Tuesday, Dec. 28th.

I woke up when my alarm went off, and I was like, “is it time to get up?” 

Anyways, I jumped out of bed, showered, got dressed, ate breakfast, and rushed to catch the bus. As I was about to cross the pedestrian crossing, I watched the bus I wanted to catch drive down the street. Okay, I thought. It’s fine. I’ll catch the next one. I crossed the road. While walking towards the bus stop, I turned and looked behind me, and another bus was coming. I thought, “oh, this is perfect timing. I’ll catch this one.” Thinking I have time, I casually stroll down the sidewalk. The bus stop is in my view, and the bus is still coming up the street. I’ll make it. I look to my right just as the bus passes by. 

It slipped me that if you don’t hail the bus drivers or someone isn’t getting off, they don’t stop. “Okay, no big deal,” I think, “the next one is mine.” Third time's the charm, they say. I checked the schedule, and I had to wait 4 minutes. 

Again, I saw lights coming up the street. Oh good, the bus is coming earlier than expected. I flagged down the bus, and it pulled up next to the sidewalk where I was standing. I turned and faced it to get on, but it slowly kept moving. Now I am doing a little jog and starting to panic. I reached out my hand towards the bus to knock on the door, but the bus driver was still driving. My arms couldn’t catch it. In my head, I’m like, “oh my gosh!” I am so sure the people on the bus were laughing at me. I mean, thinking back, I am laughing at myself. Finally, the bus comes to a stop, two people get off, and I get on. Phew, what a task, and it’s not even 8 am yet.

The day can only get better, right?

I got to the hospital and headed to the doctor’s office. I was the first one there. Once my doctor arrived, we began looking at the patient files. This was interrupted when a patient needed an ascites puncture, and another required an arterial blood gas.

My doctor told me, let’s go, you’ll be performing both.

First, I did the ascites puncture. I grabbed the portable ultrasound machine and took it to the patient’s room. I turned it on and let it warm up, while my doctor went to grab the Lidocaine and the so-called ascites cart. On this cart, you find everything you need to perform the puncture. As soon as the ultrasound machine was ready, I put the gel on the probe and checked both sides of the patient's abdomen to see which side was better to do the puncture. You have to make sure there’s at least 5cm of fluid between the abdominal wall and the intestines. You don’t want to puncture the intestines. Once I had the spot, I marked it with my pen and cleaned off the gel. I pulled up the Lidocaine into a syringe and removed all the air bubbles. I prepared the patient, cleaned the abdomen with disinfectant, and informed them they would feel a small prick. Then, I inserted the Lidocaine into the spot I’d marked. Slowly going in, I injected some anaesthetic about every centimetre and pulled back every time I inserted the needle further to ensure I wasn’t hitting any vessels. I went all the way in with the needle until I pulled back some ascites fluid. 

While I waited for the local anaesthetic to take effect, I got everything I needed ready and laid out on the cart for the ascites puncture. Then I repeated almost the same technique. Again, I cleaned the abdomen with disinfectant and informed the patient they would feel a prick. I inserted the needle until I saw some ascites fluid. Once I did, I went in 1 more centimetre. I pushed in the catheter all the way and removed the needle while informing the patient she might feel some warm fluid. I connected the catheter to the ascites collecting bag, secured the catheter in place, and then cleaned up. The nurses took it from here.

Second, we did the arterial puncture. This was a bit more difficult. One because I hadn’t done it before and two because it just is. Before going to the patient’s room, we collected what we needed. I felt both wrists of the patient to decide which radial artery was better for me. I chose the left. I cleaned the area with disinfectant and felt again for the place I wanted to prick. I told the patient they would feel a prick and introduced the needle. I didn’t get it at first, but I moved my hand around a bit and voila. There was blood in the syringe, but one more slight movement and the artery was lost. 

Despite this, I’m so happy to be given the opportunity to gain practical skills here at UZ Leuven because I don’t know many other places in the world that would allow me to do so, given that I am still only a medical student. With practice and experience, I promise I’ll be better next time.

This day started crappy, but it turned out pretty good. 

In the doctor's office on the ward between seeing patients.