medicinalchemistry

Concord Repatriation General Hospital has a somewhat undeserved reputation for its geriatric patient demographics – these days any tertiary referral teaching hospital in Sydney has just as many geris as Concord. It is true however that Concord does not admit children, so it was quite refreshing for my group to see several younger patients during the past fortnight at Concord Clinical School.

Firstly, our SCORPIO sessions for the last two weeks have included patients with:

• Cushing’s syndrome
• Hypopituitarism post-hypophysectomy for pituitary macroprolactinoma
• Type 1 diabetes mellitus
• Type 2 diabetes mellitus

It was during one of the SCORPIOs that we spoke to a fellow medical student with type 1 diabetes mellitus (T1DM). Although it was a little unusual at first to have the “patient” teach us how to take a medical history from him, it was great to hear his experiences and perspectives from the other side of the patient-doctor relationship. We later spoke to a high school student also with T1DM, who gave us his perspective on being a teenager living with diabetes. Both had a great insight into their condition (demonstrating the adage that patients often know more about their chronic illnesses than their doctors do) and were very proactive in self-management of their diabetes. These were normal people trying to live normal lives as best they could under the circumstances. Indeed the high school student was trying to get his learner driving licence and, as I was practising assessing his visual acuity and visual fields (prior to our tutor conducting the formal medical assessment), I related my experiences at the RTA motor registry when I’d gotten my Gold Licence the previous week.

The other young patients we saw were an entirely different experience altogether. Our tutor had brought in two young children (and their mother) from his private practice – an 18 month old girl with asthma and her 3 year old sister – to help us practise paediatric history-taking. As was usual practice for our communications tutorials, we were each assigned a task (history taker, “phone-a-friend” buddy, information reporter, etc) and I was assigned the task of… keeping the girls entertained! Not waiting for my doubtful look to disappear, he proceeded to give me some props with which to play with the children: an Aurorix clown puppet and a Seretide soft toy dragon – we later reflected on the irony of drug companies marketing the antidepressant moclobemide (Aurorix) and the asthma medication fluticasone+salmeterol (Seretide) to young children. Anyway, now I will readily admit that I’m probably not the best with children and lack paeds experience. Despite my initial self-doubt, however, I took on the task and quickly warmed to it – by the end of the session, I was even crawling around with the kids!

So yet again I found myself enjoying a refreshing change from the endemic frustration of endocrinology block. Thank goodness for Concord!