the medical record

a weekly dissection of death and life in the human body, and the medicine we hope can save us
27 Mar 2019

five things a GP most loves hearing

"Mine's just a quick one for you today." Once someone was right about that. It was amazing.  At the end of the thirty minute consult about travel vaccinations and the gut microbiome: "While I'm here, I'm having this crushing chest pain and a sense of impending doom." "I need a referral for a blood test." No. You need to tell me what the problem is, I'll ask seemingly irrelevant questions and examine you, and together we'll decide what you need. "I feel like it's gone to my chest." Hand on sternum and hopeful upward give me the antibiotics gaze. Yes, it has. The virus has gone to your chest. My personal favourite, "I've just turned fifty so I've made a double appointment to discuss my personal and family history and lifestyle and current issues. I'd like to be examined and receive personalised information and counselling regarding any evidence based screening…

17 Jan 2019

First night

My first intern shift in emergency, the consultant smirked pleasantly at me. “Don’t be nervous” she said, “Just remember – the air goes in and out and the blood goes round and round.”   That is only half true. That’s what happens if you are a senior doctor. If you are an intern the referrals go in and out and the chronic pains go round and round. If you are an intern you spend more time fighting with the surgical registrar, arguing with the medical registrar, receiving barbs of criticism from the ICU registrar and being scared to call the gynae registrar than you do making blood go round and round. It turned out, I should have been nervous. By some piece of creative rostering genius, my first time on the ED floor was a night shift on the Easter long weekend. The smirking consultant went home. The registrar smiled…

Three Compliments

  The Indirect Compliment   He was a doctor, a real one. Raised in the bad old days, when your boss left you with three hundred dying children and went to play golf. He walked around with premature babies hanging from the endotracheal tube swinging jauntily over his shoulder. Born with his hands in abdominal stab wounds, bred on the blood of a thousand postpartum hemorrhages. Cut his teeth on hundreds of dehydrated infants, who, the legend goes, ventilated a toddler by hand for a seven hour flight in a Cessna through a hurricane. This was a man who had slept under the beds of children who would stop breathing at the flick of a light switch, who carried in his pocket a crico-thyroidotomy kit, in case he came across an obstructing croup while out for breakfast. He walked the earth before negligence cases existed, and thus had learned to practise medicine, rather than self defence. He was scattering wisdom to the starry-eyed colleague of mine sitting at his feet and for some reason they started talking about me.   “We have too many doctors who think like this.” He made a triangle with his fingertips touching, like a pointy volcano top. “She thinks like this.” He turned the volcano inside out, bringing his hands together at the wrists, and spreading his fingers, like he’d…