January 17, 2008
The second week here in Clonmel have flown by. Pretty much more of the same, as far as the medicine goes. A lot of sore throats and coughs, rashes, joint pain/injury, a well-baby check… I’m wondering if anxiety is as rampant every where as it is here. A lot of people very anxious about their health, or that of their children. Even in parents whose children are older, there are a lot of very nervous people around.
Once again we got to see very few of the female doctor’s patients, even fewer than last week. I understand why women might be uncomfortable having extra people in the room for a pelvic exam or Pap smear, but it brings to the foreground some of the frustrations of getting trained in a Catholic nation that is still very squeamish about gender relations. For our classroom based clinical teaching, they only want men to volunteer to be patients. I’m beginning to wonder if I’m ever going to really get to treat a woman. It turns out not just to be in training, either. Dr. Lynch almost always puts his stethoscope underneath a female patient’s clothes, rather than ask her to take her shirt off.
I’m noticing this week I’m frustrated about a few things. I think the pace of this experience isn’t agreeing with me, so I’m generally irked. It may be that most of my training at this level will feel slow to me; I’m pretty much just a fly on the wall, so my day is filled with standing around listening and watching. I’m learning, but I really prefer hands on stuff. I feel like I need to be learning practical skills and differential diagnoses, not just getting better at communicating with people. Perhaps because I don’t feel like I’m really learning all I could be, it’s easy to let the aggravating things about this rotation get to me. It’s a lot of travelling. 1.5-2 hours each way, every week. Having to buy lunch and dinner every day, while trying to maintain a somewhat healthy and affordable diet. Scarce internet and phone access, making keeping in touch with friends and family difficult and/or expensive, depending on which solution I choose. This week I bought a loaf of bread, and some cheese and mustard that I keep with the milk for coffee and some vaccinations or something at the office. I supplement that with a Pot of Noodles (which actually has tvp in it, so I’m getting some protein with the fat) or yogurt and fruit or something. Dinner continues to be a search around town. Last night I found a place to get a decent felafel for cheap. The guys who run that restaurant are from Bagdad.
Another thing that is beginning to grate on me is Dr. Lynch’s disdain for all treatment outside medicine. He continually disparages chiropractic, acupuncture, rehab, and all forms of mental health treatment that don’t involve medication. WTF? I have yet to tell him that both my parents are therapists. I’m just not interested in having that conversation.
I’m not really this cranky, actually. I’m enjoying meeting people, and having fun on our little sojourns into town. I’m already more used to the routine, and I imagine will continue to get more accustomed to it. It’s only a couple of months.
I was going to take some more pictures of my life here, but awoke to a nasty rain storm that involved a lot of wind, some thunder and lightning, and about 1 minute of ferocious hail. It mostly cleared up over the rest of the day, but my camera-phone isn’t exactly high tech, so I’m waiting for a little more sun. Stay tuned.
To quote Calvin, more news as events warrant.
Saturday, January 19, 2008
Friday, January 11, 2008
January 9, 2008
Last night the 4 of us (there’s two more at a B+B around the corner, and John has a car) went into town to find dinner. We’ve been a little spoiled living in Cork, I’d say. Not much open in Clonmel, even at 7:00. There were a few restaurants of varying quality and price, and we eventually settled on a chipper. Why, you ask? That’s an excellent question. If you come up with an answer, please let me know. It was fine. Not great, not terrible. It was dinner, and it had protein, which were about the only criteria I was aiming for that night. Tonight will be a similar scenario. Only The Nose knows what we will find.
Today was a little slower medically. There was a different doctor there in the morning, a younger woman. She was quite friendly, and had a really calming, competent air about her. Unfortunately most of her patients didn’t want us in the exam room. My hypothesis is that younger patients are generally shyer than older ones. I doubt I will collect the data necessary to prove or disprove that idea. I don’t have any striking memories from this morning, so I guess that I’ll skip the color commentary. The afternoon was interesting. More back pain, chest colds, and the like, but also a couple of more interesting things. One was a man with a likely haemorrhoid. The GP actually had a simple proctoscope that he used right there in the office, through which he was able to see some internal piles. I was once again struck by how comfortable Dr. Lynch is at doing a number of different procedures in different parts of the body. Injections into joints, a ring to support a prolapsed uterus, injections into piles, foetal ultrasounds… I’m not sure how much all of those skills get utilized by urban GPs, either here or in The States. The last patient was a young woman of 19, on what I believe is her second pregnancy. She was grinning the whole time, which I interpreted to mean she is quite excited to be having a baby. He did an ultrasound on her, which was really amazing to see. I think it is the first time I’ve been in the room for a foetal ultrasound. At 24 weeks, we could see its limbs, heart, liver (those things are giNORmous in foetuses, by the way) and head. There may have been some boy parts, but we weren’t sure. Very cool.
Since it was raining pretty hard the secretary (or Hub, as Dr. Lynch introduced her as) gave us a ride home, which was very sweet. Just chilling at “home” now, waiting to hear back from our friends about dinner plans. The three kiwis moved out today, but I suspect we’ll see them next month at the hospital. I think the Simpsons are on. I’m Eli McKenna-Weiss and you’re not.
Here's a behind-the-scenes view of a medical student's bedside table and dresser while he's on a placement in Clonmel.
Last night the 4 of us (there’s two more at a B+B around the corner, and John has a car) went into town to find dinner. We’ve been a little spoiled living in Cork, I’d say. Not much open in Clonmel, even at 7:00. There were a few restaurants of varying quality and price, and we eventually settled on a chipper. Why, you ask? That’s an excellent question. If you come up with an answer, please let me know. It was fine. Not great, not terrible. It was dinner, and it had protein, which were about the only criteria I was aiming for that night. Tonight will be a similar scenario. Only The Nose knows what we will find.
Today was a little slower medically. There was a different doctor there in the morning, a younger woman. She was quite friendly, and had a really calming, competent air about her. Unfortunately most of her patients didn’t want us in the exam room. My hypothesis is that younger patients are generally shyer than older ones. I doubt I will collect the data necessary to prove or disprove that idea. I don’t have any striking memories from this morning, so I guess that I’ll skip the color commentary. The afternoon was interesting. More back pain, chest colds, and the like, but also a couple of more interesting things. One was a man with a likely haemorrhoid. The GP actually had a simple proctoscope that he used right there in the office, through which he was able to see some internal piles. I was once again struck by how comfortable Dr. Lynch is at doing a number of different procedures in different parts of the body. Injections into joints, a ring to support a prolapsed uterus, injections into piles, foetal ultrasounds… I’m not sure how much all of those skills get utilized by urban GPs, either here or in The States. The last patient was a young woman of 19, on what I believe is her second pregnancy. She was grinning the whole time, which I interpreted to mean she is quite excited to be having a baby. He did an ultrasound on her, which was really amazing to see. I think it is the first time I’ve been in the room for a foetal ultrasound. At 24 weeks, we could see its limbs, heart, liver (those things are giNORmous in foetuses, by the way) and head. There may have been some boy parts, but we weren’t sure. Very cool.
Since it was raining pretty hard the secretary (or Hub, as Dr. Lynch introduced her as) gave us a ride home, which was very sweet. Just chilling at “home” now, waiting to hear back from our friends about dinner plans. The three kiwis moved out today, but I suspect we’ll see them next month at the hospital. I think the Simpsons are on. I’m Eli McKenna-Weiss and you’re not.
Here's a behind-the-scenes view of a medical student's bedside table and dresser while he's on a placement in Clonmel.
January 8, 2008
I’m writing to you now from my room at the B+B. There’s no internet here, so this posting is likely to be a compilation of several days’ ideas. Or I’ll separate them by day. still, though, perhaps too long and boring to anyone but my mother. It’s the end of my first day on location in Clonmel, only my second full day back in Ireland. How strange we can change locations and lives so quickly. One minute I was enjoying my vacation in Massachusetts, the next I’m learning to be a doctor in ruralish Ireland.
I hopped on a bus Monday evening, glad to have some quiet time to myself to try to get my brain and body less lagged behind the jet. Put some Josh Ritter on my headphones and… took a nap. Sean, one of the proprietors of the B+B picked me up at the train station (yes, you read correctly. Don’t ask me why I can’t take a train from Cork to Clonmel, but the bus stops at the train station. It sounds like something they would come up with in Russia.) I quickly got settled in. The other inhabitants of the inn: 3 women from New Zealand doing some of their medical training at South Tipperary General Hospital, where I’ll be next month, a GP from Capetown filling in for a few weeks, and 2 medical students from UCC. Arguably one of the safer places to be in the area. My room has a double bed, a little t.v., a closet, a dresser, and a sink. Both mirrors in the room were either designed for small people, or tall people who like to look at their torsos. There’s a shared toilet and shower (separate rooms, also a la Russia) with a comfortable sitting room downstairs. Breakfast was also a group affair, with people coming and going as their schedules necessitated and their breakfast arrived. Sean couldn’t stand for any of us to have to go to work in the wet weather, so he made a couple of trips with the various people to where they had to be. I feel like I am in one of those English comedies that have no apparent plot, barely move, and yet are utterly charming.
The G.P. we’re with, Paddy Lynch, is a great guy. Talks a mile a minute, and is a very patient teacher and doctor. Today was mostly about observing, but found little teachable moments. Today’s patients were varied, as they seem to be in a GP’s surgery outside the big city. A woman with symptoms that appear to be intermittent claudication, an infant in for some immunizations, some adolescents with ear aches and chest colds, some adults with chest colds, some routine blood tests, cryosurgery for a sebaceous keratosis, a prolapsed uterus (or womb, as the doctor said, which does have a friendlier ring to it), a woman with a as-yet undiagnosed nerve problem, a few folks with lower back/disk pain… You get the idea. We felt some pulses, listened to some chests, got to see how ESR is measured. Then off home, to change and relax. Somehow very tiring, despite the fact that we didn’t actually DO anything.
I’m writing to you now from my room at the B+B. There’s no internet here, so this posting is likely to be a compilation of several days’ ideas. Or I’ll separate them by day. still, though, perhaps too long and boring to anyone but my mother. It’s the end of my first day on location in Clonmel, only my second full day back in Ireland. How strange we can change locations and lives so quickly. One minute I was enjoying my vacation in Massachusetts, the next I’m learning to be a doctor in ruralish Ireland.
I hopped on a bus Monday evening, glad to have some quiet time to myself to try to get my brain and body less lagged behind the jet. Put some Josh Ritter on my headphones and… took a nap. Sean, one of the proprietors of the B+B picked me up at the train station (yes, you read correctly. Don’t ask me why I can’t take a train from Cork to Clonmel, but the bus stops at the train station. It sounds like something they would come up with in Russia.) I quickly got settled in. The other inhabitants of the inn: 3 women from New Zealand doing some of their medical training at South Tipperary General Hospital, where I’ll be next month, a GP from Capetown filling in for a few weeks, and 2 medical students from UCC. Arguably one of the safer places to be in the area. My room has a double bed, a little t.v., a closet, a dresser, and a sink. Both mirrors in the room were either designed for small people, or tall people who like to look at their torsos. There’s a shared toilet and shower (separate rooms, also a la Russia) with a comfortable sitting room downstairs. Breakfast was also a group affair, with people coming and going as their schedules necessitated and their breakfast arrived. Sean couldn’t stand for any of us to have to go to work in the wet weather, so he made a couple of trips with the various people to where they had to be. I feel like I am in one of those English comedies that have no apparent plot, barely move, and yet are utterly charming.
The G.P. we’re with, Paddy Lynch, is a great guy. Talks a mile a minute, and is a very patient teacher and doctor. Today was mostly about observing, but found little teachable moments. Today’s patients were varied, as they seem to be in a GP’s surgery outside the big city. A woman with symptoms that appear to be intermittent claudication, an infant in for some immunizations, some adolescents with ear aches and chest colds, some adults with chest colds, some routine blood tests, cryosurgery for a sebaceous keratosis, a prolapsed uterus (or womb, as the doctor said, which does have a friendlier ring to it), a woman with a as-yet undiagnosed nerve problem, a few folks with lower back/disk pain… You get the idea. We felt some pulses, listened to some chests, got to see how ESR is measured. Then off home, to change and relax. Somehow very tiring, despite the fact that we didn’t actually DO anything.
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