Adult textbooks + cartoons . . . WHY????

I am so keen on next semester that today I went out and bought a textbook that should cover the topic for the next few weeks, and is a "Crash Course" review book for students rather than a full-on medical textbook.

Summarising is now my friend, whilst massive tomes with 1000+ pages are the enemy.

However, I can't say that I am a fan of books with cartoons next to their bullet points. I know they are trying to make the book more "fun", but seriously, no student using it is going to be younger than 18 or 19 in the most extreme case, and most will be in their mid-twenties. I grew out of cartoons a good fifteen years ago in language classes. I can only imagine how ridiculous this must seem to a medical student in their fifties, if I find it painful at my age.

Yet textbooks aimed at adult learners STILL have cartoons. And not funny ones. They are pictures of a strange-looking person looking happy and pointing his finger in the air, as if he is elucidating some brilliant point.

However, the fact that I can actually understand it forces me to forgive the inclusion of these annoying little figures. I would rather understand the subject, pass the exams and be a good doctor than be put of by zany cartoon figures.

Hmm, now I'm sounding even more odd than usual. I'm blaming boredom. I am getting to that point in the holidays (even though I have been working) where I am bored and ready to study again. Bring it on, baby!

Oh, the shame . . .

Well, I have sunk to a new low, everybody. I have to admit it publicly, so I can grow, and move forwards.

My name is the Girl, I have a blue stethoscope, and I am a medical school addict.

We go back to university soon, and I am actually looking forward to beginning to study the new topics. I am getting very excited that I am more than half-way through first-year, particularly as I really enjoy practical work much more than theoretical. (I like theory but I can only get really into it when I see it applied in real-life. Then it all makes sense!)

I have all these plans in my head about how this semester will be more organised than last, about how I am going to summarise and shorten rather than get bogged down in masses of detail and feel lost. Somehow I know that it won't quite work out that simply, but I like to dream that it just might!

I miss the campus, I miss the coffee, and I miss the people. Most of all, I miss the hours. I know that you work pretty hard studying at uni, but compared to full-time work, it just isn't the same. I like getting home at midday, knowing that I have the rest of the afternoon off to study. I miss being able to sleep in during the week.

I miss being able to sleep in instead of going to a lecture, knowing that I can just wake up later and read through the notes myself. I miss being able to go to the shops during the day. Good grief, I have completely morphed back into a uni student!

Not long, now.

Somewhere over the rainbow . . .

. . .there is a mysterious place that is free of all of the farce and nastiness that goes on in the hospital system.

Sometimes when I am drifting off to sleep at night, I like to imagine this place in my head. It is a special place. Some would even call it magical.

All that glitters is gold. There are unicorns, pixies and elves in the woods on the hospital grounds who are seen by everybody, not just those who have gone for 30 hours without sleep. In the middle of the night they clean and wax your cars and procure you healthy take-away food when the hospital cafe is closed at dinner-time, and surround everybody entering and leaving the hospital with a wondrous cloud of pixie dust and cheerful applause.

When you ask a more senior member of staff a perfectly reasonable question, they look deeply into your eyes, give you an honest, in-depth answer, and then thank you for your hard work and effort. Whenever you turn a corner, you will often see consultants shaking hands with the cleaning staff and wards-people for the tireless work that they do.

The medical students are well-trained, hard-working and prepared for every situation, due to the top-notch training and mentoring that has been invested in them by the staff who have sufficient time set aside each day for this important task. They feel like a valued part of the team, and love coming to the hospital. They look forward to graduating and coming back as interns, knowing that the training that they have received will stand them in good stead to step up to the role ahead of them.

When a patient has just had their life saved and they thank the doctor, the doctor replies, "Thanks, Mr/Mrs Smith, don't just thank me. It was a team effort!"

In the operating theatres, the surgeons and the anaesthetists all get along really well. Everything runs on time, the teams are prefectly co-ordinated, and when there is an emergency case or equipment malfunction, nobody gets angry and attacks the nearest helpless minion. They all just nod, smile and say, "Oh well, these things happen, let's make sure the urgent cases get done first and then we'll take it from there."

The doctors value the nurses, the nurses respect the doctors, and the nurses don't take out their frustrations on everybody else. It is a wonderful place, where everyone who walks through the door knows that it take much more than doctors and nurses to care for patients.

The patients are all seen promptly, treated as individuals and experience excellent care due to the large number of qualified staff allocated to look after them. Nobody ever slips through the cracks.

Nobody ever assumes that psychiatrists are crazy or aren't real doctors. The surgeons go home every night at 5pm to their happy families. The other staff know that anaesthetists do more than sit in the corner and play sodoku, and are applying passive attention as well as working hard behind their drapes and machines. The pathology staff are seen as a valuable part of the team, and everybody comprehends what they do. The radiology department is loved by all, everybody understands that you can't fit three patients into the CT scanner at once no matter how urgent they all are, and people appreciate the valuable skills and years of work that have gone into the expertise of the radiologists.

People understand that certain test results can't be received instantly because of the time required to do them. Everybody knows what all those other people in strange uniforms who aren't doctors or nurses actually do. The small amount of administrative staff who are required are extremely competent and get everybody's pay right the first time.

Usually by this time, I have drifted off into a blissful sleep, where nobody ever throws instruments in rage, yells at me for broken equipment, rolls their eyes when I show up to perform a test that they actually requested or tells everybody (right in front of me) that I am a moron and they could do my job easily when it took me an entire 4-year degree to become qualified. One can only dream . . .

In the eye of the storm

Well, exams are over for now at least.

I just don't feel like blogging much at the moment.

Time to take a break (from uni) and get back on my feet.

The exam was fairly brutal. I know now how I will study next semester, but I don't know how much good it is going to do me. Don't worry, I know I will get through it all and pass. But sometimes it is frustrating when there is so much to know, and so much is expected, but we can't possibly do it all.

I just have to get my confidence back up again and get back on track.

Peace

Sarah Toller, a blogger and young melanoma sufferer, passed away yesterday. Her blog is well worth reading. I feel so sad for her family, particularly her husband, whom she clearly adored.

It is an excellent read and contains a lot about the constant waiting and living in the meantime that cancer sufferers go through, as well as taking life as it comes.

Goodbye, Sarah. Wherever she is, I hope she has found peace.

What is wrong with this picture?

I love this scan - it is from the site Radiology Image of the Day which I have linked to the right.

See if you can pick what is wrong with the picture before you go to the original site (which I love!). Even first-years should pick this one!

Good-bye, old friend

Yesterday I found out that our family cat of 19 and a half years had died. Apparently she died in her sleep, as they found her stretched out and looking like she was relaxing, in one of her usual sleeping places.

To be honest, I was relieved for her, as she had been uncomfortable for years, suffering from arthritis. She lived a wonderful life, spending her entire day walking around my parent's farm, finding warm places to sleep in the sun, and yelling at the dogs if they did not move so she could lie down in the best spots.

She was deaf, so she yelled VERY loudly. When she yelled, she would brace herself so the force would not knock her backwards, open her mouth and let rip with the loudest yowl you have ever heard. Thankfully she lived on a farm, but the neighbours a little way down the road could STILL hear her early in the morning.

The day before she died, my father had fed her a small filleted fresh fish, which she devoured, so things weren't out of the ordinary. She wasn't suffering from any infections, but it sounds like she was in heart failure and probably just died quickly in her sleep.

My younger brother cried for a couple of hours after he found out. I did not shed a tear, even though I was sad. I felt bad that I did not have more of a reaction, and it made me wonder why I felt this guilt.

I know why I didn't react more - I have been working around the sick and elderly and seen enough people die to know that death is a consequence of life, and is not always to be dreaded. This cat was VERY old. She hung on to life with all four paws for as long as possible, but 19 years is a long time to avoid death. She lived a fantastic life. I don't think there is anything to be sad about, apart from the fact that we will miss her.

So why did I feel guilty? Probably because I was concerned that by not reacting more, it seemed like she meant less to me than she did. I was also concerned that my parents would think I was being cold or heartless. I grew up with this cat. She was one of my best friends growing up (as much as a cat can be) and used to sleep in my room every night. I used to protect her from my brother when he would play rough. She meant a lot to me.

But it has been years since we expected her to go. I guess I knew it was her time to move on, and can accept that. It wasn't a sudden and violent death. She did not need to be put to sleep forcefully in the vet's office (as was our old family dog), with the vet telling my father that, "We need another injection. He just doesn't want to leave you." Hers was not a traumatic death, but a peaceful one at home.

Goody-bye, old friend. I'll see you again someday soon.

Things that bug me Part 1*

Warning: rant alert!

People who think that they know more than their specialist because they can use Google bug me.*** Particularly when they don't realize that they are coming across as being at least as arrogant as the doctor they are criticizing for the exact same flaw. (Arrogance, not using Google. Although if my doctor used Google in front of me during a consultation, my eyebrows would raise slightly.)

Yes, everybody has a right to educate themselves. Everybody SHOULD educate themselves as much as they can. We would all be a lot healthier if we all took responsibility for our own health.

However:

I have friends who do this, and it bugs the hell out of me, particularly when they insist that something they have read on the web contradicts what the doctor says, so the doctor must automatically be wrong.

It also really bugs me when they contradict something I am explaining to them because of said "alternative" information sources, when the topic something that I know very well because of years of experience in my previous job. (Particularly when the opinion they are asserting is, quite frankly, physically impossible for anybody with normal human physiology.) I realise that by saying this, I might come across as being arrogant, but trust me in that it isn't.

We are all entitled to our own opinion. They can take my opinion or leave it. I'm just a medical student, and don't give out medical advice, and this was not about me playing doctor. If they want to ignore my basic explanations of how the body works, that is up to them.

But if they ignore what I have to say completely and brush me off, in spite of the fact that they have known me for years, surely it should be obvious that this could be somewhat injurious to the relationship. I'm their friend, and they know that I have a lot of experience in certain things. Ignoring what I say is hurtful and disrespects my feelings.

Said people have also complained about the advice they received from their medical specialist, because they thought he was covering his back rather than helping them. When I explained that he was just following accepted health policy and evidence-based practice in that area, they still insisted that he was covering himself.

I wasn't there with them at the doctor's office. Perhaps he didn't explain himself very well, and wasn't seen to take their concerns into account and work with them to develop and implement a model of treatment that they were all happy with. But he was certainly the one in the room with the experience and knowledge to deal with the situation as safely and as best as possible.

I guess this is why it is a very poor idea to treat friends and family. Because a patient has every right to their own opinion about things, and should not feel obliged to follow what the doctor says because of any prior relationship. Also, the doctor should be able to remain neutral and impartial to the patient (while being empathetic and welcoming, of course) so that they can accept when the patient does not want to listen to what they have to say.

I think it is also fair to say that people, friendships and priorities change over the years, and so what was once a firm friendship can become difficult to sustain because people who once seemed very similar have become very different in small but important ways.

*I don't have a follow-up planned, but I'm human, and I know that many publishable things will bug me in the future. I now have more than one hundred posts. Wouldn't a series be cool?

*** Please note: I am not talking about patients with chronic illness who can become specialists in their condition and share things with their doctors that they did not know. I know a number of these people personally, and they rock. I'm talking about people who look up the basics on the internet and get sorely misled.

The mysterious case of the snoring cat

I'm about to get all deep and meaningful on you, so look out:

My cat snores. He also meows in his sleep. (This picture is not him, but it might as well be - it could pass as him by anybody who knows him.)

Does anybody else find this as odd or hilarious as I do?

I'm sitting here studying and wondering what the strange soft grunting noise is, and then I worked out that I had heard it before. I found that it was coming from the cat, curled up in the corner fast asleep.

I wonder if he knows how funny I find this.

It has woken me up before, and then my husband woke up when I nearly fell out of the bed laughing at the snoring, meowing cat. Then the cat woke up and the fun was over.

Yes, he is overweight. No, I'm not a bad fur-parent - all the cats get the same measured amount as each other. I think he scavenges and gets fat off the neighbourhood mice. Perhaps this is what he dreams of. Food.

I think there's something in that for all of us, don't you? ;)

Welcome back to high school

For those of you who haven't yet arrived at medical school and are wondering what it is like, just imagine what high school would have been like if everybody was legal drinking age.

Other people, including Audaci, have written about it really well. (Think "Mean Girls" + lots of textbooks = medical school.)

For the main part, I keep out of the cliques. I'm too old, anyway, and have found a group of sane and friendly people. We get along well, support each other, and don't get involved in the silliness.

But seriously, I would like to know who some of these people are trying to impress. I have never before been in a course where girls wear designer clothes to university lectures. Everybody else is in jeans and sensible tops, and they look like they are ready for a day out at the races. All they would need to do is add a fancy hat and they would be right to go.

I wonder if they really know what kind of job they are studying for, or how they will handle having to work and train in the public hospital system for the next seven years at the very minimum.

Sure, some doctors might recognise the designer-wear that they are sporting. Maybe even some patients. Will it impress them? Maybe if they can keep that fancy long-sleeved shirt spotless while disimpacting some old man's bowel, doing an enema or dodging projectile vomited blood. Maybe not.

The main thing I get confused about is where on earth they get the money for these clothes. Every other time I have been at university, we were all strapped for cash, and were happy to be wearing decent, clean clothes. The thought of wearing a $500 dress to university would have seemed (and still does seem) downright mad.

They must get the money from their parents. But what parents would be happy forking out this kind of money for university-wear? What kind of perspective on life are you indoctrinating in little Sally and Johnny when they think this kind of expenditure is normal and justified? I know they are in medical school, but doctors aren't sickeningly rich (for the main part).

And what must people like this think of the rest of us? Or even worse, what will they think of the patients they have to spend their days and nights helping? How will you deal with the homeless person who wears six layers of clothes to keep warm and hasn't taken any of them off in months, all while you are wearing an outfit that is worth more money than this person has seen in their entire life?

100 Posts!

Can you believe it? This is my hundredth post. I'm not going to go on and do a big list of things, as I have only been keeping this blog since December last year (although it feels like more than 6 months have passed since then!).

I can hardly believe that I am half-way through my first year of medicine. It seemed like such a dream six months ago. Things have changed a LOT in the past six months!

The other day I was looking through the photos on my mobile phone and I found one of me from May 2005! I had no idea that I had owned the phone for anywhere near that long. At that point I had not yet decided to study for the GAMSAT, and was working full-time. I had brought a few novels along on a weekend trip and was busy trying to work out what I wanted to do with my life. Looking at myself back then, I know how much happier I am right now, in spite of being just before a massive exam.

It is funny how your whole life can change in such a short space of time, in ways that you could never even imagine. I am very lucky in that my life has changed for the better. Sure, there have been sacrifices, but nothing that I have really missed.

In the same space of time, I have become an aunt, my best friend has had her baby, other friends have gotten married and my brother has also had a complete career change. I now only have one grandparent left, my father was very ill last year, and I went through hell-on-earth at work and came out the other end stronger but scarred.

Well, that is my little tale for now. I am actually very stressed at the moment, although you would have to live with me to see it. I'm acting normally around other people, but I am not cooking or doing things that I don't absolutely have to. Next exam period I am going to try to keep a better balance in my life. I'll try to exercise and not eat all of the junk that comes my way. Ironically, my diet has really gotten a lot worse since I started medical school. Over the holidays this is going to change!

One last note: medstudentgod wrote about Que Sarah, Sarah and her battle with melanoma on his blog a little while ago. She is still with us for now, but if any of you pray/send positive thoughts her way, it can't hurt.

Cats don't need diapers or nappies

Is there some way of having children without actually having them yourself? And raising them? And being there all night when they won't sleep??

I'm only half serious when I write this, by the way.

Friends of ours have recently become parents for the first time, and while they clearly love their son very much, I look at them and think, "You are absolutely insane." They have a newborn, so of course things are tough. But they don't get to sleep, they don't get to eat properly, they look like a pair of zombies who have to spend every waking (and sleeping) hour caring for this little bundle of need and want. It looks like the worst deal on the planet, on the face of it.

Sometimes I really doubt that I am cut out to be a parent. When I spend an afternoon with other peoples' children, I need to go and have a sleep myself. The thought of being pregnant somehow repulses me. I don't find other pregnant women repulsive, but think of it as a normal part of life. However, I am definitely not one of those women who worships pregnant bellies and gets all teary when they feel a kick from a stranger's pregnant belly.

I don't mind dealing with children as patients, particularly when they are old enough to talk and be spoken to. However, I get to give them back after a short space of time. I don't have to wash their dirty clothes or tell them for the hundredth time why they can't have a mobile phone at the age of eight.

There is also the question of how I could manage to be any kind of parent while training as a junior doctor. Being pregnant during this period could be an absolute disaster. The whole experience is stressful and time-consuming as it is, without being exhausted, feeling like you are losing your mind and feeling nauseated at certain smells to the point where you have to bolt to the bathroom every time you walk too close to certain patients, and feeling dizzy at things that only made you mildly uncomfortable before.

And then there is the whole childbirth issue. But I won't even touch on that one. If anybody is wondering what I am talking about, just look up "episiotomy" on Google.

Perhaps one day in the distant future I will be ready. But not now. No way.

Dreams of fish

I have never had recurring themes in my dreams before I started studying medicine.

Now I dream about fish all of the time. There are always multiple tanks that I have somehow inherited from somebody. There are many kinds of exotic fish in all of these tanks, and invariably there is at least one tank in trouble that I have to help in a hurry.

Last night it was a tank of dumped goldfish who were so overcrowded that the top ones weren't even covered in water. I tried to contact my parents who have a massive pond in their front yard, to see if they wanted any. By the time they arrived, all of the fish had somehow turned into second-hand novels. (I don't know - it's a dream!!)

I'm always running around managing things in the dreams. Somehow in a lot of them I will end up swimming in a fishtank or two.

I wouldn't say that they are nightmares. I'm never afraid, just stressed. The fish never attack me. I just have to manage and help them.

Stress does odd things to my brain.