Switching blogs

Hi everyone,

I wanted a complete revamp of this blog and decided that it would probably be easier to just start a new one.

It’s going to be similar sort of content still tracking my way through medical school with anecdotes from my life mostly focussed on the people I meet and the mental times we have.

My new web address for this blog is https://untilthepiecesfalltogether.wordpress.com/

Hope to see you all over there 🙂

Radio Silence

I’d like to first start out this post by apologising for the radio silence over the last few months (is it that long? I’ve lost track) but I’ve been stressed with exams and deadlines.

On the plus side exams are now done which is a wonderful feeling (sorry to all of you who are still going… keep on trucking!). I have made full use so far of my free weekend with much wine and fun. I went to a cider festival yesterday at my favourite club and spent 12 hours there in a mission to win a gold card which gets me in free for the next year. I am pleased to report that the mission was successful and I am now the happy owner of a card that I probably won’t have time to use next year. Well done me. But the day was really fun so no regrets.

And I’m done with the second year of medical school. All that stands between me and a summer back at camp in America is a couple of weeks of workshops on my dissertation for next year. I can’t believe how quickly these past two years have flown. It’s also extremely scary that we have now had most of our teaching, it’s pretty much clinical from here on out! I’m very excited to leave lectures behind actually; they get very tedious after a while.

Onto the next challenge which is my research project. I’m conducting mine in colorectal cancer and looking at liver metastases and their gross characteristics and how this influences survival. It’s going to be exciting and scary to write a research paper but thankfully my supervisor is wonderful and extremely helpful. So the next two weeks involve putting all the applications etc in for the project and learning about how to do all the statistical analysis that I’ll need. Fun, fun, fun! But there is also a lot to look forward to in the next couple of weeks.

I’m involved in a 24 hour show which is exactly as it sounds; we find out, rehearse and perform the show within 24 hours. I intend to document it on this blog because I think it will be highly amusing to watch me deteriorate as I get more and more sleep deprived but I guess it’s good practice for future night shifts! So look out for that, there will probably be multiple snapchat photos involved in the telling.

Then I’m off to America so there won’t be much occurring, though I will be filling in with anecdotes from working at camp when I get back. Then it’s onto the research project and finally clinical years where I’ll hopefully have some interesting stories to tell via the old blogosphere.

Anyway, I am rather enjoying my lazy Sunday in bed so I’ll be off on that note. I’ll try and avoid the radio silence in future. Good luck to anyone still with exams, whatever the level!

Results and still no time!

So results came out… (they actually came out a while ago but I am too unorganised and didn’t write a post about them!)

I imagine you’re curious to know how I did?

I PASSED! With pretty good marks actually, averaging 83% on Neuro and 70% on Respiratory, Cardiovascular and Renal (not bad considering I did next to no revision for that particular paper).

So I’m really pleased. All my friends also passed which is wonderful and we had celebratory wine/ice cream night but are yet to go out to celebrate because none of us have any time at the moment. (Though we did go to Turtle Bay for lunch and cocktails the other day so I guess that mildly counts.)

I have also confirmed details of my project and am pretty much sorted for my return to America which is incredibly exciting!  There is still so much going on at the moment though with the medical school piling on the deadlines, the usual burden of a medical degree and the two shows that I am involved in, I am metaphorically dying under the weight of my commitments. But I’m also having so much fun at the moment! In rehearsals we have a lot of banter and moral boosting things like all dancing to the Cha Cha Slide in the middle of a rehearsal for no other reason than because we want to. Lectures are also pretty interesting at the moment. We’re looking at reproductive function so all of the gags and innuendos from our lecturers vastly lighten the mood on those days when it’s just lecture after lecture. I cannot wait for clinical years now, lectures are getting a bit tiresome and it’s always nice to get out on the wards/gp surgeries and meet actual patients and learn skills that we’ll be using in the future.

On that note, I have another rehearsal to go to so I’ll be leaving things there – I hope anyone else who had results in Jan/Feb was happy with them and for those of you with impending deadlines/midterms – all the best!

Exams are done and I’m no less busy! Typical!

Exams have been and gone for over two weeks now and yet I feel much more busy and swamped with things to do than during revision time!

Whilst we’re on the subject… exams went fine for the most part as far as I can tell. I felt good about all but one of them and so we’ll have to see how that one goes. I didn’t get a chance to revise that much for it as I focussed a lot of my effort on the other content which was more challenging so if I have to retake it, I have to retake it. I’ll find out soon enough as results are literally a week today! It’s come around so fast, I can’t quite believe it. For those of you interested in the structure of pre-clinical medical school exams – certainly for my medical school anyway – we tend to have 3 each sitting. We normally have a multiple choice paper, a written paper and a practical anatomy spotter paper across two modules covering broad system areas of basic science. It’s alright actually as the exams are done within 3 days though the period of revision leading up to them is not particularly fun. Generally the pass rate is 50% but it is adjusted based on difficulty of the paper. To most people who aren’t yet at medical school that sounds astronomically easy as I’m sure you’re used to getting at least 80% for your A grades but it can be quite difficult to achieve due to the amount of content that theoretically can be covered in each of these exams. Anyway, I’ll let you know how results pan out. If they’re alright I’ll no doubt be bouncing off the ceiling!

Now that exams are over though I’m more stressed than I was before, oh the irony. It’s because I (rather stupidly) have got on board with three different productions of musicals with my students union. One of them finished last week and went so well but I still have rehearsals every evening for the other two. It’s madness! Still it is good fun, I am a little bit concerned about the lack of time that I have to do work however. The module that we’re currently doing is thankfully extremely forgiving (we’re doing a gastrointestinal module which after a nervous system module focussing entirely on the central nervous system is a nice relaxing step down!). We move on in a weeks time though to a module about endocrine and life cycle which is going to be much busier and more conceptually difficult so I will have to keep on top of that.

Other exciting news (sorry this has now totally turned into a mega splurge update post) is that I will be returning to America this summer to work at the summer camp I worked for last year! I’m so excited I can’t even contain myself! For those of you unaware – which is probably everyone as I don’t think I’ve yet mentioned this on this blog – I went to Virginia last year with Camp America to work at a summer camp for adults with disabilities. It was THE most fantastic thing I’ve ever done and a couple of weeks ago I decided, screw it, and have decided to go back despite the costs etc etc. (The picture at the top of this post is a snap from my travels after camp from Santa Monica beach in LA) So immediately after the end of the semester I’ll be flying out to see all the wonderful people I met last year again. I think my medic friends are already getting bored of my over excited anecdotes from last year and the constant updates on the progress of my visa and flight booking escapades but oh well! Life is for living, you have to grab it by the horns and I won’t have a summer long enough to ever do this again so I’m going for it.

Anyhow, I will let you know the outcome of results and if anything else interesting crops up I’ll be sure to write about it.

Speaking of which I have just remembered – I had a bizarre almost out of body experience today in the anatomy lab. I was looking at a dissection in which all of the abdominal fascia and peritoneum around the spleen had been removed, hence the spleen was free enough that you could pick it up still attached by its vessels and hold the whole thing. I picked it up without really thinking and was having a conversation about something completely irrelevant with my friend when it occurred to me how casually I was holding this spleen without finding it at all strange. It’s bizarre because, however horrible, as a medical student you quickly become immune to the anatomy lab and the fact that you are looking at dead people who have kindly donated themselves for your education. There are moments in the lab when you look at the situation as though from outside eyes and realise how weird it is. I had one of those moments today whilst holding that persons spleen and found myself wondering about the person who the spleen belonged to. It’s unfortunately far to easy to forget that once it belonged to a walking, talking complex human being. I was reminded today of the importance to take a minute to be grateful to the people who have agreed to donating their bodies for the education of medical students.

On that reflective note – until next time!

An interesting case…

Fortnightly we at our medical school take the afternoon to go to a local GP surgery and get some teaching from current GP’s and meet a few patients.

We’ve been going for a few weeks now and I must say our GP is a fantastic teacher, one of those highly enthusiastic people who is ready to tell you absolutely everything he knows about a topic.

Back in our first week we were learning initially about general end-of-bed observations and taking an examination of the hands and face. We learnt first and then to practice what we had learnt on a few patients who had some interesting signs.

One of the patients had psoriasis which on examination of her hands was hardly noticeable but then she rolled up her sleeves and we saw that she was covered. From this I learnt not to just take the surface of things, to dig a little deeper and you might uncover something that you’d otherwise have missed. This would obviously have come out in the history but as we just examining the patient today we could have easily missed it.

By far the more interesting case for me, however, was her husband who just came in the capacity of taxi to bring her into the surgery. He had however had a pretty obvious and extremely interesting operation that I had never seen before or knew existed.

Before he even entered the room we could hear him chatting to our GP in a gravelly, very hoarse voice which at first I just thought was his voice until he walked into the room. It was immediately obvious that he was talking through a valve in the middle of his neck which he pressed in order to make sound and let go of to breath. I had truly never seen anything like it.

He told us that he had had a tumour of his true vocal cords and that in order to be cured he had, had to have a total laryngectomy (surgical removal of the larynx (voice box)). This obviously removed his power of speech however surgery can provide a solution to this. He had, had what is known as a tracheo-oesophageal puncture performed and then a prosthetic valve placed in to allow him to regain a form of speech known as oesophageal speech.

Apparently his degree of speech is very good in comparison to the normal outcome for these patients and I must say that apart from the gravelly tone of his voice his speech was entirely normal. He has learnt to use the valve very well.

The principal of the operation, from my understanding, is that a patient who has had a complete laryngectomy needs to breathe permanently through their neck. A hole (fistula) is made between the trachea and the oesophagus and the voice prosthesis is inserted which does not allow food down the trachea but does allow air into the oesophagus.
Air in these patients enters and leaves through the valve in their neck but when the patient occludes the valve and prevents air escape by this pathway air enters the voice prosthesis and enter the oesophagus and escapes through the mouth. As the air passes through the upper tissues of the oesophagus it vibrates replacing the vibrations previously produced by the vocal cords.

This is what it looks like in the flesh:

Oesophageal speech, I’ve been told, is hard to master especially initially but there are clinics for these patients to go to where they can learn to speak well using these prostheses and the result is truly astonishing.

There are of course implications on this man’s life, he will never be considered in the same way and there will be a prejudice that comes from the sound of his voice. He said himself that children are scared of him now and he does resent that, but for him the ability to still communicate close to how he used to succeeds that and once people get to know him they understand and there is no judgement.

It amazes me everyday the things that modern medicine can achieve and this man and his surgery reminded me why I decided medicine was the career for me in the first place.
Very cool!

Just to show those of you who haven’t seen this – here is a patients story:

https://www.youtube.com/watch?v=SaREnCLP3RM

Throwback Thursday: Throwback to First Year: Sem 1

It’s a lovely morning and I’ve got some great tunes on on 8 tracks (an app which I cannot recommend downloading enough, it is wonderful to search for all kinds of music, especially easy listening music to study to.) and I felt like now was a good time to write about first year.

It will obviously be completely impossible to write about first year as a whole in one blog post so I think for now I’ll just focus on what starting medical school was like and the first semester as a whole.

I distinctly remember our introduction lecture, I’m pretty sure I was slightly hungover and tired from the freshers night I’d been on the previous evening but I was pretty excited. That lecture felt like the start of the medical journey I was embarking on. I met up with some fellow medics who were in the same block in halls as me and we walked up to the hospital together. It was pretty strange because I hadn’t met them before that morning and they are still my closest friends today. The introduction lecture itself was not particularly exciting and was spent mostly with the senior lecturers trying to scare us with attendance/performance statistics. We went for coffee afterwards and lo and behold we were on our way.
There was a lot of admin stuff to get done and I’m pretty sure I obliterated that from my memory for my own sanity though I do remember going to collect our fancy magnetic badges with our names and new ‘medical student’ title on them.

Then lectures began. It was an interesting first semester with just a mish mash of information to try and bring us all onto a similar level before we started working on bodily systems. This was fine but it made revision particularly difficult when it came to Christmas because there were very few links between topics like Pathology and Pharmacology at this stage. I spent a lot of the first semester just getting acquainted with the university, the hospital (which I still struggle to find my way around), the city and being heavily involved in the musical theatre society Showstoppers – the only society which really stole my heart and who I intend to commit the majority of my free time to this year!

Then before I could blink we’d finished the first semester and had already broken up for Christmas. In terms of work the first semester was almost entirely lectures and tutorials with some time in the anatomy lab working with cadaver bodies (a very strange and disturbing concept to begin with – though you quickly get used to it) and we did start on some GP attachments once a fortnight which served to remind us why we were here and actually taught us some things which were very relevant to our future practice such as history taking and very basic physical examination. I really enjoyed the GP attachments, they were probably the best part of the year as a whole. It just gave us a chance to meet and chat to real patients about their problems even though we have less of an idea what that means than they do.

We also got to see a birth in first year. I think I was in my second week when I went in to watch one – it was crazy. The experience was amazing though and probably the most memorable clinical experience of medical school so far. I’m not sure what purpose the birth visit was supposed to serve given our complete lack of clinical knowledge at that stage but what I took from it was a reminder why I was at medical school and some valuable teaching from an anaesthetist who was there to supervise the spinal block the patient received and took the time to teach me a little about the relevant anatomy and the procedure itself. I also took away a greater understanding of patient communication and how it makes such an incredible difference to the patient experience. It was made particularly clear from this particular experience because the midwives were so very good at communication and bedside manner whereas the obstetrician who came in when the possibility of a c-section was put on the cards was awful at communicating and this made the patient much more apprehensive about the potential for a c-section and this did not help the situation at all. Overall it was a valuable clinical experience and one I think I will always remember. The miracle of life is not quickly forgotten.

Christmas was pretty much a chocolate fuelled revision holiday. I was so panicky about the January exams because they were in a format which I had never had before. We had two written papers (a multiple choice style and a long answer style) and an anatomy spotter test. For those of you unfamiliar with the concept of anatomy spotters we have a series of stations set up in the lab with a range of questions from pins in cadavers (dead body specimens) to blu tac pointing to structures on an x-ray. There are approximately 60 questions in 30 minutes giving 30 seconds a question before you move on to the next station. It’s a high pressure situation with no time for you really to stop and think, you either know it, or you don’t. Simple. This was the paper that scared me the most for that very reason. I wanted to well as our first year counts towards our final year rankings amongst the year group but at the time of revision  I was really just looking to pass!

Thankfully I didn’t need to panic as much as I did because the papers were all fine and I did much better than I anticipated. Woo! We had a lovely exams blowout by going to watch Frozen (despite the fact we’d all seen it several times before) and going to Sprinkles which is the most amazing ice-cream place in the world. We also went out to the Palace of Dreams – otherwise know as Jesters the official worst night-club in the UK but for that very reason – the best night out you will ever have.
Then we had a couple of days off, now I definitely remember not knowing what to do with myself during these few days. It was nice to not feel guilty about not revising every second of every day but equally I felt pretty without purpose. I didn’t even have any Showstoppers rehearsals to go to because the show I was in in first semester was over and done with before Christmas. Incidentally that was one of the funniest shows I’ve ever been in and I still love the cast to pieces! We had a reunion yesterday and performed one of the songs from the show at this years Bunfight where the societies try and get all the new freshers to sign up, it was so much fun and so nostalgic!

The first semester as a whole was a bit of a blur, what with moving into halls, meeting so many new people, starting a completely new course which was finally exactly what I wanted to do, trying to divide my time between all the new stuff I was trying out – it was just amazing. I don’t think that any semester will ever really match up to that very first one.

Care, Compassion and Commitment…

To me these are the things that make up a good medical student and a good doctor.And of course you need to have a little bit of charisma and personality as I hope to demonstrate with this frankly glorious photo if I do say so myself.
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This is me, little bit exuberant at times but I like to think that I possess the qualities to become a good doctor. My name is Lydia Edge and I’m just starting my second year of medical school in the UK. Having just completed first year and finding that the more I progress through medical school the more I need somewhere to share the experience I’ve decided to start a blog where I can do just that.
Expect to find posts not just about medical school but about university life in general, about my summers and how I’m spending my time away from studying. I’m still learning about myself as well as about medicine so there will be an element of reflection about decisions I’ve made, paths I’ve taken. Let’s see how it goes!

Ask questions, get involved, I would love to hear from all of you!