Wednesday, September 29, 2004

Immunol Clinic

Sat in with the immunol clinic today. HIV patients, Hepatitis patients, patients with SLE, patients with some unknown immunological pathology, overanxious parents who work in the health profession.

Boring as hell.

Went to the Grand Round, listened to the talk for a bit, which was about the history of the lumbar puncture/epidural anaesthesia. It was quite interesting - back in the early 1900s the smart doctors who invented this injected cocaine into the epidural space of one of their esteemed colleagues. It worked, of course, and then they proceeded to test its effect by pinching his testicles, whacking his ankles with iron bars, giving him nipple cripples, effacing his pubic hair, amongst other forms of inflicting pain.

The poor guy didn't feel anything until the next day when he woke up with no pubic hair and swollen testes, ankles and nipples.

Ouch. What a way to dedicate yourself to science.

Other than that, the day sucked. Boring lecture at Grace Vaughan House.

Tuesday, September 28, 2004

STD Clinic, and bad news about the car

So I tried my best to be late to the STD clinic today. It's 7.30, and my dad's asking me what time I need to get up. I lie and say 7.45, when I know the bus I normally catch leaves at 7.55. No way I could get that bus that quickly. -Anyway, I take my time and miss that bus, catching the later one. I get to Warwick at 8.30am.

After that, I caught the train; got to Perth at 8.45, and then caught the CAT to RPH. Arrived at Ainslie House at about 8.51am.

And I'm early, despite my best efforts.

STD clinic wasn't nearly as bad as I thought it could have been. Saw some interesting things that I hope I never see again. Genital wart, herpes, chlamydia, vulvar vestibulitis.

It was eye-opening to say the least.

The microbiologist was really nice - got to see some nice slides of those things I never bothered to learn. eg

What is the pathology?

This is a pap smear. Look at the bottom right hand corner of the pic. That entire cell is covered in bacteria. Mixed flora, including Gardnarella. This is bacterial vaginosis.

It's meant to be Gardnarella vaginalis, but in reality it's an overgrowth of that bacteria and lots of others too, like anaerobes and stuff.

You can't see chlamydia on the gram stain. It's an obligate intracellular pathogen, but it's almost impossible to see. Diagnosis is made clinically and via the presence of neutrophils on a high-powered field.

With gonorrhoea you see gram-negative intracellular diplococci. They're not hard to see.


Candida. Yeasts. You can see the hyphae (fronds).

Anyway, after that clinic had a quick lunch, met some guy called Ian who's a friend of Winston's. (Physio student)

Then went to the team meeting and then a long ward round.

Back home at 5pm.

Arrived home to the news the car won't be ready until October 20!

Damn.

Hmmm.

Go to sleep!

Monday, September 27, 2004

Astra



That's the car. Except its a hatch.

I should be studying. Getting a bit scared about the exams... They're very soon, and potentially very failable.

STD Clinic tomorrow. Should be 'interesting'.

Sunday, September 26, 2004

New Car

Oh, and I got a new car yesterday. It's coming on Friday!

Holden Astra Classic, 1.8L in Lightning Silver.

Infectious Diseases

Tomorrow I start my final term of the year: ID. Hoep to see some good cases, perhaps of TB, syphilis, etc. Also hope to learn a bit more about antibiotics and other treatments.

Very worried about the exams though. I need more practice examining patients! At least I'm a little more confident than I used to be now. I can fake things better: "Ooh, I heard a murmur."

Anyway. I'm still thinking about the meaning of it all. In 100 year's time none of this will matter.

Saturday, September 25, 2004

Stuff

So what's been going on with me? Well, lots of things. On a superficial level, I've finished another term. Ophthalmology is over. This leaves Infectious Diseases as the only remaining two weeks between now and exams. It's a tad scary.

Who the hell cares about my exams anyway? I still don't. I've only just realised that I should start studying - and already I can see that I don't have enough time to study everything. It was strange - things just seemed to shift between 'oh there's plenty of time to go' and 'oh crap, there's no more time left'. There was no middle.

And then. Following exams I expect I will have a holiday, whatever that is. I have gotten two weeks off this year, in April. What good did that do? I can't remember. It was that long ago. But after the exams are over I think I have until the end of January. So that gives me roughly 3 months off.

I think I'll learn to play the guitar.

So what else has been happening? Well... I still haven't finished saying what happened during my busy week. It was at the end of psych wasn't it... Yeah. On Monday, or Tuesday (can't remember), I had the Psych Exam. The dreaded psych exam. Where they lock you in a room with a psych patient for an hour and you interview them, diagnose them, and then present your findings to the examiner before they grill you.

Anyway. Mine was fairly straightforward. Major depressive episode. This patient had also had some psychotic episodes. So she also had a past dx of Schizophrenia. Funnily enough I got my mark back recently. 70%. Not bad. Not good.

And then I crashed the car on the Wednesday. Oh yeah. I was driving in to RPH in the morning to get my book signed off by Doc Armstrong, and I was cleaning my windows with the washer thingy. Whilst I was driving. That's not a smart thing to do. I suggest you don't do it. Anyway, I crashed into the back of this white stationwagon. And withing about 10 mins the towtrucks had arrived. And then lots of stuff happened. But I'm currently without a car.

Funnily enough, I may/likely will be getting a car tomorrow. A Holden Astra Classic. The new ones are coming out in December and these ones are going to get superseded. So we're hopefully going to get a demo model, at about 17000 hopefully. And I've paid my 100 buck fine.

And I bought a pink shirt. And I bought Sarah some blue Pumas. She loves them. And I'm very poor now! So poor that I couldn't afford the train ride home today after this evening. I reached into my pocket and there wasn't enough change! Haha. That's something that only happens in movies and videoclips. Anyway I arranged my dad to come pick me up from the trainstation, so that was ok.

And then we had that Summative on Thursday. I was in shock for most of Wednesday, and then I only just passed that test on Thursday. I did, thank God.

So how am I feeling now? Tired. I can't seem to find motivation to study or go to sleep before 1.30am. It's now 12.59am. So I should be sleeping soon.

Got a lot of things weighing on my mind. Exams. ID. OSCE. Car. Holiday perhaps.

Arsenal play tomorrow. Man City should be a good game. No Pires or Berto though. So maybe RvP will get a run out.

Whatever.

Thursday, September 09, 2004

Terrorism

NEWS.com.au | Bomb an 'attack on Australia' (September 9, 2004)

So much wrong with the world today. Beslan, now this.

Makes you ashamed to be a human being.

I'm not having a good day.