Can he drink beer?

"Can I drink beer?" is this week's PBL (problem-based learning) case. A quick run down: A young man (19) Stephen K. has been brought to Accident & Emergency by his mum. She says that Stephen has been losing weight recently despite eating as much or more than usual. As well, she has noticed that he always seems to be thirsty. “He drinks so much that he gets up several times each night to go to the toilet.” While still in A&E, Stephen’s blood glucose was measured on a glucometer as 28 mmol/L (RR: 3.5 - 5.5 mmol/L). A urine dipstick test indicates glucose ++++ and ketone bodies ++++.

Alright, so what's wrong with him? Don't all speak out at once because the cacophony will make me go deaf. (hahahaha). Those of you that are have been following very closely...he has Type I diabetes mellitus. Yes.

So, what does all this mean? Well, it means that Stephen will have to jab himself with insulin every day; he needs to make sure that he doesn't get hypoglycaemic or hyperglycaemic (too little or too much insulin, respectively, in his blood), and I still need to answer the question if he can drink beer.

All this seems quite simple...but NOOOOOOOOOOOOOOOOOOOOO. Damn metabolism! It is late Saturday afternoon and I have declined a few offers to a couple of different parties (Now I should be able to see pigs fly! I thought that the day would never come where Mr. Thankey has willingly declined a social function! There is something wrong...perhaps, it warrants a trip to the hospital?) I have a number of learning objectives left to finish (out of 8, I have finished the first two - the anatomy of the pancreas and the role of insulin/glucagon in the regulation of metabolism), which I am determined to get before I got to bed. If that means staying up all night, then so be it.

Aside from uni, I still haven't gotten over the novelty of being here in Brisbane. A few days ago, I was walking to uni and I saw a huge flock of cockatoos (sulphur-crested cockatoos to be exact)! Now, I can never say that I have seen cockatoos outside of a cage or the zoo - it was awesome! (Yes, birds are making me excited...sad but true). A few weeks ago before leaving for New York, I saw a flock of rose breasted cockatoos or, more commonly called, galahs. Also, the fact that Autumn is in full swing and it is still nice out. Sure the early mornings and late nights are a bit cooler and it seems to rain a bit more often, but I can deal with that. :) Also, I am starting to really consider where I want to be after I graduate from here. A huge part of me wants to stay here in Australia (that will depend on the benevolence of the Australian government); however, I have been looking more and more into the UK and Canada. I guess I should be keeping all my options open.

Now, there are a couple of things that I have been missing - my mum's cooking (I only wished that she was able to send care packages of food but they would a) go off in getting here and b) Australian customs would incinerate it on the spot or they'd eat it); I miss some of the cultural aspects of my life, for instance, I miss speaking Gujarati. I know that this sounds odd but for those of that can speaking another language part from English, know what I mean. I have yet to meet any Gujaratis here in Brisbane (not that I am actively searching for them) but it would be nice to speak a language that is very close to my heart.

Sorry about going back to the medical thing but I forgot about something quite important that happened this week. This was the first week (of 10) that I went to my clinical coaching course. This is a 10-week course that will help prepare me and my other classmates on the MSAT (Multiple Station Assessment Test). This is a 3-hour clinical exam that will assess out clinical skills in terms of taking the history of a patient and looking at taking exams in gastroenterology, central nervous system, cardiovascular, and respiratory. There will also be a component on the ethics and law in medicine in that exam. Okay, so my group (6 people from my PBL) went to the Greenslopes Private Hospital, it used to be primarily a veterens' hospital but now it admits all adults. My preceptor is a psychiatrist, Dr. A. Majumdar. Okay, does anyone see what's wrong with that? PSYCHIATRIST? Give me a bloody break! The very first thing that Dr. Majumdar said when we entered his office was, "I want to let you know that I am a psychiatrist and I don't know how helpful I will be with the stuff that we are to be looking over." Even if that is the truth, you don't have to let us know that! Many of us asked ourselves, "well, why the fuck are you doing this? and why are we here?" Don't get me wrong, I believe that the area of psychiatry is very interesting (it is the flavour of the month for me) but wouldn't it be more conducive for us to have a preceptor that did general medicine/gastrointestinal/cardiology/surgery etc? Also, this means that the probability of our group seeing any patients is nil. All the other groups, or at least all the ones that I have talked to, have been able to see patients and practice their skills with taking the clinical exam. Seeing patients that are commited to a psychiatric ward of any hospital requires special training, which is something that we won't have until much later. I just wished that that the hospital administrator was a bit more cognizant of those sort of things, as opposed to finding any physician that is willing to host a group of 6 students.

Mmmm, I just took an hour break to make me some dinner. What did I have? I made mutter paneer with rice (Tilda basmati of course). :) Indian food makes Veevek a very happy person (then again, all kinds of food make Veevek a very happy person).

Alright, I need to start on the remaining learning objectives while my mates are out having a good time. There is one exception that I know of - Dave. He is my partner-in-crime that being said, he is also studying. Just makes me smile knowing that there are a few of us socialites out there that are willing to take one for the team. :)