In which he does two weeks in A&E and discovers that recording opera arias after a day seeing patients isn't that great an idea...

Thank you to those readers who emailed and let me know they were thinking of me after my last rather gloomy post. I'm doing much better thank you. I had a good two weeks in A&E (ER for those of you of a North American persuasion; Accident and Emergency). It was good feeling as if I actually knew something. My IV cannulation got much better, I hit several ABGs without incident, and I am starting to be able to take a history, do an exam, and come up with a differential and a plan with minimal input. I also saw some pretty cool things. I can also say unequivocally that performing CPR while slightly hung over is not a good idea. For those of you who have never done actual chest compressions on a person, it is HARD physical work; and work that I recommend one be in top physical form before attempting. And several of the docs and ENPs I was working with said nice things about me and my skills as a medical student. A little ego stroking praise can go a long way when you're feeling down. Especially if you're a tenor.

And apart from the cowboy stuff, I did get to see some sobering medicine; the young patient who died unexpectedly from an unforseen complication of a totally treatable disease, the cancer patient who came in dying sooner than anticipated from something rather peripheral to their struggle with cancer, the senior citizen who was fine yesterday, but today was aphasic and whose CT shows a tumour in the brain. There's nothing like a little life and death to put some winter blues and homesickness in perspective. And frankly, as sad as these things were, I am actually gladdened that in a few small ways, I was able to acknowledge their humanity, and ease their suffering.

And last week, I did a bit of recording. I got together with a pianist friend with a portable recorder, and sang some Handel and Donezetti (among other things). And while I don't recommend singing difficult repertoire after a day seeing patients at the hospital without doing much warming up, I was generally pleased with how the recording turned out. There were some really nice moments, despite the fatigue, and I have some real ideas of what to work on next in the shower. And I hope to head to Berlin in Feb. for a weekend masterclass with my voice teacher, which should be a welcome break from things medical.

I have now started my last rotation here in the UK, Paediatrics. And in 6 weeks, I will officially be finished my third year of medical school. Ummm...where did that time go? I'm not quite sure. It's a bit scary. But I'm looking forward to being home and one year closer to not knowing what I'm doing with my life.

Be well!