Wow, I made it all the way to Friday without being asked that question! Last day Peds!

Awww man, last day.

We got a few more admissions over night. We spent the time before rounds checking up on some kids and looking at the new kids. I checked the findings to see if my patient had any new values. 

Rounds was hilarious today. I don't know if everybody took an extra dose happy pills but we were cracking jokes and having a good ole time. At some point the doctors talked about an actress that was on the screen in one of the patients rooms. They were all super excited about her and not knowing who the heck they were talking about, I asked. They all stared at me like I had just asked them who Obama is. The one resident even gave me the "talk to the hand" gesture. The attending said he had thought about letting me go early and giving me the top score as an evaluation but after revealing my lack of knowledge over this apparently very good looking lady, I would have to do overtime and would only achieve a subpar score. Haha. I looked her up later and it turns out I do know who she is, I just didn't know that that was her name.

The attending came into the work room later and asked me if I was related to David. Wow. I made it all the way through to Friday without anyone asking me! New record. I told him that we are distantly related. He thought that was pretty cool. He left the work room and about two minutes later a nurse walks in and says, "so guess what I just heard." Well gee, that didn't take long. She told me they were singing "I've been looking for freedom" out in the work area. ....of course they are. Haha. I mean I think it is all very entertaining.

(Wow, made it all the way to Friday without that question)

After lunch I had to sit around a bit waiting for the attending to have time to quiz me a bit and give me my final evaluation score. I was so ready to answer just about every question about inflammatory bowel disease. In the end it was short and sweet. Even with my lack of knowledge about the actress, I got the top score.

I went home to get some sleep assuming I had a night shift to go to. I don't. There was a glitch in the planning system. New plan is to get some work done at home and maybe bake some cookies. We shall see.

The week in peds was so much more than that I expected. I was really lucky with my ward and team though. I'm also a strong believer that your own attitude contributes a lot to the experience as well. It was fun, I would have no problem going back on Monday. Now it's time to get ready for two days OBGYN and then really go in on this doctor thesis. 

I think the kids may have made me sick though, I've had a tightening feeling in my throat since this morning. I hope not!

Have a great weekend everyone! I have my 26 hour shift on Sunday. Hope I have a lot of interesting things to report on!

Baci 

V

"Oh that is not necessary. We aren't the surgeons!" Day 4 Peds Ward

Oh it's been quite a long but good day. Let me get yall caught up.

I really must say that I enjoy showing up for work at 8:15 apposed to 7am. It is a world of a difference. Not every specialty has that luxury however.

We got a few new kids over night and I was appointed a kid that apparently fell and hit its head. I looked at the admissions report and headed in with the resident to interview the parents and child and do a physical examination. He was up and doing just fine. After a thorough questioning, we examined him and had him do all kinds of neurological tests. It's fun in peds because you often have to demonstrate what you want the kids to do so not only does the patient look like a fool but so does the doctor jumping around on one foot.

Rounds went a little longer today because we had multiple things to organize for some of the kids. I like rounds though. I think its because of the great team on the ward. Everybody is allowed to say something without having the feeling that you are constantly criticized or only there to observe.

 

(A little more neutral today but I have my zebra phone!)

By the time we got around to my patient, I presented his case to the attending with ease. Granted a patient that fell doesn't have the most difficult case to report on but it still feels awesome to just throw out a good report and get positive feedback!

After rounds I worked on finishing my doctors letter. We got a whole bunch of new findings back from the lab that I didn't even notice it being 11:30 already and time for the morning meeting. I ran up the two flights of stairs only to enter the room almost empty with a few other students in the last row. Everybody else was just starting to arrive.

I've mentioned the situation with seating arrangements in the hospital before. In the surgical departments, the students are the ones that sit way in the back...always. It is quite the faux pas to sit in the row where the residents or even worse the attendings sit (although I accidentally did that my first elective). The pediatric doctors are much more relaxed about it but at this point, we students are so drilled in finding that spot furthest away from the front. Later in the day, I got up from my seat to move back in a MRI findings meeting when some doctors walked in and some students and I had taken up a row. The doctor was almost shocked at my action and said, "Oh that is not necessary. We aren't the surgeons!" Thought that was sweet.

(I need at lease one of these a day. Very fitting I think)

After a quick lunch, I was back on the ward putting my final touches on the letter. When the resident sat down to go through it with me, I was afraid she would think it was terrible. She even started the conversation saying she is a total grammar control freak. Greeeeeeeat. 

In the end though, I really did a good job. There were only minor things here and there that she wanted formulated differently. All in all though, we didn't change much. Yay! Might sound stupid that I am so happy about that but I am not afraid to say that one of my weaknesses is the German grammar (I'm sure enough people reading this are cringing at my English grammar as well). German is hard! 

I interviewed and examined another patient with the same resident from earlier. Another boy that hit his head. He was doing just fine as well. You wouldn't have thought that he was brought into the hospital the night before with the ambulance. Again the same gymnastic routine of neurological tests was performed.

After a bit more work here and there, I was done for the day on the ward. I headed to the library to work on some translation work with another student for an attending in the hospital.

Since my uncle is on vacation, I went and had dinner with my aunt. We went to a very good greek restaurant. We ended up chatting for 2 hours while eating. We had just finished up and were close to leaving when the chef cook came and sat down at our table. We ended up chatting for another 2 hours with the guy! We discussed so many topics and it was interesting how we all contributed stand points from our respective fields. The obvious being good nutrition and medicine. We also discussed the work ethic of people today, differences between countries (since we had representatives from Greece, the USA and Germany at the table), the towns development over the years, TV documentaries....really everything! It was a really nice evening. Now its off to bed though because I have my last day of peds tomorrow and then a night shift. If I'm lucky, I'll get out a bit early and will get a few hours of sleep in.

Baci

V

"Here is a tractor and now I have to go cook some building blocks"....oh kids. Day 3

The more time I spend on this ward, the more I like it and the more I think I'd be a great pediatric doctor. The only aspect that I would miss is the operating room. I could of course be a children's surgeon but then I'm basically only in the OR and don't have the daily encounters that I do right now. So at this point I am still sticking to my plan of becoming an urologist and eventually specializing on the little ones. 

The patient I had planned to interview this morning and present in rounds was at the ENT doctors when I got to work. Apparently the case was a bit more difficult than I thought it was going to be. Instead, I interviewed a 2 year old and his mother because they were admitted last night. The little bugger didn't want to drink the last few days. He was doing a lot better already this morning.

I got all my infos together and went to the patient again with one of the residents to do a physical examination. 

By the time rounds rolled around I was good to go. We went through all the rooms with the same entourage from the last few days. A few more interesting cases, including some rare diseases where admitted.

My presentation was as breeze. A lot easier than I thought it would be. The rest of the rounds was good as well.

My new task was to write a preliminary release note for my patient. I finished up before heading to the morning meeting.

After lunch, I finished up a few things on the ward and started to check in on some of the kids. I played around with some of the patients. They are just so adorable. I feel so at ease on this ward. The staff is friendly, the kids are fun and the parents are, for the most part, very friendly.

I had to leave a bit earlier today to be able to teach English.

The time is really flying in this week long internship. 

I could easily work in this department for a while. But I've got a lot of other things I need to get done.....so the kids will have to wait. Hopefully I'll see a lot of kiddies in Ghana!

Baci

V

"Hey, don't give me that look, I didn't do anything!" Peds day 2

Day two with the kiddies. I woke up rather refreshed and ready for the day. The weather has become a bit milder so the walk over to the hospital was actually quite pleasant.

My usual wardrobe includes copious amounts of neutrals and earth tones. It's just something about working in peds that makes my clothing selection look like a skittles rainbow produced it.

Never would I ever run around this colorful unless it was for the kids. 

We had a few new kids to look at on the ward this morning. I spent a lot of time dictating my doctors note though. I'm trying to study up on my patient as much  as possible to be as prepared as possible on Friday. 

The morning was as it was yesterday. Getting to know the kids, checking on the ones we know, then rounds with the attending and off to the morning meeting.

A few new diseases came in today. A lot of the time the kids have some kind of infection though. There was a precious little infant there with such a stern look on his face I almost felt guilty as though I had done something wrong when he looked at me. It was entertaining, 

Even after just two days, you can really start bonding with the little critters. 

After lunch, I finished up what I could on the doctors letter and brought the tape to the secretary. The afternoon was a bit monotone. I looked through multiple patient files, read a few things in a textbook and did everything possible not to look bored. There were a few conversations with the psychologists regarding some of the kids. 

I was allowed to leave a bit earlier today.

I already picked a patient to interview tomorrow morning so that I can present her to the attending during rounds. 

I'll have to leave a bit earlier tomorrow as well because I have an English class to teach.

I'm really enjoying the time on the ward so far and don't mind having to get up in the morning to go to work. Always a good thing!

Baci V

Guess who's back! One week Pediatric Medicine!

I just lost my whole post...:( here we go again.

Well another semester is over and another break full of things that need to be done has started.

This week I'm on the pediatric ward!

I was appointed the general pediatric ward. I showed up at 8 to find another med student and an intern already there. The first day on a new ward is always a combination of chaos and boredom. Chaos because you have no idea who does what, where things are and how things are done specifically. There is always a timeframe (usually on non-surgical wards) where everyone is busy working on their own things and as a newbie, it is difficult to find productive work. This time is usually spent reading and rereading charts in order to look occupied and try to remember as much as possible about each patient.

The morning was spent getting to know all the patients before the grand rounds started. Mondays is grand rounds day. We ended up being a huge entourage of chief, attending, residents, intern, students, nurses and psychologist going from room to room. The kids were quite cooperative though.

I like peds as a specialty. The peds ward is like no other. The kids were racing on little carts. The lungs were listend to in the "pit stop" before they were able to proceed with their race. Kids are running all over the place, yelling, drawing, playing, etc. It is quite the fun environment. The kids tend to be quite cooperative. The bigger problem is usually the parents. Usually they are rightfully concerned but sometimes they just really make life unnecessarily hard for the doctors. All part of the job.

We had kids with all sorts of diseases on the ward today ranging form infections to chronic diseases to circumstances quite bizarre (but can't be discussed due to patient confidentiality). Let's just say it's never monotone.

After the morning meeting with all the pediatric wards, we students took a lunch break.

Back on the ward, more specific work was done. I was given a patient for the week. My responsibilities included finding out what diagnostic work up still had to be performed, looking for findings and starting to compose the doctors letter.

We are required to present a patient to the attending during rounds and on Friday we will have a sit down with the attending to further discuss our patient and be asked a few questions.

So what am I up to the next few weeks?

This week peds. This Friday I have a night shift. Sunday I have a 26 hour shift in the delivery room(I am hoping a lot of babies decide to be born in that time). On Tuesday I have a 10 hour OBGYN shift on the ward. The rest of February will be filled with a lot of lab work. I really need to make some progress on my doctor thesis if I ever want the thing to be done. I have three more night shifts towards the end of the month. In March I will go to Ghana for a month to work there. I am quite excited for that adventure.

I will be reporting about peds, OBGYN and of course Ghana! So feel free to stop by and see what I am up to. I appreciate your interest and time reading this! 

Hope you enjoy!

Baci

V

"Wait, did that make sense to you?!" 2 days Psychiatry-- A Review

Well, its been a whirl wind of two days in the psychiatric hospital.

Yesterday morning, I was picked up by my friend with her car which was already packed with other friends. Our destination was the same. The psychiatric hospital on the outskirts of town (typical for old psychiatric hospitals).

After wandering around the very Harry Potter-esque grounds, we eventually found the conference room. The medical director was responsible for my group. He gave us a short history on psychiatry before heading onto the wards. We were split up into groups of two and then dispersed onto different wards. The set up on the two days was the same:

Meeting
Ward with 1 or 2 patient interviews
Discussion of cases
Lunch
Meeting
Ward with 1 or 2 patient interviews
Discussion of cases

And that both days. Essentially we were on 4 different wards and saw between 4-8 patients.

So yesterday morning, I was on the addiction ward. My friend and I talked to two alcoholics. They were very honest with us. They had different ways of becoming alcoholics and it was interesting to see how it started with each of them. It was also amazing how sweet the lady was. She really doesn't want to be an alcoholic and quickly sought help this time around. Neither of them had very supportive social circumstances. It is hard to tell how much of that is because they are alcoholics or they became alcoholics in part due to those circumstances. In the end, it is devastating to see what alcoholism does to the people. I wish them both the best on their way to recovery.

The medical director was a character. He did a great job explaining things and we had quite the laughs during lunch. He was motivated, which is important for such days.

After lunch, we had two schizophrenic patients to interview. This was exhausting. The conversation was fluid and on first glance made sense but if you did the math of the years they proclaimed things happened it didn't quite add up. At the end of the conversation, I felt like I had a lot of information but it didn't fit together. Luckily, my friend felt the same. Even luckier, the doctor told us that that is the way conversations with schizophrenic patients often go.

After the discussion with the group about their patients, we were free to go. We were all a bit exhausted from all the impressions we had gained that day.

Today was not different. During the morning meeting, the medical director gave us a history lesson on how psychiatric patients were euthanized during World War II and how the medical director of the hospital at the time was one of the very, very few psychiatrists that were against it and were active about stopping it.

My partner from yesterday wasn't here today, so I was on my own (which was absolutely no problem for me, the others hated doing things alone). I was sent to the depression ward. I had a very nice lady to interview. She was at the end of her treatment and it had worked very well for her. It was nice to see that with the right therapy, these people can be helped. After our chat, I chatted with the ward doctor a bit and then headed back for group discussion.

Then came lunch! They have quite the good food there.....almost everything is better than what we have in the hospital were we study.

After lunch, I grouped up with two of the others and we had two patients to interview. One of them was an Oxycontin addict (although he didn't tell us that, the patient records did) and the other was also schizophrenic and his symptoms had worsened, leading to his admission. Both of them were some what difficult to interview. The second just got up at some point and said he had to go and would see us next week.....?! I guess he will be disappointed this time next week, if he can remember it.

I was quite drained after the three interviews today. It is literally crazy to see how quickly someone can develop a psychiatric disease. It's frightening sometimes to see how many characteristics I share with some of the patients. In the end, everyone has their issues. It is about how you deal with them which differentiates where you are at in life. And a stable, supportive and loving social surrounding is essential. So love the people around you and be nice to them. Don't do drugs. And don't be afraid to ask for help should you need it.

The last few weeks in psychiatry have definitely changed my views on some issues and the way I perceive things. It was very enlightening.

We start with Pediatrics on Monday and that continues through winter break and into January. After Peds, we have a few weeks of OBGYN.

You can all catch me here again in February, at the latest, when I do my Peds Internship and OBGYN rotation.

I wish you all a lovely holiday season. Enjoy your family and friends. Be thankful for your health, your family and hopefully supportive social surroundings!

Baci

V

Psychosomatic Medicine--Should I be here?

So sorry I didn’t post the last two days. No Internet connection will do that to you. And very big lack of sleep.

I had a night shift Thursday, Friday and Sunday. After the night shift on Sunday, I directly went to the train station to catch a train to a town 1.5 hours away from Göttingen. A few friends and I were attending an internship in psychosomatic medicine.

We arrived in the town and took a taxi to the hospital. It is a huge hospital specialized on psychosomatic medicine and psychotherapy.

We found out room on the top floor in the medical directors department. We had a conference room waiting for us including a cart with tea, coffee and cookies. (We had so much of tea, coffee and cookies over the two days that none of us wanted to see cookies anymore.) I was very happy about the offering of caffeine.

The director of the hospital welcomed us and discussed what to expect for the next two days. Then we were asked what our expectations were.

The next point on the schedule was a patient interview done by one of the doctors. Patients in this hospital have psychological issues that cause bodily ailments or the other way around. I tried to listen as much as I could, fighting the tiredness, drinking more black tea and doodling to keep myself awake.

After the patient interview, the patient left and we discussed what had just happened. The interesting thing about how they taught us the patient history taking here apposed to how they do it in the university hospital is that we have a lot more time and we discuss how we felt during the process.

Over the course of the days, I noticed that a big difference in psychology compared to the other specialties, is that the interaction is so dependent on the therapist as well. In other specialties, the patient has an ailment and there is a process of taking care of it (hopefully, and this is a extremely simplified statement). With one patient, half the group thought he was a nice guy and felt bad for what had happened in his life whereas the other half didn’t like him at all. That shows that the therapy could be completely different depending on what the therapist feels, has gone through in life personally and how he identifies with the patient.

I mentioned this point in one of the discussion and was then informed that the doctors have a period in their training where they focus very much on themselves and their own issues to better understand them while treating patients.

We had lunch in the hospital and then were off to music therapy. That was fun. We all grabbed an instrument and started playing and seeing where it goes. Afterwards we discussed it and found that many had had musical training, which might have led to us quickly finding a rhythm.

We had another patient interview to see before the last thing on the schedule. Relaxation therapy! We were all in a cozy room, got a mat, a pillow, a blanket and a cherry seed pillow and the therapist starting explaining a few things to us and telling us how to relax. After 24 hours of no sleep at this point, I totally fell asleep and slept for about 10 minutes.

We stayed in the hospital for dinner before heading to our hostel. There was a Christmas market in town and everyone wanted to go. I was at 27 hours without sleep and managed to go along for one hot-spiced wine before I headed back before the group and slept…like a rock.

The next day we had more coffee and tea and cookies while interviewing a patient again.

Then we had the opportunity to have a one on one conversation with a patient. We were given 50 minutes for the talk. I talked with my patient for an hour before realizing it and having to go meet up with the doctor. My patient and I got along so well. I’d say we were on the same level on 80% of the time. The other 20% is the reason he is in the hospital for treatment and I am not.

After the one on one, we talked to doctors about our experience and got feedback.

After lunch, we had another patient interview. This time a friend and I did it for the group. It was amazing. Again, I could identify with about 90% of what this patient felt and had gone through and those little 10% were the reason I wasn’t in the hospital as well.

It was crazy just how well the patients fit to my personality that I saw yesterday. Maybe this should concern me on some level.

After that last interview, we had Qigong. That was fun to experience. It’s the Asian exercise you see people do in the morning. Slow movements and energy flow.

We had a last discussion with the chief and then caught a cab back to the train station and then headed back to Göttingen.

Tomorrow starts the first of two days psychiatry. Let’s see what that brings.

Baci

V