Elective Stories

Abstract

Mental health issues are not always evident from physical appearance or speech which highlights the need for a comprehensive psychiatric history. This became particularly clear to me during one of my early experiences in old-age psychiatry; an elderly woman who lacked insight into her dementia diagnosis. Although she appeared neat, organised in her speech, and showed no obvious neurological symptoms, she frequently experienced delusions of individuals breaking into her house—issues that only came to light when directly inquired about. Her confusion regarding everyday matters, such as visits from friends or upcoming appointments, revealed subtle cognitive impairments that were not apparent on the surface. This emphasised the importance of using specific diagnostic criteria and cognitive assessments to provide objective measures to accurately identify mental health conditions that may otherwise be overlooked. - Celeste Hernon

For my junior elective, I did a placement in the cleft department here in Glasgow. As the cleft centre for Scotland, I got to see the breadth of cleft care. I was welcomed as part of the team and encouraged to get involved from the very start. From the very important task of holding and entertaining the newborn baby whilst the consultant talked to the parents, to harvesting bone from a child’s iliac crest and observing a speech and language therapist running a video fluoroscopy clinic there was always something to be a part of. My timetable was flexible and allowed me to meet and work with many members of the cleft team. By seeing new patient consultations, cases in theatre, post-op ward rounds, and follow-ups I was able to explore a cleft patient’s journey. Scrubbing in theatre every week was encouraged and re-affirmed by the aspiration to do surgery. It was so interesting to see operations that only happen here within Scotland, with the youngest patient I saw being only 18 weeks old and the oldest at 59 years. As I was assisting I got to look through the microscope for a cleft palate repair which meant I had one of the best viewpoints in the room. As a patient’s journey will span many years of their life, holistic care and support is so important, from a midwifes support when a cleft lip is diagnosed via ultrasound, to a clinical psychologist making time to check in on each patient, and to daily visits by the cleft nurses and consultants when in hospital. It was a fantastic experience to learn from and I appreciated how supportive all the team were. - Caitlin McEvoy