Lonely is a Freedom

Based on the poem by Tanya Davis.

Indomitable

I don't know how many of you have been following the performance of the U.S. soccer team at the World Cup this year in South Africa. To be honest, I've never followed it like I have this year. But this year, in part thanks to the enthusiasm of my flatmate, Lua, I've really gotten into it.

Those of you who've known me for a while, know that I'm a big soccer fan... but not really so much of the sitting in front of the telly and watching the sport as the getting into the grit of it on the pitch kind. I love this sport. Have loved and played it since grade school, all the way through into medical school. I love how you can just get on the field and go all out. Get down and dirty, fighting and tearing up the field. The aggressive physical and mental spirit of it is invigorating and liberating.

Maybe this year it's because I'm in England and not in my home country and we ended up in the same group as England. Maybe it's because I'm tired of taking all the BS I have to deal with being an American abroad. Maybe it's just because football/soccer is such a big deal here and it's hard not to be swept up in the excitement. But regardless of the cause, I have a keen interest in our performance at this World Cup. I feel invested. Similarly during the Olympics, but even more so. And being in England it's so much easier to really get into watching the game a the pub because everyone else is yelling at the screen so you feel liberated to do likewise. It's quite fun actually.

But I digress... I must say that I am so proud of our Team. We've performed above and beyond expectations. The first match against England was a HUGE deal here. Lua, Tiffany, and I were the only Americans at a pub jammed to the max with fans wearing their white and reds. At first we thought it best to keep a low profile... Especially when even just during the pregame show every time a commercial or commentary came on with the U.S. team showing there was much booing and jeering, which only escalated during the singing of the Star Spangled Banner. We went out in our blues to represent, since this was such a key game! Def not the time to be diplomatic and dress neutral.

I found that my cheers where largely overwhelmed by the groans of despair of the crowd, so I could pretty much cheer to my hearts content. It was a nerve wracking game, especially with England scoring only 4 min in. But watching soccer is so much more entertaining in England than it would have been Stateside. The crowd is much more involved and vocal. Every 5 minutes would be a round of singing and chanting with the lulls filled in with random berating or yelling at the screen. I remember sometime near the end of the second half, a woman screamed, "KILL THEM!!!!" To be sure, there's never a dull moment. I was so nervous during the first game, I was shaking. I wanted us to do well and represent ourselves before a world who thought we were just a bunch of pretty boys that didn't even know the name of the game.

I think that we've been playing solid games thus far. We've done a great job personifying what it means to be American. Our indomitable spirit and our sportsmanship have consistently stood out. Despite being plagued by injuries, ridiculously bad calls and denied goals, we have come through at the top of our group. We fight, get back up, stand our ground, move forward, and never give up. We are ready to take on the next stage. Inspirational.

Come what may, we're still number ONE! Bring it on!

When Money Fails

Sometimes I'm almost persuaded that national health care is the way to go. Working in the NHS has given me some insight to how great it can be when it works, and just how completely horrific it can be when it falls short. Getting my MPH really opened me to the idea of universal health care... health care for all regardless of your social or economic status, age, sex, orientation, race, religion, etc. It seems so right and just, this free and equal access... But this world we live in, though at times fueled and inspired by such dreams and hopes, is not always this fair or merciful. It's too practical, rational, pragmatic. Universal health care cannot just be wished into existence with a light dusting of pixie dust. It comes at the price of cold, hard, unyielding cash.

In the A&E there was an elderly gentleman who came in because he had tripped, fallen, and hit his head. He was slightly dazed from the fall, but only had mild abrasions on his head to show for it. His son brought him to the A&E and on arrival he was grand, GCS 15/15. Very pleasant chap. About an hour or two after the initial incident, he started sluring and couldn't remember his last name or the date. Five minutes later, he could barely speak. An emergency CT was ordered but had to wait 30 minutes because there was another pt being scanned at the time. By this time, he was seizing and it was fairly difficult to gather a clear CT, but what came through clearly showed large bilateral subdural hematomoas. Now most even junior medical students could have told you from the just the initial history that his man most likely was at high risk of having a subdural hematoma. Many junior doctors would probably also be able to tell you that this situation could be treated and alleviated by boring a hole(s) in the pt's skull to relieve the pressure. While this procedure comes with considerable risk, not doing anything was even worse. True, 20% or so will recover without any intervention... but, come on... this is an old guy with 2 large hematomas. Really, what are his chances? No way, any moral, ethical, or humane person would just leave him as his brain slowly gets squeezed by the increasing pressure within his skull til it herniates or he suffocates, or however the end result is the same. Death.

But that's just what happened. Because of his age and the fact that he had a few comorbidities, the procedure that could have saved his life was not NHS approved. It is deemed a waste of money. Instead, his son must call the rest of the family to quickly come to the hospital because their husband/father was not long for this world even though just a few hours prior he had been fit and well. Would he also have to tell them that one of the reasons why their loved one was dying was because the NHS didn't have the money to allocate to a potentially lifesaving procedure? The doctors' hands were tied. They couldn't do anything because it wouldn't be paid for...

I was flabbergasted at this. I can't imagine that this would happen in the States. Even though our health care system had been far from perfect, we never denied life saving emergency treatment based on a person's ability to pay. Maybe I'm being naive and ignorant. And now our health care system is one step closer to maybe even the government dictating who gets to live, and who will have to die.. because frankly, you're just not worth the copper.

Scotland cont.

So I made it to Scotland Thursday morning... later than intended, but hey, I'm here :)

Toured Edinburgh for the day. Free walking tour that was pretty great and "ghost" tour that was highly recommended that I have to say I was quite disappointed with. A friend of mine's boyfriend lent me the keys to his apartment while he's in England.

Anywho, I'm in Fort Augustus right at the moment at the foot of Loch Ness... no luck thus far on spotting Nessie, but there's still Sunday :)

Scotland

Headed up north to the land of William Wallace, Nessie, Sean Connery, golf, Scotch whiskey, haggis, bagpipes and kilts. Be back next week :)

Ireland

This is for those peeps who wanted to make sure I was alive and didn't get blown up or something...

I made it to Ireland Thursday morning, despite the volcano.. Checked out Dublin for the day... caught the train to Mallow.. caught a ride at Mallow to Killarney... Drove the Ring of Kerry... Biked through the Killarney National Forrest... Tore off a quarter of my left palm's surface area and could possibly have needed a stitch on my left knee from a fairly deep puncture wound... Just arrived in Belfast just under 2 hours ago.

More details when I get home to upload pics and such.

Short. Not too sweet. To the point :)

Oh yeah. And I'm loving it! The fact that there's a lot more good looking guys here than back in England doesn't hurt either. lol. And I've met some fantastically awesome peeps along the way :)

I rearranged my room. Because I was bored. Because I wanted more space to work out. Because I wanted some change. And now I love it. I have some plants on my windowsill. I should buy more flowers. They make me happy :)

I found more bruises. Big ones. Sheesh.

Bruised

So I have these random bruises that have cropped up in the past day or two. I'm assuming they must be from when I assailed that fence, but I don't remember it being that physically traumatic. I have a fairly impressive one that runs medially along my left calf and spans just over 5.5 inches. Several others over my ribs, triceps, palms, and along where the adductors and gracilas are situated...

A depressing fact to note..

"The 2010 Main Residency Match was the largest in NRMP history, encompassing more than 37,000 applicants, 4,100 graduate medical education programs, and 25,500 residency training positions."

This seems to imply that over 10,000 applicants for this year's match failed to match. Of course this probably includes the ones who "pre-matched", e.g. signed outside the match, but even so, that's a really sobering number who did not match. I know several people who didn't and thankfully some of them were able to scramble into open spots, but others have not yet been so fortunate. I'm thankful that most of my interests are non-competitive so I have some resemblance of a chance of getting a field I'll enjoy, but still...

Barbed Wire

I knew I should have worn jeans to go into town. But I figured I'd just be making a short jaunt to the school office to drop off a form and deposit, so why bother changing?

I decided to go exploring on my way home and took a path I hadn't tried before that ran between the cemetery and train tracks. As I was walking down the path I saw a group of teenagers, 4 boys and a girl, poking at something on the other side of the barbed wire fence that ran alongside the railroad tracks. As I approached, one of the boys said something to me but I had my earbuds in so I couldn't didn't catch what was said, but I gathered from the sight of the soccer ball on the other side that he had asked something about how to get it back over or something. Here's me thinking, dude, there's 4 of you guys.. in jeans no less.. and you're asking me, a girl in khaki slacks for help? Any way, when I asked why they didn't just jump the fence and get it, they kept saying, but it's barbed wire... um... so? It wasn't like it was a rusted over tangled mass of tetanus breeders, but rather a vinyl coated chain linked fence with 3 lines of green painted barbed wire. Seriously? And these weren't like boys dressed in their prep school finest, but they looked like they wanted to be the punky cool kids with low riding jeans, converse shoes, and spiked hair. Lame. My roommate said English boys were pansies. Guess so.

I took off my backpack and climbed the fence. On my way over, my khackis caught on the barbed wire and there was a nice rip right over my knee. Great. But without further difficulties, I went over, tossed back the ball, and after tossing over my shoes...with some help from the boys holding back the wire, I climbed back. I got many thanks, but I can't say I really actually even looked at them and made eye contact with more than maybe that first boy who had asked me for help. Maybe it was cuz I didn't want to feel like I was showing off, because I know I have the tendency to enjoy proving myself to challenges. Or maybe it's because I didn't want them to feel bad to have a girl throw them back their ball, when they were too much of a wuss to get it themselves.

We parted ways and after walking a bit, I looked down to check out the damage to my pants only to see a dark spreading stain above it. Huh. I took a peek, and yup, low and behold a gorgeous 2 inch gash that was happily oozing away. I hadn't felt it. It didn't hurt. I had some pocket tissues and tried to blot and stop it, but it just kept a going, so I figured I may as well just keep walking home. By the time I got home, the entire area was soaked in blood.

So it would seem I paid the price for being nice and all tough girl idiocy. I tore up my one pair of khaki work slacks and am left with only one pair of work slacks. I have a beautiful gash above my knee. Slight rush from finally doing something active and out of the ordinary. And I need to go shopping now. Lame. I shouldn't have chased the goose. Or maybe just say no. I should have just worn jeans.

Can't help but love her

I had a patient today that almost made me ache to do Peds. She was maybe 7 years old with a history of hypoxic ischemic encephalopathy and late diagnosed subdural hematomoa resulting in cerebral palsy. She also had some speech impairment and developmental delay. But what was so remarkable about her wasn't her disability, but rather despite her disability, the pure and simple cheer and joy that radiated from her. She was so funny, cheeky, and sweet that my lips and cheeks were sore from the smile I that couldn't help but respond with. We asked if she was always so cheerful and chatty, and her parents laughed an affirmative. She lit the room and her charm was irresistible. I felt myself almost jealous of her innocent and effortless charisma. I couldn't help but think that despite how difficult it must be to raise a disabled child, her parents were amazingly blessed. I hadn't been so purely delighted in a long time. Simply put, she was awesome.

She was beautiful.

I lost my first baby today.

No one understands or can explain why. How could it all go wrong, without an inkling of a warning? The baby was perfectly healthy, no antenatal issues. The obstetricians are at a loss, the pediatricians are at a loss. We did full on resuscitation measures, and kept a flicker of hope that somehow it would be enough. It was an extremely intense situation and such a horrible outcome that all the adrenaline just leaves a hole in you. I have this feeling, right below my sternum...

I don't think it's hit me yet.

International Relations

So this past Tuesday I went to the Emirates Stadium, home of the Arsenal football team, in London for an international friendly match between Brazil and Republic of Ireland. To be honest, this isn’t something I would usually shell out money for, esp not 42GBP since I’m much more into the actual playing of the sport than the watching. But since I was kind of put on the spot to make the decision, I went with an affirmative. It was definitely a fun game and I’d say a good time. I went with my roommates, Clayton and Lua, who are both big football fans. We had great seats in the first row of the upper tier and had great vantage view of the field. Lua and Clayton cheered for Brazil with their Brazilian flags and I cheered for Ireland. I mean, I knew Brazil was the better team, but I like Ireland :) Anywho, we were sitting in a predominately Irish fan crowd, though they were way outnumbered by the number of Brazilian fans. It was a good game, even though the fate of the game could easily have been guessed prior to the ball drop. Ireland clearly dominated the first half of the game and Brazil only scored off a lucky shot 2 minutes before half time. Sadly, after that, the second half seemed almost like a joke. Ireland seemed to lose all will to live and Brazil pretty much played Keep-Away from the boys in green. I think the Irish fans though were the most amusing with their accents and caustic, rowdy comments. Provided much amusement throughout.

Sorry for the delay, folks

I've been mucho busy... Just finished my Ob/Gyn written exam less than 30 minutes ago and whew, I think my heart is still racing... I have my oral exam in about an hour... But I think the written exam went fairly well, I'm thinking maybe a B... Hope I'm not being too optimistic :)

I just sharpened my first wood pencil in I don't know how many years. Can't go wrong with the original. It had stamped on the side, "Knowledge is the enemy of disease." Yeah, baby.

I have much to regale you with, as in my blogging absence, I've made two trips to London, celebrated Chinese New Year, avoided Norwalk virus like the plague, and attempted to open a UK bank account.. my venture into getting a credit history here.

So til that time comes that I can update you, so long and farewell my faithful friends. lol.

I plan to celebrate tonight!

Update 2

Monday, February 1, 2010

I discovered that while I may not be all that into surgery... laparoscopy and laparoscopic surgery is amazing. When I saw the first images sent by the laparoscope onto the screen, my jaw nearly dropped. My first thought was that the human body is a beautiful thing. Seriously, exquisitely beautiful. It was like a National Geographic special. I had seen images online before, but I just thought they were computerized renditions and that there was no way it was that clean and put together inside our bodies. I don't know what I was expecting, but having only ever really seen drawings of internal organs, or images from surgery where the picture is marred by blood and other fluids, or organs after they have already been removed from the body... I hadn't really grasped what the human body looked like from within. When everything is where it should be, living, working.. and you take a peek inside... words aren't enough. I think I was in love, lol. It's just so incomprehensible seeing the liver, uterus, fallopian tubes, omentum, vessels, etc all in their proper place... it was like being let in on a great secret. Like someone said, "peek-a-boo" and opened my eyes to a never before seen wonder. Even better than the magic school bus :)

I was able to scrub in and assist in an laparoscopic oophorectomy for a torsioned ovary. Viewing it inside the body and comparing the greatly enlarged, hematogenous, necrotic ovary to the normal one only inches away was like, wow. Then watching the removal of this ovary with an 11cm cyst from a 1cm hole in the abdomen was incredible. Now that I can get into :) It really is as others say, like playing a video game. Soooo cool.

I also attended an infertility clinic. Seeing all these couples coming in looking for some hope to have a child made what I had seen in the labor & delivery ward all the more precious. Despite how often I see and hear laboring mothers suffer and cry that never again will they put themselves through that experience, I can't help but think of all the woman who are desperate to be in their position.

Witnessing these laboring women has made me wonder whether or not I will still want 5 after my first. lol. They say that your memory of the labor is but a distant faint image once you behold your baby for the first time, but I know many that would beg to differ. I've met women who were so traumatized by their first labor experience that when they found out they were pregnant again, they cried for days. It is hard sometimes to distance yourself emotionally from what the patient is going through so that you can have a clear clinical focus. Then of course there's the weight of having all the knowledge of everything that could and does sometimes go wrong...

Another heart wrenching scene is bearing witness to a mother's guilt and pain in terminating a pregnancy that was a miracle in and of itself since she had been sterilized twice and still gotten pregnant, but the pregnancy turned out to be positive for a Down's baby. Just her waiting in the ward for the medication to take effect and her body to expel her baby, I don't think it's something she will forget for a long time. And the guilt of another mother going through the same knowing that she works with mentally disabled children. How hard is that? I mean, the heart break such news must have been to them, and the subsequent internal turmoil they must have had to reach such a decision. I can't even begin to imagine it. Especially if they had begun to feel the quickening within them.

Today, Thursday, February 5, 2010

I went into town and donated blood today. I have to say that I quite enjoy donating blood. I'm not really sure what exactly it is that I like, but I like knowing that I'm giving of myself to help another. I like watching them insert the needle and watching my blood flow through the tubing into the bag. I like trying to see how quickly I can fill the bag. I'm a pretty fast bleeder when I try, so I feel a sense of satisfaction when I can fill my blood bag before others. Is that morbid? I dunno, it's weird but I enjoy it so I do it whenever I have the opportunity.

I must commend the Brits or at least those here in Winchester on their fervor in donating blood. There were a lot of people who came to the blood drive. They even had appointments to donate. It was the busiest I had ever seen a blood drive. People just kept coming in the door. It was quite heartening to see so many people desiring to donate. It wasn't even like it was Christmas and people would feel compelled to do something charitable. It was just donating to donate. Kind of public healthish too and that's just great :)

Update

Friday, January 29, 2010

This day was horrible. Like downright awful. So bad it made me cry... twice... In front of two different consultants no less. So for those of you who know me and my opinion about crying... it was that bad. I mean, I've gotten over it now, so I can talk about it with a blasé attitude, but that was a pretty miserable day, and that kind of translated to the stress I've been under since.

It started out well enough. I went to theatre that early that morning and was able to perform my first vaginal exam and speculum exam, so that was cool. I feel that my fingers are too short to really be all that effective, but maybe it's just my technique. Even with me feeling like I was pressing my hand as deeply against the pelvis as possible, my fingers barely grazed the "bump" that was the cervix. I couldn't get in deep enough to actually manipulate the uterus, but I was able to palpate one of the ovaries :) I was told that since the patient was nulliparous, her uterus was still pretty high up which probably contributed to my difficulty. But I think that unless my fingers miraculously lengthen I'd be pretty useless at VE's on nulliparous women. Guess Obs & Gyn is out for me, lol.

I had a one-on-one teaching session with Mr. Olujide on menorrhagia, and that went well enough until the end. Sometime in the middle of our session, he asked if I wanted coffee and went out to make some. While he was out, his phone rang 3 times, and I thinking that it might be important since it rang that often in such a short period of time went to look for him. I ran into the husband of a patient who's history I had taken and had a little chat with him about how his wife was doing. While I was out I saw my preceptor, Mr. Louden, walking down the hall. At the same time, Mr. Olujide was also coming towards me, and I went to him and gave him his phone. Mr. Louden came up and said he was supposed to have been doing my mid rotation assessment that day. This was news to me, as when I had checked the schedule at his secretary's office the day before, I had seen no such appointment. I expressed my surprise and He said he had to talk to Mr. Olujide, so I went into the office where I had been having my teaching session. However, they were standing only a few meters from the open door to the office and I could pretty much hear everything they were saying... Mr. Louden expressed his concern about my missing so many days of the posting and his doubt and "puzzlement" about this "induction" thing that I said I had to attend, and other stuff to which Mr. Olujide agreed and said he would talk to me about it. I got the impression, they thought I was making up this induction thing and was just skipping days. They both did not sound pleased. After hearing all this, when Mr. Olujide got back to the office, I asked him if I was in trouble. He said, not much, but yes and we would talk about it later. Of course after that moment, I had a hard time focusing on the teaching and was just dreading the end of the teaching session.

When we came to the end of the teaching and moved on to the topic of my performance thus far, he asked me how I had been doing and what I'd been doing. When we came to what happened that miserable Wednesday afternoon in Scan, I stopped talking because I couldn't really talk about it. I had no desire to go into what happened, but I guess just thinking about that afternoon brought all the feelings to the fore and on top of my nerves about the fact that I was in trouble... my lips started to tremble, I couldn't look at Mr. Olujide and every time I started to say something I felt my eyes well up. It was pathetic. To make matters worse, Mr. Olujide asked me what was wrong and his being nice about it was what tipped me over to full out tears. *sigh* I'm sure my stressing out and exhaustion didn't help my restraint in the matter, but I find it so much harder to be composed when people are being nice than when they're being mean and stern. He discussed things I should be doing to improve matters and gave me some pointers. Then he brought up two Biblical analogies about Joshua, and that just made me cry again because he wasn't just being nice, but also offering up biblical and spiritual support which was even more unexpected. He also said that the particular consultant with which I had such a miserable time with did not like students working with him and that even the SHOs and and other residents who were sometimes assigned to him, he wouldn't let them do anything.

After that, I attempted to compose myself, went to the restroom and washed my face with cold water, took a couple deep breaths before heading over to see Mr. Louden. I asked if I could reschedule my mid-core assessment as I didn't realize it was today, but that it would be fine if he wanted to continue with it that day. Then was pretty much a repeat of the conversation I had with Mr. Olujide. In addition, he asked me to clarify why I missed the days I missed and detail what I had been doing each day that I had been in the hospital. He said that I couldn't afford to take any time off during the day to do reading and that I had to make sure I was doing something each AM and PM session. He said that he had asked around about me and none of the consultants had really seen me or even knew who I was. No one had really seen me working in the hospital and as far as they knew, I hadn't been there. This is exactly what I had been afraid would happen and I guess that showed on my face because then he said, "Oh you look upset, don't be upset, what's wrong," then reached out and touched my hand. I lost it again. Sheesh. I'm so weak against people being nice. lol.

I told him that this was exactly what I had been afraid would happen and that I had been stressing out about it for quite some time. I explained to him that I took that Thursday morning off to read because I had been miserable and felt like a complete idiot after the Wednesday session, though I wouldn't go into what happened. When he heard the reason for why I took that morning off to read, he said he now understood why I took that morning off to read, and it was okay. So that made me feel better that he realized what happened and it didn't really surprise him I guess. I suppose the consultant told him I was a dimwitted American who'd never amount to anything. lol. He expressed annoyance and frustration that I had missed the days for a mandatory induction. He called my student coordinator to check on it and when he confirmed my story said that it was ridiculous and unfair that we SGU students had to go through that when the Southampton students did not. He asked who he had to take this issue up with because it had seriously adversely affected my posting.

Once the story was all out, he said he understood why I had missed all those days and that it wasn't anything of my doing. However, I had a lot of making up to do and couldn't afford to miss anymore days and that going to clinics were of paramount importance because that was where the consultants would actually see me. He gave me all satisfactory checks for my assessment for which I was ever so grateful and said to let him know if there was anything or anyone that I was having difficulty with. And that was that.

After all that, I went home that evening for about 2 hours before I went back in to the labor ward for voluntary night shift. Maybe I was trying to prove that I am willing to work hard and put in the hours to make up for lost time, but I ended up spending almost 24 hours at the hospital that day since I didn't get home til about 5am the next morning.

The best thing that happened was that I got to deliver my first baby :) It was a baby girl and she came out fast! Her mother was only 5 cm dilated then just 10-15 min later she was yelling that she needed to push. After only about 3 pushes and 5 min, out came the bundle of joy. With the midwife guiding me, I got to deliver her, clamp and cut the cord, deliver the placenta and all that lovely goodness. Despite everything that happened earlier, I ended my day with a smile.

Today, February 3, 2010

I delivered my second baby today. Also a baby girl, and they even were gracious enough to name her after me :) Her middle name is Grace. Well, okay, so they had already picked out the name long before, but it's kind of a cool coincidence :) This time I was also able to give the mother an injection of Syntocinon to help her deliver the placenta.

I also went by the breast screening clinic this morning and watched a few mammograms. Sat in on an Antenatal clinic, and didn't eat all day til dinner. But I have to say that today was a good day. It was the first day since Friday that I have actually felt more at ease and not so stressed out. Maybe tomorrow will even be sunny :)

Seeing is believing

Sorry, but I've been so exhausted since Friday that I haven't had the energy or even really the will to write anything. My days currently consist of me going to the hospital in the morning, going home for lunch, back again in the afternoon, staying til the evening, coming home and making/eating dinner, drag myself to the library, go home and attempt to read, fall asleep reading, worry about not getting enough reading done, giving up on reading and collapsing in bed.

I'll try to actually have a catch up post sometime down the road, but suffice to say that I'm keeping busy.

The login I was using to access internet on my lappy at the hospital was disconnected or inactivated or something so I can no longer use my laptop for skype or other internet related things.

I've seen and done some cool stuff at the hospital, but it's pretty stressful trying to always be smiling, cheerful, and attentive and not let on that you really hope that no one asks you anything because you don't know diddly. But I do want to be asked questions because I know it helps me learn and it helps me make connections to the material I know is up there, but just hasn't been accessed in a while or not often. But I want to be asked because they want to help me learn, not because they want a means by which to judge me.

Really I feel like I'm trying so hard to make sure everyone sees me doing something productive. It's like a show I have to put on because if I just go and do the work and not pay attention to what other people are seeing or what they may be thinking, I get in trouble... not because I'm not doing anything, but because they won't notice unless I make the effort to be noticed. It's like I have to make the effort to constantly mentally shout, "Look, I'm here on the ward!" "I'm here at clinic!" "I'm here, I'm here, I'm here, and I'm working hard!" And the effort of the show is exhausting. I'm exhausted from stressing out. I just want to do the work, get the most out of this experience, and learn as much as I can. That's what it's supposed to be about... learning and growing. I shouldn't be worrying about proving myself to the consultants or anyone because my actions should speak for themselves. Unfortunately, if the actions aren't seen by the consultants themselves, they are considered nonexistent.

Apology

Maybe I owe the general British people an apology. They're not all bad. And despite what I said, I think that saying "most" are ungentlemanly or what not is a bit of an exaggeration. There have been a few that have colored my opinion and those are the ones of which I've spoken, but there are even more that are gracious and kind and wonderfully nice :)

Today was the last day of orientation. We did "Manual Handling" training which involved teaching us how to move patients. It was quite an interesting training session and very informative as well as practical. I learned how to use slide sheets, slings, hoists, etc. I think their methods of handling are ingenious and should be employed everywhere. Of course in the reality of the field, these items don't get used nearly as often as they should be, and patients aren't moved appropriately and safely every time. But at least the skills are there, just the application of such sometimes falls in favor of speed or just because of laziness. It happens. But the reasoning behind the use of these maneuvers and products is sound. They reduce the chance of injury to both the patient and the handler. They also make the process much easier and smoother.

There are many things they do here in the UK health care system that I believe works better than that in the States. An obvious one is that they have now gotten rid of all the white coats worn by doctors and medical students. White coats are no longer allowed as part of the uniform because it is believed to be unhygienic and spread disease and infection. Another thing is their "bare below the elbow" rule. No sleeves, watches, or jewelry of any kind below the elbow except for a single wedding band. Long sleeves have to be rolled up, watches placed on belts, and jewelry nil. Nothing hanging either and this applies to both jewelry and neckties. So while neckties are still allowed, they must be taken off or tucked in when seeing a patient. All this makes perfect sense from an infection control standpoint.

Today a few of us new SGU students here met with, Dr. Dryden, our clinical director here at the hospital. His specialty is microbiology and he was not what I expected when I saw his picture. He was pretty cool and seemed really interested in trying to resolve some concerns we had since coming here. For example, prior to our arrival we were quoted a rental rate of £300/mth. However, upon our arrival, our lease agreement had our rent set at £350, which is more than a 10% increase. Another thing is that the lease agreement ends our housing before we're actually finished with our rotations. Also, the lack of Internet. And much more. So it was nice to see that we had someone who would be trying to sort things out for us since we had no one to go to about that kind of stuff, or the people to which we had gone to have been unhelpful to say the least. He's also starting up teaching sessions specifically for us SGU students. Nice. He also suggested we meet up to hang out at a pub sometime. Awesome. lol.

I did a venipuncture today. Yay me :) It was difficult as this patient had almost no veins whatsoever. She had never had her blood taken, she was afraid of needles, and after I stuck her she felt faint. Oi. And she's not a bleeder. Even though I had a vacutainer attached, the blood filled slowly and she looked like she was going to pass out even as she was grimacing in pain. Sorry :( The SHO had to insert a cannula and even she couldn't find a suitable vein. After digging around for a while in one arm, she had to try the other before finally getting it in. She too was only able to draw a small amount of blood and she even used a syringe to do it. I hope it was enough for the vials, but there wasn't much in them... hopefully the labs will still come out on those. But at least I can get that checked off my list. She said if I came by next time she was working, she'd let me do a vaginal exam and a speculum exam. Excellent.

So I guess it's safe to say that today was a pretty good day :)

Concerned

I'm concerned. I seem to have a lot of concerns of late. And I seem to vent a lot about my concerns on here. Does this make me seem like an angry person? lol.

I've been here for about almost 2 weeks now, had one week of actual hospital experience, but this is technically my 3rd week of my O&G rotation. I will soon be getting my mid-rotation assessment, and starting next week I will be having these mini-CEX's (clinical evaluation exercise) which are a method of assessing skills essential to the provision of good clinical care. I'm just worried because I feel I will be graded on the expected 3 weeks of experience even though I've only had one. *sigh*

Anyway, I've been quite exhausted so far this week even though I haven't really done much. Maybe orientation is draining in how boring it is. Apparently the US is quite backwards and behind in its CPR standards. We had a review of CPR here and things have changed since I last went through the steps. You no longer give breaths at the beginning during the ABC's section, and you don't check for a pulse either. You go straight from look, listen, and feeling to compressions. There's a couple other changes, but those were the most significant. What bugged me about the guy doing the lecture was that when I brought up the difference between what we had been taught and what he was telling us now was his response. That response was that we were still using the old 2005 standards and were behind while they were using the new 2010 standards. It wasn't so much what he said as how he said (isn't that how it always is?), with a hint of smugness. Otherwise, the guy was funny, entertaining, informative, and could be kind of cute. And I have no problem with learning something new, I would have just liked for him to explain the new change and how it improved upon the old. Rather then just assuming that I was hung up on the old standard because that's just how I always did it, as he put it. I'm not hung up on it. I just want to understand. Plus I have taught it, so I'm doubly interested in the new changes. I know the standards change every 5 years so I'm sure we're due for another overhaul (though there was a fairly recent change I think). I'm not going to just assume that these new standards are better because you say so. Help me understand. How do I know that the UK and the US don't have different standards? I would assume that CPR is a universally taught standard, and I'm fine with you guys being ahead. No big deal. I'm not one to think that America is better than everyone else and that we know everything. I know there are a lot of things we fall short on.

British people are so disappointing. I had expected them to be more cultured, accepting, polite, well-mannered etc than the average American I guess. Perhaps I had idealized them and held them to too high a standard resulting from my reading in my younger days because so far they have done nothing but disappoint. I've found that the typical American is much more accepting and less bigoted, in my opinion, than most of the lovely English I have had the pleasure of meeting. Sheesh. Now I've started my ranting again. Grrr...

Back to CPR. So I went to Google and did a search on the new 2010 guidelines. There are new guidelines, but they won't go into effect until October 2010. CPR is an international standard and there is an international review board that looks into all the problems and questions people have had on improving CPR and implements the changes based on this feedback and research. And often the UK is ahead of the US in a lot of the medical and healthcare managements. Nice. Good for you guys. That's awesome. Who's got the ego now? You want to drop down and compare size?

Boring....

Today was orientation. And it was boring. Really quite boring. I had to struggle hard several times to stay awake. And I still have 2 more days of this drudgery. I yi yi. The one amazing thing I learned about this hospital is that it has had only 1 MRSA (Methicillin-resistant Staphylococcus aureus) infection in 2 years! ONE. That impressed me to the point where I felt my eyes grow big lol. They said that one of the biggest sources of MRSA was determined to be cannulations (IVs) so now those can only be initiated with a prescription order and there are strict protocols for how often it has to be checked and replaced.

But what was great today was that I went running with my roommate. First time in a long time and it was a rough start. If I hadn't been running with someone I would have quit a quarter of the way and just walked the rest. But since she was running the entire time, I felt like I couldn't just stop but had to keep going til my legs gave out. The cold air didn't help, but once I got past the point where I thought I couldn't keep running, it got easier and I hit a stride. Just focused on breathing in and out, in and out. It was a happy accomplishment and one that surprised me. Oh and on the run back home, I was sure I could smell the distinctive scent of weed as I passed the hospital... Someone self medicating perhaps?

Not much going on...

I went to the Winchester Family Church today, and though I was late to the service, I arrived just in time for the start of the message. This church was more of your modern/contemporary type compared to last week's which was more traditional. Their mission is "...to magnify Jesus Christ by building a Spirit filled Christian community of all ages and backgrounds that is engaged with the culture around it but is clearly different from it - Something Different!" They have a band that includes electric guitars, drums, and keyboard along with more contemporary praise and worship music. It wasn't overtly "Rock out Jesus Christ," but more contemporary than say, "How Great Thou Art." The message seemed a bit superficial, but brought up some interesting points that I hadn't noticed before in the passage in 1 Kings about Elijah and the widow of Zarephath. I have a vague feeling they believe in speaking in tongues, but I'm not adverse to visiting again next week if I can't find another to try.


This week I have the Trust Induction. Sounds like some sort initiation into a secret club or cult, but pretty sure it's just general hospital orientation. Plus I think it comes with free food... always a bonus. It'll go on for 3 days, so nice that I can sort of have those days "off" though I'm considering going in to do some histories on the days it ends early... or I can go touring Winchester with my roomie. To be studious or not to be... The decision may actually just be dictated by the weather...

Communication Interuptus

My school is notorious for its lack of communication. And that's not just in reference to their communication with the students, no, but even with their staff, faculty, affiliated hospitals, etc. Often, when you have a question you start out with the most obvious source of information, who will then refer you to someone else, who will tell you to email this other person, who will then never reply to your email so you call someone else up, who then never responds to your voice mail, so you return to your original source who tells you to check back in a week.

I'd like to think I'm a fairly patient and forgiving person. I tend to let things slide and try to be understanding. Sometimes I will get frustrated, but that tends to happens when things start to buildup and there's the accumulation of questions and a stark absence of answers.

Take for example my first clinical rotation. I arrive, and report to the student coordinator here, who's a lovely lady and full of helpful information and such. I am given a packet that's specifically made for SGU students with a booklet tailored for our clinical rotations at this hospital, Royal Hampshire County Hospital. I'm then told that the information within the booklet is not very reliable, however, and that schedules in there are subject to and most likely have already changed. Well, that's fine because I understand that schedules change and it'd be hard to keep un updated list of all the schedules of all the departments.

Then I find out that I'm not scheduled to do my Psych rotation here as I was previously told, but that I have been scheduled for Peds. Well, this was a surprise as I had clearly communicated with the clinical director of the UK program that I did not want to do IM or Peds here because I felt it important to get a US recommendation letter for those programs, as I am considering them for residency. I was told that this was fine and that my UK rotation schedule had been changed accordingly and confirmed for Ob/Gyn, Psych, and Surg. Wonderful. Now I arrive and the student coordinator is at a loss as to why I was told that I would be doing Psych when I have clearly been scheduled for Peds. Even when I showed her the letter I received stating I would be doing Psych, she couldn't explain it. Well, that's okay. I can always do a Peds Sub-I rotation and get a letter out of that.. no big deal.

I start my rotation eager, excited, and nervous. This is what I've been training for: to work in the hospital, rub elbows with up-and-coming who's who health professionals, learn the secret of the healing touch from veteran attendings, perform innovative procedures, and work miracles. Can we all just agree that I'm naive here and get that out of the way? Anyway, I'm handed a schedule and a welcome letter explaining the schedule and told, "This posting is self-directed. We believe this will facilitate you to learn what you feel is important and of interest to you. Now go forth and do great things."O-kay... Now what? How do I start? Is there a list of things I should be doing, maybe some objectives I'm supposed to try and meet? Who do I talk to? What does the school want me to be able to do? How am I being evaluated? How is anyone going to know that I'm actually doing anything? Hello? Help?

Over the next week I slowly find answers. But it's like scrounging around in a urban city trash bin looking for a slice of unmoldy cheese. Asking the student coordinator doesn't always help because she hasn't been given the answers by the school. Searching on the school website reveals that we're supposed to be keeping logs of our patient encounters so our preceptors can have an idea of how much we're doing and what we've been exposed to. Oh, really? And when were you going to tell me that? So much of what I do know is hear-say from other students. I don't know if I'm missing something crucial or if there's something else that I should be doing that's going to be vital in how I'm to be evaluated in this posting. My concern is that I will finally find out when it's too late, and I can hardly tell the school, "Hey look, it's your fault."

Expensive

Today was a good day :) Teaching session in the morning that I was able to actually follow along with because I'd had the chance to read up on the subject matter ahead of time. Then I did a bunch of clerking for practice. Clerking as I discovered is the term they use here for taking a patient history. So I practiced my history taking skills and presenting them to a doctor, in this case a Senior House Officer (SHO, like an upper-middle class resident).... (Residents here start as Foundation Year 1, Foundation Year 2, Senior House Officer, Registrar, until you are finally the big kahuna: Consultant.) She offered me some helpful tips that I intend to put to good use. Then I decided to take the rest of the day off. Oh, oh, oh! And I got to put on some blue surgical gloves and help change a pressure bandage. lol. Lame, yeah, but hey at least it was actual patient contact! Yay. Also I'm going to start doing blood draws. How exciting.

I learn a lot from doing histories because seeing an actual patient with the clinical problems that I've been reading and learning about for the past few years puts a "face" to the disease, disorder, complication, etc. Also there are so many things that I haven't even read about or only studied because it was part of the curriculum that become real when a patient is telling me that she's had an ovary removed because of a hemorrhagic cyst, or she's here for a Mirena coil replacement, or she just had a hysterectomy because she initially started out with just some annoying malodorous vaginal discharge that was resisting all treatments thrown at it until it was discovered there were displastic patches of abnormal cells growing in her uterus. I met a lady today who had a very strong family history of breast cancer. Her mother died of breast cancer, she had breast cancer which ended up in a double mastectomy (DCIS in one breast and stage 3 invasive breast cancer in the other), and one of her two daughters also had breast cancer and had an elective double mastectomy when it was found that she also carried the BRCA 2 gene. So that's 3 generations of breast cancer. It's something you read about with genetics and how genes play a role, but to actually see the family that was so affected makes it more real and tangible. It's not just academic now, it's reality. Plus it gives me a reason to read up on breast cancer, endometrial carcinomas, IUDs, etc and this is a good thing :)

My roommates and I went into town this afternoon to do some grocery shopping. From Wednesday to I think Saturday there is a sort of small open market type deal on Market St. We found this really amazing stall with fresh baked goodies. Couldn't resist loading up on the carbs even though, I had so far resisted buying and bread. Everything tasted heavenly and we promised to return next week :) Once again, it was raining so we were quite soaked by the time we were ready to head back home.

Lua and I are planning on going out to try a Thai restaurant we saw in town when we were there earlier. It looked kind of fancy though, and we heard from a taxi driver that there are no cheap restaurants here because after all we are in Winchester. Apparently if you can afford to live in upper-middle class Winchester, you can afford the prices here. Guess that makes what that lady said yesterday about a well fed, well paid, middle class population here, make sense. There is a pub by the O & G building that apparently a lot of the students go to for decent food that's reasonably priced, so if the Thai restaurant proves to be unreasonable, we'll head there. Since Lua and I are still waiting for our refund checks, we're still counting our pennies. But we've been here for a while and haven't really had a chance to do much in ways of chilling and down time, so we figured this weekend was as good as any to start. Also interestingly, the only "fast-food" restaurants we've seen have been American: Subway, Pizza Hut, McDonald's. Perhaps they are others, but just aren't obvious to us that they're "fast-food." Or that could also be another reason why there's much less of an obesity problem here as there is in the States.

Still much to learn

So apparently "fraternal twins" is an American term. Or maybe just not one in the British English vocabulary. I asked the 2 Southampton University med students if they knew what that term meant and they were quite baffled. So... looks like I can educate them a little ;) Well, looky here, an American student that has an English term or two that the Brits don't know... lol. I'm sure it's considered quite pedestrian *shrugs*

So because yesterday was so abysmally miserable and I felt like such a failure, I decided to take most of the day to do some reading and self-educating. I did a fair amount of reading and it felt good. I'm not usually one to do a lot of textbook reading. Especially of the sort where you start at the first page and work your way to the end and often end up quitting somewhere between page 5 and 20. I usually have to have some sort of goal or a focus. If I have a desire to read up on a certain topic, I will more than happily find several sources and read page after page on that topic. So it's not that I'm not capable of doing the reading, I just have to feel the purpose of the reading, since it's not really reading for pleasure. If reading with a focus, I actually get something out of it.

I'm thinking of taking tomorrow off as well as there isn't going to be any consultants around really except for one doing theatre. But I have a teaching session in the morning on Ovarian Hyperstimulation Syndrome. I actually got to see a patient with this and it was quite interesting as apparently it's not too common around here despite the increase in families seeking IVF. There wasn't much to see of course, but the patient history was interesting. This woman was going through an IVF program and instead of the expected 10-15 extra eggs after the initial stage, she produced over 30! So her body was reacting to the excessive increase in her hormone levels.

I got a new roommate today, Clayton. He's also from SGU and was supposed to start at the same time as I did, but had passport issues so he was delayed. Lua (my current) roommate and I were slightly dismayed as we were quite enjoying having the place (and shower) to ourselves. lol. But no matter, he lives downstairs and we upstairs... and the shower's upstairs anyway :) Plus there are 2 separate entrances so it's really not that big a deal. I knew of him back in school in that I knew who he was and had seen him around. He was friends of friends, but I never spoke to him directly. Funny though when I met him downstairs after he arrived, we spoke as if we had always known each other. Guess that kind of happens when you're in a new place and you meet someone that you "know" or at least has a similar background and you kind of just assume a familiarity based on that common background.

So my knowledge of anatomy has needs to be improved, being as it's been about 3 years since Anatomy, but I've learned that I shouldn't guess... though it really depends a great deal on which consultant I'm talking to. With Mr. Olujide, I can be more relaxed and not worry too much about being wrong, but concentrate on learning. I tend to have a problem with thinking out loud, because for me it sometimes helps to verbalize my reasoning out an answer to a question. But I'm getting the impression, it's just not done here. With Mr. ____, I don't think I'll speak unless I feel like what I'm saying or asking is actually remotely intelligent. I don't remember if I mentioned, but in response to an answer I gave to one of his questions, he replied, "That is a ridiculously stupid answer." Gee.. really? You think if you just explained to me the correct answer or why my answer couldn't be correct, I wouldn't be able to deduce that my given answer was really quite amateur and outlandishly misplaced? Maybe in his experience when a student is publicly humiliated in front of a patient and staff, they remember the correct answer more vividly. This may be well founded, as I do remember the correct answer now, but I remember more the experience rather than the question and correct answer. But that is just the way of it. Part of the whole learning experience. Well, bring it on. I'll take it.

Oh and right, doctors in O&G and Surgery are referred to as Mr or Miss or Ms and not Dr. This is based on something way back, when they used to just do surgery's and deliveries and such as a 2nd job and were just referred to as Mr. But when they were finally brought on board with all the other official doctors and accorded with the title Dr. they wanted to stick by their traditional titles. Seems to only really be applicable to the old school docs here and not so much the new breed going through now... though, I would have thought this changeover had occurred prior to anyone living's birth, much less career.

Bi-polar

So you're wont to think I'm bipolar after this as today in my writing this, I'm a bit bummed. I dunno. I guess I just need to develop some thick skin and seriously, I do need to review a lot of material admittedly. But, really, how is "fraternal twins" such an American thing to say? I mean, really? Okay, so I'm a bit biased being American and all, and sorry if my terminology isn't as polished as you'd like. Sorry if I can't quite follow your line of questioning because I'm completely lost as to what you're asking, and it doesn't help that you sometimes mumble or maybe my American ears just can't discern the finesse of your proper British English because I've been listening to watered down American swill English all my life. Seriously. Whatever.

Anyway, now that I've got that off my chest :) Today was fine. I went to the Gyn outpatient clinic this morning and saw a couple patients with urogenital problems mainly dealing with pelvic prolapse or urinary incontinence. Watched a few replacements of pessaries. And that was that. Went to a drug rep lunch so free lunch was nice. Then brief teaching session on thecomas.

This afternoon I went into a scanning (ultrasound) session with one of the consultants. First time I met him, and well, I'll reserve judgement. It was a scanning session for high risk obstetric patients which means they usually come in for a scan because of some sort of complication or problem with their pregnancy. Today, most of the patients who came in was because their genetic screening showed that their baby had a reasonable-significant risk for Down's syndrome. The worst one was a 1:3 chance, so it was kind of sad. We did quite a few amniocenteses which was I found kind of surprising, though I understand the use of them and why they were being done here. I got pimped and I answered maybe one out of 20 questions correctly, which meant one question the entire afternoon. I tried to think, but my brain wasn't cooperating, which is my fault because I haven't been using it much lately. So anyway, I'm sure this dude thinks I'm a complete idiot as do the patients and the registrar (aka senior resident) who was training on using the US machine. Anyway, I'm still slightly miffed about it all, but I'll get over it.

Something that I find kind of odd, well, maybe I guess it's not odd, but it doesn't exactly help people's opinion of me, even though I know that shouldn't matter that much.. .but is that they assume that because I went to med school in Grenada that I'm from Grenada and therefore should know all about life in relations to what is standard procedure in hospitals, etc. And yes, I realize I write in run on sentences when I'm not caring. I mean, how many people really read this anyway.

I didn't sleep well last night though I passed out early, before 11. I've been exhausted and I'm not sure if that's because of not sleeping well at night or because I've been working long days. I don't really feel like I've been doing much to warrant being exhausted, but I guess I am at the hospital usually 10-13 hours a day. And this is supposed to be a nice little posting. I dunno why I'm working so hard when the other students seem to take this posting (O&G) much less seriously. I should start skipping :) But back to sleeping, I was warm last night in my sleeping bag, though I kind of wish it wasn't such a strict mummy shape as my legs were really sore and I felt that I wanted to stretch them out. They've been sore since arriving, and I'm not sure if it's from all the standing I've been doing + the 20 minutes maybe I worked out or if it's still from my flight over. Maybe I have problems with my veins.

So to sum it all up: I'm frustrated, discouraged, annoyed, disappointed, and just not quite happy with the way things went today. But I'm sure I'll be over come morning. So here's to my sunny morning disposition.

Me say...

So I'm pretty excited right now. Though I doubt the excitement will last for long and it's a pretty pathetic reason to be excited all things considered, but whatever. I was leaving the post-natal ward this evening when I stopped in to see if one of the consultants was still in his office. Surprisingly, he was despite it being past 5:30pm. I was able to get some good direction on how to proceed with my posting in O&G and now I actually have an idea of how I can be more proactive in my education. I also got a recommendation for a church in town, so I think may try it out on Sunday :)

Today was actually a pretty good day. The morning wasn't much as the labor ward was really dragging and not much in ways of goings on, so I went to see a scheduled elective C-section. It was pretty cool, though I found looking at the baby more interesting than watching the surgeon close the site. I had hoped surgery would be more interesting, but I guess not. lol. The opening of the site was much more so. Maybe I'd be more into it if I was actually doing something to take part of the procedure. The most interesting aspect of the C-section was that the mom bore a striking resemblance to Sigourney Weaver.

The coolest thing I did today was play translator for the doctors to a Chinese lady who couldn't speak a lick of English. Okay, that's not true, I heard her say, "morning" and "thank you". But it was nice to just actually feel like I was doing something and being helpful, since I'm still trying to figure out what I'm doing around here. She is an asylum seeker so when she had her baby, she wasn't able to go back to her previous accommodations. Now she's staying at the hospital because the UK Border Agency says she has to go back to her previous address because that's the only address she has permission to stay at, but since she can't go back, she's staying in the hospital until other arrangements with Social Services can be arranged. Her case was fairly interesting as well, but I don't think I can go into that here. But my broken Chinese made up for her lack of English and at the end I think both she and the doctors were happy with the progress made in communication.

Oh and I bought me a sleeping bag today. It's a fairly nice Vango Fusion 2-3 season bag that was on sale at an outdoor specialty store so I got it at a fairly reasonable price. I weighed my options after seeing both the sleeping bags offered and the duvet + set offered and my choices were 1) get a sleeping bag that I would actually use after I left here but pay about $15 more or 2) get a duvet + set that was cheaper, and would make the room look more homey, but would probably end up just leaving here. I opted to get the sleeping bag as I could get more mileage for the money put in.

Anywho, enough. I'm off for food and a potential work out :)

Forceps

So today was a long 13 hour (7am-8pm) day in the labor ward. Voluntarily mind you, but nonetheless, long. It doesn't feel really like it's been that long because I'm not really tired, but my legs and feet are a bit sore. And now my preconceived schedule has gone to pot. I got to see my first "professional" birth, and while it was prob not the best to see as a first, it was quite interesting. It was a birth by foreceps. What this basically entails is that the baby is literally pulled out with a pair of foreceps while the mother pushes.

There are 3 methods of delivery: your usual spontaneous vaginal delivery, then there's the assisted delivery (e.g. with forceps), and then there's the C-section. So the assisted delivery is the middle ground where the mother can't quite get the baby out on her own, but either she doesn't want a C-section and really wants to just try assisted first, or the baby just needs a bit of a help.

This one required the doc to really put his back into it though and there was concern at one point when the baby's heart rate seemed to drop to a scary level.. the baby came out understandably bruised, but seemed otherwise unharmed and in fairly good health. The mother was just so grateful that the baby was finally out. Completely understandable as the baby was postterm and on the way to becoming quite the bruiser :) Didn't really disuade me from having children, despite the frank distress I've witnessed that comes with childbirth, but yeah. It could all change with my first.

I'm not sure what I can really say more on here without risking breaking confidentiality, so suffice to say, it was a good day. The midwives I worked with were great and I learned a lot about the birthing process. Still haven't met any of the consultants I'm supposed to be following though...

There was a lady that was brought in by ambulance because she got stuck in solid traffic on her way in and was having contractions 2 min apart. She ended up giving birth about 10 min upon arrival, so the midwives made a good call in sending the ambulance to get her from the the road.

Think I'll try the labor ward again tomorrow morning and maybe try something different in the afternoon... Or maybe take the afternoon off since I still have to go and get that comforter.... Decisions, decisions :)

The Anointing

Today was beautiful. The first non-gloomy, dreary, rained upon day since I’ve been here. So my walk to church this morning was lovely.

I got a bit turned around when walking there, but in the process found the public library and another grocery store, a Tesco express. So church. Yes, I visited the Winchester Baptist Church… read BAPTIST. I was late as I had forgotten what time the service started and got a bit lost, but back to it being a Baptist church.

So, here’s me walking into a nice looking, kind of formal building, their sanctuary is fairly small but has a balcony and choir loft. I’d say about 35-40% of those in attendance were 50+. I squeeze in past some folk and take my seat. I’m sitting there listening to the speaker for a while… he’s speaking on the power and the pain that comes with being a Christian, and all seems to be fairly kosher. He continues on about the suffering that Christians are sure to experience and that while many new Christians look expectantly for the power of God to come upon them, most are surprised by the suffering. But it is when he starts talking about the experience of the power of God that my ears start to perk up… And how the experience of God is manifested in the speaking in tongues (uh-oh). Then he mentions that this is a conservative Baptist church, planted by Charles Spurgeon (very cool) and that they have progressed in inviting him, a Charismatic preacher, to speak to them. It’s here that all the not so subtle wordings he’s been using like “anointing,” “laying on of healing hands,” and such clicked and I think to myself… oi, this is going to be interesting… and sure enough…

He spoke about a famous Charismatic preacher, Smith Wigglesworth (cool name), who raised 14 people from the dead (including his wife for a short moment before she told him that God wanted her and that he should let her go so he did and she went back into death), and warned the congregation about praying to God for that kind of anointing because it comes with a heavy price (e.g. the death of Wigglesworth's beloved wife). About how he healed, by the grace and power of God, the black Labrador retriever of a burly, miner-type skinhead who then as the result of seeing such a healing, got saved and became the youth leader of his former church, and so on. I think the church has a ministry where they go out on the streets periodically and lay on healing hands, and they do this as part of a group of churches that included charismatic, Anglican, Unitarian, etc churches.

To cap it all off, at the end of his talk, he said he was going to do something that he was sure was unusual here: he asked those in the congregation who had need of the power of God, whether for healing, troubles in their lives, etc to stand. Everyone was then to take a hand and lay it on one of those standing close by and pray with him for the power of God to come upon them. There was one girl a seat away who started to break out in sobs at this point and continued even after the service was over. The speaker said he could see with his spirit, the power of God descending from above, coming down from the ceiling as golden 24 karat leaves floating down upon them. He warned that sometimes when a church prays for healing, there is a time when at first there is a surge of sickness so as he closed, he commanded and called out to banish and bind sickness from this church. The girl was still sobbing at the end of the service so after waiting politely for 5 minutes, I decided to do what the guy next to me did… climb over the seats in front and make my way out.

So that was my first, first-hand experience with Pentecostals/Charismatics. I hope I don’t sound callous in my rendition of what I heard and saw, because it was obvious that these people were sincere. I do believe in the power and anointing of the Holy Spirit. I do believe that God heals and is able to perform miracles. I just don’t believe that He still manifests Himself and power in such ways, like speaking in tongues, now. It’s not that He can’t, but that He doesn’t. I’m still debating on whether I should go back next week since this was obviously an atypical Sunday morning service and most of the other churches within walking distance are Catholic. Maybe I can find one that’s close to a bus route…

The rest of my day was spent getting a library card, cooking, and the majority trying to make sense and organize one cohesive schedule from 4 very confusing and sometimes contradictory O & G (or as we call in the States, Ob/Gyn) schedules.

Now for some reading, then bed.

To Town...

I've been doing some reading for my clinicals and have finally gotten my room cleaned up and organized. I haven't really been sleeping very well mainly I think due to the fact that the amount of blankets I need to keep warm at night weigh very heavily on me so I wake about every 2-3 hours. It's quite bothersome. I was hoping to sleep in today since it's a Saturday and I went to bed pretty late the night before, but nope, was out of bed before 9. I really have to give housekeeping a call on Monday... I went into the center of town today to see if any of the charity/thrift stores had any duvets/comforters for sale, but alas, none was to be found. So I guess Monday...

Like I mentioned, I went into town today with my roommate and we both got new SIMs for our phones. I actually switched mine from Orange to Lebra because it had cheaper rates for calling international and local. It costs about $0.06/min now for me to call the US with this SIM (vs $0.09/min with the previous), but all incoming calls regardless of origin are free. How sweet is that?

Also went to Sainsbury's, a local grocery store, kind of like a small Bi-Lo/A&P/Shop-rite. It's about a 15-20 minute walk from where I live (about 0.8miles). The walk was nice despite the on again-off again rain. Food and just generally everything is more expensive here. Even items on sale, it hurts making the conversion, so I've stopped at just making a cursory conversion, enough to determine which brand is the cheapest and just go with that.

I walked past a church on my way to the grocery store and it looked like it would be a good one to try out tomorrow. "Breaking Bread" starts at 10am, Sunday School at 2:30pm, and something else is in the evening around 4:30. I'm not really sure what "Breaking Bread" is... but that's around the time I'm used to going to the morning service at church, so I might try that out. I couldn't see the name of the church on the building, but it looked cool. Old traditional stone style building on the main shopping road. But for all I know it could be some Catholic Cathedral. I'll see if I can find any info on Google...

Well, didn't find any info on that church but found another one that looks like it might work, Winchester Baptist Church. After browsing their website, I'm left with mixed feelings, but I think I'll check it out since it's the most promising of the ones within walking distance to me.

Winchester, UK

So, I arrived in England yesterday morning after flying out from Charlotte, via JFK, to London Heathrow Wednesday evening. I took the National Express coach from the airport to Winchester where my hospital, the Royal Hampshire County Hospital, is located. The flight was uneventful other than my missing my original flight from JFK to London, but I was able to catch the next flight out an hour later. (I told security that it was my flight they were announcing "last boarding call" for, but they just kept saying, "Oh you'll fine, you'll make it. You have plenty of time." They were wrong.) Flight times were decent with a little under 2 hours from Charlotte to JFK and a bit over 7 hours from JFK to London. I had a 3 hour layover in JFK and thanks to a handy dandy free voucher from my Dad, I stayed at the posh Oasis lounge. People if you travel a lot and have loads of money, invest in one of these airline club memberships. Free hot and cold buffet, well stocked open bar, Starbucks coffee, decent tea, free wi-fi, comfy seats, bathrooms with nice looking showers, and all that first class service. Plus it makes you forget that you haven't gone through security yet and to take that time into consideration when catching your connecting flight ^_^

Accommodation here is fairly basic, but works. I'll see about getting pics after I actually get my room kind of straightened up, but suffice it to say that my homestead for the next 6 months is very much like a 4 bedroom duplex. 2 bedrooms on the downstairs and 2 upstairs. There are 2 bathrooms (1 half, 1 full) a common living room, and common kitchen. One of the big perks is there is a sky light in each room which I love, but I need to get me some higher wattage light bulbs if poss, cuz for those who know me, I love me some light :) Each bedroom comes with a twin bed, desk, wall shelf, 2 chairs, a dresser+mirror, night stand, ottoman w/ storage, tiny closet, and sink. Bed linens were standard hospital issue.

I'm looking into getting an internet "dongle" (mobile internet key thingy) here that will give me internet access on my laptop, as there is none to be found in my complex. Only access at the moment is at the medical library about a 2-3 minute walk away. It's not bad, decent connection, slow responding computers, IE 6, Office 2003. Right now it looks like it will be fairly expensive ($25 or 40/mth for 3 or 10 gb down/mth respectively), but I think it's something that's fairly important (or maybe that's just the withdraw speaking) as there are some things that I will need to do regularly online.. It'll also give me free calls home and back using Skye... But really, a 2-3 minute walk every day isn't that bad. I walk further to the hospital every day...

Anyway, I did my first full day of Ob/Gyn today. It went very well, though I'm still kind of nervous for Monday when I will be pretty much on my own. The teaching style here is very much "self-directed". This means that you're given the freedom to do whatever you want, whenever you want to do it. If you want to learn a lot you can go out and be proactive and do a lot. If you don't want to do much, no one's making you do anything. So basically you can spend as much or little time as you like in the rotation. There are 2 other students in my rotation. They are from the Southampton University School of Medicine. They've been very helpful and nice so far, so I think we'll get on well, though I'll prob only see them mostly in the teaching sessions we have together.

The weather here is cool and fairly dreary for the most part so far. I've seen some sun, some rain, and there's still a lot of snow on the ground. It's been about 2-4 degrees Celsius (35-40 F) here lately and I'm told this is quite chilly for this time of year. My room was cold last night and I woke up around 1:30am to put on a jacket and add 3 more doubled up blankets to my already 3 layers of blankets. These blankets though fairly thin are uber heavy so it felt like I was sleeping under a sheet of metal. But at least it was warmer and I ended up waking in a sweat and had to take off my jacket. Afterwards, it was fine. I'll have to call housekeeping on Monday to see if I can get a comforter, or I'll just get to their equivalent of a Walmart here somehow and buy one...

I'm not too jet lagged, but I do think I will be sleeping in hopefully tomorrow.

Anyway, I guess that's all for now, I'm going to head home now.