Merry Christmas

Hi,


My last week before Christmas holidays, so a merry Christmas and a Happy New Year you all (or a 'Happy Holidays', depending on which you prefer). The last term has been 16 weeks long, which seems like it has been quite long, given all the essays and the SJT that have had to slot into it as well, so I am looking forward to a nice relaxing Christmas holiday, though revision will have to start soon for finals. Finals are still a long way off, around late March, early April (I think, though I am not definite), but I am not sure my usual revision method will work out too well (cram fervently a week or two before) due to the large volume of facts that I should know but I don't. 

As for this week, it was my last week of my obstetrics and gynaecology rotation. We only have two weeks of this speciality in 5th year, as we have some experience during our 3rd year, and this is meant to just be a refresher. I have been trying to make the most of it, as I cannot remember a lot of my third year as it was so long ago! 

The best part of this week was finally getting a chance to practice my suturing skills on a real live patient. Those who read this relatively regularly will remember that I had lots of practice last week in tying knots (though I did spend most of my post last week complaining about the SJT... sorry about that...) This week I got to practice them for real in theatre, closing up holes in the abdomens of all patients who needed a laparoscopy. These holes only need a couple of stitches  as they are pretty small (large enough to put a small camera down for the keyhole surgery) but its still good 'real life' practice for me. The gynaecological consultant is fantastic in trying to get me as involved as possible, and the team are great fun as well. I can see the appeal of being a surgeon. You do your work in the theatre, which you hopefully enjoy, then you get to go to the staff room and relax for half an hour or more while the patient is taken away, the new one is prepared and sorted out by the anaesthetist, and then you come back and operate again. Quite a relaxed job! 

I do have a scare in one of the theatres, though. I am late to one of the later operations, as I am answering a bleep for one of the registrars, which means I don't know why the patient is having this operation. I am asked to hold something for one of the more junior doctors, as he has to leave, and warned to be careful in case I damage the uterus. Not too sure how careful I need to be, I try and treat it like paper until he returns. Later on, they are talking about a ruptured uterus, and passing dye in through the cervix to watch it leak out into the abdomen. I am petrified that I have made a hole in this poor ladies uterus, but it turns out that she was being operated on for a suspected hole in the uterus, after having a hysteroscopy in Yemen (for some reason?!). I am very glad that this wasn't me, but I suppose this highlights the dangers of surgery and how you have to be careful with everything you do. It also highlights the dangers of having invasive tests done in an underdeveloped country.

While I had good experiences in theatre, I struggled to get much obstetrics experience at all. There are a lot of midwifery students at this hospital and, rightly so, they take precedence over me in getting involved in normal births. Because there were so many students, every time I went to the delivery suite, all women who were giving birth were already partnered with a midwifery student, and those who were due to come in had already had students assigned to them. I spent some time with the obstetrics doctor, though the doctors only tend to get involved when there are problems with labour, rather than in normal deliveries. I did leave my bleep number with the midwives, as they told me they would bleep me as soon as there was someone going into labour who didn't have a midwifery student assigned. I didn't get bleeped though. It is a shame, I agree that you don't really want more than one student in the room when there is a woman giving birth, and the midwifery students need a lot more experience in this than medical students do, but it would be nice to have just a little experience of normal births. I hope I don't run into someone in labour on a plane or something similar, or if I do, I hope there is a midwife present!

Anyway, have a lovely Christmas period, I am off now 'til Janurary, and I will keep you posted after that.