Yo muthacrushas I'm back, baby. I'm sure you've not even noticed the 2 week absence of my blog and, as such, you're all off my christmas card list (muahaha that'll save me whole pounds on cards this year). It has been quite the eventful fortnight but don't let that lure you into a false sense of hope that this blog will be in any way interesting. In the news this week: Who even knows? Something to do with going on a Summer Holiday? I dunno...
Day 1:
Lets not pretend that I can remember anything at all that happened 13 days ago. Furthermore the copious sugar ingestion from this week has given me vascular dementia so I'm doubly screwed.
06:00 I'm awoken to a strange light display as ALIENS ATTACK THE HOUSE
*pew pew* *pew pew*
Stealthily dodging their mind rays I escape into the confines of the shower which, for reasons inexplicable. is only producing water of a lukewarmety that is most often associated with a girls reaction to my chat up lines. I find on my return that Sam, presumably using some kind of analysis and his springy brown hair has fought the aliens off and I stumble around pieces of spacecraft and other debris to find my clothes.
Obviously this has all been added in for comic effect, as nothing interesting has or will ever happen this early in the morning. Also the only thing less likely to happen than aliens attacking is Sam being awake at 6am.
06:30 Back in reality I'm perusing my shirt collection. There are 6 shirts left. "Oh good, I've got enough to last until..." I think, before realising that there are still 7 days of work to go. Crushing.
08:00 I arrive at work to find that my melancholy influence has caused widespread depression amongst the ENT staff, most notably Matt who had to endure my company for longer than anyone else over the weekend.
Also, thanks entirely to my super elite doctoring skills, there are all of 4 patients on the ward. One of whom is going home. As such we all bugger off upstairs for coffee.
08:45 "So, does anyone want to come to clinic?" asks the Registrar
"Murgh" reply all 8 of the ENT doctors
"It's just that I know for a fact none of you have ANYTHING to do and every one of you needs me to sign you off in their ePortfolio"
This kind of subtle demand is usually met with some kind of activity but we are all feeling far too lazy and, if the Reg doesn't sign us off it at least means we can sit around doing nothing FOREVER. Woop woop.
10:00 I ring the Reg, Alan, who was on over the weekend to discuss what we're going to do with one of the annoying brat children who decided it was a great idea to stick some gunge in their ear, a sleepy voice answers the phone.
"Yes?"
It's interesting that, no matter how sure you are that you have an important question, a grouchy sounding voice can make you immediately regret picking up the phone.
"Oh, Hi, er... did I wake you up?"
"Yes"
"So you're off today?"
"Yes"
"Agh sorry"
"Yes"
"I'd better... just go then..."
"Yes?"
"Is that Yes? What do you want? or Yes! You should just go?"
"Yes"
"Well anyway this kid with gunge in their ear I told you about?"
"... .. ..."
"Um when should we bring them back in?"
*click*
No ePortfolio sign off for him EITHER then.
11:00 We're a-chatting down at the nurses station. One of the particularly mean and rude ones needs some pictures for a poster she's making as she doesn't understand THE INTERNET so Matt and I task ourselves with buttering her up by helping. I'm constantly (un)impressed by the lack of tech savvyness displayed by some staff at the hospital, with people often being completed flummoxed by a change in icon location or redesign of a website. The plus side to this, however, is that I can be extra helpful and thus loved by all.
12:00 Proving that I am most definitely not loved by all, the mean nurse barges into the doctors office demanding to know 1. Who left the Treatment Complex in such a state and 2. Why noone has come to deal with some patients.
I apologise profusely, though I don't really care as we all know my feelings on cleaning up the treatment room, and come out to see who the patients are. To my great amusement it transpires that these 'patients', who have been waiting at least half an hour, are actually the family of someone on the ward and that the nurse completely failed to realise this, mistaking them for the sick.
Ha! In your FACE! Though I did feel a bit sorry for the family.
13:00 In order to cheer Matt up we decide to go to the canteen for lunch. Matt has recently decided he's going to train to be an All Black by moving to New Zealand and step one of this plan is to eat nothing but salad.
"But Matt there's no way we're going to cheer you up with salad, how about some cake or something?"
"I hate cake" he responds, sounding worryingly like myself. I begin to wonder how having lunch with me could possibly cheer him up as I am likely the source of his misery but then I CRAVE FRIENDSHIP so I don't care.
His girlfriend/fiancee then rings but for confidentiality reasons I can't write out their entire phone conversation here. Trust, however, that it was INTERESTING BEYOND YOUR WILDEST IMAGININGS. At the very least it seems to cheer him up abit. Awww isn't love sweet. (No)
16:00 We all go home, having achieved literally nothing all day. Brodie is left to work for another 4 hours.
Day 2:
07:45 I arrive, expecting to find the rotting corpse of Brodie after his having died of boredom the night before but am surprised to discover him sitting perfectly happy at the desk. Apparently the iPhone 4S really IS that good.
08:00 It's a Sri ward round. I take the lead, as I always do in Sri ward rounds in order that he might LOVE ME.
I then realise that I don't really know anything about any of the patients because they're all post-ops from the night before and were looked after by Brodie. In fact the only thing that my attempting to take the lead actually achieves is me looking bad for not having done some Calcium levels on the patients (even though this wasn't my job but Sri assumes it was because I'm the person humping his leg).
08:25 Matt and I pair off to take the two Calcium levels from the two almost identical patients in the bay next to each other. There is NO WAY that this can ever go wrong. As we round the corner I hear the nurses say "Eh up, me duck, heres tweedle dum and tweedle dee". I'm about to retort when I realise we're both wearing almost identically glasses, have our hair parted the same way and are carrying identical blue trays with identical equipment in. Plus everyone loves Matt, so being identical to him is probably the best thing I've got going for me,
08:35 I put down my unlabelled blood sample on the desk, knowing that Matt will likely do the exact same thing but there is little I can do to fix it because my pen has run out of ink.
08:45 A small earthquake causes the objects on the desk to switch places before I can label up the blood sample.
08:55 The mixed up samples get sent to the lab, analysed for Calcium levels and then used to group and save blood matched to the patients different blood groups. We then infuse the blood into the WRONG PATIENTS killing them horribly.
NB This didn't actually happen, but the actual story is much less interesting, so let this be a warning to you: Incompetence and/or lack of fully inked pens kills.
10:00 I'm bleeped down from the mess because my work experience student has arrived. Despite my clear instructions that said student should be a busty teenage girl it was a very scared and pale looking boy. Called something ridiculous like Foo Quan.
"Hiya buddy, my name's Dr Geoffrey Ewart Burnhill MChem 1st Class (Hons) BMBS (Hons), but you can just call me 'My Lord'" I don't say because I'm not Andie Brodie... who I guess wouldn't say that either but... anyway
"Oh h-h-h-h-hi" he replies, shaking visibly.
"OK so basically nothing ever ever ever happens on this ward so your work experience is probably gonna suck, I apologise for that. Why do you wanna go to med school"
"Because I'm really clever and I think doctors are really clever"
Oh for God's sake, that's the equivalent of saying "For the power, the money and the women". Which is CLEARLY the wrong thing to say at interview, mostly because medicine will bring you none of those things.
"I see. What you mean by that is that medicine fits into your skill set and thus allows you to be an effective member of a multidisciplinary team." Such sage advice, I think to myself, before realising that I clearly suck at all this buzz word talk as evidenced by my <bitterness> MTAS marks </bitterness> *crushes a paper cup*
Furthermore it turns out that one of his A level subjects is, like, Basketweaving or some shit. I don't have the heart to tell him that the med school will take one look at it and laugh mockingly in his face. Well not at his face as he wouldn't be there, but you get the idea.
10:30 In order that this poor kid gets to do anything at all I take some of Brodie's on call patients off his hands. One of them thinks she swallowed a soft mint about 4 months ago and it's still there. She has been instructed to drink plenty of coke, as is the standard protocol (the acidity/bubbles/magic helps food boluses pass more easily) but visions of the Coke + Mentos clips on YouTube have me thinking that this could have a devastating if hilarious outcome should the mint still be there.
I thrust my endoscope in her face with quite some difficulty as her nose is as impenetrable as the gates of Mordor and, as Boromir once said "One does not simply Endoscope into Mordor". I've never had any issues with such things before and so I curse the damned work experience student for his bad vibes. Busty teenage girls never cause these kinds of problems.
11:00 Eventually I am successful and allow the W/E dude to look down at the ladies (mint-free) larynx. The next patient has some gunge in her ear which would be all very interesting (OK very very mildly interesting) for the kid to see if it weren't for the microscope having no teaching arm on it. As a result he gets to sit in a corner and watch as I poke stuff in her ear for 40 minutes.
12:00 I send the work experience kid on his merry way, feeling bad that he's had such a dull morning but then realising that when I had to do work experience I spent at least 3 days cleaning the floors before any of the doctors even spoke to me. I also remember being fascinated by the different sizes of cannulas that the nurse showed me, failing to realise how much I would grow to hate the fucking things.
13:00 Teaching. It's one of the scary renal physicians and he's doing some kind of interactive presentations where we answer questions. I fail to get any of them right, despite the fact that I've done a renal SSM and am also super bad ass at medicine. I decide that probably NOONE got any of them right and that I reign victorious.
14:00 Matt informs me that he didn't get a single question wrong and reminds me how he was always telling me about [Insert Drug I've Already Forgotten Here] causing [Insert Renal Problem Here]. This does not help my burgeoning suicidal tendencies one iota.
16:00 Nothing else has happened all day so I go early so I can get to the Summer Holiday Rehearsal.
18:00 I arrive at the Summer Holiday rehearsal, feeling low and generally displeased with the world. Not least because it's taken me 2 frikkin hours to get there.
"Geoff!" Says the choreographer who, as far as I can tell, has never said anything nice to me ever "Have you got your keyboard tonight. We're doing harmonies and I really don't think this piano is in the right key" Notice that there are no question marks. This is not, for once, because I couldn't be bothered to type them but because there were none intimated.
"Pfffft, whatever wench", I mutter, disregarding her due to her obvious lack of music knowledge. Just to prove I'm right I pull out my Tuner App (bless Steve for this) and test out the piano.
The piano is 3 semitones flat. Which might explain why the boys were suddenly able to sing the high notes. It's too late to fix it now though so I don't tell anyone.
20:00 I return home cheered up by the kiddos. Bless their hearts.
Day 3:
13:00 It's 1 o'clock (as you can see) and we've been in the mess since the wee hours of the morning. Nothing at all is happening. Matt and I grow so bored that we head down to the secret old doctors office on the ward to try it out. This office was once home to the finest ENT doctors the ward had ever known but got requisitioned by the powers that be and turned into a completely empty room with no purpose whatsoever (nice WORK hospital management). Some say that the ghosts of those ENT doctors still remain and that there is treasure buried 'neath the floors. Others say the room is cursed and that any who enter will end up miserable and alone.
Knowing that I'm going to end up miserable and alone anyway I enter the room and am overly excited to discover that it contains a whiteboard, some chairs and some theatre clogs (no more wearing other people's clogs like a CHUMP for me). It also has some super bad ass reclining chairs. We doss around heavily for a while before remerging on the ward to see if anything is going down. Nothing is.
15:00 We're still dossing but are slightly confused as to where, the hell, Brodie has got to. He went off to answer a bleep from A&E about 2 hours ago with his work experience student and hasn't been since. Tsk. Crazy ol' Brodie.
16:00 The nurses ask us to assess a sick patient. Groaning we go and grab the requisite stuff and meander over to him.
"Hi sir, the nurses say you've been feeling a bit unwell"
"Wuh bluh buh fuh nuh guh" says the patient in a way that only someone who has recently had extensive surgery on their FACE can
"I see I see, well we're going to have a listen to your heart" we say before draping a stethoscope over him in a lacklustre fashion.
"You're probably fiiine" we tell him before rushing off to continue our important task of doing absolutely nothing.
NOTE: Actually we performed a thorough examination on this gentleman and deemed using our considerably medical knowledge that nothing acute was occurring
16:55 The senior nurse tells us she's really not happy about the patient we just examined. We decide she's probably right but can't really be arsed to get involved with anything major as we're about to finish work. It has, after all, been a hectic day.
17:00 Brodie is in the office looking stressed. Apparently his call to A&E was for a women who had broken her nose in all KINDS of horrible ways. The nose was bleeding unstoppably despite his attempts to fix it and there also turned out (despite A&E clearing her for a skull fracture) to be considerable evidence of a skull fracture. Brodie is beating himself up about all this despite the fact he's really done a very good job and his cool composure impresses me significantly.
In order to ruin his day further Matt and I hand over the patient we've been dealing with. If it had been me in his situation I'd have said something like "Fuck youuuu douchebags, you can damn well sort him out yourselves I've got enough to deal with" but Brodie calmly replies "OK right yup, I'll sort it" and we go on our way.
02:00 I awake in the night feeling as though something really bad has happened.
Day 4:
07:45 It turns out that the patient Matt & I cleared as being totally fine was as totally not fine as it's possible to be as at around 2am he had a massive heart attack and went into cardiac arrest.
Shit.
10:00 I'm still beating myself up bout this, despite the fact that there really was nothing acute going on when we saw him when one of the nurses comes to tell me that we can't feed one of the patients via his feeding tube because the pH of the tube is too high.
Nurses take pH readings from feeding tubes because when they are inserted blindly they might end up in the lungs, the pH of the lungs is much higher than that of the stomach because, unlike the stomach, they are not filled with ACID. Therefore nurses get edgy when the pH reading is high as pushing syringe-fuls of food into someones lungs is considered a bad idea amongst many people.
In this case, however, the tube was inserted radiographically by a consultant radiologist. It was proved to be in the right place upon insertion and was used subsequently with no problem. 2 days previously they had noticed a high pH and so, to make them happy, we got them a chest X-ray which (as reported by a consultant radiologist) showed the tube to be in the correct place.
Apparently they'd not bothered to tell us they weren't happy with this evidence and, after not feeding the guy for two days (in reality he was refusing food for these 2 days, before you get all sue-ey about it) decided to tell us again about the high pH. As the guy seemed to be unwell for general other reason we got him another chest X-ray.
This X-ray (all together now) AS REPORTED BY A CONSULTANT RADIOLOGIST showed the tube to be in the same place. Furthermore the LAWS OF PHYSICS do not allow tubes to withdraw 50cm metres, move to another hole and then reinsert themselves 50cm without anyone noticing. Also the place the tube was lying is right next to a duct that delivers a high pH fluid into the intestines so that the stomach doesn't melt them the hell up. This would lead to a high pH. I tell the nurses this.
"OK can you write it in the notes so it's on record"
I write it in the notes.
10:30 "I'm sorry I'm STILL not really happy to do this" the nurse tells me. I ring the registrar
"Alan, [insert longwinded story here]"
"That's ridiculous, what are they trying to starve the guy. Tell them I demand that it is done"
I tell them he demands it done. They do not appreciate this.
"We don't have to do ANYTHING we don't want to do" says one of the usually very nice nurses "You DOCTORS can't order us around, we're independent people you know".
I'm beginning to get pretty fed up of this whole scenario but really get pissed off when she adds "And remember last time you didn't listen to the nurses a guy ended up having a cardiac arrest so maybe you should think again!"
FUCK YOUUUUUUUUUUU NURSES.
But really I can see their point, they have to follow protocols, it's what nurses do and it's to prevent random up themselves doctors from doing crazy shit and then them getting in trouble. The whole situation is, however really really annoying and is only fixed when the pH magically comes back as 1 nullifying the problem entirely but removing about 5 years from my life.
I decide at this point that my best course of action is probably to burn the hospital, and everyone in it, to the ground.
13:00 Kishan the CT2 (previously known as 'The ST2') and I go to examine some patient on some ward somewhere. I spend a good 10 minutes trying to find an Otoscope that works as the one in the office is dud. After watching me run around for a while Kish picks up the 'broken' otoscope and it bursts into life, as though nothing had ever been a problem. I curse the world once more.
After we finish examining the patient who has had quite the most terrible problems with her ears, we emerge to have all the nurses shout at us because, while we were behind the curtain, they decided to strip all the ladies on the ward naked and then plonk them in the middle of the bay.
"We should burn the place to the ground, I'm telling you Kish"
I'm concerned that Kish worries about me, psychiatrically, but the fact that he is always always smiling makes it difficult to read his true thoughts so I continue "Though of course I'd let you escape first"
16:00 Kish, Alan and I go to theatre to sort out this nose from the previous day. Everyone in theatre is in a horrible mood because they all wanted to go home early and us bloody doctors are just too intent on SAVING PEOPLE'S LIVES for that to be allowed.
16:40 The scrub nurse is getting angry at me because it's taking me too long to stitch up this persons nose. She is clearly on a power trip, like all scrub nurses, and my desire to stitch up HER nose is increasing dramatically.
17:00 We finish just in time for everyone to go home and eat their donuts or whatever but, just as I'm about to leave the scrub nurse starts yelling at me again.
"Oh great" I say "the humiliation never ends"
She then continues to shout at me because I'm apparently not taking off my gown in the correct way.
17:15 I leave the hospital muttering "Burn the place, burn it all"
19:30 Piotr Wisniewski is shouting at us all because he's had such a terrible day doing ABSOLUTELY FRIKKING NOTHING again. Malcolm walks in after literally flying back from Holland just to be at rehearsal and is shouted at for reasons frankly unknown to anyone but he keeps on smiling somehow. Likely because he's so tall.
Night 1:
23:00 We've just finished watching all of Live & Let Die and I'm gloating to the medical registrar about how absolutely nothing happens on ENT night shifts and he's getting annoyed. I decide to go down to the ward because there is talk about getting pizza in.
23:05 "Hey we've been bleeping you and bleeping you and bleeping you, where have you been?" asks the HCA
"Ahahahaha" I say "Sure"
"Literally we've been calling you through switchboard we needed you down here an hour ago. Why were you ignoring us"
"Because I don't like you" I jest, knowing that nothing has happened really
"What? Seriously. You need to ring switchboard and get your bleep working"
At this point I look at my bleep
"SILENT MODE: 20 unread messages"
I shit my pants and ring switchboard. Fortunately it was only the ward trying to bleep me and they only wanted someone defibrillating or whatever so it was all fine but seriously WHO PUTS THE BLEEP ON SILENT. IT DOESN'T EVEN VIBRATE ON SILENT. IT DOES NOTHING. AGHHHHH
07:45 I wake up after 8 hours sleep. The bleep hasn't gone off (for real) all night. I feel as though I really should stay at work and do some actual healing but Matt sends me home.
Night 2:
18:00 I arrive at work 2.5 hours early so that Matt can get home to see his poor fiancee who's been sitting around bored all day. Given that he actually has people to see and that I have had ridiculous amounts of sleep I see it only fair that he be let off early.
Unfortunately Matt is too damned nice for such things and refuses to let me do a 14.5 hour shift on my own. As such he hangs around until...
20:00 at which point my bleep goes off 3 times in a row. The first is a paediatric airway emergency, the second is someone bleeding to death out of their nose and the 3rd is the ward needing a review done on that guy we nearly killed the other day because of our crap examination (though I'll note again that it wasn't our fault, he really was fine at the time).
As a result Matt ends up staying LATE to sort out the patient while I go and attend to the dying children.
20:30 The children aren't really dying at all, one of them has a mild wheeze and the other is a long term resident of the hospital and nemesis of Captain Kirk. Nevertheless it takes me a good hour to stop the bleeding from the dudes nose which is not fun for either him or me. He also concerningly appears to have become addicted to morphine and is constantly badgering me for some.
23:00 I'm bleeped from the H@N team because yet ANOTHER person is bleeding out of their nose. They have a weird clotting disorder much like the Star Trek Villain and need transfusing in order to survive.
I spend the rest of the night going between the STV and the other guy sorting out their noses. It is quite annoying, though I imagine actually HAVING the bleeding nose is more annoying still. As such I get no sleep (which is fair as I am actually being paid for this stuff... though not much).
08:30 I get home and go to bed
11:00 Sam arrives home. Sam being home is such a rare event that I decide to get out of bed and hang out with him. There is much playing of computer games and his lovely girlfriend also cooks us dinner and makes cake. This is all gravy but cuts out the amount of sleep I get significantly.
20:00 I'm back at work, after around 3 hours sleep. Somehow I'm feeling alright though. Matt hands over that the only job I need to do is ring the lab and chase the calcium result on one of our patients.
20:05 I'm bleeped to go and sort out Star Trek Villains nose, again. It takes forever to fix, again.
21:30 Having successfully cauterised off the majority of the kids nose I get a chance to ring the lab. As the phone is picked up at the other end I hear the sound of machinery going haywire.
"Hello?" says the harassed voice
"Oh Hi I'm after a calcium result?"
"Right... hold on a second..." there is a pause and in the background I can hear her shouting "No fuck YOUU machine!!! How do you like this?!" there are some banging noises and she returns to the phone.
"Yea sorry we're having a bit of a problem with the calcium machine, I'm trying some things to get it back up and running but you'll just have to wait".
03:00 BLEEEP BLEEEEP BLEEEEP
"Oh hi it's Geoff, the ENT F1?"
"Hi, it's the Paeds SHO here, could you just do me a favour and remind me of the treatment for lymphadenitis?"
"Um... lymphadenitis as in swollen lymph nodes?"
"Yea, I mean I'm obviously putting the kid on IV antibiotics but I didn't know which ones to use..."
"Er.... well it could be just like a cold so you don't really need the IVs"
"Oh no it's really swollen"
"Right... where is it?"
"Just under the jaw, it's definitely a lymph node"
"OK and how old is the kid?"
"4... no... no he WAS 4, now he's 5, no 6. No 5!. No wait 4. No no no 6"
"Riiiiiight erm well I guess if you're insistant on the antibiotics just give him some penicillin?"
"Oh right you mean like Superbadassakillacillin?"
"No i mean like amoxicillin, the pink stuff that the GPs give thats basically homeopathy"
"OK and I'm admitting him onto the ward"
"Good, the paeds guys'll be able to take over from there" (subtext: and let the poor kid who just has swollen glands go home)
"<indignantly> I AM a paeds guy </indignantly>"
"Oh right well yea cool er gotta go someone is er yea bye"
I spend at least 30 minutes mulling over how weird that conversation is and feeling bad for saying "the paeds guys" even though the lack of knowledge exhibited by this person clearly differentiates them from being a "paeds guy". I hate empathy it sucks.
07:00 I've been kept up most of the night for various things and have just had some sleep when I'm bleeped by the ward. The (super badass knows what she's doing) HCA has noted that a patient has tingling lips and might have low Calcium...
...calcium you say....
I check the computer to find that the calcium still hasn't been reported. I ring the lab again.
"HELLO?!" comes the answer in a voice that seems to say "you'd better not be ringing about the fucking calcium results"
"Oh hi, sorry just wondering if the calcium machine is working"
"No (YOU FUCKING RETARD) it's (FUCKING WELL) not working (SO FUCK YOU AND FUCK YOUR CALCIUM)"
"OK thaaanks"
I remember that you can get calcium results from one of the fancy machines in the medical assessment unit so I stab the poor tingly guy in the radial artery with a needle and go a running off.
07:15 His calcium comes back at 0.7 (normal range 2.2-2.4). The machine helpfully adds "OUTSIDE OF CRITICAL RANGE!!!" on the slip to add further fear to my life. To make matters worse he also has a cripplingly high pH, low oxygen and various other bad looking things. Despite this the guy seems completely fine.
07:30 I ring the med reg, who replies serenely to just give him some more calcium and let the day team sort it out when they start the shift in 30 minutes. This fits with my plans just fine and the reassurance that, despite the horrible numbers, this guy is probably OK makes me feel a whole lot better.
08:00 I hand over the terrifying patient to the day team and get sent home to sleep (which I don't do because Hywel arrives a few hours later for super fun awesome happy times).
ADDENDUM:
Week 2:
Hywel came down and we went to CostCo and spent £200 largely on sweets. We then ate the sweets. We also played Summer Holiday for the Nottingham Operatic Society Youth Group who, I think it's fair to say, gave us all reason to live because they are a talented bunch and also are quite funny. So go them.
However FUCK YOUUU ANNOYING BACKSTAGE WOMAN WHO TREATED US ALL LIKE 2 YEAR OLDS. SIGN INTO MY ASS.
OK I feel better now.
Much love
Tune In Next Week For More "Trust Me, I've Got Diabetes From All These Sweets"
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