About the Handbook:

The World of Medicine is a complex and diverse ecosystem, containing a countless number of unusual and varied species of medical staff - be they doctors, nurses or students.

If, like me, you are a medical student, then you will often explore this fascinating place. In this handbook, you will find (hopefully) entertaining reports based on each type of species that you may encounter, including tips on how best to survive and flourish in the healthcare habitat.

Enjoy, and good luck on your travels!

Tuesday 26 April 2016

The Stufferfish

Illustration by Lynda Richardson
Jay from Inbetweeners is not what you'd call a good role model. A crude, depraved and ultimately generally sad individual, one of the character's signature traits was his relentless blustering and exaggeration in any scenario - despite a total lack of credibility to the claims.

It is a trait found not only in coming-of-age hit comedy tv series from the late noughties, but also unto the Healthcare Habitat, with one particular species channelling their inner Jay at any opportunity (haha inner Jay) - the Stufferfish.

As you can imagine, the Stufferfish's stock-in-trade is exaggeration, with any scenario blown out of logistical proportion to ensure maximum empathy points from those that care to listen. They are easily identified by iconic claims, such as "I have done absolutely no work for this exam" or "I never stick around for MDTs or audits, I just walk straight out". However, though the statements seem bold, their claims are far from the truth. Sure enough, an explorer in proximity to a Stufferfish, with a little digging will quickly unearth the species' flimsy facade.

With multiple witnesses claiming they saw the defendant writing notes for hours in multiple locations on multiple occasions, on top of eye-witness reports of the individual sitting silently in the corner of an audit for three hours, while the decision was made whether to invest in 5p or 10p gloves. Like a lawyer with a client who actively murders the judge mid-way through their trial, their defence collapses with but the slightest of pressure - revealing the deep-seated need for validation by their peers.

The Stufferfish's antics pose very little danger to an explorer - although there is the infinitesimally insignificant risk of believing their claims, which can impact how explorers compose themselves in doing work and in the Habitat (kind of your own fault if you do fall for their claim that they saw a copy of the exam paper and said it was 90% psychiatric medications - did you know if you read first letter of ever paragraph's second line it spells out gullible?) - but they can quickly become grating.

Once aware of a student's nature as one of the species, it becomes very clear when the individual is breaking out their classical exaggerations, inspiring feelings of irritation within the explorer, as the Stufferfish receives validation (or in some cases, admiration), for claiming to do something that they would have absolutely no intention of doing when the chips were down. And unless they can provide irrefutable evidence to the contrary right there and then, there is little the explorer can do but wait and listen to the species' outlandish claims.

The best way to cope in encounters with the species is to sit back, let the claims wash over at your liesure, and remain comfortable in the knowledge that you know their secret, and that you could crack their dubious story wide open, revealing the insecure little person within. But really? That sounds a bit mean - do you want to irreparably shatter this fellow human being's already seemingly delicate self confidence further? It's not like its hurting you right? In fact, maybe you could just not hang out with them if it bothers you that much. That seems like a better plan, come off as less of a jerk that way. Good plan.

Of course, there are instances where Stufferfish claims, despite their seeming ludicrousness, do eventually prove to be true, and the non-believers are left just a teensy bit red-faced by the whole incident. Maybe you should check the second line of every paragraph again.










Ha. Made you look.

Tuesday 5 April 2016

The Consultiger

Illustration by Lynda Richardson
Tiger trails, where tourists are driven through the Indian jungles in the hopes of seeing real-life tigers, are not exactly the best holidays. Several days on an uncomfortable and mosquito-infested coach, and generally the closest that you come to seeing any actual tigers  is when one of the guys at the back, in the midst of a dodgy Indian food fever dream, thought that he maybe possibly saw some orange in the undergrowth. So, the coach stays there for another half-hour in the vain hope that there is something to see in the obscured shrubbery. There isn't - nobody sees tigers on tiger trails, and an explorer can't help but empathise when he is assigned to shadow a Consultiger.

Found, or rather unfound, in most regions of the Healthcare Habitat, Consultigers are an elusive species. There are many incidences of explorers attending the first day of placement, arriving at the location where their Consultiger is scheduled to be, only for it to turn out that the individual is away on annual leave, or has gone to attend a conference on the other side of the country. This makes shadowing difficult, so said explorer's seek out other vicinitous species to follow instead.

These species tell of the Consultiger's famed kindness and teaching ability, but once again the individual is absent on days two, three and so on, until the explorer begins to doubt whether they exist at all. Is this some elaborate joke by explorer command? Or is this some Fight Club scenario, and (spoilers - but the film came out in 1999 so really you should know by now) the Consultiger is your Tyler Durden, a hallucinatory manifestation of your impulsive actions?

Sadly, for most explorers this is not the case, and the ultimate truth is that they are merely subject to the cruel hand of fate, assigned to a consultant species who just happens to be taking a lot of time off when you arrive, or whose schedule changes so frequently that it is impossible to conclusively pin them down to a location at a specific time. You might catch a glimpse of them down a corridor one day, but like any half-decent mysterious figure in a movie, something will cross your line of sight and they will have instantly vanished, as if they were never there....

An explorer's best bet at maximising the quality of a placement with a Consultiger is through early and prompt communication with both the individual and their specific ecosystem. Though elusive, even a Consultiger cannot evade an e-mail - the seeker missile of communications, pursuing them relentlessly and inevitably arriving in their inbox, an inescapable beacon to them that must be read.

If an explorer knows through communications that the Consultiger is away on leave, they can adjust their plans accordingly, thereby minimizing the time spent awkwardly waiting for an individual to arrive that will never come. Furthermore, if the Consultiger is made aware that they are expected to have an explorer assigned to them, but know that they will not be there, they can arrange alternate plans, making an explorer's quest to find opportunities that much easier, and reducing wastage of time in the Healthcare Habitat.


Shadowing a Consultiger can be frustrating, but the species has no malicious intent in its absence. A pragmatic and early stance on communication with Consultigers can help turn what may be an inefficient and inconsistent placement into one of great benefit to an explorer's education. Just pray that the Consultiger checks their e-mail - if they don't, it is going to be a looooooonnngggg placement.

Tuesday 22 March 2016

The C.Q.Cobra

Illustration by Lynda Richardson
The internal affairs officers of the healthcare habitat, the C.Q.Cobra's abbreviation actually stands for Care Quality Control (although I'm sure there would be far more applicants to the job if they actually replaced the "control" in their name with cobras), and they are responsible for ensuring that all other denizens obey the laws of the jungle - making them an important part of the ecosystem, ensuring patient care standards and safety remain at a high level.

No species puts all other denizens of the healthcare habitat on edge quite like the C.Q.Cobra. The arrival of a C.Q.Cobra onto a ward produces an effect akin to Darth Vader's arrival into an Empire staff meeting - all those in the local vicinity enter a panic state, all the while trying not to look like they are panicked.

This is because all inhabitants, regardless of position on the food chain,  know that if a C.Q.Cobra finds something on inspection that does not meet the high expectations set by the powers that be, there will be consequences. OK, unlike in the case of Darth Vader, "consequences" are less likely to involve being throttled by an evil space wizard, and will probably be more on the lines of a sternly worded report or instruction to attend specialist training. But still, neither outcome sounds particularly fun.

Some, the more devious of the species, are even known to set traps for unwary prey, such as leaving their watches on, insisting on wearing a jacket or not wearing a name badge when accessing the ward. These little tricks are designed to ensure that protocols are followed, and can catch out those having a particularly hectic day - if an explorer notices a trap, it is a good idea to point it out to another individual - they will appreciate and remember the assist and may enable more opportunities on the ward in the future.

For explorers, encounters with the species are somewhat anomalous, in that despite the threat that they can present to other species, C.Q.Cobras pose absolutely no danger to an explorer. Sometimes, they may even use explorers to test the mettle of others, examining how individuals react to the presence or actions of an explorer and making judgements based on this.

Though they may ask a few questions of the explorer, particularly regarding how they are enjoying their time in the ecosystem (this may be a good time to mention that Consultasaurus' general rudeness by the way - vengeance can be sweet), the C.Q.Cobra is not attempting to find fault in an untrained explorer's technique - they are too busy scrutinising the other species. Still, best to avoid doing anything too malpracticey - they may not be observing you specifically, but will still file a report if you uppercut a patient in front of them.

The biggest risk to explorers occurs indirectly to the presence of a C.Q.Cobra, and comes not from the species itself, but from everybody else. With tensions running high, species can be more hostile, for fear of committing some error that could be reported - suddenly, leaving your backpack out of the way under a chair (as you have done every other time you have visited the ecosystem this week, without complaint) becomes a crime on par with grievous bodily harm, indecent exposure and mass genocide, and apparently warrants a good telling off. Explorers need not worry about being reported for behaviour, but their improper actions may still provoke the rage or scorn of the other species.

In summary, surviving an encounter with a C.Q.Cobra is relatively easy for an explorer. However, explorers must do their best to aid the targets of these predators, remembering that one day, when they have metamorphosed into species that the Cobras consider prey, it will be their turn to be judged, and they too will need all the help that they can get...

Tuesday 8 March 2016

The Registrargoyle

Explorers will experience a wide array of emotions during their time on the Healthcare Habitat - pride, excitement, anxiousness, exasperation and irritation to name a few - and in turn will trigger a range of responses from the doctors that they work alongside, with their underlying emotions (often overwhelmingly) apparent. This is a pretty standard rule for doctor-explorer interactions, but like the rules of any unnecessarily complicated board game (looking at you Marvel Superheroes game - you broke my skills of deduction), there are exceptions. The registrargoyle is one of these.

The registrargoyle takes its name from its face - no I'm not just writing an entry about really ugly doctors (but if I run out of ideas, maybe in the future?) - rather the constancy of its expression, as if it were hewn in stone.

Be they pleased, annoyed or disgusted, the registrargoyle's poker face is resolute (side note - logically, not a good idea to play them at poker), never once expressing any sign of emotion, just the penetrating stare of their cold, dead, oblivion-consuming eyes.

Naturally, this is fairly disconcerting for a naive explorer, who quickly becomes used to their actions eliciting responses from the doctors that they work alongside. Wary of ambush, an explorer is left on edge around the species, unable to attain any state of comfort - a factor that can damage confidence, concentration and - possibly most crucially - motor control, to the point where even simple tasks become impossible.

Taking bloods? The patient's veins seem to visibly shrink under the registrargoyle's gaze, and your hands appear to have suddenly developed extensive nerve damage, making it impossible for you to hold a needle steady, let alone stick one into somebody's arm.  Taking a history? A few seconds of supervision from the species can induce a temporary dementia, not only preventing recollection of which questions to ask, but impeding the simple ability to talk, instantly devolving individuals from high-achievers into pea-brained neanderthals.

The registrargoyle's power lies in their target's inability to read expression. Without any hint from their supervisors that what they are doing is correct, explorers begin to doubt their abilities, stimulating the effects of the species' gaze. Overcoming this can be difficult, but it isn't impossible.

One method is to ask them how you are doing directly - though the registrargoyle's poker face is rarely broken by this, normally they are forced into response, giving some insight into their satisfaction, at the cost of the patient suddenly getting very worried that you don't know what you're doing (just do what you're doing before they can interject).

Another option is to try to break through their emotional barrier. Difficult to achieve in first encounters or when contact is infrequent, but getting to know the human behind the stony facade can help. Asking them about extra-medical interests, especially common interests, will help break barriers between you, not only improving your ability to identify tells in their expression, but giving them more inclination to be friendly.

Sadly, these techniques don't always work - sometimes their deathly expression is simply due to them being truly dead inside, and no amount of conversation about football will revive them. Fortunately this is not the case 99% of the time, and explorers that make the attempt will generally find the effect of the dementor-gaze lessened, dramatically improving quality of time spent in such encounters, now and into the future.


Tuesday 23 February 2016

The Piranhacademic

Illustration by Lynda Richardson
A while ago, this blog discussed possibly the friendliest creature to grace the Healthcare Habitat: the Studolphin. Unfortunately, not many other species live up to the standards of care and cooperation of these amazing specimens, some even going so far as to become their exact antithesis. One of such species is the Piranhacademic.

Like the studolphin, Piranhacademics are members of the student family, but this is as far as comparisons go. The species distinguishes itself by its voracious, self-centred attitude towards learning in the Healthcare Habitat, greedily consuming every opportunity that it can get into its hungry jaws (through unjust means if need be), leaving nothing but its unwanted scraps for fellow members of the ecosystem.

The Piranhacademic's origins are unclear, but it is speculated that the species originally branched off from the main student evolutionary line due to an intense drive to succeed in the Healthcare Habitat. However, somewhere along the way the race's pure intentions became corrupted, with individuals discovering that they could prosper best not by cooperating with other students, but by actively competing with them for their learning opportunities, ignoring the unspoken code of honour amongst fellow students.  

Succumbing to these dark temptations, this fallen species has devolved, to the point where "honour", "comradeship" and "not stealing somebody else's placement allocation because theirs looked boring" have become alien concepts in their soulless, uncaring minds. This makes Piranhacademics loners, a situation only exacerbated by the species treating their kin no different to any other type of student - to them they are just another competitor to defeat in the rat race of life.

Devious creatures, Piranhacademics will utilise any advantage to gain an upper hand upon other students. Normally, Piranhacademics use the simple technique of snatching up any opportunities that present themselves before any other students can get to them, meaning  an explorer in piranhacademic-infested  wards must be wary of the species creeping up to steal away opportunities. Commonplace are stories of explorers setting down bloods forms while they gather equipment, only to return to find said forms whisked away and the bloods already taken by these roguish creatures.

Others of the species can exhibit even further disregard for their comrades, with individuals known to ignore both written and unwritten laws of conduct in the Healthcare Habitat and beyond. These infringements can be minor, such as a piranhacademic taking another student's placement rotation, or major, with truly evil members of the species going so far as to steal unguarded notes or books. Though piranhacademic attacks of this severity are rare, they do occur in the modern day, and as such explorers must be cautious - do not leave notes unguarded for extended periods, especially in secluded areas, as these are hotspots for piranhacademic activity.

There must be some advantages to working with piranhacademics, I just can't seem to think of any.... Maybe if you prefer having less interesting placements or would rather not do anything all day? Nope, can't think of any. The species is truly a blight upon the rest of the student genus, but that doesn't mean that they can't be safely navigated. Explorers can best avoid harm from the species by remaining alert - a Piranhacademic will only strike when it perceives vulnerability, so by keeping your guard up, never leaving important things where they can be snatched away, and being prompt to all timetabled activities should help stave off any attacks.


Fortunately for the Healthcare Habitat, the species is a rare one, with most students honouring the code and shunning those that choose to break it. Even worse for the species, its more unethical methods of attaining superiority can draw the eye of the ecosystem's apex predators - consultants and educators. Woe betide a Piranhacademic who steals from another and is discovered, for their penance may go so far as to be cast from the Healthcare Habitat, never to return (unless they come in as a patient and need treatment - Hippocratic oath, etc. - but we'll give them evil looks the whole time. That'll make them feel bad).

Tuesday 9 February 2016

The Familiar Foundling

Illustration by Lynda Richardson
As each explorer progresses through their studies into the healthcare habitat, they will doubtless become acquainted with a number of other explorers, at different stages along their expeditions - some only just getting started, and others closer to the end of their time as explorers.

It is the latter group that this article will discuss, for this group of explorers will one year be seen by their younger counterparts as fellow explorers, but by the next they will have undergone a profound metamorphic change, becoming foundling members of the doctor genus. These individuals that have been by an explorer observed as both fellow explorers and newly emerged doctors are known as Familiar Foundlings.

A fairly typical species within the doctor genus, individuals are most commonly spotted on wards, particularly on ward rounds and going about the routine tasks of the local ecosystem. Familiar foundlings can vary drastically in terms of personality and their approach to explorers that they encounter  in the healthcare habitat, with the prime determinant being their pre-metamorphosis nature as an explorer - if they were friendly and had a pleasant relationship with an explorer prior to their transformation, chances are they will remain friendly and pleasant towards the explorer post-change.
The recognition of a familiar foundling whilst on an expedition can be advantageous to an explorer in a number of ways.

1.       Having just completed their own explorer training, these individuals are the most likely to empathise with the hardships of explorer life, making them more friendly and inclusive to those trying to make the most of time in the habitat.

2.       The foundling will have gone through the same course as the explorer, giving them a better understanding of an explorer's tasks compared to a doctor that had trained as an explorer in a different location. This can be more accommodating, in terms of receiving opportunities to complete said tasks.

3.       Having a bond prior to an encounter on the ward can help both parties feel more comfortable with one another, eliminating the awkwardness of first encounter introductions, as well as providing the explorer with additional information regarding the foundling's extra-medical interests, allowing conversation to continue more easily despite both groups having run out of medical-related topics to discuss.

Of course, working alongside a familiar foundling does have its risks, in particular in terms of an explorer getting too comfortable. An explorer must remember that a FF is still a member of the doctor species at their place at work, and though many will not mind be addressed by their first name (best to find out first though), it is probably best to avoid calling them by their politically incorrect nickname, especially in front of patients or other doctor species.

At the same time, one should avoid over-hassling the foundling, for they have only just undergone their transformation and may still be feeling the pressure of life as a doctor. Being too much of a burden, particularly when they are busy, could have adverse effects on their willingness to assist and altogether weaken the underlying bond between both parties.

A friendly foundling, if treated with respect and not over-demanded, can be a valuable asset to an explorer's training. Explorers are encouraged to build healthy relations with as many senior explorers as possible, in order that they too become FF doctors in the future, thus augmenting their prevalence and increasing likelihood of these advantageous encounters in the future.

However, an explorer should aim to build bonds with not only the old but also the young, for he too shall someday undergo the transformation, and those less experienced will from then on see him as a newborn familiar foundling. With this the cycle shall be complete, allowing future generations to reap the benefits of such relations as we did before them.


Wednesday 27 January 2016

The Worker Studant

Illustration By Lynda Richardson
The student genus has a  menagerie of different species, each possessing their own evolved abilities that make surviving life in the healthcare habitat a less arduous task. Some rely upon their natural intelligence and deductive skills to overcome the trials of the ecosystem, while others employ their far-advanced communication skills or their composure under pressure to elevate them above their competitors. However, few species are as gifted as the worker studant, whose advantage trumps almost all competitors. And what is this innate ability? The answer is simple:  sheer unrelenting, indominable willpower.

In a word, the studants, are a driven species. Relying on a work ethic stronger than Hercules and the Hulk combined (Hulkules?), the studant is capable of working for exceptional lengths of time, retaining energy and focus where almost all other species would have become fatigued and bored, quickly succumbing to the temptation of going home and checking on Facebook. This ability means the species can take in an immense volume of information/practice that is vital for end-of-year examinations, meaning members of the species are normally among the highest achievers in the entire student genus.

Though taking many forms, the worker studant species can easily be identified with one simple observation. The studant stands out by always being the last (and often first) person at placement, or alternatively the first (and often last) to start work in the evening.

Many  expeditions into the healthcare habitat are to desolate or barren wards, with explorers spending a great deal of time following doctor species and doing very little. This is enough to drive off even a hardy explorer, but the studant will not relent under such boredom,  enduring hours of tedium (often against the advice of more experienced species of the ecosystem), through some belief that their patience will be rewarded in the end.

For many explorers, who can easily find their patience and energy drained by early afternoon, it can be easy to compare oneself to this formidable and tireless worker species, with most comparisons coming back negatively. Your 25 minutes of work before checking Facebook and reading this article isn't going to hold up particularly well against the studant's 5 hour marathon session completing their entire drug formulary in one go. These comparisons can be of some advantage to an explorer, with the studant's toilings acting as an icon to inspire the less motivated into buckling down and getting work done. However, explorers and other members of the student genus must be wary of over-comparing themselves, as this can have damaging effects upon psyche and body.

The studant brain is a highly-evolved machine, that eliminated unnecessary organic feelings like fatigue and boredom, filling the empty spaces with extra determination, willpower and just a pinch of anxiety that if they stop working, they will fail catastrophically. No other brain in the healthcare habitat is adapted this way, and those who subject their unprepared minds to such an arduous challenge risk loss of self confidence, fatigue and burn out. It is good to try to keep up with the studant, but each explorer must remain aware of their limits. All work and no play makes explorer's head's explode.


The studant is a reliable and ever-present member of the healthcare habitat so explorers would be wise to become accustomed to  their presence, without being daunted by their awesome endurance. Plus, they usually have great notes, so it's always a good idea to keep one close at hand when exam-season comes around.