Semester 12 - Medicine (RETROSPECTIVE POST)

Semester 12 was the “Pre-Internship” Rotations of Medicine, Surgery and GP, which I also happened to do in that order.

My Medicine Rotation was IMHO, academically and socio-emotionally less interesting than my Geriatrics Elective. The Casemix seemed narrower even though the Medical Units included some middle-aged Patients - nevertheless lots of Pneumonias, Cellulitis and GIT Bleedings. The Ward Rounds were really long, about 4 or even 5 hours as the Unit list could extend up to 30 Patients, which I personally thought was ridiculous for 2 Interns to manage. The Consultants leading our Unit were very good-tempered and polite though, which surprised me given the Patient Load. As the relevant Patients were scattered throughout the Hospital on different floors (unlike Geriatrics where everyone was on the same Ward), and these Interns were insistent on writing the Progress Notes, I quickly ran out of Patience and decided to leave the Ward Round halfway through to help with typing Discharge Summaries instead, which was still time-consuming but engaging. I did appreciate the Venepuncture and IV Cannulation Opportunities I got during this Rotation, and was enjoying the process of collecting Patient Stickers from the Pathology Nurse and taking Blood Samples / inserting Cannulas. It was a bit like an Adventure hunting down Patients to intervene on. I probably did about 30 Cannulations and 50 Venepuntures in this Rotation. It felt gratifying to put Test Tubes into a Container which got placed into a Chute to be suctioned to the Pathology Department, “Futurama” - style.

Two interesting Cases though. We had a Bedside Tute and the enthusiastic Registrar showed us a Patient who had Janeway Lesions on his hands, which are flat painless skin lesions following prolonged, undertreated Infective Endocarditis. To be honest it didn’t look that remarkable, but because this Clinical Sign is so apparently rare in Australia (maybe except Aboriginal Communities) that we would probably never see one again for the rest of our working lives.

Second Case was a young Autistic Man who was very agitated on the Wards. I found it particularly unusual that his Expressive Speech was approximately that of a 3 year old, yet at one point during his Meltdown, he rapidly said "Our Conversation is Over". At the time I wondered if they neurologically have the Capacity to acquire significant Vocabulary and other Information, but are unable to retrieve / integrate it efficiently due to inefficient Wiring, almost like he was "trapped" in a sense? I managed to calm him down by squeezing his hands and forearms, and also stroking his back or arm repetitively with his Soft Toys, and talking about his Special Interests, hence reducing the need for Psychotropic Medication on that Day.

His Mum was pleased and complimented my Actions to the treating Team.

I think this Medicine Rotation further emphasized the Notion that it’s not necessarily the Medical Specialty that influences your enjoyment of a Rotation, but also the Staff within. Particularly as this Rotation was even more bread-and-butter than Geriatrics, I still looked forward to each Day coz the Interns were otherwise friendly and very appreciative of the Help that I provided, and were willing to give little bits of Advice here and there.