Dispel the Smell from Hell

Not everyone is so blessed by fortune as to have teachers as inventive and inspiring as the great Tim Koelmeyer. Such was his prescience, he foresaw the day when the equanimity of his students would be ravaged by smells from hell. Indeed, he took steps to protect us, his eager but unknowing students. Filled with the confidence of youth, we already thought our constitutions sufficiently robust thanks to myriad trials of the Prof’s teaching autopsies.

We were wrong.

Our cloak of blissful ignorance was torn from us the day the Prof introduced a new assistant to his autopsy room. The newcomer was the not-so-fresh corpse of a dog – in reality, just a collection of decaying bones. Somehow, the beelzebubian stench of these meagre remains made trivial all other malodorous scents belonging to our plane of existence. Our inner voices pleaded, questioned and exclaimed: “How could such a horror suffuse from mere bones?… What terrible act cursed humankind with the creation of cadaverine and putrescine?… If only there was a Red-bellied Black Snake around to render us all anosmic!”

The Prof jostled us along by reminding us of our invincible future as fully fledged doctors and how we would soar like eagles through the colorectal wards of the world’s hospitals. At the end of the session we walked to our lecture halls savoring the now strangely sweet city air. We lauded one another for having overcome an ordeal comparable to the cleaning of the Augean stables.

How little we knew.

The bones were there to greet us the next day… and the next… then day after day for countless weeks…

It has been said that ‘in patience ye shall win your souls,’ and what is this patience but an equanimity which enables you to rise superior to the trials of life?

William Osler, from ‘Aequanimitas‘ In: Aequanimitas. 1914:9
Bulldog Skeleton
Just looking at this makes me experience a Pavlovian stench response… (Photo: cyborgsuzy)

It seems that Michelle Lin of Academic Life in Emergency Medicine was not as lucky as I in receiving a truly complete medical education. However, to compensate for her training deficiencies she has developed some clever ‘Tricks of the Trade’ on how to defeat the stench of pus and how to cure toxic sock syndrome. The comments are also worth reading – don’t forget to leave your own tips and make the blogosphere a better place.

Does wisdom perhaps appear on the earth as a raven which is inspired by the smell of carrion?

Friedrich Nietzsche

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of three amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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