Finals, part 1

A Ugandan tomorrow: considerably longer than 24 hours.  Allow me to contextualise.

Tuesday 18th May.  Clinical finals, day 1.  I spent morning doing some last minute revision and ironing a few shirts.  The temptation to nervously chain drink highly caffeinated hot beverages was easily overcome by the knowledge that doing so would induce profuse sweating and a noticeable tremour in an already over-stimulated nervous system.  Half the year was already being examined on their ability to manage a patient from scratch after 20 minutes of contact.  Although bound by the expected professionalism not to divulging any information to the afternoon cohort, as the hours approaching midday ticked by we were nonetheless hoping for some nonspecific reassurance that it would ‘be alright’ from our friends.  This never came and rumours started in my house that they had been sequestered after the exam to prevent talking.  (Although these rumours were largely started by me.)

One o’clock came and I drove up to the big tertiary care hospital on the edge of town.  The cars of my friends who were sitting the morning session were still parked on the side streets and as I walked up the road to the medical school a couple of these friends started walking back the other way.  I asked if they’d been kept back for some reason and they replied, no, they’d only just finished.  “It took you 4 hours to see 2 patients?”
“Yup.  Enjoy!”

Fortunately, 4 hours goes a lot faster when you’re sitting the exam than when you’re waiting to sit it.  I was introduced to my first patient with “this gentleman has a long standing skin problem.”  Dermatology.  Great.  It passed fairly uneventfully, save for my dermatological examination.  Five uncomfortable minutes of looking and feeling, desperately waiting for the bell to go; rather more theatrical than most medical examinations, as you really have to convince the examiners you are… well, looking.  And feeling.  My second patient had a complex array of neurological symptoms that didn’t seem to fit very well with his history.  He turned out to have something very rare that I knew very little about and I bumbled my way through the explanation with the examiners.  And then, it was home to prepare for the following day in the best way possible: an early night and a carefully judged fluid intake.