Tuesday, April 12, 2011

How to win at med school

Medical school.  You can work your little heart out if you wish.  You could graft your buttocks to a library chair.  You could shamelessly brown-nose a senior doctor and hope to "noticed" and taken on as a new protege.  You could get all military and launch "Operation: Study".

But frankly, why bother?  The sole determinant of your clinical confidence as a med student is your ability to place intravenous lines into people's veins.  You may have eaten your textbooks for breakfast but if you can't slam in that cannula your mojo will be shot, down in flames, MIA.  Conversely, you may have skipped your last few years of classes but as long the first cannula of the day slides in sweetly, you'll feel like you can cure cancer.  Or at least dehydration.

When I was doing my anaesthetics rotation recently I noticed that anaesthetists like to hover over you and give you gratuitous advice.  If this happens to you, do not listen.  They are trying to steal your mojo using this old anaesthetic voodoo curse.  Shrug off the advice and dwell instead on this advice, given to me last year by a nice GP-anaesthetist:
Find the vein.  Put the needle in it.
Seriously.  You need to approach this task with a Zen-like serenity.  The less you are thinking, the better.

The reason anaesthetists try to steal your mojo is that cannula mojo is a zero sum game.  The better you get, the worse someone else gets, and vice versa.  Thus, it is important to mentally destabilise other students if you see them trying to place cannulas (or cannulae, as we used to call them in the Vetus Hospitium Romae).  This is easily done by offering advice, or more subtly, implying that they are so good that they don't need advice and thus the pressure to perform is on.

Last week on the wards, an Esteemed Colleague had been asked to change the cannula in one of the patients, a lovely old lady.  I wandered past in the nick of time and was able to wage psychological warfare on him from the outset.  Sadly, he got me back immediately.

PTR
Oh, going for that vein there, eh?  Huh.

Esteemed Colleague
Well it seemed like the best one.

PTR
Oh sure, you've got to go take your best shot.  

Esteemed Colleague
Darn it, I've burst the vein.  Big haematoma there.  Sorry, I'll have to try your other arm.

PTR
Oh yeah, that looks like a great one.  A sure thing.

Esteemed Colleague
Darn it, not again.  Maybe that first arm was best.

Lovely Old Lady
Maybe PTR should have a try?

PTR
Sure, I'd be happy to.  Hmm, this vein here looks good.

Esteemed Colleague
PTR's just done six weeks of anaesthetics where he did this all day, he's great at this.

PTR

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