 |
 |
Back to reality
Exams fast approaching, so spend the morning reading the newspaper supplement, including all the free prize draw cards that drop out. Fascinating. Jeremy Paxman's voice now has an incredible allure and politics seems altogether interesting. Thankfully, my delusions about Paxman last about two minutes. Start to feel clucky later, during my neonatal examination competence test. That is until the infant decides to show me what meconium looks like on a white shirt. I inform my examiner that "I think the anus is patent." He disagrees however and insists I "clean him up" to make sure. Resuscitation practice is more fun, as I have long since perfected the role of the "unconscious patient." Clare comes in to inform us that a man has been found dead in Mr Blair's pool. We later discover that she actually meant Mr Barrymore. Presumably, Mr Blair's pool remains dead body free. Family planning. Volunteer to role play a 16 year old pregnant girl. Slip into the role all too easily. Slip into paranoia too when congratulated for the third time on how convincing I was by the staff. Fire alarm snaps me out of it. Move to the breast clinic where the registrar says he is too tired to teach and can we go with the SHO. He says the same. Find myself trying to demonstrate an orthopaedic examination. Know things are going badly when the registrar says, "What does that do?" My explanation doesn't seem to clarify things either. The phrase, "I don't mean to alarm you, but how long to go until your exams?" is equally disturbing. Consultant meets us for our final morning round. He is intent on discovering what we would do if we won a million pounds. Contemplate saying that not having to get up at 5.30am to answer that question would be first on my list of priorities. He seems to be taking notes so I reconsider. Fire alarm goes off, for the second time this week. I'm quite literally saved by the bell.
Jason O'Neale Roach fourth year medical student, Guy's, King's, and St Thomas's Medical School and former editor, studentBMJ jasononeale@yahoo.com Physician, heal thyself
It's happening again. My mind is exercising its power, making me more neurotic. The process of training to be a doctor offers privileges and opportunities. We are given access to people's lives, and are allowed to take part in ward rounds, clinics, and surgeries. We are encouraged to become caring, skilled professionals. But being a medical student does bring with it certain demands and drawbacks. We are pressured physically, emotionally, and intellectually over a five year course. Illness, distress, and death are difficult to deal with when they occasionally occur in our own lives, but to cope with it professionally takes its toll. However, this goes with the job. What we don't necessarily know is the hypochondria that medical education engenders. For me it manifests itself as feeling that every twinge is a tumour. Usually, the syndrome depends on the topic we are being taught at the time. So, after our oncology course I became increasingly frantic over moles and blemishes that have been on my arms for probably most of my life. In a desperate state, the GP is contacted and an appointment requested urgently. Seeking reassurance, and with the discomfort of feeling like an extra burden on overstretched NHS resources, we venture into the consulting room. We overcome our embarrassment and humiliation to unload our terror. And what happens? One scenario is that our sympathetic doctor listens patiently while we stumble through our brief medical history. The GP has already cast a knowing look at the computer, confirming our subject of study. "And what do you think you might have?" "Erm... well... .it's just that we had this lecture... and pictures... and, and...." A brief physical examination follows, then a few reassuring words that our suspected melanoma is in fact benign and harmless. We are going to live after all. No metastases, chemotherapy, or premature death. The GP then offers a few words of reassurance about how common it is for medical students to self diagnose, incorrectly, and always with something aggressive and terminal. But, as I'm about to leave the room, feeling relieved and a little sheepish, the killer line hits home, "Don't worry, it's just as bad even after you qualify." The alternative scenario is the stuff of tabloid stories. A visibly irritated GP gruffly inquires as to the problem. We stammer out our fears, conscious of the atmosphere. "And what makes you think you might have a malignant melanoma?" "Er, well...." "What are you studying at the moment?" A few minutes pass in a blur. We remember a few phrases: "Pull yourself together," "You should know better," "Bloody medical students." Then we stagger out feeling worthless, a hypochondriac taking up valuable time that is the right of the genuinely sick. Perhaps it's not just my mind. A little knowledge is indeed a dangerous thing.
|
