational health therapist tells me how he presented, and how his rehabilitation has gone so far. I observe the man, as he cunningly dupes a nurse into lo Read more:Stroke
Nuclear warheads 2008-04-18 12:01:00 There are some weird and wonderful disorders in neurology. From the man who could only say ‘tan’, to patients who cannot differentiate between background and objects, and, famously to Phineus Gauge, the first accidental frontal lobotomy. All of which suffer from unusual, bizarre consequences.And then there is my uncle, who has been diagnosed with ‘Exploding Head Syndrome’. Now, at first when my mother told me about this I was sceptical, but to my astonishment it was actually listed in my Oxford Medical Dictionary. As he describes it, he hears an enormous crash that wakes him up in a sudden jolt sending his pulse racing.Last night I swear I heard a massive bang, but couldn’t really tell where it came from. The next morning no-one else seemed to have been woken by any noise.Here’ Read more:Nuclear
Suture Self? 2008-04-20 11:04:00 Hospitals are a foreign place, especially for us first year medical students. On the rare occasion the university will let us set foot on a ward to have a supervised interview with a patient, one that tends to be on the road to recovery with full mental faculties. In short, we all seem to have a naïve, romanticised idea of what goes on in these places.The other week a friend and I ventured into the basement of the Royal London for a guest lecture. It would seem that the silent corridors and rooms of the hospital basement are for three things; the MRI, the morgue, and the medical students. Sat in the dingy and dated lecture theatre, most likely surrounded by radioactive dyes in storage through one wall and cold dead bodies through another, we ponder as to what dramas are playing up on the
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