I can’t believe that I’m over 3/4 of the way through my internship program in London! Over the past two and a half weeks since my last post, I’ve visited Stonehenge, Bath, and taken a trip to Wales. During my time at Stonehenge, the stones were much larger than I expected. Unfortunately, we couldn’t view them super up close, but it was still incredible to stand in the English countryside and think about the theories surrounding how and why they were arranged this way. When constructing the site, the smaller bluestones were transported over 140 miles all the way from Wales, while the massive outer stones weigh around 25 tons each. The site was built to be aligned precisely with the movements of the sun during the summer and winter solstices. After visiting Stonehenge, our shuttle bus took us to the city of Bath, where we saw the Roman Baths museum. It was super interesting seeing the naturally heated thermal springs that the Romans used for their public baths almost 2,000 years ago. 

During my trip to Wales, I visited two different areas: Llandudno, a town on the north coast, and Betws-y-Coed, a village an hour south of Llandudno by train. The landscape of Wales was really beautiful, with coastal views and smaller mountains in Llandudno, as well as waterfalls, large forests, and fields in Betws-y-Coed. It was quite a journey getting there from London, taking over four hours on the train with multiple transfers, but it was a great weekend adventure filled with nature, fun hikes, and lots of sweat and steps!

Besides weekend trips, I’ve done a lot during my internship over these past few weeks. I shadowed geriatric ward rounds, observing a wide range of patients alongside trauma lists focused on various fractures. It was interesting to see how normal conversations with Alzheimer’s or dementia patients could be, only for our quick delirium assessment, the 4AT test, to reveal underlying cognitive impairment or delirium triggered by hospital stays. By asking targeted questions like naming the current year, location, or reciting months backward, the 4AT quickly screens for sudden changes in mental state so the medical team can address the root cause right away. 

Additionally, I shadowed at the falls clinic, where a multidisciplinary team consisting of nurses, doctors, occupational therapists, and physical therapists evaluates fall risks in elderly patients. I was surprised by how holistic the care was. OTs would ask about home environment setups as well as a bit about emotional well-being. PTs would, of course, evaluate physical strength and balance. Now, I’ve moved on to calling patients and analyzing outcome measures in Excel. 

My other projects are also making steady progress. I’m continuing work on the craniotomy satisfaction surveys, though we are pivoting to retrospective data collection, i.e., phone follow-ups with previous patients. I’m also drafting our special care dentistry article on accommodations for patients with autism and learning disabilities, analyzing almost three years of demographic and trend data. Meanwhile, data entry for the fractured neck of femur audit continues on Epic and Excel, though it’s a bit slow and repetitive given the number of fields. Lastly, we started a new audit evaluating how thoroughly anesthetists document patient consent and risk discussions. Overall, things are tracking well, and I’m hoping to wrap up several of these projects soon. 

Outside of work at the hospital, I’ve been taking in what day-to-day life is like in London. Spending time living here, rather than just visiting, has made me notice a few differences between the UK and back home. One of the first things I picked up on is how much of a priority sustainability and environmental awareness seem to be here. I noticed early on that most buildings don’t have air conditioning, though that’s largely because Britain’s weather tends to be milder and its buildings are often older. But there are other, more intentional signs of this, including paper straws, different and more sustainable types of packaging, more posters and campaigns around sustainability, more solar panels, and a higher adoption of electric vehicles, including the public buses. 

There are also a few subtle communication differences I’ve noticed. Obviously, everyone speaks English, so there’s no real language barrier, but certain phrases and words carry different meanings than I’m used to. For example, people often say “I appreciate that” as a way of saying “I understand,” rather than meaning gratitude. Communication here can also be a bit more indirect than what I’m used to. People often circle around an idea rather than stating it directly, and there’s a strong emphasis on polite phrasing, even when delivering criticism or disagreement.

The infrastructure in London has been another really cool contrast to experience. Because England has such a longer history than America, it shows in how preserved everything is, creating a unique mix of old and new. It’s wild seeing centuries-old churches and massive historical cathedrals sitting right next to tall, modern glass office buildings. That blend of ancient history and modern city life is something harder to see back in the States, depending on the city/area.  

I can’t believe how quickly this program has been going, and I’m really looking forward to seeing how everything comes to a close!