I’m tired. (KUA/student-lead ward finally over)

I’m tired. For the past two weeks of this student-lead ward placement, I’ve been met with prejudice, discrimination and disrespect. Even some trying to undermine my role as in this case, the doctor. It turns out, it doesn’t matter how many times I present myself as the doctor. Just because of my appearance, it will never sink in for some. During the day, I told myself to hold on for just a few more hours but… I broke down.
 
The world is unfair I told myself. No matter what I’ll do, some people will just never take me seriously. Why did I even choose this profession in the first place? After crying on the phone to my friend, I returned to the ward.
 
At the end of the day, as it was our last shift at the placement, I said goodbye to our patients. They then told me that they were sorry to see me leave, and thanked me for all that we’ve done.
 
“With you guys around, I will always feel safe even if I’m home alone. We always hear nonsense on the news, when they should really be publishing about the work you all do. I wanted you to know that and, thank you very much for everything.”
 
I remembered why I wanted to be a doctor again. ❤️

World Health Day 2017: my story

I know this might come as a shock to some of you, but I have long thought that it’s about time for me to speak openly about it. Especially today, on the launch of WHO’s 2017 World Health Day campaign. Two years ago, I was suffering from depression. #letstalk 
I was doing well academically: published as an undergrad and was even invited to present my research internationally across the world. I was proud of what I had achieved, but others around me did not share my happiness. I was bullied in my medical school. I sought help from my medical school but I was told that it was my fault. They referred me to doctors and psychologists/psychiatrists for my depression, who all disagreed with my medical school. However, my medical school didn’t listen. I was forced on medication and psychotherapy. I then started to believe that maybe there was something wrong with me, that it was my fault I was being bullied.

I left my medical school that following summer and moved back home to Sweden from the UK. I was ashamed of the weak and lost person I perceived myself to have become. I chose to isolate myself and battle with my thoughts alone, as I didn’t want my depression to be noticed. Until one day, my sister sent me contact information to a therapist, and I secretly started to go.

After half a year of therapy later, I came back to my now new medical school, continuing where I left off in the UK. I learnt that everything that happened wasn’t my fault, and I was no longer ashamed. Now, I can talk about it more openly and I’m back to the same old happy and always smiling Sam that I’ve always been. 

So to all those battling depression, you are not alone. Acknowledge it, open up, and talk. I’ll listen if no one else will. If needed, professional help is always available. No matter what, never believe that it’s your fault and never be ashamed. We’re all human so in the end, we’re allowed to act as one every now and then! 😊

No man is an island (Psychiatry in Växjö)

I’m now on my final week in psychiatry in Växjö, and so far it’s been amazing. This week is a bit special though, as now I’m in Children’s Psychiatry. Otherwise during the past three weeks I’ve been in Adult Psychiatry, rotating within Emergency Psychiatry, Psychosis, Geriatric Psychiatry, General Psychiatry and lastly what I call the Psychiatric Jail. I’ve seen a great array of cases, and I think if there’s something I’ll bring from my placement, that would be that no man is an island.

Psychiatry is all about relationships. Well, for the main part anyway except for perhaps the cases of schizophrenia, autism etc. Otherwise, it’s all about relationships.

Relationships with your family, with your partner and of course with yourself.

When I was in the Emergency Psychiatry clinic on Valentine’s day, we all of a sudden saw a rise of emergency bookings compared to the day before. 10 patients vs the 2 yesterday on a Monday. It’s just a regular Tuesday I thought, but nope. It’s Valentine’s Day. The next day, only one patient came to the clinic.

Patients came in with depression which started from their divorce and/or patients coming in with suicidal thoughts from failed relationships. I thought to myself, this must be because of the holiday. If you’re surrounded by things that will constantly remind you about love, loved ones and relationships, if you don’t feel loved, it’s not too surprising if you would do something crazy on Valentine’s day.

As humans, we have a strong sense of belonging. Sure, being strong and independent is a quality to be desired and to strive for, but being independent doesn’t mean one is alone. Being independent means you are in control of yourself and your surroundings. With surroundings, I don’t only mean the things around us, but also with whom we live our lives with. Because it is through these people we feel like we belong and we gain purpose. It is through these people we find a home. And a home is a place where we feel loved.

When I meet these patients in the clinic, it saddens me that they are deprived of a home where they feel like they belong, a place where they receive love. If these basic needs were met, I believe a majority of these patients wouldn’t be here in the first place. If they have a place where they feel love, it will be easier for them to have love within them for themselves. And with self-love comes our power as human beings. Without power, what are we then?

It’s true what they say, love makes the world go around. Love is the answer. I believe this is more true than ever in psychiatry. Sure, as doctors we can give medication to try and help their situations, but if they don’t have that love within, medication is only a band-aid. If they haven’t nurtured a love within, with the help of others’ love for them, then they definitely need it now. In the end, no man is an island.

…But then again, what the heck what do I know, I’m only a student ✌️️

5 lessons I learnt from failure

For my entire life, I have never failed an exam. Study or no study, somehow, I’ve been lucky with exams. I have always taken pride in my ability to have a perfect pass record and my high marks. Failure, has never been an option neither a possibility for me. Then I came to Linköping and I failed my first exam ever. Twice.

I was devastated. For a long time, I questioned my abilities. How have I managed so far when I can’t even pass an exam, even after redoing it? I was discouraged, and all of a sudden, my belief in my natural superpower of doing well in exams was gone. Countless tears were shed and I was crushed inside. Then I thought, perhaps I made the worst mistake of my life by transferring to medical school in Sweden. I doubted myself and my decision.

I felt like a failure. I felt unworthy of staying in medical school in Linköping if I couldn’t even pass this exam after another try. Nevertheless, I persevered. I listened to my friends who told me that it’s okay to fail, and it’s understandable. You’ve never studied in Swedish and this is your first time taking an exam in Linköping and in Swedish they said. I held on to that thought for the entire of last semester, with the fear of being put on academic probation in the back of my head. I retook the exam once again in January, and I passed. Third time’s a charm.

Failing, was definitely a tough experience to go through, but I believe that it is a valuable experience to have. After all, we learn from our mistakes right? Failure is the best teacher.

 

5 LESSONS FAILURE TAUGHT ME

1. Failure doesn’t define you, but rather what you do about it afterwards

I had this idea that by failing, I will always be marked as a failure. Something that will continue to haunt me for the rest of my life. I was wrong. After failing, no one seems to remember that I failed, but only remember the fact that I passed. Looking at successful people in the world, like Bill Gates and Michael Jordan. Are they remembered for dropping out of college or not making it to their basketball team? Nope, they are only remembered for what they had achieved afterwards.

smooth save gymnastics girl on bar

2. Failure is simply an opportunity for growth

After finding out that I had failed, I repeated to myself of how I knew nothing. I beat myself about it, telling myself how stupid I was that nothing had gone in my head during my entire time studying. When I got to see my score, I found out that I was only 3 points away from passing. The second time, 4 points away (wrong way I know).

Failing doesn’t mean that one isn’t capable of succeeding, but rather one isn’t there just yet. 3 points away to be precise in my case. In this case, one is given the opportunity to continue developing using the lessons learnt from one’s failure, so that one in the end one can reach one’s goal in the best way possible.

you can dust it off and try again aliyah gif

3. If your friends and family believe in you, so should you

When I had failed, my friends and family kept telling me nonchalantly, oh don’t worry you’ll make it next time. I kept saying I would do my best, but I already had failed twice so my statistics looked grim. How come my friends and family trusted my abilities so much but I didn’t? Once passing, I was over the moon, and then they told me that they told me so.

If I had believed in what my friends and family said, I would’ve saved myself all the mental anguish and anxieties from the fear of failing yet again. There really is a strength in faith, especially faith in oneself. If they didn’t believe in me, who knows if I would’ve passed if I didn’t even believe that I would. The first step in doing something is believing one can accomplish it right?

child saying you have got to believe in yourself gif giphy

4. Not reaching one’s own expectations doesn’t make one a failure

I expected myself to have gone through medical school without failing a single exam, and on the time I expected myself to finish. I was supposed to be a graduated doctor by 23, with a perfect academic record. I’m graduating at 24, in Sweden, with a few failed exams here and there. Does that make me a worse doctor? Does that make me a failure? Nope, in the end I will still become a doctor, which is my goal in the first place. With a lot more experience than I had expected to graduate with.

arrested development i don't know what I expected

5. Failing is not the end of the world

You failed, so what. Life goes on. In the words of my favourite prayer:

God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.

In other words, better luck next time!

i'm rooting for you patrick star spongebob gif

The concept of health insurance in the US

I’m now back in Sweden after an amazing three weeks in Guam and currently am suffering from a severe Guam hangover. From sunny tropical weather to darkness and snow on my face for the next couple of months, yes there is a difference. Ah well, at least winter is kinda pretty and Christmas is just around the corner.

During my time working as “Dr. Sam” at the clinics and hospitals in Guam, I got to experience what is really alien to most of us here in Europe, which is the novelty of health insurance.

It’s true. All treatments are based on the insurance of the individual.

Let me explain it a bit more. Before going to a doctor, to be sure that the insurance will cover it, you need to apply for what you will be going to the doctor for. Because of this, some people are forced to wait, which sometimes leads to the worsening of their condition. Sometimes, it gets too late. This is mainly the case of patients who cannot pay for it first, or those who don’t want to risk the ability of not getting reimbursed by their insurance.

Secondly, there are different types of insurances. Depending on the type of insurance you have, doctors will treat you differently. Most health insurances are costly and privately owned, but some patients get free health insurance from the government as they are earning below a certain amount. Because of this, some greedy doctors (I’ve heard) do not prioritise these patients, as they barely will get money from them from their health insurance. In contrast to the patients with expensive health insurances, they will profit a lot from them.

To those who do not receive free health insurance and cannot afford the privately owned one, they’re in trouble. Going to a doctor then becomes very expensive, and a trip to the emergency room alone would cost several thousands of dollars. I wish I was exaggerating. Even the medicines are expensive.

For example, during my time in the US I managed to get an external otitis, aka swimmer’s ear. For this I needed anti-bacterial ear drops for. I got a prescription from my uncle, went to a pharmacy, and got my ear drops for $57.60. This is about 550kr. In comparison, I had a surgery in my arm in Stockholm in May, and that cost 350kr. Crazy isn’t it. I guess in this way, in one way or another, it is good to be home.

img_7796

Hafa adai from orthopedics in Guam, USA!

“Tito (uncle), that man has a limp on his left foot, what do you think is the possible cause?”

And so starts our lecture over lunch at the Hilton hotel, about different causes of asymmetrical limb lengths, ending with the classification of the different types of scoliosis and how to treat it.

Right now, I’m in the middle of the Pacific Ocean on a tropical island called Guam, which is a territory of the United States. (I know you were wondering where Guam is). I’m here for a three-week external orthopaedic placement with my granduncle-in-law, who is the local orthopedic surgeon in the region. I’m currently staying with him and my grandaunt (my grandmother’s youngest sister) at their house and am following my granduncle whenever he goes to work. It’s basically a mixture of vacation with work which I like to call, workcation. There is no better kind.

Since I was younger, I’ve grown up knowing of the many great things my granduncle has achieved throughout his career. I cannot even begin to describe how honoured and fortunate I feel to now be a part of it as his pupil. The generations of doctors in my medical family are now meeting. From breakfast lectures and handouts to clinic and surgeries, and finally ending the day with yet another dinner lecture. Everyday here in Guam has been countless learning opportunities in orthopaedics, and no time has gone to waste. Even the short car drives.

So you may be asking, how am I liking it so far? Well, I’m loving every bit of it, and somehow studying actually became fun now. I’m getting more and more tanned, bigger (no student diet here no) but definitely learning. I often reflect on how I ended up to be so fortunate with such amazing opportunities in life, but all I can do is be grateful.

This week I will be with Dr. Landström (yes, he is Swedish – what are the chances!) the local hand surgeon of the island, to have a greater diversity of cases within orthopaedics. Hand surgery cases that is. Tomorrow, I’ll be seeing my first hand surgery with him, and I better be on top with my anatomy. Like my granduncle, he is a very well-respected and experienced doctor too, who even has worked in Afghanistan. So to be on his good side, I better get back to studying, my break is over.

Hafa adai (the local greeting here which is pronounced half-a-day) from Guam! I promise to be back to write more about medicine and life here on the island. Until next time! 🙂

Just another day with me and my knee (model) at Guam Orthopedic Clinic 🏥

A post shared by Sam (@samvsworld) on

Self-development and forensic medicine in two weeks

So I’m currently on the plane to Tokyo, and thank God they’re offering wifi on this plane. Blog time!

These past two weeks, I’ve been with my T9 class (semester 9) for our theory weeks. This theory block is called Folkhälsa och Förhållningssätt (FoF), which basically is all the other parts of medicine which doesn’t involve any actual medicine like physiology and anatomy etc. These past two weeks, were devoted to self-development, forensic medicine and social medicine/public health.

The first week started with a three-day retreat at Vårdnäs, all paid for and provided by the medical school of course. Half of us in the class were divided into smaller groups with classmates who we don’t know at all. Together we learnt new leadership techniques and shared deep personal things with each other. Why is this necessary to become a doctor you might wonder? The explanation was this: patients entrust their deepest and most personal secrets to complete strangers, doctors, us, and the only way we can understand this if we do it ourselves. Then we know how patients feel when they visit doctors, and hopefully, with a better understanding of how they feel, we can in turn improve in our patient contact and as doctors. The first day basically began with a tough 30min presentation of ourselves to our group mates. Difficult, as we are not used to opening up to such personal things to strangers. However, who knew that would be an opening to something very special. 

The second day we learnt about the different leadership profiles. I turned out to be a “yellow” profile aka a motivator. I recommend you all to do that test too, and from there you can understand what kind of person I am with my profile. The rest of the days were based on building on what we know about our leadership profiles and each other. At the end of the three days, we went home having warm and fuzzy memories from our time there. We also most probably gained weight as they gave us delicious food five times a day. All worth it.

The following days after the retreat, all the lectures spoke about inequalities in health as well as forensic medicine. I didn’t think I would be so sensitive to these things, but really, after seeing images of murder and rape and hearing gruesome stories of real life crimes, unfortunately these images reappeared in my dreams. After the lecture series, we even had the opportunity to visit the morgue. This side of medicine I never prepared myself for, but this a reality that is very real for us doctors and everyone around us too. Which unfortunately I believe we will encounter in one form or another in the future. At least now I’m better prepared.

In summary, it’s been a tough two weeks, but very nourishing indeed. Tough personally and also tough as the lecture topics were hard to chew. I guess I can’t expect my last two weeks with my semester 9 class to be all fun and games. My next theory block will be with my semester 8 class on the same theme but until then, Orthopaedics in Guam here I come! 😁

5 uniquely British medical practices

I’ll be blunt and admit that I don’t really have a lot of exciting things to tell from the hospital after my placements. I think my placement in medical emergency is a tough one to beat. However recently, I’ve been remembering all these medical practices that was everyday for me in the UK, which now actually seems completely alien to me. I’m converting. There’s a lot that comes to mind, but for starters, here’s a list of five uniquely British medical practices.

1. Clinical wear is basically formal wear

For doctors, clinical wear entails shirt/trousers (NOT JEANS) for men and shirt/blouse/skirt/trousers (again NOT JEANS) for women. Nice flat dress shoes for both genders. Yes, this practice is extremely questionable hygiene-wise, as you come to work with the same clothes you will be wearing the whole day at the hospital, but there is some reasoning behind this.

The medical practice in the UK wanted to take a step away from the hierarchical system by abolishing the white coat and scrubs for doctors. There shouldn’t be anything to distinguish a doctor from a patient appearance-wise, as in the end they’re both people. This is so that there will be no “us and them” mentality between the doctors and the patients, and hopefully, doctors become more approachable during patient contact. It’s a nice thought I guess, and perhaps the prevalence of “white coat syndrome” has diminished over the years. However hygiene-wise once again, questionable.

homer gif giphy saying why so formal lenny you're my go to guy

2. Only black or white shoes are allowed to be worn in the hospital

The professional clinical look in British standards is to be somewhat uniform. Black or white shoes are to be worn as they are more professional. No bright colourful sneakers were allowed. However, I was always jealous of my sister and the bright colourful sneakers she wore around the hospitals in Sweden. So I never listened and decided to rebel and wear my bright orange sneakers. Did I get looks? Yes. Did I get scolded? Sometimes. But boy did I get compliments from patients – “I like your bright orange sneakers, you’re hard to miss in this hospital!” At least I was remembered for my fashion sense.

3. Some doctors wear bow ties or tucked-in ties

As an attempt to improve hospital hygiene, it was implemented that anything hanging around one’s neck is not allowed to be worn in the hospital. Including neck ties. This angered many doctors, as they viewed it to be a crucial part of their professional clinical wear. Therefore they came up with a compromise. Some switched to wearing bow ties, whereas others decided to keep wearing neck ties but started tucking the end of their neck ties inside their shirt. Works I guess.

bow tie from sing movie

4. British hospitals only use black pens

If you look around a British hospital, you will only find black pens and no other colour. I recall being scolded when in the hospital once for taking notes with a blue pen. They told me – how would colour blind people be able to read what I’m writing? I assured them that the notes were only for me to see, and afterwards I had to promise to never use my blue pen again. Since that day, I only brought black pens to the hospital. Yes, it is a rule in British hospitals that you are only allowed to use black pens so that everyone can read what you write, including those who are colour blind.

blue colour blind pen screaming gif giphy

5. You address surgeons as Mr/Mrs/Ms and DEFINITELY not Dr.

“Dr. McCloy… Oh sorry, I mean Mr. McCloy!”

I bet it’s probably only in the UK where some doctors would take offense if you call them Dr. Why you might wonder, which is a pretty good question. As told perfectly in this article, during the origins of surgery around the 18th century, surgeons back then did not possess any formal qualifications let alone a medical degree to be able to hold the title Dr. They were sometimes compared to butchers, and doctors were definitely more superior. However as times have changed, the status of surgeons have risen and thus have become so proud to distinguish themselves from doctors. Today in British hospitals, being called Mr or Mrs/Ms is a badge of honour and could only mean one thing – and that is that you’re a surgeon.
they call me mr tibbs gif giphy

Hello from the Emergency Department

Hi all!

Sorry for the hiatus, but I’m back now after a hectic past few weeks! I completely underestimated the stress of belonging to two classes and being a researcher at the same time. I’ve spent these past two theory weeks basically running back and forth between lectures and classes (internal medicine with semester 8 and orthopaedics with semester 9) and trying to progress with our research. Finally those hectic weeks are over and therefore – hello from the Emergency Department in Jönköping!

I’m on my next final day at the emergency department, and I must say, today has been the least busy day of the week. I define least busy by:

  • having lunch for longer than 15min at around noontime
  • not having to run as fast as I can together with my doctors across the hospital
  • not having to respond to a single cardiac arrest alarm
  • not having to respond to a single stroke alarm
  • only going to the emergency room of the emergency department once

On my first day at the emergency department, there were at least three emergency alarms we had to respond to (meaning a load of running) on top of the regular influx of patients, that we didn’t manage to eat lunch until 5pm. During my second day at the hospital, we were anticipating yet more alarms to go off around the hospital that my doctor was prepared with his scooter outside our room. I of course had to run alongside with him.

Today was a surprisingly calm day, so calm that I didn’t need to run. It was only then when I realised. As I stood in front of our only high-priority (code red) emergency patient of the day, I realised I wasn’t scared anymore. I was looking at an acutely ill and quickly deteriorating patient without being the slightest bit concerned. This has been everyday for us all at the emergency department. It was then I realised, I’ve really been blunted after these past few days. Or perhaps, my trust in the capabilities of medicine and the healthcare workers around to quickly save a life has increased. Perhaps it’s a combination of both.

So, what have I learnt after a few days in the Emergency Department? Saving lives is a very reasonable job description for doctors.

Final day in the medical emergency department tomorrow here we go! 😀

let the doctor do his work maam gif giphy south park emergency room doctors

What do you tell someone who’s about to die?

(Disclaimer: I received verbal consent from my patient to share about my experience with him.)

This week I’ve been at the Cardiac Intensive Care Unit, and nothing has challenged me more physically, mentally and emotionally during a placement.

At the Cardiac Intensive Care Unit, many patients come in after suffering heart attacks. They are in critical need of care, where many patients are vulnerable and are fighting to stay alive… and the healthcare team fighting to keep them alive.

The week began quite calmly, which gave me lots of reading time, but since yesterday and especially today, I’ve been running.

Running. Trying to learn and help out during critical situations, but mainly trying to keep out of the way. Running to wherever the alarm rings. Another patient is dying. Every second counts.

Yesterday, in the midst of a flurry of doctors and nurses trying to save another patient from a cardiac arrest, everyone leaves the room to discuss. At this point, several life-saving electric shocks had been given, and I was there to witness them all. Even seeing the patient in pain.

I tried fighting my tears as I realise, I don’t like seeing patients in pain. And I really wish I don’t ever have to. But there I was.

I was left alone in the room with the patient and I take their hand to comfort them. The patient then looks at me straight in the eyes and tells me:

Jag kommer nu.” – “I’m coming now.”

Coming. Coming to a place beyond us. Coming to death. Coming to what I like to believe, life after death. Coming to Heaven.

I was silent, again fighting my tears. I look straight back not knowing what to say. What do you tell someone who knows they’re about to die, and you know it too? What do you tell someone who’s about to die?

*

This question wracked my brain until the next day. Could I have said anything to improve the situation? What if that really was the last chance I got to talk to them? What if I was the last person they spoke to, and I couldn’t even say a word?

Fortunately, this story has a happy ending. After a rough night and morning of more emergency interventions, the patient is alive and recovering. I finished my day early and decided to pass by the patient’s room to talk to them. It didn’t really feel right for me to leave for the weekend, not knowing whether they will be okay or not when I return. I waited for their room to be free, came in, and in the end I stayed for over an hour chatting. At the end of it they took my hand and told me:

“You have an important duty to pass on your genes to the next generation and I hope you have many children… but be careful with your choice!”

I promised I will, and in return I made them promise they will be around when I come back after the weekend.

As a medical student, I usually joke that another day at the hospital is another life saved, but now I realised this is not a joke at all. As healthcare workers, we are given the unique opportunity to make great changes in people’s lives, and sometimes even save a life. However at times, we are also there as they take their last breath. Being prepared for both scenarios would make the best impact on people’s lives and today, I realised I still have a lot left to learn.

heart ECG tracing recording