Killer toothache

My grandad was a dentist. My cousin is also a dentist. I study medicine. And yet I’m on NHS Choices frantically working out why my tooth hurts. (and getting horrified by photos of terrible teeth)

We know very little about our teeth. I don’t know when teeth and gums divorced themselves from the rest of the organs and went off on their separate ways but it is a shame because the last time I had any official teaching on my teeth was back when I was 7 years old and in primary school. I think dentists and the field of dentistry is great. But isn’t the glorious oral cavity – the entry to the human GI system, still part of well – the human? Why is this not part of being a doctor? Why is dentistry its own vocation? Why did we draw the line with teeth?

Perhaps its because I have a toothache and am suddenly very aware of my aching teeth but I’m now trying to do all the things the dentists always tried to tell us to do. Here’s a reminder incase you also forgot:

  • Brush teeth twice a day
  • limit the sugary foods (this includes fruit, chocolates, juice and even bread!)
  • floss!!
  • go see the dentist regularly (last time I went was years ago)

Thing is in most countries healthcare is free. Take the NHS for example…if you have any kind of pain all you have to do is get yourself to the doctor and everything is fine. But for dental care you have to pay. You have to actually find a dentist and it’s a bit like looking for the perfect cake – you’re never satisfied because you paid for a particular type of cake and its not there. The point I’m trying to make is that dentistry is privatised and with it the sense of entitlement goes. And perhaps the state’s vested interest. If the government has to pay for our health then it is in the interest of the government to keep people healthy. Not so much the case with dentistry.

The second reason why I think the general public is so ignorant (like me) is because everyone for some reason seems to emphasise the importance of having ‘good looking teeth’. Now lets get real. Teeth are not meant to make you attractive. They’re purpose isn’t to bag you a marriage but to help you chew foods and remain healthy. So the idea that your teeth should be pearly white and straight is great; but also a bit misleading. They should also be cavity free, not have plaque on them, not be infested with bacteria and not developing gum disease.

Teeth are much more interesting than just providing you with a good smile. Look after them – they’re just as important as your heart, lungs or brain!

Click here  for a dentist’s parody of Ed Sheeran’s ‘Shape of You’ And Click here for Ed’s original song.

Peace

-Vitzy-

Transcending the role

A week ago I met with a patient who was staying in hospital for a few days after having had bowel surgery. He was upbeat. Telling me about plans for when he would go home. Telling me about various events in his life. I took a history. In medicine, ‘taking a history’ basically means finding out as much as you can about a patient, as efficiently as you can, so that you can plan their treatment and hospital stay optimally. It requires practice and there is a technique so I thought I’d get some practice in. I was feeling quite happy by the end of the chat. The patient was jovial and I had done my duty. I got up to leave, smiled briefly and he went back to reading his newspaper. I went home that night, narrated my experience to my family and thought nothing more of it.  Continue reading

And when our brains just don’t want to cooperate…

I write when I’m excited. I write when I’m sad. I write when I cry. I pretty much write with the easiest of triggers. And yet I came here today to write about my surgical placement and found that I just didn’t want to. I actually came to my blog as a way of trying to get myself in the mood for studying. But I’m in this strange limbo where I want to work and I just can’t convince myself to actually open my books. I want to become a doctor and yet I just don’t have the energy to look at yet another x-ray, another blood result, another exam question. I feel as if my life is a video and somebody has turned the speed down to 1/2 speed. And the weird thing is I don’t feel particularly sad, happy or anything really. I’m sort of in an apathy. This is certainly not the first time this has happened. In fact I struggle with this pretty much all the time.

The thing that always gets me going is that I’m scared to fall down a path of darkness and despair. I feel like an ex-smoker who desperately wants another cigarette but knows damn well the consequences of cancer and COPD and that’s their single motivator to not do it. And my motivations are that I want to be a doctor. I love being with patients, talking to them, finding out about their life. I’m well aware that I’m not at all an unfortunate person. I have a roof over my head, a family, food and education. Not everyone is as lucky.

Rationally, I know all this. And yet I still feel this way and I can’t explain it. I’m sure in a little while I’ll be fine. It’s just a passing mood but what if one day this mood is here to stay and its staying becomes a permanent part of my life? It’s strange because all this is in my head and it is my own mind that scares me the most.

-vitzy-

Ward Rounds, Bloods and flying stethoscopes…

Medical dramas on TV were my favourite because I always imagined myself to be like Turk from Scrubs – cool and smart, or Dr. House – grumpy but loveable or Meredith from Grey’s anatomy – dramatic and brilliant, her hair always perfect.

This was me Monday morning: Stethoscope falling out of my bag, having no clue where the patient files are kept and forgetting my water bottle so that by 5:30 pm on my first day on emergency medicine placement, I looked more like a drowned rat than a medical student on placement.

Placement is essentially practical, hands-on experience at doing what doctors do. Except I know less than half of what the most juniour doctor knows and I’m pretty sure that I’m getting in the way more than I’m actually helping. Not to mention being a medical student qualifies me to be able to do exactly nothing on my own – and patients know this!

Take this morning, for example. I was sat in an acute ambulatory unit in the acute medical unit, waiting to take blood samples (venupuncture) for the first time ever on a real patient. Previously I’d always practiced on a mannequin. The first patient just flat out refused. The second one looked a little dubious but agreed in the end but his arm kept shaking, revealing his inner doubts on my ability (not entirely misplaced!). The thirds patient was eerily calm. That was good and I managed my first ever independent venupuncture. There was red stuff coming out…pretty sure it was blood!

Hospitals are busy places. You have acutely sick patients. Porters moving beds and patients around the wards. Nurses caring for their patients, doctors doing this that and other. And the bustling wards are a beautiful place to learn about the weird, common, rare and simple interesting pathologies of the human body. A sick heart can make so many sounds. Just a quick listen can illicit if somebody has a pleural effusion or more like a pneumonia. A quick chat to a nurse will tell you whether the patient is a returning patient or a new admission. The juniour doctors always know what management plan a patient is on. You simply can’t get bored. I do feel selfish in the knowledge that whilst I am here I’m really only helping myself learn.

But there’s always a moment that you remember. And I think for me today it was a small fraction of a second that sealed the deal for me. We were on ward and I wasn’t doing anything particular. All I did was look up whilst I was examining a patient and smile. I apologised for taking so long and not letting the patient finish a sudoku puzzle.

The patient just smiled back and replied: ‘you are the future. You’ve got to learn somehow’

It occurred to me quite suddenly that placement is fun and enjoyable and really exciting. But at the same time I’m not just learning for myself. By ensuring I know my medicine properly today, I’m having an impact, however small, on the lives of real people. They’re not just a disease. They’re a person.

I walked out from the ward whilst relatives were visiting. And as I walked near the doors, the patient from this morning recognised me and said ‘goodbye’.

I don’t know why but it made me smile. I might not be Turk or Dr. House or Meredith. But these small moments make me feel even more cool and smart and on top form than any doctor I’ve seen on TV.

After all, TV is fiction and hospital medicine is reality!

Peace

-Vitzy-

De-cystifying Poly cystic ovary syndrome…

In the past I have written about the clinical picture of PCOS and why it happens and all the pathophysiology of it. I’ve written about treatments and management and the psychological impact. In the past I’ve talked about my own battle with the condition (still have it 😀 ) and so today I’m trying a different tack…I’m attempting to bring PCOS back on the table but in a celebratory fashion as opposed to a problem.

I love PCOS. And studying it at university yet again has only served to reaffirm my love! It’s not a particularly pleasant condition to have. But it has brought me more in tune with the inner, finer working of the female human body. And our bodies are miraculous. Perhaps massively inefficient – after all other species don’t have periods and they can certainly get pregnant more often than for a few days a month. But the beautiful, complex and intricate nature of our reproductive cycles never ever ceases to amaze me. Starting from the maturation of our eggs (follicles) to ovulation, to fertilisation (that glorious moment when sperm and egg meet) and if allowed – to pregnancy and the birthing of a newborn human. We do that. Us. Women. So many things can go wrong with the process. And normally things don’t go wrong. A gynaecologist once said to me that if a woman never sees her gynaecologist during the nine months then that’s actually a good sign. After all babies have been born for generations. Gynaecologists only came around in the era of modern medicine.

The other reason I absolutely love PCOS is because it has made me more willing to accept unusual things about people. So you stutter? That’s okay I only menstruate a few times a year. So you have a facial deformity? That’s okay, I have hair on my face. So you worry about what other think of you? That’s okay – we all do. And that’s absolutely acceptable because we’re humans. We’re not perfect.

Also PCOS is all about hormones. And about women having hormonal problems. It combines (IMO) the two best specialities in medicine: Gynaecology and Endocrinology. If I could, I would totally create my own speciality called Gynaeo-endocrinology. Here I’d celebrate the different and wonderful and exciting world of hormonal problems that women can have.

Most of the time having health problems is sad. But when our health problems help us become stronger, better individuals, that’s something to celebrate.

I’m proud to be De-cystifying PCOS.

Peace

-Vitzy-

P.S: I have a massive rant about the importance of consent in clinical settings coming up, so watch this space.

Human Cadaver Dissection: My thoughts

Disclaimer: Please be aware that the following post contains sensitive material on dissection and the topic of death. Please read with caution. In addition, anything discussed below is purely my opinion and not meant to be educational. 


It is currently 1am and I have no idea why I have the sudden urge to write about this topic now. Guess muse and thoughts are something that we cannot control. I do urge you to read with caution though. Death and the discussion of death are important matters in both the field of medicine and society. But there is a time and place. A way of discussion and an audience. If you are not in the right frame of mind or don’t feel ready to delve into such topics, I’d highly suggest you don’t read further.

In addition, I do just want to also clarify that the views expressed in this article are solely mine and do not have any bearing on the institution that I belong to. I do not aim to educate through this and this is simply a place for me to openly discuss my thoughts and opinions on the topic of death, dissection and autopsies. As said before, please read with caution. Continue reading

“You have hair on your chin…”

A couple of months before my 15th birthday, my mum took me into the doctor’s surgery. The following weeks revolved around concerned parents, blood tests, lots of doctors including paediatricians, gynaecologists, endocrinologists and even radiologists and finally a diagnosis of PCOS.

PCOS, short for Polycystic Ovarian Syndrome, is an endocrinological disorder which affects the hormones oestrogen and testosterone. It results in multiple small follicles (eggs) in the ovaries which struggle to mature. The main result of this is irregular periods. The high testosterone results in male pattern hair growth and skin problems.  Continue reading