Day 174 - Block 4 Over (16/03/2018)

Once again we've hit the end of another block. This I think has actually been my favourite so far in terms of learning the material (a very common view throughout years seemingly). This is likely down to high anatomy content and logistic approach to things - and the relative density of Block 3, of course.

In the morning we covered assessment of palpable masses, essentially a primer to abnormal dermatology to follow on from our lecture teaching. Turns out there are a lot more names for weird skin lumps than you'd think, and virtually all of them are gross. This was followed by revision of the thyroid exam, which I managed to technically pass despite a poor attempt from lack of practice. I'm starting to get the idea that it's reasonably difficult to fail a Year 1 OSCE based on my experiences with them so far.

Managed to nip away a tiny bit early to catch some optional neuro teaching on one of the trauma wards, which was a fascinating experience. It was essentially consultants talking us through an interesting case, and really managing to put the neuroanatomy on a level we were able to understand. There were also some things a room full of neurosurgeons straight-up didn't know off the top of their heads and had to google, before devolving into an argument over some obscure nerve. It was funny and grounding at the same time.

From then I went on the wards shadowing one of them, who was excellent to be with, always explaining what he was doing. There seems to be the possibility for some theatre shadowing in future, but the focus of this afternoon was breaking bad news about choosing to not operate on a patient for fear of a worse outcome. It's the first time I've seen news like that delivered and it was difficult to know where to look, but I guess that must be an extremely common reality. As were walking back I asked the surgeon how he coped with the weight of that, and he said that it changes your view of what quality of life is to have to do it every day, which was very interesting, and has been echoed by books that I've read penned by doctors.


A long D&D session in the evening, playing from 7ish to nearly 3 in the morning - we're getting longer and longer, but at least we're progressing with the campaign story somewhat.