Flying away!

Today I fly down to Hobart for the Global Health Conference. I haven't done any med-related travel in the past four years (rural rotation doesn't count), so I wanted to do something before I finished the course.

A lot of people I know have done wonderful electives overseas, but I can't justify spending the money on that. I guess it is easier when it is just your money and you don't have a mortgage and a partner who is still working full-time to support you both.

Anyway, I did the fair thing and he is coming with me to Hobart for the four nights, so he gets some time off work and I get to sit and listen to talks on global health. I hope it is interesting - there look to be some good speakers and good topics.

Unsurprisingly, I am very keen to go to the ones on mental health, and they are addressing some pertinent topics such as mental health in refugees and other disenfranchised people. Of course, you could also argue that the severely mentally ill of most cultures have lost a lot of their power, rights and autonomy, but I can imagine that it would be an incredibly powerless situation to be a mentally ill refugee or asylum seeker.

I'm in the middle of packing, and things would run a lot smoother if I hadn't decided to be a complete nerd and type out my list of things to double-check. Unfortunately my Macbook is now three and a half years old, so it is getting clunky, and I keep getting the Beachball Of Death every few seconds in Word.

Still, a packing list is worth it. I find that it doesn't matter too much if you leave packing until the last minute, as long as you have a solid list. On our last holiday, I made a list and Mr TGWTBS didn't. I remembered everything, and he forgot underwear. Did you know that some tropical islands don't sell men's briefs? We know now.

Anyway, I had better get back to packing. Have a lovely weekend. :)

Now to wait

For three and a half weeks until our provisional offers come out.

At least now I know my odds. It isn't a shoe-in, but it isn't the worst, either.

Fortunately I also have a very unpopular hospital within driving distance of my home as my second preference. I don't quite understand why it is so unpopular, as I have heard good things from people who have been interns there, but I can imagine. It isn't a big centre with a load of support. Their interns work hard and learn a lot. I guess it is in a poor area that is too far to drive from most areas in the big city, so they would have to move closer to an area that they don't like. (I would deal with the long drive, I think. I live on that side of the city.)

One of the problems with our current system is that the government panicked at the doctor undersupply and then gave the universities free reign to increase medical school places and medical schools which they did exponentially, so we are on the lip of a tsunami wave of fresh graduates.

This means that the two largest hospitals in the state will have 95 interns each, another has 85, and smaller places have also increased their intake to help cope with the increase, so that we don't have massive numbers of unemployed interns.

This is good in theory, but what do you do with 95 interns? You put them in education sessions. You double them up on the ward. You put them in radiology, pathology or GP surgeries doing educational work, or the scut work that they are capable of. You send them out to smaller places or private hospitals, which could be good as long as you are getting appropriate work.

This isn't to say that the interns in those big centres aren't going to work hard. They do work, but some of their rotations aren't ideal. On the bright side, they get shiny doctor's facilities to use. Free fancy freshly-ground coffee is a bonus of sorts.

Their experiences will be a little different to the people who get to be based at the smaller hospitals, both metropolitan and semi-rural.

As I am still dreaming of all things psych, and most centres have psych units with registrar positions, I didn't really need to make contacts in the big hospitals, which is a relief. I have applied to a smaller hospital (600 beds) that only takes a few interns and has more residents (PGY2 and above) to deal with the more medically complex rotations (e.g. transplant medicine). It was slightly oversubscribed, so I have to wait to see if I got a place, but the odds are good.

I don't have anything against the larger places, but 95 interns in the one hospital is an immense number. I do better in smaller crowds. Now to wait and get on with life in the meantime.

Master Procrastinator

Our ballot closes very soon.

Clearly (from the blog design change) I am procrastinating.

Perhaps I need to pull my finger out and do something that would distract me a little better - like, perhaps, studying? :P

More changes

Due to the shifting numbers in the live intern ballot and logistics involved in attempting a renovation while only one of us is working, we have decided to put off the move until next year and I will be applying for the hospital that I have been at for a while, which is only about 20 minutes from my house (in traffic).

We looked at moving to a place in between our works, and there are some lovely neighbourhoods that would be closer to his work (via the motorway, cutting out the big suburbs drive that he now has), still close to where my hospital would be (as well as other hospitals I might switch to) and that would allow us to upgrade our area, if not the house as much.

My husband has only been working for his current employers for a little over a year, and most employers in his industry are in the city centre, so planning a big move based on his job may be a little premature when he may change jobs in the next year or so and go back to the city centre. His industry can be a little volatile with work contracts.

I don't really mind not upgrading the house much, if it comes to that. Our current house is quite comfortable, and could be a lot nicer if we did some renovations.

I am just not a huge fan of our neighbourhood. It is quite a safe one, but there are lots of "bogans", lots of fast food places and no decent restaurants nearby. I don't have much against bogans, but when your neighbour thinks it is okay to work on his motorbike/car at 10:30pm on a weeknight right outside your bedroom window, it can do bad things to your quality of life.

This way, we will get to take our time doing the place up, do a better job of it, and live in it for quite a few months to enjoy what we have done. It will be nice to not do one of those crappy renovation-on-a-shoestring-budget that you see for sale around the place.

If you live around my area of the world, you will know what I am talking about. Some people try to make a faster sale and profit by slapping on a quick coat of paint and polishing the floorboards over the whole house.

Frankly, polished floorboards in the bedrooms in a highset home is a BAD idea. There is no sound buffering, there is no insulation and it seems quite cold and uncomfortable. We have lived in places like that in rental properties, and I would never do it if I were renovating.

To be honest, I kind of prefer carpets, or tiles if you don't like carpet. Even floating floorboards are a better option than having nothing between you and downstairs than one thin layer of wood that may have holes through it big enough for venomous spiders to use as an entrance. (Yes, this has also happened to me.)

I have to wait for Mr TGWTBS to get back from working thousands of kilometers away, and then we will start to make plans to actually kick things off. It is still exciting, and not having such a set timeline is much more pleasant!

Time, machinations and all that stuff

I have completely switched my preferences around for the intern ballot. I figured that it was fairer on Mr TGWTBS to move somewhere closer to his work while we have the chance to do it (relatively) easily.

The only problem is that this means we have to sell our house. Which means that I have to tidy and unclutter it. REALLY unclutter.

I'm not a hoarder, but we have inherited furniture from his parents when they moved interstate, plus we kept some old cupboards that we had to buy for earlier rentals (which had no built-in wardrobes).

Then there is all of the clutter of 6 years that builds up with time. I really need to get vicious and go through things that we haven't used or don't need any more. A lot of it can be donated or maybe sold, I just have to work out where and who I have to contact.

We have been in this house for 6 years as of October. I started this blog in this house. I started contemplating medicine when we were living here. This is where I studied for gamsat, prepared for interviews, fell apart, pulled it all back together again, and lived a lot. It is amazing to think that so much can happen in such a short space of time.

I get attached to people and places, probably because we moved a lot growing up, so the thought of moving is challenging. However, I may end up with my holy grail in housing: an indoor laundry!!

I have always wanted one, and never had it. The closest we got was in our first unit, which had the laundry in the garage, two stories down from our bedroom. Not fun.

Previously we have been moving from rental to rental, so appearances meant very little. However, now that we have to dress the place up a little to sell it, I have to get my bum into gear.

On the bright side, we may get to upgrade our house a couple of months sooner than expected (or move into a rental in between) and I might actually live somewhere that has a decent asian vegan-friendly restaurant nearby. That would be entirely too brilliant.

It just feels like the right time to move.

Intern applications have started!

I have put my name down in the ballot process.

We can watch our results live as the numbers change over the two weeks, keeping an eye on how full our preferred hospital is, and changing preferences if we need or want to.

This means that people tend to shift their preferences if certain hospitals become over-subscribed to maximise their chances at staying in the big smoke. It also means that less people need to be balloted after the date for change of preference closes, because most hospitals don't end up being massively oversubscribed.

Fingers crossed!

My Day

I had another good day in O&G. We spent the morning in obstetric clinic, the afternoon in gynaecology clinic, and got free pizza for lunch.

It doesn't get much better than that. ;)

I really love how positive most of the interactions are in O&G. The outcome for most of them is a healthy baby and the gynae surgery can make a real difference.

On the other hand, when it doesn't go well it can be completely shattering. I don't think I could deal with that.

Even if the labour was going really badly, was not likely to end well and your intervention saved the mother while the baby dies, you can be blamed. Having a dead or seriously ill child is heartbreaking, and society seems to expect a healthy child out of every labour, so obstetricians catch a lot of unfair blame for things that they have no control over.

At least with other areas of medicine you are dealing with people who are already ill. People are generally more guarded and less likely to have expectations for a flawless outcome.

Having a dreadful outcome at the end of a healthy pregnancy would be horrific for everybody involved.

Changes

Having been around for a few years and lived through a great number of changes and shifts in my world, I know that there are periods in your life where you feel things move and alter, and you come out the other end a slightly different version of yourself.

I feel like I'm going through one of those now. The next stage in my life is on its way.

I'm not entirely sure why. We apply for internship in a few days, and so I know that I'll be back in the working world very soon. This could be it. I'm starting to get back into the working-person mentality.

I'm so very glad that I have had a previous career. Starting out into the time of your life where you begin your first career job is challenging. A lot changes about the way you see the world and see yourself, and it can be a painful process, even though you may not admit it to anybody else.

Students are both coddled and dismissed as a general rule. You are sheltered from most of the responsibility. As much as you might think that you are acting as a doctor/nurse/radiographer/whatever, you are still directly supervised by somebody who has to clean up your mess or check up on you all of the time. Although some might think that we are going to be in a similar situation as interns, being supervised by registrars, the interns still have assigned work, responsibility and their own job role.

When things get really shitty, you are just the student and can be pushed out of the way for all of the actual doctors to take care of things. As the intern, you are one of the doctors - albeit a junior one.

I also think that I have matured a lot in the past four years. I'm a lot tougher, and things that I would have taken personally and would have made me cry now just make me shrug or not even blink. Social slights from friends (unintended or not) just slide off me like water off a duck's back. Sometimes I wonder why I'm not more included in things, but then I wonder whether I would really want to be. I'm happy being an introverted homebody.

Thankfully I seem to have retained some capacity for empathy and joy with patients. I get all misty-eyed when I see the new dads weeping at the sight of their newborn resting on their wife's chest, and I feel so proud of them sitting there and supporting their wives, being themselves proud of how hard she is working and what she is going through. The women amaze me.

The same thing goes for patients elsewhere. It is just easier to relate positive empathy, as you feel more distanced towards people who are going through rough times. I have been in the lift on multiple occasions with families who have just lost a loved one. Their weeping would break your heart, if you let it.

It isn't my burden to bear, and I couldn't do my job if I let it get to me, but I can be kind and empathetic and give them as much time, talking (or not-talking) and tissues as they need.

Years ago when I was a student in my first career, I heard the dark jokes of the staff about patients and was mortified. I nearly left health at that point because I didn't want to become cold like that. The impression I had was that they were heartless. Now I know that it is just a protective mechanism (and several of them were just pricks anyway), and having that impact on me so early in the piece, I like to think that I'm more conscious of any tendency to become that black.

If you told my 22-year-old self that at 32 she would be nearly finished medicine and have retained empathy and not become a hard shell of a person, she would be both disbelieving, happy and relieved at the same time.

So, what is shifting right now? I'm not sure, I can just feel a change coming. I think I've become more honest with myself about certain social patterns, and know that I'm not as close to some people as I thought I was. This is nobody's fault, it is just the way things are.

I think things will change a lot when we all start work next year. It will be one hell of a test, and some friendships won't make it and will die natural deaths, and new ones will spring up in their place. This is the way that life works. We change, we grow and we move on.

To be honest, I can't wait to be back to work. Being a student has been a challenge, but on my worst day I never felt as awful as I did leaving work on my better days as a radiographer. However, as much as I disliked my job, there is something that I love about working - actually working, not student "working". I like responsibility, I love feeling part of a team, and I like being a part of the big machine rather than an onlooker. I miss genuinely being able to help.

I could also be stressed, but my husband has said that he is beyond proud of me finishing medical school, and is happy to move to wherever I go. There are some rural places where he is more likely to get a job than others, so I'll put them up the list of preferences.

It could also be PMS. But not really.

This has been a long post, so if you have gotten this far, thanks for reading. It felt good to get all of that off my chest.

How To Have An Afternoon Nap, TGWTBS-Style

1. Lie down after lunch on your bed in a semi-dark room and read a book. It doesn't matter how interesting the book is, if you have had a long and draining week, it will work. Within ten minutes, you will have put the book to the side, turned off the reading light and gone to the land of nod.
2. You are disturbed by the sound of your own snore, which scares you as much as unexpected bodily noises can, and wake up and roll sideways, going back to sleep immediately.
3. Twenty minutes into your sleep, your parents call. "I knew you would be asleep," they say. Way to use your psychic powers for evil instead of good, Mum and Dad.
4. Get back to sleep after a blurry conversation about the rain and somethingorother about school meetings.
5. Get woken up by a marketing person who demands to talk about marketing and advertising to somebody over twenty and working. Telling them that your number is unlisted and you are on the Do Not Call registry is beyond you, so you just say "No" and hang up. Marketing people have the Gift and will call during dinner or naps. Evil.
6. Doze off.
7. Get woken up by a kid next door playing trumpet. Must be a visitor, as I have never heard him before. Why? Perhaps he, too, has psychic powers for evil.
8. Doze off again.
9. Get woken up by remote-husband's text message, telling me that he is going to see a movie. 2000km away. Awesome.
10. Get woken even more by a second text telling me that he also got a haircut. I won't see it before it all grows back again. Even better. Sweetness and evil together are the most fun combination.
11. Try to doze off but am now surrounded by hungry cats who are obviously confused as it is a good two hours before their dinner time. They take turns purring and miaowing. Cats never try to hide the evil.
12. I give up, get up to finish Saturday chores and resolve to not feed cats for another two hours. Evil rubs off.

The end.

Blah blah blah

I haven't written much in the past few weeks because somehow so much has happened, but there is so little that I feel I can write.

I have done something to my hip, and it hurts. It is much improved from when it first started, but I don't know if I should run the 10km tomorrow, and I have been training for this one for months. At least I did a different 10km a couple of weeks ago and managed my goal time in that one (58 minutes), so the disappointment is mildly diminished.

I can run about 5km at home without any issues, but I'm concerned that if I did the full 10km, it would aggravate it even more.

Obs and Gynae rotation is going far better than expected, and I am really enjoying it. Apart from nearly fainting during my first caesarian and being chased out of the theatre by an overly aggressive nurse before the second one could start, the experiences have been positive.

I don't think I could work in that area, as I would be so very concerned for the mothers and babies, but it is a fantastic area to do a student placement in. The vast majority of patients have happy outcomes, and I get to see a lot of babies and pregnant ladies, both of whom I really enjoy spending time with.

Mr TGWTBS is also away for work for a great many weeks, so I'm grateful for long days. I really don't like being home alone, and as much fun as the cats are, they aren't the same as human company. Intern applications are also coming up, so I'm stressed about that as well.

What are the healthy ways for a medical student (or anybody) to cope with stress? Exercise. Find positive and fun active things to do in your down time. Plan out your day. Minimise the stress by delegating the things you don't have to do. Laugh. I know it all in theory, now to put it all into practice.