I briefly mentioned ‘Simon Says Study’ on my Instagram stories yesterday, so I guess I should explain what is going on! I’m fully into studying for my next exam as well as writing my next assignment, and for this one I need a little help. Turns out Microbiology is complicated, and thorough, and quite confusing in some places. I’m very lucky to have a Simon in my life, a friend who is pretty much an expert in that field and who I can say ‘I don’t get this’ to and he can explain to me in one way or another whether that be drawing it out or explaining it in ‘Gemma’ terms. See an example of drawing it out in the image below, by Gemma terms I mean so simple anyone could get it! We arranged to have a study session last night, Simon writing an assignment of his own and me trying to get my head around Gram staining and Bacteriophages. I will crack this and I am ever so grateful to Simon for agreeing to help me!
Drawing out lipid membranes and proteins on the back of an envelope and suddenly I get it!
Other than that it’s been what I would like to call a bowel-themed week. Alongside writing an assignment about gut bacteria, I also had a day where I did two eviscerations on people with past procedures on their bowel. What is interesting about this is the fact that wherever you have had surgery in the past, especially in areas like that, you will see adhesions where organs would have normally been free moving. For example, the bowel can usually be moved about easily, it is attached by one side by what is called the mesentery. There is also the peritoneum down there that sits over everything and holds it in place, like a layer of fat that extends downwards and covers it all in an apron-like way. Generally, you can lift the peritoneum and then remove the bowel starting with the duodenum and extending downwards cutting through the mesentery. I hope you’re following me so far! In those that have had surgery or procedures, for example appendix or gall bladder removal, the areas of surgery can scar and form adhesions so areas of bowel become attached to places they would have not been before. Not only is this confusing for following the bowel for removal, but it also can make it much longer process for a trainee. I had to have help with one of the cases this week because I got really confused and knew I needed to stop, I was pleased that the other case actually went really well.
I think some of you may well ask why we remove the bowel. The bowel is examined along with all the other organs and can provide some very useful information. In some cases we even open the bowel, where we cut open the entire organ lengthways and open it out so you can see the membranes inside. The pathologist will look to see if there is any inflammation or conditions affecting the bowel, often this is done by observing a colour change in the tissues. Notably, I have seen a few cases where the bowel has been very dark or even black in places and this is where the bowel tissues have died or become necrotic. If the bowel is damaged this way in life the patient would have to have the sections of the damaged bowel removed which is a common procedure. By removing the bowel at post mortem it also means we can see the organs and structures below such as the kidneys, reproductive organs and bladder. As a trainee it often feels like removing the bowel is a big achievement towards the start of the evisceration and once I mostly mastered it I was quite proud of myself. I hope this was an interesting little insight into the bowel!
Are We Ready for Dying Matters last week, Rainbow NHS badge and my trusty hipster Grumpy Cat I have had since I started!
In other news, I am now the proud wearer of a Rainbow NHS badge. Our trust has been giving these out to people who pledge to support the open, inclusive and tolerant NHS, for those who don’t think any barriers should be there for people who identify in any LGBT+ way. When I saw these badges I knew I had to get one because I think they really could make a difference and show people that they don’t need to be scared about being who they are just because they are in a healthcare setting. More information can be found at their Twitter page here.
Hope you all are having a much quicker week than me, and if this applies to you don’t forget to vote today and have a lovely Bank Holiday weekend.