Being a patient

It is commonly said that doctors make terrible patients. You can imagine why, they know a lot, and often think they know even more than they actually do. So when it comes to them being ill, most of the time they'll know what is wrong, know how they want it treated and in some cases probably treat it themselves. This goes against the GMC's Good Medical Practice and for good reason. When looking at yourself, at the best of times you can be wrong, even more so when you're ill. It's far better to seek an objective and independent view from another clinician who can then treat you appropriately.

[That concludes the medical ethics lesson for today]

As medical students we're probably even worse, our knowledge is generally far better than your average Joe Patient but not up to the standard of the doctors around us. Couple this with the usual hypochondriac tendencies of medical students who, after each teaching session, come away thinking they've got one obscure disease after another. It's a recipe for potential disaster or at the very least, embarrassment.

Or is it?.... Today I went to my GP. I'd already diagnosed myself and asked a doctor on my placement to have a look at my 'problem'. I sat in the waiting room reading a book about medical careers. It's a while since I've been to a GP, in fact, I've not been for anything significant since starting medical school. When it came to my turn, I went into the room, the GP was very pleasant, she asked me why I was there to which I replied with my presenting complaint, followed by the entire history of the presenting complaint. By this time she must have twigged about me being a medical student as I wasn't using your typical 'lay person' language. She took a quick look at my throat and confirmed my diagnosis of tonsillitis, she then asked me which antibiotic I thought I should have to which I replied 'Penicillin please', she checked that I wasn't allergic, and said that she assumed I'd know the importance of completing the course. Finally after handing me the prescription she said it's probably best if I stay away from the paediatric ward for a couple of days. The whole process took less than a minute, it was probably her quickest consultation of the day and I was completely satisfied.

So as I sit here with tonsillitis, barely able to swallow, taking my antibiotics 4 times a day, what better way to waste away the time than reading blogs. Perhaps I should do some work instead. I quite enjoyed my experience of being a patient, I am bloody fed up of being ill though! Especially because everyone thinks I'm skiving!



[sorry about the picture of my minging mouth, I was just hoping for some sympathy]

The 'Perfect' Medical Student

At the risk of alienating many of my readers, its about time I moaned about medical students. Not all of them mind, you all know the types. The ones who have already been published in an internationally renowned journal by the end of the first term at university. By the end of the second term they are president of the student council. During their first summer they go to Africa to cure AIDS whilst also managing to present their international research at some flash conference in Hawaii. Always top of the year, or there abouts, captain of the football/hockey team, doing a part time research project to cure cancer, etc etc. You get the idea, those perfect medical students who are involved in everything, always work hard, brown nose everyone and probably think they're better than everyone else.

I've always hated those types, some people have even accused me of being jealous of them. That's ridiculous, it couldn't be further from the truth. I do acknowledge the fact that they'll probably get their first choice job, will be consultants before you can say 'I'm a medical student get me out of here', and will probably be running the country before they're 30. I just can't stand their attitude, maybe I'm just too cynical but their brown nosing, underhand and selfish tactics piss me off. They're always far too enthusiastic and can often be found having 'secret teaching' which should be open to the rest of the group but which they've conveniently forgotten to inform the others about.

I think I need to make a distinction between those who work hard to look clever and those who falsely epitomise perfection. I've recently come to realise, its not those who genuinely put in the effort to look good who annoy me. Its those who's ears prick up at the prospect of being published to boost their CV and those who take up places on student committees to give them something to write about on applications. Its these people who sneakily have 'secret teaching' without telling anyone else. These people are completely false, they don't actually care about anyone or anything but themselves, its those people that I hate. Not the people who work hard and actually care about others.

Hmmm, I seem to have made another booboo about what I'm talking about, I've lost myself so if you're reading you've probably got no idea what I'm talking about.

Basically, no longer do I harbour immense hate towards those 'perfect' types its those who want to be perfect in a false, CV whore type way that I can't stand, those who will actually use underhand tactics in order to make themselves look better than you.

I've recently realised that I need to put in a little more effort to make my CV worthy of giving me a job. I don't intend to be someone who just cares about myself, I'm perfectly happy to share my knowledge with the next person, unlike some.

I need to start thinking about my posts a bit more to make them make the sort of sense that I want them to. *dumbass*

New Government Scheme - Child Licence

I'm currently doing a 7 week paediatrics firm, 2 weeks in I've come up with a fantastic idea. In order to have children one should first have to obtain a licence.

In the last 2 weeks I've seen some shocking things, I can't quite believe how some of the parents treat their children and I've just seen the tip of an exceedingly large iceberg. One young girl of about 10 was on the ward, she was covered in a strange, unidentifiable rash. Her hair was in an awful state, completely matted and literally swarming with nits it was desperate for a wash and comb. Unfortunately the back of her neck was the worst, the skin had peeled off and all that was left was a red raw patch of wet, sticky and inflamed gunk. It must have been so painful for her and nothing could be done to her hair, except cut it off because of the state of her neck. I felt so sorry for her, she was sweet, co-operative and very clever. Obviously the parents were nowhere to be seen on the ward. This girl had obviously had a problem for ages, yet only now had her parents even bothered to do anything - WHY? the poor thing winced in pain whenever anyone touched her, nobody could possibly have missed it, it was probably spotted at school before the parents even noticed! If parents don't want to look after their children properly then they shouldn't be allowed to have them!

Another girl, only a couple of months old was admitted with a cough, it wasn't a terribly bad cough, the consultant admitted her because her mother, an IV drug user, had just left her. The poor thing was coughing, the parents didn't give a fuck, the health visitor had taken the baby to doctors and he referred her for admission. These parents don't care about their children, it means they get a few more benefits to go and spend on drugs, they don't give a fuck about the welfare of the child. What sort of future does that poor little girl have? She'll probably go home, grow up with drug abusing mother and will probably turn out just the same. What a waste of a potential life.

My girlfriend who is currently teaching in a roughish comprehensive sees another side of these children, many of whom, at the age of 11 are writing in their schoolbooks that 'people how are 11 should smoke if they want', and god knows what else. These children aren't all stupid, the parents just fuck them up and don't help them at all.

I propose a simple solution whereby if you want to have a baby you must first apply for licence which would be granted if you meet certain criteria:
a) You're not a drug abuser
b) You've not a benefit cheating whore
c) You're over 18
d) You're a sensible person
e) You've got a job and will be able to cope financially with having a child (I suppose we could have a system where you can have 1 child if you're on benefits in the interests of fairness and all that)
f) You don't wear burberry/hoodies/other counterfeit designer clothing
g) You don't have an ASBO
h) You're not going to call your child after the last winner of celebrity big brother/your favourite brand of cider.
i) You're actually going to care for for your children
j) You're not going to sit your children in front of the TV all day and feed them turkey twizlers

Not only would this stop incompetent imbeciles from littering the country with children they don't care about it would save money on health care costs, save benefits and even reduce unemployment by proving jobs for people to assess potential parents. Seriously some people just aren't fit to be parents and it makes me sick to see the results of their neglect. I could never be a paediatrician for that reason alone.

Quite how we go about implementing such a system I'm not quite sure but that can be someone else's job, I'm just an ideas man.

If anyone else can suggest more criteria, please do. :)

Its Snowing!!!!

It seems to be snowing! YAY! I love snow, although it makes for trecherous roads so driving to hospital should be fun in the morning.

(shortly before taking this picture outside our door, someone drew a cock on the car opposite which amused me greatly. Simple things.)

To GP or not to GP.

The one thing I was sure of when I started Medical School was that I didn't want to be a GP. Why? I'm not entirely sure, it just didn't appeal to me and my character, I envisaged my future in a hospital, ideally in a surgical specialty. These feelings remained until I actually spent 2 weeks at a GP in my 3rd year, although I still felt the GP life wasn't for me it was not longer a certainty in the 'definitely not' list of specialties. Half way through my 4th year I find myself starting to think about what specialty I want to follow. Still top of the potentials list is something surgical, perhaps orthopaedics, although I'm not sure I can cope with the competitiveness. Medical specialties don't particularly appeal, I'm can't cope with endless ward rounds. Emergency medicine interests me and I like the idea of getting stuck into something challenging. I even find myself considering general practice. Maybe its articles such as this BBC one which are beginning to change my mind - a potential salary of £250K is a definite tick in the GP box (although even I'm not stupid enough to think that this is the norm, and I'm not a money grabbing monkey, honestly.) I've actually enjoyed the time I've spent at GP's far more than i thought I would, although this does depend very much on the GP, my last GP was atrocious and could have single handedly put me off general practice for ever. Maybe I will be one of those medical students who ends up drifting into general practice despite spending 5 years at medical school saying its not for them, although I hope I'm not.

Dr Crippen's take on the GP contract and the current media obsession with GP salaries provides a far more realistic vision of general practice. I don't know much about the GP contract but I do know that its not the only reason for the NHS financial crisis although it seems that is what the government and media want the public to believe.

Although this post may sound a bit like I'm just going to follow the money, that's not the reason I decided on medicine as a career. I'm not going to sit here and lie and say I don't give a fuck about the money because I do, but its not my top priority and not the main reason for doing medicine, if it was I'd be stupid, I could earn more elsewhere. Medicine has, and I hope, always will inspire me. I like challenges, I like being practical and I even like helping people. I think the media has screwed so much with society's opinions about doctors pay, the public think all doctors are paid too much, from lowly F1s to high flying consultants. I disagree, I think doctors deserve everything they earn, I also think professions like nursing and teaching are vastly underpaid but that's a different argument.

[I've read this post back and I hate it, It doesn't really convey my feelings well, its waffly and crap. Who knows what specialty I'll end up in but I know now, not to judge something until I've tried it. One thing is for sure, I can say for certain I won't be doing Psychiatry!]

I hate Kylie Minogue.....and people who can't drive!

Disclaimer - This is going to be a rant, so if you're a) easily offended or b) someone important its probably a good idea if you don't read it! (you can also skip the first half to get the juicy ranting)

Lets start from the beginning:

6:30am - My alarm goes off and after pressing the snooze button once I get up, I endure a fairly cold shower and get ready for the day. I'm still sniffling and feel manky.
7:00am - Say bye to girlfriend and set off to hospital
8:15am - Arrive at hospital having spent an hour fighting through a very heavy storm, traffic is bad but parking relatively easy for a change. I realise I've forgotten my swipe card so have to wait outside for someone to let me in.
9:00am - Get to clinic - obviously consultant is late but that's to be expected.
9:30am - Clinic starts, see various babies, mostly with feeding problems (aka - parents who obsessively weigh their children and become worried at nothing)
11:30am - Spend half an hour waiting for a child who eventually doesn't turn up. In the mean time, me and my consultant discuss why many 21st century parents are crap and why the media cause so many frenzies about child health.
12:00pm- Go for lunch, sit with a bunch of bitchy medics, woo hoo
12:30pm - Go to medical student committee meeting, am late and miss the only relevant bit to me.
1:00pm - Spend an hour in the library checking emails and blog comments rather than doing work.
2:00pm - PBL - oh happy days! Session is relatively painless, tutor says very little and its obvious her opinions on PBL are similar to mine. Excellent.
3:20pm - PBL finishes, I decide that I'm feeling like shit due to still having cold so I decide to go home rather than brave a couple of hours 'on take' in the children's ward.

Here is where the really angry bit starts

3:30pm - Set off home - Expect to be home about 5pm (thanks to the medical school for sending me 40 miles away.) Traffic is already atrocious because the motorways around the hospital are closed due to high winds! 'Fair enough' I think to myself, I take a different route to the motorway and after queuing briefly, manage to get to the motorway without too many problems.
4:00pm - Continue down the motorway without too many problems, I'm getting blown all over the place but at least its not raining.
4:30pm -Hear on radio about huge traffic problems on motorways, infact, the motorway is closed further on. 'Shit,' I think to myself. Motorway is closed. The suggested diversion takes me a different way which I'm unfamiliar with but it shouldn't take too much longer than usual. Infact I'm pleasantly surprised how quiet it is.
4:45pm - I spoke too soon. I've hit traffic, its awful, I'm at a standstill, still miles from home, its starting to fucking rain and I'm not really sure where I am. Oh well, I think positive and turn the radio up, keeping one ear open for travel news. There is plenty of it, every few minutes my radio switches stations only to inform me that there is traffic chaos due to the weather! Great. I'm completely stuck moving at 2mph and I've got no idea where the heck I'm going.
5:00pm - I'm moving VERY slowly, creeping along. The traffic news announces that various roads are closed due to unsafe buildings/fallen trees/fuck knows what else. I begin to realise that I'm stuck for a while.
6:00pm - I've been stuck for an hour, have travelled about a mile and am already livid! I've still got no idea where I am or whats going on! The radio is still telling me the 'windy death toll' is rising. What time will I get home? Who knows. I start taking pictures on my phone to amuse myself as I'm bored out of my mind crawling along.
6:30pm - I start to recognise where I am, not really where I want to be and I'm still blooming crawling!! For fucks sake! The road in front of me is closed! - Have to go a different way, am shouting at the cars in front. Some cheeky person tries to nip in front of me after nipping down a quiet lane! POO TO THAT! I beep my horn and he slowly retreats but nips in behind me, what a tit! I get to a junction, its packed full of cars in all directions but it seems that nobody knows how to drive. "Get the hell out of the yellow box you ignorant fool" i scream. It makes no difference, nobody can go anywhere because people are blocking the junction. Where are the fucking police when you need them?
7:00pm - I finally get somewhere near home, but despite having had a brief period of clear road I'm at a standstill yet again queueing to get off the dual carriageway. The queue is long and slow, I creep along but I can already see people cutting in, cheating the queue, twats! I beep my horn some more as knob heads try to cut in front of me. They can wait the cheats! I get closer and closer to the end of the junction, unfortunately that just means more cheeky gits are trying to cheat the queue by cutting in. Your typical white van man (see picture above) goes right to the end of the queue and begins to indicate!!!!! I throw my fucking map on the floor and beep my horn, I'm so ANGRY! What makes him so special? I'm more intelligent, more important and a decent driver. I have to wait my turn so why doesn't he? Because he's a fool that's why!!!!!!!
7:30pm - I finally get home, am screaming with rage inside, am exhausted, horrendously bored and fed up with driving. Over 4 hours it took me!!!!!
7:31pm - Am greeted with a vanilla milkshake and cuddle from my girlfriend to calm me down! 8:00pm - Finally calm down, relax, and write angry blog post.

Soo...why do I hate Kylie? Well, on top of the fools who can't drive, the closed motorways due to high winds and the closed roads due to unsafe buildings there is a Kylie concert on. Thousands of cars full of Kylie fans make the situation worse, not only are they making the traffic situation worse but in an effort to make sure they're not late for the concert they are dumping their cars at the side of the road acting like fat in an artery!! I blame Kylie, although its more to do with the stupid weather, people who can't drive and the medical school for forcing me away in the first place!

*breathes....* Rant over.

What a stupid exam!

I've just spent 2 and a half hours guessing the answers to 125 multiple choice questions. I actually knew the answer to about 10 of them! now I have to hope that I'm good at guessing.

It's a stupid exam anyway. Why the medical school think giving the same 125 questions to years 1 to 5 is a good idea is beyond me. The questions are also rather ridiculous, many of them involve picking the best answer, but most of the time there are a few answers which seem perfectly fine but you have to guess which one is considered 'most' right. I don't like the concept, its all about luck, most of the questions are so obscure you couldn't learn them by reading books, or talking to patients or even being taught by consultants, the ones you know are just random tit-bits of knowledge that you pick up from god knows where.

I'm useless at remembering questions after the exam which is probably a good thing as I don't really want to think about it but here is one I do remember:

You are the F1 doctor on the ward, a 60yr old male patient who has just been
diagnosed with inoperable lung cancer due to smoking 40 a day is in hospital and
about to begin chemotherapy. The patient has developed pneumonia and as a result
has just cardiac arrested, you arrive to find the ward sister bag and masking
the patient.
Which of the following is the best course of action:
a) Cease resuscitation effort
b) Contact the family to discuss their wishes
c) Ask the advice of the ward sister
d) Commence full resuscitation
e) Bleep the patient's consultant to ask them what you should do

Answers on a postcard, I went for commencing full resuscitation but I don't know if that's right or not. You need more information to answer so many of these stupid questions.

Anyway, at least its over with, I can forget about it till whenever results come out. Lets just hope that I'm not in the shitest few percent of my year who'll fail and will have to resit the stupidest exam in the world!

Exam! - Shit.

Tomorrow I have the lovely, biannual 'progress test', the most ridiculous exam in the world! Unfortunately I seem to have come down with a bout of man flu, ok so its a bad cold but I can barely breathe and concentrating tomorrow is going to be interesting. [sympathy to my girlfriend who has also been struck down with poorlyness - "I'm dying harder" - girlfriend]

The progress test: 125 multiple choice, best answer questions which could be on anything from all 5 years of our medical course. Remember that I'm only in 4th year, and even more ridiculously, the same exam is now sat by all 5 years, at the same time! So spare a thought for the poor first years, who having been in medical school for all of a term get to spend 2 and a half hours guessing the answers to questions most doctors probably don't even know.

Learning Based Problem

The course at my medical school is almost exclusively based around PBL and the question I get asked most often by students applying for medical school is; “What is PBL?” This is also a common question at interviews, in fact, it was one of the questions I was asked 4 years ago when I applied – I think I gave a better answer than I could give now having done it for 3 and a half years.

I thought when I was applying that a PBL course would suit me far better than a more traditional based course. In that respect I think I was right because I usually fall asleep in the few lectures we have, I dread to think how I’d have coped with a lecture based course studying traditional components such as anatomy, physiology, etc, etc.

It wasn’t until I got to medical school that I realised just how different PBL is from the didactic teaching styles I was used to. Even now I’m still unsure if it’s a good or bad way of learning but I can say, sometimes I love it and sometimes I hate it.

In order to get the most out of PBL, one must be very self-motivated, not one of my strongest qualities. This is perhaps why PBL doesn’t suit me quite as much as I thought it would. In fact, I can often be heard moaning about how I hate PBL or that PBL is boring/stupid/a waste of time. Interestingly many of my PBL tutors, usually clinicians of consultant level who supervise our group sessions, tend to agree with me when I throw one of my PBL tantrums about how it’s a stupid way of learning.

Fundamentally I like the concept that is PBL however the reality is, this concept is rarely, if ever, fulfils its true potential. My understanding is that PBL is supposed to stimulate a group learning experience which will be of benefit to us as ‘life long learners’ and improve our ‘communication skills’. These benefits come at a price – in my opinion, at best PBL leaves gaps in our knowledge and at worst (and more often) more like huge craters of emptiness.

The thing I like most about PBL is the freedom to do what you want, when you want. In the last 4 years, I’ve been able to work when I wanted, cover what I wanted/thought was relevant and had the freedom to be my own teacher. The problem with this is that often the temptation to procrastinate overrides me and I end up doing no work at all. It does generally come together at the end of the day though and as yet I’ve had no problem passing my exams [touch wood]. One of the main gaps in my knowledge is anatomy, I know little, if any, but neither does most of the rest of the medical school. We get only a fraction of teaching on anatomy during our pre-clinical years and as a result often look stupid in front of consultants who have now come to understand that its not our fault: its PBL’s fault. Nobody ever knows what we need to learn and in how much detail, I sometimes wish we were just spoon-fed exactly what we need to learn, although I accept this probably wouldn’t make us better doctors.

When done properly, a PBL can be a very stimulating and interesting experience, but in the hundreds of PBL sessions I’ve been to in the last 4 years, the number of really good sessions probably remains in single figures. Most of the time it’s made up of a group of students reading out extracts from textbooks which they’ve copied into their notes. Everyone knows that everyone sat around the table has exactly the same information as everyone else but still they see fit to subject us to reading it aloud, it’s like watching paint dry. Why? That’s not the point of PBL, you’re supposed to have spontaneous, interesting discussion about hard or interesting topics and when you do get the occasional interesting topic I really like PBL but otherwise it’s as boring as fuck. The number of interesting discussions is dependent on the dynamics of the PBL group; this is the single most important factor in determining the usefulness of PBL.

So… is PBL a good or bad thing overall? I think it probably depends on what type of person you are. Personally I wouldn’t have it any other way as I’m sure I’d hate a traditional based course, however I do often hate PBL, usually when I’m in an awful group. There will be gaps in my knowledge which may yet hinder my career but at least I’ll be well placed for ‘life long learning’. Will it make me a better doctor? I don't know, i'll tell you in a few years, if I make it that far!

It takes one to know one.

My faith in Medical School has been restored single handedly by the consultant my current firm. When starting a new placement, one is always worried about the lead consultant; will he grind you into the ground? Will he fire question after question at you and berate you if you get a single one wrong? or conversely will he ever even be around to teach you? Consultants are often the subject of rumours among students about who is strict, who is evil, who is nice and who won't mind you skiving etc etc...

I wasn't sure what to expect of our new consultant, the rumour mill was quiet apart from describing her as cynical. Before then I barely knew what cynical actually meant, that was until I was sat at lunch one day being accused of being a huge cynic. Some people would probably be quite offended to find their character described in this way, personally, I was quite satisfied. I couldn't really give a fuck what most people think of me, but I do see myself as a moaning, cynic-type person, boo hoo for you if you don't like it, I have to amuse myself somehow.

So, having been quickly introduced to her and subsequently following quietly around the ward round I couldn't help myself chuckle at some of the things she came out with. I was pleasantly surprised to see that she remembered our names,which is more than most consultants I've come into contact with. (Quite how these consultants are expected to evaluate us at the end of a firm I don't know. My orthopaedic evaluation apparently came from a consultant I'd never even met!)

"This room [full of children] is boring, so I have to argue with everyone to keep myself amused"

- My particular favourite, whilst during a ward round.

I've decided I like cynical people. There aren't many around, but when I meet them I get on well with them, we share the same ideas. Whether being cynical is a good thing or a bad thing, it certainly keeps me amused and I'm looking forward to spending the next 6 weeks working under the most cynical person I have, as yet, met. If I turn out anything like that in 20 years, I'll be more than happy.

p.s. I thought it was about time I introduced some pictorial fun for my few readers and what better way to start than with a cartoon.

Enjoy.

Modernising Medical Careers aka Taking Medical Careers Back to The Dark Ages

It's about time I blogged about something actually medical, and what better way to start than with Modernising Medical Careers. Now I don't know a great deal about this subject which is a bit odd considering its going to change my life next year but I do know more than a lot of people at my Medical School because I'm a geek that way. My Medical School have yet to give us any information about MMC and our foundation applications, in fact they haven't even mentioned what MMC is or what its got to do with us. I only found out what I know from reading elsewhere.

What I do know is that our application for foundation years is going to be based on our academic ranking within our medical school and the answers to handful of questions such as "Describe a time through Medical School where you showed integrity" with the answers judged by lord knows who in an office somewhere.

I'm not a complete geek and I'm not really a waster, I'm an average medical student, probably slightly above average academically but below average on my 'enrichment' (CV boosting) activities. Which will make me a better doctor? Well neither in my opinion. Yes I need to have the knowledge to know what I'm doing but I don't need to know the precise chemical formula for every amino acid. I also don't need to know how to climb a mountain blindfolded and with my hands tied behind my back, although according to MMC, this could come in handy. I dislike those medics whose ears prick up at the thought of being published, some of my 'friends' seem to think that this makes them better than me. Bullshit.

We've just been told that our academic ranking for MMC which will be about 50-60% of our application will be based on year 3 and 4 exams and SSC (student selected component aka SSM) marks from year 3 and 4. Were we told this by the medical school? Ha, NO! By another student who happened to know. So, the medical school are going to use retrospective data to rank me against my peers, that's all well and good but I'd like to have been told this before I sat the exams. This isn't really the medical school's fault, its the fault of MMC. What is a mistake on the part of the Medical School is including SSC marks, now I've just finished an SSC with a supervisor who I really got along with and who will probably give me a good mark but I've done SSCs in the past with supervisors who barely even knew my name and hence gave me a mark based more on which side of bed he got out of that morning not my academic abilities. SSC marks are too subjective, why bother including them? No longer will people choose SSCs they are interested in, they will choose based on supervisors who will give them good marks. (fortunately I've got fairly good SSC marks and will probably benefit from them being included, maybe I should stop moaning)

So, this MMC thing is going to decide my future, it would be nice to have been told something about it without having to look for it, such is medical school. Who knows where MMC will take me, I just hope they've sorted out what happens after foundation years by then, otherwise I might just decide I don't want to be a doctor anymore and go find a job that will pay me more, and treat me properly.

2007?!?! Happy New Year

Christmas and New Year have been and gone, I've not blogged because I've been busy doing fuck all! Finally, after 16 weeks of solid of medical school, a 3 week break, well not strictly a break, I still had an exam to revise for and an essay to write although that did get left until New Year's Day in my typical last minute fashion.

I've been back at Medical School a day and I'm bored. I might not have much to do this week but anyone who thinks medical school is exciting needs a CT scan. Yes there are exciting times such as your first day in A+E when you can't even remember what your name is let alone all the reasons for a cardiac arrest and how to treat each individual one - first thing that happens, you're pushed into resus and told to lead the team. WTF? You've only been there a day! There you are minding your own business and someone grabs you and leads you into the chaos. Anyway, not everything is exciting as that. Today I spent the morning sat at a computer in a GP surgery, fuck knows what I was supposed to be doing but the best part of the morning was taken up reading the BBC news website and checking my emails. Great, first day back and I've travelled 40 miles and done fuck all.

I'm currently writing up a project on smoking, a rather topical subject since the government haver just annouced the minimun age for buying cigarettes will be raised to 18. Not that it will make much difference, everyone under 18 will probably just start smoking weed instead. Bring on July 1st when finally I'll be able to go out and enjoy a drink or a meal without someone else's smoke wafting my way. Go right ahead and smoke yourself to death if you want but stay the fuck away from me!

Anyway, enough swearing for now. A new year a new start and all that...

New Year Resolutions:
- Actually do some work
- Don't moan as much
- Be nice
- Get rid of tummy flab