Monday, 17 September 2012

Mad house


The elderly medicine/stroke rotation madness continues as more crazy-seeming people are bought in. As I spend more time on the ward, I get more useful and thus actually get less of the things 'I' want done, done; and I get to enjoy free drug company lunches three days of the 5 weekdays!

So drug company lunches... Often meetings in the hospital are sponsored by a drugs company, who put up a little billboard outside the room where something to do with the hospital is being discussed. This may be a teaching session for junior doctors, or a management meeting. In response for putting this board up, and perhaps giving a little talk about their drug as people leave, they put on sandwiches for everyone who turns up (or in one case this week, a yummy hot meal). This is fantastic for Mr 6th-year-medical-student over here, living on the bread line (well, not quite), and doctors love them as well. Who doesn't like free food! I am not too sure how ethical they are, though. Drugs companies shouldn't be trying to 'curry' favour [see what I did there] from doctors with gifts of food, which mean the doctors spend the NHS money on more expensive/different drugs. All choices should be made using evidence as to which are the best to use! I would have thought that these boards and minute-or-two speeches wouldn't make much difference, but if they didn't, then why would drug companies pay the money for the lunches. They must do. I guess drugs companies will argue that they are just using these sessions for 'education', and informing doctors of the most up-to-date and effective drugs (as well as the most expensive, I would imagine). Oh well, definitely not something for me to wonder about too much. As a student the free lunch is something to look forward to!

Perhaps not quite this bad, but I am always sceptical with companies wanting to turn a profit getting involved in the NHS and healthcare

As I said before, it seems that the more I learn about the job of a junior doctor, the more useful I become and the less I get what I need to do. As a medical student what I really need to be doing is seeing as many patients as possible, getting used to signs and symptoms, and performing procedures such as putting in a cannula or taking blood. I have sign offs for these sort of things, which I have to have finished before I can graduate. Unfortunately, these are not the sort of things that the ward really needs doing, as the nurses can do most of the practical tasks. Instead, what really does need to be done is an absurd amount of paperwork for bloods, investigations  discharges, basically anything you can think of. I am spending most of my time being helpful, which is much appreciated, by helping fill all this in. Unfortunately its not too useful for my 'education' - though it does give me a good taster of what work is like as a Junior Doctor (a bit boring :P). Next week I am going to try and be a little more selfish and do what I want need to do. If anyone has time to do these things with me!

So, back onto the patients who have been admitted this week. Due (in part) to me being super productive [obviously other people are involved, such as physiotherapists, and speech therapists and so on] lots of people got discharged this week, meaning lots of new patients have been admitted to fill their places. Some of these were new admissions needing beds, and others were patients that other wards didn't really want, so somehow managed to get them transferred to one of our empty beds. A very sneaky practice indeed! We have a couple of lovely patients on the ward who don't believe me that they are in hospital. One things he is in an aeroplane, and insists that he is flying whenever you talk with him. These conversations are fantastic, and he really sticks to his guns. I asked him if he drove, and he told me that he didn't need to, as he had an aeroplane. The other is a lady who thinks she is on holiday rather than in a hospital. I haven't tried to correct her, as I think she is pretty lucky to think she is on holiday, She is loving it, and all of the free food that gets bought to her! Unfortunately these 'funny' pathologies are a result of a stroke and parts of the brain dying. Hopefully they will begin to gain more function, though I am not sure how realistic this is. People cannot be sent home on their own if they cannot look after themselves, so if they don't improve they will have to go to a nursing/residential home, or have a large care package for the home.

Other patients include a Spanish lady who has forgotten most of her Spanish and can only speak in English (very interesting) and a man whose symptoms of a stroke were the world 'melting' around him, like a nightmare world. He can still talk, understand, and make sense of things, but still has the sense that everything around him (and everyone) is 'melting'. Very disconcerting. 

Would your world meting around you give you a nostalgia trip?

The final patient who we got from another ward is a lovely little old lady who sits cutely in her chair at the end of the ward, and yells BUGGER at anyone who walks past. I have no idea what she has got, as I can barely have a conversation with her. A colourful character none the less though. Perhaps she has dementia and severe disinhibition? Very similar to one of the patients one of my friends saw in the acute medical unit this week. She had gone in to take an ABG and he told her that he had better get it first time, or he would spank her 'as he loved spanking little girls'...
We were not sure if he was ill or just a bit of a pervert...


  1. Hi,
    Sorry, completely irrelevant comment(!) but I was wondering which company you organised your medical elective with? I'm starting to think about mine, but don't really have a clue where to start! Any advice would be appreciated!

  2. Hey! Just found your blog, I'm a med student in Texas. About drug company lunches... they are starting to go the way of the buffalo here. I think there's definitely more harm than good that comes from them. And any drug rep that argues they are trying to educate more than they are trying to make money is full of bullocks!

  3. Hi guys,

    Sophie, I didn't use a company as you get heavily charged for the organisation you could do yourself. I used The Elective Network via the MDU (you need to belong to a medical defence union, and while at med-school this is free) The link is below. They just list loads and loads of hospitals by speciality or by area, and I just searched sub-Saharan countries til I fould one that sounded good to me. They have contact details online, so I then used those details to contact the hospital and organise things myself. So much cheaper, and the money you do pay goes to the hospital and buying medicine rather than to a company...

    Link is
    (you need to belong to the MDU (free) to use it.

    Sam, it is interesting that these are dying out in the USA, where it is still fine to advertise drugs direct to the consumer. I think you are right, though, and there is a lot more harm in the lunches. Saying that, I filled up on a lovely lunch from M&S today from a company selling a medication for a neurodegenerative disease. That must be where the money is. Years and years of constant use needed! I am sure if they fund 10 lunches, and one just leads to one patient being put on it permanently it must be a profit!