Day 114 - A Day of Depression (16/01/2018)

Today was all about depression, both in terms of physiology and pharmacology, as well as treatment options. I found the topic extremely interesting - despite not suffering from depression myself, I know many people who have, including within my own family (we seem to have a bit of a predisposition towards mental illness). There are many more treatments available than I realised, and the management of chronic depression is more complicated than I had previously guessed.

In the afternoon we were back at George Eliot hospital in Nuneaton. We arrived in good time and split into groups of 4 to go and speak to a patient with a doctor, this time on a general surgical ward. Once again we took a history as best we could, and Tom performed part of a general exam. I experienced a bout of 'question stress' when asked what gastritis was and answered incorrectly, despite knowing full well what the answer was in minute detail - I'd been through it only yesterday. Ah well. He asked us plenty of questions throughout the consult, as well as taking us through the relevant clinical imaging afterwards. Different doctors clearly have their own structured ways of doing things, so I need to work some fluidity into my approach at some point (probably after OSCEs).

We didn't have long with our doctor (the hospital was quite busy), and we finished earlier than we had before. Between us we decided therefore that we should go and find patients to speak to ourselves, which we had previously been told we could do. We then further split down into two groups of two, trekking around different wards looking confused until a consultant took pity on us and found us a patient. He then instructed us to take a history and come to his office in 15 minutes, where we were to present it back to him.

The patient was very compliant in giving us a history, although it was noticeably very much not in the order we were used to receiving the information in. It was a really good exercise for us actually, a much more realistic attempt at getting organic information from a member of the public rather than an actor. It actually made certain sections (like ICE) feel much less awkward than usual because the patient did actually have their own genuine concerns and hopes for the outcome.

We found the consultant and did a not-fantastic job of delivering the history back to him, which is not something we've actually learned how to do yet. After our hatchet-job attempt, he took us through a structured approach to delivering a 5-step history in such a way as would be relevant to an actual consultant, which was very helpful. This I think is the advantage of being in a slightly smaller hospital - the staff are all extremely helpful and willing to give you one-on-one contact if you need it. A very good learning experience.