These hands ...

... have stitched up cuts

... have, as Turk says, been so far inside someone's abdomen I couldn't even see them

... have held bowls for patients to be sick in

... have palpated countless chests and abdomens

... have stuck needles into countless arms to take blood

... have been inside people's mouths, noses, ears, vaginas and bottoms

... have been covered in blood, vomit, sweat, poo, urine and amniotic fluid

... have catheterized three bladders

... have delivered two babies

... have held patient's hands

... are, along with my eyes, my most prized posession

End of A & E

I'm done with Emergency Medicine for the time being. Not for long, as I have enjoyed it so much I don't think I'm going to be able to stay away! I'm starting Oncology next week after a full week off for Easter - I haven't been given so much Easter for a long time!

I had a preview of Oncology recently though. One man - comes in, as his family had insisted on it. Quite non specific about what's wrong, over the last few months he's been breathless, pale, and very sweaty at night. His white cell count was 102. You'd wonder what was going on if the white count was over 10 - 102 is stupidly, ridiculously high. He turned out to have leukaemia. Another man - the day after - came in after collapsing. He had been breathless, and was coughing uncontrollably. I listened carefully to his chest and froze my face to not let my concern show. (I have a terrible weakness of being very expressive, loads of people have told me that.) His right lung sounded so sick - no pleasant whoosh of air. Just ominously quiet sucking, cracking sounds. He turned out to have a really large tumour in his lung. This really got to me, these two patients in succession that I had seen the worry in their faces, and their family's, increase as their time in A&E dragged on. I was crying silently in the toilets by the end of Wednesday.

So winding down from A&E I am far far away from the city, staying with my parents and the boy, surrounded by farms, where I am woken by chickens and lambs, where the buses go every 3 hours and stop at 6pm. Where the church and village hall are the social centres and people buy vegetables and animals from each other. Where the silence is so deep it feels noisy after living in the big smoke. When we weren't living abroad in the Middle East (we followed Dad's job) I spent much of my childhood around here, and took it for granted. Now I savour every second I'm here. Where people aren't rushing, where it's dark and so silent at night, where everyone knows each other, and likes that they know each other. It's so delicious, I can almost taste it.

Blues and Twos

I've been out with the paramedics this weekend. When I was younger, when I wasn't being a juvenile deliquent, I wanted to be a paramedic. This weekend made me realise how much I would have enjoyed it. Saw some great cases, including a little 8 year old boy who'd fallen from a tree and had a huge nail, foot-long piece of wood attached, through his foot. The paramedics were so great to him. So friendly and jolly, and defused the rather stressed situation in an instant. After a few puffs of Entenox he was giggling away and complaining about his ruined trainers. Bless him!

A & E

"Outside a new day is dawning. Outside surburbia's crawling everywhere."
-Kim Wilde
Doing A&E at the moment. In an area of the city where even the name of the place is a buzzword for middle-class. But I love every second. It's an almost palpable pleasure to be somewhere so organised that patients honestly don't have to wait more than an hour, even for very minor stuff, and for anything serious it's immediately. If they need a specialist to see them, they get seen. If they need to have a scan, they get scanned. It's delicious! The NHS really can work!
I lov every second of A&E. It's brutal and ugly and beautiful and visceral and it's so interesting compared to other specialities. I think I'm going to at least try to go into it as a speciality. You meet fascinating people - from the self-confessed landowner who had cut his hand on his chainsaw and joked that he should be greeted with a bottle of Moet every time he comes as his taxes alone pay for the place. Tee hee! What a prat! To the alcoholic man, fitting from withdrawal, trembling involuntarily under every touch of my hand. To the woman from Myanmar, who didn't actually know the difference between an A&E and a GP. To the childs arm so broken from a trampoline tumble that he had a new right angle in his forearm. To the endless numbers of elderly people with so many things wrong that I take up pages and pages writing it all down. To the motorbiker, who had been hit by a car, who ended up getting 8 stitches from me in his elbow and knee. Love it.