My parents' last request before they went galavanting about Martha's Vineyard was that I should update them on the goings on of last week. I spent the last 2 weeks in the emergency department of the Mercy Hospital in Cork. It's a relatively small hospital in the middle of the city, and provides emergency care mostly for people in poorer sections of town. Not a ton of major medical or trauma cases, but very steady musculoskeletal injuries, asthma, COPD, abdominal pain, overdoses, and paediatric cases. It proved to be an interesting time. The two consultants in charge seem to enjoy their roles as teachers, and the registrars and SHOs did for the most part as well. The figures for the number of ER visits in America, Ireland, and the UK are all about the same, and end up with an average of 1 in 3 visiting and emergency department each year. That's astronomical. The Mercy is no different, though has fewer resources than many at it's disposal since most of its patients have public insurance which means inadequate resources. So the idea of the ER there was very much "first aid." Even if a patient had complicated or unknown medical problems, they wouldn't be sorted out in the emergency department. The role of the ER is to make sure the patient can breath, help a cut to heal, find the infected appendix, etc. While this is generally the idea of emergency departments in the States, the Mercy operates as an extreme example of it in order to stretch their resources as far as possible.

What did I get to do? During day shifts I was generally with one of the consultants, seeing patients or practicing reporting on patients to the doctor. The evening was when I generally got to do things like take venous and arterial blood sample, do ECGs, and suture wounds. It was educational and fun. Though lately I have been thinking more about intensive care as a future for myself, I appreciated the fast-pace nature of the emergency department. I got to work with doctors from all over the world, including Ireland, Malaysia, New Zealand, Austrailia, and Sudan. I got to see a little girl's hair used to hold togther a scalp laceration, and the finger of a sterile glove used as a tourniquet for a man who accidentally planed his finger instead of the door he was working on. I'm not sure I would have seen that if all of the doctors had been from fully industrialized nations with relatively adequate resources.

We also had a day of lectures about the fundamentals of emerency care, set up in the "ABCD" paradigm of medicine -- Airway Breathing Circulation Disability. The main speaker was the chief at the CUH, which is effectively the best ER in Ireland. A very cool man. He started the talk off with a picture of a man whose face had been shot off. A useful demonstration of the importance of a good airway, no?

I'm sorry to be moving on. Just as I was starting to get comfortable there and develop relationships with the nurses, doctors, medics, security guards, etc, it's time to move on to a dry couple of weeks discussing how and why to do research. I'll probably show up to the ER a couple more times to tie up looses ends, which will be nice.

In the mean time we're trying to have some fun when we can. Yesterday was beautiful (as is today, much defying the odds) so we lit up the grill. Almost felt like a normal person again.

TTFN

Greetings and salutations. I have finished my whirlwind first two weeks of lectures. They were doozies (they were a doozy? hmmmm. apologies to grammerians reading this.) Generally 7 hours of lecture a day, covering reproductive physiology, embryology, birth, neonatal health, neonatal ill-health, parental ill-health, psychiatry, ENT, opthamology... probably some others I'm forgetting. For a complete rundown feel free to read my schedule which is linked to the side of the blog. Most of it was really interesting and well taught. The obstetricians were so enthusiastic and such good lecturers that a number of us started wondering if maybe we were interested in that after all. Not likely for me, but good stuff. I'm looking forward to my time in the maternal hospital.

Monday I start my 2 weeks in emergency. We are the first class to get a dedicated rotation in emergency (in Cork, I mean. It's quite normal in the States.) which is exciting. The schedule they've given us ahead of time doesn't make too much sense so I'm not sure exactly what I'll be doing, but at the very least will include some casting and wound management. From what I can gather the clinical teachers in the hospitals are prepared to make us work hard, which is great. It seems like rather than simply letting us loose unsupervised all the time we will have more tutorials and practical teaching along side the patients and house staff.

After emergency (or A&E as it's called here) I will have two weeks to work on my research project. This project was traditionally done in final med, but do to years of feedback and a new faculty member in charge, it is being split into two tears and actually assigned credit and dedicated time. I'm not sure what I'll be researching yet, let me know if you have any ideas! After that I'll have a mixed month of special surgery (neuro/plastic/orthopaedic),opthlamology, dermatology, and anaesthetics, with a week for each. Then another couple of weeks of classes and a month of renal medicine and neurology to take me through til Christmas. Should be a good, busy term.

Thanks for stopping by!