The musings of a final year medical student

Sunday, 26 July 2015


I passed my first year of medical school!

However, it certainly didn't happen with ease. I didn't pass all my exams this year, missing the pass mark by 5% and so had to retake.

This is NOT a fun process, but I learnt a hell of a lot from it. I am not shy from admitting I had a certain degree of arrogance to my course content. If something wasn't covered in a lecture then I didn't see the point of learning it, even though it was a learning objective. If there's one piece of advice I would give, it would be that you can never read too much around the subject in medicine. Surely if the lecturer can't be bothered to mention it then it isn't relevant? Sadly not. 
The learning objectives can be very vague. For example, if a LO says simply 'meiosis' this can be quite tricky. Do I learn my A level version of meiosis? The one in Tortora? The one in Medical Sciences? The one in Essential Cell Biology? Wikipedia? Or do I amalgamate them all into one 'mother explanation' of meiosis? The particular lecturer who covered genetics wasn't the best and his lecture slides left much to be desired.

I digress.

One thing that really struck me when I learnt that I had to retake was how nearly every doctor-friend I told then told me that they had to retake *something* at medical school. A Bristol-educated now neurosurgeon that my dad knew apparently failed every exam and exam retake you could imagine. I know other surgeons, anaesthetists, GPs and others who failed a variety of exams, whether it be first year or finals. 

I'm not saying that is any excuse, but I'm glad that I got the kick up the backside that was needed at the start of the course rather than at the end of it. Revising at home whilst everyone was at festivals and far-flung holidays wasn't great. There was an ever-present burden in my head that there would never be a point where my revision was complete; I could never know too many CT scans, I could never revise muscle compartments too much. However, I am so glad that there was never a point where I questioned "Is this worth it?". The thought of losing my precious place at medical school after working so hard to get it was terrifying. I was not going to waste the opportunity I had. 

Having to retake made me feel like I had let everyone down, including myself. It also made me feel inadequate, and it could have been a sign that medicine wasn't right for me. I was furious with myself. How did I not pass when this is the vocation set so rigidly in my mind? There never was and still is no back-up plan if medicine doesn't work. Nothing will ever be as good as being a doctor. 

I had already applied for mitigating circumstances due to various health problems I have had to put up with this year. This meant that if I had failed the retake I would have had grounds to appeal. Fortunately it didn't come to that. 

The morning of retake results was hard. I thought I was going to be sick as I furiously refreshed my emails. And finally, those big red letters next to my exam code saying 'PASS' appeared. I was delighted. 

So, I've had my first proper week of relaxing in the knowledge that I am going into second year this September. To be honest, I'm already bored. I've been travelling and having fun, but I actually miss reading textbooks. I miss opening up my new clinical cases and deciphering the questions set. I want a reason to get out of bed early in the morning, something that is fulfilling and worthwhile. This is such a comforting feeling, a real appetite for knowledge. It is comforting because it confirms in my head that medicine is right for me. I am smart enough. I can do this. And most importantly, I want to do this. 

If you ever have the bad luck of retaking a medical exam, I feel your pain. It is horrible. You feel like shit. It's a cliché, but what doesn't kill you makes you stronger. You wouldn't be at medical school if someone didn't believe you had the potential of being a great doctor.

Sunday, 19 July 2015

Stop putting yourself down

I am realising more and more that sadly, as humans we are conditioned to not to like ourselves. Is this part of our DNA or due to the society that we've created for ourselves? I wish I knew. 

Regardless of the reason why we are all to some extent self-deprecating, I think it's something we need to address. I started my new Twitter account, @TheMedicJournal, and whilst it's a very small account, one of my tweets got some attention. The mental health charity, Mind, started a conversation about the one thing you'd tell a stranger about yourself under the hashtag #DearStranger.

Clearly a lot of people feel the need to be perfect, or the most perfect version of themselves. What is perfect? To me, it's according to what society defines as a successful person: great career, slim physique, expensive car, big house, perfect partner and fabulous friends. The perfect person doesn't oversleep and stumble into work with no makeup on and greasy hair; perfect people aren't meant to have duvet days eating Nutella out of the jar. But what is wrong with that? What is wrong with being human? Particularly when nobody is immune from these so-called 'flaws'. Why is it so hard to accept that we can't do everything in an orderly and civilised way? We're not robots and we shouldn't aspire to be like them, either.

I definitely ask too much of myself, as do most people. The other day, I had one of those days where everything goes wrong and after an achingly long day of holding it all together on the surface, one little comment scuppers that façade - the floodgates had opened. I really thought that I hated myself at that point, I wasn't even crying about anything in particular, just that I felt like a failure. My mum was very nice about it and reminded me of my previous academic and extra-curricular achievements, and it was the first time that I actually recognised that I had achieved them. When I was doing those tests, I just got on with it, not taking any perspective or giving myself credit just for trying. But at the same time, I feel strongly that those pieces of paper with my exam results don't mean anything. Sure, they're helping me to further my career which will shape my life, but we as people do not have to be defined by our achievements. You don't need to have a single grade to your name to be a decent person. You don't have to be clever to love your job. You don't have to be any specific dress size to be loved. You can't buy real friendship. 

Being perfect is not the epitome of self-fulfilment, and we need to remember that. 

P.S all I've done today is watch Netflix in bed and play Débussy on the piano, and I'm totally okay with that because I'm not a machine 


Saturday, 18 July 2015

My food bucket list!

Twitter: TheMedicJournal

Hey everyone, 

Apologies for the lack of consistency of blogposts.

In preparation for my orthagnathic surgery, I had a pre-op assessment with a nurse at the hospital where my surgery will take place in 13 days! I am so excited for this op.

Anyway, the assessment was basically like a health MOT. She checked my blood pressure (slightly below normal), pulse (normal), BMI (normal), did some chest auscultations, checked my family history, allergies, and quizzed me on anything you can imagine! I had to bring in a urine sample (gross) and then I had to swab myself for MRSA in a nostril and upper thigh. I have no idea why those areas, but I did it anyway. She then sent me off to the phlebotomist to get my blood taken, checking my liver function amongst other things. Another blood sample has to be taken less than a week before the operation, so it's good that I'm not scared of needles!

I have one further appointment with my surgeon and an appointment with a dietician and then I'm ready for surgery.

I decided to write a food bucket list because I am a massive foodie. I love cooking and I love my food. So, I am anticipating that when I am on this liquids-only diet after the operation I will be in a very irritable state. It will be a good two months until I will be back to eating normal food again, so here is my list:

- Thai green curry
- Sushi
- Chinese takeaway
- Porridge with mashed banana (weird I know, but SO GOOD)
- Sweet potato chips
- Ben & Jerry's ice cream
- An almond croissant
- Pancakes
- Sticky toffee pudding
- Fruit salad
- A roast dinner
- A fry up 
- Steak (it will take a long time until I can handle something as chewy as this after the op!)

A slightly strange list I know, but these foods will be sorely missed! 


Sunday, 12 July 2015

Orthagnathic surgery

On the 31st of July 2015 I am hoping to have my long awaited orthagnathic surgery to correct my overbite.

I have mentioned this surgery in previous posts but will go through it again.
I get so many questions about the operation, and most friends look exasperated and a little scared for me. So, I have structured this post to explain the When/What/Why/How/Whos surrounding my orthagnathic surgery.

I would like to put out a disclaimer that I am not in any way an expert, and my personal explanations are formed from information accumulated from my surgeon, orthodontist, dentist, the internet and general heresay. This operation varies from surgeon to surgeon and country to country, so  this information is specific only to my own case and my experience of NHS care in England.

What is an overbite?
The maxilla and mandible are meant to lie parallel, and most people find that the lower teeth are slightly behind the upper teeth. For me, the lower teeth are more recessed than what would be usually expected. An underbite is the reverse problem; the mandible protrudes further than the maxilla. Many friends have told me they've never noticed I had a 'funny jaw' - it can be quite subtle for some people and much for noticeable for others. The overbite means I can actually stick my tongue out between my front upper and lower teeth when I bite my teeth together! 

What is it like to have an overbite?
For me, it's very embarrassing and frustrating. Despite most people not noticing there is anything particularly wrong about my jaw, it causes several problems for me. Firstly, I can't keep my mouth closed for more than a minute at a time. This may seem very simple, but it is something that really gets me down. If I try to keep my lips together, the muscles surrounding them become very sore and I get an aching, throbbing sensation. Eating is also difficult, and I am always worried people are going to notice, although they almost never do. It's rude to eat with your mouth open, but I find it really hard to chew with my mouth closed. I also get jaw ache whenever I talk too much or become stressed. 

When did I know I had an overbite?
I first noticed there was something wrong with my jaw when I was preparing for a flute exam. I was 13 and was preparing my pieces for my grade 6, and I started to notice the aching and throbbing sensation around my mouth that I mentioned in the previous paragraph. It became very uncomfortable to maintain the correct mouth position, and by the end of an A4 side of sheet music my mouth would throb so much that I had to have a break from playing and wait for the sensation to stop. I had to give up because I couldn't progress due to this problem, not knowing why it was happening. I saw an orthodontist at 15 who told me I had an overbite and offered me the surgery. It all made sense after she had explained it. 

Why am I having orthagnathic surgery?
Initially, I said no to the operation. I didn't understand how it worked or why I needed it. I then did some research and also consulted my dentist. She informed me that the operation would stop the jaw ache, I would be able to eat normally and I would be able to close my mouth comfortably. She also warned me that if I did not have it done then I would run the risk of molar erosion due to the uneven distribution of weight caused by the overbite. There was also a possibility I could start playing the flute again. So, after a lot of consideration, I realised that this operation could benefit me in many ways and in the long-term, and I said yes.

What does the surgery involve?
The surgery is performed by a maxillo-facial surgeon, and they are required to obtain a degree in both dentistry and medicine. The surgeon makes incisions on the inside of the mouth (so no visible facial scarring), and breaks the jaw bones. He or she manipulates the bones according to very precise lengths arranged prior to the operation and then secures the bones with metal plates. The surgery requires the patient to go under general anaesthetic and takes around five hours. These operations vary depending on the individual's case. For example, some people only need one jaw moved; I require both to be altered, so the operation lasts longer. 

What happens after the surgery?
To use my orthodontist's words: "You'll look like you've been hit by a bus". Charming. The facial swelling varies from person to person; pain relief is prescribed and is often taken for the first week or so. After a day or two, elastic bands are attached to the braces vertically; the bands will attach from the upper tooth to the immediate bottom tooth below it. This is so that the range of motion of the jaws is limited whilst they are healing. Consequently, you can't open your mouth much at all! The elastic bands stay on the braces for about a month, and during that time you are resigned to a liquid-only diet. For this, I am booked to see an NHS dietician to give advice of what to have during that time. Once the elastics are off, soft foods can be introduced, progressing slowly back to a regular diet. Your face will look 'more normal' and proportional. It can also affect the position of your cheek bones and your nose shape and width slightly. Normally people need 2-4 weeks before they feel well enough to go back to work, and normal speech will come back after about a month. 

Is it cosmetic?
I thought initially it wasn't at all, but it can be depending on the individual. This is an NHS treatment that was offered to me in order to help me feel physically more comfortable on a day-to-day basis and prevent possible complications in the future. For me, that is the only reason I chose to have it. Given that nobody ever suspected I had a jaw deformity, it is unlikely that this operation will have a dramatic change to my appearance. In my later surgical appointments I was told that because they were also moving the maxilla upwards 3 to 5 mm, this would mean that I will show less gum and teeth when I smile. I didn't get any say in this, and I didn't ask for them to correct my smile - I don't have a problem with my smile! It is a part of the corrective process. 
However, I know that for some people, having an overbite/underbite has crushed their self confidence, and I can understand why they would want this surgery to help them. For some, a jaw deformity is the same as having a big wonky nose or a cleft palate; some people have put up with years of bullying just for how they were born. I am very lucky that my overbite isn't very noticeable and I have never had any confidence issues surrounding it. A blogger called Leanne Woodfull has documented her orthagnatic surgery experience, and her underbite was a massive contributor to her depression. She describes in one vlog on her YouTube channel that if her surgery was delayed again she wouldn't want to live or she would "jump out of a window". I found that heartbreaking to hear, and I am so happy that orthagnathic surgery has empowered her and boosted her self confidence. 

I am prepared to show before, during and after photos and document the process in order to shed some light on this operation. It is a massive decision for anyone to make and should not be taken lightly, and I want to help other people make an informed decision. 


Tuesday, 7 July 2015

8 photos of happiness - tag

I was kindly nominated by Hannah from Pull Yourself Together. She is one my favourite bloggers because she is so consistent in updating her blog; I also love her style and admire her courage for speaking so openly about depression. On a personal level, her posts really have helped me and I know that they help so many others.

I love the idea of this tag, it's so uplifting.

The rules of the tag are as follows:
1) Thank your nominator/s and link them in the post
3) Post your 8 photos of happiness - the photos can be anything that represents a moment, object, place or feeling that makes you happy.
4) Pop in a brief description of the photo, why you chose it or just let the photos do the talking!
5) Spread the happiness and tag up to ten other bloggers!

I am absolutely mad about the performing arts. I started acting classes at 6, and later took up piano, flute, singing, ballroom and latin dance. Although piano is my strongest area, I don't think I've ever felt happier than when I'm on stage. This photo was taken aged 13, when I got my first title lead role in 'Daisy pulls it off'. It was only a school production, but for someone who had very low self-esteem and had done so many productions and only got the 'chorus' or small role parts, it felt really special. Two years later I got to play Eliza Doolittle in My Fair Lady, and I don't think I would have had the guts to audition had I not already played this role. My drama friends at school were brilliant, and we were such a tight knit group. Nobody has ever made me laugh harder than those people. 

What is Matt doing?! This was my 18th house party. I still think house parties are my favourite kind of night out. I had the best time at this party; I had a limit of 30 invites but may have gone a bit over.... 
As I have a December birthday, I had a Xmas theme, and most of my parties have been themed. We all had great time, although I do remember cleaning the house at 3am with Mum because it was Christmas Eve the day after... she wasn't impressed. 

This is me and my Granny, who is a massive inspiration for me. I think my love for fashion and beauty came from her. She always had perfect nails, Gucci watches and a timeless sense of style. She did so much in her life: Parisian finishing school, then took over her Dad's wine merchant business in Chelsea, and worked for Gucci Timepieces. Later in life, she worked for charities and currently works for a Champagne academy even though she's in her 70s. She's outspoken, hilarious and driven. 

Barcelona 2014. This was crazy! It was the typical first holiday without the parents, just after our A levels. We got tipsy on the EasyJet flight on mini Malibu bottles which I've kept as a momento. We had the best time. The stand out memory from that holiday was going to a club called Razmatazz and the boys forgot their ID, and us girls partied until the club closed around 6am. It was the perfect celebration for 2 years of hard work and well earned freedom. We then got stuck at the airport on the way home and had to sleep on the floor. Ellie and I decided that singing rap music very loudly at 3am was a good idea, as well as spending all my left over euros of Absolut Vanilla vodka and then drink it neat. I did get some dodgy looks. 

There was a pub near our secondary school that we always went to in our last year of A levels. It was special for all of us because they serve Stowford Press cider, which you can't get anywhere in Liverpool, I've tried! I probably should have spent more time at college than the pub, but that last year was wonderful. 

This was Halloween 2014, my first year at Liverpool. This year has been bittersweet in that there have been incredible highs and very desperate lows. But these kids were so much fun to be around. I had an absolutely wonderful time whenever I was with them. I had no idea that the first person I met at uni was then going to end up being my boyfriend. They always say don't sleep with your flatmate, let alone go out with them! I am forever grateful that there is someone who has seen me at my best and my worst and never thinks any less of me; my first year would have been so different if we hadn't met.

Skiing holidays are by far my favourite, but this was the best one. One night, Lucy, Jessica and myself went to a bar that had a board of drinks where the price changed every 60 seconds. We had a great time, above are 'after eight' shots. We then went on to find our parents at a karaoke bar and then went to this strange nightclub, with our parents!! I never thought I would say that I've been clubbing with my parents, but sadly I can.

The first term of uni was so blissful; very little commitment, just partying and shopping. This was from the Medics Ladies' dinner, and we had a fantastic time. This was also poignant for me because it was the first time I felt accepted. I didn't feel like I was the 'fat friend' or whatever, I was so nervous about wearing this bodycon Missguided dress, but I felt great and had a lovely time, but drank way too much sparkling wine!

Anyone who feels like doing this tag can do it :) 

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