Dermatologists for the day

It’s coming to the end of our dermatology placement here in Jönköping and apparently as always, during this week they give us the opportunity to have our own clinic. It may just be me but I was slightly worried, but excited to have our own patients. I remember enjoying this when I got the opportunity in the UK. But this time it’s dermatology though. Do I know enough about skin?

My first patient came in and luckily he was a jolly man coming to check on a skin lesion on his head. After a few minutes of conversation, our doctor supervisor knocks on the door to take me out of the room for discussion together with my classmate, who also had his own patient. After the discussion, we decided to see my classmate’s patient first and then mine. However when we went to my patient, he was gone!

Great, my first own patient ever in Sweden vanished into thin air. Well that wasn’t a very good start now was it. (We called him later on and found out he didn’t leave because he was unhappy with the care but because he had an appointment to keep.)

Nevertheless, I had to put my worries aside and take my next patient in.

I let in my next patient who was a woman around my age with acne problems. I don’t know if it was because we were of similar age or that I also have had acne problems in the past, but we got along really well! She was telling me of the negative impact her acne has had on her mental well-being, and I definitely could relate. So I decided to give her the same self-care advice I was given which helped me with my acne – “off the record” of course. I told her I will now step out of my “doctor” role and now into my role as a girl helping another girl out.

Unfortunately, as I was giving her my acne care and makeup tips, the doctor came in to bring me out for discussion. Darn, I was in the middle of something I thought.

After discussing my classmate’s and my patients, we decided to see my classmate’s patient before mine once again, mainly because I asked for some time to speak with my patient some more afterwards. Then we came to see my patient.

We discussed at length with my patient regarding the etiology of acne and its treatment, which she greatly appreciated. We also discussed the negative impacts it has for my patient. At the end of the consultation we came to a treatment plan that both she and we were happy with. After this she said:

“At first annoyed that I had to come to the doctors this morning because it’s my birthday today. But now I feel that I’m getting something from you so I’m happy I came. It’s like a present for me, so thank you!”

Touched, we all said goodbye to her. As I said goodbye however I asked if she had more questions for me. She then asked me for more acne care and makeup tips, and I was happy that I could continue where I left off!

I told her the importance of moisturising (which I learnt from my sister), and informed her of the type of make up she should use and not use. I also quickly told her how I usually do my makeup to hide all the spots (perhaps a video tutorial in the future?). She was happy to hear my tips and told me she will buy the products I recommended. I was happy I could talk makeup in a medical setting. Afterwards, we happily said goodbye, and wished each other all the best. I greeted her happy birthday once again, and apologised that I missed that it was her birthday today from the medical journals.

Shame, shame, shame on me. But at least this time, this patient didn’t disappear!

As a doctor, my goal is for my patients to leave the clinic the same way that my second patient left – happy, and with the feeling that we did something that helped them. Even if it is on a day like their birthday. Who knew being a “beauty expert” was part of the job!

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The Nobel Prize Museum with Nils from Läkarstudent.se

 

Ever since I e-mailed Nils from Läkarstudent.se (Sweden’s largest independent website for previous, current and future medical students) regarding contributing my guide on applying to medical school in the UK to his website, we’ve had small e-mail conversations regarding medicine and other things about life and all. Now that I’m at home in Stockholm for a relatively long period of time ever since leaving for Linköping, I thought it was a good time to meet! Where else better than the Nobel Prize Museum, which celebrates people’s revolutionary ideas through the years?

It is always a treat to meet like-minded medical students: generally interested in a lot of things with a passion for research. I thoroughly enjoyed our earlier discussions about potentially revolutionary ideas, historical fun facts and current events especially regarding the medical educational system. The Nobel Prize Museum could definitely not be any more fitting of a location. Until next time! I wonder where to next, the bar is definitely raised high after today.

Nevertheless, as this post has the Nobel Prize Museum in its title, I should probably write something about the Nobel Prize. My favourite Nobel Prize laureate is Marie Curie and Nils’ Röntgen (the discovery of the X-ray). I think those we chose do say something about us, because in the end you would choose something that resonates with you right? Nils’ one is understandable as he has a great interest in the field of radiology, but for me, I wouldn’t really say that I have a great interest in radioactivity, which is Marie Curie’s most famous discovery.

Marie Curie is definitely my favourite Nobel laureate not because I have a great interest in her work, but rather because I have a great interest in her. Marie Curie was the first woman to win the Nobel Prize, the first and only woman to win twice, the only person to win twice in multiple sciences and was part of a Curie family legacy of five Nobel prizes. She had everything that it takes to become a successful researcher: brains, patience and dedication. Oh, and luck too of course. She is not only a role model for us women, but for everyone wishing to discover something that can really make a difference in the world. It was an honour to work at the Curie Institute in Paris, on Pierre and Marie Curie street, where the laboratory they worked in and made their discoveries was located and stands until today. It was definitely a pleasure to visit their old laboratory during one of my lunch breaks, and attend a lecture in the lecture hall where they used to teach.

My dream is to be like Marie Curie. Find an idea I’m passionate about and believe in, and follow it until the end. Maybe it could make a difference in the world, or perhaps even lead to a Nobel Prize. Who knows, but only time will tell!

Nässjö and jogging around the beautiful Rocksjön

Just like yesterday, I had to once again travel to a new city, new hospital in Nässjö. Once again, we were positively surprised at the hospitality of the people at the clinic.

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We were welcomed with an Easter buffet breakfast!

We came at about 9.30am, and was told to go upstairs to the kitchen. As we entered, we were greeted by the kind staff who invited us to the table. Apparently, they had set two plates for us at their Easter table since yesterday, anticipating us. Yup, I don’t think we could’ve felt even more welcome.

During the rest of the day, we were able to see the typical cases you’d see at every skin clinic: eczema, psoriasis, skin cancers etc. The staff there guided us to the rooms every time they knew there was an interesting case for us to see. We were going to end our day with scabies – which I read from our Swedish dermatology book is a typical Scandinavian skin infection – but on examination, it later turned out to be dry skin. I guess that’s both good and bad news. Nevertheless, it was yet another enriching day at dermatology!

When I came home, anticipating all the Easter food I’ll be eating in the next few days at home, I thought it would be a good time to go for a jog. It was pretty sunny too anyway. So I decided to run around the lake right in front of where we live called Rocksjön. I don’t know if I ever have had a more scenic run before because boy was it beautiful.

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If you look to the right I took some random running route to finish a 5k, because I noticed that someone was randomly following me… He luckily stopped running after me at some point. The red-ish spot by John Bauer’s park is where I took the photo below!

I have been extremely fortunate to have been placed at such a beautiful place, with such an amazing group of people. I can’t believe my first week at dermatology here in Jönköping is already about to end by tomorrow, time is going so quickly! I’ll make sure to cherish the time I have left next week. But first, here comes a long Easter weekend back home in Stockholm!

Rocksjön is absolutely stunning, a wharf by the lake

Could one really ask for a better evening jog?

My utomlänsplacering turned me into a local jetsetter

This week I started my first “utomlänsplacering” which means a placement outside the county of my medical school. I’m currently placed on a two-week dermatology placement in Jönköping, Småland.

My friends also placed in Jönköping and I left Sunday evening and arrived at our apartments in the hospital grounds, provided by the hospital. We took our keys from the emergency room (“What was the first think you did in Jönköping? Go to the emergency room of course, ha!” -.-) and went to our temporary accommodation for the next two weeks.

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This is the beginning of the Jönköping hospital grounds, isn’t our apartment building beautiful?

I was worried about how the accommodation would be recalling the nightmare of accommodation we received back in the UK (see photo below), but one can say that I was positively surprised to say the least. THE ACCOMMODATION IS AMAZING!

bathroom at medical student accommodation blackburn hospital preston manchester

This is the accommodation bathroom provided for Manchester medical students based at Blackburn hospital… our accommodation now is definitely a step up #nightmare

Apart from the beautiful exterior, our apartments were MASSIVE! Two separate bedrooms for my roomie and I (it’s probably the biggest room I’ve ever lived in that’s not a hotel), a big hallway, a fully equipped kitchen etc. Free wi-fi, clean linen, pillows and towels to take downstairs, access to the free laundry room, a little library and a TV. At least they definitely thought about our comfort as “travellers.” To make things even better, there’s a full shopping centre right across the road from where we live in the hospital grounds.

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I’ve been to Jönköping once before with my choir but I don’t remember much from the city. Therefore, being a true traveller, I was quite excited to explore this new place.

We came to our first day yesterday at the clinic and was warmly met by the staff. We have never been so warmly met before! We received our little introduction booklets, keys and decided our schedule amongst us. We found out that it is obligatory for us to travel to different cities as a part of our placement, and I was the “unfortunate” one who gets to travel to two different cities two days in a row.

welcome note for us medical students at jönköping ryhov hospital!

Look they even made us a little welcome note posted on the board!

So this morning as I’m writing this, I’m sitting on the train which will take me to Värnamo where I will be during the day. The travel there takes 2h, which is basically the same time it took me to go to Jönköping from my medical school Linköping. And it costs 80kr each way (about 8 euros each way – my student wallet is crying). Tomorrow, I will be going to Nässjö, which will luckily take less than 2h to travel to.

Four cities (Linköping, Jönköping, Värnamo, Nässjö) in four consecutive days. I never realised that going to medical school would mean this much travel. I guess we just need to get used to it since in the end, we need to go to where our patients are. And not everyone will be lucky to have all their patients at the same place as oneself. Luckily, I enjoy being a jetsetter anyway.

I really need a driver’s license.

Medical School In Europe: Sam Valles’s Story

This is my interview featured on DailyMedicine.co!

Daily Medicine Blog

Have you ever wondered what it is like to go to medical school in Europe? Well Sam Valles knows all too well. She was raised in Sweden but went to medical school for four years in the UK! Even more amazing, she is not only going to be an MD doctor but also is receiving her PhD. Check out her unique medical school story for more about international medical schools.


  1. Who are you to the world Sam?

Hi! My name is Sam and I’m on my penultimate year of medical school in Sweden. I also do cancer research on the side of medical school, aspiring for a PhD. I started medical school in the UK: three pre-clinical years at the University of St Andrews and one clinical year at the University of Manchester. In the end I decided to return home to Sweden, as I realized I wanted to be…

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Five years later, I’m finally getting operated on

Five years ago I had to give up one of my passions which is playing the violin. It was not only because I was moving to the UK, but also because of a chronic injury on my wrist/arm.

Throughout elementary school and gymnasium, those who knew me always associated me with the violin. I even had the nickname “Violin Sam.” I used to say that the violin was like an extension of my arm. It was a part of me.

I was 17 years old when I got my injury, originally diagnosed as a Repetitive Strain Injury. I couldn’t move my hand/arm for a month and was in so much pain. I was devastated. A part of me was gone all of a sudden. Nevertheless I still kept playing as much as I could, at least to finish the concerts as well as I could. On a positive note I was allowed to skip my Physics final exam because I lost the ability to write – and my grade was pretty much set anyway.

I learnt to live with the pain and occasionally visit doctors and physiotherapists. During my entire time in medical school, I have always used a computer to write my exams. I wanted to be a surgeon back in the day, but quickly ruled that out as I can’t do surgery if I get constant pain every time I use my arm. Goodbye surgeon dream, goodbye violin, goodbye writing and drawing. Oh well.

 

me with my violin from the royal college of music in stockholm

This photo was taken on the day I returned my violin to the Royal College of Music in Stockholm in 2011, a few months after my injury. This was one of the last times I played the violin.

Years passed, and during my first clinical placement at Manchester University, I spoke of my problems with one of the doctors who was my supervisor. Intrigued with my story, he suggested for me to revisit my problem and get examined once again. I followed his advice and went to a doctor.

The constant visits to doctors began. During the entire year I was in Preston, I was examined by various orthopaedic surgeons, underwent MRI, X-Ray, Neurophysiological tests you name it. They didn’t even finish examining me within a year. I was told they couldn’t find anything wrong. When I moved back home, I decided not to give up and continued my examinations here in Stockholm.

I was referred to see a hand surgeon who turned out to be an anatomy lecturer at Karolinska. Within the 30min that he met with me, he diagnosed me with an unusual condition called Radial Tunnel Syndrome. I will have a nerve decompression surgery at the end of April/May.

For an entire year in the UK if not longer, I had to undergo so many tests when the diagnosis could’ve been made within a few minutes.

In other words, I could’ve been okay by now.

NHS, after being both a medical student and a patient in your system, I don’t doubt the abilities of your doctors but rather the system itself. I agree with the headlines – NHS, it’s time for a reform.

I can’t wait to return to playing the violin once again! 🙂

More than a patient

 

Being my family trade, becoming a doctor had always been expected of me. I had never allowed myself to consider other options. Because of this, I had always focused on how I was going to become a doctor, instead of why I wanted to become a doctor. And it was going well. Or so I thought.

Four years into medical school, everything was going as I had planned and better. But suddenly, I saw my life racing away from me. My life was getting closer and closer to the goal, but I was only at the starting line. I thought I was almost there, when really, I had never started. I had no fuel to start, with nowhere to find it. Because I had never known what it was in the first place.

Why do I want to become a doctor? Is it for me or for my family? Is it actually what I want to do? I had to find the answers to these questions, and I knew I couldn’t find them whilst I was in the hospital. I believe that sometimes you need to lose your way to find it. So I took a break.

On my break, I was fortunate to work as a gymnasium (high school) teacher for students studying to become healthcare assistants. I was able to use my experiences from medical school for my students’ learning and development. All the theory, and more importantly, all the stories I have from encounters with my patients. One day, a student came up to me after class. He said:

“I wish we could have you as our permanent teacher. When you talk, we can relate to the things you say and it makes it easier for us to listen.”

I was touched to say the least. I guess like what people say, if you speak with passion, people will care. People will listen. So it turns out, I was and am passionate about what I do. But it was only then when I finally realised what it was.

As a doctor, yes, I get to utilise my interests in science and yes I get to make a difference in people’s lives – but that’s not my passion. What I love the most about what I do, is that I get to be a part of people’s lives. As a doctor, I am given the gift of being entrusted into people’s lives. A part of their family and everything  else about them, even their thoughts, fears and dreams. For me, I don’t only get to treat the patient, but I also get to meet the person.

See, sometimes you do have to lose your way to find it. And I found it when being a teacher.

Everyone who I see when wearing my white coat, are all more than a patient. Being able to be a part of it all is the beauty of my profession, and is what makes me passionate about what I do. I want to share this with all of you, so on occasional Sundays (because #storysundays), I want to share you stories from my patients. Stories not focused on their disease, but what makes them more than a patient. Stories on what makes my patients people.

If I didn’t choose Oncology I would’ve probably chosen Infectious Diseases

During the first week of my Infectious Diseases placement, I recall attending a teaching session by one of the specialists. With much enthusiasm she said: “All diseases start with an infection!” I pondered about that statement for a while and realised that maybe she has a point.

In cases like rheumatic fever leading to heart problems etc later on in life, or H pylori infections leading to gastric ulcers that could eventually lead to cancer, maybe there is truth to her statement.

Infections occur in all systems, and has a multiple-system effect. They don’t always present themselves in the same pattern either. By giving the right antibiotic/antiviral etc among the masses available, you can save a life. Pretty exciting indeed.

During my placement, I met several patients who were in severe sepsis (basically dying) one day, seemed unaffected the next. Magic. One patient around my age came in and was barely able to open his eyes and breathe (he was breathing about >30 breaths per minute). He was losing his breath whilst talking to me. We administered antibiotics and when I visited him the next day, he was back to normal. Magic.

Perhaps my mom had a point when she was encouraging me to pursue Infectious Diseases as a specialty. She has always spoken highly of the specialty, ever since she worked very closely with them as a clinical epidemiologist. I recall the days when mom would travel to Vietnam with the WHO to help eradicate malaria. Perhaps it is due to my early exposure to the specialty that I took a natural interest to infectious diseases. Or perhaps it’s actually in the blood.

Nevertheless, after these two weeks at the Infectious Diseases department, my commitment to oncology is still as strong as it has always been. But my respect and interest for the specialty has definitely grown.

I maybe won’t become an Infectious Diseases specialist in the future, but if there’s someone I would entrust to save the lives of the masses, I would definitely turn to an Infectious Diseases specialist to save the world.happy dancing cats

“Vad bra svenska du talar!”

“Vad bra svenska du talar, verkligen!”

Translation: “You speak really good Swedish, really!”

Ever since coming here to Linköping to continue my studies, I seem to get this quite a lot. Once I tell them about my background of course.

After I tell people about moving to Sweden as a 7-year-old from the Philippines and being in medical school for four years in the UK, somehow, people seem to only focus on that. I chose to study in the UK, because I have studied in English ever since moving to Sweden – international schools from elementary to university. However, I did grow up in Sweden in the end. Somehow, the fact that I’ve been raised in Sweden is overshadowed by my immigrant background and international education.

Should I take this as a compliment? That I learnt how to speak good Swedish after living in Sweden for over 10 years? And didn’t forget it whilst abroad?

Or should I feel offended that because I look and am from a different country, I was expected to speak Swedish badly?

Nevertheless, I must understand, I’m a minority. Not everyone have met us modern Swedes with international backgrounds. In that case, I can be an ambassador to show that assimilation into Swedish culture from another background is possible. Maybe next time they meet someone like me, they won’t be as surprised.

My patient hugged me goodbye :)

For the past two weeks, I have been placed in Infection, and this final week I have been placed in the wards. But I’ll write more about this Infection placement some other time.
During the entire week, I have been in charge of a patient ever since he came into the ward. I was there when he came in, and watched him improve with the antibiotics as the days went by. I was sent in to take a quick history with him alone, and I even met his wife in the corridor. She was looking for him, and luckily I knew where he was.
Today, his infection had improved so much, that he was ready to go home.
I typed out his discharge notes, and came to him with the doctor in charge. Since he was my patient, I was going to discharge him. I gave him my papers, explained what we had done and asked him if he had any questions. At the end of the consultation, I stretched out my hand to say goodbye and to wish him well.
He took my hand and shook it, but then afterwards, he pulled me in for a big hug, thanking us for taking good care of him during his stay.
“I have felt very well taken care of during my entire stay here! At first I was quite angry about it, but you all have been so nice towards me. Thank you very much!”

It is not always you actually manage to reach out to a patient, and for them to understand that you want what is best for them. But when you do reach out to them, the feeling of knowing that something you have done has helped someone else feel better, and for that person to actually appreciate it, is priceless.

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