Off

I have a day off, hooray. Its already been spent playing tennis and recovering from hangover and the rest of it will be spent in front of the laptop watching cricket highlights

Food

The Fuddled Medic likes food, especially when coming back from a tiring day clerking patients or playing sport to find his housemate has cooked a wonderful dinner. A decent meal will make you feel refreshed and energise.

Feeling refreshed and energised might seem like a good think? Unfortunately patients wont feel like this on the wards in a huge proportion of hospitals.

What scared the FM most was the government response. It was all about GPs and the new changes. Readers may know that the FM is sceptical of these NHS reforms. From what has been said on the dispatches program it seems that any criticisms of the NHS will be met by this . . . .

"We are giving GPs all these powers, so that the public can themselves raise standars and GPs will be able to say what they want doing."

But without significant resources GPs wont be able to make a difference and the FM feels that these reforms are in place so the government can devolve blame to the GP.

But the FM is a bit of a cynic

Goodbye

Had my last day in paediatrics yesterday. Very sad, until now I have not had a placement which instantly caught my interest. If I want to do it again (i.e. as an FY1 doctor) then it means at least 18 months of not doing paediatrics.

Surgery

I have now been told twice in one week that I come across as a surgeoun, why?

Incident 1 - Saying to a colleague, he'll live whilst practicing cannulation on each other - this wasn't in response to a failed attempt on my part

Incident 2 - Discussing 1st year male medical students and how immature they are. This was whilst helping out in a teaching session they were going through. I commented that any immaturity they had would quickly be knocked out of them when they started out on the wards and someone started shouting at them for it

Confidence

I am a much better medical student i.e. presenting/taking histories and examining, answering questions when I am surrounded by other students who at least pretend to give me some respect. When working with the type of person who would sell there own grandma to proceed up the ladder and makes it plain they conisder you to be inferior, then I simply fall apart.

Bugger

Differential diagnosis

Its important to know the differential diagnosis of various diseases. The Fuddled Medic has just had a lecture about epilepsy. Or rather a talk on "what else could it be?"

The FM was solemnly taught that epilepsy itself is boring, everyone will probably end up on Valproate if its not contraindicated.

So what else could it be?

1. Bening myoclonic jerks
2. Benign paroxysmal vertigo
3. Obstructive sleep apnoea
4. Night Terrors
5. Adolescent stretch syncope
6. Other types of syncope
7. Sandifer's Syndrome
8. Daydreaming
9.Infantile Gratification
10. Reflec anoxic seizures
11. Head Banging

Anymore out there? Please let me know

Lucky and Education

I was lucky to go to a state Grammar School. As a result I got pushed and did the best to my ability at GCSE and A-level and went on to study medicine at University. After watching Andrew Neil chatting about social mobility it would be fair to say it has stalled.

This is probably due to the decline in Grammar Schools. Children who went to a Grammar were able to compete with children who were sent to a private school. As a result the top jobs in business and politics were opened up to people outside the upper classes.

Perhaps this is why politicians dislike grammar school? They know that there success meant the end of "jobs for the boys."

All I know is that I was very lucky to go to a Grammar School and I wouldn't be writing this blog if I hadn't gone