Friday, October 16, 2015

7 Weeks Down Plus a Trip to Scotland

It's hard to believe that I've been in the UK nearly 2 months already! 
So far things are going well.  I'm pretty comfortable with getting around the area I live in and going into Central London.  I haven't been a hard core pedestrian/commuter in ages but here it's all walking, trains, or buses to get around.  It's not always convenient but many times during my walks/public transport trips I'm able to really process a lot of what's going and focus on my innermost thoughts.  

Hospital life has been interesting.  I've completed Endocrinology & Gastroenterology rotations so far and now I'm in the MAU (Medical Assessment Unit, which is the holding location post Emergency before you get admitted to a ward if warranted).  I've seen patients with diabetes, end stage kidney disease, heart failure, liver failure, pancreatitis, alcohol induced peripheral neuropathy, Crohns & Ulcerative Colitis, paracetamol (think Tylenol) overdoses, asthma, pulmonary edema, COPD, pneumonia, abscesses, dementia, gallstones, cancer, and more.

I've participated in out patient clinics, observed upper endoscopies, colonoscopies, ERCPs (endoscopic retrocholangiopancreatography procedures--bet you can't say that three times fast without getting tripped up!) which have included gall stone removal and biliary stent placements, laparoscopic colostomy surgery, fistula excisions, and a reversal of an ileostomy--that's one I actually scrubbed in and assisted!  I've learned how to take blood, insert cannulas, catheters & nasogastric tubes. I'm working on honing my interviewing skills and physical exam techniques and getting more comfortable overall in a clinical setting.

It's been a great learning experience so far.  Understanding how to manage the patients with so many different health concerns has been one of the biggest challenges yet  The diagnosis and procedural steps are usually fairly straight forward but the work comes in knowing what to do for the acutely unwell patients and how to manage those with multiple chronic illnesses.  It's a process that I'm slowly getting better at but there's soooo much to learn....That and managing my time after work to study for the upcoming shelf and STEP 2 exams is where I could use some improvement =(  

Aside from the steep learning curve and readjusting to a new department/specialty, staff, and style of teaching/working/patient interaction every 3 weeks, things are going well.  I've been very lucky so far and worked with some great Consultants, Registrars, and Junior Doctors.  Everyone has been willing to answer the most basic questions, incorporate teaching when applicable, and generally support my educational progress.  

It's not all work all the time.  A few of my classmates and I actually took a weekend trip to Edinburgh Scotland.  Between hospital life, and really settling into this new lifestyle there are a few things I've noticed that are different here in the UK compared to what I'm used to in the US:
-Everyone loves my American accent! The sweet lady in the hospital now calls me Ms. America, ha!
-Parents walk their kids to school, kids ride bikes & scooters and in the morning, I can time my progress based on where I cross paths with certain ppl in the mornings.
-Ambulances have blue and white lights and in a medical emergency you call 999 (instead of 911).
-All temps are in Celsius vs Fahrenheit so I've had to learn to quickly estimate what the weather will be (besides rain)
-You can only order well done beef burgers/steaks according to the English health code...bummer.
-Light switches are turned ON by switching them DOWN instead of up
-And of course, I have to remember to look Right when crossing the street and always mind the Gap!

I'll leave you guys with a few pics.....

                                                                        Edinburgh Trip

                           Edinburgh Castle that contains the Crown Jewels of Scotland

Loch Ness & Highlands Tour

                                                                        Arthur's Seat
They told me we were gonna climb up a hill!  I don't think anyone actually realized we were climbing up a ragged, jagged mountainside, more than 700 feet in the air.  The first few minutes of the near vertical trek up had me seriously winded and wondering how long it would actually take to make it to the top. There were many stops for pictures (and to catch our breath) but once we made it to the top the view was breathtaking.  We also found out on another path down, that we chose one of the difficult routes to the top!

                                           The view once we reached the top was amazing!!!!

And yes, we even tried Haggis!!!  (pictured with turnips and mashed potatoes) It reminded me of a mushy textured meatloaf.  It actually had a decent flavor and no where near as bad as I thought it would be after hearing the tales of a creature in the hills of Scotland who's legs are shorter on one side than the other so it can only run around the mountain in one direction...All a bunch of BS but still pretty unpleasant thoughts when you actually find out what Haggis really is o_O  

                                                                      First time scrubbing in

Until next time...

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