Dave – Page 30 – Ramsay Family Classics

Creatures of the night

There is a courtyard between the orthopedic and surgical wards which is a designated smoking area, and there are always people out there during the day, but I’m always amused and astonished to see how many people you find out there at night.

Walk past it at 10pm and even though it’s pitch black out there you can still see vague shapes moving in the gloom, and the occasional orange glow as they suck on their cigarettes and cause the ends to light up.

It’s 10pm! I don’t approve of smoking at the best of times, but if you’re outside and smoking at 10pm, it seems as though you can’t really be that sick can you?

Life transitions

On friday night I did ward call, and saw the two ends of life.

I had to declare an old lady dead, after she had passed away as a result of her cancer, in the palliative care ward.

Then as I was leaving the palliative care ward I saw a literally newborn baby being wheeled down the corridor in a crib obviously off to the maternity ward.

It says something about life, but I’m not sure what it is right now.

The wisdom of rotation

One of the features of internship which I’m a little uncertain about is the wisdom of changing departments every 10 weeks.

I have just changed from Orthopedics to general surgery, which is not that big a change, but others have gone from medicine to surgery, or mental health to obstetrics. or visa versa.
I was at a point in orthopedics where I knew the team, I knew the nurses and allied health staff, I knew how things worked in theatre and on the ward and in outpatients. Basically I had gotten to the point where I was good at my job and felt I was being a genuinely useful member of the unit… and then they shifted me.

Now admittedly the learning curve is not as steep this time around, but I’ve still gone back to the situation of not knowing the skills and temparements of my team members or of the nursing and other staff. I also don’t know all the differences in the way the surgery department’s systems and processes work yet either, so basically they have taken a bunch of interns had been trained up to usefulness, and made them inefficient again.

Now as I understand it many countries in the northern hemisphere run their medical internships on a system where you do a 6 month medical term and a 6 month surgical term, and I have to say that I wonder if that isn’t a better arrangement. That way you spend a month or so upskilling, and then 5 months just being good and efficient.

On the other hand however I suppose that people who got stuck for 6 months on a discipline you didn’t like, with a team you didn’t get along with would probably discagree with me on this.

A series of Scientific Coolnesses

A few weeks back I read about a number of very cool things from the world of science, however it has taken me a little while to get around to writing about them.

Without further ado here they are:

Methanol Powered artificial muscles:
http://www.newscientist.com/article.ns?id=dn8859&feedId=online-news_rss20

Optic nerve regrowth on a nanofibre scaffold:
http://www.newscientist.com/article.ns?id=dn8840&feedId=online-news_rss20

Big new reservoir of water ice suspected under Mars:
http://www.newscientistspace.com/article.ns?id=dn8857&feedId=online-news_rss20

Advances in coagulation:
http://www.newscientist.com/article.ns?id=mg18925435.800&feedId=online-news_rss20

New insights into the “Spokes” in Saturn’s rings:
http://www.newscientistspace.com/article.ns?id=dn8860&feedId=online-news_rss20

There. Wasn’t that both varied and fascinating.

Soft tissue adjustment disorder

One of the things I’m finding quite amusing going from orthopedics to general surgery is that whenever someone puts up a CT scan for me to look at I start looking for the fracture, and almost completely ignore the all the other soft tissues (which in general surgery are bits we are actually interested in).
Its a habbit that’s quite hard to break, not least of all because generally it’s an awful lot easier to spot fractures on CT that the generally rather vague and ambiguous soft tissie changes which constitute general surgical diseases.

New Tobacco

Have you noticed recently how pervasive the whole mobile phone marketing apparatus has become?

It’s everywhere.

There are phone shops by the dozen in any shopping mall you walk into. Almost every sporting team or event has some sort of mobile phone sponsorship. Ads for plans and handsets are everywhere and seem to be constituting larger and larger segments of TV ad breaks.

In my mind I can’t help think that the other industries that have been able to employ these kinds of mega budget advertising campaigns have been the likes of alcohol and tobacco, and as a result I keep on wondering what skeleton is going to eventually come out of mobile phones’ cupboard…

After all, anything that lucrative cannot be entirely healthy or wholesome, can it?

They don’t build ’em like they used to

In an amusing story out earlier this week, it turns out that one of the NASA’s Mars Rovers has finally broken (somewhat).

The rovers, each designed to last 6 months, have been going for 2 years, and are still happily trunding around their landing sites doing really good science. The other day however one of the rovers broke a wheel. 1 of the 6 it has. And so with one wheel trailing it’s just continuing to roll around on it’s remaining 5 wheels. Now that’s what I call solid.

That new computer smell

I have finally gotten my new computer. Yay. It’s so fast and shiny!!!

I picked it up friday afternoon, missed out on playing with it yesterday as I ended up doing an unexpected additional ED shift until 10pm, and plan on spending almost all today ensconsed infront of it’s softly glowing screen happily emersed in mindless tinkering.

I have to copy all my files and settings from my old computer onto my new computer, then copy all simone’s stuff from her computer onto my old one so that she can have it, and then set up Simone’s old computer for her parents to have. I don’t remember the last time I’ve gotten to do this much under the hood computer tinkering, and I certainly don’t remember when I last (if ever) set up 3 computers in one day.

I’m going to be like a pig in mud!!!

Strugling against the machines

We have recently started using a new computer system at work, which allows (to a limited extent) electronic record keeping and note taking for patient charts.

Old chart entries are scanned in, so that you can pull up old charts from any computer in the hospital, and things like xray reports and blood test results are all accessible through it.

I personally find this a godsend, as it allows me to do a fair bit of my work without writing, and from anywhere I want to do it, rather than being tediously paper based from wherever the charts are kept (on the ward, in medical records, etc).

Recently however they added a new feature which allows you to directly add notes into the online charts, with the idea that in certain situations (especially outpatient clinics) doctors would simply type in notes, rather than writing things and having them scanned later.

Brilliant, I thought, and promptly started entering notes left right and centre, and taking to it like I’m sure the IT people were hoping everyone would, however I have been quite bewildered by the fierce resistance I have seen in my fellow doctors to the system.

Even the relatively tech literate and young (comparatively speaking) doctors seem to resist using it, not because they can’t, but seemingly because they don’t want to, and it is new technology. They want to keep on writing illegibly. They want to sort through piles of crusty old paper charts. They like being able to winge about the system, even though it really is quite a good piece of software, and both an improvement on the previous version that was in use last year, and a monumental improvement (in my opinion at least) on the paper systems of old.

I suppose that that is just the way the world works. Some day it will be me being tech illiterate, and some other young upstart winging at my intransigence.