Moving Along
So, today was the last day of the Neurology component of my elective. I've already been in the hospital for 4 weeks (although I'm taking tomorrow off to go to Eilat and Petra over the weekend. The former is a beach resort town on the Red Sea, the latter an ancient cliff city in Jordan, best known in the Western world for being the site of the Holy Grail in Indiana Jones and the Last Crusade) and it seems to have flown by.
I didn't love every second of the rotation. I actually spent a large chunk of it quite bored. I occupied some no-man's-land between the doctors and the other 13 medical students from the local university. I couldn't speak Hebrew well enough to get the most out of the lectures I attended (staying away from the ward-work in the afternoons because either the doctors told me too or because there was nothing I could do) and tended to drift off in them. I went to clinics, where I found myself with 1-3 other students at times, at others alone. And needless to say, I got the most out of the ones on my own, because I could interrupt and get a translation of the key words I was constantly missing. That was the main problem, really. I'd understand perfectly for the first five minutes, which was when the doctors first checked if I was following, then five minutes later there'd be a key word I'd miss, and I'd completely lose the track of the talk. Then when they asked me in another 20 minutes if I understood, I'd stop daydreaming/folding paper cranes/discreetly doing the sudoku in the free paper and in my embarrassment over not having tried to catch up, cast my mind back to the last few words and try and show I knew what we were on about, or smile sickly with a shrug...and go back to whatever I was doing when the doctor moved on.
There were some things that were very different to Australian hospitals. I missed the Indian and Asian doctors. Here we have Russians and Bedouins, but it's not the same. There are clans of stray cats haunting the hospital grounds, and I'd watch the kittens who were usually in one area play-fighting as I went to the laundry to change white coats. Oh yeah, white coats. We all had to wear them when interacting with patients, but I wore mine all the time. I felt it raised the class of my clothes when I was wearing jeans (and sneakers, this morning) and the pockets are second only to scrubs for convenience. There was/seemed less emphasis on practical Neuro skills for the students. On the last day of their three week rotation, they were still being shown how to do things like visual fields properly by the consultant. That said, they had a neat little trick for testing the quadrants that I don't think the textbooks teach.
Some things were very similar though. Idiosyncratic consultants, for one. The tall bald one who played games on his mobile phone all through the meetings, only stopping when something required his full concentration or scorn. And although I never fully understood him, I think he had a lot of scorn; he tended to declaim rather than speak, pausing and emphasising the last word of every ...SENTENCE. The registrars who are really great/competent but whose attitudes towards the student vary between full involvement, tolerance and ignoring. Although the ones who sorta ignored me were mainly the Russian ones, and that's fair enough because our only mutual language of communication was non-fluent on both sides. The students who were really only concerned with what they needed to do/learn to pass, plus the keeeeen ones and the hardly-ever-present ones on either end of the bell curve. Every morning meeting seemed to follow a similar pattern in some ways too...the doctors in the middle, the students hanging around the edge, and we'd discuss the patients (and there was of course the one whose repeated admissions would always bring a cry/sigh of recognition) and then the consultants would start talking about a tangent or gossiping, then we'd mill around or get coffee before the first work of the day...
So, what did I get out of my elective so far, other than a trip to Israel?
- I've learnt that not understanding what's going on only works so far as a motivator before the sheer lack of understanding becomes indifference
- I've learnt there's a lot more to Neurology than I realised, and it's bloody complicated and full of eponymous syndromes
- I've learnt that despite my cynicism and apathy, getting involved in an interesting case and having a decent textbook at hand can revive my interest in a subject
- I've taken more bloods in four weeks (hell, in the first week) than I did all last year, using a glove as a tourniquet
- I've learnt that although there's no headache clinic in Perth, if I did do Neurology I wouldn't be the one to start one, because I'd kill the patients
- I've learnt the Hebrew words for admission, seizure, headache, haemorrhage, blood pressure, treatment and arsehole (ok, that last one I learnt at the protest in Jerusalem, but I think it still counts)
- I've learnt that just because a ward is full, it doesn't mean it can't take another 7 admissions (there's always room in the corridor!)
I think I finished on a high note, with successful cannulations, blood takings and presentations at the morning meeting. And last night I stayed until 10, only leaving the interesting cases because I had no other way to get home and I needed to sleep because we're taking off at 5 tomorrow morning.
So, a weekend of hiking and relaxing in a town with temperatures in winter comparable to the nice end of summer, and then on to Paediatrics for a fortnight!
I didn't love every second of the rotation. I actually spent a large chunk of it quite bored. I occupied some no-man's-land between the doctors and the other 13 medical students from the local university. I couldn't speak Hebrew well enough to get the most out of the lectures I attended (staying away from the ward-work in the afternoons because either the doctors told me too or because there was nothing I could do) and tended to drift off in them. I went to clinics, where I found myself with 1-3 other students at times, at others alone. And needless to say, I got the most out of the ones on my own, because I could interrupt and get a translation of the key words I was constantly missing. That was the main problem, really. I'd understand perfectly for the first five minutes, which was when the doctors first checked if I was following, then five minutes later there'd be a key word I'd miss, and I'd completely lose the track of the talk. Then when they asked me in another 20 minutes if I understood, I'd stop daydreaming/folding paper cranes/discreetly doing the sudoku in the free paper and in my embarrassment over not having tried to catch up, cast my mind back to the last few words and try and show I knew what we were on about, or smile sickly with a shrug...and go back to whatever I was doing when the doctor moved on.
There were some things that were very different to Australian hospitals. I missed the Indian and Asian doctors. Here we have Russians and Bedouins, but it's not the same. There are clans of stray cats haunting the hospital grounds, and I'd watch the kittens who were usually in one area play-fighting as I went to the laundry to change white coats. Oh yeah, white coats. We all had to wear them when interacting with patients, but I wore mine all the time. I felt it raised the class of my clothes when I was wearing jeans (and sneakers, this morning) and the pockets are second only to scrubs for convenience. There was/seemed less emphasis on practical Neuro skills for the students. On the last day of their three week rotation, they were still being shown how to do things like visual fields properly by the consultant. That said, they had a neat little trick for testing the quadrants that I don't think the textbooks teach.
Some things were very similar though. Idiosyncratic consultants, for one. The tall bald one who played games on his mobile phone all through the meetings, only stopping when something required his full concentration or scorn. And although I never fully understood him, I think he had a lot of scorn; he tended to declaim rather than speak, pausing and emphasising the last word of every ...SENTENCE. The registrars who are really great/competent but whose attitudes towards the student vary between full involvement, tolerance and ignoring. Although the ones who sorta ignored me were mainly the Russian ones, and that's fair enough because our only mutual language of communication was non-fluent on both sides. The students who were really only concerned with what they needed to do/learn to pass, plus the keeeeen ones and the hardly-ever-present ones on either end of the bell curve. Every morning meeting seemed to follow a similar pattern in some ways too...the doctors in the middle, the students hanging around the edge, and we'd discuss the patients (and there was of course the one whose repeated admissions would always bring a cry/sigh of recognition) and then the consultants would start talking about a tangent or gossiping, then we'd mill around or get coffee before the first work of the day...
So, what did I get out of my elective so far, other than a trip to Israel?
- I've learnt that not understanding what's going on only works so far as a motivator before the sheer lack of understanding becomes indifference
- I've learnt there's a lot more to Neurology than I realised, and it's bloody complicated and full of eponymous syndromes
- I've learnt that despite my cynicism and apathy, getting involved in an interesting case and having a decent textbook at hand can revive my interest in a subject
- I've taken more bloods in four weeks (hell, in the first week) than I did all last year, using a glove as a tourniquet
- I've learnt that although there's no headache clinic in Perth, if I did do Neurology I wouldn't be the one to start one, because I'd kill the patients
- I've learnt the Hebrew words for admission, seizure, headache, haemorrhage, blood pressure, treatment and arsehole (ok, that last one I learnt at the protest in Jerusalem, but I think it still counts)
- I've learnt that just because a ward is full, it doesn't mean it can't take another 7 admissions (there's always room in the corridor!)
I think I finished on a high note, with successful cannulations, blood takings and presentations at the morning meeting. And last night I stayed until 10, only leaving the interesting cases because I had no other way to get home and I needed to sleep because we're taking off at 5 tomorrow morning.
So, a weekend of hiking and relaxing in a town with temperatures in winter comparable to the nice end of summer, and then on to Paediatrics for a fortnight!