Anything can happen

One of the perks of being a medical student is being able to sit in on the free lunches provided courtesy of big pharma. I speculate; am I selling my soul, sitting there devouring piles of moderately priced sandwiches and sausage rolls, gratis, as I listen to a drug rep hail the wonders of their latest snake oil? - “Peptic ulcers getting you down? Bleeding into your GI-tract? Lansoprazole still not touching it? Kick that ulcer into submission with our latest proton pump inhibitor – Mansoprazole. Are you MAN enough??” Part of me thinks perhaps not, and fortunately for the tax payer I’m in no position to prescribe such wonder drugs just yet. Still, an Oaf can dream. Perhaps there really isn’t such a thing as a free lunch.


More recently, I spent two weeks pulling my hair out on a renal medicine rotation. Much of the day seemed to be a never-ending ward round followed by haemodialysis, rinse and repeat. Regrettably, I had little enthusiasm for the specialty. One highlight however, being learning a new joke whilst conversing with a patient plugged in to a haemodialysis unit – ‘Q. What’s grey, sits at the end of the bed and takes the piss? A. Dialysis machine’. I later broke this one to the consultant nephrologist, only to be greeted by a face of bemusement and a raised eyebrow. Regular readers may now start to realise just why I really am the Hippocratic Oaf.

Part of our formal assessment for passing the firm is a short OSCE examination - which to the layman involves being asked to examine a patient with a real medical complaint, report our findings and suggest a possible diagnosis. The Oafs first patient was a genial character with a systolic ejection murmur radiating over the carotids. Quietly pleased with myself, I actually correctly diagnosed the problem – aortic stenosis, despite never actually having heard one previously. The next patient, another familiar face – was someone I had seen twice a day for the past fortnight on renal medicine. I fallaciously reeled off a list of findings to the examiner – hepatomegaly, ballotable kidneys and a mass in the right iliac fossa. When prompted for a possible diagnosis I noticed the patient wink at me – “polycystic kidneys, and a previous transplanted kidney” I replied with a wry smile, “superb! And you got all that without even noticing his fistula!” A touch of dishonesty, but I passed the station by merit of the examination technique rather than through diagnosis. I’m counting it as a win anyhow.

I’m finishing my 10 week placement on a surgical rotation and have in all honesty, been quite excited by the prospect of surgery – the shorter ward rounds, acute medical problems and scrubbing in to name a few. It therefore came as a great shock to the Oaf when reporting on his first day, on his first ward round, with a new team to see a familiar name on the patient list. It would seem unlikely that out of all the hospitals, and all the wards, and all the consultants in the country, that the Oafs ex-girlfriends grandfather would be a patient lying in a bed midway through rounding, but karma has a cruel sense of humour. So ensued a rather embarrassing explanation to the registrar as to why I could not round on that particular bay. The Oaf has since been working hard on creating a better second impression, and avoiding the ward during visiting hours.

I still can’t quite believe it. One week to go and I shall have survived the first placement, but as the Oaf has come to realise, anything can happen in a week.