You know that feeling when a chill goes down your spine?
Well I felt that tingle shoot down the moment I saw the Da Vinci Machine.
I don’t know whether if surgery is the direction I want to pursue, but I know I want to play with one of those babies for sure!
While I can’t imagine what the future of surgery will look like, I am definitely excited!
AH
As a second year medical student, we rarely get clinical experiences into the real world. When the chance came to watch a gastroenterologist perform endoscopies, I jumped at the opportunity.
Here I was, all gowned up in the theatre. Lying in front of me was Mrs Jones (not her real name of course). She was an elderly woman referred to the clinic for both a gastroscopy as well as a colonoscopy. Previously she had went to a small hospital to receive transfusions for iron deficiency anemia. The hospital doctors then referred her to the clinic to investigate the possible cause. From her history, she didn’t have any symptoms.
After a perfectly normal gastroscopy, “What could be causing the anaemia?” the doctor asked me as she prepared for Mrs Jone’s colonoscopy.
“If we’re talking about the lower GI, I’m think that polyps and possibly colon cancers can cause anaemia.”
“Exactly. Now where would you expect to find this tumour?”
I stared blankly back at the doctor. I tried to dig through my limited pool of knowledge. After all, I was just taught about colon cancers less than 24 hours ago.
The specialist must have seen the blank look on my face and answered her own question.
“In an asymptomatic patient, it would likely be the right side.”
By now the scope was prepared and plenty of lubrication was applied. We were ready.
During the colonoscopy, I found identifying the segments of the colon quite hard compared to the upper GI as it all looked the same to me. Hmm… round tunnel with semilunar folds… round pink tunnel..
A normal colon
“Sorry doctor, could you please tell me where we are again?”
“Near the splenic flexure”
“Thank you”
Hmm… pink round tube with… what the?!
On the monitor, the smooth round tubes of the colon disappeared. Replaced instead with a sea of small raised lumps and bumps. Polyps… and a lot of them.
Clarification: Not the real patient’s colonoscopy. I just found this online to show a close approximation of what I saw.
I was surprised. I expected polyps, but not 30 of them at once. The specialist quickly took multiple biopsies of the region, and while further investigating found a hard cancerous mass further down the colon. The scope was then withdrawn after another biopsy was made.
As I watched the procedure, I was ecstatic! I felt like the luckiest med student alive! It is unbelievably satisfying to physically see a disease that you’ve only heard other people describe. However, I also felt… uneasy.
As I watched Mrs Jones gradually recover from the anaesthetic, I realised the source of my unease. Guilt… I felt guilty!
While I was feeling excited seeing pathology come to life from textbooks, I also just witnessing a life changing moment for Mrs Jones. In those 30 minutes, we have discovered a tumour in her colon!
While the doctor continued to type reports and organise a follow up with a surgeon. I had a chance to talk to Mrs Jones in the recovery room.
“Hi, I’m a medical student”
Mrs Jones smiled and nodded “The doctor told me before the procedure. Sorry you had to see such an unpleasant thing”
I presume she meant the procedure and looking at her bowels. “No, not at all!” I replied quickly, “At this stage in my degree, I don’t see much at all. I’m deeply grateful for just the chance to be here today! Thank YOU so much for allowing me to watch.”
We then looked at each other for a few seconds in silence. All I could think of was the tumor in her colon.
“I think I’ll need to go back in. Once again, thank you!”
“Take care”
“You too!” and with that, I rushed back to the doctor.
***
As I left for the day, I happened walk by Mrs Jone’s bed. She lay there wiping tears from her eyes. The doctor must have told her the news. Although I don’t know how severe her diagnosis is, I could see how upset she was.
I didn’t know what to say to her, so I hastened my pace and left the hospital.
Of the many things I learnt that day, I realized that I’m caught between two mindsets, a clinical mind and a human mind. One that feels excited to see rare diseases and terminal illnesses in person, and another one imagining the possible pain and sadness the patient would feel when they find out the diagnosis.
These mindsets are conflicting. It makes me feel guilty for feeling joy from someone’s suffering. However I don’t want to sacrifice either. Ten years later I don’t to be a doctor who only sees patient’s suffering and forget the joy of learning and identifying diseases. Neither do I want to become a doctor who only sees patients by their disease.
I guess I’ll need to live with both… for now.
AH
Have you ever wondered what it would be like to fly in a Royal Flying Doctors Service plane? I was really fortunate to be given the opportunity as part of my John Flynn scholarship placement.
What’s more incredible is that I was given the opportunity to sit next to the pilot in the cockpit and become mesmerised by the amazing technology of the planes and the outstanding capabilities of the pilots who operate these machines. Without the amazing work of pilots, support crew and planes many communities would miss out on vital primary care services in rural Australia.
The footage below was taken on our way back from a remote Aboriginal Community in South Australia. On this flight was a precious child who had to be retrieved for further assessment by paediatricians at our hospital.
For more information on the RFDS and donate to this wonderful organisation follow this link: http://www.flyingdoctor.org.au/
HS
Yesterday I found out a friend from university passed away. For someone my age at 23, death is one of the last things you think about. For heavens sake! I’ll even considered getting married, settling down or buying a house before I consider that my friends will die.
And yet, he’s gone.
To be honest, I didn’t know him that well when we were at university. But I remember him as a pretty cool guy to have around. Last time I saw him was at a Christmas party playing board games two years ago. That guy was way to drunk that time to play Cranium.
Embarking on the journey of medicine, I’ve readied myself to deal with death at work. After all, I expect that I’ll be encountering him (or her). But I was not at all prepared to deal with death among my friends and family.
I always assumed I would have another chance to see my friend. I don’t know when, where nor was I making plans to. I just thought that we would run into each other some time in the next 10 years at least. The news was just so sudden and unexpected. It might have been unexpected even for him! I found out that a few days before he died, he just purchased a new car. A NEW CAR! I heard that he was so excited.
And yet, he’s gone.
I don’t know what exactly I’m feeling, and I don’t know how to articulate it. All I know is that I wanted to say something.
This makes me realize that I taken every day for granted. I always expect to see the sun rise tomorrow. His death showed me that death can come any day to any one of us, despite any upcoming exams, assignments or whatever troubles are going on in life.
From today on, I’ll try to live everyday with a sense of appreciation. Death brings a certain perspectives that make all those woes and worries seem not worth stressing about.
Dear friend, I hope you find joy and comfort wherever you are. I’m really sad that you’re gone. From what I can see, you will be sorely missed.
I’ll leave you with this comment from your closest friends:
You know I don’t drink but it’s one of the bottles you left behind last year. You were supposed to come back with the others and help finish it. Now that won’t happen. We were just talking yesterday and suddenly you’re gone. Here’s toast to you. Farewell my good friend.
Goodbye… dear friend.
A
Life is usually not what you expect.
Have you realised that the things taught at school are a lot simpler than what happens in the clinical world?
In the real world, the case studies and scenarios becomes broader than just the patient, their disease and treatment plan. Sometimes we need to consider the patient’s living arrangements, family background and financial capacity. If you’re really unlucky, the universe will find two seemingly distinct events, mash them together and present them to you as a problem to solve.
Recently I came across a situation where I had to make a decision. No class in pharmacy school prepared me for this scenario. Place yourself in my shoes and see how you’ll handle the situation. What would you do?
The experience and knowledge that I acquired during the John Flynn Placement Program (JFPP) has surpassed all my expectations. It has encapsulated the beauty, challenge and excitement of rural medicine. I have had the opportunity to work within the local teaching hospital, assist in the operating theatre, consult patients within clinics, observe provision of youth mental health services through Headspace clinics, as well as flying to remote mines, communities and cattle stations with the Royal Flying Doctor Service (RFDS).
A short post this afternoon. We have been really busy tackling the complex, mind-boggling concepts being taught to us during the haematology lecture series. Our Haem and Oncology block is pretty difficult and no doubt lots of my peers and myself are feeling the pressure and stress.
This is a timely reminder to look after each other and ourself and to provide assistance to our mates in distress.
My thinking stemmed from a recent podcast that I listened from ABC Radio about mental health and doctors. I encourage you all to listen (a bit of change from our usual podcast). Let us know what you think and how you feel medicine is affecting your physical and mental health. If you are at all distressed talk to your peers or seek professional help.
You can listen to the podcast – Doctors in Distress
Common Rounds 