14 Mar Summer at Stanthorpe
Nothing is more rural than having your car towed because a kangaroo jumped in front of it.
But let’s rewind to the start of my experience. This summer I had the opportunity to do the rural summer observership at Stanthorpe Hospital. To say I was nervous on my first day would be an understatement – I was absolutely terrified. How could I even talk to doctors when I had only done one year of medicine? And let’s face it – 6 months of ISM added nothing to my already limited clinical knowledge (sorry not sorry). However, despite my fears and crippling self-doubt, I came away from this experience with a much richer sense of what it means to practise medicine and rural medicine in particular. I learnt so much in those few weeks (more than I did in ISM, that’s for sure) and hope to enlighten you on some of those lessons in this short post.
Lesson 1 – Responsibility can be scary (at first)
For the first few days, I felt scared every time I was asked to do anything beyond observation. Even taking a history felt daunting. I couldn’t shake the feeling that these were real patients, not SPs, and they were relying on me and the rest of the team to help them – the weight of that responsibility scared me more than I would’ve thought. However, slowly my nervousness turned to excitement and soon enough, I developed the confidence to independently work with patients. I give credit to the doctors and nurses on placement who believed in me before I did. They initially assigned jobs to raise my confidence and then it slowly progressed to the point where I was voluntarily asking to do any jobs. In fact, my last day truly exemplified how far I had come. I was able to take a history and examine the patient, present it to the doctor, along with my differentials, and detail the steps required to diagnose and manage the patient. When a patient came in requiring sutures, I performed the entire procedure with minimal supervision. I stapled head injuries, administered local anaesthetic, performed biopsies on skin cancers, cannulated, injected tetanus vaccines and scrubbed into my first surgery. It’s safe to say that I learnt more than I could imagine.
Lesson 2 – Maybe ISM wasn’t completely useless
You realise how far you have come after one year of medical school. Going into placement, I thought that I wouldn’t know enough to do anything. However, it was quite the opposite. I was able to make sense of most of the medical conditions, predict differentials for patients and answer questions that doctors would ask. It was quite surreal to see medical conditions that you learnt on paper applied in real life. Yes, even that one sentence in Dissa’s slides about paradoxical embolism came to life. Yes, I did hear a pan-systolic murmur from a VSD. Yes, Kartagener’s syndrome is in fact real.
Lesson 3 – Patients remember you, believe it or not
There was a patient that I was responsible for in ED. I took his history and did an examination on him. He came in for musculoskeletal pain and the doctor recommended RICE (rest, ice, compression and elevation). The doctor told him to come back if his pain had not resolved. Fast forward a couple of weeks and I recognised his name on one of the triage notes. I went out to bring him into ED and he remembered me before I even called out his name – a moment I will never forget. It was rewarding to know that I was one of the faces of the treating team he remembered. Even as a student, I was not forgotten.
Lesson 4 – Adapt, adapt, adapt
Working in the hospital, I realised a doctor’s job is more holistic than just diagnosing and treating. When challenged with working in a rural setting, doctors have additional concerns regarding resources and patient placement. However, the one common thread amongst all the doctors I met was their passion to serve their patients. To them, nothing goes beyond the patient’s needs and comfort. Whether it’s a gentamicin shortage or being overworked, the doctors would adapt and with a smile on their face at that.
So while a kangaroo may have hit my car while I was driving back from Stanthorpe, I ended my experience with fine-tuned clinical skills, the advice of many doctors and the memories of numerous patients. I leave you with the wise words of a lovely intern I met: ‘Never do discharge summaries unless you’re paid to do so.’
Image source: https://www.thechronicle.com.au/news/hospital-upgrades-underway-at-stanthorpe/3083235/