Day thirty-two - Thursday

Bit of a lazy morning, reset the alarm a few times. Unlike Fort William, there's no specific time to be in here, but as the morning's are generally quiet I can justify to myself not going in until 0930/1000ish - in the knowledge that often I'll stay till 2000ish if I've started with a patient. Coffee/porridge then walking in, bit clearer today, still overcast. Arrived in A&E, Steven buzzed me through. He's the front man of the department, booking people in, collecting medical notes from the hospital record archive, making brews etc. Top guy! One of the nice things about working in the ED is that I can wear a scrubs top - so much better than shirts. I reckon all doctors should wear scrubs, and they should be colour coded to their grade - be much easier to pick out the juniors from the regs etc. Also be smarter I reckon, definitely cleaner and more hygienic. Doctors are the only health care profession to not have an official uniform - doesn't make sense.

First patient was in, referred from GP land with a potentially serious provisional diagnosis that needed to be excluded. Clerked them in, examined, did baseline bloods/ECG. Presented to one of the docs, then sent the patient for CT. They were pretty stable, and the diagnosis was pretty unlikely given the patients observations but the history was suggestive so needed to rule it out. Whilst that was being sorted I saw a patient with a minor injury, sustained on a cruise ship a few days ago. They'd been referred in by the ships doctor for follow-up, query xray. I took history/examined, thought it didn't need xray. Checked with ENP, agreed. Discharged after filling in the paperwork, which included a section that they needed to take back to the ship's doctor. Interesting as hadn't seen one before - it's mainly for medical treatment in other countries I think, in case the payments need to be sorted out by insurance companies.

   

After that another man came in 'under the influence', this one much more comatose than yesterdays. Got them in a bay, weren't going to get much of a history off them, so examined and then trawled through the computer system to get some history. Can get these good 'Emergency Care Summaries' which included a list of current medications, usually from the GP. Was useful, as this patient was on quite a few relevant meds that needed to be looked at. They ended up staying for a few hours, and was interesting to watch them sober up with subsequent visits to make sure they were ok and improving. Eventually they self-discharged as well.

A bit of a lull followed, interrupted only by four pre-nursing students coming for a tour of the department. Steven was hauled into the resus room to be a manikin for the Autopulse machine - wrapped it round his legs to demonstrate the force required for adequate CPR. Was fascinating to see, pretty mental bit of equipment! I think he only agreed in the hope of impressing the ladies... !!

Later on in the afternoon had yet another alcohol related case in, this one in pretty bad shape. Needed a lot doing, cannulated/bloods/group+save/cultures, fluids up, full examination from the docs, consultant around. Can't really write that much, they would be staying overnight. One really confusing thing came up - two people of the same name had been treated in the department today, both of whom had xrays! So when looking up the image had to be really careful that got the right person, as same name on the same day - happens quite often up here apparently because of the ubiquity of certain clan surnames.

Left just after 1800, walked into town to a restaurant called Digby Chick where some of the juniors were meeting for dinner. Arrived at 1830, first one there as they'd all been held up in the hospital! Before long got sat down and ordered, they have a great deal where get 3 superb courses for under £20, and the food was sublime. I went for soup of the day, a chicken main and then gorgeous treacle tart desert, all immaculately turned out. Well worth the money, and great chat with the docs, finding out what brought them all to the island.

Mmmmmmmmmmmmmm, sublime treacle tart desert!

Wondered back, bumped into my new neighbour whilst coming into the flat. A guy who's just about to start nursing here - there's a Western Isles campus run as part of University of Stirling. So here's just at the start of a 3 year course on the island! Had a brew and chat with him before turning in for the night. Really interesting day, learnt alot of useful stuff and covering lots of common emergency and also routine presentations. The responsibility you get given here is immense, and sometimes pretty daunting. Yesterday the patients were generally less serious than today's, so I felt comfortable doing stuff whereas today the cases were potentially a bit more serious, especially the last one, so I was glad to have the other docs around to check what I was doing and seeing the patients too. Really feel like part of the team, and like I'm doing something useful - got good feedback from some of the juniors today and good teaching from the consultants. It's fantastic here so far, very well supported even though being pushed to take on more responsibility than ever before!

Day thirty-one - Wednesday

Leisurely morning, grey day. Walked in for 0930, straight into it with a patient with extensive history of a surgical problem, which sounded like it hadn't been got on top of with their previous interactions with GP/hospital. Got stuck in, taking the history/examining, doing bloods, ordering/interpreting tests. Ended up sending them for a contrast CT scan, which I went along to to see what the radiologists get up to. Bit nervous when they hook up the contrast, hope the cannula I put in works ok! By the time they got back to ED and the report was on the system most of the morning had been taken up. Time really flies when you start doing everything for the patients - as the department is nurse led they are happy for me to see the patients and then call down the doctors if necessary, which means I fill out all the clerking paper work, do all the basic investigations, order them all, write up the results etc etc. So even though only had one patient in, as I was doing everything for them along with the documentation it took a lot of time up - good though, never twiddling thumbs!

Really nice baguette from the canteen for lunch. Wondered back via the mortuary, as I was quite keen on seeing what the pathologists get up to here; whilst searching for the entrance however I was informed by some helpful theatre staff that there aren't any pathologists here! I asked what happened to any postmortems, turns out they all get sent to the mainland, only a handful of them a year here. So not a goer then!

Back in A&E someone had changed the label on the ambulance 'red phone' to the bat phone, quite amusing! Not so amusingly though some of the calls that come through on it are trying to sell PPI - crazy that they can get the number, surely it should be on a special system so they can't call it? When it goes off everyone gets a bit twitchy, and annoying when it's a false alarm cold call.

The Bat phone - aka PPI phone...

Saw my first alcoholic after lunch, picked up by the ambulance crew and brought in. Pretty docile, if hard to understand! Left them in a cubicle, then one of the juniors came down to see them and suggested admitting for observation until they'd sobered up a bit. Unfortunately patient had other ideas and shortly self-discharged! There's only so much you can do I guess, make sure the alcohol isn't masking any more serious injuries/conditions, but if the patient is competent and wants to leave you can't really stop them - plus what's the alternative? Admit them when they'd most likely be disruptive and non-compliant, and end up self-discharging anyway...

Late in the afternoon a minor injury came in, someone who had a quite bad laceration. Again I got stuck in, history/exam, decided that it probably needed some sutures so got one of the ENPs to check it out. They agreed and left me to get on with it! Local anaesthetic in, 4 sutures, applied some mupirocin cream - recommended for that particular place on the body apparently. There were no suture kits, so had to use a minor ops kit which meant the only needle holders were massive! Ended up doing it with artery forceps as they were smaller and much easier to handle, although the curved ends made it a bit tricky. Think I did a fairly good job though. Gave them the advice about getting the sutures taken out, then spent 30 mins documenting everything - good prep for next year I guess!

Another satisfying day in the ED! Back to the flat by 2000, fairly long days so far but always felt busy, never slow. Don't mind being in when I'm doing stuff all the time. It's quite a contrast to Fort William as even though there are fewer patients here I'm much more involved in the care, often doing all of it and getting it signed off at the end, including all the paperwork, so feel busy.

Fresh pasta dinner then into Stornoway for drinks with another King's student up here, so random! Freezing and raining on the walk into the town - easy to imagine that I'm on a small island in the middle of the sea when the weathers like this! Met them in An Lanntair, the Arts Centre with a cinema - newly refurbished with digital projector and 3D facilities, will have to try and get a film in whilst here. Sampled some of the bottled Orkney ale along with an Oban whiskey - with some water to open up the flavours, very nice. Expensive though, those two drinks were £8.50 ish! No ales on tap either :( Went from there onto McNeill's, aka the 'husband creche'...

Sampled another of the Orkadian ales (again none on tap) and good chat with the two others, listening to how they'd got on over the past month on the island. One of them is a medic at King's, up here for part of their elective in GP land. The other came up too to write up their dissertation in the non-distracting surroundings! Parted ways and was back at the flat by 2330, slightly tipsy. Another great day!

Day thirty - Tuesday

Started the day with a lie in, till 0900ish when I was woken up by the cleaner coming round. Porridge and coffee, both with milk this time = much more palatable! Got my things together and was just walking out of the door when I poked my head into the kitchen where the cleaner was at work. She'd obviously done the fridge as all my food was out on the top. She then took her headphones out after seeing me and said she was glad I'd come in as all the food in the fridge was out of date, motioning at the food on the top... The food I'd just bought yesterday! I mentioned this to which she said no, we're in late September now and all of this stuff goes out in August... I then reminded her that we were actually still in August! After a bit of to and fro, she eventually relented and put it all back in the fridge rather than in the bin - lucky I'd gone in otherwise £30 worth of my food would have been chucked out!!

Walked into the hospital, arriving to a very quiet A&E department, I'd missed the first patient of the morning who'd come in at 0930, and since then no one. Occupied myself with planning walking routes using a combo of Bing maps and walkhighlands. Bing maps is amazing - free OS maps of the entire country, 1:25000 and 1:50000! Printed off a few ideas, mainly down in Harris taking in the highest hill on the island, Clisham (779m). Patient arrived, interrupting my planning session. Was a review of a wound, which was going along quite nicely so quick case where we just discharged with follow up in a week or so in GP land. After that grabbed some lunch downstairs in the canteen.

What is this funny money...

Back in the A&E for the afternoon for a few hours between 1pm-4pm there were NO patients! All the staff here said it was really unusual, so I guess my presence was a lucky charm for them (relaxing day) but unlucky for me as I was keen to see some patients! Spent most of the time flicking through Acute Medicine Oxford Handbook, and going through radiologymasterclass tutorials.

Late in the afternoon the phone went off warning of a patient coming in, sounded a bit more complex than the morning's case. Patient arrived, into resus. Nurses and I hooked up all the monitoring equipment, sats/BP, then took an ECG before the ENP tried to cannulate. They missed, so I went for a wrist vein and got it in, took off a whole load of bloods, flushed. Then once we'd ascertained they were stable I took more of a comprehensive history, did a brief examination and took a collateral history off a relative who'd come in. By this time one of the medical F2s had come down from the wards to see them, so I presented my findings so far and what differentials I was thinking of. Patient went off to have a chest xray, and I grabbed a bit of dinner- lovely chili/rice/cheese from the canteen! Some of the results then came back, wasn't a clear picture so the consultant was called and I took 3 sets of blood cultures to send to the lab. The patient wasn't the easiest to bleed, and in fact for the cannula we'd used this awesome bit of kit in the department called AccuVein - a device that emits laser light and shows up veins under the skin, even if they're not visible by naked eye. It's pretty incredible, and I'd never seen one before. Also up here they've got the automated CPR machine (AutoPulse), which again I've not seen anywhere else - haven't seen it in action yet, not sure if I want to!

So although this patient was a bit of a mystery I got the chance to do some stuff and get involved in thinking of differentials, using the investigation results to whittle these down and decide on further management plans. Finished dealing with them by 2030, so went back to the flat. It had been a slow day but had the chance to brush up on some knowledge, and the second patient was really satisfying to get involved with. So after the first two days here in the A&E I've sutured, cannulated, taken bloods, done blood cultures, taken a few histories, examined cardio/lungs/abdo and knees, requested/intepreted xrays, presented  to juniors etc. Successful! Hope it continues :)

It was pretty cold when I stepped out of the hospital, noticeably cooler than Fort William, properly felt like Autumn! Walked into the flat to find 3 students sat round the kitchen table, got chatting and they're dental students here for the week from Aberdeen. As it was just before sunset I mentioned that I was thinking of driving out to the coast somewhere and asked if they were keen. 5 minutes later we set off for the west coast - I was thinking might be able to catch a decent sunset but in the end we were just too late and it was a bit cloudy. Was nice to get out though, get some fresh air and did come across a historic site of a battle (see pic). Rapidly got dark so drove back for some pizza/brew in the flat. Chatted a bit more then headed in for the night, hope tomorrow is a bit busier than today!

Nice inland loch

Historic site number one!

Day twenty-nine - Monday

First day of the second part of my elective - Western Isles hospital in Stornoway! As I hadn't managed to get to a shop yesterday it was porridge from just water with black coffee for breakfast, mmmmmmm... Headed in for 0830 to meet my supervisor in A&E...

The view of the hospital from my bedroom window - barren lanscape of Lewis

Pretty big hospital compared to Fort William!

Grey morning, only a 5 minute walk from the accomodation to the hospital though. Arrived in A&E to meet some of the Emergency Nurse Practitioners, or ENPs - highly trained nurses who take care of the A&E here. They see the patients and if it's something they can deal with then the attenders will not see a doctor during their visit - saves time and money all round! If it's something more serious then they just call down a junior from the wards and they come and see them.

After a quick chat I headed up to the surgical ward to meet Dominic, one of the F2s who I followed round for the morning. Saw a few of the patients on a mini-ward round, then did some bloods for them before heading back down to A&E at 1000 to meet Agnes, my supervisor. Great to meet her after lots of emails whilst arranging the placement! She took me through how the department works, and gave me a mini tour before showing me the way to Infection Control for an induction at 1100. Cue hand washing test with UV light box and hand dye! Never done this before but heard about it - basically have to cover hands in a UV reflective cream, then put your hands under the light box and it shows up all over you hands. Then you wash your hands before putting them back under the light to see which bits you missed. After spending lots of time scrubbing into theatre in Fort William I was in proper hand washing mode and so passed! Then spent a while quizzing the infection control person about the best beaches to visit in Lewis, got lots of recommendations...

Back in A&E saw my first patient, someone who had quite a deep cut on their hand. Took a history, examined and then sutured it up under the guidance of one of the ENPs, using 3 interrupted sutures. The technique was fine, got lots of practice in theatre in Fort William, but I'd never done it in an A&E setting. Just have to think a bit more about the sterile field! Before long they it was all dressed and they were good to go - successful first patient! The next patient wasn't quite so straightforward, and needed some input from the medical team - probably not an accident or an emergency but they came in and probably need something sorting out for them! After that grabbed some lunch from the massive Co-Op down the road.

Back in for the afternoon, was quite slow to start with. Got my computer passwords sorted out before another patient came in with quite a complex history. Got the chance to practice some orthopaedic exams before coming up with a plan. It's really good to build on the confidence I gained in Fort William re doing the whole process - history, examination, impression, plan, discharge. Think this is going to be a good placement - everyone in the department is really supportive and helpful. Stayed till around 1730 before heading back to the house, first day done!

Headed down to Tesco in town to do a big shop, £65... Stocked up on loads of supplies though, and now have the luxury of a cooker and full kitchen facilities! Made the most of them once back with the first proper pasta meal I've had in ages - my trusty staple of pasta/pesto/bacon with onion/garlic/Boursin/mixed veg = gorgeous. Washed down with chocolate sponge pudding, an orange and a brew. Did some clothes washing left over from Fort William and listened to Radio 2 all evening, tributes to Pink Floyd and Dark Side of the Moon, interesting to listen to! Heading back in for 9am tomorrow, I'll have to start exploring the island at some point, see some of these beaches I've heard so much about!

Day twenty-eight - Sunday

Slept pretty well in the new tent - first outing for the replacement Tadpole 23! The old one I'd had for quite a few years but was no longer waterproof so I chanced it and sent it back to North Face via Cotswolds and a few days later = brand new £200 tent! So first time I've used the new one, did well. Pitched on top of lots of heather, so was super comfortable to sleep on. Great view in the morning, although probably due to lack of wind and proximity to water it was midge central - unreal. Packed as much up inside the tent as I could before donning the head net, covering up as much skin as possible and doing a speed tent take down before running up to the car. Was horrendous, at one point I focussed on the net hanging about 10cm in front of my face to see about 100 midges all crawling over it, trying to get through to my face! Argh!

The view in the morning

Tent did well on it's first outing!

Sped off down the road with windows wide open to blast all spare midges away before pulling into the Sligachan hotel for a rather posh breakfast - decided since I'd saved the money on a nights accomodation I could treat myself for breakfast! Plus it was either that or cook porridge outside my car whilst slowly being consumed by midges. On the way in I overheard the receptionist saying that it was one of the worst days of the year for midges - I felt slightly less of a wuss! The breakfast was only £10 too, great value for buffet cereal, coffee, orange juice then very nice fry up with poached eggs etc. Beautiful! I was enjoying it perhaps too much, as when I glanced at my watch and saw it was nearly 10am I quickly got my stuff together and set off for a horseshoe walk up Beinn Dearg Mheadhonach, Beinn Dearg Mhor and the finale Glamaig (775m).

Great views from the bridge near Sligachan

Start was really boggy underfoot until I gained a bit of height. Sun was beating down and before long I'd followed suit to yesterday and the t-shirt went into my bag - something I'd pay for later! Superb clear skies and great visibility all over the island. Bit of a slog up to the top of Beinn Dearg Mheadhonach, not very high at 651m but the Druim na Ruiage ridge is pretty long. From there I turned north, descended to the bealach before ascending up to 731m for Beinn Dearg Mhor - a tough ascent in the heat but was thankfully over before long. From here the views towards Glamaig were fantastic, as well as across to Sgurr nan Gillean and Am Basteir, the end of the Cuillin ridge.

Glamaig in the middle, with Beinn Dearg Mhor to the right

The route ahead

From here the ridge descended steeply to another bealach, at 415m before one of the most punishing ~350m ascents I've ever done - relentless steep scree slope to gain the summit of Glamaig, horrible! By this time I knew I had to get motoring in order to make the ferry at Uig as well, so I was trying to push on in the sweltering heat with my legs burning from the Bla Bheinn traverse only 18hrs ago! The views from the summit of Glamaig were fantastic, although the pain in my legs made me consider whether it had been worth it! Either way I then had to push on down the other side straight down to Sligachan, bit of screen running, bit of falling over down the grassy slopes, bit of jogging over the boggy flat end to the car. Forgot to mention I'd neglected to fill up my water bottle in the rush to set off, and so had done the whole round in the sun without a drink...

Looking back at the steep descent off Glamaig - the route of the infamous fell race

Got back to the car at 1240, quickly filled up a water bottle in the hotel before speeding off towards Uig and my ferry. The tickets said last check in was at 1315, and the hotel receptionist had said it was ~35min drive... Cue some rather tense driving, the black box really won't like me for that bit. Was amazing road though, piercing straight north through the heart of Skye.

Arrived with lots of time to spare in the end

Arrived at the ferry terminal in Uig after a frantic drive, picturing the ferry docked and ready to leave, me driving down the road and boarding just as the ramp was about to be pulled up and set sail. Sadly I was instead met by a man in high vis saying that I had about 45mins and to collect my tickets from the office - bit of an anticlimax and seriously (cue rant) why on earth do they say that last check in is at 1315 when you could arrive at 1350 and drive straight aboard the ferry? If I'd known that they cryptically meant 40mins after the time they wrote I wouldn't have punished myself on the walk or driven so fast to get here, thinking I had only 1min to spare! Whilst waiting in the queue I rang Alice and caught up - she got back from France and was now working on a DofE trip in the Peak.

Harris in the distance

Anyway, boarded and set sail at 4pm! I spent most of the journey relaxing in observation lounge where they had a cool computer screen diagram showing where the boat was on a map of the crossing. Ventured outside onto the deck for a time, but pretty windy and chilly, plus the sea was so calm that I didn't feel ill staying inside where it was warm!

Arrived in Tarbert on Harris at 1540, and straight away hit the road north to Stornoway. It was about an hour drive, and had a fantastic contrast between Harris, a mountainous land full of rock, to Lewis, a barren flat heathery island with no trees. Drove past lots of small lochs/tarns, with small dilapidated crofting communities dotted by the sides of the road. Was a little bit grim!

Arrived at the hospital and picked up my keys from the reception. Had a chat to the receptionist, who explained that everything is shut on Sunday. And by everything they mean everything. Can't buy food. Can't even buy petrol! Moved into accomodation, it's a shared block where I've got a single bed (booo) room in a 4-bedroom flat, very similar to my accomodation whilst on a placement in Chichester/Worthing. Sadly the room's no where near as good as my Fort William one, but on the plus side I've got full kitchen facilities here! First things first, a hot shower, desperately needed after a big hill day, camp, then another hill day! Terrible pressure, but hot at least. Bad showers do my head in! It's the one requirement to make me feel human, a shower with a decent pressure and hot.

As I didn't have much food with me I went back to the hospital for shepherds pie dinner, only £2.39 and was pretty tasty. Back to the room and settled in, skyped parents on wifi = that's the other requirement to make me feel at home - hot shower and wifi! Had a second dinner of potato/tuna/sweetcorn, cramming in the calories after an epic 24hours on Skye! What a weekend. I'm in Stornoway!

Day twenty-seven - Saturday

Really nice to have a bit of a lie in again, up around 9ish to finish off my packing. Picked up Brett from his B&B, gave him a lift to the station via Wetherspoon's for a 'goodbye-Fort-William' fry up! Was very tasty, even though the sausages were square - what's that all about?! Not to mention the 1500-odd calories mentioned on the menu - would fuel me up for the truly awesome day ahead...

Took Brett to the station headed back to the house - I was now the last one standing in Fort William :( Loaded up the car with all my stuff then bade farewell to the MacRae's who have looked after me excellently during my stay. Left a bottle of vino, a postcard and some Kendal Mintcake as way of a parting gift! Set off around midday for the north, went via Glen Shiel, stopping off at Glen Garry to enjoy the dulcit tones of a ceremonially dressed bagpiper - was the perfect atmosphere, looking out onto superb Scottish highland wilderness with the sorrowful drone of the bagpipes ringing out. Before long I was looking at the impressive bridge over to Skye, the scene of my afternoon adventure!

Crossed over to the island and at Broadford hung a left, heading for Torrin and the Black Cuillin, home of Bla Bheinn, often described as the best mountain on Skye. I parked the Polo up in a layby for a shot with it in the background, including the incredible Clach Glas ridge to it's right, my objective for the afternoon!

The Polo with Bla Bheinn in the background - incredible scenery/weather

Parked up in the car park and although it was only 3pm as soon as I opened to door to start packing my bag I started getting midged! Quickly got my stuff together and set off. First bit was up the path to gain a bit of height, before then cutting right and gaining the top of Sgurr nan Each. Was a steep ascent, on some loose scree before reaching the ridge line. Scrambled over to join main ridge seperating Garbh Bheinn from Bla Bheinn - at this point hadn't decided whether to tick of the former. It's not a munro, and due to my late start I decided to just carry on towards Bla Bheinn to get the main objective, the traverse, done with time to spare, rather than losing time on the accessory. I'd definitely like to come back and tick it off though, looks like a great mountain. Turning round I saw what was ahead - truly spectacular!

Cut right up to the ridge line, then left all the way to Bla Bheinn (pronounced Blaven), with Clach Glas in the middle

Steep scrambling up Sgurr nan Each

Clach Glas, the Matterhorn of Sky, with Bla Bheinn to the right

The actual terrain wasn't as intimidating as it looked - although it was exposed the scrambling was always comfortable. Some of the rock was a bit loose, so required extra care. I'd brought my helmet so donned that to give some protection against any rocks coming astray from above! Also gets me in serious-mountain-route mindset, once the lid goes on I start to concentrate :) Before long I'd reached the summit of Clach Glas. I can't really remember much about the difficulty of the scrambling, no bits particularly stood out as being 'the crux' so I guess it was all ok! I was too busy staring at the incredible views out to the main ridge and all over the coastline.

The route ahead, PSYCHED!

The summit of Clach Glas, with Garbh Bheinn behind - next time

After descending the summit, getting a sweat on

Made my way off Clach Glas summit, some tricky downclimbing sections which were probably the hardest bits of the whole traverse. Went over this feature called the 'Putting Green', a very random patch of grass where the path actually goes horizontally for around 5m before plunging back into vertical rocky mayhem! Provided a nice spot for a sit down, bite to eat and rehydration. Stunning views over to an amazingly perched huge wall of rock on Bla Bheinn, thought there must be routes on it - sure enough there are but the only one up the main face is E5! Looks classic. There's a few HVS' that skirt round the edges. Definitely a place to come back to, just insane.

Looking back over the terrain covered

The crux chimney

From the putting green it was more steady scrambling, all straight forward until the crux chimney was reached. This gets 'Diff' as a rock climbing grade, as it's vertical with some smaller holds to start with. It's not exposed though - you could slip and you'd just go to the bottom of the chimney, rather than the bottom of the mountain like on some other sections! Pretty polished, and lots of crampon scratches (sorry wild cat claw marks). This would be one hell of a winter route! And then it was all over, I was on the summit - wow!

Does life get any better than this?

The dream route - the Cuillin Ridge, what a weekend this would have been for it

Wow. Wow. Wow! The traverse in all it's glory, fantastic.

I think I can safely say that it was one of the best days out in the hills I've ever had. I think the semi-exploratory nature of it made it even more satisfying - I'd seen it as a possibility on the map, but hadn't read anything about it in advance. Didn't really know how hard it was going to be, and was prepared to turn back if the climbing looked like it was getting serious enough for ropes/gear. In the end it was all very amenable, much more so that it's looks would suggest. All added to the euphoric feeling on top!

Spent around 30mins on the summit, soaking up the views courtesy of the type of weather one could spend years waiting for. As I was taking it all in two other walkers got to the top, and we got chatting. Turns out one of the pairs brothers is a 1st year medic at King's, and is going on the KCL Wilderness Medicine Society expedition to India this summer - crazy! Small world. Left them to the vista's and headed down.

Reached the car in good time, spent 3h30m moving with 30m on top. Superb. Learnt from my previous midging and just threw everything into the car before driving off with the windows open, blowing the midges away! So psyched - the afternoon had surpassed my mountaineering dreams, I was on such a high!

Skye - the place where dreams come true!

Headed round to Sligachan Hotel where I'd heard there was a nice bar - got a celebratory pint and chips in. They had a superb whiskey collection too, but decided to stear clear, maybe next time! That's the one thing that could have improved today - someone to share the experience with. Not that it wasn't enjoyable, it was the best afternoon I've ever had in the hills, but would be good to relive it with a friend over a pint. Just had to placate myself by planning the following day's adventures, and my bivi site for the night...

Celebratory pint, and planning tomorrow's adventure...

Day twenty-six - Friday

Last day at the Belford! Walked in for morning tutorial at 0745, last early morning start... On ABGs, was pretty useful, going back over interpreting blood gases and the physiology behind partial pressures, oygen saturation and delivery. After that was straight down into the board round, which was very full today and quite sober due to some ill patients at the moment. There were no surgical patients on the CAU, so the medical ward round went on for a lot longer than normal as they had to go round and see all their patients. I followed the surgical round, which went through onto Ward 1 to check up on only a few patients.

Once back in the doctors office everyone was properly on it, people were working so hard! Lots of jobs, which I did my best to help out with. Ended up clerking in a surgical patient - taking history, examining, sent bloods, got urine samples, took ECG, ordered x-rays etc. Really good to get through the whole process on one patient, tied up a lot of stuff! Lunch then a child protection teaching seminar at 1230, some pretty gruelling content but important topic to cover. After that we (the elective students) said our goodbyes to the consultants and juniors before leaving the Belford for the last time! Pretty sad times, had a great experience here over the past 4 weeks. Helen had arranged chocolate/cards for the staff on the ward, A&E and theatres from all of us :)

In town I first attempted to track down some Kendal Mint Cake, as a gift to my hosts for making me so welcome in the accomodation. Nevis Sport didn't have any, Field and Trek had one battered bar that had seen better days! Got some in a newsagents next door - amazing that can buy it pretty much anywhere with a vague outdoors theme. Popped over to barbers then back to the house for lunch and brew. 1hr violin, was good fun, sounding better, trying to remember to keep my bowing fingers curved - Mum was having a go at me over Skype for poor technique!

Checked out the maps for Skye - got a plan for the weekend. Scramble tomorrow afternoon on the south of Skye, then camp near Sligachan before doing Glamaig on Sunday morning, then the ferry over to Harris and drive north to Stornoway for Sunday afternoon. Started packing up my room too, sad times. Watched a bit of tv, baked potato then picked up Brett and drove to the Ben Nevis Inn at Achintree for a last night drink. Hadn't been to the bar before, so was keen to check it out. Really nice inside, and the food looked amazing!

Pub at Achintree, at the bottom of the tourist track up the Ben

Feeling refreshed we emerged just as the light was leaving the sky, so we headed over to Corpach where I'd heard there were great views over the loch back towards Fort William. Sure enough we found the marina and we rewarded with fantastic twilight views over the loch towards the town, including the majestic silhouette of the Ben towering above the water to the left.

Corpach marina on the Caledonian Canal

Ben Nevis on the left, Fort William in the middle, with Loch Eil on the right

The marina was quiet, with only the noise of water pouring over the canal locks disturbing the peace. Glad we came out to see the view. Back to the house and then nipped down to Wetherspoons - mainly so I could have a pint by walking home! Sampled the Stag ale, could only manage one of them - very rich, yeasty flavour, felt like drinking a smoother Guinness! Chatted to Brett about Leeds' crazy medical student assessment processes - every med student there gets given an iPhone, with the purpose of filling out 5 mini-cex feedback forms per 5 week placement. This is in addition to other iPhone based feedback forms, as well as written log books, which include multiple skill sign offs like 10x cannulations, as opposed to King's system of just single sign offs. Quite glad we have it like we do at KCL! Would be absolute carnage if King's tried to introduce a similar system - we're bottom of the league tables for student satisfaction as it is, without adding extra meaningless jumping-through-hoop feedback forms!

Arranged a farewell Wetherspoons fry up tomorrow and headed back to the house. Sad to be leaving. Hope I don't get midged too badly on Skye tomorrow - you might have to wait until Sunday for an update on my weekend!

Day twenty-five - Thursday

Day started off with spectacular weather - walked in with Helen with not a cloud in the sky. Board round was packed from a very busy day yesterday. I'd like to write about who came into the hospital today but feel it wise to refrain - suffice to say it was the cause of stress and humour in equal measure! Sorry for being cryptic...

Jobs list was pretty long after the medical round, so straight away cracked on with getting some bloods done. In the middle I was summoned to the anaesthetic room to do a 12-lead ECG on a patient who had just been cardioverted - they were back in sinus rhythm, success! Back to the ward, took some more bloods and was just tidying up in the prep room when the crash buzzer went off - for the patient I had just bled! Correlation yes, causation hope not... Turned out they had collapsed shortly after I'd left but then a few minutes later were pretty much recovered and doing well. After that decided not to do any more bloods!

Tom jumped ship due to blazing sunshine outside, but I felt like I should stay after my day off yesterday. Nipped upstairs for some food then went along to the F1 teaching via video link from Aberdeen! Was on blood transfusions - very important topic, but the session was so incredibly dull I found it hard to concentrate. Even the novelty of having it streamed on a TV while the 4 of us were sat in a hospital miles away wore off after the third powerpoint slide of SHOT graphs. Finished at 1330, after which Helen left to do some shopping. I went back to the ward for about 30s before deciding to follow the other two's lead and try and capitalise on some fantastic weather in what remained of the afternoon. Headed back to the house and quickly hatched a plan to head down to Glen Coe and do Curved Ridge, a classic grade 2/3 scramble I'd wanted to do for ages!

Drove down in beautiful sunshine, blasting out Chili Peppers from the stereo, amazing! Parked up at Altnafeadh, left the car around 1500. Smashed the walk in, and before long I got stuck into the scramble. Was amazing rock in an incredible situation, the vast expanse of Rannoch Moor behind, and the towering sillhouette of Stob Dearg above, forming the impressive Buachaille Etive Mor, shepherd of the glen.

Stob Dearg, 1022m

Crowberry Ridge behind, the scramble just to the left

Looking back down, not a place for the faint hearted!

Mind blowing Rannoch Wall

The route overlooks the aweinspiring Rannoch Wall, an incredible face of vertical rock. I passed the only people I saw all day at this point, two women descending Curved Ridge after doing January Jigsaw, a Severe. Carried on up the ridge and before long reached the cairn marking the end of the route. Here I cut right, passing under the impressive East face of the Crowberry Tower before gaining the northern ridge and continuing all the way to the top, incredible exposure and a really thrilling scramble! Paused on the top, soaking up the exposure, before reversing ~20m back down to cut across the col to gain the mountain proper. From here continued up for a few minutes before popping out suddenly on the summit plateau, right next to the cairn, 1h20m after leaving the car. Fantastic! Views were amazing. Route was amazing. Weather was amazing. What a way to end my time in Fort William!

Rannoch Moor, awesome vistas 

Tasty scrambling!

What a view! If you look closely in the middle you can see the Ballachulish bridge

Quick refuelling with fruit bar and squash before launching into the descent down Coire na Tulaich. Ran the whole way down, scree running at the top at breakneck pace before slowing down slightly once I regained the proper path. Before long I was back on the home straight, running over the bridge and arrived at the car 1h50m after setting off, 30m descent - brilliant! Had the advantage of starting off at nearly 300m from the car park, so only 700m odd height gain/loss over the trip. Amazing thinking about where people in London go for an afternoon jog, when if you lived in Fort William and had 2 hrs free you could smash out Curved Ridge on the Buachaille!

Taken at 1635, contemplating the descent...

Taken at 1652, looking back at the descent and wondering quite how it went that fast!

In the Polo I headed back through Glen Coe, powering along to Otherside by RHCP, life seemed pretty good. Done a classic route in a speed smash'n'grab effort, driving in my own car down Glen Coe, just finishing a truly brilliant 4 weeks in Fort William and looking forward to the next stage of my elective adventure on Lewis!

Quick shower then onto Cobbs for the last of our Thursday evening tutorials, sampled the Northern Lights ale with a Scafell burger, like to think I'm representing the Lakes up north! Quick interlude home before returning to the hospital to watch The Imposter in the doctors accomodation, very strange/disturbing documentary, brilliant manipulation of viewers emotions though, whole view of the situation suddenly gets inverted half way through! Enhanced by Leffe and microwave sponge pudding. Final lift back to the house from Helen and chilled out. What a day. What a 4 weeks in Fort William. I'm gonna be sad to leave. It's made me think about what I want from where I live/work. Up here if you have a few hours off the most rugged mountains in the UK are literally on your doorstep, ready for the taking. Want to nip out and do Ledge Route on the Ben - OK. Drive down the staggering Glen Coe and smash out Curved Ridge - that's cool. Spot of cragging up Polldubh - yep. Definitely opened my eyes to what's possible. Maybe I'll move to Scotland one day?