Add another one on the fire . . .

Barbados Butterfly and her plight have made the papers. The Age has published an article detailing some of what happened. Here are some quotes:

CAT scans, personal thoughts and photos in the blog of surgical registrar Jillian Tomlinson allegedly got her hauled before The Alfred hospital board and suspended for one week. She is expected back at work soon.

Diary contacted Tomlinson, the treasurer of the Victorian Medical Women's Society, and she declined to comment.

Hospital spokeswoman Tracey Ellis declined to elaborate. "It's a matter between the hospital and the staff member," she said.

I hate to say it, but when I graduate, I think that the working environment will be such that blogging will no longer be possible. Call me over-dramatic, but book burning is alive and well.

Sleeping in!

On another note, thank God daylight saving is over! An extra hour's sleep per morning is just the thing. It is not like I am getting any extra sleep at all, but it sure does feel good!

Grasshopper brain

My brain has been a little scattered lately, so in order to try to get things back on track and work out why it is trying to run in all directions at once (like a grasshopper* on speed) I tried doing a little bit of my own version of mindfulness meditation.

When I say "my own version" I don't mean that I came up with it myself, I just mean that it is the way that I do it myself. I'm neither a Buddhist nor an expert.

The best brief explanation on how this would work, is just to be aware of, and name the thoughts and general feelings that are going through your head at any moment. You can do this while meditating (i.e. sitting still somewhere quiet and comfortable), or while doing simple actions like driving the car or walking between classes. If you are into journaling, you can even do it in a written form.

You try to keep your head clear, and pay attention to the emotion you are feeling at that moment. Then you name it. Then, try to work out why you are feeling that way, or what these feelings are specifically about and name that, without being judgemental or involved. It is a good way to recognise what you are feeling in an objective way.

I was in my car driving to uni this afternoon, and the conversation in my head was going well, until I discovered that I was rapidly getting bored and annoyed with myself for asking how I was feeling. Some things don't work for all people, all of the time! It did help me focus.

Sadly, I learned that I don't always think very nice thoughts about the people in the other cars on the road around me, or the pedestrians on the side of the road. Who would have guessed that I felt annoyed by the pedestrians walking past me as I was stopped at the traffic lights? And don't even ask what I think about cyclists. (It's usually fear, on their behalf. I have been where they are, and buses are big and scary.)

This, and burning candles are about as new-agey as I get, folks. Actually, actively practicing mindfulness is beginning to attract attention around the place as a good therapy technique. (If you look up "mindfulness" on Pubmed, you can spend hours/days perusing the results. Interesting stuff.) Personally I think that anything that makes you understand yourself better can only be a good thing.

__________________________
* I tried to find a picture of a grasshopper that didn't make me cringe. I figured I'm not the only person on the planet who can't stand them - ever since I had one land on my face in the middle of the night (a "present" from my cat) as it was flying around the room, I haven't been able to stand the things!

These are a few of my favourite things . . .

It is a sad fact of my life that I love ordering things over the internet and having them delivered. Every time I open that package, be it groceries, a textbook or something more fun, it is like a little present to myself.

(Unfortunately I will never be the kind of person who is able to order clothes on the internet. Apart from the occasional amusing t-shirt, it isn't going to happen. I'm very picky with what I wear. This doesn't translate into looking fantastic the second I turn away from the mirror, but such is life.)

My latest favourite thing to be delivered were boxes containing flashcards with which to revise/learn pathology, pharmacology and microbiology. I'm writing out my own as I go as well (mainly because I am a visual learner and this works for me) but it will be nice to have a set of neat-looking cards with pictures.

Yes, real pictures! Not the abstract scratchings I can muster using a ball-point pen on the tiny corner of a piece of cardboard the size of my hand, done in the space of five seconds! Sometimes all it takes is simple things.

Looking at them sitting in their neat little piles on my study table, I can feel the knowledge flowing into the wood, through the table, up my arms and into my brain. The cards are MUCH smarter than I am at the moment, so learning-by-osmosis is practically guaranteed.

Ordering them and opening the package even felt like study! It is like that feeling you get when you are planning going on a diet and somehow the act of planning your meals for the next week or two makes you feel like you have already started to lose weight. Delusions can be fun! Join me next weekend, when I get fit by watching a marathon!

"Name That Enzyme" and other fun family games . .

I'm still enjoying being a medical student (particularly the social aspects!) but I can honestly say that the shine has well and truly worn off.

The most fun part about learning a new skill is the point at which you see your ability level rising dramatically. You realise that with each effort you make, you will see an immediate corresponding return in your skills. Unfortunately, this tends to happen at the beginning, at the point when your knowledge or fitness is so small that any advance seems huge in comparison.

The worst and hardest part is when you are plugging away constantly, day in and day out, and the work you do doesn't vary enough to keep it interesting. This is much worse when you are in the middle of a long journey and can't see either end. You are already a little experienced, and so it would take a sudden and massive improvement for you to notice and real change. Motivation can be an elusive beastie to uncover at this stage of the journey.

Right now I feel as if I am wading through the second type of experience. We are half-way through the first semester, exams are still far enough away to not have me experiencing night-terrors, and we aren't going to be doing anything new or exciting for a little while yet.

Don't get me wrong - I am incredibly grateful to be here! It is where I want to be and there is no way in hell I am going to be returning to my previous career - they would all beat me to a pulp for throwing away the opportunity of a lifetime.

I think I need to mix it up a little. Perhaps I should change tomorrow's study into a game-show format. I have the flash-cards written out. All I need is somebody to ask the questions and some kind of reward. Perhaps if I win my own version of "Name That Enzyme" I can shout myself a new outfit for a party I'm going to tomorrow night. The more questions I get right, the better the outfit.

In that case, I had better go to bed to prepare for tomorrow - I don't want to embarrass myself in competition with the other household contestants. The cats would never let me live it down.

Put on a happy face . . .

Today we had our second practical assessment, making sure that we were reasonably competent and knew our way around the system of the body we are currently studying.

We had to go into a room one by one and be assessed by an examiner. I kept having flashbacks to when I was involved with assessing students in my area of work.

There were two trends that I didn't particularly like to see. The first one involved the student who was generally quite slack and had a bit of an attitude, who would somehow get lucky and score the easy patient for their examination, and would breeze through, getting good marks.

The second (and more vexing) trend was the student who clearly knew his stuff, had worked hard on prac, had done the same examination a million times before on more difficult patients, and had done it well, but when it came to being assessed by the university's official assessor, he did not do as well as he should have.

I guess the major lesson to learn from this is: confidence. If you don't have it, at least learn how to fake it. Particularly during assessment. Put on that happy face. If you are going to say a wrong answer, say it with confidence!

I have this odd muscle thing in my face where I tend to look worried when I am not. Or perhaps I'm so repressed I don't know when I am worried any more. Irrespective of any of this, I need to get good at acting confident again. It's either that, or invest in a round of Botox prior to examination week. A blank face may inspire more confidence than a worried one. ;)

Whiney Post #99874276

I'm feeling completely unenthusiastic about everything at the moment. I got home in the middle of the day and felt so tired that I just had to have a bit of a nap. I lay down at 1pm and woke up at 5pm! So much for the afternoon of studying I had planned. The dreams I had were much more interesting than the Krebs Cycle, so it wasn't a complete loss.

I think one of the reasons I am finding it tough is that we are focusing so much on the theory behind the human body rather than the illnesses themselves. The human body IS very interesting, but at the moment I am just a little worn-down from constantly feeling like I am behind everybody else. I'm looking forward to getting out into the hospitals again, where I actually feel comfortable.

The best way for me to get through this year is probably going to be focusing on the fact that in second-year everything becomes much more based on pathology, and then after that life becomes almost completely hospital-based. I am really looking forward to it, but am trying to be conscious of enjoying today while I am here.

My back has also been giving me merry hell for sitting down for so many hours each day. I am used to being on my feet all day, and studying is proving to be bad for my waistline, my bank balance AND my back! The only time it feels good is when I am lying down or standing up. I have three alternatives - either I study lying down (which would be a speedy trip to Z-Town) or while I am pacing the room (I would get good arm muscles from my textbooks!), or I go buy some anti-inflammatory cream and learn to sit with better posture!

It feels MUCH better to have gotten that off my chest. Back to my arch-nemesis, Mr Krebs Cycle.

Snapshot

I just had to add a quick snapshot of how I feel right now, just to record it so I can laugh over it later.

I am feeling highly overwhelmed at the moment by all of the work we have to learn. I have been told that this is a completely normal way to feel at this point in time and I think that if I didn't feel this way I should be more worried.

Our first exam is in June this year, and I am quite nervous about it. I'm moderately sure that I will have done enough to pass, but it just seems too far away and insurmountable at this point in time. I might as well be looking up towards the top of Mount Everest. And yes, I know that it will feel this was at EVERY stage in my career from here on in. I like a challenge in front of me. It is part of why I am here.

Every week they throw new information at us and we somehow try to clamber over it and assimilate it into our brains before they start hurling new information the next week. Come to think of it, they don't actually throw the information at us all of the time. A LOT of the time they ask us questions about things that we are apparently supposed to know and we spend the time clambering around piles of textbooks in a blind panic trying to find whatever the hell it is we are supposed to know, in a form that will allow our brains to understand it.

Anyway, the part I wanted to record is the fact that I am completely and utterly in awe of anybody who has passed first-year medicine. Even the mid-years. Wow. You guys rock.

Yes, laugh it up. I will, next year. Which is why I wanted to write it down.

Next year I will read it, and think, "Hey, that is exactly the way I feel about the third-years!"

Don't even ask me how I feel about consultants. It is just too far away to see.

Godspeed, Barbados Butterfly

"Like real butterflies, her blog's presence may be ephemeral, to be enjoyed while it lasts."

I found this article while searching for Barbados Butterfly on Google to see if I could piece together what might have happened. Sadly, his prediction turned out to be true. Her wonderful blog is gone.

NHS Blog Doctor has posted a more complete account of what happened, including an e-mail from the Butterfly herself.

I just wanted to write and say how much I appreciated her wonderful posts, wit and sage advice, and that I hope blogging hasn't caused her career or professional reputation any trouble.

Farewell, Barb. You will be sorely missed.

Never listen to the talking house

More fun timewasting. As students, we can't afford decent therapists, and we are highly self-obsessed, so we love on-line tests and other fun things.

I don't trust the house. It clearly lies. About the tidy part, anyway.

Your house tells the world that you ought to be a leader. You are a freedom lover and a strong person. You love your house and family. You are a gifted artist as well. Once you have a problem, you need a friend with you. Your life is always full of changes. You are very tidy person. There's nothing wrong with that because you're pretty popular among friends. Your life is always full of changes.

You see the world as it is, not as you believe it should be.

Why would there be anything wrong with being tidy that would involve you losing friends? I'm confused. If you were excessively messy it might become a problem, and people might have words with you . . . but being tidy? No.

Ah, also my life is full of changes. Which is nice. But I'm tidy, so nobody notices. ;)

Devil's advocate

Is it wrong to want to crash-tackle a tiny female runner to the ground/trip her and sit on her (because I could do it) when she lapped me during a paced training session (because she could) so that I can strap a good 70 pounds of weight around her neck and see how bloody fast she could run then?

Sometimes I am not a very nice person. ;)

Welcome to the flock

Sometimes it seems that in order to get by and do well in the world of medicine, you have to become a clone of those who have gone before you. We have already been advised that we are now walking advertisements for our profession, and as such we are to conduct ourselves in a manner that reflects the rest of the medical "club".

We are to dress, sound and look like everybody else. If we don't, we could me misrepresenting the rest of the doctors and students, and people would think less of us as a profession.

Now, I realise there is a huge difference between a medical students who discusses patients in a disparaging and unprofessional manner at a party and a student who chooses to wear a loud scarf. But how much do you really need to conform and play the game to get by?

Part of my concern probably stems from the fact that I am very good at being myself, and while I am a compassionate, professional and responsible person, I don't know how good I can be at fitting the "mould" that we seem to be given. Moreover, I honestly don't think I WANT to learn to become somebody else.

No, I am not one of those people who is cruel to others under the guise of "honesty" and "helpfulness". Really, some people seem to be able to turn any flaw into an asset just by changing the word they use to describe it.

Yes, there is a professional mask that you put on when you see patients. It is like that in every single job on the face of the planet. But I wonder how much damage laying low and acting like everybody else in the flock is going to ultimately do to me as an individual.

After all, I have had an entire life before now, and am a well-rounded and stable personality. I know myself very well. I LIKE the person I am. How much of this is going to change in the coming years?

The PBL of futures past . . . ?

I quite like PBL. I got very lucky, and the members of my group work hard and all contribute well. They are all easy-going and pleasant, and our facilitator is experienced and helpful. I'm getting a LOT out of it. (N.b. over the following post, I may use the words "tutor" and "facilitator" interchangeably.)

However, a few weeks ago we experienced a trial tutor who is looking at gaining a position in the PBL program at our university. Whilst he was qualified, polite and highly intelligent, we didn't get anything out of his session, except when our regular tutor took over.

It frightened me a little, for a number of reasons. I wondered, how much would the group actually get out of PBL if we had a terrible tutor? For anybody unfamiliar with the PBL process, the tutor "facilitates" the sessions, meaning that he or she is meant to guide you through the process without actually telling you the racts involved. You are supposed to learn to think through things sytematically and logically and learn to access the information yourself and be able to present it in a clear way that shows you understand the information and how it relates to the case.

If the discussion veers off course, or if the information is blatantly wrong, the tutor is there to correct you.

One of the worst possible ways I can imagine a PBL session being run, is if the tutor turns it into a didactic teaching session, talking about all of the topics as they come up and not giving the PBL ample time or prompting to work through the logic. Apart from the fact that the tutor may potentially be incorrect (and yes, this did happen during our trial tutor's session - he disagreed with both the main tutor and one of the students who majored in the area of disagreement), it is not teaching the group how to think through things. Being able to think through things not only helps the learning process, but helps you work out why what is happening to the fictional patient is actually happening, and turns rote learning into practical knowledge.

Unfortunately I feel that most of the problems encountered by our trial tutor were caused by an insurmountable language barrier (English was not his first language), with potential cultural differences. We couldn't understand his accent (and I have a LOT of experience working and socialising with people from non-English-speaking backgrounds), and he had difficulty following us, evidenced by his asking us questions that a member of the group had just answered. I have nothing against accents of any kind, but there needs to be some level of mutual understanding for group teaching to be possible. On the bright side, we would learn to be more independant.

As bad as I felt for him, it was a huge relief when the regular tutor took over in the weeks afterwards. I don't know what the outcome was (we're not privy to that) but I sincerely hope we don't get him as our next PBL facilitator.

A special kind of irony . . .

I am finding study quite stressful at the moment and with all of the gastric chaos that ensues when I get stressed, my doctor has put me on Somac (pantoprazole - proton-pump inhibitor). The irony is that we are currently studying gastro and proton-pump inhibitors. Which is contributing to my stress . . .

Discipline

I need to develop a little discipline. Be it food, television or other silly distractions, I have been not quite as on-track with study as I would like.

My aim this year is to pass comfortably and stay sane. I think that people with better time-management skills tend to have more time to enjoy themselves. Taking one hour to study something that a master-procrastinator would take three hours to learn leaves you with more time for the better things in life. (At least, this is what I am telling myself to help make it seem better.)

Speaking of the better things, I have finally gotten around to cooking from recipe books again. I haven't done that since uni started, and last night I remembered how much I really missed it. It was really good.

I am attempting to impose a zero-television policy for myself for the next month and see how I go. Exercise and study is in, and tv is out. I have a huge pile of books sitting on my bedside table that I want to get through. Wish me luck.

Nap time

Why am I finding uni so boring at the moment?

Having worked so darn hard to get in, currently lectures make me sleepy. The background information is interesting to look at, but sitting down and learning it is awful.

Am I doing the right thing? Should I even be here? That question is easy to answer. My old job was even more boring than sitting down and learning basic science. I'm not going back to it.

I probably need to try to put it into context and see that even though the little part is quite dull, and having to memorise it is also not very exciting, it should help me become a better doctor in the long-run.

So for now I just have to endure the pain, push through it and look forward to the time when we will be concentrating more on the disease processes rather than just the basics.

I just wish I didn't feel so damn sleepy.

Everybody needs good neighbours . . .

Damn it! I hate getting new neighbours! Just when I am comfortable with the old ones, they seem to leave and we get new ones moving in.

Previously our next-door neighbour was a retired lady in her 70's who took fabulous care of her garden, was home most of the time, had a big dog, was NICE, and never made any noise. When we went away, she would offer to feed our cats. She was the Perfect Neighbour.

Unfortunately, being alone and in her 70's meant that her house and garden was becoming too much work. She sold her house and moved out. On the weekend, our new neighbours moved in.

I'm scared.

They are a young couple in their early 20's. It is the first home that they have bought. They moved themselves in on Sunday, carting heavy furniture right up until 9pm that night.

They were very loud while carrying the furniture. It was educational. I learnt some new words. Yes, I know it sounds precious. But I have had BAD neighbour experiences before.

Like the two young females who lived above us when we were living in an apartment. They would smoke pot well into the night while playing dreadful music, and our deck would be covered in the ash and beer drippings. One morning we found a lacy black teddy had been thrown over their deck onto ours. I did the neighbourly thing and hung it on their front door.

I'm still hopeful about our new neighbours. If they are a young couple and have bought the house, they are probably both going to be working while paying off their super-sized mortgage. (We can truly sympathise with them there.) They will probably both be working. Which hopefully means sensible bed-times and no mid-week parties. Yes, I'm precious.

We might even share the same cranky disdain for the children who live in the house over the back of both of our yards. These children like to wait until 9pm at night when it is VERY hot and we are lying in bed dying while trying to sleep in the heat. Then, they all run SCREAMING to their backyard pool and jump in and out for at least an hour, while screaming and saying things like, "Wow, it's so hot! This pool is great! Why is the crazy cat lady over the back waving a broomstick at us and screaming?"

Yes, there is hope yet. And if I don't know anything about them by next week, I'm sure I can ask our neighbour from across the road, who fancies herself as an amateur spy/private investigator/CIA operative and watches every move of every resident on the street. I love my neighbours.

Rant time

I'm mildly annoyed. One of the things I learned in previous studies is to keep on track with study by looking at past exams from time to time to see if I am covering the material in a way so that my study should be reflected in my ability to answer the exams.

There is nothing worse than spending an excessive amount of time studying for an exam that you don't do well in. I firmly believe that you should be rewarded for the hard work you do. I'm not a "gunner" - I'm happy to help everybody else who needs it, too. I hate seeing other people who have worked their arses off not do so well.

This morning I printed out the exam questions that we are supposed to be able to cover after having studied what we learned this week. Unfortunately there seems to be little of the finely-detailed science, and a lot of the social-impact type questions that were:
1) not given much time in lectures OR PBL; and/or
2) not even provided in lecture notes because they were supposed to be "sensitive material".

I would love to be able to write on an exam paper that I couldn't answer the question as the material was "sensitive". How the hell are we supposed to study something if they won't even give us the information? Bollocks to the fact that it is "sensitive", if we are supposed to learn it then give it to us!

If they can't even give us the information, then it is grossly unfair that we could be examined on it. It is a giant farce.

Why is it so?

Why is it that the fastest temporary cure known to man for any kind of niggling pain is to go to the doctor?

You can be sore for weeks and do everything possible to alleviate the pain, and it won't go away. However, the day you have your doctor's appointment, not only is the pain gone but you can't quite work out where it was to begin with.

Then, in the car on the way home, it rears it's ugly sleepy little head, as if to say, "Hello! I'm awake again! Did I miss anything?"

Cheeky. Little. &*)&&^*()%.

I always tell patients not to worry, because if there is anything there it probably will still be there even if the pain has temporarily taken a holiday. However, I can completely empathise with just how silly it makes you feel when this happens.

If you go to the doctor and this happens, don't worry. The exact same thing has probably happened to them, too.

Procrastination 101

Your Simpsons personality is.... Dr. Hibbert

Horoscope: In an ironic turn of events, you the doctor will be sent to the hospital, due to being poisoned by an ice cube containing a fly. Although they won't do anything to make you feel better, they will be able to tell you exactly how sick you are. Fortunately, three months later, you will be miraculously cured by the ingestion of a single lollipop (the only known cure).

To find out which Simpsons character matches your personality, go to:

The Official* Simpsons Personality Quiz