Worth the pain

“Doc, I couldn’t sleep last night, it was agony. The pain was just...” she broke down.

Mrs AJ was diagnosed with breast cancer a couple of years ago. It had metastasized to her bones...

Pain is something that physicians deal with all the time. A simple analgaesic can sometimes do wonders for any miserable patient in dire pain.

The WHO pain ladder is a step-wise guide designed to aid doctors in describing pain meds.

The higher up one goes, the more side effects there are. Opiods such as oxycodone or oxycontin were very good opioid analgaesics. But their side effects are nausea, addiction and in some cases respiratory depression. Given the choice between the side effect versus pain, which would you choose?

My thoughts wandered...

It was a superb through ball which sent me past the keeper. The last defender was standing between me and the goal...

Judging by the trajectory of the ball, it was 60-40 favouring me to get to it first. I knew I was quicker. I also knew that he'd give it a shot anyway.
We both lunged for the ball.

I toe poked it home.

As the ball bounced into the net his trailing leg was still coming at me in full force.
The referee blew his whistle signalling a goal. As I limped off the field, I sometimes wonder if it's ever worth the pain for a moment's glory.

Rewind to about 9 years ago. I was 14. It was a martial arts sparring competition.

I had injured my right toe in the semifinals. My opponent in the final was a real cocky guy from the east coast. He had earlier whooped my good friend whom now had a crooked nose.

My coach took out a red spray can. He sprayed it all over my toe. I suddenly felt no pain.

A minute passed in the first round. We were evenly matched. Suddenly I felt a sharp pain all over my right foot. I signalled for a timeout.

The coach again sprayed the contents of the red can all over. I felt relieved but still tender.

As far I was concerned, I was destined to lose unless I used my right leg to counter his kicks. It was hard and predictable using just my left.

Round two

He had figured out from my numerous timeouts that my right foot was useless. He had the advantage.

A minute left on the clock...

At that time it felt like I was being heroic. I managed to whack his face twice with a roundhouse kick using my right leg. It probably hurt me more than him. But it was enough.

Two months later...

I stared at the gold medal hanging by my bedside. Then I stared down at my crooked right big toe, which was still tender at times...

Was it worth the pain?

Deja Vu

Another three weeks in St Micheal’s Hospital, a place very close to my heart due to the overall atmosphere of the hospital. The people are old; but they’re adorable and kind. The doctors aren’t too busy to tend to medical students; giving tutorials or bedside examinations.

I said hi to a few familiar faces.

Dr Mcsteamy (the girls actually call him that) was still looking as suave as ever in his one-size-too-small shirt and gelled up hair. He winked at me as we passed in the corridor.

Or maybe he was winking at my partner, a tall leggy blond wearing the shortest of skirts.

Little Carrots

In order to pass your final OSCE exams, you have to be street-smart. During your history presentation, throw a few little carrots to the examiner,” said Dr Carthage.

Little carrots are when you pretend to stammer or trail off on certain words, pretending that you don’t really know what you’re talking about. For example :

The patient, err, might be suffering from hypercalcaemia.

In theory, the examiner will pick up on your moment of hesitation and try to catch you off guard. When in fact, you’ve been reading up on hypercalcaemia and can totally hit it out of the ballpark.You’re basically setting the tone for the whole exam and talking about the things that YOU want to talk about, instead of leaving it to chance.

A useful tip, I hope.

A word of advice from our endocrine tutor,

“Only watch Grey’s Anatomy if you want to learn how to start a sex scandal in a hospital,”

Ending on a high

I had finally finished my surgical rotation. No more 5am starts. I felt invigorated. Starting class at nine gives me at least two extra hours of sleep, something I had been sorely lacking during the past six weeks.

Surgery was depressing. Not to mention tiring. On the last day of surgery, I just couldn’t find the strength to get out of bed. I loathed going to the hospital at such early hours in the morning.

I decided to stay home and do nothing.

I texted Adrienne and asked her to pass my attendance sheet to my consultant, Mr McDermott.

Oh, surgeons are addressed as “Mr” instead of “Dr”.

I got a reply from Adrienne.

“McDermott made me stay back after lectures and attend his clinic before he signed my sheet. He refused to sign yours. Sorry!”

Served me right to skip class.

I made my way out to St Vincent’s to meet McDermott. He seemed cheerful after performing a wide local excision of the right breast.

He put his arm around me.

“Now, where were you on Friday?”

I couldn’t decide whether to lie or not.

Somehow it just didn’t feel right to say, “I was depressed so I stayed in bed”

So a white lie it was.

“I wasn’t feeling too well”

He opened his mask and looked at me head on.

“Sounds like you were out drinking”

“Errr, no I wasn’t”

He didn’t seem convinced...

And no, I didn’t get my attendance sheet signed.

Dream of a dream

I stared at the exam questions for a long time. The Bimbo had surprised us by giving out test papers during one of her tutorials.

Classify and define Hyperparathyroidism.

My head started to feel heavy. I know this. I closed my eyes and tried visualize the diagram I once drew in my notes...

“YOU ARE NOT ALLOWED TO SLEEP DURING MY EXAM!” she shouted.

I was roused immediately. For a moment, I prayed that the nightmare would end. That I would wake up from this potential horror movie scene.

Then I realized that it was totally real.

She stood right in front of me, eyes wide open, breathing heavily.

“Was it THAT easy for ye?” she asked sarcastically.

“Err...I, I”

“You what? Have you finished?” as she grabbed the paper from my hand.

All eyes in the lecture theatre were fixed at the events that transpired. But I was alone in this. There was no get out of jail card...

My heart rate got faster and faster as she read through my answer sheet. I didn’t study and I knew most of my answers were crap...

And no, I didn’t wake up. It wasn’t a dream...

Feeling green

He was wearing scrubs. His stethoscope was hanging around his neck, his hair gelled to perfection. His subtle irish accent coupled with strikingly good looks has made him very popular in this small hospital. His name tag reads senior medical student. Oh, they call him Lee. Even his name is cool.

Just what I need. A teacher’s pet on my team. Thank god I have 3 days left.

I hate not being the centre of attention.

Let the stress begin

“Have you taken the patient’s history?” asked the registrar

I nodded.

“Well, I think you’re ready for the real thing,” as he passed me another patient’s chart

“I want you to clerk this patient in,” he added.

My heart was doing jumping jacks.

Another milestone.

She was in for a right temporal artery biopsy, a relatively simple and low risk procedure.

And she was my first.

Bad Dreams

The lecture was about breast cancer. I was sitting in my room, listening to the live streaming option. I was too lazy to thread out to Tullamore Hospital, about half an hour’s walk from the bed and breakfast I was currently living in.

The lecture was boring. My eyes started to feel heavy. I dozed off.

I heard a knock and a girl walked in. It was Hermione. I thought it was a dream.

What the heck was she doing in my room?

“Errr, hi there,” she said furtively.

My mouth was still half open.

I realized that I wasn’t dreaming.

“I thought this was my room,” she explained.

“I was given this room last night,” I said.

“Oh, there must have been a mixup, I’ll go check with Maria,” she said hurriedly leaving my room.

I went back to sleep.

That was almost a nightmare.