Sunday, November 13, 2011

Socks with Birkenstocks

Alright...time to switch things up. Since I am only writing one blog for the week + weekend, I'm going to start with the weekend then come back to my week at the hospital on the urology service. 

I got my first piece of mail this week - the results of my MRSA screening. For my non-medical readers, MRSA stands for methicillin-resistant Staphylococcus aureus. It is a resistant bacteria that is unfortunately common in the US but quite uncommon in Sweden - a statistic they would like to maintain. So every person who comes to Sweden or returns from Sweden from being abroad that is working with patients has to be screened for MRSA and treated if found to be colonized by MRSA in the nose or throat. Thankfully, my MRSA tests were negative so I don't have to worry about getting treatment!

liten kaffe and kanelbulle
I have a new love in Stockholm - kanelbulle. The Swedes really know how to do their sweets well. It is a thing in Sweden to get a coffee and some kind of pastry...any time of day. The favorite is a pastry called kanelbulle which is pretty much a cinnamon roll with sugar crystals on top. It's delicious. There is a chain of convenience stores called Pressbyrån that have a great selection of pastries. Their deal is to get a liten kaffe (small coffee) with a pastry for 20 SEK (or about $3). They even have a card - buy 5 and get the 6th free :) I started my card this weekend after being introduced to this delicious tradition by my Spanish friend, Almudena. When you come to Sweden (as I am sure you all will after reading my fantastic blog!), you definitely need to have the Swedish experience of kaffe and kanelbulle. 

Almudena and Ana
This weekend has been interesting for several reasons - one, it is the weekend before my last week of general surgery which means that I have to make a presentation and prepare for an exam on Wednesday. I have been attempting to work on this during the weekend although haven't exactly been the most successful in being productive. For some reason, the weekend days seem to go by really fast - I don't get up earlier than 9:30 or 10 and usually go work out and by the time I get back from that, it's already 3 in the afternoon. Secondly, this weekend was interesting because I actually went out with some people. My friend that I mentioned above, Almudena, is a medical student from Spain studying here for a year. She has a good friend, Ana, who lives across the hall from me in Jägargatan. They invited me to go out with them on Friday night. We started out by going to the apartment of a German friend of theirs who is living and working in Stockholm for dinner. We were quite an international group at this house - 4 girls from Spain, a girl from Turkey, 2 guys from Germany, 2 guys from Switzerland (one from the Italian part, one from the German part), one guy from Singapore, and me - an American. We had fun hanging out and talking for a while then went to a bar that they had heard about via Facebook that was supposed to be a great place to go out on the weekends. When we got to the bar, we learned that it was a 23+ bar and several members of our group did not meet that criteria. So the group split up. I ended up staying at the 23+ bar since there was no cover charge and I felt more like I belonged with a 23+ club then one that was 18+. The group I stayed with included one of the Swiss guys, one of the Germans, and we met up with another German girl and another Swiss guy at the bar. While waiting in the queue, I heard someone speaking what sounded like American English - turns out, it was a guy from Ohio who had been living in Sweden for 5 years and it was his birthday. We talked for a little while in line and I met the group of Swedish friends he was with. When we got into the bar, I spent the earlier part of the night with the Germans and Swiss group that I entered with but then at some point ended up talking with the American and his Swedish friends. The bar was interesting - over 90% of the music was American and it is really amusing to watch all of these Swedish people singing along and getting really into the American music. It wasn't even all contemporary - there was a fair share of bad 80s music that was played as well. According to one of the Swedes that I was talking with, this bar was not representative of the night life in Stockholm and he actually referred to it as the "white trash" bar. I didn't know they had "white trash" in Sweden and said as much - he couldn't really explain to me what people fit into this category but apparently the crowd that frequents this bar does. The bar closed at 1 am and I couldn't find the group that I had entered with and to be honest - I knew this new group for as long as I did the people I came to the bar with. So I left the bar with the American, the 3 Swedes, and a Serbian guy that was with their group and we went to another club that was apparently more representative of Swedish night life. They also served popcorn - I was in! We stayed out until this bar close at which point I was pretty tired. After getting some Swedish fast food (falafel!) I made my way to the T-bana and back to Jägargatan at a little before 5 in the morning. I fell asleep quickly by the time I went to bed and was so tired the next day that I accomplished very little. This is why I don't stay up that late...

I actually did accomplish something productive on Saturday, however. I had been hoping to go to Oslo, Norway for a weekend and for some reason, the online ticket purchasing system doesn't like any of my credit cards. So Saturday afternoon I headed to T-Centralen and Stockholm Centralstation and purchased my train ticket for Oslo! Next weekend - Norway :)

Now for the work week. This week was spent on the Urology service. All four of us international students were back together for this week. Our first day we didn't have to report until 9 which was so nice. When we arrived and met with our mentor of the week, he handed us each a schedule for the week detailing where we needed to be, the times we needed to be there, and a lecture schedule. It was a great sign that this week was going to run very smoothly and as a result be quite enjoyable - I was not disappointed! We were split into twos and each had two days in clinic and two days in the operating room. All of the urology staff knew we were going to be there that week and were very welcoming to include us in both the clinic and the operating room. This was definitely my favorite service I have been on so far. I got some good practice with prostate exams, urological disease management, inserting Foley catheters, and was able to be first assist for a total amputation of the penis for a guy with penile cancer. I won't go into more detail on that - needless to say, it was fascinating. For those of you who know about my first trip to Haiti a year ago, it was the same sort of fascinating as amputating a man's leg with elephantiasis - something you really don't see very often at all, possibly even once in a lifetime. The day I assisted in the amputation was probably my best day of the week. It was the kind of day when you are just "on." On the ward rounds, we had a patient with a UTI and I was able to impress my attending with my knowledge of antibiotic allergies - specifically the use of cephalosporins in penicillin-allergic patients. Secondly, on the ward, we had a patient with tumor literally eroding through his skin and had to do a bedside debridement and re-dress the wound. The attending forgot that I didn't speak Swedish and was asking me for things in Swedish. I didn't need any instructions to know what he needed and when he realized his mistake, he was impressed that I knew what to do without being instructed. Third, as first assist, I impressed my attending with my OR skills. I was able to anticipate what he needed me to do as his assistant without him needing to give me any instruction. He told me that I was really helpful and actually made the surgery more efficient - probably the best compliment you can get as a medical student! Our final day on the urology service, our mentor gave us lectures in the morning then took us all out for lunch in the hospital restaurant. It was a great week and I am actually going to miss urology.

One thing I noticed this week in the hospital is how much the Swedish doctors seem to love wearing socks with sandals - specifically Birkenstock sandals. I don't know if it's because the sandal-wearing season is so short, but I have never seen so many people wear socks with their sandals. It was almost as disturbing as the penis amputation. If the doc isn't wearing socks and sandals, he/she is typically wearing a pair of white clogs which also makes no sense to me especially for surgeons... I do not fit in with my footwear, and I intend to keep it that way!

This upcoming week I am back on general surgery with the upper GI service. I hope it is a good week and the presentation goes smoothly and the test is easy. I am looking forward to completing the rotation and for my weekend in Oslo!

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