YES WE CAN!!!!!

It feels strange that it was only a week ago that I wrote the last blog update. I've had so many experiences since then that it feels impossible that they could have all happened in a single week. The climax of the week (in fact maybe even the climax of the whole year) was going to the University graduation ceremony today in the 110,000 seater "Big House" University football stadium where none other than Barack Obama, the president of the US (as if he needed that extra introduction), the leader of the free world (as they like to call him here) was to be conferred an honorary degree and give a speech.

Needless to say, Ann Arbor has been getting very excited over the last few weeks about the visit of the president. I was certainly very excited being a big fan of Obama since his election campaign, but not everyone here shared this enthusiasm.

I find the attitude of some here towards Barack Obama to be very odd indeed. There are those who hate him with such a passion that you would think he was the cause of some terrible genocide or holocaust. The explanation given for such hatred is usually along the lines of Obama being the root cause of all the USA's economic woes (funny as I'm sure the economy crashed before he was elected) or he is a socialist (because he is trying to reform the very unfair health care system here), non-American (they even doubt his nationality!), and so on...

I've not met many people who will even admit they voted for him, and those who say they did often tell me how disillusioned they are that he is introducing "socialism" in the form of a health care bill. The fact that a health care bill was a very clear priority in his election campaign seems to have been forgotten.

The truth is that there are those who are doing very well in the current unfair system who do not want "change we believe in". There are also those who do not like him simply because he is a Democrat and they are life long Republican and always will be. Sadly there are also those who hate him because he is black. (Most strange of all is that often these are people who could benefit most from the changes he is introducing).

The Americans are passionate about democracy. Everyone talks about politics here. Yet many are now complaining that a guy who was elected by majority vote is now delivering exactly what he promised. And the response by some has been most undemocratic in nature, including death threats. I'm certain that every place he visits breathes a huge sigh of relief when he leaves in one piece.

By any politicians record, Obama's is pretty impressive. In his short term to date he has passed most of his manifesto - and all done with high levels of opposition, and a press that has been critical at best, and at times vitriolic.

Sadly, most of the doctors in the hospital are very much against a universal state funded health care system where no-one will go without health care cover. They fear our NHS model partly because of the loss of their independence to increasing government interference (probably with good reason), and also because of a potential reduction of their income. (Before you get too judgemental about this, I would like to point out that most of the residents I have spoken to have debts accumulated of about $400 000 from tuition fees. It is not unreasonable that they fear they will not be able to pay this off as easily as they thought they could when they took out the loans).

So anyway, I managed to get a ticket to go to the graduation, and I got through security without hitch. The logistics of searching 100 000 people must have been a nightmare, and the queue to get in was pretty awful but it was worth it. The ceremony on the whole was a great occasion (including Glee Club style choirs, brass bands, and of course the Star Spangled Banner sung in ear-piercing ultrasonics).

Much better than my graduation ceremony, that's for sure, and the highlight of course was Obama's speech. Despite the battles and negative press he has had, he has lost none of his passion for what he does. He comes across as very well read, educated and knowledgeable. He has a great sense of humour and humility, and he sure can deliver a speech. I could have listened to him all day. He talked about the importance of furthering your knowledge, engaging in debate in a civil way, understanding all sides of an argument even if you disagree (all very apt...). The speech was very well received by the audience and he had several standing ovations. I found the experience very moving and inspiring and it was a day I will remember as long as I live. Almost as impressive was watching the motorcade and entourage leave, followed by 5 helicopters (3 Chinooks!) to take him away again afterwards. The cost of the visit must have been $millions.

So enough about Obama.

The rest of my week was pretty eventful too. I did my first overnight on-call on Monday. When on-call we come in at 3.30pm and take over some-one's cases so they can go home. We get told which rooms to take over by the floor runner - one of the senior attendings who co-ordinates the staffing of the rooms. We keep taking over cases until there are just 2 rooms left running. Then the last late person leaves, and it is just us for the rest of the night covering everything except Obstetrics, Paeds, Vascular, Liver transplants and Cardiac. There are 3 residents on at night. The most senior one co-ordinates the work throughout the night. The on-call was OK. Busy-ish but never run off my feet. There was an on-call room for us which I managed to get to for half an hour. Normal can be anything from no sleep to 6 hours or more. We get the next day off, then back at work the day after (Wednesday).

I had a case of anaphylaxis during my night. At least I'm pretty sure it was. Severe Hypotension (nearly arrested) just after morphine, responding only to adrenaline. (I even got to ask for "Epi stat" - though it didn't sound right in a British accent. It was a sort of "Would you mind giving some epinephrine stat please?" - not quite ER)

Then later in the week there was a case of Malignant Hyperthermia (a really rare life threatening reaction to an anaesthetic) in recovery, which I got to help out by drawing up lots of Dantrolene. Anaphylaxis and MH in one week? I keep meaning to work out the odds of that but it makes my brain hurt.

I also got to do some liver resections that I've never done before and a couple of Bariatric (Laparoscopic Gastric banding) cases.

I sometimes think that even if I got kicked out of the country now, after only a month, I would have gained invaluable experience from this. I cannot recommend a year out of programme highly enough. It opens your mind to different techniques and different ways of working, as well as different ways of living. Honestly, if you have the opportunity then definitely take it. If anyone is interested in coming here then get in touch and I will tell you more.

Oh yeah. I got paid too. Boy did it feel good to check the bank balance on Friday.



Can we spend it?..........

YES WE CAN!!

Till next time,

Drake.




P.S. - Hope everyone at home gets out on Thursday and votes. I'm not able to because I didn't register for postal voting in time.