Friday, 4 September 2015

Fingers on the pulse

Block: Neurology, week 1

I'm back at uni and officially a final year now! Before that, I had a two week summer break where I went home and chilled out - O&G had been a really intense block with night shifts and a pretty tough end of placement exam. Most end of placement exams are seen as a bit of a formality, but this one really was quite difficult indeed, though thankfully I managed to pass. So yeah, the two week break was pretty welcome but I'm glad to be back now and getting into the swing of things again!

I'm now on a general medicine block which involves placements in two departments: neurology and geriatrics. I'm pleased to have received this combination since neurology is quite a difficult area of medicine, so it will be good to receive eight weeks of experience and teaching in it. And similarly, geriatrics is such a vast specialty with patients with lots of different presenting complaints, co-morbidities etc, it will be a good opportunity to brush up on all the internal medicine I've forgotten!

Mind you, before this placement started, we had a two day session on "complementary and alternative medicines" (CAM). I think this is a GMC requirement, not a med school one, so it's just something everyone has to do.

I went along and I tried my best to keep an open mind. I really did. But it's all just so wishy-washy and plain nonsensical. Setting aside the lack of evidence base for most of the "treatments", the theories behind how they (supposedly) work were so frustrating to hear. The number of fingers you take the radial pulse with can indicate where a pathology might be, the colour of one's tongue can reveal information about a person's inner state, transmission of different forms of energy etc etc. When one of the speakers started talking about "mind-body-spirit", well, that's when I fully switched off. Spirit, for crying out loud. Is this medical school or a seminary?

Honestly, if medical school was Hogwarts, this particular class would have been Divination.

The end result of those two days was that it merely re-affirmed what I believed before, that CAM is mostly used by patients who have conditions which aren't that well treated or understood by evidence based medicine - probably because the conditions themselves are quite...controversial...in terms of their aetiology and pathophysiology e.g. fibromyalgia, ME, IBS, etc. Certainly CAM does seem to help some people, and whilst I'm no fan of the big pharmaceutical companies, I can't help but wonder how much of CAM actually works and how much is a placebo effect and a tidy money spinner for its "practitioners".