14th February 2020 - So you wanna be a Dive Doc?
Have you ever sat across from the dive doc during your medical or a consultation and thought – “Yes, I could do that – it looks easy!”
Well now is your chance to see if you are cut out for this profession or whether you should stay in your old one at GCHQ or Parliament.
Let’s do the Dive Doctor Quiz.
Q1-
You get a call from the Coastguard. They have just picked up a 50+ year old male diver found floating on the surface with a deployed SMB. He is barely conscious and there are remains of pink sputum around the mouth. An SOS bracelet on his wrist shows him to suffer hypertension and diabetes. What do you do?
A1 – Prep the helopad, and have a gurney waiting with some oxygen and an IV line ready for insertion. Check the defib is powered up and get the anaesthetist ready. Have a nurse with cardiac experience ready to go in the chamber as well, should the need for any rescuss be required. This could be a lung barotrauma from rapid breath holding ascent – maybe he was caught in the SMB. But there could be overlying heart problems coming at you too.
A2 – Explain that they have called the wrong number and put on a fake Chinese accent and keep saying you need to spend over 20 quid for free delivery.
Q2 –
An email from a 35 year old female diver comes in. She writes that since a series of 6 dives in Malta, 2 of which she missed her safety stops – that she has not felt quite right. Symptoms include lethargy, muscle pains and a persistent occipital headache. She has no other medical history but she has also noticed an increase in breast size on the left.
A1 – Never say never. Remember the mantra – “if it was not there before the dive, but is there since – blame the dive”. Get her in for full assessment and read up on bubbles in the lymphatic system that can cause some breast swelling.
A2 – Tell her she is simply depressed and to go and find a councellor.
Q3 –
A potential diver has come in for a PADI medical as they have ticked 2 boxes on the medical declaration. One is for epilepsy, the other for a previous pneumothorax 2 years ago. They are really keen to learn to dive as their partner is already qualified.
A1 – Tell them that there is zero chance of passing the medical as these are 2 of the biggest no-no’s to recreational SCUBA diving, but gently explain there are plenty of other past-times they can engage with, with their loved one.
A2 – Do the whole medical, warts and all, take the money – then fail them with a degree of derision that they ever thought it was possible to pass.
Q4 –
A 25 year old female asthmatic is in for a BSAC medical. After a few minutes it becomes clear that her asthma is really badly controlled. Her GP has given no advice on inhaler technique, and even then she is on the wrong inhalers anyway. There has been no asthma revue at any time and she has just started smoking due to work stress.
A1 – Stop the medical. Work out what she should be taking for her asthma, such as more preventers and less relievers. Write a note for her to take to her GP explaining your reasoning, and then review her 2 months after she has been put on better meds. She may well pass, but give her the Stop Smoking info leaflet you have had printed recently.
A2 – Give her the number of your Romanian bootleg ciggy dealer and tell her asthma is all in the mind.
Q5 –
Your local dive club is having a Club Night. As it is on the last Friday of the month, you have the evening free and are ready to hit them with some fine talks. How do you prepare and proceed?
A1 – Write a fine Powerpoint on something seasonal. From their website you see they are all going to Egypt next week, and so a talk about diving in hot climates with chances of Gippy Tummy would be good. Likewise a special section on hydration and DCI would be useful for them too. Leave after a simple shandy – remember you are not at Med School any more.
A2 – Roll up a fashionable hour late after a pre-lash at the nearest Witherspoons. Tell them you have lost your laptop and so are happy to chat with a few of the prettier members of the club. Mention that BMA rates for your time equate to 200 quid behind the bar and proceed to drink that in Creme de Menthe. Your Grand Finale is to be sick in the pool as they are running a Try-Dive for some local disabled children.
Q6 –
A male diver of 45 has just returned from the Red Sea with a rash across his chest that developed immediately after a dive where he lost buoyancy at 25 metres and hit the surface. He has symptoms of lethargy as well, enough to have called work to take the day off despite it being of upmost importance.
A1 – Clearly a skin bend with extras. Prep the chamber and tell him to call work to say he might not be in for 2 or 3 days depending on how he responds to the treatment.
A2 – Blame a new washing powder for the rash, and jet lag for the lethargy. Go back to your Suduko as there’s only a few squares yet to fill in.
Q7 –
A BBC journalist who has been injured by an IED and left paraplegic comes in for a medical. He has been told he can never dive again, despite it being his first love. Is there anything you can do?
A1 – Yes, he is otherwise fit and well. Pass him and put him in touch with a diving charity that supports diving for the disabled. Their care and attention will get him back into the blue and fulfil his dreams.
A2 – Agree with the others and say there is no chance. Charge an exorbitant fee for this advice as a means of retrieving your TV licence fee.
Q8 –
A charming Kiwi diver comes in for an HSE medical as he is a PADI Dive Instructor. He has a reputation for competitiveness and is young and healthy. How do you do the fitness test?
A1 – Tell him that most English divers can do the step test in under 3 minutes. Watch as he comes in under the time by a full minute and congratulate him on his Antipodean perseverance.
A2 – Send him out to clean your car and run to the shops to buy your lunch. All in under the time it takes you to write FAIL in big letters across the medical form. That’ll learn him for supporting the wrong rugby team.
Q9 –
It’s the EUBS annual medical conference. The European Underwater and Baromedical Society meeting is an important part of your post-graduate education and also a chance to meet other doctors working in your rarefied medical area. This year it is in Prague – how do you do this?
A1 – Prepare a couple of talks. As a UK chamber you see way more divers than any EU chamber and they will find your presentations useful for the occasions a landlocked country actually sees a case of DCI. You can learn from them about all the cases of diabetic feet and carbon monoxide they get more of that the NHS currently refuses to fund. Wear black tie for the gala dinner and learn to say “hello” and “cheers” in 5 different languages.
A2 – Turn up on Day 1 to get your badge and the conference notes. Return on the final day to get your attendance certificate. Spend the time in between at as many bars as is humanly possible and rock up in shorts and a Brexit T-shirt for the dinner - only to punch out a couple of German doctors.
Q10 –
You are on a diving holiday travelling incognito. There is a disaster waiting to happen. Your Sharm dive boat has decided to pull another boat that has become stuck on the reef due to the tide, off it by throwing a rope that they attach to a bronzy chunk of metal. You know what is going to happen next. What do you do?
A1 – Go to the back of your boat because at any moment it is one of those BBC Casualty scenarios where stupid people end up near dead. Wait for the gunshot sound of rope snapping or the metal flying at your boat. Go clear up the mess afterwards, where 2 deckhands have been hit by flying rope and metal as their fellow crew are now wailing and preparing the funerals. Place a hand on their necks and find pulses and say in Arabic that all is well.
A2 – Remain near the bar below-decks. Use the distraction to hoover up the last of the imported beer and at the sound of the screams go quickly up to pronounce everyone dead and arrange the burial at sea, despite the muffled grunts emanating from the body bags. Charge accordingly at BMA rates for Sea Funerals. That will cover the cost of the whole trip. Proper sick.
HOW DID YOU DO?
All 1’s.
Sir or Madam – I think you have what it takes to become that most celebrated of medical professional – the Dive Doctor. Only a few make it to these giddy heights – perhaps there are only under 20 good ones in the whole of the UK. Worldwide that is still under 3 figures. So prepare yourself for 15 years of hard graft – but one day you will make it.
All 2’s.
Oh Dear. You seem to lack empathy, nous as well as common-sense. Stay in Parliament where you can get away with these failings.
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