BluE Scrubs

I was never told that I am a good listener. I don’t mind. Not that anytime today I was told differently. In fact I was convinced I am not a good listener.

Of all the 3 anaesthetists in this hospital tonight, I pulled the short straw and had to go over to a neuro centre. To a 50 minute ambulance blue light drive away hospital. Blue light means we can go through red lights and in between cars and against traffic flow but we don’t make weeee wooooo sound. We took this lady who was earlier in the evening was at a party, very merrily drinking away, who then unfortunately fell down a flight of stairs and bled into the brain. We call it extradural haematoma. She also broke her neck bones.

But wasn't it just a nightmare. She had her head sandwiched with blocks on both sides and her neck in a stiff collar. She complained it was uncomfortable, I listened I reassured. She complained and fidget and I listened and I explained. She then started screaming, and the line she had somehow came off with the fidgeting. Was I crossed? I bloody well was. Very.

Apart from her vomiting a concoction of red wine and some partially digested roast dinner on my scrubs, I would say that inter hospital transfer was quite uneventful and deafening. It is better to not listen, if it’s going to be the same thing that you have to explain over and over again. I am not good at that. Once, I could do. Twice, yes if you have hearing impairment. More? Sorry. Sometimes you have to be mean to be kind.

This is what you’d call dry, ‘err-what’ and has near perfect properties of an agent to induce sleep, however, not quite in one arm-brain circulation. (For that, you must either whack yourself in the head, or walk into a lamp post). If it is not yet obvious, I am feeling a bit ratty today. A bit? Some would say.

But, if you are sitting the FRCA exam anytime soon and want to know what it is like, rather than asking me ‘watchu get asked, whatcu get asked?’ I will tell you, first hand. So you may find this almost like a little cava sangria. Just what you need.

There were two poker face examiners. And then there was a you, shitting yourself across them. It’s worse than a job interview.

Viva 1 (Physiology)

1. Sinoatrial node resting membrane potential and action potential. Ionic changes for every phase. Compared with myocardial action potential. (he looked slightly sleepy and bored, I can soooo tell he soooooo wanted to sit there and ask me questions on tiny little thing in there somewhere, which if it stops you’ll die…err so fairly important, so yeah ok, it’s a fair question, so he grilled me).

2. Nerve cell resting membrane potential, what are the figures for potassium and sodium, what happens during the propagation? Nernst equation and Goldman’s equation. ( So I don’t know if all the constants are in the right order, but they didn’t seem to disagree. They probably couldn’t remember themselves. At least the equation looks correct on paper. You know like when people ask you to spell ‘konshens’ as in conscience, you have to marvel at it on paper first, to know that it’s the right spelling? So this one is like that. My throat was closing up and drying at this point, I so wanted to jump in a big river and soak my self . Sweaty as well mind you)

3.What is Parathyroid hormone, what kind of hormone is it? Explain in terms of calcium handling. Osteoclastic activity. Calcitonin action. ( Reduce, increase, reduce increase seemed the only words I was using, I wasn’t sure if they followed me, it’s not like gossip this, you can’t have much facial expressions to make it interesting apart from, eyebrows up, frown, down, very far apart, far apart, and semi lifted. And maybe just no expression when they said, right let’s move on to the next question)

Viva 1 (Pharmacology)

1. Acetylcholine receptor at neuromuscular junction. Nicotinic receptor .Draw the pentameric structure. Where does it bind, where does the atracurium bind. What about aminosteroid group? Where does that bind? (I think they liked my fat karipap style receptors, but the other examiner was starting to fall asleep)

2. Antihypertensives during anaesthesia, classes of drugs, explain in detail sodium nitroprusside. Action of GTN, and nitric oxide. Esmolol, what kind of beta blocker is it?( Right maybe I don’t quite remember how many cyanides get liberated, but I know what they do, ok not bad not bad.)

3. Pharmacogenetics , and I was like you are kidding me!!! I wanted to die.

So in the afternoon, some more torture.

Viva 2 (Physics, Clinical measurement and Equipmet)

1. Capnography- tell me all about it. So I did and he asked me about infrared, so I told him. Tell me the difference between capnometre and capnography. I waffled but I think he accepted my waffle. Something to do with continuous monitoring and sampling.

2. Latent heat of fusion, latent heat of evaporation of water. Explain the graph of heating up a block of ice. Saturated vapour pressure and critical temperature. Hmmmm. People melt ice everyday, in a plastic bag, by the roadside in a bowl, with cendol and red stuff and kacang and syrup and all the goodness you can think of. But I paid these people to ask me what happened when you melt ice. Can I not be me?

3. LASER. How it is produced. How is it made, how it is used, what precautions you have to take in theatre. Laser ..laser lah kan?

That took me to the clinical question which was 18 year old boy involved in a road traffic accident for splenectomy. How do you manage. Well, you just have to tell a story of how you would have done it. Something I like and enjoy doing so I didn’t feel it was all that bad. But I am soooo, tired now and I need a break.

I am a woman. Just so people know that this is not a sexist fabrication to inflame any delicate souls.

I classify female surgeons as type 1 and type 2.I don’t like female surgeons type 1. You can see that there is some form of a deprivation clouding them. I just don’t know what it is. Love? Were they neglected when they were growing up? Did they come home with 30 A stars and nobody pat them in the back and say ‘Clever girl?’.

Type 2 female surgeons are the ones coming to work brushing cereals off her skirt, doing internet banking between cases , rush off home to pick up kids, and more importantly courteous towards her patients, anaesthetist and the theatre staff.

Nurses?… now that is a different story altogether.

I think it is bad manners if I don’t apologize for the hiatus. That is I conforming to the tenets of blogging. You go missing for a few months, you call that a hiatus. The only hiatus I know is hiatus hernia. That is when your stomach herniates up through a hiatus, a something that allows free movement. A rotation, a sliding. Jumping and shouting crying and laughing. Things you could do during a hiatus. Probably not something a stomach would do.

So between now and then, in no particular order this is what happened. Brother bought a car, brother neglected his blog, a sister started a blog, another sister got 10 A’s and going to Japan, little brother has husky voice, mother misses me (she didn’t realize she’s not good at pretending she is not).

Also between now and then, I passed an exam, I moved house, a new job, making new friends. I miss writing. I will write more because it makes sense to do so, only as that group with 2 black guys one white woman and a strange not so asian looking guy says…where is the looooovvvee. (the looooove, the loooove- the woman one love one love- the black guys) echo.

Only it’s not the love I need, it’s the time.