This week this has happened an awful lot. So far I have managed to listen, nod my head sympathetically. Yet what is going on inside my head is a different story.
We were warned right at the beginning of our degree that this would happen. That when when we graduate and work as doctors we'd come home and our families would complain about their days and we'd snap and say 'here's 50 cents, go call someone who cares'.
I know that I'm not a doctor yet who cares for others all day. However I have to study A LOT and therefore have very little time for myself. Last weekend I studied from 8:30 am to 10pm on Saturday and Sunday and then followed this by a week of lectures from 8:30am to 6pm with extra study when I get home. All with the added stress of still being behind and not knowing enough. On top of all of this I am meant to cook, clean and wash my clothes, oh and sleep.
So when people complain about their busyness and I know that they at least have time to see their friends most days and certainly don't study on their weekends I have to restrain myself from saying something horrible. To me it's like they have a splinter in their thumb and I have had a whole arm chopped off- their pain seems negligible.
BUT... I do not want to become this person, the sort of person who only has compassion for other doctors (single parents probably also work as hard or harder). Pain is still pain. There are also different types of pain. My pain is grief for my free time, my friends and family back home and all my nice pretty things that simply won't fit on a plane. Yet perhaps my pain is not that bad, I CHOSE this life and I although the cost is dear, I GAIN medicine and a whole lot of new friends.
The lecturer who warned us of this horrible attitude, that we may develop towards others, gave a lovely solution. Instead of saying 'I'm such a mean person' and feeding our self pity even more he suggested that we must find time to CARE for ourselves too. No one can give and give and give without receiving. Far out even Jesus took time out early in the morning away from everyone who wanted his help.
So this week I've done two things. I've bought lots of brightly coloured stationary to make study more fun (back in high school aqua and purple highlighters did not exist). I've also decided that I don't care how far behind I am, I AM going to take Friday night off to watch a movie, eat yummy food and crochet.
When I had my interview to get into medicine they asked one final question- 'Do you have any other achievements you'd like us to know about'? This freaked me out. I mean I've done nothing amazing. I was sure that all the other applicants would be amazing athletes, volunteered in orphanages overseas or at least won the nobel peace prize. All I could scramble together was my passion for knitting and crocheting. Weirdly enough this got an overwhelming response from the three interviewers. For 5 minutes they drummed it home to me that no matter what I must maintain this passion- that it was vital. The doctor on the panel was particularly adamant. I wonder now if this was because he knew, that without it medicine would take over everything and I'd become the bitter person I described above.
Do I have a cool medical fact for this week? YES. This week has been all about the gastrointestinal tract. I seriously think this is my favourite part of the body- it just makes sense.
Helicobactor pylori is a bacteria that can survive the acid of the stomach and it has a few tails (flagella) to help it swim to the mucus wall. There it uses spikes (frimbrae) to attach to the wall (so that the intense muscle contractions of the stomach don't knock it off). It the secretes urase (enzyme) which helps to break down urea in the stomach to carbon dioxide and ammonia. The ammonia makes the area around it more alkaline (protects it from the acid that it can survive in, but not thrive in) and the CO2 is absorbed through the mucus, into the blood and is finally breathed out through the lungs. It also releases toxins that destroy the mucus layer of the stomach wall. This means that the acid can now destroy the stomach wall and an ulcer forms. The only way to heal the ulcer is to kill the h. pylori with antibiotics and to slow down the acid secretion in the stomach.
An Australian from University of Western Australia discovered this bug and is now a hero. I can't count the number of times we've heard about him and the person who helped him. Before him the world thought that ulcers were stress related. So now patients no longer are blamed for their ulcers and treatment is pretty non invasive. The poor surgeons get less work though.
Okay so that is all rather specky. However what I really love is one of the key diagnostic tests done to detect h. pylori. The Urase breath test. The patient swallows a tablet of urea which is made of ammonia and an isotope of carbon. (isotope means it is difference to the normal carbon breathed out in CO2). If the h.pylori is in the gut it'll break it down and with 30 minutes a sample of the patient's breath is taken to see if the isotope is in it. This is AWESOME. Finally I get to use a little bit of physics.
The other cool thing I learnt was about faecal transplants. Now I understand that most people are squeamish. However if you're not, google this! It's exactly what you think it is. If you were dying from gastro you may let this be done to you. Maybe.
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