Saturday, 31 July 2010

A fine line

Spoke to someone today who was a patient at a mental health hospital who believed he had a cure for type 2 Diabetes, three days later talked to a member of staff who believed that september 11th was caused by the US government and that all the worlds government are really controlled by someone else.

In each case I gently challenged these views, in a nice and diplomatic way like what we have been taught.

Wednesday, 28 July 2010

Fat, not Obese

The FM used to work at a care home, where various members of staff wanted to lose weight. Or more accurately they wanted to talk about losing weight. This is easier then actually getting off your backside and going for a run/swim/cycle/walk.

It would be quite common for the FM join the rest of the staff when they had a fag break. The FM was amused at one time to see the Deputy Manager marching up and down on the spot. This was the latest craze to get fit and into shape. This is unlikely to constitute a sufficient enough lifestyle change needed to lose weight.

People were often annoyed at the FMs response to “How to avoid getting fat, you always eat more than us!” The response usually involved a list that included three hours of doing karate a week, going for a jog, family walks and going to the gym and playing tennis when people were free.

Perhaps the FM is being too harsh, but at the end of the day fat people get fat because they eat too much. Maybe if the FM was not blessed with her particular genetic makeup she would think differently.

NHS should use term fat instead of obese, says minister, but then should HCPs be worried about causing offense to people? Certainly medical students have had to walk a fine line when presenting a patient to a consultant (in front of the patient) who is seriously overweight. Being asked what are the risk factors for having an MI by a consultant is not nice , especially when you then go and state diet and obesity in front of a seriously overweight patient.

Perhaps we are too nice as a society? With regards to the earlier situation presented in this blog it took some self-discipline for the FM to remain quiet and not say something along the lines of “Stop bloody talking about it, replace that Mars Bar you have with an apple and instead of spending all evening watching neighbours, home and away, emmerdale, coronation street and eastenders go for a fucking run.”

Tuesday, 27 July 2010

Just Silly

"Oh, I'm just a medical student," replied the FM when asked who she was. "Just a medical student!" roared the person chairing the meeting I was attending, "Why do you put yourself down by using the word Just?"

"I'm now going to have a little listen to your heart," said one of the FM's friends whilst examining a patient. "Why do medical students say "a little listen?" asked our consultant, it does seem a little patronising to the patient.

Two bad habits medical students often get into when wondering around

Friday, 23 July 2010

Making a Recording

Some of the FM lecturers decide to record there lectures online and make them available as a podcast. Thank you very much, much appreciated.

What do others think of this? Any other medical students get lectures recorder? Any lecturers out there who record what they say maybe?

Some of my lectures are exclusively online, the FM access them online and listens to them at home. Is this a good thing? Perhaps in a few years lecture halls will become extinct as students stay at home and listen to the lecture on glycolysis from four years ago?

Wednesday, 21 July 2010

The post on religion

It has been coming for a while, a post where I basically slag off religion in all its forms. However as this has already been done by people far cleverer then me I shall do something different instead.

What is a delusion?

"The most recent Diagnostic and Statistical Manual of Mental Disorders defines a delusion as:

A false belief based on incorrect inference about external reality that is firmly sustained despite what almost everybody else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. The belief is not one ordinarily accepted by other members of the person's culture or subculture."

If the last sentence had not been put in then the vast majority of the worlds population would be deemed to suffer from delusions.

Let us accept for the time being that people brought up and taught religion in a religious environment are not suffering from delusions, what I am curious is when people swop from one religion to another or from atheism.

If a friend of yours was to suddenly start giving lots of money to scientologists would you be concerned? What if they suddenly became a born again christian and started to spread the message that homosexuality was a sin?

Do they need psychiatric help?

In my posts the views expressed are my own, in this please note I am playing devils advocate with myself. I am not sure what to think.

Tuesday, 20 July 2010


I am pretty sure that I do not want to be a surgeon, standing for three/four hours nearly killed me. However it was pretty fun at time, but I know its not for me. I can understand why people like it though. One consultant said to me that surgery appealed to him as everyone is equally important, especially as everyone wears the same.

Being an anaesthetist could be fun though. It was quite bizarre to be asked for suggestions for "Level of command (7)."

Friday, 16 July 2010

Today not having broadband makes people feel deprived," said Steve Robertson

Should this be the case? Even if we dont have broadband at home don't we all have acess to broadband at public libraries? Is it really the governments job to use its money (I mean "taxpayers" money) to prod and poke private companies into trying to get broadband into every home?

Tuesday, 13 July 2010


Looking at statistics in a different way can often alter our perceptions of things. A significant portion of people have a mental image of old people generally being down and depressed as a result of being old. It is thought at 5-15% of the elderly population do indeed suffer from depression.

However this means that 85-95% of older people are not suffering from depression and therefore it is normal for them to be perfectly happy and mentally well.

After making this poin the lecturer then moved on to consider the differences between depression in younger people compared to an older person. Perhaps I shall see this in practice but apparently in older people the symptoms tend to be more biological (altered sleep and appetite for instance).

Also discussed pseudodementia, where someone is diagnosed with dementia but actually are suffering from a psychiatric illness. Is there any information out there I wonder on how many people have been diagnosed with dementia when they are actually suffering from a condition that could be treated relatively better then dementia with the possibility of a recovery?

Saturday, 10 July 2010

Neurology and Cowards

Headaches are common, therefore the Fuddled Medic is required to know a little bit about them. Indeed a mock exam paper asked the FM to state which type of headache best fits this description. . . .

"A woman describes to her GP a band like pain across her forehead that slowly develops during the working day and is relieved by weekends."

More interesting are migraines, untill the FM started Medical school she was unaware that most migraines dont have an aura and generally aren't caused by cheese, red wine, chocolate etc. This is important to the FM as family members suffer from migraines and as a result have probably given up cheese, chocolate etc for no real reason.

The word Coward is in this post as a result of seeing this article.

Wednesday, 7 July 2010

Today, I learnt something

I learnt something today, that you don't appreciate what you have untill its gone. To be honest I could not help but learn this as I sat through the latest Shrek film and had this particular message rammed down my throat. A terrible, terrible film that was punctuated by bits of sheer brilliance every ten minutes or so.

In other news I passed some exams and can now proceed to the next part of medical training

Sunday, 4 July 2010

Another sensible suggestion?

Yes, Michael Gove is right that it would be best to return to the more tradition A-level system where students take their exams at the end of upper sixth, as opposed to throughout the two year a-level course.
This is a good thing, lower sixth should be a time to relax and develop your interests in the subject and not focusing on exams. For A-level chemistry I sat six different papers, to revise for this I did every past paper available for each paper. As there were approximately 10 past papers per difference module I did about 60 past papers per subject. As a result when I took the real things there weren’t that many questions that I had not seen in one form or the other.
Is this a good thing? Is this what A-levels are for, to prepare you to jump through hoops? Suppose you could argue that life is generally becoming more and more a game to get through. Got an OSCE coming up? No problem just polish up on your act and memorise statements such as “to complete my examination I would look at the observation chart, check the sputum pot and see a CXR.”
Don’t bother about learning stuff properly; just remember to rehearse various answers.

Saturday, 3 July 2010

Another Joke

"An Alcoholic is someone who drinks as much as his GP." The deaths of cirrhosis amongst doctors is higher than that of the general population. Scary, in practical terms there is a good chance that I or someone who I'm friends with at medical school will get addicted to alcohol.

I can totally understand the articles point of doctors being unwilling to seek help when they need it. Alcoholics are stigmatised by the medical profession, so knowing this and seeing it first hand, why on earth would you own up to it?