Reflections on Phase Three – Steven Davis
I started Medicine with the view that I would like to become a rural GP. The variety, opportunity for continuity of care, the challenge of less access to technology and the beauty of the natural landscape all appeal to me. With six months of Phase Three completed, I have not been disappointed. I want to share four anecdotes that capture the essence of my six months in Milton and hopefully convey why Phase Three is unique and something to look forward to.
1- The pros of a small hospital
I had a late start on this particular Tuesday. I had just finished my CBL when I got a phone call from one of the other students down here with me:
Sam: “Did you get the email?”
Sam: “Theatre is on today and they forgot to roster one of us on. Neither Rhys or I can go.”
Me: “Sweet, I’ll go if we haven’t already missed the boat.”
I then messaged the GP anaesthetist (who we knew from RAD days, ED and GP placement) to see if there were any patients left on the list. Two carpal tunnel releases to go. I left in my boardies, drove 2 minutes to the car park, put my scrubs on and met the team. The GP anaesthetist said to me “We are doing a light sedation and a local wrist block, I’ll show you how to do it and then you can do the next one." Under her supervision, I did as she directed. Once the block was in I then scrubbed in, assisted the surgeon and helped close up. I left an hour and half after having arrived (not before I had some cake that one of the team made and left in the next room) with such a great experience under my belt. The fact that there were no registrars, residents or interns opened the way for me to be able to come in at such late notice and get hands on experience.
2- Continuity of care - riding the roller coaster
One of the things I love about medicine is being able to interact with people on a very real basis. I first met patient X whilst parallel consulting. Despite his six-month old diagnosis of a terminal lung condition and rapid decline he was a man that maintained his sense of humour and positive outlook. Equally, his wife who was always with him was a pillar of support. We quickly developed a good therapeutic relationship and I followed his case with interest. One month later I happened to be doing my ED shift when he was brought in by ambulance with a respiratory rate of 45 on the background of a respiratory infection. I knew his history and was able to fill the team in before he arrived. It became clear that his need for a transplant was rapidly approaching. I then saw him another month later in the GP practice the afternoon that his application for transplant was rejected from the transplant team. Three weeks later the transplant team reversed their decision and he was told he was getting a transplant tomorrow. He is currently doing well. This case was a powerful example of riding the roller coaster of life with patients.
Being a medical student in a rural area for 12 months opens up real life stories that can be both inspiring and heart breaking. Either way, we are given the opportunity to walk alongside people through times that are highly uncertain. Being at Milton has given me many opportunities to walk with people through the seemingly mundane and the extreme. I have many patients that I have now seen for the fourth time and I am only half way through!
3 - The medical community - banter and care.
I was attempting to take blood from patient Y. After my first miss she told me that I reminded her of malaria through her thick accent.
Me: “I’m not following.”
Patient Y: “When I was young I had malaria and the doctors needed to get blood from me on many occasions.”
Me: “As long as you weren’t saying I’m a parasite.”
I then told my supervising doctor the story. He told me she must have been confused, clearly she meant to say that you reminded her of melena! It was good banter. It was banter that was well received because of the depth of relationship I had built with him. The same doctor bent over backwards to help my wife when she was sick which meant that we didn’t have to go to hospital. In Phase Two you change team every five weeks. In Phase Three you are with the team for twelve months. They get to know you and you get to know them. With that relationship comes trust and increased opportunities. This has been one of the best things about Phase Three.
4 - Time for refreshment - the local landscape.
I got home from my ED shift a touch after 6pm. My wife was home from her teaching job and daylight savings had just kicked in. We decided to take the paddleboards out at our local spot and were not disappointed (see photo below). There is so much to love about living in a rural area where such spots are just around the corner and you are the only people out. Despite what happens through the day you can come home, throw the board on the car, head down and enjoy the beauty of the local area. There is so much to explore that you can always find a new place which is one of the many reasons why we can’t wait for the next six months.
I would not have changed anything about Phase 3, if you are not there yet you have something to look forward to!!