Back to business

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I’m back in the UK now and having left one third world country, am now in another as I’m on placement in Fife……

I’ve attached my elective report for any keen beans, though in advance, it’s saccharine enough that it might put you into a diabetic coma. Insulin on standby, please.

It’s nice to be back in a hospital where there are things like working lights and rules against leaving needles lying around, though I do miss the culture and the people, and have every intention of heading back to somewhere similar as soon as is feasible. In other news, I had a lovely treat to come home to as I found out my jobs for next year and got my absolute first choice! I feel very blessed. I’ll be starting on geriatrics at the infirmary (a ward my student visiting society frequents!), then combined assessment (read: the war zone) over Christmas and into the Spring, and finishing on childrens surgery. All of the posts are within the city, which means I can keep doing all my outside interests and it’s generally so exciting that most of you probably already know about it, or will do soon enough. It’s proving quite difficult not to be too excited about it at the hospital as a lot of people didn’t get their first choice, so I’m going to rejoice here instead! You may disagree, but I honestly think that being involved in healthcare is the best job in the world. Particularly when it’s healthcare involving the very old, the very young, and the very sick – which is basically a summary of next year – and my favourite sorts of people!

Full steam ahead to finals! Elective Report2

Below are some photos from Annapurna too – made it back all limbs intact and with minimal frostbite….

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A wedding, a proposal and a cinema of wailing Nepalis…..

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It’s been quite busy this week and I’ve had a few unusual experiences to say the least. These include:

1) going to a Nepali wedding (lasts 3 days, on day one all the blokes go to fetch the bride and the women, including me, stay behind and bang drums/wail until they return, which in this case, was over 24 hours. Apparently, we have it easy with our walk down the aisle and cocktail sausages on sticks afterwards). It was lots of fun, they taught us (read: attempted to teach us0 to dance, and there was a bizarre dance done by the grandmother, in drag, acting out ‘bedroom scenes’ with the future mother in law. Note to mum, this is a definite NO for any wedding I may have. Which brings me on to……

2) Getting a genuine proposal of marriage from the man I bought a scarf from a few weeks ago. Apparently, I would make an excellent bride, could help with the accounts, and learn to ‘cook properly’. When I expressed both being flattered, but disadvantage as I leave Nepal in two weeks, he assured me that this was enough time to organisae everything and I didn’t need to worry about anything. Muneer is very gentlemanly (even a tad rugged) but when I firmly explained that I could not acquiesce to his request, he started crying. In the middle of his shop. Needless to say, this was pretty grim. Fortunately, the bar opposite had lots of gin in stock. Either way, this brings my tally of proposals up to four (I got three on geriatrics) and is the first from someone who hasn’t faught in a world war. Whether this shows progression, or regression in my ability to attract inappropriate men, I simply do not know.

3) Having an altercation in the street when the above gentleman saw me exiting a different handicraft store, apparently having committed the sins of covetting another man’s pashmina, also known as ‘scarfdultery’. In Muneer’s eyes, apparently my sinful nature knows no bounds. Good news is that the scary text messages/late night calls (which have no fear, I never answered)  have now ceased. Bad news is that I’m a bit concerned I might wake up to a yak’s head in my bed one morning. At the end of the day…..kehgarni?

4) Going to see a Nepali film, which made Neighbours look OSCARworthy and like hardhitting drama, by comparison. There was a very John Cleese type period where I kept asking what films were on/which the best was/were there subtitles/ad infinitum and the man kept saying ‘I am sorry’ which I took to mean he didn’t understand. Obviously, this was in fact the name of the film. Either way, as the first foreigners to attend the filmhouse in living memory, the owners plied us with Nepali cinema snacks (masala popcorn, tibetan bread with sweet butter, other things that defy description but may once have been some form of vegetable…..) and repeatedly asked us if we were enjoying it, which we did immensely, mostly because the other viewers kept crying at the plotline. Best 80 pence I’ve spent in a while!

5) Going kurta shopping. I’ve ummed and ahhed about buying one for weeks, but after borrowing Claire’s spare one for Sivaratri (see photos) decided I needed to seize the day and make a purchase. The shops are like aladdin’s cave, for someone with a love of textiley pretty things like me, with towers of fabrics in every imaginable colour, with every sort of embroidery you can think of. The shop assistants were very helpful and I love the one I purchased, though the measuring procedure was a bit odd (was measuring my groin really neccessary……?). To me, kurtas seem to epitomise the Nepali view of femininity, as they are very modest (everything is covered), but opulent in design. It also is much easier than clothes shopping in the UK as really you have a choice of tunic-with-slits or tunic-without-slits and trousers-with-baggy-legs and trousers-without-baggy-legs – s opposed to the endless dilemma when dress shopping at home of strappy or strapless, sleeved or sleeveless, A-line or empire line, floor length, knee length, mini…..the list goes on. Goodness, being a Western consumer is difficult. Perhaps the Nepali are on to something.

6) Obs and gynae: well, it’s a mixed bag, that’s for sure. I’ve seen some very rare cases – a ruptured uterus, a bicornuate uterus, a molar pregnancy and an intersex woman, which is of course interesting. However, I did find last week difficult after being present at the birth of an anencephalic baby (undeveloped brain, not compatible with life) as the mother wanted to carry to term, rather than terminate. The baby was surprisingly born alive, and after looking at it with complete disgust, the midwives left it exposed on the side, to die, and then left is uncovered for hours, at one stage putting another naked stillborn child next to it. Usually, families take bodies down to the river behind the hospital, to burn on pyres. These babies were destined for a rubbish heap, apparently. I find this difficult to understand, though in Nepal, where infant deaths are not common, but more so than in the West, perhaps their lack of empathy is understandable, as these events are seen as just a part of life. Either way, it reminded me of the importance of a neutral face when delivering health care. No baby deserves to be looked at, like this one was.

That’s probably enough for now! I’m spending my last week writing my report (any suggestions for an ‘original angle’ much appreciated. Considering writing it in iambic pentameter just to see if that meets the med school’s ridiculous criteria….) and buying far too many souvenirs. I think it’s going to be a case of wearing ALL OF MY CLOTHES to enable everything else to fit in. Hmm. This week I’ll also say goodbye to the Swedish friends I’ve made, which will be sad, but also a good excuse to visit Sweden at some stage in the future. I’ve also had lots of time to think about what extra-curricular (or, extra occupational, whoop!) next year. Being out here has enforced my plan to join the Rotary as they do a lot of good stuff in places like Nepal (and I won’t be the oldest, unlike in uni stuff) so I’m looking forward to getting stuck in when I get through finals.

Special messages:

-L and L, can’t wait to see you and congrats on the interviews at Metaswitch! Have sourced Nepali bunting (also known as Tibetan prayer flags) to grace the flat. Too exited for words.

W – hope revision is going well, hope you’ll make it home to see me when I’m back!

Prospects folk – looking forward to seeing you and already planning April’s meeting!

Rowena and rugged heros: man in Nepali film deffo meets criteria. May need to have a Nepali themed night at some stage…..

 

A near death experience and a celebration!

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It’s been a bit of an odd week as I missed a few days at the hospital after being struck down with the dreaded gastro (talking the language of dinosaurs gets terribly tiresome after a while) but fortunately perked up enough to be allowed to go rafting and canyoning at the weekend.

I’ve rafted before and often been a bit disappointed by the ‘danger’ factr, but these rapids were the real deal and we all ended up capsizing more than once. A highlight (or downside, depending on opinion) was that to reach the campsight, we have to be pulled over a gorge in a small iron cage suspended on cabling – more than a bit risky as every time it went over a rivet, it bounced as though it was going to fall off. It felt like the sort of hideout that features in the famous five – ‘terribly exciting, what what’ and all that. Photos to follow.

Canyoning was brilliant – we abseiled down 90m waterfalls, and also slid and jumped down a few too. On the first jump, I managed to thwart death after slipping just as I took off (all the shoes were far too big for me, despite Nepali usually being very petite) and falling off the edge, down a ragged rock face, and not knowing on the way down if the water at the bottom was deep enough to save me from breaking my neck. Fortunately, I survived, despite being a bit shaken – though nt to shaken that I didn’t go head first down then next drop; as always, adventure wins over risk.

Yesterday was Shivaratri, or literally, the celebration of the birthday of Shiva, the Hindu God of destruction, who is the most revered of all the Hindu Gods in Nepal. Now in addition to taking a liberal attitude to destroying things, Shiva was also quite the daredevil and also enjoyed smoking ganja, meaning that for one day only, it is legal to use cannabis in Nepal. As a result of this, legend goes that when the teenage Shiva got the munchies, his snack of choice was roasted sugarcane, so this crop was being sold in the streets, so that you could buy whole canes, stick and end in an open fire, and when it gets hot, whip it over your head and onto the ground. The heat makes the end of the cane explode, so you can then eat the fibrous inside. I can’t say we were good at the smashing bit, (you wouldn’t believe how loud some of the locals couild make it go!) but it was very tasty, though I was quite anxious about someone having an eye taken out as the Nepali don’t really go in for health and safety…..Nonetheless, it was interesting to see how the Nepali celebrate their biggest festival and lots of fun to dress up in Kurta, though again, I was convinced that my long scarf was going to end up catching alight and incinerating me; lucky once again.

I was also a bit embarressed as I hadn’t  realised that sugar cane is actually……a cane. You learn something every day….

I started on obs/gynae today and once again it promises to be an interesting few weeks, though I think here, it’s harder than ever not to compare to our own slightly pretentious attitude to childbirth. Here, the women lie in one room until the head is starting to emerge, at which point they have to get up and walk to another room at the far end of the corridor, then climb up some steps onto the birthing bed, push out the baby as quickly as possible, and then walk to the post delivery room (down another corridor) as soon as they are stiched up. There is bsolutely no pain relief and episiotomies (being ‘cut’) are done with used, bloody, blunt scissors. Ladies, I can feel you cringing as you read this…..and can assure you that the nsight made me cross my legs hard enough to cut off the blood supply. Ooch. The attitude to a new bby is also so different; although there may be a small smile for a boy, girls recieve little welcome into the world. There are no flowers or cards, no proud photos sent from mobile phones, no anxious grandparents keen to know the weight of the child. It seems to be a mostly negative affair, and so much more so for those unfortunate enough to bear a girl. Even the doctors insist that my parents were disappointed to have two girls (though I’m fairly certain they’ve rolled their eyes more than a few times at my sister and I, I’m fairly certain they liked us to begin with, and at least we never burned down the garage unlike William), and look astonished when I say that I would be happy to have either gender in the future – and this is from high caste folk, whose daughters can achieve just as much as the lads. It makes me wonder how Nepal is going to move and improve, if such ideas remain rooted in the entire communities psyche. The WHO Millennium goals list ‘furthering the education and status of women and girls’ as one of their key aims, for a reason.

Before I go, I’ve also nhad my options through for my job next year, so fingers crossed that I end up with my first choice of triplet (paeds surgery, geries, and combined assessment/cardio). It suddenly all seems very exciting; it’s two weeks past six years ago that I got my offer for a place at Edinburgh med school, and even now as I reach the end of the first hurdle, it still amazes me that I’ve had the oppurtunity to learn something I’ve wanted for so long. And I won’t lie – the prospect of earning and being able to afford things like special K cereal, grapes, and green and blacks chocolate, is also rather exciting. So long, tesco’s own bran flakes…..

First choice job: ACHIEVED!

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I found out today that I’ve been accepted to my first choice of programme for my first two years of doctoring, starting in August. Incidentally, this is the most competitive programme in Scotland – excuse the small brag, but I’m very pleased. This essentially means I am guarunteed to be living in the city for two more years, at very good hospitals, with a definite paediatric job in my first year and a good chance of a neurosurgery job the year after. Now I just have to find out how the allocate the exact jobs, but I’m hoping for a geriatric job and a combined assessment/acute job in my first year, which I think I should manage to get given that the draw of this programme is the paeds, and most people who like paeds do not like old people.

Edinburgh friends who are reading this, I am afraid you are landed with me for a little longer….brace yourselves!

Also, the young boy I mentionned a few posts ago (road accident, liver damage, chest damage, collapsed lung, brain injury and looking set to lose both eyes) was not transferred after all, and is surprisingly  doing very well. He’s lost one eye, but will keep the other, and is recovering well from everything else. Although I have no doubt that the staff did all they could to achieve this, I think this is also something of a miracle as the odds really weren’t looking good at all. The swelling around his face has come down so much that I didn’t recognise him at first.

It’s days like this, with this sort of patient, that I honestly don’t understand why most people don’t want to be a doctor (or allied health professional – also key!); it truly is the best job in the world! And today, it certainly feels like I am one of the few people lucky enough to be able to say come August that I have achieved my childhood dream. I may not have made it to US President as I aimed for age five in California (or learned to jump out of aeroplanes and catch rainbows, not sure where that particular dream came from….), but this seems like an excellent compromise.

 

Back from the mountains

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This is to accompany the photo post below….there aren’t many yet as I’m on a totally incompetant internet cafe and their sodding computer won’t let me upload now, for no apparent reason. It’s pretty bad when I know more about computers than the person owning the business…..(slightly riled, apologies)

We got back last night after covering just under 70km over 4 days, and a range of terrains from lush forrests to snowscapes truly comparable to Narnia, and rural villages where the only means of transport is the mule and packer. As you will see, my walking sticks were an excellent addition to both the fashion stakes, and also physically as without them I think I’d have broken more than  few ones trying to get up and down sheets of ice. We set off at 5.30am on the third day to catch the sunrise from the summit, at a height of 3600m above sea level, and although on the way up I was getting to the stage of lying down in the snow and not bothering (I’ll just be some time…..), it was so worth the effort, with a panoramic view of the himalayas, and that (somewhat cliched) sense of infinity stretching across the peaks, and the smallness of our own lives against these towering heights.

Our guide, Suresh, was the same guy who took us up Panchassee a few weeks ago and was fantastic. This strongly contrasts the lads in the house, who went off on their own ‘man trek’ (boys will be boys….) with a guide who turned out to be unqualified, had no idea where they were going, got drunk en route and got them all hopelessly lost up a mountain in minus temperatures with no coats; we certainly had the better deal as Suresh and his brother Biral, who acted as porter, made sure no one was going to fall off a cliff/into a river/under a mule and was very good at finding posts with hot fires and lots of masala chai in the evening.

The third and longest day didn’t end well as I fell ill due to a combination of altitude, walking 30km in one day, and being a bit under the weather before we even set off, so ended up spectacularly ‘talking with dinosaurs’ for the last night we were out, and the last day trekking. I have to say, as a veteran of motion sickness, this was by far the most beautiful place I’ve vomited for some time. As they say, you take the rough with the smooth, and try to look on the bright side.I’m off from the hospital today as it’s theatre day, and somehow I didn’t think that would mix well with being prone to the old wakwak laagyo, so am recuperating and trying to work out if my leg muscles have actually died, or are just not talking to me. Kehganri?

Anyway, I’ll leave it until I can get toa better facility and get some more photos up. Hopefully by then my calves will have began to feel attached again. In other news, I’ll find out this week which foundation job pack I’m in – I’m assuming I’ll be in either my first or second choice (both packs contain 15 jobs in all, split into 3 placements each year. My first choice has a guarunteed paeds jo in year 1, and both packs have neurosurgery as an option in year 2. They also both have geriatrics, which is a plus point, and lots of acute jobs, which are good to do). I’m looking forward to knowing what I’ll be working in come August, as that will also enable me to start setting up extra projects etc to get my CV nicely orientated towards whatever I chose to do. Being out here has certainly emphasised that a surgeon’s skills are always needed, and that they can also overcome tye language barrier better than a physician. It’s also true, however, that I’d be quite a ‘fluffy’ surgeon as I like old people/children/small animals and am not that good at treading on people to benefit myself, which is often how the cut-throat (no pun intended) world of surgery works. It’s going to take some thinking. Either way, cross your fingers for me this week folks, and remember, stay away from the hospital the first Wednesday in August – it’s called ‘black Wednesday’ for a reason…..