The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:
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Requests for advice and / or encouragement. On basically any topic and for any scale of problem.
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Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.
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Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.
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Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).
Jump in the discussion.
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Today has been an awful day to have eyes. Or a nose. I can't say my ears have been assailed too badly so far.
That gentleman who can play the flute both ways was around, thanks to missing most of his mandible. I didn't miss having to do the dressing, especially since he's developed maggots and needed insecticide of some sort poured over his gnashing pincers.
But even worse was the other gent with a MASSIVE growth in his chest, like JFC I've never seen anything like it. He could have been an extra in the Last of Us show without any makeup. When I was swabbing out his insides, I was genuinely scared that if I poked too hard I might find myself inside his mediastinum and fondling his heart. It split open his ribs and stuck a good half a foot outside him, dripping with pus. I was all "isn't that an excessive amount of bandages" before I began, but no, you needed the output of a small cotton plantation to cover him back up.
The smell. It's a good thing I have a strong stomach and that I've had no time to have breakfast, lunch or dinner. I didn't have the appetite to check his notes so I don't even know what cancer he has, but I'm swearing to never get that one.
Gangrenous diabetic feet? Not that bad, I'll debride a dozen a day (and had to). But when you can smell the patient from the other end of the ward, that's when you wish the COVID anosmia stuck around for good.
As a layman, you are doing God's work.
Not everyone has the brain or the fortitude to do your craft and act like its all cool and no big deal.
Blushes
I appreciate the compliment, but dressing wounds isn't a particularly hard job. Incredibly disgusting, depressing (because these two chaps are not going to get better, though they'll probably die at home instead of in the ward, and someone else has been slacking, since the first patient definitely did not have maggots when I did this last week) and good at making you lose weight through a loss of appetite, but anyone can do it.*
Where I feel particularly useful, and like I'm actually applying my medical degree, is when I'm counseling patients. I was called to deal with multiple "difficult" patients and their families today and did a damn good job at it. I assuaged their doubts including on the relative benefits of further treatment options, helped synthesize conflicting opinions from multiple consultants (I keep the sordid deals and angry debates to myself) clarify concerns that they either didn't bring up with the senior doctors or the latter didn't have time to cover, and basically showed impeccable bedside manner. I know it's a good day when someone cares to ask my name, and so far it's never been because a patient wished to lodge a complaint against me. Someone even left me a gift once, shame I didn't have time to spare to go retrieve it from a building about a ten minute jog away.
Man, just let me get a psychiatry degree already. I'm already the poor soul delegated to deal with them, and it's because I do a good job at it.
But dressing suppurating wounds? I suppose I do it gentler than most. I know what the patients are going through and have no wish to prolong their suffering, be it by tearing off the old tape too fast and taking hair with it, or poking at things too hard. There are some doctors who, if not outright abusive, certainly have less care for these patients who are well past being able to speak up for themselves, and as they correctly reason, are going to die in 3 themselves. (3 what you ask? 2. 1..) . The ones who need it the least complain the loudest, here I have to go by muffled grunts and their diminishing frequency that my bone-sawing is doing some good.
But it's not difficult work. You just need a very strong stomach or the ability to keep your eyes open and still think of England. Thank you nonetheless, for all that I bitch about the profession I do derive some small satisfaction from helping. Even if here, it's too little too late.
*Should have seen my fellow interns run when asked to debride diabetic feet. I didn't find the sickly sweet aroma of rot nearly as off putting as they did, so it was a good opportunity to trade tasks I personally hate. Like plastering fractured limbs, I was still prying plaster of Paris out of my USB-C port for weeks afterwards.
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What would happen if you swallowed a piece, big or tiny, of someone's cancer tumor?
Nothing at all. Well, barring some projectile vomiting into a conveniently placed bin.
Cancers are almost never transmissible by that route. Barring the odd exception like a sexually/contact transmitted disease in dogs and Tasmanian Tigers.
The piece would land in my stomach, all alone but for the gastric fluids (I really haven't had a chance to eat), and it would be promptly digested.
There's a minor risk of poisoning or gastroenteritis, depending on how rotten the tumor is, and this guy had a volcano.
But in all likelihood? I would come out of it with a well taught lesson not to open my mouth while dressing tumors, or spraying them down with saline prior to it. I was offered a mask, but it wouldn't help with the smell unless it was an N95, and would otherwise just fog up my glasses. I would rather eat a dozen tumors raw instead of endure a needle prick accident while reviewing an HIV or HepB case, the risk is almost certainly lower.
I'm largely used to this shit, today's cases were extra awful by the standards of a rather jaded Resident Medical Officer.
(I suppose you could make a nice steak out of a rhabdomyosarcoma, but I find that the clinical pathologists aren't game, and the cautery tools in theatre don't give them them quite the sear I'd like.)
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