Extraordinary experiences in medicine

Nottingham Medical school, QMC

Medical school is an extraordinary place to be.  Some lifestyle things get left by the wayside on a tight schedule in the Midlands, but the existence offers some most unusual experiences.  They've engaged us with some of the UK's extraordinary events on my doorstep, reminding me of Sheffield days.  A few of the memorable medical experiences so far below...

We're skilling up - and hence to learn we have to 'do':

• Attending to a crashed motorcyclist and leading the first aid until the doctor and helicopter arrived
• Delivering a baby as a midwife stood by
• Performing CPR with a paramedic on a dying man's chest at his home
• Visiting and assessing a patient having a heart attack in his house
• Suturing the skin of an anaesthetised patient (after having taken consent!), and removing non-absorbable suture 5 days later (tougher than you might think!)
• Physically tapping-in a regionally anaesthetised but awake patient's wrist prosthesis
• Performing a surgical evacuation of retained products of conception (under close surgical observation, mind, with consent!)
• Cradling human prosections of brain, liver, heart, lung in my hands (that's in the anatomy suite) 
• Assessing a still-warm placenta in my hands
• Training in laparoscopic (keyhole) surgery on a simulator
• Assisting in surgery as the camera operator
• Teaching practical skills in formal classes for the first time in all my days - cardiac dissection and suturing ; and a large handful of theory workshops & lectures, the like of which I've not taught for years.
• Explaining to a fella and his family what it means that he just had a heart attack
• Visiting a tuberculous patient on the infectious disease wards while wearing a facemask, reminiscent of a plague-doctor's beak
• Cannulating, bloodtaking and injecting - needling becomes surprisingly consistent once you get your eye in.

It's not just doing, it's observing life and death too - watching experts in action

• A major obstetric caesarean haemorrhage with a terminally ill-unless-supported baby with a very slow heartbeat, all in a completely calm room, mother and baby's problems resolved so calmly by the surgical team that the husband (present in the theatre) was unaware!
• Re-break of a man's malunioned tibial fracture by an orthopaedic surgeon using his bare arms, and then fixing it with a 14" titanium nail!
• A one-sided breast surgery (mastectomy) performed using a large oval incision to remove a huge cancer that the patient had left unchecked for years 
• Breaking bad news - of serious inoperable abdominal cancer to an elderly woman, but focused on what could be done.
• Rapid decline from chatty to death of a young alcoholic (30s) - seeing a valiant but unsuccessful team effort over two days, after variceal-rupture induced oesophageal bleeding
• Watching a postmortem take place, respectfully but unflinchingly by the mortuary team
• Watching an embalming being performed on a tour of a funeral home (a respectful team, a calming outcome for the family, but a process takes a bit of getting used to)
• Breaking bad news to a family - of meningitis in their daughter - seeing how this tragic situation can be approached sensitively
• AND - seeing a (clearly delighted) male college pupil learn that girls can take contraceptives in a 'pick up your condoms' drop-in session
• seeing a baby quietly have its tongue-tie (frenulum) cut in clinic
• seeing a comical mountainbiker who was trying to impress his son on BMX have his broken ankle (trimalleolar) tractioned and twisted back into place in A&E.  Yeowwwch!
• seeing a guy who'd just had a heart attack being rushed into the cardiac catheter lab to have his coronary arteries stented (i.e. opened back up)

Meeting compelling characters in this people profession makes it all worthwhile

• A PT instructor (who was an ex- army gymnastics display team member) who told his compelling story of career, sustaining a neck fracture, becoming paraplegic, and coming to terms with it through an exercise device, a mighty modified Mercedes van, an army pension and getting used to scanning new venues for toilet opportunities
• Special needs kids (a busload of them - nice bunch) who we took to a family festival, though after a dramatic rendition of 'The boy who cried Wolf', mine did spend the day making sheep sounds.
• Recovering alcoholics - in a group session where they shared their childhood-to-present life stories
• Extraordinary fellow medical students on their journeys, including the young, the fiercely bright, the wealthy and sporty enjoying the experience; the something-to-prove career-hungry surgeons; the settled, balanced characters approaching the creative opportunities to serve well in the GP niche; the industrious mature students hunting and carving out meaning in a speciality, the rangy or gawky among us finding something to excel at.
• Dedicated GPs and hospital staff, whose general desire to invest in others emerges in the effort they expend to teach and mentor each of us, and help us swell their ranks.

And in my pipeline - I'm still waiting for the day I nail my first medical consultation

• It'll be the day where I gather the right history, I examine the patient right, come up with the right differential diagnoses, and recommend the right investigations and empirical treatment.  Am closing in...I can sense a gastric reflux patient coming my way...here's hoping it'll come in time for Christmas!

'tis a privilege, this.

Levity