It's been a long time, Snoopy

It's appalling long since I have posted, and I do judge myself for this. BAD medical student.

In my defence, it has been a crazy 2 months or so (now that really is terrible - a shockingly long time).

So what has happened to stop me from posting - other than generalised laziness?

Unfortunately, my dear father died on All Saints Day, from a horrible fight with oesophageal cancer. This was diagnosed in March of this year, and despite putting up a brave & optimistic battle, the cancer grew & spread. We were told it was terminal in summer - the very end of June, and were advised not even to try chemotherapy.

We were, however, fortunate enough to know that the end was coming, and spend some wonderful time together as a family - in the summer, when we went to France, went sailing, and generally enjoyed being four of us plus a dog, and particularly during the last week or so that we had with Dad, when we passed the time talking, laughing, crying, and reminiscing. It was, in a strange sort of way, a very happy, very blessed time. He died with my mum, brother and myself next to him, as he had wanted.

The funeral was an amazing service, a real celebration of his life. Apparently, around 300 people came, and were able to hear a very fitting eulogy delivered by dad's very close friend, a vicar who did the entire service. As a mark of respect, the three of us travelled in our Landrover (Dad's pride & joy) to the funeral, and Dad himself had his "blue badge" in the hearse with him (it had been a VERY happy moment when the blue badge arrived....Dad loved free parking!)

The wake was real proof of how well-loved Dad was; organised & catered for by the church congregation, it was amazing to see how many people stayed & wrote lovely things in the Book of Remembrance... however, I was asked (more times than I care to remember) "how are you" - quite a difficult thing to answer!!!

The rest of my time really has been spent in catching up on the work I missed during that week at home. Unfortunately, while the hospital have been extremely supportive throughout this pretty awful time, (as have so many friends, neighbours, colleagues, and occasionally strangers), the department have not been anywhere near as good...

And of course, Christmas (the dreaded "C-word") is coming nearer and nearer... and with it all the stresses that come at this time of year, namely Christmas shopping, Christmas decorations, Christmas music, Christmas cheer, you know... that stuff! I am feeling underprepared - so have spent particularly the last week racing off in free minutes to try and sort out my Christmas presents, etc. Thank goodness for the joys of internet shopping - how did we manage without ebay?!

So, overall, a difficult few weeks, and a fairly good excuse for not posting, I think! But I hope to be getting back into the swing of things now - I think I am, anyway! - and so with any luck, normal service will resume shortly. For which we may all be grateful.

In any case, TWO WEEKS til the holidays! So I will trudge resignedly on until then, when I can sleep, eat, and chill to my hearts content...

What happened to the weekend?

I'm sure it was Friday about 10 minutes ago. But no, my clock and my housemates reliably inform me that in fact, it is Sunday evening, and I need to get ready for the hospital tomorrow.

It's been a busy few weeks, what with skiing (!!!), a visit home, cake-baking and video-planning, I've barely had any time for hospital work.

And what an amount of hospital work it's been.

In the last couple of weeks I have

1) attended (and worked on) 2 cardiac arrests
2) taken everyone's blood. At least once.
3) been responsible for 2 work experience students (they're such babies!!! ahhhh)
4) acted as junior doctor for the entire ward when no other doctors were around - for a WHOLE DAY.

This last was genuinely terrifying... I have never been so stressed in all my life...
And I was entirely knackered afterwards. I am now officially dreading graduating!

But on the plus, we are making a video about our life in the hospital... a skit... and any more information than that is classified until I feel the need to divulge it. Except to say that it is going to be HILARIOUS.

Oh, and the most exciting/lovely moments of the last few weeks... meeting two gorgeous wee babies, one belonging to a medical student who is a very handsome young man, and a second who belongs to some lovely, lanky people, and is just about the most beautiful baby I've met (and I'm not exaggerating, she's literally perfect!).

So all in all, rather a good few weeks.

It's just a shame it's Sunday evening. I may petition for 4 day weeks...

I've got that Friday feeling... and it's G-O-O-D

And I think to myself, what a wonderful world...

There is something about a Friday that just seems to make everything better. I don't have to get up tomorrow (well, not early), I don't have to go to the hospital, or answer to anyone else's timetable. Lovely.

And the last couple of days have been pretty fab actually... Thursday involved a delicious carrot cake, free (scrummy) soup for lunch, a meeting with my absolutely lovely tutees (I am a college tutor! This is terrifying!), a bbq to celebrate finishing the pedometer 10,000 steps/day challenge, a pub quiz, and a long chat with fantastic housemates. All in all a very very good day.

Today, I presented some cases - and the notoriously harsh doctor who supervises us was almost nice :o) As in, he actually signed my cases off rather than telling me to redo them three or four times to get them to "fourth year standard". So hooray!

And I went on the ward - on my DAY OFF. Blimey. Dedication at it's best eh?!

And now it is Friday evening, Alfie has had a bath, and been cleaned out, and I am watching Shrek 2, and cleaning my room. I mean, life just doesn't get better!

What a wonderful world...

Just a catalogue of disasters...

Well, one disaster to be more specific. And actually, not so much a disaster as an amusing anecdote... for you. Not for me. For me, a painful reminder of why our dog is so rubbish.

I was home this weekend, and like a good daughter (and 1/3-owner) I walked the dog morning and evening every day I was back. Once my beloved boyfriend was back, he was dragged out as well, much as he tried to look disapproving (he loves walking her really, he just doesn't know it).

Anyway... Sunday morning was my last chance to walk the lovely puppy for an entire two weeks, so of course I agreed to a nice long walk over the Down's with beloved & the puppy. This was my first mistake. What I should have said was "no, no, mum, you take her, I will be wrestling with gorillas" - or any other excuse.

So off we went, in a bit of a manic rush... got to the Down's, and realised we hadn't brought a lead. How smooth. Oh well, the dog mostly comes back when she's called (unless, of course, there is something moving/breathing/generally being there, which she finds more interesting), so never mind. Off we went.

Of course, she did a poo within seconds, and as best beloved refuses to pick this up, I was on dog poo duty. Which isn't a massive issue, you have to take the rough with the smooth, blah blah blah. Oh, and I do medicine, so I see far more grim things literally every day.

Anyway. We carried on, the dog chased the ball, we walked, it was sunny, fantastic. Until we got to the bit near the dog poo bin, when I "would just pop over there to the bin, back in a sec-----". For ----- you need to imagine yours truly going flying when foot gets caught in a rabbit hole. Even as I fell I remembered how many times I have broken my wrist, and so tucked it out of harms way. Consequently landing on my shoulder. OW. Ow ow ow ow ow.

But it seemed ok. So eventually we got up (best beloved came over and gave me a cuddle, the dog ignored me for 5 minutes then brought the ball over so I could carry on playing), and walked back, arm still a bit achy, but nothing awful. Finished our day at home (yummy fajitas for lunch), got the train back (lots of idiots with loud music), and walked home. Arm still painful... but you know.

Unfortunately, my arm has now changed it's mind. And it HURTS. So, I can't move it forwards, backwards, sideways, or up. And that's pretty much all the options for arms, exhausted. I have a torn supraspinatous muscle, which will "improve with rest". My right arm (the injured one) doesn't understand this concept, particularly as I still need to write, brush my teeth, cook, get dressed, you know... live.

So in summary, don't get a dog.

Or make someone else pick up the poo.

Almost four weeks in...

I can't actually believe I've been back for, well, certainly 3 1/2 weeks. I have been running around in the hospital, taking blood, taking more blood, and, well, taking even more blood. And I've only got one patient! (That, people, was a joke. A poor joke, it's true, but I'm very tired. And not a comedian).

So what have I been up to in these past few weeks? Well, I have been to TWO shows, at TWO separate theatres! Dave Gorman, at the Lancaster Grand was absolutely superb. Unfortunately, he (quite rightly) requested that we didn't leak any details of his show on the internet, so that those who haven't seen it don't have it ruined. Suffice to say, it was absolutely fantastic, and I laughed and laughed.

The second show that I went to see was booked on an absolute whim (Dave Gorman having been booked in about May)... whilst looking on Ticketmaster for various other things, I ended up finding that "I'm Sorry I Haven't a Clue" was playing in a) Manchester and b) Bristol. Now, when we were little, my parents used to listen to ISIHAC in the car, and I'll be honest, I never understood it. Or not much of it anyway (other than the end bit - the Doctors ball/the mechanics film club, etc). However, when searching for tapes to play in my car (I know, I am the only person with the exceptionally old school tape player), I found some of these tapes. And they are fantastic. Crash-the-car-laughing funny... and so I've been listening ever since.

So of COURSE I couldn't pass over an opportunity to see them live! And although it was tempting to pop back to Bristol for the weekend, I had plans, and so instead I found myself on a train to Manchester last Friday evening, ready to see ISIHAC stage tour. It was hilarious. Again, I laughed, and laughed, but this time, I also played the kazoo! This was so very exciting... I hasten to add that it wasn't JUST me playing kazoo, but that the rest of the audience were able to play along too.

What else? Ah yes, the infamous pub quiz. Three of us went merrily along to our local to participate in the good old pub quiz. Knowing that it's not really a student pub, and that the average age of participants is, well, significantly higher than ours, we weren't expecting to do well. And yet... and yet at the end, we appeared to have tied with another team... in FIRST PLACE.

Unfortunately, the other team are well-known as the pedantic, annoying people who contest everything (and as a result, always win)... but this fact we only found out when we went to the bar and found them arguing about not only their (clearly correct) but also our (obviously wrong) answers. *note brackets denote their beliefs, not mine*. Long story short, we finally were allowed to win (!!!)the tiebreaker with some dignity - at which point the other team 'graciously' stormed out. Ooops. We can't go back now - we think they might break our legs.

And I have just realised, that it is dark, and a certain tortoise needs some cress soon, so I must pop upto Spar and get some. Unfortunately, it IS dark, and I have to go right past the pub where our murderous competitors spend their time. I may wear a mask...

If you've not heard from me in, say, three weeks... maybe send out a search party...

I might as well be writing by candlelight...

Before I commence on my main, bitter, angry theme for the day, a brief reflection on the joys of a first day back.

Well, busy, really. MAU (Medical Admissions, the next logical step after A&E for a lot of patients) is always full, and crazy. Lots of poorly people, lots of tests, lots of histories to be taken. But I bravely plunged in, and had a surprisingly good day, although rather exhausting – a VERY long ward round was followed by a lot of clerkings, and the day was rounded off by a reminder of how much I hate cannulae.

Anyway! On to my reflection for the day…

I live in a house I love, in a nice neighbourhood, with friendly neighbours, and I have a gorgeous garden (with a rhubarb patch!). The house is cosy, my room is beautiful, and I am very happy here.

Unfortunately, la mouche in la ointment is the unbelievably annoying people who take my rent. This is not my wonderful landlord, who is always helpful (and very accepting of the tortoise). No, this is the so-called “housing service” for the university (naming no names, you understand). They insisted that this year, we go all-inclusive for bills; i.e. rather than organising our own energy, internet, etc, we would pay them more and they would deal with the bills.

Fine.

Bills last year were not really an issue. Annoying when we had to pay them, even more annoying when we had to fight with the various companies because they’d overcharged us, but still. Just the way life is. Internet was set up, the phone was set up, everything was fine.

After arguing (to no avail) with the housing people, we finally accepted that we had to go all-inclusive, but with one condition. As medical students, we were going to be back early, and we therefore needed the internet to be ready when we moved in. This was to allow us the chance to work of an evening.

Guess who doesn’t have internet. And who had to wait in all evening because “our engineer is coming round after 5.30 to sort it out”. And guess who is absolutely FOAMING at the mouth because she can’t research her essay. Oh, and one final guess who… guess who is going to make a huge fuss at the housing company tomorrow.

If you said “why, Liv, it is, of course, you”… you would be right.

Incidentally, when I rang the housing office today to confirm that the engineer was coming this evening, they referred to me on FOUR separate occasions as Jodie. Despite introducing myself, correcting them every single time, and explaining that noone in the house was called anything even approaching the name Jodie. (Oh, and I know the people who have lived in the house for the last 6 years. None of them have been called Jodie).

So I am angry. And “disappointed”. And debating which side to show tomorrow, when I go to the housing people and demand the internet…

Rant over.

It’ll be a better day tomorrow.

** Update on the internet situation... not for the faint hearted...

New estimate for getting internet at our house... 14th September. I hate them, I hate them. Oh, but it's ok, because "we can use the library on campus if we're desperate". Except that it's shut on Sundays. Because it's not term-time.

So we are reduced to crouching in the little room, laptop precariously balanced on the windowsill, pilfering the unsecured internet in the street.

It's quite challenging to research diabetes when your back feels like it might fall off because you're in such a terrible position (and manual handling lady from the other day would be APPALLED).

Going home next weekend. Can't wait.

Ah, Lancaster, we meet again...

Yes, I am once more back in the bosom of Lancaster, awaiting a bright and early start tomorrow. Well, 9.00. But that's pretty bright and early.

It rained as I came up the motorway, and since then we've had impressively heavy rain and thunder and lightening. But I'm not here to talk about the weather... instead I shall tell you about the last few weeks...

With swine flu over and done with, mum and I started painting yet another room. We now have a beautiful deep cherry pink study. It's absolutely gorgeous (and has 3 cream walls so isn't as overpowering as you'd think!) We also sorted a lot of paperwork out. It's frankly terrifying how much paper you need to lead a normal life... car insurance, house insurance, banks, mortgages, student finance, everything.

My wonderful boyfriend and I spent a hilarious week camping in Cornwall, near Perranporth, at a wonderful little campsite. We slept at a very strange angle, the campsite being on a hill and all... and enjoyed the main delights of Cornwall: cream teas, pasties, icecream and beaches. All pretty delicious if you ask me. Peanutbutter & chocolate orange icecream has definitely hit an all-time pudding high as far as I'm concerned. We didn't JUST eat, you understand. Really. Ahem. We did, however, get the chance to resurrect our brilliant camping pudding from last year - melted chocolate (due to hot sun + lack of fridge) with tinned fruit. Scrummy yummy.

Then one last, emotional week at home. Coming back was extremely hard, and I sobbed for a significant part of Sunday morning before leaving. I wasn't alone in this, either... mum had more than a couple of tears in her eye (you'd almost think they were going to miss me!). However, my glorious exit was one of laughter... when I realised (halfway to the motorway, thank goodness!) that I'd managed to pinch Dad's Blue Badge. Cue frantic turn around in petrol station...

And here I am now, back in Lancaster. My room is unpacked, my lovely housemate (ONE of my three lovely housemates) has moved in, and the energy company sent us chocolates! And I am released from dog-walking duties. Incidentally, our wonderful puppy who we have now had for an entire year (!!!) and who has given us NO trouble inside the house, got herself into trouble a couple of days ago. She has graduated over the year from sleeping in her basket to carte blanche on the sofas (i.e. we now get told off for disturbing her if we want to sit down, I'm sure there's something not right there...). I came downstairs one morning to find a certain young lady having jumped off the sofa most guiltily... only to notice that our sofa cushion was now, well, not entirely in existence. She has torn about half of it to shreds. So we have turned it over and not bothered to tell dad.

Oh, and delightful other half and I went and saw Bill Bailey on Friday, a slightly belated celebration of our year anniversary! Happy, happy days. Unfortunately beloved boyfriend heckled during the performance, prompting the unhappy nickname "massive dong guy". It's very hard to pretend you're not with someone when they've got their arm around you...

But for now, back to normality and reality. My room is tidy, my folder & notebook lie waiting for me, and, oh joy of joys, a student British Medical Journal was waiting for me on the doormat when I arrived. Welcome home.

Boating

A most enjoyable weekend, all in all.

Despite the tail end of swine flu (or something equally vile), we managed a lovely lovely weekend. Two "lovely"'s will tell you just how good it was.

My uncle, aunt and one cousin headed down to Bristol, and together with my parents, brother, fantastic boyfriend, and other aunt and uncle, spent some quality time "messing about in boats".

My uncle has a RIB (inflatable but with solid base) with a big engine so we spent Saturday evening pootling around Bristol harbour, watching the balloons launch over Bristol, checking out the locks for Sunday, and laughing at our daft dog who went bananas at the sight of so much water, and spent a good hour swimming in the end. And then got so overexcited in the boat we had to take her out before she combusted.

Saturday evening was spent in a wonderful, if chaotic, family meal at our house, with much laughter, beer, cheese, and noisiness. This was cut somewhat short by the thoughts of the next morning (not so much excitement as dread, really, with a 7.30 start. That's 7.30 IN THE BOAT)

But we managed it. Leaving the dog behind (she glowered at us from her basket), we spent the day cruising up the Avon to the river Severn and the Bristol Channel, passing under the suspension bridge with the balloons rising up around us, and reaching some pretty decent speeds, which made picture taking a challenge, at best.

THEN we went for breakfast. Yes, I know. But it was only about 10.00 by the time we'd been up and down the river. And going to Lockside really is a treat. For me, a cup of hot chocolate (more cream than chocolate, and more mini marshmallows than cream may have given me my entire days calories. But having not eaten with flu, I deserved it) and Eggs benedict with bubble and squeak. Delicious.

Then back to pack the boat up. It is amazing how much work packing a boat away is. Literally ages of faffing around and sorting and tidying and stuff. I remembered why I don't sail (other than lack of money, boat, ability, time, etc).

So, as I said, a lovely lovely weekend.

I like boats.

Birthdays, Swine flu, rain...

Well, it's been a (long) while since I posted, poor effort entirely on my part. So here goes...

France was lovely, very hot (except when it rained!) and full of delicious food. Unbelievably expensive however, due to the poor pound - euro exchange rate. There was a time when I didn't understand quite how this would affect us, it scares me a little to realise that I now completely understand just how rubbish it is when sterling is weak.

Anyway! After France I popped back down to Dorset for the weekend, and went to a fantastic street fair, everyone was dressed up in "olde tyme" clothes, and there were loads of fab stalls, and awesome displays. Came back for mum's birthday on the Monday, which involved a walk on Brandon Hill in the centre of Bristol... and so a VERY wet dog who swam without stopping for 20 minutes, oblivious to the rest of us!

We redecorated a room that week, and it looks absolutely beautiful, I am soo pleased we made ourselves do it! It's now cream with reds and yellows in it, and an American/boat theme to the decorations. And it still smells of fresh paint which is just delicious!

A week after mum's birthday is my birthday... and following a 21st where none of the family (barring parents and brother) bothered to show up (!!!) I decided a tea party for the relations would be rather nice, so on Sunday we had a lovely day full of cake and scones and cream, which was just fantastic, and I was more than spoilt with some lovely presents.

Monday, my actual birthday, was a very quiet day, relaxed and easy, spent with family and best friends (or "fuzzies"), and opening more presents, how nice. And finishing with several games of German rummy - our new favourite form of entertainment.

And now... it is Wednesday... and I appear to have swine flu. This is not a particularly pleasant experience, but I am far from death's door, so life could be worse. And I hope to be getting it out the way (and becoming immune) before I go back to uni and need to treat all the patients with swine flu... and maybe, maybe this will make me slightly more sympathetic to those with it?!

We shall see.

So, a brief run-down of the last month. Busy, but very nice...

Bon voyage!

So I'm off to France.

Bordeaux, to be exact. For une semaine, or one week to we English. Yes, indeed, why not? Insurance for my papa was to be in the region of £500... so we chose the "basic" option... which works out as £14.57.

Either way, I will be in the land of frogs legs, carots rapees (grated carrots), cheese, and beach beach beach! (AND lake lake lake cos we're staying on the lake, yay!)

And I have spent the weekend with my fantastic, wonderful boyfriend in Poole, celebrating his birthday. He is now an old man, tis true (all of 22), but we sent him off into elderly-ness in style, with a variety of meals, including an indian-chinese all you can eat buffet. I think I'm still recovering from that.

Today was spent NOT packing, but instead spending some quality time with my cousin & his girlfriend who have just flown in from New Zealand, my younger brother (just back from his 3 weeks going around Europe) and the dog - who managed to go swimming three times in one afternoon. If you're not shaking water over your owners every five minutes, you're just not trying hard enough. Or rock and roll enough.

So I still haven't finished packing (including this laptop) and we leave the house at 9.30 tomorrow morning. Oh well. Who needs clothes? I have swimming costumes and books, and am spending a week on the beach. I'll be fine.

Oh, and I packed sunblock... because I currently have an attractive tanline and particularly defined necklace mark.

A bientot, mes amies, jusqu'a je te revoir....

Home again, home again

Well, for one reason and another, I am back in Bristol. The elective was, unfortunately, cut short, so I have left the land of 40 degree (yes, I am told I originally got the temperature wrong...) days, and fried chicken, and returned to, well, a slightly damper, colder climate, but with better chocolate. So I suppose it goes both ways.

So what have I been doing since coming back? Well, celebrating that I passed all my exams - which is a massive, massive relief! - and sorting out the house. I decided that if I was going to be at home for the summer, I needed to do something productive. I suggested redecorating the spare bedroom... which has still got Thomas the Tank engine wallpaper on it. This, somehow, has turned into organising the entire house, and getting rid of a lot of things. If anyone wants 500 books, please let me know!!

So in short, yes. Here I am, in England. It's good to be back, but I do miss the USA. I'll be back though. I will.

Being A Tourist

This city is just plain amazing. I love it, love it, love it. It's crazy hot, it's humid, but it's fantastic.

Today was my first proper "I'm going to be a tourist" day here. I had my recommendations (French Quarter, French Quarter, French Quarter), I had my map, and I was wearing sensible shoes. Oh, and being environmentally conscious, I had a handbag AND a shopping bag. Go me, saving the planet.

So I got onto the streetcar ($1.25 - EXACT change, please, thankyou ma'am), and spent a lovely hour travelling downtown in the already unbelievable heat. Incidentally, I've been getting it wrong - the US has been hitting the FORTIES for heat.

Arriving on Canal St, I grabbed some batteries for the camera (how prepared I was, right?), and started walking to the French Quarter when I saw... Basin St. The street. One of the main reasons for coming to NOLA, thanks to the song "Basin St Blues". Wow.

Anyway! Straight on to Cafe du Monde - the cafe in NOLA - for Cafe au lait and beignets (ben-yays) - squarish puffy donuts loaded with sugar. Yummy scrummy but overly filling. Then some shopping; there are a LOT of shops filled with, um, touristy stuff. T-shirts saying "I got Bourbon-ed on Smash St", "I drove my chevy to the levee but the levee was gone", and so on. And a lot of Creole/Cajun spices.

So I shopped... in the still insane heat. What hits you is that inside is all airconditioned, so you feel like you've been whacked over the head with a pan when you step outside. HOT.

I found the most amazing 2nd hand bookshop, ever. It was huge. Unbelievably so. And crammed full of books, with a great owner who was so helpful and friendly...and had visited Bath before, madness. So I bought a lot of books (and would have bought more, except for stupid luggage allowance on the plane, grr).

Then lunch. Now, I was stupidly hot, I really was. But I had been told about a restaurant that I had to try, so despite the lack of hunger and abundance of sweating, I set off to find "jonny's po-boys". Po-boys are huge sandwiches, stuffed with food, and unbelievably good. And the restaurant are happy to wrap what you can't eat for later. Yum yum yum. BBQ beef po'boy. Wow.

After lunch, my first sight of the mighty Mississippi (Spelt right!). It's huge. But a lot grubbier than you think. And it makes the surrounding area cooler. So I was more than happy there. It was fantastic. h

Back to Canal St, and finally I bought my camera! I had been looking for a long time, and was thinking of an SLR, but bought instead a Sony DSC-H50, which is beautiful and fantastic and wonderful. So very fitting for a camera from N'Orleans.

By 4, I was exhausted, and VERY hot and sweaty. So I headed back, collapsed for a bit, showered and played with the camera.

Tea was... interesting... my first ever crab. Now, I dislike fish. I am unsure about seafood, but the rule is "try everything once". So crab (fresh in it's shell) it was. Peggy helped me get into it, and I tried it. My final assessment was that it would be good in something like paella. But alone... I'm not entirely sold on it. But I ate crab. And we should all be impressed & proud.

Then, that evening, we went for a ferry ride across the Mississippi. It was stunning, the town lit up across the water, the cool(ish) breeze. Wonderful.

Oh, and last night, LSU WON!!!! A fantastic ballgame, very exciting stuff. And I had my first every "Snowball"... finely crushed ice with syrup on it, mmmmmmmmmmmm. Lemon-lime. Mmmmmmmmmm. I LOVE ice.

Tomorrow... more shopping... and packing...

Musings upon the subject of commercials.

I like to think of myself as a fairly open-minded, unshockable person. The line most doctors use is “I’ve heard it/seen it all before”. Even if this is not strictly true, there are many things we are told that may… surprise.

However, I found out today that there are limits to my tolerance, namely certain commercials. Note they are being called commercials because they are undoubtedly an American phenomenon which I have not come across elsewhere.

Whilst watching the news earlier – around 6pm local time – I was treated to a pair of happy, older people gallivanting across the screen. So far, so good. Unfortunately, this couple were all smiles as a result of Viagra. Yes. Viagra. The immortal line “if you experience an erection lasting more than 3 hours, consult a physician” will be haunting my dreams for a good long while.

Having seen this, I started paying attention to the other things being advertised. A myriad of commercials related to drugs in one form or another. Now, this just doesn’t happen in England, presumably because we only pay the £7.15 needed for prescriptions.

There is no point to this post, but I thought it was interesting. Something to think about while you eat your tea… slightly more appropriate than the “perky” (and I use that term after much thought) twosome I had to contemplate over my meal.

Up at 5.50, twice in a row?!?!

Yes. Yes I was. Need to be at the ER at 6.50, a ten minute drive, and need to be ready and smart beforehand. No promises, but I may never moan about going to Barrow again (that’s a lie, I will ALWAYS moan about going to Barrow!).

I love wearing scrubs though. It’s pretty challenging NOT to be bare-below-the-elbows (BBE) if you’re in scrubs, so I’m all for every doctor and student wearing them from now on. Bizarrely though, BBE doesn’t apply in America, I could have decked myself out in rings, bracelets, etc, had I so wished. I started off wearing a couple of rings, but it just felt so wrong, I had to take them off…

The other major positive for today… I appreciated the neurology rotation I’ve just finished oh-so-much. I saw a youngish patient with a history of seizures over the past few months, and was able to take a history, examine and diagnose the patient with confidence. I also discussed some of the epilepsy issues with the consultant, things I would never have known about otherwise.

I love it when what I’ve learnt has immediate relevance. It makes all the work worthwhile…

Some musings on language barriers.

One of the (admittedly multiple) reasons for choosing the USA for this elective, was, in all seriousness, because they are English-speaking, so I wouldn’t have to be trying to work and cope in another language at the same time. Oops.

While fellow students learnt Spanish medical words (l’estomacho! Phayngeo! Laryngeo! El guardo!), I merely smiled and contented myself with looking through a couple of A&E handbooks, and revising my emergency care knowledge.

Um, yes. So I turned up at the ER and my first three patients all spoke Spanish exclusively. It’s not taken long for me to 1) befriend the fantastic people who speak Spanish (a couple of the doctors and nurses) and 2) learn some important Spanish words. A typical consultation: “Hola! Mi llamo Olivia. Dolor? Si? Esta qui? Muchos? Por quito? Urinado? Sangrias?” (Hello! My name is Olivia. Pain? Yes? Where? Lots? Not a lot? Weeing? Blood?”). Which, when you think about it, is all you really need to know… ish.

But I do have an entertaining story about one of the patients who spoke Spanish with a tiny tiny bit of English. I went in with one of the other doctors, and a nurse who spoke Spanish. The patient was a teenager, and her mother was with her. We took a history, with the nurse translating, which was pretty challenging all in all… then went out to write our notes and think about what was going on. A little later, the resident I’d been following came over to us and started talking about this patient. She had a somewhat different history to us, and we asked her who’d translated for her. Hmm. Apparently, the same patient had spoken perfect English. (!!!).

The other main language difference I’ve noticed is, bizarrely, one small word. Ma’am. I have been called ma’am almost continuously. “How are you feeling today?” “not so good ma’am”. “does it hurt here?” “yes ma’am”. “Where is the bathroom, please?” “Right over there, ma’am”.

I’m all ma’am-ed out.

2 for the price of one… 2 for the price of one…

Yes indeed, you will be getting multiple entries today, mainly because the internet is having a funny old time of it, and doesn’t want to work, so I’ve been typing it up, just so I don’t forget it all, and ready to upload when I can!

So, it’s still insanely hot here, but all that is of no consequence, because I spent twelve hours in the ER, and didn’t leave the building once. I turned up (rather nervously) at 6.50, ready for handover (“rounds”), and met my lovely resident, who I intended to follow all day, not being all that familiar with what is expected from American doctors.

How wrong I was.

I was assigned to the back part of ER, or Gulf ward. This deals with medium emergencies, for example chest pain, diabetics with high blood sugar, and unfortunately a lot of genitourinary problems…

So today, I saw (in no particular order) epidydimitis, stomach pain, back pain, chest pain, hyperglycaemia, vaginal bleeding, threatened miscarriage, epiglottitis, dizziness, and the list goes on. That’s quite a lot of patients! There are 12 beds in the Gulf ward, and a lot of the time at least 75% of them are full. It’s busy, very busy.

I followed the resident or the junior doctor for the first two or three cases… and then off I went (horrifically nervous), and took my first “H&P” – history and physical exam – which needs to be quick but thorough, and the exam needs to check all the systems – heart, lungs, abdo, muscles, nerves, etc. Straight out, present to the resident, who then says “ok, so what do you think?” So I make some suggestions, and say what tests I think we could do. The exact response I got was… “ok, off you go then”. So I was ordering tests, getting consults from any and every speciality. Wow. That’s more responsibility in one day than I’ve had in three years back here!

It was fantastic though. I was actually a proper doctor all day!

What has really surprised me is the difference in tests. I’d say I sent about half my patients off for a CT scan, and they were normally gone for the test before I’d finished writing my notes. Crazy quick!

For routine tests – blood tests & urinalysis – I just had to order them and they’d be done by the (absolutely WONDERFUL) nurses. What intrigues me is that urinalysis (one of the quickest and easiest tests… just dip a test strip into some wee and check it against the chart provided) is always sent off to labs, and yet when I did a high vaginal swab, I had to go look at it under the microscope myself, which we really don’t do here.

A twelve hour day passed pretty quickly though, because you are always busy. The worst bits are when you’ve written everything up, done all your tests, and you’re just waiting results. There’s nothing you can do, and so you do end up sitting at the desk for a while, which is rubbish, and I imagine really annoying for the patients (actually, I know that it’s really annoying from being a patient in A&E!).
It got to 7pm, and we went for rounds again, handing over to the night staff. And then blessed freedom! I walked outside for my lift, and my goodness, the heat HIT me like a… thing that hits you. It was SO hot, and I had completely forgotten about it, being in the lovely, temperate ER all day.

Incidentally, LSU (Lousiana State Uni) , the university I am affiliated to for this placement, is in the finals of the college baseball championships. This doesn’t sound massively impressive, until I tell you that ESPN (the major sport channel) is covering it for about 3-4 hours a night. The final is “best of three”, and LSU are playing Texas (the reigning champs). Last night was the first game, and we were losing until the very end, when it went to extra time and we won! Tonight is the second game of three, so we either win and take the championship, or lose, and have to play tomorrow. We shall see…

First Day Blues...

Well, I say first day. I mean "orientation" although to be honest, that was plenty!

Just to get me off to a great start, I turned up at the ER... and there was a metal detector. You know, like the ones you go through at airports? Yes, them. To check for guns. Wow. You're not in the RLI any more.

So I manage to get over this, and meet the lovely resident who is to show me around, and she does - first letting me watch the trauma case that had just come in - someone hit by a pickup truck. There were more than TWENTYFIVE people in the room with him, and I can't even begin to list who exactly... but surgeons, anaesthetists, bloodbank, etc.

Not bad for 20 minutes spent in the ER.

Anyway! So I have my ID, my manual, my shift cards, and am ready to begin properly tomorrow. 7am - 7pm. Gulp.

But, because all this lasted approximately 90minutes, I was free to spend the rest of the day 1) riding on a streetcar 2) wandering around the French Quarter 3) getting lost in same 4) taking a few pictures of where I am staying... which have all been thrown onto Picasa... so check out:

http://picasaweb.google.com/originalliv

And now, I must go and read the orientation manual, and then watch the LSU (Louisiana State University) Baseball game. I feel so American!

All-American Hospitality

Well, it's official. New Orleans is going to make me FAT. But happy. So who cares?

I was so privileged today to be included in a my host's family gathering - celebrating Fathers Day (which is a WAY bigger deal here in the US than back in the UK, Barack Obama even did an interview about it!), and two of the "younger generation's" birthdays. It was lovely, a really happy family gathering, with Grandma, 3 kids plus husbands/wifes, and the some of the grandkids. And me, the anomalous Brit. But one who was accepted with open arms - partly due to my love of ice (because of this, I was referred to as the "respectable British person").

Anyway! So we went to a beautiful family home (all the houses here are huge and beautiful, spacious, with fantastic design and furnishings) for a meal. Since being here (i.e. an entire 24 hours), I have been eating the traditional American fare with a vengeance. My list:

-Fried chicken (LOVE it. Hot or cold)
-Italian salad (a meal in itself: ham, chicken, salami, shrimp, egg, asparagus, cheese x2, lettuce)
-Ranch dressing (mmmmmm!)
-Potato salad
-Doberge cake (a New Orleans speciality. Multiple thin layers of cake with eg custard/pudding between them, and chocolate icing. Google it. And be jealous)
-Brownies (made by yours truly and my lovely host, JD)
-Chocolate peanut butter brownies (oh my.)
-Reece's Pieces
-Milk Duds (chocolate covered caramal. Yummy!)

Like I say, FAT.

But it's wonderful. All of it. Absolutely wonderful. I love it here, I love the heat, and I am very excited about tomorrow - my orientation day at the hospital.

Fallen on my feet in amazing N'ORLEANS!

Yes, I am here! After... 17 (!!) hours of travelling, and about 1 hour of sleep in the past 40, I have arrived.

And what an arrival. The place is beautiful, the people I am staying with are wonderful, and my little home from home is incredible!

Can't believe I'm here, it is wonderful :o) AND boiling. Literally. Over 90 deg F - no idea what that is in real money, but I will just tell you: when I left London it was 12 deg C outside. When I was 1,000m above Chicago, it was... yes, you've guessed it... 12 deg C. I love air conditioning.

Pics to follow in due course. Right now, I need to shower. It's really not pretty (me, not N'Orleans).

Oh, and I also LOVE Reece's Pieces.

Leaving on a jet plane

Well, it is finally here! Exams are done, I'm packed (as much as I can remember, anyway, and despite several cruel and heartless "culls" of pretty things that Mike wouldn't let me take), and I've said goodbye to Alfie (the tortoise).

So I'm readyish to go I suppose. I got my rotation details yesterday, and am now officially terrified. I'm expected to suture, clerk and examine my own patients, help in resuscitation, you name it, I'll be up to my ears in it! I suddenly remember my complete and utter lack of experience in A&E...or ER, as I must call it.

And now, the M4 calls, ready to take me to Heathrow, and then Chicago, and then, finally, New Orleans! Watch out America... I'm on my way....

It beats revision...

And so it starts.

I am heading off to New Orleans in (countdown) FOUR days for a medical elective, and want a record of all the exciting times out there. Thus, a blog starts.

Also, I don't want to revise this afternoon and so playing around with the colours on this website is quite good fun, comparatively!

So here we go. A lot of these posts will be slightly odd ramblings, probably bought about by jetlag, and exhaustion, and such like, but there might be some good stuff in here every now and then. You never know...

Enjoy!