Scrubs

Last Tuesday, I spent the day in Musgrove Park Hospital, mainly with the neurology team in Triscombe Ward. I started off with consultant ward round with Dr. Fathers and his team. I saw a variety of rare neurological conditions, varying from informing a patient that he had motor neurone disease to finally speaking to a woman who had been dumb for 2 months following a neurological problem. I also saw the value of MRI scans to review inflammation, among other problems, in patients, which can damage nerves and nerve transmission. Next in the plan for the day was viewing neurological tests. However, upon arrival, I was told that there were no tests that afternoon, but one of the testing team would be monitoring a patient’s neurological observations during a spinal operation. Was I interested in watching? Of course! So, for the first (and hopefully not the last!) time in my life, I got scrubbed up, complete with pyjama-like clothes, hideous shoes, a face mask and a very attractive hat. I also donned a lead apron (which was surprisingly heavy!) and then, fully dressed, I was allowed to go into the Operating Theatre (upon my promise that I didn’t faint at the sight of blood). I was in Theatre for 90 minutes, watching rods being inserted into the patient’s back as some of the vertebrae plates had fused. This had to be done with constant checks, both radiology checks to assess position, and nerve transmission checks to ensure that no lasting damage was being done. It was epic. After the operation (and lunch) I went to watch a lumbar puncture, where I saw the time taken to perform the procedure, due to the small size of the gaps and the precision needed to avoid nerve damage. Overall, I left feeling really excited and even more committed to my dream of being a doctor.

The Beacon Centre - Oncology

Yesterday, I spend the day at the Beacon Centre at Musgrove Park Hospital, which specialises in Oncology. As they recently won the International Quality Improvement Award in May 2012, I felt very privileged to be spending a day there. I started my day in a gynae-oncology MDT where I saw a variety of care teams discuss the latest changes to the patients’ conditions. This was supported by CT scans (which I really enjoyed looking at) showing progression of tumours and cysts etc. It was interesting to see the number of different specialties in the MDT, including a radiologist, a pathologist, a gynaecologist and both a medical and a clinical oncologist, which showed the importance of teamwork. I then spent the rest of the morning on the ward, shadowing 2 junior doctors. The patients, whilst it was an oncology ward, were mainly all suffering from other diseases as well as cancer, and many had palliative care programmes. This taught me the importance of reducing adverse symptoms to make patients more comfortable, rather than always trying to cure diseases. After this, I went to radiology where I saw the in depth planning systems required for radiotherapy, including CT scans and the colourful mapping of them. This, along with specifically angling the rays and being able to shape them using lead ‘fingers’ helped to reduce irradiating healthy tissue that could lead to unwanted side-effects. I also learnt how they use small tattoos on the patient to ensure that their numerous radiotherapy treatments (5 a week for 7.5 weeks in some cases) all go in the same place, and how increasing the number of rays used decreased side-effects by reducing dose except to where the rays met. I then went into the room where the radiotherapy occurs (luckily no-one was in there!) and saw the machine used to create the high-energy beams of photons or electrons used for the radiotherapy, and numerous safety devices to ensure that no-one but the patient receives doses of radiation that, if repeatedly received, could cause damage. In addition, I saw the bench for patients to lie on whilst they receive radiotherapy and it felt very uncomfortable but needed to be hard so that patients could always lie in exactly the same position.  Overall, I felt I learnt a lot and it was a worthwhile and interesting day.

Yeovil District Hospital

Last week, I spent 4 days in Yeovil District Hospital as part of a work experience programme. This gave me some insight into some departments in the hospital that I hadn’t seen before. This ranged from time with the porters and in the linen room to the Academy to the Day Hospital and the Cardiac Rehabilitation Unit. Whilst all were interesting and, as I learnt, important to the smooth running of the hospital, the areas I enjoyed the most were the Cardiac Rehab Unit and the Day Hospital. In Cardiac Rehab, I saw the importance of exercising after a heart operation for both physiological and psychological reasons – whilst rebuilding heart muscles is important, it is equally important that people doesn’t feel alone and realise that they can still do the things that they want to do. There was a great atmosphere, and the volunteers (who took me round pretending that I had had a heart operation) told me that the thing they strive for is for you to have fun. In the Day Hospital, I saw 3 blood transfusions being prepared and taking place. I was surprised how long the transfusion took and saw how the nurses constantly checked for adverse reactions to the blood.