Is It Advantageous For Student Doctors To See Patients Earlier In Their Careers?
I’m asking this for a friend.
I asked Google AI the question in the title of this post and received this answer.
Yes, it is advantageous for student doctors to see patients earlier, as it can increase motivation and confidence, provide a better theoretical understanding, and help them develop clinical and communication skills earlier. Early patient contact also helps students build professional identity, gain comfort with patient encounters, and better understand the realities of being a physician, which can also improve patient experiences and facilitate the transition to becoming a junior doctor
That all sounds pretty sensible to me.
These are some thoughts.
Could The Same Philosophy Be Used For Other Health Professionals Like Nurses, Pharmacists And Radiographers?
I don’t see why not!
I actually feel, this philosophy might be already being used by the City University, who train radiographers at Homerton Hospital in Hackney.
I Was Used By University College For Interview Practice
A few years ago, I spent four nights in University College Hospital.
- I had my own single room.
- They wanted to do a few more tests.
- So one of the Senior Tutors asked if I’d mind being interviewed by student doctors for practice.
As I said, I wouldn’t mind, I was interviewed by four student doctors over two nights.
It certainly relieved some of my boredom and at least two of the students had never met a coeliac before.
Conclusion
I believe this patient/student interaction could be used very much to the advantage of both groups.
To Norbiton For A Plate Of Lovely Liver
I seem to need a lot of Vitamin B12.
- I am coeliac, which probably means I don’t absorb enough out of my food.
- Although, when my gallstones were removed, the surgeon had a look and said everything was good.
- When Homerton Hospital found my Uncomplicated Pancolonic Diverticular Disease, that I talked about in I’ve Got Uncomplicated Pancolonic Diverticular Disease, they also said everything else was good.
- In the United States, Vitamin B12 is given to stroke patients to help recovery.
- I’ve had Vitamin B12 injections for nearly thirty years, since they were prescribed by Addenbrooke’s hospital.
Certainly, I find that a Vitamin B12 injection doesn’t seem to have the same effect, it had twenty years ago. So, is my brain saying, I’ll have that, when I have an injection?
When I lived in Suffolk and I felt my Vitamin B12 was low, I’d go down the pub or carluccio’s in Cambridge or Bury and have a plate of liver.
But liver is rare in London restaurants and Carluccio’s don’t serve it any more.
A guy in the reader’s comments in The Times told me of a restaurant called the Trattoria Calabrese, that sold liver in sage butter yesterday. So today, I took a train to Norbiton to get myself some extra Vitamin B12.
These pictures describe my first visit to Norbiton.
The short walk to the restaurant from Norbiton station was very much worth it. I shall go back!
A Funny Turn On Thursday
Because of my endoscopy at five on Thursday, I had a quiet day. I wasn’t allowed to eat anything for eight hours before or drink anything but water for four hours.
About one in the afternoon, I was sitting at my computer, typing a post into my blog.
And then everything, went rather fuzzy and words were coming out garbage. Often each letter was replaced by one of the next on the keyboard.
I was also a bit unsteady on my feet and as I was alone in my house, I decided to go out, so that if it was something worse and I collapsed, there would be someone to help me.
As I got to the bus stop, which is about fifty metres away, a violent thunderstorm broke out.
On the bus to The Angel, I tried to check my phone to get the time. It didn’t respond and I couldn’t unlock it. And even with help from the EE Shop and a guy on the bus, the phone wouldn’t respond to my fingers.
At the Angel, I did at least have a sensible conversation with an assistant about a clothes purchase, but in the end I bought nothing.
I left the Angel earlier than I’d intended and as I was on a 38 bus, which starts my journey to Homerton Hospital, I gave up on the idea of going home for some water.
I had a long change at Dalston Junction for the 242 bus for the hospital, but at least the rain had stopped somewhat and I was by now steady on my feet.
My phone was also working, so I was able to read the instructions about where to go at the hospital.
So what had happened to me at one in the afternoon?
Was there a low pressure before the storm, that sucked all the water out of my body and in the process made my fingers dry, so they didn’t work the phone?
Interestingly, I lost 0.9 of a Kg between 08:00 on Thursday and 08:00 on Friday. Was that just the fasting?
My INR also dropped from 2.4 at 08:00 on Thursday to 2.0 at 08:00 on Saturday. Was that because of all the fluid I lost, thickened my blood?
I Had My Fifth Endoscopy Yesterday And The Fourth Without A Sedative!
After two at Addenbrooke’s in Cambridge, this was my third endoscopy at Homerton in East London.
The most difficult part was not eating for eight hours before and only drinking water for four hours before.
I have mild anaemia and they were looking for cancer.
Luckily for me, they didn’t find any.
I did however lose nearly a kilo in weight.
Was that the diet or the long walk to the bus, which took me home?
Endoscopies At Homerton
On their information, they sent me, Homerton said they prefer to do endoscopies without a sedative.
I suppose it is more efficient, as Addenbrooke’s told me nearly thirty years ago.
Conclusion
I am certainly not worried about endoscopies and if your doctor says you have should one, make sure they talk you through it sensibly.
Years ago, I was on holiday in Capri and met a party of about six American gastroenterologists, who were horrified, that I had had two endoscopies without anaesthetic.
But then, I think they were more worried about the fees, that the anaesthetist didn’t get.
When Homerton investigated my gallstones, I said I’d be happy to undergo the procedure without a sedative, although, the specialist private surgeon, doing the procedure for the NHS, was accompanied by an anaesthetist. In the end the anaesthetist just stood by, in case he was needed and the surgeon did his first endoscopy without a sedative. He was very pleased with everyone’s performance including mine.
Homerton Hospital Is Bottom Of The List
In The Times today, there is an article, which is entitled Ambulance List Shows NHS Trust With The Worst Delays.
My local hospital is Homerton and it gets a very honourable mention.
At the other end of the scale, four trusts accepting patients by ambulance reported no delays of more than an hour, led by Homerton University Hospital in east London.
It is interesting that Homerton is down as one of the best.
My GP reckons it has improved greatly in the last few years. He also says, that they seem to have more spare capacity, than the other hospitals in the area.
The hospital removed my gallstones using endoscopy and I walked out to a waiting car. I could have taken the bus, if required.
I also had a knee X-rayed, where the GP gave me a chit and told me to just turn up unannounced in one of two specific three-hour periods. I was in and out in just over ten minutes.
Homerton seem to be thinking hard about their organisation and methods.
Could this be why they are the best on the list?
So what is our South London Mayor doing to improve transport to this much improved hospital?
He’s cutting out, one of the major bus routes to the hospital.
Goodbye To My Gallstones
It is now some weeks since I said goodbye to my gallstones.
They were in my bile duct and were discovered by using an ultrasound probe on an endoscopy at Homerton Hospital. I didn’t even put on a hospital gown.
I had that endoscopy, as I did my two previous ones at Addenbrooke’s Hospital in Cambridge to check for coeliac disease without a sedative, as Addenbrooke’s likes to be efficient and cutting out sedatives reduces the manpower required, cuts the need for recovery beds and allows patients to drive home.
After this endoscopy, I came home the way I arrived – on the bus!
I would say that a good endoscopy operator should be able to do the procedure without a sedative. Although in this case, the nurse holding the oxygen tubes up my nose, was stroking my beard to calm me down. Not that I needed it! But it was a nice action!
I had the removal of the gallstones with a sedative, but I only remember the anaesthetist saying something like “Lovely” as he threaded the camera and attachments down my throat.
They broke into my bile duct from the duodenum and then inserted a balloon, which was then inflated to flush the stones back into my duodenum.
I must have dropped off and I woke without any pain or even discomfort.
One complication for me, was that I am on Warfarin, but I dropped my INR to one before the operation, so that there wasn’t blood everywhere.
I have had some after effects.
Where Has My Constipation Gone?
Since I was about sixty, I have suffered from constipation and my GP has prescribed a laxative.
I felt it was a family trait as my father was also a sufferer.
But since the operation, I have only taken one pill, that may not have been necessary.
My Appetite Has Returned
I am certainly eating better and I have not put on any weight.
Conclusion
If you have gallstones and removal is suggested, go for it!
Prioritising Patients
Homerton hospital is hoping to remove my gallstones on Thursday by endoscopy, so it’s just a fairly small procedure.
I do wonder if there is a shortage of nurses, doctors and other staff at the hospital caused by either the Covids or the fuel crisis, if some operations will be cancelled.
At no time, in the diagnostic process was I asked if I was in pain. Which I am not!
Surely, in the Age of Covid-19, where there is great uncertainty about predicting hospital capacity just a few weeks in the future, I should have been asked a few questions, so that urgent cases could be given priority if necessary.
As they must have been there for a few months causing me no trouble, surely a few extra weeks won’t make much difference to me.
The Diagnosis Of My Gallstones
I arrived at Homerton hospital as instructed today for the endoscopy.
Strangely, it was C’s birthday.
The procedure would involve passing an ultrasound probe down my throat and through my stomach to take an ultrasound image of the lump close to my liver.
I’d had two endoscopies before in the late 1990s at Addenbrookes to check for coeliac disease. One was a normal one, but in the second, I was also providing a sample of fluid for a research project at Cambridge University.
I seem to remember at Addenbrookes, I had been instructed to turn up in something like a tee-shirt and shorts, which is what I did. In this case, I took my shirt off and put a hospital gown over my cord trousers.
As I’d had the two endoscopies at Addenbrookes without a sedative, I suggested strongly, that they do the investigation without one this time as well.
The doctor, who was of an age to be very experienced, said he was up for it and we went for it without a sedative.
There was two big differences to the procedure at Addenbrookes.
- There were more staff, than Addenbrooke’s doctor and a technician.
- They were fully gowned up, as opposed to normal clothes.
But, then I got the expression at Addenbrooke’s they were aiming for speed and they were only confirming their earlier diagnosis of coeliac disease. that had been made by a genetic test.
Everything this time, went without a hitch.
- I was laying on my left side.
- I had oxygen tubes up my nose.
- With my right hand I can feel the probe in my stomach.
- To calm me down, a nurse was stroking my beard.
After not a long time, everything was done and I was walked back to recovery area.
Within half an hour, I was informed by the second doctor, that I had got gallstones and they would be taken out by endoscopy on September the 30th. Later they will take out my gall bladder by surgery.
I got the impression, it was the first time, that he’d seen this procedure without a sedative, as he described me as the Star-Of-The-Day. But then I’m a London Mongrel, with more survival genes than a garden full of Japanese knotweed.
I went home the way I came – On the bus!
After Effects
The only after effects were that the air in the theatre had dried me out and my left left arm hurt because I’d been lying on it.
So I vowed to drink a lot of fluids before the operation and do something to improve the strength of my damaged left arm.
A Lump Near My Liver
In A Mysterious Attack On My Body, I explained how I ended up in the Royal London hospital after my hand stopped working, probably due to an infection.
A couple of weeks afterwards my GP called me in to the surgery and repeated the blood tests on my liver, as the first taken in the hospital, weren’t quite what they should be!
These blood tests didn’t show the improvement they should have done, so I went to Homerton Hospital for an ultrasound on my liver.
This didn’t satisfy the GP, so he arranged for a CT-Scan at Homerton hospital.
After the scan, but before the results were known I saw a consultant, who told me about the lump.
He said it could be benign or something nasty and hopefully after he reviews the CT-Scan next week, we’ll know.
He said an endoscopy will probably sort out what it is!
The weird thing, is that, I’m not in any pain.
Except that is, for the lower back pain, I’ve had since I was about twenty.
As I can never sit comfortably in a car and my mother told me, my spine turns the wrong way, that probably explains that.
When I’m working at the computer, about every half-hour, I lie flat on my back on the floor and that seems to sort it.
Why did I get such an odd body?
Any advice gratefully accepted.
The Anonymous Widower 