Bath-time

As I stewed in the bath this evening, I was playing some music off of my mobile ‘phone. One of the lines, from a Scroobius Pip track “Waiting for the Beat to Kick In”, caught my attention:

"How hard is it to decide to be in a good mood,
And then just be.. in.. a good mood?"

It reminded me of my post from earlier on today about how the weather appears to affect me, especially in the mornings. When I was younger, home life was quite tough for a number of years - my parents divorced and the subsequent ups and downs were hard to deal with as a child. Now that I’m older (and wiser?) I can look back on those times more objectively with less of the emotional baggage associated with the memories. If I had the chance, I don’t think there’s much I’d change. Over the years, I think it is these events that have helped shape my personality into what it is now and fuelled my independence and determination. Sometimes personal relationships or difficulties with work can cause me to get down. The boy I used to be locked himself away and wallowed in self-pity, but now I’ve learnt to face up to problems with a positive attitude and remind myself how lucky I am.

In the future I know there will be periods in my life where it will be very hard to decide to be in a good mood. However, I have come to the realisation that most of the time, my mental state and frame of mind is under my control; glass a fraction filled and all that business…

P.S. The line in the song is taken from the character Lloyd Dobler from the film “Say Anything”

Grey, grey, go AWAY!

A blogless week has passed, not for any reason in particular, maybe just a mild attack of writer’s block?! The holidays are drawing to a close and today the sky outside my bedroom window is suitably grim – August my arse… On the one hand I’m champing at the bit to start a brand new year of medicine, one step closer to success, but on the other hand it means the days become shorter, the nights longer and cursed rain. I really think at times I suffer from some sort of Seasonal Affective Disorder (SAD). If I was like Lois Lane and had a direct line to Superman, from September to April I’d get him to take time off from saving the world and focus his efforts on blowing away the bloody clouds! It’s funny how little things can make a big difference to my mood and motivation, such as a waking up to rays of sunlight flooding my room – illuminating the countless little dust particles, silently floating in and out of view. That’s all I need to put a smile on my face in the morning, but when it’s pissing down I just want to slip back under the covers and sleep.

It’s not all bad though, Liverpool have won their first two games of the season (and face a hugely important 2^nd leg Champions League qualifier tomorrow). I really hope they can put together a proper challenge for the league title this year – I was only 2 and a half the last time they won it…

The wagon is creaking into gear

Today I logged on to the medical school intranet, where notices, timetables, PBL cases and plenty of other useful things our accessible. I’ve been doing this regularly hoping to find some new info about 3^rd year and partly just force of habit. After weeks of nothing much there are updates!

The next year’s worth of PBL cases have been uploaded, all TWENTY FIVE of them… Wow, I’m still unsure how exactly they will integrate the cases into the hospital setting and if I will end up spending as much time having to read books and make notes as I have the past two years. However, a cursory glance over a few scenarios shows that there are a few innovations in the style. Apparently there is more emphasis on test results, management etc. and also some accompanying material such as GP and hospital letters. The sheer volume of cases is a bit disconcerting, but I’m hoping that they’ll be thought-provoking and the hospital work will be relevant. I doubt I’ll read over any of the cases until I know which module I’ll be starting. That’s the next thing I’m waiting for: timetable please! I would love to find out that I have a couple of late starts per week and a few early finishes, but I suppose that’s wishful thinking.

Another link that caught my eye took me to a mind-numbingly long word document outlining everything I could hope to know about the organization of the student-selected components, of which I will be undertaking two, in each of the next two years. Lots of guff in there, although plenty of useful information regarding marking criteria and the skills they want to be displayed. Unfortunately I can see the potential for these modules to take on an element of hoop-jumping, ensuring you tick all the right boxes for your tutor without necessarily learning a great deal. Fingers crossed that there will be an ample number of ‘kind’ topics when the time comes to choose (as yet they haven’t provided any details about individual titles, only that they will be hospital or community-based).

It’s good to know things are starting to gather pace.

Time waits for no one

Now that it is a matter of weeks, rather than months, to recommencing medicine, I am scared! Exactly what will I have achieved over the three months of my summer holiday? No doubt a few million brain cells have bitten the dust due to my preponderance for alcohol consumption and combined with the shocking rate at which medical knowledge has leaked/is leaking from my head, I think I will be half the student that left way back in May! Literally my only exposure to health-related matters has been via other people’s blogs and I don’t think learning medicine vicariously through the tales of others is going to help me pass my exams. In short, I’m cacking myself… The prospect of being grilled by a consultant on any subject whatsoever is enough to make a bead of sweat spring from my brow. At least I don’t think I’ve forgotten how to speak, so I should be able to talk to patients if all else fails. I really hope all my colleagues are in a similarly clueless boat.

Elsewhere…

Phwoar! That is what the Olympics is all about… Seeing Usain Bolt make history in the 100 metres final gave me goose bumps all over. I was hoping for a fantastic contest, expecting a Bolt win, preferably with Powell a close second. In reality I witnessed an incredible demonstration of power, speed and flamboyance all rolled into the 6 ft 5 inch frame of Usain Bolt. He has strutted and strolled his way through the Games thus far, winning races at a canter and I suppose if you know you’re so much better than your nearest rivals then you can afford to be a little cocky. Part of me wished he hadn’t started celebrating 10-15 metes from the line and carried on pushing just to see what this superhuman Jamaican is capable of – however, it is the showboating that makes Bolt such an entertainer. The excitement generated will reel in a whole new audience and inspire others to try and emulate him, while hopefully doubling as a catalyst to help improve the damaged image of athletics over recent years.

A fine day for Britain too, securing cycling, swimming and rowing golds; the latter pursuit providing a nail biting conclusion to the men’s coxless fours and making it a hat-trick of victories in the event including Athens and Sydney. Honourable mention to Michael Phelps as well, who will no doubt go on to break Mark Spitz’s record and achieve 8 gold medals in a single Olympics. I must say that swimming does seem to hand out medals like confetti though; as such I don’t regard him as the greatest Olympian ever as some people appear to.

Exasperation

Ever get the feeling you’re being taken advantage of? Because I’ve had that twice today and it’s playing on my mind as I sit here watching ‘Get Shorty’.

The letting agency are continuing to bend us over and ravage us vigorously from behind, while we pay handsomely for the privilege. A flatmate is back up there for a couple of days and gave me a call this afternoon. The kitchen floor is warped and bubbling, the downstairs bathroom ceiling is bowed worse than ever and the whole place apparently smells of damp! We have called numerous times about the problem; supposedly someone came round to have a look, but still no action. My flatmate called again today, only to be informed that the builders are busy until next week, even though they would be visiting the place next-door tomorrow. Why can’t they check our place too?! The landlord, the people in the office and the builders seem to have no bloody idea what each other is doing and are aware we’re just lowly students. What the hell are we paying them for! I just wish I knew what exactly I could threaten them with to spur them into action…

Second is that the mechanics servicing, MOT-ing and fixing my car, have deemed it necessary to keep it incarcerated for another 24 hours. I booked it in at 7:30am Monday morning and was told it may have a chance of being ready that evening, if not then the day after. They called today to say it will actually be ready Wednesday and kindly told me of the cost of the work. Nearly £350 to replace the brake fluid and fix the driver-side door handle (and lock) alone. It took me about 10 minutes to work out how to open the bonnet of the damn thing, so obviously I have no idea what all these repairs should cost.

It makes me angry that I’m probably being swindled by all these money-grabbing bastards and I don’t know of any way to avoid it (unless I decided to leave my car unserviced, uninsured and used it to double up as my university accommodation). John Travolta wouldn’t have these problems!

___________________

UPDATE:

The garage called mid-afternoon to let me know the car was ready at last. I arrive about an hour later, only to be told that someone had cocked up and not done the MOT!!! Amateurish in the extreme. So while they completed it I had to wait a further hour with nothing to do until it was all checked out. Fabulous!

Total car service work ended up being £800-odds :@

Dedication

I love sport, both playing and watching, whether it’s something I’m totally familiar with like football or an altogether more obscure pursuit (‘curling’ comes to mind). I think it taps into the competitive element ingrained in my psyche, which also comes to the fore in academic activities. Even going back to early P.E. lessons in secondary school, I always wanted to push myself and beat others in the yearly fitness tests. A favourite was the ‘bleep test’, consisting of getting from one side of the gym to the other before the tape machine bleeped next. It starts at no more than a brisk walk, but progresses steadily and relentlessly until the last poor soul collapses out of exhaustion after failing to reach the other side in time. Perversely I loved this self-imposed torture, seeing the fatter, lazier kids dropping like flies while I still felt full of running. Then, after the chaf had been well and truly discarded and the final few remained, the competition hotted up. I always fought through the screaming sinews and burning lungs to finish in the top two, and was proud of myself for doing so.

Having left school and the mandatory physical assessments behind, I still love to play football, tennis, squash and golf. Maybe it’s a bit sad feeling the need to prove myself and take things more seriously than some others, but I think those same traits are the ones that have got me into medical school. It would have been far easier to coast through A-levels and get into a less demanding, middle-of-the-road degree course. Instead I chose the (widely regarded as harder) scientific subjects, put myself through the UCAS agony and finally obtained a conditional offer after three prior rejections. However, I enjoy being stretched and challenging myself. Stimulating my mind through learning is just as important as stimulating my body through sport – hopefully I’ll be able to maintain both as I continue in my studies and future career.

In terms of watching sport, this summer has left me spoilt for choice! The European football championships (strangely more satisfying without having to worry about when England’s inevitable exit would come) were fantastic, Lewis Hamilton’s exploits on the racetrack, a truly memorable Wimbledon Men’s final, watching Padraig Harrington retain his Open title before being the first European to clinch the USPGA in 78 years were all highlights. Now the Olympics in underway and the competitive spirit within me has awoken. For me the crowning glory is the athletics, in particular the men’s 100 metres. What an achievement to be the fastest person on the planet - the sheer explosion of power gets me every time. Rowing, swimming, cycling and gymnastics are also great entertainment. On the other hand, I resent the inclusion of sports whose most prestigious titles lie away from the Olympics. For example, today in the tennis, Andy Murray was clearly not interested, some other big names have stayed away and it’s perfectly logical considering the final grand slam event on the calendar is only a fortnight away! These sports don’t have a place in the Games as far as I’m concerned. An Olympic gold medal should be the pinnacle of an athlete or sportsman/woman’s career, but in several disciplines this just isn’t the case and the Olympics is poorer for it.

Swings and roundabouts

My legs are sore and I’m tired! I had to get up at 6am today, which is probably the earliest I’ve been up in the last year, to book my car in for its MOT and service. I was also up at 6am on Sunday morning, the difference being that I was only just returning home… I was out on Saturday night for a friend’s 20^th birthday in central London – unlike last week, there wasn’t a problem getting in as we were on the guestlist. At about 2:30am I left to meet up with the girl I met in Electric Ballroom, but unfortunately I had underestimated my level of inebriation and things went tits up from there.

She was in Leicester Square (apparently only 5 mins away from my location) however my navigation skills are poor at the best of times and this wasn’t one of them. After about 45 minutes of purposeful, yet fruitless walking, I had still not found her and she had rightly given up and gone home. Why I didn’t just ask for directions is beyond me! By now it’s getting on for half past three and I’m not sure how, but I find my way to a bus stop – events are a bit hazy here. My travel card is still valid so I manage to get on a bus and head for home. Regrettably the alcohol wasn’t finished with ruining my night as I was forced to run off the bus after about a quarter of an hour to purge my poor stomach of the toxins within. Looking back it’s clear to see that this is where I then made another mistake by not waiting for the next bus, but taking it upon myself to walk home. I knew where I wanted to end up and I knew that the bus was heading in roughly that direction, my actual location was, and still is, a mystery.

Sobriety was a fair distance away and again I’m missing about 30 minutes of memory, presumably as I stumbled about uneventfully. Then my recollection returns and with it a feeling of joy as I recognised somewhere at last. I made my way confidently towards home as dawn threatened to break - nevertheless I was rather weary and upon seeing a bus I flagged it down. As it slowed I got out my wallet. Bugger! No ticket! No money! I’d lost my travel card on my journey and spent all my money on the £4 bottles of beer in the club. Thinking fast, I thought it best to flash my driving license at the bus driver as I hurriedly walked past – but it predictably failed and he called me back. I pled my case, but it was in vain. As I departed I asked if he would kindly tell me the quickest route to the place I live. He then proceeded to get slightly irate, accusing me of wasting his time (fair enough) but I pressed for an answer. He pointed behind him. What?! In fact the place I thought I recognised, wasn’t what I thought it was and the previous half hour had been spent walking in the wrong direction altogether. If the bus driver wasn’t paying attention (as they rarely do) I would have been on a one way trip back to central London!

As I retraced my steps, the sky lightened and my pace slowed. It was just after 5am, according to the timestamp of the text messages I was sending (informing mates of where I went), and I had managed to get back on track. Over the next hour I saw various shop keepers going about their business, road sweeps clearing up the mess of the night’s excess and odd looking folk, who appeared to have no reason to be up and about at such an hour – I suppose the same accusation could have been levelled at me. Eventually I rolled in the door at about 6:15am, thoroughly knackered, with vomit-flecked shoes and a mouth that felt as dry as a Jacob’s cream cracker!

Over the past couple of years, both at home and university, there have been times when I’ve been recklessly drunk, miles from home having deserted my friends. Yet something from deep within, basic and instinctive kicks in. Like a primitive sat-nav system, my autopilot guides me home and keeps me out of trouble. Getting pissed is neither big nor clever, but the human mind’s self-preservation ability is fantastic.

Portfolio

I hate them, I hate them, I HATE THEM!

Right, now I’ve got that out of my system, allow me to try and explain. Within the first few weeks of entering medical school, we were introduced to a rather innocuous blue folder. ‘Ooh what’s this little bundle of fun then?’ Well I’m still not really sure…

Everyone has one of these blue folders, called a portfolio, and it’s divided into a number of sections such as ‘Relationships with colleagues’, ‘Good medical practice’ and ‘Probity’. The general idea, so we are told, is to keep a log of our personal and professional development throughout the course and obtain evidence and write reflective pieces to show that we are progressing. In theory it’s commendable, of course we should all reflect on notable experiences and think about our strengths and weaknesses – but it has degenerated into an exercise in jumping through hoops and ticking boxes! At the end of both academic years we have our portfolios checked and assessed to ensure we are following the guidelines and to give an opportunity to raise any questions. Most people I know spent the week before their review frantically finding things to pad it out, trying to remember patient encounters from months earlier and knocking up wishy washy SWOT analyses and Phase Two goals… Clearly not what the medical school Portfolio coordinators had in mind.

However, the vast majority of these folk blagged the interview and passed - the system is believed to be sound. Do I think keeping a portfolio is necessary in the first 2 years of medical school? Perhaps. Do I think it achieves what it sets out to i.e. improving us as individuals by making us reflect, keep records and fill in endless forms? No. What I think it comes down to is the infamous “white box” questions on the Foundation Year application forms, reducing much of our 5 years of hard graft into a bullshitting contest! If you have a well kept portfolio, with plenty of exaggerated tales of moments you showed leadership or teamwork or reflective qualities, then you’re sorted. If you focused more on actually studying, learning and practising clinical skills, but neglected your portfolio and creative writing proficiency, then screw you. I just happen to think that jobs should be allocated on a far more objective basis, through our written and practical examinations – communication skills are already assessed in OSCEs and creative writing skills should be kept out of the process altogether.

Mmmm.......

There's nothing quite as versatile AND satisfying as a sandwich. I’ve just polished off a rather boring, yet tasty corned beef and cucumber number – with lovely thick white bread! Oh and I’m gonna say right now that I am not a fan of putting butter on, not because it’s fatty or anything, it’s just wrong… Butter on toast on the other hand is fantastic.


I don’t quite know why I’m writing this. Perhaps due to me envisaging a fair amount of sandwich consumption this coming year, what with it being unlikely I’ll have the time to pop home at lunchtime as I would often do from the medical school. At hospital it’s going to be a choice of canteen food, packed lunch or starvation. Options one and three don’t appeal, which leaves me to prepare my own culinary delights to bring in and what could be easier than a few bits of bread and filling?! Sorted…

(I guess this means the cling film budget will have to be revised)

Amusing myself

I’ve had an enjoyable week partaking in a number of my favourite pastimes. I suppose I’m not too unusual in that I’m a 20-year-old boy/man (the distinction is a hard one to make, mentally at least) who likes to play sport and spend time with my friends. Having not been able to play any regular football in the past couple of months since uni, it was great to play three times in the last five days and a fourth in the offing tonight. Suffice to say my fitness is in need of some honing if I’m to be raring to go for next season’s exploits in the division above – a potential source of bloggery I’m sure. As well as a return to the pitch, I had a great night out in Camden on Saturday with a few of my buddies from school, though only just…

Upon leaving Camden Town tube station, we headed towards Electric Ballroom – none of us having been there before. Unfortunately as we approached, it became immediately apparent we weren’t getting in, what with the back of the queue well out of sight to even a keen-eyed falcon. Not to be deterred, a couple of us sauntered up about twenty yards from the entrance and started making small talk with some girls in a half-cut effort to cut in. The girls were fine with it, the bouncer less so. After this minor knock-back, the call of nature took hold and I found a suitable spot to void my bladder. With a renewed sense of vigour I journeyed back to the queue and was pleasantly surprised to see my four friends ensconced in the line. I made a beeline for them, while trying not to stand out in my slightly garish t-shirt. Success! Uh-oh… *shit* I think, as a luminous security bloke approaches:

Security: “Excuse me; can you please step out of the queue?” [Very polite I must say]

Me: “Oh sorry, I just had to make a quick call.”

Security: “Why didn’t you just do it in the line?”

Me: “No reception.”

My friends: “Yeah he was just gone a minute, too loud here as well.”

Security: “Hmm… OK, but stay in line in the future!”

Fantastic, my alcohol-addled brain was still a match for the powers that be. All in all, he was the most reasonable and understanding bouncer/security guy I think I’ve ever met. Usually their meathead mentality precludes them from any form of adult conversation at all – the ironic thing was that this time I really did deserve to be chucked out… That was a good omen for the remainder of the night. I spent very little money, despite the extortionate prices, we all had a good laugh and a dance, and I pulled and got the number of a rather cute girl. Moreover, I didn’t have a hangover the next morning and I’ve ascertained that the girl also happens to be pretty, funny and entertaining while entirely sober! *bonus*

Before I dash off, I also want to say that the blog, Bête de Jour, is fantastic!

What does the future hold?

Officially just one month until uni restarts! It’s strange to think that I’m not going back to the usual combination of lectures, PBL, dissection and physiology. Instead I’ll be seeing patients on the wards and experiencing life in a rather large teaching hospital, which will be my academic home for the next three years. Details appear to be a bit thin on the ground, but my first unit will be Heart, Lungs and Blood (HLB) or Nutrition, Metabolism and Excretion (NME). How this will translate into teaching I don’t know – however, from preclinical work I preferred the cases that focused on HLB over NME. There was just something I found intrinsically more absorbing with the workings of the cardiovascular system, whereas the GI tract and metabolism left me bored to tears (perhaps because it was in the last semester before 3^rd year and I had had my fill of bioscience and PBL).

As for PBL (Problem Based Learning), there are mixed opinions on using it as a method to teach. I don’t know how it will translate into the clinical part of the course, but my experiences of it from the past two years have been generally pretty good. Maybe I’ve been lucky, for example I haven’t really suffered from having groups with a dozen people who would all rather sit in dead silence until somebody has the guts to offer up some information. Often the majority of the group was involved in the discussions despite the inevitable quieter/lazier members. PBL is also great to talk about difficult concepts, especially in the ‘Mind and Movement’ module. It was useful as a way for the students struggling to have things explained to them, while also allowing the person explaining to test their own understanding. Obviously not all sessions were productive, particularly if you have to rock up at 9am having been out ‘til 4am after a couple of drunken hours of sleep – even worse if most of the others were out with you and feel equally shit! My major criticism was the variability in tutors – who have been branded facilitators. Quite what their job description is remains a mystery to me. Apparently it is to guide us if we go off track and ensure we reach broadly relevant learning objectives. My own theory is that they are glorified prison wardens, keeping us incarcerated for the allotted 90 minutes, while providing bugger all in the way of help! Most facilitators aren’t clinicians and for three out of the four that I had, it was their first time, meaning the blind were leading the blind. Nonetheless I managed to pass all my exams at the first sitting showing that engaging with the system, coupled with self-motivation, and aided with a smattering of associated lectures and practicals, is definitely a technique that suited me.

The modest insight I have as to what I’ll be doing over the next year has mainly been provided by older guys I know from the medics’ football team I play in. Earlier this year, on the way back from Dublin where the National Association of Medical Schools (NAMS) football tournament was being held, a 4^th year told us some of the things he’d got up to within a couple of months of beginning clinical years. Interesting stuff generally, that was until he slipped in that he performed a digital rectal exam. Where unfortunately ‘digital’ refers to fingers and not a type of watch display. Not only that, the patient got a little - how can I say - excited...