Catch-up!

I missed writing over a couple of days so this is catch-up!

Wednesday I didn't feel like going to clinic in the morning so I worked on my IRB, had lunch in the kitchen with the girls, and went in the afternoon.  It was oncology clinic.  One of the girls has ALL and most of her treatment is being monitored by the pediatrician, not the pediatric hematologist.  The pediatric specialist here train for the same amout of time as a general pediatrician, and a general pediatrician can declare "an interest" in a speciality field, and be the main consultant for nephrology, hematology, etc clinics.  So I asked the consultant I worked with when does a patient actually see a pediatric hematologist.  She said that it is at the start of their treatment.  After that, the general pediatrician monitors resposne to chemo and cell counts.  I would be too nervous to have my kid see a general pediatrican for that.  I mean, think about the responsiblity and training you have as a fellow in the states!  Its no where near what the STs (aka SHOs)/residents" here do, which is just observe in clinic!  The other thing is that all doctors get paid the same, based on the number of years they spend working for the NHS.  It works out to be about 110K for entry to 160K for working more than 7 years.  I don't think I'll ever be a doctor in the UK!

Last Thursday I had a very sad day in clinic.  It was IBD clinic and the consultant let me see her new patients.  The first one was a 15 y/o girls with BRBPR for 6 months.  She was evaluated by her GP who thought it was hemorrhoids and nothing was done.  She continued to bleed and have abdominal pain, saw another GP who recommended a colonoscopy but she never got one. 

The second girl was the one who broke my heart.  She is 11 y/o and had a 1 year history of oral ulcers, up to 20 at a time.  She saw a dentist and an orthodontontist who attributed it to stress.  She later developed severe crampy abdominal pain, and a vulvar ulcer.  Her mom told me she had missed the last 2 weeks of school, and I was tying to understand if it was fatigue or from her surgery.  However, during this questioning the girl got extremely upset.  She started crying, and covered her face with her hands, and wouldn't look at me.  I did my best to ask what was bothering her, focus on the positive by saying I thought she was a very lovely girl.  During her exam, I sat right by her in the bed and made heart beating sounds and gurgle sounds when I listened to her abdomen.  That brought a small smile.  When the consultant saw her and told her she would need a blood test that day she lost it again.  She was almost inconsolable.  I wanted to tell her its okay to be scared and that I still get scared when I get shots but I let the SHO do all the reassuring. 

Thursday after clinic I had dinner by Jess' friend's place.  We made a greek salad, with chicken and pita bread, had Rose wine, chatted, and watched an episode of New Girl and Downton Abbey.

I went to clinic on Friday morning but due to an annual review, CF clinc was closed to students, and I didn't want to do derm again, especially since I'll be doing in in May.  I took the train to Greenwich, most famously known for being the location of Greenwich Mean Time.  It is also the birthplace of Henry VIII and Elizabeth the I, and will be the location of the equestrian events during Olympic games. 

On the way to the train station, I got off at the Tower of London.

Here I am standing with a foot in both the east and western hemispheres.  The silver line is the Greenwich Meridian, at 0 degrees longitude. 

A couple of summers ago I was at the Tropic of Capricorn in Namibia.  I've now had my body sectioned by the 2 bisectors of the earth!   

The river Thames with the Millenium dome way in the background.  I walked past a gate that had a sign that said the gate is never to be padlocked as a measure of saftey.  A very tiny part of me wished I could go down to look for Roman clay sculptures!

I next went to the the Victoria and Albert museum. 

Its hard to appreciate from the picture but I really liked this sculpture.  Its made of jade, a material our tour guide explained, that is very hard to sculpture because it is so hard.  This is of 10 geese, each look different and each is actually a small box that can open allowing you to store things inside. 

These giant vases were made by a modern british sculpture who had to go to China to make it because no other


And here is a picture and video from the Museum of London:

A victorian dress. How did women pass through doors with this thing?

 Tonight I'm going out with my cousin to celebrate her friend's birthday at a reggae club.