Monday 4 July 2011

Ch Ch Ch Changes!



Exciting times. I AM going to be a doctor, and I've just moved house!

The house we've moved to is in a small village near the hospital I'll start work in next month. It's bigger than the teeny flat we were in last year - we've a big bedroom, an attic room that we've made half music studio (him) and half crafting corner (me), a BATH not just a shower and much more kitchen space. It's lovely too, polished floorboards and exposed brickwork and beams and wooden doors. Very cosy. I've spent all week half expecting the letting agents to call and say there's been a mistake, they were never supposed to give us the keys to a house this nice.

Going through all our belongings to pack seemed like the perfect time to clear out and declutter. Exhibit A: three shelves full of A4 binders of lecture notes, charts, papers; the detritus of five years' hard study. I didn't want to throw them away, but frankly I've never looked at them since the final exam for each module. I didn't even look at them for finals revision, for that I mostly stuck with the Oxford Handbook and Davidson's (fondly nicknamed the Bible and the Beast, for any medics reading ;) ) I read through some of them then and looked at how my writing's changed over the last five years, at how concepts that seemed impossible to follow back in first year make sense now. One thing I found, filed away neatly, was my assessment from my first ever hospital placement, two and a half years ago. I was on a surgical ward in the hospital I'll start work at soon. The assignment was a case report - pick a patient, take a history and examine them, write about the investigations, possible diagnoses and what treatment they'd had. I remembered meeting this patient, struggling to remember what questions to ask, going back to examine them two or three times because I'd missed key things and he was a friendly chap who was happy to help. I remembered wondering what on earth all these different blood tests were for and how people could keep track of what numbers were the right levels for each test. I remembered being baffled and intimidated by the idea that in two and a half years I would be expected to know all this, that I'd be expected to confidently ask the right questions, examine the right bits, order the right blood tests and know what the results meant, order the right scans, be ready with the answer when the consultant asked about tiny details of the patient's care so far. Of course, two and a half years seemed like a lifetime at that point.

Our grad ball was a couple of weeks ago, a weekend of costume parties, formal dinner, fun and games with friends. As part of the formal dinner there were videoed speeches from different people at the medical school. One that really resonated me was a short excerpt towards the end. "You're all sitting there, feeling sneaky and a little guilty, thinking 'Ha! I tricked my way through! I passed, I beat the system!' That's not actually the case. What's actually happened is that, probably without you noticing it, the system has made you good enough that you SHOULD be let through."

Reading through that first case report, I got it. I wondered why I'd missed a big chunk of the history - when I got to the final page, so had the consultant marking my work. Those blood test results, numbers that I'd carefully copied from the notes accompanied by a chart of reference ranges and a biochem book, made sense on a quick read through. I had to laugh at some of the suggestions I'd written for differential diagnosis. It was the work of a bewildered medical student, and I've learnt so much since then.

I'm still scared shitless about starting work next month, but so's everyone else I know, even The Smart One. We'll manage somehow, just like the generations before us. It'll be fine.

I've still not convinced myself we're really allowed to stay in the house, though.