Chuz out mang

At a time when many of my Esteemed Colleagues are having brain implosions from the tension and stress of having to prove that they are not idiots, I am floating in an ethereal world of bliss and happiness - it's like Nirvana but with cheese on toast and a gin and tonic. 

What is the secret of my success?  Simply this: I have so much on my plate that I can't even see the turd underneath the mashed potato.  So I'm just digging away with my fork saying yum yum yum, due to get a nasty surprise soon but carrying on regardless.

I'm moving house on Tuesday.  Actually, we've already started.  Yesterday my Smaller Half and I spent all day smashing our possessions into small pieces, tipping the debris into boxes, loading the boxes into our cars, driving up to town, unloading the boxes from the cars, tipping the boxes out onto the floor of our new house and gluing the pieces back together again into new and exciting combinations like some kind of domestic version of Voltron - Defender Of The Universe!

I hate moving so much that at the moment it completely dominates my every waking moment.  Intellectually I am aware that I have my Death Star Exams in a few weeks but it is having no emotional impact on me at all.  I'm not boasting about this - I think it's actually quite bad because it means that until the end of this week when we are finally mostly settled in to our new place, I am highly unlikely to actually do anything studywise.  Shrug.

The other thing I have on my plate is my fractious relationship with my supervisor.  After last week, when I emailed him and the university informing them that I was not prepared to have him supervise me any more due to his almost total lack of constructive criticism and fondness for asking "Have you stopped beating your wife"-style loaded questions, things have kind of died a whimpering death.

The university people were all very supportive of me, my supervisor sent me an lengthy email talking about a different issue entirely, and that's about it.  I went back to the clinic during the week and I was like the invisible man.  I saw a few patients, helped out a bit with a collapse and a chest pain, but none of the doctors or admin staff talked to me about what's going on.  My supervisor gave me a strained smile and waved across the waiting room at me.  So right now I don't now if my name is Mudd, if I have a new supervisor, or if the whole thing has been written off as me having a pre-exam mindfart that we should all awkwardly pretend never happened.  Shrug.

In the meantime, I'm going to spend today doing some study.  Eeeeexcept I just realized that all my textbooks are up in town, glued together in the shape of a giant marauding ant robot.  Bugger.

The OSCE is like a dose of clap

In a few weeks I'll be sitting our final OSCE (a practical exam).  There will be twenty stations, each of five minutes.  Because there are more than twenty people in my class, we're divided into in four groups: a morning and afternoon session each of which has two parallel "streams" running at the same time with the same stations.

Yesterday we got the email allocating us to our spot in this big chaotic event.  I am not pleased that I am in the "yellow" stream.  This immediately made me think of Whistler telling the Prince Of Wales that he was like a stream of bat's piss in the Monty Python sketch about Oscar Wilde.  That's not really the image I need to get me psyched up.

So I'm going to think of it as the gold stream.  When the rebels attacked the Death Star, did they have a yellow squadron?  No, they had a gold squadron.  Red, blue, gold, green.  Much better.

Actually, since I am listed first on the list of stations, I think of myself as Gold Leader.  A quick check on Wookiepedia shows that this makes me Jon "Dutch" Vander.

Which is nice, sure, but there are a few problems with it.  First, Gold Squadron was flying Y-wings, not X-wings.  Y-wings are pretty gumby starfighters if you want my opinion.  X-wings are where it's at.  The Y-wing is to the X-wing as C-3PO is to R2-D2.  And second, Dutch was shot down and killed by Darth Vader after he panicked during the trench run on the Death Star exhaust port.  Not a good omen for my OSCE outcome. Hopefully none of the OSCE stations will involve exhaust ports.

Still, at least I stood up for what is right and sacrificed myself to help defeat the Empire.  Maybe I'll get bonus empathy marks to make up for my lack of galactic competence.

Plummer-Vinson (Paterson-Brown-Kelly) syndrome

Dysphagia and ... ...
Screw it, I'd rather be a
Landscape gardener

Buerger's test

Elevate the leg
And observe it for pallor,
Dependent redness.

Myasthenia gravis

Eye muscle fatigue
Is often the first symptom -
Pyridostigmine.

Henoch–Schönlein purpura

Little red bumps, sore knees,
And a bad pain in the tum?
Monitor kidneys.

Hyperglycaemia

The patient must have
Much too much glycaemia -
So give them no more.

Hypoglycaemia

The patient must have
Not enough glycaemia -
Give glycaemia.

Concerning poems in the haiku form

The more keen-eyed of my readers will have noticed that I've been on a bit of haiku fling recently.  It's kind of my thing - I get caught up in an idea and have trouble moving on until I've wrung all the fun out of it and given it a few more squeezes just for good measure.  You may remember my similar binge of appalling Ernest Hemingway jokes about six months back.  Or my stuttering War On Innumeracy.  Or perhaps you've suppressed those memories.

Anyway, some of you are getting sick of my poems in haiku form.  Some of you like them.  And some of you are getting freaked out by them.  The first two responses are fair enough.  But please, please, do not respond by getting freaked out.  These poems in haiku form (dammit, that's getting tiresome to type, I'm just going to call them haikus from now on!) are not, as you may think, a representative sample of my medical knowledge.  They are the entirety of it.  Every time I learn something new, I write a haiku.  So if you come across something you don't know yet, just think of all the things you do know that I haven't written about yet.

I had a big start to my study binge.  I learned 4 or 5 new things that day.  Since then I've really slowed down.  But that's okay, medicine is not a race.  Not unless somebody is dying right in front of you, in which case it kind of is a race, except it's the winner who dies.  So why rush?

So I'll finish this post with a haiku about medical haikus just to be a little bit post-modern.

Medical haikus
Encapsulate my knowledge
In pithy verses.

(image swiped from savagechickens.com without permission but with much admiration)

Neostigmine

Quickly reverses
Neuromuscular blockers.
Give atropine too.

Hypoparathyroidism

Back pain, cataracts,
A tourniquet makes hand jump,
Tap the cheek for twitch.

Seven affirmations

As you may know, I live in interesting times.  Just had a bust-up with my supervisor, moving house next week, exams in a couple more weeks, baby due a couple of weeks after that.  By this time in December I will be a tiny wizened old man.

My Aged Mother was clearly concerned about me so she emailed me to remind me to recite my Seven Affirmations every morning to keep my spirits up.  I had to admit to her that not only do I not recite them, I do not actually have Seven Affirmations.

Sure, I have a morning recitation, but it goes like this:

1. Arrrgh, somebody get that cat off my face!
2. What's that godawful noise?  Snooze button!  Snooze button!
3. It's happening again!  Turn it off!
4. Oh my god, look at the time!  Get up!  Get up!
5. It's freezing in here!  Where are my ugg-boots?
6. I think my bladder is about to explode!  Run!
7. Maybe I'll cut back on coffee next week.

I don't those are the type of Affirmations that my Aged Mother wants me to make.  I think she wants me to leap out bed and say something like:

1. I am beautiful.
2. I am intelligent.
3. I am certified in the use of power tools.

and so on.  But (as is probably obvious from the paltry list above) I can't actually think of seven things that are positive (as opposed to not negative, such as "I am not anaemic").  I think the problem here is that I'm a medical student. Somebody is paid a rather large wage simply to tell me what a hopeless sack of shit I am.

Well, the joke's on them.  I am certified in the use of power tools.

Hyperparathyroidism

No get up and go?
Drink so much and pee a lot?
Find adenoma.

Haemochromatosis

Bronzed diabetic,
Arthritis and bad liver -
Treat bloody often.

Kawasaki disease

Red eyes, mouth, palms, soles?
IVIG will reduce
Ruined heart vessels!

PR, RR, BP for birth, infant, toddler, child.

One sixty, fifty,
Seventy at birth.  Fifteen,
ten less, fifteen more.

Red flags in paediatric heart murmurs

Loud diastolic
Harsh heart sounds when lying,
Aortic symptoms.

Kallman syndrome

My dog has no nose!
Oh really? How does he smell?
Simply terrible!

A simple question

So what is the plural of haiku?  "I wrote a haiku.  I wrote many ..." what?

Haiku?  Maybe it's like giraffe or wildebeest to hunters.  "I shot a brace of giraffe today."
Haikus?  Perhaps, but it's not an English word, so do you still pluralize it like an English word?
Haiku's?  That doesn't seem right.  As far as I know the only place that apostrophes are correct for pluralization is for things like the 60's and 70's.

Perhaps someone could google it for me. I'm a busy man.  I have bridges to burn.

Pertussis

Paroxysmal cough,
So bad you thought you'd vomit.
Vaccine lasts five years.