I was ill with norovirus for the last week of my Geriatrics placement and so couldn’t go in. Apparently I didn’t miss much but was gutted all the same (no pun intended). Norovirus is one of those things that closes wards down, so even if I could drag myself from the bathroom for long enough to go in, I actually wouldn’t have been allowed. Believe me, it was absolutely horrible. A young man like me found it hard to deal with – it made me wonder how a ward of elderly and frail people managed to survive it at all. Some don’t, is the answer to that I suppose.
Anyway I managed to get signed off by the consultant all the same. I found him sitting in his office, looking unwell, in the dark looking at me bemused as to who I was. If he were a colleague I might be concerned but I just got his scribble and scampered out, desperate for a quiet life after the week I’d had. I hope that doesn’t make me a bad person. When I start work as a doctor I know for a fact that I’m going to really struggle with the change and stress of the job. I can’t say I’m looking forward to it, which is a shame. But I hope there will be people around me for support, and feeling the way I know I will, I hope that I can provide that same support for others who may need it. But right now I’m just a student who consultants forget as soon as they meet, and I have a limited ability, socially and medically, to deal with anything.
This week we start Rheumatology and Ortho. Yesterday was a non-event – we met our consultants and were given timetables. It seems fairly laid back but there is a lot of stuff that we have the option to attend. I’ll update as we go.
For the last two weeks I’ve been doing healthcare of the elderly. It’s been good; a nice return to general medicine where I can strut my stuff again from 3rd year and bolster it with what I’ve picked up so far from 4th year.
I began the day helping to cover an absent F1′s patients. I was told to get an MMSE score for one of the demented patients in the ward. It was a slow process and required much patience as the guy tended to confabulate if he didn’t understand what I’d said, which was most of it. Eventually I got him to focus and got a score of 17/30 from him, which is indicative of his dementia. I put it all in his notes and signed myself as having done it. I hope I was useful.
After that I attended a memory clinic and was given a patient to fully clerk myself. I’d need a full history, Addenbrooke’s memory score (like a very long MMSE) and a full physical. After a kerfuffle getting a pen from a nurse (“this is the NHS young man, we don’t have spare pens.”) I sat down opposite the man and began to have a panic attack. I don’t know what it was – I suppose it just dawned on me that I had a finite amount of time to get all this done and couldn’t get out of it now. Weird. Anyway that passed and I cracked on, doing a good job according to the consultant. I got the impression he had very minor memory problems and was more depressed than anything.
After lunch I joined a ward round and lost browny points with the Reg for poo-pooing his 10mg dose of Citalopram for a patient. The Consultant agreed with me and my 20mg suggestion, which didn’t help my cause. After that I saw my first locked-in patient. He was about 70 and had dementia too. He could only look up for yes and down for no.
I started to read the Diving Bell and the Butterfly later that night.
