LME=London Medical Elective
Let's begin with some anecdotes of the last few days in paediatric gensurg:
Some heartwarming arts and crafts celebrating the Year of the Ox in the hospital
On closure of ileostomy with mucous fistula: ‘stand there cursing yourself for doing such a fine job!’ (To prevent prolapse) – as every stitch had to be painstakingly diathermied away, every suture unpicked, and the stomas reversed, adhesions lysed’ The unpicking of it all definitely took (approximately) at least twice as long as the formation of the stomas!
And while I was sat chatting with the scrub nurse, I spotted an infographic on the theatre’s door. Someone had helpfully put a fun fact: diathermy of 15g of tissue was equivalent to smoking 6 cigarettes?? (Or something similar). Oh dear. Occupational hazard indeed. :_(
On anaesthetists’ choice of music: the other day, as the surgeons were operating on a 600g premmie (the relevance: technically challenging because tiny baby’s tiny surface area + fragile + an exception degree of calmness needed) and some um-pum um-pum um-pum techno music (CLUB MUSIC BASICALLY) was pounding away in the background. Evidently, the surgeon’s annoyance skyrocketed and had to kindly request the anaesthetist to please change the music. And also, someone looped the Bridgerton classical soundtrack.
On an obviously one happy paediatric urologist who loves his job: ‘come on baby!’ let’s do it!’ – says one consultant urologist (to no one in particular) prior to a urostomy catheterisation on an (already sedated) child with renal transplant. In any other context, it may be rather inappropriate but here, grudgingly I must concede it was somewhat appropriate.
‘Maybe we should consult someone clever’ – said one paediatric surgeon, drawing some irk + unhappiness from another consultant during the virtual surgical grand round! I mean, fair enough it was a very complicated medical case beyond the remit of surgeons and requiring immunology input, but, I don’t even know what this was insinuating (or not? It can be construed as an attempt at some lightheartedness) Haha! Aigooo the offence taken by the other consultant was palpably broadcasted on the live Teams meeting on the big screen.
The testing, I mean, teaching round – preparing for the FRCS: imagine this, a consultant, a reg, 2 fellows, an SHO/trainee, 3 medical students – what a party! On the rare days where there is (literally) a handful of patients to see on the ward round, what better time than to teach all the juniors (i.e. everyone apart from the consultant herself). With the case outlined, the consultant starts off with basic principles questions – starting directly from the medical students (bottom of the chain) and making a round up the hierarchy (repeat x10 for each question) Bilious vomiting + heart defect baby – what are you thinking? (Then the scenario evolved, as the baby develops post-op vomiting again).
What this teaches us: 1) Breaking a big problem into smaller ones and addressing them sequentially 2) Being grilled is inevitable
And subsequently: more thoughts