CTs are not always all that useful.

'OK, so we have...trachea...trachea...trachea...weird thing...bigger weird thing...what even is that?'

Ladies and gentlemen, today's doctors!

Clinical School: hurry up and wait

Being a clinical med student is a lot like being a duckling. You spend a lot of time following someone bigger than you, hoping they'll teach you things like eating bread or whether all those numbers mean a patient's dying or not. Sometimes they do lead you to good things, but they're nearly as likely to lead you to certain doom. Also, like ducks, you know nothing about medicine. And you're cute and fluffy and bad at metaphors.

Clinical School

Those of us still in Cambridge have just finished our second week of clinical school (I was going to update at the end of the first week, but then the weekend was as hectic as the week, so go figure). Distressingly, after three whole years of introducing ourselves with a variation upon "Hi, I'm Felicity, I'm a medic", the gap between us (bottom of the food chain) and the all-knowing consultants and GPs we see seems just as huge as ever. More distressingly still, the gap between us now and the FY1s, who are brand new doctors fresh out of clinical school, seems almost equally gigantic: they know things, like how to diagnose and what drugs to give people and what they're listening for when they play with their stethoscopes and so on; and yet even they are often seen as ignorant little pawns in the grand scheme of the NHS.

The thing is, despite three years of what was ostensibly 'medicine' at the best university in the world, I am still pretty sure that I could not diagnose anything from a list of symptoms above 0·1% of the time. That tiny percentage where I might hit upon a diagnosis is when the symptoms happen to match something that I, a close friend, or a family member has had. None of it is the result of any of the knowledge I've clung to from my actual degree. I'm terrified by the sheer volume of knowledge I'm apparently expected to just pick up over the course of three years in an institution which we are constantly reminded is 'chaotic' and does not have our education as its main purpose (obviously - there are patients to care for, primarily).

So, at the end of our second week, what have we learnt? We have been taught how to introduce ourselves to a patient. We have been given a framework for collecting information about what is wrong with a patient - both 'biomedically' (i.e. in terms of symptoms and diseases) and 'from the patient's perspective' (which reduces down to 'how are these symptoms affecting the patient's life, in their own opinion'). We have been taught to stick needles into people (so far only each other) in a safe, hygienic, aseptic way, and hopefully achieve a bottle of blood at the end of it. In the last three days, we have been taught how to examine a patient's cardiovascular (heart and junk) and respiratory (lungs) systems, and their abdomen.

Unfortunately, we can't actually do much with most of this. I can get a full history of what is wrong with a patient, including what they think about it (if the patient is nice and co-operative); I can possibly work out which bit of them is going wrong and check for other symptoms that might be associated with what they've already told me. If they have something wrong with one of three bits of them, I can examine them to find out other stuff. I've been told that I am so far incapable of presenting any of this information to anyone more senior than my friends, so I can't pass it on. I don't know any diseases, so I can't decide what is actually wrong myself, and even if I could, I can't decide what to do about it. Worst of all, if I examine a patient, I'm so busy trying to remember what comes next and not miss anything out that I more than likely have forgotten what I worked out by the time I'm finished.

Finally, a secret: I suspect stethoscopes are mostly a fashion accessory. So far, I have yet to hear anything other than a vague rushing noise through the earpieces of that symbolic bit of kit - even when assured that the patient has the most obvious *insert medical term here* that whoever's watching me has ever heard. I'm pretty sure it's all made up.

Scientific papers are not happy things

If you write a paper, how do you get people to read it? Surprisingly few take the sensible approach, a variation on something you were probably told as a child: 'If you don't have something awesome to say (about cancer/ion channels/dinosaurs), say nothing at all.' Fewer take my favourite approach: have an amusing name. Even something childish that I'd normally take perfectly seriously will make me far liklier to want to cite you in an essay. Wang, for example. Or something with unusual characters, like an o with a line through it. If I can't pronounce it, I want to write it lots. Maybe I should write a paper on that, once I've changed my name to the result of mashing my hand into my keyboard. Or Dong.

Of course, there are plenty of people who just try to make bad jokes in their titles. As a general rule, scientists trying to be funny are more or less ultimately pathetic. I have begrudgingly read 'Keeping abreast of the mammary epithelial hierarchy and breast tumorigenesis'. A lot of scientists, either intentionally or as a result of their own strange minds, just give their papers really odd titles. 'Evolution of the human X--a smart and sexy chromosome that controls speciation and development' contained an anthropomorphised 'sexy' X chromosome brandishing a whip. The fact that three whole people were involved in creating this paper and not one of them thought that this was a bad idea should make you scared for all humanity: these are people with access to lasers.

But then, there are papers that are unredeemably awful: 'Vulvodynia and chronic pelvic and perineal pain' springs to mind. Gragh.

AND ANOTHER THING

Dear Authors of papers,

If you cannot spell, write English, punctuate, or write coherently, please desist from writing papers. There is nothing worse than reading a paper, trying to cram, and being constantly distracted by spelling errors and odd uses for the comma that just force all the sense of what you were reading out of your head.

Sincerely,
Felicity xxx

p.s. You are strongly encouraged to write papers if you have a funny or memorable surname. Please don't write more than one paper a year, though, or we start having to add 'a', 'b', etc to the references.
Geraldine

The End Is Nigh

The Rapture that we were promised last Saturday failed to take any of the medics up - we assume we've all just been sinning too hard for the last three years - unfortunately meaning we still have to sit our exams. My first is in about two and a half hours' time, so naturally, I am updating the blog for the first time in three or four months. Sorry about that.

Here are some ways to guarantee you do badly in your third year exams:
1. Fail to read papers until Easter term.
2. Spend most of the Easter holiday working on your dissertation, to the exclusion of all revision.
3. Spend most of Easter term with a not-work to work ratio of about 5:1 or higher.
4. Cram, in the last week.
5. Fail to stick to even your cramming timetable, meaning you only finish going through lectures the day before your exam.
6. Update your blog in the last three hours before your first exam.
7. Cultivate a sense of impending doom, but manage to avoid getting The Fear until, oooh, half-way through your third exam (I'm guessing).
8. Remind yourself, often and loudly, that you only really need to get a third.

I'll see you all on the other side.
Felicity xxx

A note to lecturers

Unlike some things in life, we really don't mind if you finish early.

We do mind, however, if you go at double speed so that you finish 20 minutes early. That kind of thing leads to chafing.

Geraldine

Clinical School

When you make the ominous decision to apply to Cambridge to study medicine, you are warned that you will need to reapply for clinical school. However, this warning comes at the time when you still consider yourself reasonably, or even very, intelligent, and therefore falls completely on deaf ears. You think to yourself, 'If I can get in the first time round, surely doing it again will be no problem?'

You promptly forget about such things, merrily failing exams and perhaps trying a few bits and pieces here and there until third year, when a horrifying application form finds its way into your inbox. It is awful. It wants to know everything. And now you have the sneaking suspicion that while on UCAS you were some shining goddess of a student, you are now just so much insignificant mediocrity. Perhaps your DoS has even said that you stand not a single chance.

Come January, you attend an interview, and are briefly reminded just how much sheer terror makes you want to evaporate in your interview suit. You are asked awkward questions that you agonise over for weeks to come. You dread that answering something just a little wrong will land you living in London, paying twice as much to do a course you didn't really apply for.

And then...you wait.

We are still on stage three. Today is the 17th February, and according to our handy timetable our offers were made nearly two weeks ago, and we replied to offers yesterday. Good to know the clinical school cares so deeply about our wellbeing.

The lecturers you'll meet in third year

We still see a lot of the old characters (the mumbler, the one with the inexplicable accent that's particularly confusing when they're teaching you signalling pathways and you've no idea whether they're introducing you to a new molecule you've never heard of or massively fudging the word 'therefore'), but we also have a few new faces. Here are a selection:

The one who will get to the end of their lecture time and realise they're overrunning. They won't slow down or cut their lecture for next year, just keep going. They frequently ask, 'I might run over, is that ok?', and no one will ever dare refuse.

The one whose references are a twelve page list of everything that's ever been written on their subject, with no indication of what is a good idea to read, and what will actually lower out IQ by a few points

The one who references only himself, even if his papers are all twenty years old and are biographies of someone everyone now thinks was wrong about everything.

The arch-enemies, Professor This-subject-is-really-complex-and-interesting-but-here's-a-picture-of-a-tree, and Doctor This-sucject-is-simple-but-here's-an-in-depth-review-of-one-specific-and-confusing-paper.

How I miss Professor Mumbles.

Geraldine

The medics get nostalgic

Tomorrow is our third RAG Blind Date. We are reliably informed by our tutor that Blind Date has been running annually since SHE was at Cambridge, and thus is at least twenty years old. This is pretty awesome for a charity event that basically relies on people going 'ah, what the heck, I'll just give it at shot' and kind of slightly hoping that maybe they'll meet the guy/girl of their dreams, but inevitably being disappointed. And then doing it again the next year, with roughly the same thought process.

We, obviously, are taking part - because it's Cambridge and Lent term wouldn't be Lent without an achingly awkward four-way date with (inevitably) three guys (one of us always gets stood up) who spend roughly an hour and a half to two hours gazing bemusedly at us while we act as crazy as possible; somewhere around the halfway mark, they either decide 'screw it, I'm going to just run with it' or 'this is the single worst experience of my life' and either join in the insanity (the former, in which case we subtly claim their souls for ourselves) or start checking their watch.

So, tomorrow, it is Joanne's turn to be stood up (leaving Felicity REIGNING CHAMPION at never having her date fail to show), and we are all going out for Chinese, probably, of which approximately half will definitely be peppers, just so that Felicity's date (and everyone else's) can judge her when she picks them out.

Blind Date is made even more hilarious by the fact that both Felicity and Geraldine are firmly attached, and thus could care a lot more about what their dates think of them by the end of the evening.

We'll let you know how it goes.
Love,
Felicity xxx