Well, in the end I decided to just dash off a quick sabbatical report, with barely any inflammatory content, and I’ve heard nothing since it was published in the department newsletter a week ago.
Here it is in its entirety for completeness but clearly there’s nothing remarkable about it.
Happy New Year everyone! I hope you have all managed to have some quality time over the festive period, in spite of the weather. Well, barely a year after being kicked off the newsletter editorial team for being indiscreet, I’ve been asked to return for a cameo appearance, with a sabbatical report. I’m feeling slightly aggrieved, as I kept up my blog faithfully during my time away accordingtokirsty.com in order to avoid exactly this situation. However, I understand it’s fairly niche reading for family and friends, so here’s a more factual and uncontroversial version of my time away.
My first stop was the Southern French city of Montpellier, where I spent a month during my last sabbatical, looking at clot retrievals in one of the leading centres in the world, as well as observing awake craniotomies. The process for the latter hasn’t changed. The number of clot retrievals at this hospital is astonishing. They do several every day. As with most busy centres, they are generally performed under sedation. For team anaesthesia that means remifentanil and noradrenaline. I wouldn’t recommend anything different to the way we do things here. For one, they have anaesthetic nurses who do all the fun stuff while the anaesthetists themselves do the paperwork and carry the can. The working environment is pleasant but communication is poor, often cases turning up at the theatre door with no warning to the anaesthetic team. Having the procedure under sedation is generally no fun for anyone. The INRs are tolerant of anything except delay, it’s the anesthetist who has to deal with uncooperative, confused, and occasionally vomiting patients with unsecured airways. No thanks.
The second educational experience on my sabbatical was a conference on obesity, which was fascinating. I made the mistake of talking enthusiastically about my learnings to Rupert, who then asked me to present it at a future inservice. It was only after I’d rashly accepted that I discovered the very poor quality of the notes I’d taken. Have you ever done a talk, speaking to someone else’s slides? Ah well, I might be hit by a bus before the next inservice so there’s no point worrying. The conference was on a river cruise, which meant high quality lectures with very poor attendance. I also thought it meant I’d have no trouble getting my accommodation reimbursed but you live and learn.
The cruise was on the Danube, travelling from Budapest west to Germany. Most of our fellow cruisers were elderly, wealthy Americans. Our lecturers were also American, more happy to talk about their faith than politics (“it’s boring”), from which I deduced that they were Trump voters, but they seemed otherwise normal. He was an obesity surgeon, forced by circumstances to also be an expert on the medical treatment of obesity and so surprisingly holistic, and she was a nutritionist.
I attended my last conference in my final week in Europe, at Euroneuro in Florence, where I managed to put into practice my years worth of Italian lessons by buying a couple of pairs of gorgeous Italian boots. My greatest discoveries at the congress were two clever pieces of kit that I’ve never seen before but are apparently in widespread use in first world countries: an automated monitor of pupillary reaction to light, which replaces flashing a small torch into patient’s eyes at the bedside;
and yet another use for your ultrasound machine: measuring optic nerve sheath diameter as a monitor of intracerebral pressure. I also foresee a growth in use and indications for lumbar drains which might make extra work for us in theatre.
I won’t be going overseas for a while as I have used up all my CME money and my annual leave, so it’s good that I made such good use of my time away. Many thanks to both Vicki and Rupert who kept the scheduling ship afloat in my absence. Thanks for reading.