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Wilkommen to my blog - my name is Karin Purshouse, and I'm a doctor in the UK. If you're looking for ramblings on life as a junior doctor, my attempts to dual-moonlight as a scientist and balancing all that madness with a life, you've come to the right place. I'm currently a doctor/research trainee in oncology after spending a year doing research in the USA. All original content is licensed under a Creative Commons Attribution 4.0 International License.

Sunday, 21 December 2014

Twas five nights before Christmas...

The last time I had a really vicious bout of the sniffles was this summer.  It's funny how well I remember it.  I was doing locum night shifts and had been burning the candle majorly in the run up, and personally and professionally I really wished I didn't need a steady supply of tissues and paracetamol on hand.  Now I feel much the same, having just had the most jet-set week of my life so far.

SWIMS 2014
So, with my herbal tea in hand, it's time for the Christmas edition of my scribbles.  Bless my blog, it's had a good year.  As has become my blog tradition, with Christmas upon us it is time to look back at the general mayhem and madness that was 2014 and 'learn' something from it.

This year:
January - SWIMS (That's 'Sensible Women in Medicine and Medicopolitics Society') held its inaugural conference in the Peak District, celebrating being normal ladies, basically.  January was the Month Of The North, and it was jolly wonderful.

February - I was up to my eyeballs in pipettes and petri dishes, trying to Do Science - and then remembering that being rubbish at something for a while is pretty damn healthy.
Tignes looking all lovely and white in Spring

March - I spent a lot of March revising for my MRCP part two exam.  I love this funny job I have called 'Doctoring' but it isn't half exhausting doing a full time job and then cracking out a nine hour exam between night shifts.  Lesson learned - this too shall pass.

April - I left the lab and went head first into night shifts as the Medical SHO; but actually through some of my own health strife I realised what life was like on the other side of the patient/doctor divide.  Puts things into perspective, that.

May - By this point I was well and truly medicine-d.  Breaking bad news and other such difficult conversations made me see, though, that this is totally the job for me.

June - ... on a similar theme, discussing end of life decisions - another one of those 'wait just a second there, I'm only in my twenties, how can I be ok discussing this' type moments.  And then realising it doesn't matter, because you're actually ok having this sort of chat and really it's a privilege to be the one doing it.

Wedding goofing around with my other bestie Matty
July - Apparently I didn't post anything in July, but I'll tell you for free that I was saying goodbye to a lot of excellent friends from the last two years as we finished our first official posts as doctors.  I'd argue these have been amongst the biggest in terms of friends, family and self, so it was a pretty big thing to say goodbye to.  Also - weddings.  So many weddings.  Marvellous!

August - I became a part-timer!  Oh it was wonderful.  Being a self-confessed work-a-holic, I became a work-and-life-a-holic.  This is when I got my cold, by the way.  I don't think Black Wednesday really had anything to do with it...

September - What a month.  Tears a-plenty, and that's from me, the ice queen.  Although I'd say what I learned from September that going and exploring pastures new doesn't mean what it did when you were 18.  Life really will still be there when you get back; it's more like 'adieu' than 'goodbye'.  That doesn't mean I didn't bawl like a baby when I gave my final wave to my friends, of course.

Claire and kickball in Baltimore
October - I moved to America!  What DIDN'T I learn, is probably a better question.  I learned that emigrating is the only way to really check if you're ready to be a grown up.  I learned that I am a lot more accepting of who I am than I thought.  I learned that making friends is still one of life's great joys.  I learned that I love my jobs, both of them, and that I am learning more about them all the time.   And I learned that alas, for me, there is nothing to equal the British ability to make a truly excellent cup of tea.

November - OpenCon.  'nuff said.

Oh to wander the streets of Oxford in December...
December - I can't lie - December has been flipping' hard work. I submitted another job application, various lab things went all 'science' on me (read: not working), my best friend went to Sierra Leone like the hero she is and amidst all of that... I got a job interview in the UK.  So back I flew, landing back in the USA two days ago.  Which was a lot more emotionally draining than one might think.  What did I learn from this?  Stop thinking, focus, and just go with it.  (But look after yourself.  As I've said many times on this blog before, no man is an island...)



New Haven's Christmas tree.  Subtle, huh?
So I really have no clue what 2015 will bring, apart from hopefully a renewed closeness with my stethoscope.  2014 had more twists and turns than I could ever have predicted.  Which goes to show, you really do never know what is around the corner.  Although I've had moments of doubt and fear, if 2014 has taught me anything, it's that you should never stop adventuring, whatever your definition of that is.  And with that - Merry Christmas, dear blog reader!





Monday, 8 December 2014

When your best friend goes to be an Ebola doctor

Unless you've been living on Mars, you will be aware of the Ebola epidemic currently sweeping West Africa.  My best friend, Claire, is leaving for Sierra Leone this week to work as a doctor with the Kings Sierra Leone Partnership (KSLP) at the Ebola Isolation Unit in Freetown.  Claire and I have been friends since our first week of medical school - we have lived together, travelled together, solved woes over endless cups of tea together, and grown as students and now doctors together.

Along with the rest of the world, I have been closely following the devastating events in West Africa. Towards the end of my time in the UK, I had a patient who was a returning traveller from the region, and I must admit that at the time, when Ebola was just appearing on the horizon, Ebola was well down my list of differential diagnoses in comparison to malaria, typhoid, yellow fever etc etc... I suspect if the same patient had come into hospital in the UK now, they'd be straight into an isolation unit.  It does make you wonder though how many of these common tropical diseases are now being untreated.  Having had malaria myself many years ago, it remains deeply troubling to me that so many people die from a disease that cost me about £1 ($1.50) to be cured of.  But now that Ebola has taken such a hold, how do you battle a war with so many fronts?

I have been struck by several aspects of the Ebola crisis.  Although comparisons between the AIDs crisis in the early 90's and Ebola are in some ways unhelpful (in terms of transmission, pathogenesis and disease course, they are totally different), they do highlight the gross inequalities in health provision, and how often it requires people in the Western world to be affected before they take action - as discussed by Kofi Annan.  Another is the role of the media - funny how the second it was reported that Ebola was marginally in control, it's no longer in the headlines. And finally, the mass hysteria about returning healthcare workers, quarantining and transmission risks.  This is despite the fact that, when asymptomatic, you are not contagious even if you have Ebola.

I'll admit, I wasn't super keen when Claire first told me her intention to go to work as an Ebola doctor.  Perhaps it was selfish of me, but having gone through the loss of close friends once, I just feared the worst - and that neither I, nor my friends, could go through that again.

But having read more about Ebola, the desperate need for staff and the immense progress in controlling the virus that has been aided by groups like MSF and the KSLP, I started to realise how ignorant I had been.  Of course there are risks, but when you consider how many foreign health workers are currently working in Ebola hospitals, and how few have actually contracted the virus, one must give credit to the healthcare staff there having developed very effective protection techniques.

Of course I am worried and anxious, and I will miss her hugely (it's amazing how Skype makes you feel like someone is not really that far away despite the fact I've been away for over two months!).  But rather than just sob to Kodaline, I shall instead say I am immensely proud of what she is doing; someone who has absolutely no idea how brilliant and brainy she is and will bring her zany love of life to everyone she meets in Sierra Leone.  Check out her blog for her progress (www.claireferraro.blogspot.com).  As Christmas time approaches, I for one will be keeping Claire and all of her colleagues and, of course, patients in Sierra Leone firmly in my thoughts.
This beauty was taken on the roof on which we slept in northern Ghana (note our delightful sheen despite sleeping outside...) during our backpacking adventures around Ghana, Togo and Benin in 2008 having just finished our second year at medical school.