Day 19 - Real Medical Students (13/10/2017)

Very busy day - in at 8am for a lecture on the autonomic nervous system, and the differences between the sympathetic and parasympathetic systems, along with the associated nerves for each. Afterwards, we were in the anatomy lab once again to examine the structures associated with the hindgut and midgut, with particular emphasis on the relevant blood vessels and surface anatomy landmarks. No live tissue this week, but I was fascinated once again by the quality of the plastinate specimens - I could happily sit in there all day looking at them given the chance. I was pleased to notice that, like me, most people seemed not to have finished all of the pre-session work. There is a huge amount to do each week, but thankfully I had still done enough to follow what was going on in the structures before me.

Another seminar on the autonomic nervous system, and then clinical skills in the afternoon. I very much enjoyed this session, as it was concerned with performing a general physical exam on a presenting patient, including examining the hands, face and lymph nodes, alongside taking blood pressure via sphygmanometer, internal temperature, respiratory rate and more besides. We seemed to cover a huge amount, and were tasked with a roleplay wherein we had to examine other members of our group, including crucial steps such as introducing yourself and gaining consent for the process.

I have never realised up until today quite how personal physical exams get, because I've never had to perform one. You have to get very hands-on (by the nature of the task), touching potentially uncomfortable areas such as the face, eyelids and neck - this was a great chance to practice talking through what we were doing and explaining to the 'patient' as we went along. We learned how to palpate and take pulse readings in the radial (wrist), brachial (arm) and carotid (neck) arteries, and examine for common signs of liver disease and thyroid problems, among other things.

Having my lymph nodes examined by a coursemate

Having my lymph nodes examined by a coursemate

Taking blood pressure using a stethoscope and sphygmanometer

Taking blood pressure using a stethoscope and sphygmanometer

Internal temperature taking via the ear

Internal temperature taking via the ear

It was actually this class that made the transition to med school seem complete, a sentiment that seemed to be echoed by virtually all of my peers. This was why we were here, the physical, patient-centred vocational aspect that combines scientific understanding of the body with clinical practice. Just as an aside, it turns out I would be an excellent clinical partner for a colleague during assessments - my brachial pulse is almost ridiculously pronounced and easy to find, making blood pressure assessments much easier. I definitely need to practice my palpation techniques for finding pulses, and people seem interested in forming study groups to facilitate honing our clinical skills.

In the evening, I headed back to the university instead of going home to attend the gaming society for the first time. This was not a fantastically smooth journey, as I fell asleep on the bus and missed my stop, meaning I had to then take a bus going back the other way. You see I had taken a caffeine tablet at about 7am (the equivalent of two cups of coffee) and had felt really quite energised all day. At about 6pm however I crashed extremely hard and became very drowsy, leading to the bus incident. Needs more refining.

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We ended up playing Dungeons & Dragons, with a shortened campaign led by Tom whom you may remember from some of the vlog videos. Now I'm well aware of the reputation this game has, but believe me when I say that with pizza and a few beers, it's a really enjoyable evening that oftentimes becomes incredibly funny. Everyone at the society was lovely, and it was a fantastic environment after a long day at the hospital and a good chance to unwind - I'm pleased to have found a space where that can happen, because I can tell already that being able to de-stress at the end of the day is going to be an absolute requirement for finishing this year, let alone med school as a whole.