The musings of a fourth year English medical student

Sunday, 30 October 2016

THE FUTURE OF THE MEDIC JOURNAL?


Hello lovely people,

I thought I would update you all on what's been going on and the direction I want to take The Medic Journal.

I am nearing the end of my psychiatry placement and I am very glad of that! I have learnt about a speciality I have not been exposed to before, but psychiatry really isn't for me. I am very interested in mental health, as you know, but the life of a psychiatrist is not for me. There are many ways to practice psychiatry, and most consultants sub specialise. I was working with a lovely neuropsychiatrist in an outpatient facility, and now I am visiting nursing homes and disability centres. I've found the pharmacodynamics of the medications fascinating. 

When it comes to my own mental health, I have never been better. I truly do not feel like I have depression anymore. I am in the process of coming of my anti-depressant, Sertraline. I am so grateful to walk around and not feel a massive weight on my back; to look out and only see things in a grey scale. That is how depression felt for me, that there was no hope and I was a terrible person. I don't feel anything like that now, and I am so happy with my life. I feel very settled in Liverpool, I am loving being on placement rather than in a stuffy lecture theatre. Rob and I celebrated two years together on Friday and we had the most wonderful time. 


I have spent a lot more time on my hobbies this year. I have put a lot of effort in to styling my room and I am extremely happy with it. I don't know why, but having a tidy room makes me feel so cheery and calm. I am obsessed with gallery walls and am currently building up my own collection of art for my bedroom. I wanted to be an interior designer before I decided medicine was for me. Once I have my camera I will write a blogpost about my room.



I also really want to get more into fashion. I've always been the girl who would much rather read Vogue than a fictional book. I would spend ages pouring over the images, but never had the balls to execute the looks. I'm going to try to be more brave with my outfits and share them with you.

Overall, I want The Medic Journal to cover lifestyle as well as medicine. I'm also going to do some revision posts, as I've finally figured out what works for me!  You can look forward to my usual ranting alongside fashion, beauty, home and food. 

Kate x
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Thursday, 20 October 2016

PSYCHIATRY

My psychiatry placement has left me feeling emotionally drained. I wasn't sure whether to share this on the blog, as it isn't exactly cheery, but this was the first time I got proper emotional about a patient.

The first history I ever took off a patient (back in second year) was from someone who had attempted to commit suicide. So, going into my psychiatric placement a year later, I wasn't stumbling into it with total naïvety. Having said that, I found myself holding back tears throughout most of this placement. I was meeting patients who had suffered years of abuse of all forms, which had contributed to their conditions. One patient had a son who hung himself at age ten. Another patient self-harmed in ways that I found incredibly disturbing, which I won't share. Others who had such low self esteem that they decided not to press charges on their abusive ex-partners.

What was so upsetting about these patients' lives was knowing that the things they really needed we couldn't give. Almost every patient's problem was affected by money/housing/family/friendships/work. And of course, those things cannot be prescribed. In addition, many people developed psychiatric problems after caring for a loved one with a psychiatric problem. One patient had a fragmented relationship with her violent alcoholic son, which lead to her attempting suicide.

Now I feel sort of numb. I feel angry that our government can't support these people better. I feel depressed knowing we couldn't really help them. Doctors are seen as healers, but some things like this are beyond our realm entirely. 

I think it's hard to get the right balance between empathising with your patient and not letting it affect you personally. I've asked doctors how they handle this but received vague answers. I'm sure I will be better at balancing those tasks  with time, but I'm not really sure how. 
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Sunday, 9 October 2016

CLINICAL DOCTOR OR ACADEMIC DOCTOR?



The thing that has surprised me about medicine is that there are so many ways to practice it. Of course, I was aware that there are loads of career specialities I could pursue with a medical degree, but often I am wondering what kind of doctor I want to be. I've always been the person looking 10 steps ahead, rather than appreciating what is in front of me. And so despite only being in my 3rd year, I'm trying to figure out my career now. Realistically, I have at least 4 years until I have to choose the speciality I want to pursue, assuming I don't take time off or do an intercalated degree. But I still have no idea.

I went to an intercalation talk on Friday, and what one of the speakers said really hit home. The anaesthetist finished his speech by saying "Do you want to be the person following the guidelines or writing the guidelines". The way he said it suggested that the former would be too boring, and not ambitious enough. 

When I decided I wanted to be a doctor, it was because I loved biology and talking to people, but hated doing laboratory experiments. I wanted to understand people's lives, as well as how drugs work on the body. I love chatting to patients and letting them tell their story. And so when I got to medical school, I was astonished that people wanted to sit in labs and pipette things, use PCR, interpret data and calculate P values. I thought that was the point of other science degrees, and medicine was about the application, not the process. There are now plenty of medical students who are eager to get published, do intercalated degrees with their own research projects. That really isn't for me. 

However, I'm stuck  in this slightly awkward position of trying to enhance my career without doing things I know I hate. Involvement with research and extra degrees really help your medical CV and may help you to clinch your favourite training programme. They are not essential, but many of the high fliers have them. 

For some people, the glamour attached to a particular speciality is worth something. For example, being a surgeon seems a lot cooler than being a GP. But why do we think that? We need the surgeon and the GP. In first year, I wanted to get published, do an intercalated degree and hopefully be a surgeon. Now I've realised anatomy is bloody boring without knowing the physiology and clinical application of said knowledge, and sitting in my room on my laptop or in a lab doing electrophoresis are equally boring. The fun stuff is in the consulting room, on the wards, wherever the patients are. 

If writing the guidelines means looking at confidence intervals in the library, I'd much rather follow the guidelines and actually be in front of the patient.
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