A new year's resolution

May next year be better than this year. Much better.

More satisfaction for hard work, less BS, thank-you.

Good-bye, 2009. You were challenging and saw a lot of changes, but I never want to go through you again.

Merry Christmas

I hope you all had a lovely Christmas!

We had a fine time, probably the nicest day in years.

The weather was perfect, everybody was pleasant, and I even went swimming a few times, which made the warm day much more bearable.

My brother managed another truly random and interesting present (a tradition of his) - he gave me a voodoo doll toothpick holder. It may have a similar future to that of Yay's family Christmas pigs, we will have to see.

For us, Summer Christmas in the tropics consists of cool drinks, cold meats, salads, cold desserts, snoozing, backyard cricket and swimming in the pool. People from the northern hemisphere often complain that "it just isn't Christmas", but to me, it is perfect.

The spirit of Christmas future

I'm scared.

I have found out that my Uncle and his new wife are both big Elvis fans. She is very new, both to him, and to the country, so we are all being quite polite and friendly.

That said, if Elvis goes into the CD player on Christmas day, there are many things that can and WILL happen to it at my parents' rural property. The nice thing is that there will be no way to tell who did what.

I don't go and put on Tori Amos and expect everybody to love it. That would be ludicrous.

Really, when you go to a group event with a very mixed demographic, you need to be a bit careful about what music you put on, particularly if you intend to play the whole CD, and play it loudly.

It is Christmas, for crying out loud. It is a time for jingles, for "togetherness", for loads of drinking and eating and relaxation. Some of my family will be working my last nerve. Put on Elvis, and I won't be responsible for what happens.

(One or two Elvis songs might be okay. But these are a group of people with so little insight into the diversity of human opinion or taste that they will put on Abba really loudly - for hours - and expect everybody to love it. Because the Abba movie was popular. Therefore, all young people must love Abba, too. FFS.)

Wine drinking tip for hot climates

I have grown up in the tropics, and always wondered why reds didn't taste as good as they should.

Apparently, the ideal drinking temperature for a red wine is around about 60F - or 15C.

If you live somewhere warm and drink the wine at "room temperature" (i.e. straight out of the cupboard) then it will be around 28C in summer, and probably warmer than 15C even in winter. You think you are doing the right thing, drinking reds at room temperature, when you are drinking them a lot warmer than they should be. Wines are all about releasing the right flavours, and if you drink them too warm (or too cold), they can be foul.

Those of us who know that traditional reds should not be served cold from the fridge can have a happy medium. Keep the wine in the fridge, or chill it a little prior to drinking, let it breathe a bit after you pour it so that it warms up a little (but not quite to room temperature) and it may be a lot nicer.

Or drink it at 30C and think you are being a traditionalist. It takes all kinds. Whatever makes you happy.

Things are looking up

I had such a happy day today, walking around the hospital (and working, of course!). One thing that has really struck me this time around is how much better the day seems when I'm friendly and helpful to the people around me, be they staff or patients.

I have also noticed the difference in attitudes that you get when you wear your own clinical clothes and a stethoscope, compared with when you wear a uniform. Most of the differences seem to come from junior doctors. Anybody who treats another person poorly or ignores them because they are wearing a uniform is a jerk and needs to wake up to themselves.

I hate it when somebody looks straight through me, and this happens a lot less when I am dressed in "doctor" clothes. Most interns are nice, but I have had one or two look down their nose at me and be very rude a couple of times when I have gone to the bed of a patient in my role as a radiographer. Seriously people, wake up.

Now that I have passed third year, I am getting VERY excited about fourth year. The big rotation that I looked forward to last year was psychiatry, and I did it first, so the rest of the year was a hard slog. It was all very interesting, but there were no other rotations that held the same sense of "ohboyohboyohboy".

Most of fourth year is exciting for me. I don't plan on working in any of the areas, but they are all very interesting.

I'm doing:

Neurology, Clinical Pharmacology & Obstetric Medicine

ENT, Opthalmology and Emergency/ICU/Anaesthetics

Paediatrics

Obstetrics/Gynaecology

Elective.

I'm the least thrilled about neurology, but I chose it because it is interesting, and it is an area that I want to get better in. The same principle applies with clinical pharmacology. I think I should be good at these areas, both as a future intern, and as a potential future shrink.

They are also very varied, which will make it all fly by. I can't wait!

Time to celebrate!

I am now a fourth-year!

I passed all components of surgery and can now move on to the final year of the degree.

It is such a relief!

This is the best Christmas present ever. :)

Our exams results may come out at some time in the next week. Possibly. According to rumour.

Is it normal for a medical school to never let its students know what is going on?

Bah. One year to go. Hopefully.

The screening x-ray on the dementia patient

Two weeks of work down, four to go. I'm still enjoying catching up with other people, although there are parts to the job that I find painful and mind-numbing.

Medical imaging is a lot harder physically than medicine. You have to move patients around all of the time - pulling them across the imaging tables, moving them into position, lifting them, pushing heavy equipment, pushing the imaging cassettes under 10+ intubated people in ICU rounds, as well as doing a lot of walking all day. It is quite hard work, and takes me about a week to get used to it again after I return.

I also find that I get a little angry when asked to do examinations on extremely demented elderly patients when the exam is pretty much for screening purposes. I understand that the doctors want to check for things, but I think that sometimes they send these patients to imaging because they can't talk to them and they just run as many "simple" tests as possible to get a profile of the patient's health.

My main issue with this is that a "simple" examination can turn into an ordeal when the patient is unable to comply or move. We have to force them into positions that are uncomfortable, push and pull them around and cause them quite a bit of pain and upset them, all for an exam that is effectively for screening.

A normal patient who can move onto the imaging table and stand up can have an abdominal and chest series finished in under five minutes - and most of this is paperwork time. (Yes, I know you are supposed to wait to take the erect abdomen - I do it first, after the patient has been sitting up in their chair for at least 10 minutes on the way to the department/waiting, and then do the supine. This saves time.) They walk over to the erect bucky (the upright thing that you use for chest x-rays and erect abdomens) for two/three shots, then lie down on the table for the last one. Easy. Fast. Painless. We have a little chat while I take the images (generally the highlight of the exam for me - I get to meet some truly interesting people), then they move on.

An elderly patient with severe dementia or severe illness who is unable to remove or respond, and who gets sent to the x-ray department on a trolley or bed is quite a different matter. We have to force them into the upright position by having a radiographer/wardsperson sit them forwards, jam a heavy block behind their back, force a cassette behind them on top of this, lean the back against it, and then run out of the room to take the image before their hands move across their chest fields or they slide off the cassette. Similar thing for the lateral chest, if we can do it - we turn the bed sideways and try to use the erect bucky. We often have to do it more than once, because they are quite difficult to take.

For a supine abdomen (you really aren't going to get an erect abdomen on a patient like this, unless you REALLY need it and can manage a decubitus), you have to force the patient to lie down flat, get them flat on their bed, then wedge a hard, thick block of plastic (the x-ray cassette) directly underneath their back, make sure it is in place, then run back out of the room again to take the image. If you are lucky and have trauma trolleys and your patient happens to be on one, this is much easier.

And this is if you ask for a simple abdomen/chest series. I have taken full spines on patients like this - for trauma, so it needed to be done, but it takes a lot of time and energy and is a challenge and a half.

I am gentle and patient. I always address the patient by name, regardless of whether they can respond or not. Other people aren't, but that isn't a topic for this post. The process is a lot more uncomfortable for the patient than I can get across in writing. They don't understand why somebody is hurting them, or telling them to do things that they don't want to do.

To top it all off, most of these x-rays are normal. It was a screening exam for a patient, and may have been much more acceptable if the patient would have a better outcome and prognosis with treatment. Extraordinary measures for patients who are not going to understand what is happening and have bad prognosis - well, that is just cruel. I have heard it referred to as "atrocities" in medical circles, moreso when talking about extreme medical intervention for patients who won't recover and should be make comfortable, but it is a similar principle.

I often wonder whether the doctors who order these would think more carefully about whether or not they needed them if they knew what we have to put the patient through in order to get the images. One of my favourite physician teachers told us that you should know (or at least suspect)the results of the test before you order it, and you should always be able to give strong reasons for every test you order.

Obviously the doctor is the person responsible, which is why I do the best images I can for them, so that they can decide where to go from there. I just can't wait for the day when all I do it the physical exam - it is a breeze compared to the imaging, particularly for the patient. It would also be nice if the doctors had any idea about what they were asking us to do to their patient. Not all chest x-rays are equal.

At the start, I found it really hard to get back into imaging because you have to make people uncomfortable to get diagnostic images. I shied away from making patients experience pain. It isn't pleasant, and I won't be upset when I don't have to do it any more.

We still won't be finding out whether we have passed for another week and a half, which is a bit cruel, but probably convenient for me - I will be finished my first stint of work and can celebrate the end of that and either celebrate or mourn the exam results, depending on the outcome.

It is nice going back to the area I worked in before I did medicine.

It is an area that I actually really enjoy and have seriously considered specialising in. The doctors I work with are very encouraging, and have always given me a lot of support when I thought about jumping ship into MBBS-land.

I was a radiographer for a few years before going back, so going into radiology would seem like a natural progression. I like talking to patients, but there is also something exciting about making a diagnosis from images.

The technology is absolutely incredible, as is the pathology (when it is there) and the anatomy isn't too bad, either. The advances, particularly in MRI, are mind-blowing, even since I started work less than a decade ago.

One major concern that I have had about this field is that it is reputed to be very hard to get into. I am still dealing with feeling quite inferior - my results don't reflect this, and my image interpretation skills are certainly well and truly about the rest (for obvious reasons - it really is an unfair comparison). Because part of me lacks confidence, I often talk myself out of pursuing this.

When do you get to the point when you say to yourself, "Sod it, I'm going to go for what I want anyway!"?

I have changed a lot in the past year in particular. I'm a lot harder and tougher. I'm much more pushy and I say what I mean a lot more than I used to. One area I have noticed this more is with the nurses when I do ICU mobile x-ray rounds. I am never mean and am always respectful and helpful, but I am more inclined to say what I need, and when one of them is really grumpy and rude to my face because they don't want to move their patient for an x-ray, I'm more likely to start poking fun about it (all in a respectful manner) rather than just rolling my eyes and being another bitter radiographer. I guess my communication skills have improved a lot. (Note to others who haven't seen this in action - nurses can be REALLY rude to allied health staff. It is not professional or mature to give the radiographer shit when they are only there trying to help your patient, too.)

I have noticed that I'm a lot more cynical. I have to try not to death-stare salespeople when I'm dragged along to Tupperware parties and they start talking bullshit. (I don't care how much food you put in that Day-Glo orange salad bowl, it will NEVER look anything other than fracking ugly.) We re-watched Death To Smoochy the other night, and I spent the whole movie laughing at the Smoochie character because he was such a twat rather than feeling bad for him like I did when I first saw it a few years ago. Is this cynicism or realism? The character actually IS annoying - I know that is the point. Perhaps I'm just more grounded.

I think that by the time I finish, and particularly when I start working, I'll be ballsy enough to say what I want and go and get it. I know I can do the job well. It is just a matter of chasing the dream.

So much of the time I have to be careful that I don't talk myself out of what I want because I am afraid I'll fail. At least I'm aware of this. If I were guaranteed to get into what I wanted to, what would I do? Radiology would be right up there. I don't think it is an impossible plan.

Surprised but not really

People are really stupid.

Really.

Woman admits killing sister over hair straightener

Done and done!

Well, we are done for the year!

The exam was okay, but really a little non-specific. Thus, whether or not I pass or do brilliantly depends entirely on the marking guide and who looks at my paper.

One of the questions asked us to draw a diagram illustrating the rule of 9s in burns. I feel a little embarrassed that I didn't memorise that one prior to the exam. At least I remembered that the genital area is worth 1% and that the back and front are 9% each (I think). Meh.

Without being immodest, I studied really hard for this one - harder than for any of the other areas. I don't know if it paid off for the exam, but at least I now know a lot more about surgery than I would have otherwise, and feel much more prepared for internship and to be a doctor. After all, isn't that what really matters?

Hopefully we will find out soon whether or not we need a resit. I think my paper would get through a remark if it doesn't pass muster first time. Plus, I don't think I can learn any more than I did, so even if I do need a resit, it won't involve 12 hours of study a day.

Hooray! Bring on Christmas and fourth year!

Study Bunny

I am working my way through multiple textbooks and now the School of Medicine's Voice-Over-Powerpoint presentations.

The surgeons have put some serious effort into these, and they are really good. I'm impressed. :)

In three days time I will be finished third year. Even if I have to repeat surgery (which I would like to think is unlikely), I'll be a fourth year as of next year.

I have been focusing on taking things step by step the whole way this year, so this feels like it has come along really quickly. While I'm excited for the other bloggers and my friends who are finishing fourth year, part of me is still glad that I have another year to consolidate and learn more before I get that MBBS added onto my name.

I have learned so much this year that it is astounding, and I'm looking forward to learning more next year, too. Plus, we get to do paediatrics, emergency and O&G (which I think I get two of due to my med spec choice), which I'm thoroughly looking forward to.

So close!

So close

I did the take-home exam this afternoon. With the aid of Apleys Concise Textbook of Orthopaedics, and my favourite mentor, Dr Google, I think I passed this one.

Now for the big, nasty exams at the end of next week - the ones that people don't go so well in. I have worked hard this time, so my fingers are crossed.

I just need enough energy to get over the line and it will all be happy dancing and pixies, at least until results come out.

Ploughing on

It has been a week and I feel like I should write another post.

Surgery continues to be trying. I like the staff, but there are so many demands on our time. This would be merely inconvenient by itself, but we also have a large exam looming next week which is well known for its high failure rate.

More than half of the previous group who went through needed to either get their papers remarked or resit a section of the exam.

I am working hard at studying, and have been for the whole rotation, but I hold no illusions. I'm going to walk into this one assuming that it isn't going to be marked so that I'll pass.

In a way, this takes the edge of my anxiety, but makes me cynical and exhausted at the same time. I want to spend my holidays having a break from being a medical student, not studying for a supplementary exam. Oh well. Fingers crossed.

Enough

I have really and well and truly had enough of surgery rotation.

If it was just being in the ward and doing ward work and assisting in theatre, it would be fantastic.

It is all of the rest of the crap that I have had enough of.

Just bring on these stupid exams already. I want them done.

Stupid times - when stupid ideas succeed

Tradition has it that there is a curse - "May you live in interesting times."

I don't know what we did in order to deserve the current state of affairs, because proof shows that not only are we in interesting times, but we are in stupid times, too.

Weird stuff has been happening in the past couple of years that reminds me of the kind of things that would happen in the 1980s, and I now think that we live in a decade that is basically 1980s + technology.

For instance, this man, who lives off selling advertising on the front of his t-shirt. Anybody sensible would think that this is a stupid idea, that he needs to get a real job, and that his role in life as a walking billboard would not only fail, but be monumentally unsatisfying and contribute next to nothing to a society already filled to overflowing with the effluent of consumerism and greed.

It is a sign of the times that his business is expanding and he is making a solid profit.

See? It is like the 1980s. Bring back the 1960s, please. I have already lived through the 80s once. It is a shame that there is too much profit in it to force it to go away.

I'm not even talking about other stupid things, like vaccine conspiracy theories, the re-emergence of magnetic therapy, thermal imaging and sensible people being swept away in the flood of bullshit dressed up as fact that can drown the unwary on the internet.

It is the little things that really push us over the edge. It started with crocs. Well, maybe it didn't, but I blame crocs. Somebody came up with an idea for plastic shoes with holes in them, and it took off, and now everywhere I look, I see people who would otherwise be sensible individuals who are wearing the ugliest piece of footwear known to man.

Bare feet make me cringe, but not as much as crocs do.

In a million years when all there is left of the planet is plastic, aliens will arrive, point at the piles of crocs and work out that not only were they the cause of the downfall of civilisation, but that it was fortunate that we were already gone when they got here because creatures who create these have no place in an intelligent solar system.

Yes, I'm bitter. I blame surgery rotation. Bring back psychiatry and GP, please, I want to hang out with patients and talk about care plans, babies and not have to worry about five million eponymous syndromes, and wonder about who the hell Pott was and how he got so many nasty things named after him in amusing ways. (A peculiar tumour AND a puffy tumour? What a legend. If there is a question in the exam that I have no idea about, I will answer, "Percival Pott's puffy tumour.")

Surgery Rotation, start of Week 5

I am completely and utterly exhausted. Time to take a small break.

The problem with medicine is there is an infinite amount that you can try to study, and a finite amount of time and energy in the day.

Sometimes it does the world of good to take an evening off from study. Fingers crossed that I wake up feeling better tomorrow morning.

Surgery Rotation - End of Week 4

Surgery rotation is going well. We are being involved and learning things.

I'm glad that I already have skills like cannulation and phlebotomy under my belt from earlier in the year, as it is one less thing to be concerned about learning.

We are also at a slightly smaller hospital, so we get to scrub in and assist the registrar from time to time. I can actually enjoy a little bit of scrubbing in and assisting. After a while it wears thin, but I think I'll be alright with a bit of it in the next few weeks, and then maybe again when I'm an intern and need to help out.

There is nothing much new to add. I'm still trying to learn a lot (well, enough to get through) and work hard, because we have a lot to do during the week.

Today I helped out in preparing some second years for their MSAT exams (Multi-Station Assessment Task) and took part in a mock exam. It was quite fun and it really sank in just how far we have all come in the space of a year.

The students weren't bad (a few of them were lacking in confidence) but you can see that they REALLY need personal attention and teaching from people who actually know what they are doing. It is one thing to learn a technique from a list on a piece of paper, and another to actually see that technique demonstrated by an expert.

This is just the way medical school works. You spend the first two years learning the theory behind things, and then you get to see it in action and try to understand how it REALLY works in the following two years.

I always think that it is unfair when people expect you to know something that you haven't actually been taught, specifically when these things are practical skills that you can only learn when somebody who knows what they are doing passes these skills on.

One of the problems with the massive increase in class size in medical schools in this country is that we aren't getting the personal attention that we could have received in previous years. It just isn't logistically possible.

This isn't so bad when it is in the first couple of years of medical school, but the potential for there to be so many interns, residents and registrars that we don't get proper teaching is there and it is a horrifying thought.

My fingers are firmly crossed that it doesn't come to that, but you can't have a huge leap in graduate numbers in such a short space of time without the system failing at some point. I still think I'm ahead of the biggest increase in the next couple of years. Fingers crossed.

Yet more medical school bitterness

Assignments - I never do well on the ones that I expect to, and I somehow ace the ones that I wonder are going to be good enough.

I can never tell which ones will be which.

I got two results back this week. One was for an assignment that I did a lot of work for on the main project itself, but did the write-up very quickly and wondered afterwards if it should have been more "academic".

The other was for a group assignment that I did, where we all put in a fair bit of work together. As group assignments go, you all put in work into the one thing and hope your side of the work doesn't let everybody else down.

I aced the first one and got a mediocre mark for the second. Funnily enough, I would prefer it to be the other way around, because I'm dissapointed for the group. I know how we all worked on this one.

I guess passing is the main thing.

Surgery Rotation, End of Week 3

We have just finished our first week of general surgery, and I'm exhausted.

It is much more interesting than orthopaedics for me, mainly because there are so many medical issues involved with the patients. I'm not overly keen to scrub in, mainly because I don't find the process of surgery very interesting, and I would rather be free to wander the room (not to mention gossip with the nurses/anaesthetist/techs - maybe this is why I have never had a problem with theatre staff ;) ) rather than be tied to the sterile area with my hands tucked away or on the patient.

We have been doing longer hours than we were in orthopaedics, and even though we don't have a lot of responsibility, we can help out and run around and see a lot of things. There are also tutorials to prepare for and present, and assignments to write. Overall it is a pretty busy rotation.

I have also been cutting back on the amount that I'm eating. I'm trying to find the happy medium where I'm eating enough, but still eating less. I have lost quite a bit of the weight that I have put on since starting medicine over the past few months, and that has accelerated in the past two weeks since reading French Women Don't Get Fat.

It is amazing how many extra calories you can fit in by eating everything on your plate even after you are full, and by snacking in between meals. When you stop those things (if you do them), the weight just starts to come off by itself. You can still indulge in a little bit of everything, just in moderation. I'll always be a three-meals-a-day girl, and I'm addicted to breakfast.

Sadly, cutting down on calories and being in deficit also makes you a little bit more tired. Oh well. At least my pants fit better now. I am a happier person being a little tired rather than walking around in a skirt/pair of pants that are a little too tight.

Another strange thing has been happening to me all this week. I keep running into people I have worked with before in my former professional life, some of them for more than two years, and they don't recognise me at a glance as they walk by. It is really off-putting. I suspect it is the fact that I am in professional clothing rather than a uniform or scrubs. When it happens once, twice or even three times it isn't so bad. But when it happens continuously with just about every other person you worked with over the last two years of your working life - well, that is off-putting.

They recognise me when I stop them to say hello, which is nice. (I only do this when we are stopped for coffee or not going in opposite directions down a main corridor. I'm not that anxious for recognition!) Perhaps I just pay more attention to the people walking by me. It could also be that I'm excited to be back in the hospital I used to work in, so it is more than just another work day for me. It is nice to see them around.

Surgery Rotation, Week 3

Surgery is okay. I don't love it, but I find it interesting.

I wonder if this is how the people with whom I did my psych rotation felt about psychiatry?

We did our rotation at a hospital where they have good teaching for psychiatry, so a lot of the students enjoyed it, even though it isn't what they want to do.

I quite like the practical aspects of surgery. My brain works fairly well that way, too. I am just not a surgical person, if that makes sense. I want to be the one in the room talking to them about their depression because they have had chronic physical illness, not the one treating the illness with surgery.

Still, I'm enjoying the reading. I am also really enjoying the specifics. I like zeroing in on an area and concentrating on it. I'm not much of a lover of the general nature of GP or rural rotation. I can understand how other people would enjoy it, but it isn't for me.

I think I would be keener if it weren't so late in the year and I didn't feel so completely exhausted. Rural took it out of me even more, and I have noticed the exact same thing in the others around me.

Bleh. Almost there. I'm just grateful that I get a break at the end of the year. I'm going to enjoy it while it lasts.

Things I'm looking forward to #1

I was thinking this morning about the things that I am looking forward to when I graduate and become a paid doctor.

One of them is definitely going to be attending conferences.

For some reason, I have never really been to a proper conference before. I could have gone in my past profession, but I already knew that I wanted something else, so spending money traveling and attending these as well as taking leave was not something I wanted to do. There was also the issue that for the first couple of years I was working, I was quite junior on staff in a department that preferred letting their more senior staff attend.

I got to go to weekend educational sessions, which I always enjoyed.

As a medical student, we have had the AMSA conference every year, but to be blunt, this seems to be more of a massive week-long party than a genuine educational event, and I could never make it a priority. I am older, in an established relationship, and am an introvert, so the AMSA conference seems like my idea of a nightmare.

Next year the AMSA conference is going to be in Hobart. I'm seriously thinking of going down to Hobart the week before, for the Global Health Conference. I have relatives in Hobart who I could stay with for a week who live in the centre of town. It would be nice to get away and attend this. It also doesn't cost the earth, which has been another prohibitive factor in potentially attending these things as a student.

It is something worth thinking about.

I am also wanting to attend at least one conference in my intern year. I'll just have to find one to attend before I put in my leave preferences for intern year so that they hopefully match up.

What is it about conferences that I'm looking forward to? I'm not sure. Things are so shiny and well-presented most of the time. You get to spend your whole day focusing on areas that you are interested in. If you are lucky and they haven't changed the laws yet, there may be freebies from sponsors.

I'll have to see what it is really like when I get there in 2011.

Addendum

I thought I should add that I was asked not once, but twice the other day what I was going to become after saying that I was a medical student.

After telling him what I was studying, a security guard asked me if I was a nurse and which ward I worked in. I said, "No, I'm a medical student, and I'm on the surgical team." He looked confused and ticked the "nurse" box. It was for a survey that I had to take before being allowed to get into work via a certain entrance, so I couldn't be bothered correcting him - his head may have exploded with the insanity of this topsy-turvy world where they allow females of child-bearing age to attend university and get an ed-u-cay-shun.

I was talking to a patient, and she asked me what I was a student of. I explained that I was a medical student, and am studying medicine. She asked me whether I was going to become a pharmacist or something else. I explained that I was going to become a doctor, and she was okay with that. I think in her case it was probably just a misunderstanding of the education process.

In the past I have been asked many times whether I am going to become a nurse after I have said that I'm a medical student. Now I just explain pleasantly that I'm going to become a doctor, sigh on the inside and move on.

I don't look young. (I'm no longer in my early twenties.) I dress professionally. I wear an ID. Perhaps I should wear a stethoscope more often, but something tells me that this isn't as awesome as you might expect.

MSILF is right - the revolution is far from over.

Surgery Rotation, Week 1

Surgery has been interesting so far. I know it isn't for me, but I like the theory and reading about the pathologies. I have decided that surgery is really quite revolting. I'm talking about the object of surgery (blood, guts and other random body bits), not the actual surgeons or surgical process, although the process can be quite . . . disturbing. They do things to the human body that go against all of my instincts.

This says a lot about me, too - I am intuitive and empathetic, so watching orthopaedic surgery really goes against my grain. I don't feel sick, have seen a lot of it before in my previous life, but it just feels really wrong. I have been told that I am quiet and reserved (usually by pushy people who I don't like, so who knows if it applies elsewhere), and I don't run around the place hugging patients and wanting to be their friend, but I also don't like causing them pain. On an intellectual level, I know it is helping them, but on a gut-level, my inner voices says no.

I'm glad they don't show patients what a joint replacement looks like before they get one done. If I ever have to counsel a patient who is going to get a joint replacement, I would strongly advise against looking it up on You-tube, or there other video-sharing sites. If you hadn't seen much surgery before, and were watching a procedure that you were about to have done on your own body, it would terrify you!

The results are fantastic (when all goes well), and I am lucky enough to have seen this and spoken to the people who have had joint replacements change their lives and give them access to activities that they hadn't been able to do for years. It often goes so well with one joint that they leap in and get the opposite side done soon afterwards. It works, and is a great way to give people back their mobility. The actual process of performing the surgery isn't for everybody, and it isn't for me.

Psych is still at the top of my list of specialties I want to do. I try to attack the plan as critically as possible, because I don't want to leap in and then decide that it isn't for me, but at the end of mixing it all up, psychiatry still lands on top.

I have some nice friends who bear the brunt of this, and I hope they don't think I am too flippant or chaotic. Sometimes I worry a little that I do a big anxiety dump on them, and that is what it is - a huge vent. Hopefully they won't get sick of being a sympathetic ear. Sharing the load helps.

I really enjoy the content of psychiatry, I love talking to patients about their life experiences and what they are going through, and then analysing this and putting it all together in one huge concept of cause-and-effect and results that are open to change at any moment. I just kind of assumed that most people felt this way, but they don't. That is okay - it is a varied and interesting world, with room for surgeons and shrinks!

A new page

My brother and his fiancee have set a rough date for their wedding. They will be tying the knot in twelve months time. I'm excited by this, because they have been together forever (roughly eight years), it means to much to them, and because it means the prospect of more nieces/nephews in the very near future!

I love small children, but I also love giving them back at the end of the day. I'm looking forward to having kids myself, but am in no rush to do so. I like children when they get to the age at which you can reason with them, talk to them, and have more fun. Cooing over very little babies is lovely, but I find it much more rewarding to interact with them when they can communicate back.

Having the wedding in twelve months time also gives me a great motivator to get back into shape. I exercised every day for months prior to my wedding, ending up with really toned arms and good level of fitness. I want to use this to get the impetus to get back into really good shape and exercise very regularly.

I know that I have surgery rotation next, and it could be time-consuming, but I think that it is very important to make exercise a central part of my life, much like sleep and food, and I'm taking this opportunity to get back into shape.

The sad fact is that it is now nearly eight years since I got married, so it may take me a little more time, but that is okay - I'm in this for life. :)

The End of All Things Holidays!

I had an "interesting" week off. We had a huge assignment to do, so I spent a fair bit of time either thinking about, doing or avoiding that. They give us "holidays" in this course, but fill them up with things that we are supposed to do while taking time off.

I can't wait for real work, when you get to spend your breaks travelling and getting away, as opposed to doing assignments, studying (depending on where you are in training of course) or working a paying job so that you can afford to continue to study.

I also spent quite a bit of time cooking and re-acquainting myself with my house and cats. This was quite lovely. It is incredible how quickly you get used to living differently and so when you arrive home with fresh eyes, things seem strange and exciting.

I have also changed a number of things about our house this week (minor organisational details), cleaned out some cupboards (spices from 2003 probably don't taste very nice) and relaxed.

Not having been to the gym for a couple of months, I went back again this morning. I did a Pump class, which is a group weights session with a high number of repeats and low weights. I haven't done it in a while and so I was SORE afterwards, and no doubt will be quite sore tomorrow! I also remembered just how much of a challenge it is to wash your hair when you don't feel up to lifting your arms above your head.

Things are getting back to normal, and it is just lovely. All that remains is for The Man to get back from working far, far away, and I will be happier.

The drive back

We had a wonderful drive back from rural. My father flew up to the rural city to drive back with me and so we left-mid morning. (The Man could not be there because of work commitments elsewhere.)

It was a nice drive, and it felt a lot more relaxed than when my husband and I drove up there the first time. It had a lot to do with the fact that I'm was going home, and that there was no particular rush to the destination.

It was a six hour drive, and as it went by the landscape just got greener and greener. It went from being all brown, dry and dead into green farmlands full of crops and the occasional forest.

Half-way back we took an alternative route and ended up traveling through cattle country and a lot of produce farms, and it was so nice to look around at the scenery. My favourite game is to try to guess what the crops are. I grew up around strawberries, sugar cane, pineapples and bananas but didn't see any of those on this trip. The single crop I was sure about was the mandarin trees, and we think we spotted some onions, but the rest just looked green, lovely and unidentifiable.

At one point the road got narrow and we were driving through cattle fields (on the road, of course) across cattle grids and got to slow down and keep an eye out for big beautiful beasties wandering across the road.

We had a very interesting moment when we came across a massive bull standing in the middle of the road. We came to a complete stop to see which direction the bull was going to go in, but he just stood there. Beeping the horn would have been a bad idea - he was big, intact, and may have been very territorial.

We were going to drive behind him, but then another car came along the road and the big bull moved out of the way in the direction that we were also going. We stopped, let him and the other car passed, waved to the other car as is the country way, and then we were able to drive onwards.

There were a lot of cars on the main road, but it was mostly an uneventful drive and we arrived at my parent's house in the late afternoon. We had a wonderful evening and I went home the next day to a marvelous feline reception.

I'm still not entirely unpacked, but it doesn't matter - I'm home!

HOME!!!

Rural rotation is over. Thank God. I am home and am happy again. :)

I now have a small and furry fan club following me around everywhere, which is very sweet.

Unfortunately the dust from the storms is still blowing around, so my eyes get itchy (I have very sensitive eyes) and my nose is a bit runny, but I don't really mind. I am simply happy to be home.

I'll tell you the story of our trip back in another post, but for now, I have to rest and enjoy life. :)

One more sleep!

One sleep to go!

Our exam is today. I should be more nervous about it, but I just want to go home.

At least other people will be around me studying this morning so there will be some motivation to study. Joys.

Week 8 of rural

Two sleeps to go! Two sleeps to go! Two sleeps to go!

Then I drive home!

Not that I'm excited or anything. I still have to hold myself together for long enough to pass the exam, before I snap and spend the afternoon racing around screaming with joy.

The end of Week 7 of rural

It is the last night at our rural placement!

Tomorrow we are going to be driving back to the central rural location, have a week of talks with an exam at the end, and then I get to go home.

I can't believe that it is almost over. I'm kind of proud of myself. I have never been away from home for such a long stretch before, particularly not by myself. (I know I'm with other people from the medical school but that isn't what I mean.)

I have even gotten into the habit of packing multiple days worth of lunch salads in one go, and even doing the same for dinners - it takes up less space and saves time later on, plus I'm never stuck without lunch. :)

It makes it easier to say no to takeaway when you already have a nice dinner in the fridge, and you know that the dinner will be tastier anyway.

I can't wait to get home again. I have missed my family so very much. It will be lovely to get back there and actually be able to STAY longer than two or three days.

I have also missed my kitchen more than I can say. The oven here doesn't quite cook right. I cooked a lovely Leek and Cauliflower Pot Pie tonight (from Veganomicon - yum!) and the biscuit topping didn't quite cook through.

The washing machine doesn't clean very well, either, but it is better than nothing.

We have been walking distance from the "city centre" as well as the pubs, which has been a bonus. It is nice to not need a designated driver or taxi because the pub is five minutes walk away!

The Man will be away for another week when I get back, which is sad, but at least I will be home. :)

So close!!!

Eddie, you legend!

I have always been a huge fan of Eddie Izzard. What is not to love about the cross-dressing, razor-witted comedian and actor?

Now I think he is a bloody legend. 43 marathons in 51 days, all for charity. I just hope that he hasn't hurt himself too badly. Run, Eddie, Run, indeed!

Random career thoughts 2

I am starting to think that it would be a good idea to take my time getting into a training program.

In Australia, we do a common intern year, then most people do a residency year and normally you slot into a training program after that as a registrar. Some people take more time than that to get into the program that they want to get into, as some of them are highly competitive.

Some people change programs after a couple of years of training in one, and start again in another.

I had planned on trying to get into psychiatry ASAP, but part of me really wonders at the wisdom of this.

I am still not 100% sure that this is the direction that I want to go in. I enjoy clinical medicine, too, so I don't know that I want to leave it as much as I would be if I went into psych.

I'm starting to think that it might be a better idea to just see what happens as I go and take my time making my decision. I have gone slowly in every other decision in life, so why should this be any different?

Rural rotation week 7

I'm back for my final week in the rural town - the week after this one will be a common week where all of the students on rotation return to a common rural town and "debrief" for a week, which ends with an exam.

This week I have to finish the assignment for this rotation and prepare a case presentation. I have the information on the case, and so now the main task at hand is to do the assignment.

I'm looking at this week the same way I would look at a race - goals for each step of the way (daily assignment goals), rewards for finishing goals on-time (BEER! and movies) and a plan with enough free days at the end that if I go a day or two over, the world won't end.

If I can fill my days with this it will all be fine. :)

In food-related news, I also splurged and bought myself a proper knife! It is a Furi East West 13cm knife with a silicon handle. When I was at home on the weekend, I realised just how nice it is (and how much safer) to have a decent blade, so I spoiled myself and went to the local gourmet store and picked one up.

Normally I would have brought one of my own back with me, but I was only bringing carry-on luggage and I thought the people at the airport would get excited if I tried to smuggle a massive knife on board, no matter how honest or reputable I look.

I also picked up half a pumpkin (Queensland blue - very tough) and a sweet potato, and will be roasting some veggies tonight to go with dinner. You can't buy a new knife without testing it out properly. ;)

Back on the topic of airports, I got tested again for bomb residue before the flight back home. I have a theory that they pick people who look them in the eye and won't care about being scanned. Either that, or it is proven that terrorists look nonchalant and relaxed, too. :P I don't really care, and find the whole thing pretty funny.

The long, draging days

I am home again for the weekend, and it is lovely. I bought some cheap flights a few weeks ago, and I am so glad that I did. Monday morning will come far too soon, and I'll have to fly back to the place of dust, heat and noise.

Only two more weeks of this, and then I can rest in my own bed for good.

I thought that the hard part of rural would be different. I thought I would be more actively sad.

Instead, I find myself to be constantly tired, having trouble sleeping, and feeling worn down by everything. Resting isn't refreshing. Early marks don't have that same thrill - I am going "home" but not really going home for the evening.

I can't be bothered having afternoon naps when I get the chance.

I am not thrilled about things that I would normally be excited about.

I feel like one of those little children who is so tired and is completely miserable, but won't or can't go to sleep. The ones you see wandering around half out of it, rubbing their eyes and glaring at everybody. You tell them to go to sleep, and they yell, "NO!", run elsewhere and continue being miserable and tired.

I know I miss home a lot, miss the people and that these feelings are completely normal. God it's tiring.

The rural place I am at is really good. Thankfully.

If it weren't, it would feel like I'm in purgatory. Yes, I'm being dramatic. Remember, I'm the sulky little kid who won't go to sleep. ;)

Flying home!

I'm flying home for the weekend. It is very exciting.

When I get back here to the rural place, I will have a week and a half and then rural rotation will all be over.

Assuming, of course, that I haven't failed and don't have to repeat the whole thing. God, don't let me have to repeat rural rotation!

All of us last night were joking that we would have to repeat the rotation, and could do it all again, together, all at the same time and here again. As much as we get along, the looks of horror at having to spend this time out here again as students were priceless. :)

The most that I have gotten out of this experience is a perspective on how challenging working rurally can be, and a fairly consistent ability to put in a cannula.

I also got to spend a couple of days with an awesome anaesthetist, who taught me how to put in LMAs, ETTs (i.e. "tube" people) and guided me in a brachial plexus block. I found anaesthetics surprisingly interesting. I'm hoping to spend some more time with the gas people next year - it was very scary, but also awesome at the same time.

Got to go and get ready for the day. I have a 90 minute drive to the airport tonight, then an hour flight home. I can't wait!

Knowing me I'll be extra early for the flight, but that is okay - I have a good book and some things that I can study, so the time should go by quickly.

Sh!t

Just when you think you are secure and confident, over that nagging self-doubt and sense of inadequacy that plagues you since high school, one seemingly small thing can bring it all crashing back.

Stupid marks, stupid random evaluations, stupid prizes, all working together, stupid me for letting them mess with me.

I know who I am. I know how hard I work and what I know. I know that I have never been The Best at certain ways of thinking that fit into the box enough to get Perfect Marks (except in things that require lateral or divergent thinking, but no exam anywhere tests that). To be honest, I know I haven't worked as hard as others this time around, either.

I tried so hard in high school, was in so many things, not to get recognition, but because I enjoyed them, thought I did them well, and thought they were worth doing them. I would wander along, being happy as I was.

I was VERY involved in both music and academia. There weren't many musical groups that I wasn't a part of, I did a LOT of solo work (music was my first degree at university) and I also did well at school. (Yeah, I see myself in some of those geeky kids in Glee. What of it? ;) )

Then the end of the year would come around, and the Popular kids, the ones who were Cute or Funny or who were Buddies with the teachers would get awards for being upstanding, for participation, but those of us who did the bulk of the work would be left swinging in the breeze with nothing.

Shiny people get rewarded.

The recognition didn't matter in the first place. So then, why did it sting that it never came my way? Probably because the very fact of the existence of these pathetic, small and petty awards put a value on something that could not be quantified, something that I knew (by mere adding and observation) that I was far better at than the kids who were thanked and acknowledged, but I was ignored.

It is hardly a unique experience, I'm sure. Lots of the not-so-pretty and not-so-cute and not-so-outgoing people go through their lives, living with the bitter fruit of not being the "ideal" person in a society created by other people.

At heart, I have learned to be less bitter about this, have become cynical and worldly about this sort of petty award-giving over the years. I like to think that people I know would have no idea that this is how I was, or that I would not feel that way now.

Medical school brings some things back that I wish were left buried. This is one of them.

I never really thought that I would care about medical school awards, don't work hard for them, and to tell you the truth, I don't really want them. It is just the old feelings that they drag up deserve to be looked at, acknowledged and then laid to rest.

If I REALLY cared about this kind of thing, deep down, then I would be an entire other person and act in a very different way to how I do today. This probably isn't a bad thing. I have other things in my life that matter to me just as much, now. Being a whole person is much more fulfilling than having a random award on my wall or in my CV.

Am I jealous of those who are capable of being that bright, or working that hard? A little. Well, more than a little.

Am I happy for them? Certainly.

Could I do what they do? No. Good on them.

If I can't, should I really be here? I like to think so. Surely there is a place for bitter lateral thinkers with lives outside of medicine in the scheme of things. I hope so.

On the bright side

I feel like I should add this after the last post.

I have gotten to read some awesome books.

I have gotten back in touch with some things that are important to me, and had some time to think.

I have realised how much the people I live with and love are important to me. (Cats are people, too.)

I have seen just how much the cats miss me when I come home - you know that you are missed when even the antisocial scaredy-cat comes crying to you when you get home. Or when they realise that you are leaving again, the the antisocial cat hides and the others pile themselves on your baggage/clothing/self nonstop.

I now know how nice I have it at home.

Two bathrooms between two people is a luxury. A wonderful, indispensable luxury.

As is having a bath.

And having a decent television, and a digital set-top box.

I have landed with three really nice flatmates who have made this journey a lot more bearable.

The hospital staff are nice.

Not being in traffic for two months has completely and utterly spoiled me.

We have air-conditioning here. I wonder if they would miss it . . . . (Kidding!)

I have saved money on fuel and morning coffees. (There is no cafe/coffee cart at the hospital.)

I have realised how happy I am to just be myself.

The end. :)

Hissy fit

Time to throw one.

The curtains in my flat don't block out the light.

The trains wake me up at all hours.

I feel like crap.

The washing machine leaves big patches of linty stuff (probably dead skin or fluff or both) on my clothes.

It travels around the kitchen as it cleans.

The kitchen is shit.

The knives are all blunt.

The ants are invading.

The television is tiny.

I don't have enough personal space in a tiny flat.

I miss my home.

I miss my cats.

I miss my significant other.

I miss decent take-away. Well, better take-away.

I miss shopping on Sundays.

The bogans who live behind us have too many babies at whom they swear when they won't stop crying. (Parenting tip: Screaming "Shut up you little fucker!" at your baby will not lull it to sleep, no matter how many times you repeat it.)

The bogans have too much bad music.

The bogans play their music FAR too loudly. I have to close the windows on that side of the building. Thus, I get no breeze through the flat.

I'm sad.

I'm tired.

I feel like shit.

I have had enough and I want to go home.

Now.

Not in three weeks.

Now.

The end.

So. Tired.

I am so freakin tired. I don't know if I'm getting sick, or if I have just been overdoing it.

Time to get some sleep this weekend, I feel.

Edited to add:

It is the lack of sleep. I just can't get good deep sleep where I'm staying - it is on the ground floor, near a busy road and next to a train line.

Time to cut off the caffeine and take up the earplugs and air-conditioning.

Randomness

Life is going well. Things are interesting.

I'm trying to get back into eating well and exercising, and am mostly succeeding. I need to eat more veggies - I feel so good when I do.

It is quite funny - the more I see of other specialties, the more I just feel like psych is the right way to go, even when I enjoy the day in the other specialty.

There are some interesting things happening with intern and resident numbers in Australia right now. Many hospital offer more places for interns than they do residents (aka PGY 1 and PGY 2), meaning that some residents will need to find other jobs at different hospitals, or become unemployed.

It is a scary situation. Fortunately there are still small places that employ more residents than interns.

This is a random post because I have had an exhausting day. Good, but exhausting. I enjoy surgery, but it really isn't for me.

Med school hell

I'm posting a lot more on the new blog, but thought I would put a quick one up here just to say hello and mention that I'm still alive and kicking.

I really like this post on the Happy Hospitalist blog. Med school is hard work - not only mentally, but it can take a savage toll on your emotional and physical health, and your relationships. It can be hell if you are not ready for it, and can still be hell even if you are prepared.

For those of you who are going to be starting medical school next year or in the next little while, get your stuff sorted NOW, and get it sorted well, because it can all fall in one big heap when you get sucked into the living vortex of shit that is medical school. It is wonderful, but is also terrible, all at the same time. Enjoy.

Post-weekend debrief - start of week 5

I went home for the weekend via the regional train. It was lovely to be home for a few nights, but ended up being quite bittersweet (an excellent word suggested by someone more literate than myself).

Not being around my family and husband has been quite difficult for me. I'm so used to having him next to me, living our lives side-by-side, not always doing the same thing, but always in proximity.

The cats were VERY cute. Mr TGWTBS has been coming and going for work quite a lot recently, and so the cats have learned what it means when somebody is packing a suitcase at night.

They were very excited when I came home, but were upset when I was packing to leave. My big boy cat who is quite reserved was all over me, headbutting me, climbing all over the luggage, and sitting on me whenever he could. He is a darling, and he clearly misses having me around.

Coming back was very hard to do. I was at home, enjoying the space, company and comforts. Now I am back here in my little flat right next to the train line. There is not much novelty any more, so it has lost that sense of suspense.

God, I miss my kitchen.

We are also not a part of a specific team here, like we were on the last rotation, and this makes it harder to get keen and involved. It is as if we are floating between different areas, having a quick look and then moving on.

They are friendly, but it is hard for them to get to know us, and for us to know them. We are just another group of students moving through, to whom they can pass handy bits of information when they think of them, but who will be gone again before they can blink.

I'm not so worried about this any more. In my last rotation, I put a lot of value on my practical marks, and what my supervisors thought of me. Now I am happy passing, as I realise just how subjective practical marks are, and how little they matter in the long run.

It is a long trip back, but I have been sorely tempted to try to do it again this weekend. Unfortunately both money and time are against me. Oh well. This isn't for much longer - I'm more than half-way through.

Not. Happy.

I phoned my better half this morning. He got home from a business trip away to find that the cat sitter had locked one of the cats out of the house, away from all food and water while we were away. We aren't sure how long she was unable to get inside.

We have a cat door in the security screen, and a glass door behind it. The glass door never gets closed by us, particularly in summer during hot days. She closed the glass door, preventing little Maggie from getting back inside, and locking the two boys inside (thankfully with food, water and litter). She didn't see Maggie, and assumed that Maggie was hiding from her.

We are in the middle of a heat wave. It was in the mid-30s (C) while Maggie didn't have access to drinking water.

I'm just so relieved that Maggie is okay, that Mr TGWTBS got home two days early from his trip, and that I get to see her and give her a big cuddle tomorrow. (I'm going home on a brief visit.)

Not. Happy. My poor little girl.

Two new things

I learned two new things about myself today, both of which were positive.

The first is that I can ride backwards in an ambulance without getting car sick. This was quite a surprise.

The second is that there is a level of messy that will make even a consummate slob like myself actually want to get in with a wheelbarrow and a wheelie bin and clean up a room. Yes, I felt the urge to clean.

Some houses are pretty much boxes of wood filled with piles of kindling, waiting to turn into a life-stealing blaze. It was hard to see the way that some people live. You don't need money or a lot of possessions to keep a house clean. You don't even need a lot of mobility. 

What you need is to be well enough, both physically and mentally, to move around and put things away. You need to be able to decide that things need tidying, and be capable of deciding where these things will go.

It is terrible that some people obviously need help that they aren't getting. 

Urgh

It is "winter" here. Today it is supposed to be 28C, and has been in the high 20s  all weekend and most of last week. 

Thank goodness I'm on rural rotation - I have an air-conditioner in these quarters, whereas I don't have one at home.

Other parts of the state are in the mid-30s.

In winter.

Remind me to move to Tasmania, ASAP. 

Why working in mental health is worth it

I love this post. 

Beautiful.

Hooray!

I get to spend this evening in emergency. I can't wait. 

Emergency work was always my favourite part of my previous job. I'm looking forward to spending the evening in the hospital. I figure it will either be quiet (on a Thursday night) or busier than expected, depending on what is happening locally.

I really like working up the patients from scratch, taking the history, doing the examination, thinking about what tests I would want and the management plan, and then presenting this to the doctor, and seeing what the results say, all in a short space of time. It is a lot of thinking, but it is fascinating and a challenge.

We don't get to spend much time in emergency in our course, so I'm enjoying it while I have the chance. :)

What do you think?

Should fear of litigation factor into specialty choice? What do you think?

It is something that I think about, but I don't think it is something on which I should really base career choice. 

If I were REALLY worried about it, I probably wouldn't be in medicine.

By the way, the GP visit this morning was very interesting. It still isn't me, but I liked the way that this guy practiced medicine.

I spent the afternoon chatting with the local ambos in their station, waiting for a call-out, but none came. Oh well, at least we had a good talk. I love emergencies. :)

Rural GP

This morning I am going in to do a half-day in a GP surgery. I didn't really enjoy my last GP placement - the staff were nice, but I don't like the work style. I'm not really into managing things like vaccinations and assessments for home care. It is necessary, but not me.

I'm not fascinated by managing the lives of well people - I don't have that need to control or input into the lives of others who don't need help in any kind of urgent manner. (It almost put me off psych, but psych is . . . different to this.) It is probably entirely natural that I'm not looking forward to this morning.

On the flip side, I could fall in love with the way that these people work and decide to become a GP. Unlikely, but possible. We'll see.

Medical Quotes 2

"You work in a hospital. Are you a nurse?"

My personal favourite:

"You are studying medicine. Are you going to be a nurse?"

Why don't they just say:

"You have ovaries/breasts/two X chromosomes. You MUST be a nurse!"

Clearly these are questions asked by people who have not met the awesomely kick-arse male nurses who roam the wards. 

Actually, I'm sure they have met them. They just mistook them for doctors. (Or bouncers.)

Medical Quotes 1

In a debriefing:

"She had an unsurvivable injury which, ultimately, was proven."

It was a very neat, yet sideways way of stating the simple fact of  death. 

The Girl and The Very Empty Weekend

Once upon a time there was a girl who had a blue stethoscope, and nearly 3/4 of a medical degree. She had a nice house in the suburbs, a handsome husband and three loyal and talented cats.

Then one day, she was sent far, far away by the Big, Bad School of Medicine. With her on this adventure were three other brave souls who had been plucked from their homes and plopped into the same dusty, smelly land as The Girl. They pottered along until, two weeks in, they suddenly arrived at A Very Empty Weekend.

One of The Girl's companions found herself a Magic Ticket that took her home, saving her from this wasteland and the weekend.

The two boys went off on An Adventure into the town, to see what local jewels they could discover in the dusty night time air (in a bar somewhere), and how much the local Magic Water cost.

The Girl found herself all alone, in an empty flat. She thought that she could fill the day with pottering and cleaning. However, with only herself to clean up after, and living in such a little place, there really wasn't that much to do.

So she went off on a Shopping Adventure, in which she discovered the final series of Battlestar Galactica was out on DVD. This, combined with two bottles of  Corona that had been left by friendly fairies who had been stranded prior to The Girl's visit made for a long afternoon and entertaining evening. Hopefully, wishing away the soapy aftertaste of the Corona did not use up any of her Magic Wishes. 

Thus, half of The Very Empty Weekend was filled with things that could have taken valuable time at home normally. The next challenge was filling the second half of The Very Empty Weekend. 

Should she wander off to The Emergency Department of Mystery? Or should she stay at home and attempt to explore the wonders of the Giant Pile of Books? 

One thing was for sure - there would be no adventures to the local Shopping Hole - it was firmly closed on Sundays. 

Week 2 of rural

Well, we are nearly at the end of second week of rural, and the end of the first week at the actual placement. However, it is not REALLY the first week - we have spent the entire time in introductory sessions. The whole thing has amounted to a second orientation week.

We are all looking REALLY tired, and one of the staff members joked today that it is because we have all been out partying. This could not be further from the truth - most of the time I go to bed around 8pm and just read novels. (I'm nearly finished The Satanic Verses by Salman Rushdie - I'm thoroughly enjoying it!)

Sitting through talk after talk, with long breaks in between, is quite taxing, particularly when you can't go home at the end of the day, but are stuck in a strange place away from your regular comforts.

Speaking of regular comforts, the place isn't badly set out, but is missing some fairly important things for me. Since I've been here, I have had to buy a frypan and two baking dishes (one roasting pan and one loaf pan) because there was either no equivalent here, or they were in such shocking condition that they should be thrown away! Oh well. I guess I have the luxury of that choice.

The oven is in immaculate condition anyway, so I doubt many people who have stayed here have actually baked much.

I have decided (with the approval of flatmates) that it would be awesome if we had a weekly roast. Tomorrow I'm baking, and we are going to have it all with wine. Good fun. :)

I also have my fingers crossed that after seven weeks of cooking for himself, Mr TGWTBS will be proficient and that I might get the occasional baked dinner at home. One can dream. :P

My favourite area so far has been the mental health department, because they were so keen and welcoming today, and so happy to give us guidance with what they needed (we have to do a rural health project contributing something), and are going to organise for us to sit in with one of the visiting psychiatrists.

We also had another suturing workshop yesterday afternoon. I am improving in leaps and bounds, which is a massive relief. I may not ever need to suture when I am employed and after I specialise, but I think it is important that I get proficient. It is one skill that I would like to be comfortable with.

It is my husband's birthday tomorrow, and for the first time ever, I can't be there. We'll have to have one hell of a bash the next time I see him. :)

Like the deserts miss the rain . . .

I was lucky enough to spend the first week of rural with my better half, as he was in town for work. We have been together for more than 10 years. This morning I had to drive away from him with a carload of possessions, and it hurt more than anything that I have had to do in a long, long time.

I know that it is only a temporary situation, and that I'll see him again in three weeks. The leaving was the hardest part.

Now I'm by myself in a room in a unit across from a busy industrial train line, and I feel like I have lost a limb. My partner in crime and all things fun is far, far away, and I miss him terribly. 

I know that this might sound horribly melodramatic, after all, three weeks isn't very long, and neither is the four weeks after that. However, I lived most of my childhood going from place to place, being uprooted every year or two, and never seeing my old friends ever again. Sometimes old scars resurface at the most inopportune times. Having to leave Mr TGWTBS standing at the motel, driving away with a car full of my worldly possessions hurt so damn much, and I had to try twice before I could do it. 

Thankfully nowadays we have mobile phones and the internet (bring on Skype, I say!). 

The first day of hospital work is tomorrow. Fingers crossed that it goes well. I need the distraction.

The end of week 1 of rural

Well, I have made it through the first week of rotation, and had a great time!

It is so nice being in a country city, as it only takes 5 minutes to get from one location to another, parking is easy to find (even around the busy public hospital), the steak is excellent, the streets are ridiculously wide, and everything is a lot more laid-back.

Seriously, the streets here are so wide that it is a little offputting to walk across them. I'm used to the busy streets of the capital city that I live in, where in suburbia if you have cars parked, then you cannot have two-way traffic. It is even worse in some of the new estates, where land is at a premium, and there is no room to park on the side of the road because it would block traffic.

Anyway, we had our orientation week, which was mostly interesting, but also full of things that we already know, because it is the fourth rotation of the year. I know how to give an IM injection. Really. :P

I also managed to have a vasovagal reaction when I was a guineapig for another student's cannulation practice - he was really good and it hardly hurt at all, but I still went all giddy and had to lie down. I was fine with the cannula going in (I even watched) but when he drew back and then flushed with saline, I just went all woozy. I felt like a huge drama queen, and it was all quite amusing, but everybody was really helpful without being "med students taking charge in a first aid situation". Thank God.

Everybody seems to be having a lot of fun this week, and I have had a good time, too. It is nice that Mr TGWTBS has been around and I have been staying with him, as our accomodation would be VERY crowded if I was to have stayed in the university-organised cabins. They have four people staying in a two bedroom cabin which is quite small. I'll get to experience this in our Debriefing week, so I'm not out of the woods yet.

A lot of the students have been going out to eat and see the town together. I'm thinking about going to the rodeo tonight, and we'll be going to the movies tomorrow. It has been nice and social.

I have also organised a mobile broadband modem, which will hopefully be activated as I'm typing (on the library computer at the hospital). I decided that two months was just too long to be without decent access to the outside world if I had the option of it being otherwise. I don't use a lot of data (mainly forums and blogs and the occasional photo upload) so it shouldn't cost me too much.

I'm traveling to my assigned town/small city (if it fits on four pages of the Yellow Pages map, it is a town to me) on Sunday. The people I'm staying with also seem really nice. It is interesting that there are more of us at this rural hospital than there were students on medicine rotation at my last city hospital. I'm curious about how they are going to organise us.

Anyway, this is turning out to be a lot of fun, and I'm glad.

Gone walkabout . . .

Yes, I was a child when Crocodile Dundee came out, and I reserve the right to quote any cheesy strine from the film or phrases that may be fun but culturally incorrect. :P

I'm about to go off the grid for a couple of months, on an other-worldly adventure that may involve drop bears, land sharks, man-eating crocs, but hopefully not that scary Mick guy from Wolf Creek. That is, unless he comes in injured with an interesting tale to tell, in which case it will be me, several burly security personnel, and lots and lots of IM emergency sedation (mostly for him).

If you still would like to read the new blog, feel free to email me through the link in "About me" and I'll give you permission as soon as I can get back to the internet.

Enjoy your August and September!

Rural!

The mystery! The excitement! The lack of information!

Well, kind of.

Tomorrow I am off and driving for 7 hours in my car with my worldly goods in the boot and will be on the way to . . . . 8 weeks of rural.

The first and last weeks will be spent in a larger and central base, where we will have a week of lectures and practical instructions. They have crammed our week into 4 days rather than the usual 5 for some reason, and have told us in an email on Thursday that we may not get time to go out and buy lunch. Now, on my previous rotation (in a city hospital), if we had a lunchtime education session or a session before lunch, the education coordinator would order in pizzas. If it was a bigger grand rounds, it would be sponsored by a company or the hospital would provide lunch.

In the rural education sessions, where we have to leave home, don't have access to our cooking facilities, and now possibly won't have time to leave to buy lunch, they have offered to sell us lunch. However, we have to order it the day before (or in the case of Monday lunch, you need to have ordered it by midday the Friday beforehand - I have already missed out) and pay "with correct money" or something. So, what is for lunch? Sausage rolls and $8 sandwiches. Awesome. I think I'll be going hungry or seeing if I can still slip away.

They have also told us that we MUST ATTEND every single session in that week, and if we are 10 minutes late to a session then we will be marked as not attending and will HAVE TO REPEAT THE ENTIRE ROTATION. (Emphasis not really mine.) I'm starting to smell a frustrated admin person being put in charge of a bunch of medical students and not being happy about it. Honestly. We are not grade 3 students away on camp for the first time.

No, I don't think that we should automatically be given free food. But to be offered $8 sandwiches as an alternative? Somebody should do a Red Rooster/Subway/Pizza Hut run in a car - cheaper, fresher and more interesting. I think I'll be picking up a bag of salad and some tinned tuna from Coles tomorrow afternoon. It is motel room-friendly (I only have a mini-bar fridge) and I won't have to deal with pre-ordering and paying-with-correct-money-in-advance. :P

Fingers crossed that the rural place where I am spending my middle 6 weeks are more accommodating and relaxed. I may not get to update until I get home again, as my laptop doesn't have an inbuilt modem (Macbook) and we only have dialup access, and I don't want to go any more out of my way - I'm just going to work on what I have at the hospital, and I don't think there will be a place for blog writing. ;)

Holidays

Being on holidays is a bit strange, particularly as I have been so busy for the past eight weeks. I have already had the house sprayed for ants, done the weekly shop (and new handbag purchase), and accrued enough fiction to last the week, if I can stop falling asleep long enough to read it. (I can sleep anywhere, any time - it is a skill. ;) )

Mr TGWTBS has gone away for work, so I don't have anybody around to bother except the cats, and they have a low tolerance for unwanted attention. I have already given two of them new collars, so I think I have pushed them enough for the week. I just don't like the thought of being away and having them not have collars on, even though they are all microchipped.

There was a good documentary on Salman Rushdie's "The Satanic Verses" on the ABC last night, and it reminded me that this is one book that I have always meant to read, but never did. I started it this afternoon, and it is interesting so far - his style of writing is different to what I am used to. I also have some lighter reading coming from the USA courtesy of Amazon that should be good for the trip. (The average paperback here is around $25 - $28, so it is a lot cheaper to have it shipped in, if you can wait.)

I found out today that the third season of Dexter comes out on DVD while I am away on rural rotation. This is very exciting for me, and means that I have to re-watch the two previous series before the next one comes out.

We also got our schedule for the rural orientation week today. It looks interesting, but to be honest, apart from the social aspects (which I generally enjoy if they are presented in an interesting manner - i.e. not too much statistical analysis!) it seems to mainly be things that I have gone over before this year. This would include things such as suturing, cannulation, skin lesions, musculoskeletal (hatehatehate), and resuscitation, but it is always good to revise, I guess, particularly as I am far from being as good as I could be.

There is also a lectures called "Creepy Crawlies," which I am VERY excited about. As long as there is one drop bear slide, I'll be happy. :) Also, Zoonotic Diseases could be fun. I used to play "spot the random and unexpected hydatid cyst" in my former life as a radiographer, and they are good ones to point out to students.

Plastering will also be fun, and we will get PDAs for the rotation. I'll have to bring my camera along for quite a few of the sessions, I think.

They have sent us the information about our accomodation for the week, and we are scheduled to stay in a holiday village (i.e. the caravan park) and share bedrooms with other students. I think I'll be sneaking out and staying with Mr TGWTBS in his hotel at the end of the day, although some socialising beforehand would be a lot of fun. :)

I'm really starting to look forward to this rotation. It feels like it is going to be an adventure.

Oro is a friendly cat

Honestly.

Rural rotation: Time to wake up

I have been feeling a bit sad and sorry lately because we have to go away for 8 weeks for our rural rotation, and I'm going to miss my family and friends. I went for a visit to my parents yesterday, who live more than an hour's drive away, so we slept overnight.

We had a lovely time, drank just the right amount of good wine, roasted marshmallows in their fireplace and had a lot of laughs.

We stayed in my old room, which has been redecorated as a guest bedroom. There are pictures on the side-tables of my father's parents from before and after the second world war. My grandparents met and married just before the war, and one of the pictures is of my grandfather looking very suave, fit and handsome in his uniform, with his collar turned up, looking off into the distance, with my beautiful grandmother sitting next to him with a half-smile on her face. They both look very young and were a handsome couple.

Soon after that, my grandfather went off to fight to the north of Australia, to Singapore and beyond and was captured by the Japanese, spending years in prisoner of war camps. He endured the Burma Railroad and Changi Prison Camp, becoming so malnourished, maltreated and ill that he would be disabled for life. He lost most of his eyesight, was nearly completely deaf and suffered many other physical and psychological scars, including shrapnel that was never removed - a surprise for the staff at the crematorium.

Fortunately for us, he survived the war, and went on to father five children with my grandmother, living until he was 88 years old.

Anyway, the point of this story is that my grandmother had to endure all of these years, too. She had no idea whether or not he was dead or alive for the entire time that he was a prisoner. I can't imagine anything worse than not knowing whether your husband is alive or dead at the hands of an opposing army who have a reputation for cruel and terrible treatment of prisoners.*

I was there last night in my old room just looking at these pictures and remembering their story. Then I thought about what I am about to do, and I woke up to myself. I realised that it really is nothing in comparison, and will be over so very quickly. I will have phone access the entire trip, frequent visits and support all around me, both from family, and from the people I will be around.

It will be a lot of fun, and I'm looking forward to it. I will still miss my husband, but it won't be too bad. After all, I'll be seeing him again in the blink of an eye. :)

*As a side note, there were apparently not a few men who came back after years of serving overseas in WWII, to find that they had been declared 'dead' or 'missing' and their young wives had remarried and had another family. This is a story that you don't commonly hear in those WWII documentaries!

Rural rotation: planning the switch

Now that my medicine rotation exams are over, it has begun to sink in that I am going away on rural, and that Mr TGWTBS is going to spend a lot of that away as well, so I can't plan any flights home to visit.

This requires extra organisation (apart from one lovely send-off dinner which is in the oven right now) as we have three furry bundles of responsibility to look after. Thankfully we go away every year or so, and thus we know the local pet-sitting company who can arrange somebody to swing by, pick up the mail, check the house and feed the cats. I'll miss them, too, and I can't imagine how hard it must for the parents in our course, or those who are the carer to sick family members.

Eight weeks is a long time to be away from your home base, no matter what your living situation. I am totally used to cooking and cleaning (um, sometimes) in my own home, with my better half. Mr TGWTBS is used to my style of living* and we are comfortable.

I can remember living in share-houses (nearly ten years ago - my God!) before we moved in together, and while most people I lived with were good, I have shared house with some absolute special individuals. While I don't think that any of the medical students who will be staying with me are going to try to sell me their shoes or wedding dress ("You like? You buy!?" makes for awkward breakfast conversations), or turn into passive-aggressive monsters who ask me to disinfect the shower everytime I use it and don't even pass on the news of funerals, it will be strange and different to talk with other people about how we are going to organise things for the next little while.

If I am lucky, we will just abandon all pretense of responsible task designation and just wash up every now and again and make sure that the bathrooms aren't going to become biohazard zones, and all will be fine and relaxed. Fingers crossed for sharing with laid-back housemates who are happy to share a bottle of wine and a good meal every now and again. Oh, and if just one of the three of them likes the occasional scary movie or episode of Dexter, I'll be happy. :)


* Translated = I am a big slob who suffers from domestic blindness

Why the private blog?

I have always been quite careful about what I write on the public blog - after all, it is in the public domain, and anybody and everybody is able to read it. I don't hold any illusions that the private blog is water-tight, either, but at least it is more controllable than the public one.

Anyway, I have never been the kind of person who would be comfortable being identified by one of my supervisors from my blog posts. If I have something to say to somebody, I will normally say it to their face, rather than publish it on the internet.

On my last GP rotation, my GP was talking to me about one of the previous students. He was congratulating himself on having identified the student's blog, and was following his impressions of the rotation while he was in the practice. He thought it was most amusing when the student got very excited about passing the rotation, particularly that he had been quoted on the blog.

I'm not saying that anything inappropriate was done by either the GP or the student - the GP passed the student and the student was never aware that the GP knew about his blog. But when the GP was talking about this, I felt nauseous - what if he had found my blog? Only a couple of days beforehand I had written a piece about how I don't like GP work, but had taken it down quickly because I wasn't comfortable with it being out there.

I just like to be able to write how I think and feel and what my impressions are of a situation without somebody who is potentially marking me (and controlling my future career to an extent) reading what I have written. I also change my mind about things as I learn more and get increased exposure or time to think, so I don't want someone who hardly knows me thinking that I'm the girl who has certain opinions or feelings, when it could all have changed and be completely different at the current date.

I don't mind when other students work out who I am, as I don't generally say negative things about people (except in private, to closest friends, when I need support and validation) on blogs. However, I need to be able to vent and contemplate things without worrying who will read it and what they will think, in order to be able to write.

When you worry so much about what others think, it silences your inner creative voice, and this had been happening a lot through the start of this year - just look at the number of blog posts. :)

So thanks to those of you who have signed up to read this. It is nice to be able to talk about things to a much smaller crowd. We'll see where this part of the journey takes us.

P.s. It looks like I am keenest on going into psychiatry. Just thought I would mention it. :P

Medicine Rotation Exam: The Aftermath

Hmm, that was an . . . interesting experience.

My long case went okay, and I am pretty sure that I passed it with a clear margin. I really like interviewing people and can get a bit out of them because I try to listen actively, and repeat what they have said so that we are clear on their details.

The short cases are a little harder to predict. One was an upper limb neuro exam, I picked that there was something going on with his co-ordination so asked to jump straight to that because we only have a short amount of time, and they said that was fine. I worked out that it was a cerebellar lesion, but didn't pick the cause in this fellow. (It was MS. I hadn't seen MS in a patient before, so it makes it difficult.) I guessed alcoholism or trauma. (I have seen Wernicke's in a 29-year-old before, so it isn't out of the picture completely.)

The second case was an abdominal examination, which I would normally be happy with, but this fellow's abdomen was so incredibly distended with something (possibly shit or fat) and he had guarding and tenderness, so it was hard to really feel anything. I faffed around a bit, managed to mistake some fat/poop for the liver edge until I percussed, found an abdominal wall hernia, found splenomegaly, faffed around a bit when they asked how to tell the difference between the spleen and the kidney, but got the causes of splenomegaly and this specific cause in this patient.

I feel like I didn't do the examinations as smoothly as I could (when under stress . . .) and that I ummed and awed a lot. They were not the easiest exams (particularly the abdominal exam). Another one of the students saw the same patients as I did and is convinced that he failed, too.

On the bright side, if we all do badly, then they will review our results if we failed. :( The third student on the rotation is quite talented at this area, so he will do better, I think. (He is a really bright spark who specifically wants to be a physician, and will be really good.)

Unfortunately I don't find out whether or not I passed until a few weeks time, when I will be far, far away (7 hours drive) on my rural rotation. On the bright side, if I have to repeat any part of the exam, I am at a hospital so there will be plenty of opportunities to short case practise.

Fingers crossed!

Edited to add: the word is that we all passed. Hooray for holidays!

Medicine Exam: One sleep to go!

Studying for a stressful exam while you are home alone somehow makes it more stressful.

My husband has flown off to a more northern city for the night to do some work, and, although I slept okay, I don't have anybody to distract me in the evenings or to practise fundoscopy or reflexes on. (Yes, I bought an opthalmoscope - the smaller, portable one that didn't break the bank but still does a good job, and I won't have any trouble off-loading it when I upgrade or don't need another one. I want to learn how to do this fast enough so that I don't torture the examinee.)

I would use the cats, but I don't think the tendon hammer would make a good toy - imagine walking into an exam with a hammer that looked as if you had been chewing on it for the week prior to the exam! :P

I have been keeping sane by putting the Harry Potter movies on in the background (we are going to see the latest movie in the evening after my exam) while I study, so that I am a little distracted.