Training Day
- Medical Training Snippets
Brave Young Hearts - Lessons In Courage of A Medical Student And His Young Patient
Samuel was a first year clinical medical student with his normal human feelings intact. He felt sorry for his 13 year-old female patient, one amongst several patients he had been assigned to by the senior registrar in his unit. He was charged by the senior registrar to know every clinical detail concerning all the patient’s assigned to him.
Samuel never forgot.
* Year of The TREVOLUTION!
Senior registrars are amongst the most senior doctors that run a unit of any particular specialty medical discipline. Clinical medical students rotate from unit to unit amongst the different specialties and currently Samuel was in the Cardiology unit of Internal medicine.
And here he was feeling sorry for this 13 year old female, who suffered from a disturbing heart condition: Rheumatic Heart Disease. She had to sit upright most times at the edge of her bed, lightly struggling for breath while contending with swollen, tender joints.
Over the next few days, Samuel had clerked his patient, consulted her case file and generally updated himself on her current medical management plan, with all recent laboratory results known to him. He hadn’t been found wanting by any of the junior or senior registrars in his unit.
In that short while, he had met her parents and had come to know her brave smile whenever he walked into her bay. She occupied the bed by the window in the four-bedded space that was each bay. Hers was a ward of four bays; a 16-bedded ward.
On the last evening that Samuel was to be in that unit, he was back in the medical hostels struggling with a trivial thought. Should he buy his brave little female patient a little gift of Polo peppermint or should he not. As trivial as this decision might seem, Samuel felt a little fearful when he thought of presenting his gift. His apprehension, as unusual as it might seem, wasn’t unrelated to what the Staff nurse or Matron on duty might think if they saw the gift-giving act. Also, what this act might mean about himself. Would it mean that he had become too soft; too sensitive and sympathetic towards his patient? Too immature to practice medicine courageously?
Samuel went ahead and visited her ward that evening, presenting his little female patient with the gift of a Polo peppermint. The next day, Samuel had moved on to a new specialty unit along with his medical student colleagues of the same team. Pre-occupied with new medical training challenges, he soon forgot about the case of the 13 year-old female with Rheumatic Heart Disease.
His next posting was at the Morbid Anatomy department and a month or so into this posting, Samuel walked into the autopsy room one morning to witness yet another of the first few autopsies he had begun to see and learn about. A few colleagues had already surrounded the autopsy table; the pathologist, their instructor, talking on as he demonstrated. The skull and chest cavity were already opened up with the containing organs sectioned.
Five minutes or so into the demonstration, Samuel, who had been observing from the head-side of the autopsy table, slowly adjusted his position around the table to gain a different view-point. He saw her face.
Later he wondered how he managed to stay calm, even as a slow shock ran through his body as he continued to stare silently at her face. It was the 13 year-old.
So, she died, he thought - of Rheumatic Heart Disease. She died.
* Year of The TREVOLUTION!
The one-year housemanship is a period of intense work under supervision, for freshly qualified doctors. We house-officers in fact sometimes refer to ourselves as "house-boys" to the more senior doctors in our team who over-look our duty.
And so it was for me. I was on call-duty right after the daily 8.00 a.m. - 4.00 p.m. routine; the call duty extending right into the night until the next morning, and for three months at a stretch. At that present time I was covering the male intensive care ward - ward A2.
I was concentrating on taking blood-samples early one morning, from this Diabetic man whose right leg we were going to amputate below the knee, soon. He needed this drastic surgery to survive his rotten, diabetic foot. I was busy taking my samples when this very young student nurse suddenly appeared by the patient's bed-side, immediately accusing me in a challenging tone. Her grouse with me was that I had made her patient's bed-side untidy with the objects I had just utilised in drawing my blood samples. I slowly continued my work by the patient's bed-side, silently amused as she mumbled some more accusations.
If her intentions were for me to notice her - after all I thought I looked quite the dashing, young, hard-working doctor - she need not have bothered, for I had already been eyeing her for a couple of days already. She was simply attractive in her ever-neat nursing uniform; from her head which was always adorned in her nursing hat, right down to her pair of trendy nursing shoes. Plus, those pair of legs - the solid and shapely kind that I liked; and her nicely rounded back-side that appeared well fitted inside her one-piece uniform that had made me follow her with my eyes whenever she had passed along over the last few days during my team's ward-rounds.
This kind of romantic distraction, though seemingly ironic as it occurs amongst grave medical matters at hand, offers a ready avenue for health personnel to stay normal, while under intense pressure. Imagine the reality of the fact that in that same ward, a patient had been scuffling with health personnel on duty recently, trying to prevail on them to allow him jump through the glass window. Of course he was quite simply insane with Rabies - a terminal illness when treatment gets started late - and he died a week later.
Or, the case of a rich, State-politician who was dying slowly in that same ward A2, of complications of Hypertension - he had "Stroke" - coupled with Diabetic Keto-Acidosis (a complication of Diabetes). His wife was a very attractive, sad-faced woman who appeared to be so pained each time I observed her by his bed-side. However, because the man had been bed-ridden for very long with the wife needing to go back home every evening, I couldn't help but consider the possibility that the poor man must by now be feeling frustrated, with ideas dancing about in his head that other men may have begun advancing on his attractive wife! I think I even noticed this in his mannerism whenever she suddenly appeared within eye-shot, on her return. Those moments, he would appear angry and restless. He had lost all ability to speak.
Of course, I may have been reading the wrong meaning into their matter. Or maybe I was right on the mark.
In any case, I went about my intensive duties while welcoming moments of distraction, and the attractive nurse was a joyous one I looked forward to. I should mention she was pretty-faced with a light-skinned complexion and a rather serious disposition while going about her duties on the ward.
It suffices to say we eventually became close.
* Year of The TREVOLUTION!
And so it was for me. I was on call-duty right after the daily 8.00 a.m. - 4.00 p.m. routine; the call duty extending right into the night until the next morning, and for three months at a stretch. At that present time I was covering the male intensive care ward - ward A2.
I was concentrating on taking blood-samples early one morning, from this Diabetic man whose right leg we were going to amputate below the knee, soon. He needed this drastic surgery to survive his rotten, diabetic foot. I was busy taking my samples when this very young student nurse suddenly appeared by the patient's bed-side, immediately accusing me in a challenging tone. Her grouse with me was that I had made her patient's bed-side untidy with the objects I had just utilised in drawing my blood samples. I slowly continued my work by the patient's bed-side, silently amused as she mumbled some more accusations.
If her intentions were for me to notice her - after all I thought I looked quite the dashing, young, hard-working doctor - she need not have bothered, for I had already been eyeing her for a couple of days already. She was simply attractive in her ever-neat nursing uniform; from her head which was always adorned in her nursing hat, right down to her pair of trendy nursing shoes. Plus, those pair of legs - the solid and shapely kind that I liked; and her nicely rounded back-side that appeared well fitted inside her one-piece uniform that had made me follow her with my eyes whenever she had passed along over the last few days during my team's ward-rounds.
This kind of romantic distraction, though seemingly ironic as it occurs amongst grave medical matters at hand, offers a ready avenue for health personnel to stay normal, while under intense pressure. Imagine the reality of the fact that in that same ward, a patient had been scuffling with health personnel on duty recently, trying to prevail on them to allow him jump through the glass window. Of course he was quite simply insane with Rabies - a terminal illness when treatment gets started late - and he died a week later.
Or, the case of a rich, State-politician who was dying slowly in that same ward A2, of complications of Hypertension - he had "Stroke" - coupled with Diabetic Keto-Acidosis (a complication of Diabetes). His wife was a very attractive, sad-faced woman who appeared to be so pained each time I observed her by his bed-side. However, because the man had been bed-ridden for very long with the wife needing to go back home every evening, I couldn't help but consider the possibility that the poor man must by now be feeling frustrated, with ideas dancing about in his head that other men may have begun advancing on his attractive wife! I think I even noticed this in his mannerism whenever she suddenly appeared within eye-shot, on her return. Those moments, he would appear angry and restless. He had lost all ability to speak.
Of course, I may have been reading the wrong meaning into their matter. Or maybe I was right on the mark.
In any case, I went about my intensive duties while welcoming moments of distraction, and the attractive nurse was a joyous one I looked forward to. I should mention she was pretty-faced with a light-skinned complexion and a rather serious disposition while going about her duties on the ward.
It suffices to say we eventually became close.
* Year of The TREVOLUTION!
Feminine Power - It Fears Not The Cadaver
I remember the apprehension that I felt as I approached the Gross Anatomy lab as a fresh year student at the College of Medicine.
This was the laboratory where the preserved cadavers (dead bodies treated-on) were kept for new entrants like me to get to study with, all of the features of the human anatomy.
It was part of one whole week of orientation around the key departments of the College, that we fresh, lively medical students had to undertake, and this morning it was the turn of the Gross Anatomy lab to receive us.
I had wondered all week about this day with a little dread and this morning, I walked into the large-chambered laboratory. What first hit me as I stepped into the room already full of my mates, was the powerful and choking smell of formaldehyde - the chemical preservative cadavers are treated-on with.
The large chamber was sectioned by separating walls with a metal trolley in each section and one whole cadaver, either a male or a female, on each trolley. I was faintly surprised at how dark and dry-looking some of them looked.
We gathered around two of the chambers with our instructor amidst us talking away as I tried to adjust to the surroundings, feeling a sense of excitement mixed with discomfort.
What however gave me much encouragement was the fact that everyone present appeared calm, almost nonchalant, even. In particularly this: The sight of several female students appearing all brightly clad in the fashion trend for females at the time, leaning calmly and confidently with their back-sides against one trolley that had one of the cadavers - a huge male - resting eternally on it, as they appeared to be listening attentively to the instructor. One or two might even have been chewing bubble-gum, so I seem to recall now!
I was quite impressed by this display of composure. Or were they internally as discomforted as I was? I Guess I’ll never really know.
Later that day I prepared to have lunch at the cafeteria back at the hostel. While at the lab, I concluded that I would be unable to stomach any food for over the next day or so. So, you can imagine my surprise when I began to eat the food hungrily after a tiring day, with thoughts of the sight of those awful cadavers not really giving me any qualms while I ate.
A week or so later, we walked into the lab to find we had been grouped; each group to a cadaver. We were about eight students in my group. I was disappointed to see that our own cadaver had been a dried-up, tiny old woman at the time of her death. This made it especially difficult to observe the various structures and tissue-layers which our anatomy practical manual illustrated to us week in, week out, as we went along each gross anatomy session, tearing-away at our cadaver in a methodological manner known as the dissection.
* Year of The TREVOLUTION!
* Year of The TREVOLUTION!