Monday, 26 November 2012

Hallucinating snakes


A change of rotation again today, and onto paediatrics. The best part of this is the fact that I only need to be in at 9AM every day, meaning I get at least an hour of lie in extra compared to the last four months. Obviously this is not the only positive part of the change, and there are a lot of other lovely things around this change. Changing team is a shame, as the F1 I was with was lovely, though this hospital's paediatricians are also very nice. There are no F1s (first year junior doctors) on this hospital's paediatric wards, so this week I spend all of my time spread between a couple of different consultants and the doctors on their teams. Following consultants around is a little different to what I have been doing before, where I have been following around the most junior members of the medical team. This means I get less hands-on experience of what to do next year, but it does lead to a lot more teaching opportunities! 

The team I am with for the next two weeks (yes, that is all my rotation is, a measly two weeks) is really lovely, and I quickly felt settled in and at home. I suppose you would expect paediatricians to be caring, lovely people, if they wanted to look after children, but by the same logic you would hope that all doctors would be very helpful, as they have all chosen a caring profession! The consultants seem very keen on teaching, and the more junior members (who are all still a good few years post-graduation) are very happy to let us get involved, clerking children in when they are admitted to the hospital and doing as much as possible on the ward.

Each day starts with a morning meeting, which is why it cannot start earlier than 9. All of the patients who are in the hospital are discussed between the doctors, and treatment plans decided for each one. There are two main sections to the paediatric work, one dealing with the babies, I.e. those who have just been born or those who were born pre-term, and the other dealing with babies, children and adolescents with any problems that come after birth.

I split my time between the two sections this week, spending some time with the newborn babies doing baby checks. A great chance for me to practice this, which would make a good examination come finals, though it does open you up to be showered in wee by little baby boys... Less said about that the better. 

The other section involves ward rounds, diagnosis and treatment, much like any other medical ward, but in children. There is a large range of patients in the ward, from children being treated for cancer, to the omnipresent respiratory tract infection from RSV. This RSV infection seems to lead to most of the admissions, and plenty of sick wheezy babies. There is little that the hospital can do, and it is mostly supportive care while they get better themselves. 

My favourite patient on the ward at the moment is a 12 year old boy who, two days ago, started seeing hallucinations of snakes everywhere. I realise that my title sounds as though there are snakes hallucinating, but this is not the case (and I am not sure how you would be able to tell if it were). It was this boy who just started seeing snakes wherever he looked for no apparent reason. He has been in for a few days, and refuses to wear clothes as he is convinced there are snakes in them. As he is naked all the time, he has to stay in his room, but otherwise seems very lucid and collected. I had easy conversations with him, and we put jigsaws together and so on without any problems. He seems completely well, other than being able to point out these snakes he can see all the time. There always seem to be one or two present in a room at any time. He has had full toxicology screens for any drugs or substances he may have accidentally eaten, but everything is negative. There is no discernible cause for these hallucinations, though they are obviously very upsetting to him. At a loss of what to do, a referral has been made to the child psychiatrists to see what they think. I will keep you updated next week!


  1. Hi love your posts!

    So I've started sixth form and we've just had progress reviews and I'm doing rubbish. I KNOW it's my fault (obviously) because I haven't been doing the best I possibly can. I'm not "naturally" clever and somehow I'm not motivated to do the best. Now that my teachers have told me that I'm way off from getting the grades I need for medicine and really I should try harder but I don't know how to get into THAT state of mind. I really really really want this and I know I'm an idiot for not just doing the work. I know that if I just did everything and beyond I could achieve the grades. I don't know what to do. I just want to do well but I'm not doing it and it's only going to be my fault in the end.

    Thanks, hope you reply :)

  2. Wow - really interesting case about the boy who is hallucinating snakes, would be interested to find out the eventual diagnosis!

  3. @WMOAHM - will keep you updated when (and if) we find out!

    @Anonymous - if you want to chat give me your email and I can email you - though put in some brackets or something so bots cannot steal it and send you loads of spam!
    I always find it hard to 'get down' to working and get yourself in that mindset, and I know a lot of medical students are the same as me. This sort of behaviour where you feel you should work harder but don't is pretty common. Its hard to get started working, but I always find the important thing is to get into a regime. Its like going to school - if you didn't have to, it would be hard to get up every morning and go in when it often seems pretty pointless. But you do because you feel you have to. If you write a revision timetable, or even plan to do say half an hour of reading around a certain subject a night, then force yourself to keep to it, thats the best way I find of learning. Once you have this timetable you HAVE to keep to, you just need to make it your priority. Its like going to the gym - if you keep to your regime its easy, but miss one or two sessions and suddenly you are missing loads. You just need to make sure you do this small amount of work a day.
    I found the CGP revision books really useful for my A levels - you could do a page or two of making notes on their pages a day perhaps?
    If you give me your email we can chat about it more :)

  4. Hey,

    Fellow medical student here. Thank you for your blog! It's so fascinating to read about what other experiences are like. In regards to studying, I also find it helps if you have a parter you are responsible to. Try agreeing to meet a friend at the library, and make sure it is a friend that is studious and works hard, not one that talks all the time. You may find that being around other motivated people helps you work too!

  5. Hello, thank you so so much.

    Really, this has already motivated me. I've just signed on here through my gmail, so my email name is [["jennisadm"]].


    Again, thank you!

  6. I agree with TheStudent - sounds like a good plan to me, and you help them too! Win-win

    I will email you JDM :)