The Coast Hospital has a new scenario based learning suite that Med Students, Docs and the rest of the clinical staff have been having some training sessions. The aim of the sessions is to more accurately replicate the real world; a challenge that anyone who's given Rescue breaths and chest compressions to a plastic shell will fully appreciate.

One of the real beauties of this kind of learning is the chance at a 'do-over' or as golfers say, a mulligan. Moreover, the ability to analyse and critique our reactions in a stressful 'real-time' environment is extremely helpful in future decision making.

For Med Students, the analysis unfailingly emphasises two key points; that a) we can recognise an unwell patient and b) that a systematic approach will yield positive results.

In many aspects of life, we are not afforded the chance to analyse an instantaneous decision; the situation progresses, and all hindsight is, of course, 6:6. We rarely, if ever, get a 'do-over'. To combat this, cricketers have net-sessions, rugby union players have tackling practices, and soccer squads practice penalty kicks. All those hours for one shot. To take the extreme, the intense, the unimaginable and have the brain convey normality.

I'm yet to be involved in an arrest situation; I'm hopeful it runs like in the scenarios. For those ones, there are no mulligans.

His fluoro shirt was visible a few seconds before the automatic doors whirred open, and he entered from the long dark night. As he stumbled across the shop floor, I almost reached preemptively for a sharps kit. As he reached the counter, he fumbled for his phone, dark eyes searching the screen. His gaze lifted to mine, focusing some seconds later.

"I... need... some... formula. ... For newborns." He slurred, before squinting hard at his phone and naming a brand.

Unfazed, I toddled over to the baby section and fetched the request, with a "No worries". Meantime, he'd begun to rant. About his girlfriend. About two hours of text-messages. About the baby crying.

"Plus, " he says, clearly now with a full waft of XXXX assaulting my nostrils and eyes, "I'm maggot."

"This is the one you're after?" I confirm, gently.

His pupils accommodate to the shelves behind me, and then to the behind of the leggy shopgirl, as he dumps the cash on the bench.

"Sooo, theeen... what time does your lady friend... get off?"

"You'll have to ask her yourself," I say with a wry smile. I'm met with a forty-five second string of abuse littered with F-bombs, C#$&'s and racial slurs.

I can be pragmatic about abuse; it happens in the health services. The sick feeling, biting like an ulcer in my gut, wasn't because I'd been sworn at, nor because my assistant had been abused. It was for the girlfriend, and the newborn.

Bob bounced back, his Troponin sky high, for the third time in as many months.

Under sixty and full of modifiable risk factors, a jolly round fellow, reclines relaxedly in his bed.

The cardiologist tells Bob he's in serious trouble, his angina's unstable but his risk factors for surgery are gargantuan, especially his fifty a day smoking.

Bob's round face bobs with laughter, he drives the speed limit and he doesn't chase the women, he says. There's no drama with half a dozen each night, eh doc? And what's a few smokes too, he says.

Objectively, his prognosis is terrible. The cardiologist tells him - in numbers - the chances of death, and when.

Bob bobs some more, "At least it's not cancer.", he smiles.

And the cardiologist pauses, looks square into Bob's eyes and gently says, "With most cancers you'd have longer."

And Bob, kindly, round, red-nosed, white bearded Bob, just doesn't get it. Because it's not cancer.

This week, one of the Intensive Care Registrars popped his head into the CCU to check up on a patient he'd been asked to see overnight. Luckily, they'd been well enough to avoid transfer to his unit. The patient's story was interesting enough to keep the ICU reg, well, interested, and he's the kind of compassionate fellow to actually follow up on consults.

In addition to his obvious empathy, one thing struck me about this Registrar. He had a textbook in the crook of his arm. Not the typical ICU fodder, nor a voluminous tome such as Harrison's latest offering. No, he had Guyton & Hall's Physiology, firmly within his grasp.

Somewhat surprised, I asked if he was sitting exams soon. "No," he replied, patting the red spine gently, "it's just that I like to stay on top of this stuff." He finished his observations and trotted off to the ICU.

I think every Pre-clinical Med student wishes for the day their textbooks are permanently burned into their brains, knowledge available for instant recall. Similarly, the clinical years instill in you a sense of simplicity through structure - all that basic, history based stuff. It's easy to draw the dots between chest pain and myocardial infarct. Dredging out first-year physiology, engineer-style, to explain symptoms and progression is another string to the bow.

The reg, unspeakingly, reminded me the books we use, at every level, remain relevant in every clinical context. That's why it's called life-long learning.