Worry and relaxation

I have just had several lovely weeks away from work. It has been such a blessing. I have been so blissfully relaxed. I'm happy, I'm dreaming about things apart from work, and I have had the energy to do non-essential cooking.

It has been a nourishing time, and a much-needed one.

Now I'm wondering how I can carry this feeling of peace and being chilled with me into the next rotation. I know that I probably won't, but I really, really want to try.

The last time I managed this was during my psychiatry rotation. I'm hoping to be able to obtain it again when I start to specialise in this area. I like to do things promptly and in an organised fashion, but it is far more relaxing for me to know that they do not need to be done right now and can probably wait a few hours or even a day or three.

I was quite relaxed during my emergency rotation, but found the style of work very tiring and thoughts of having missed things or having documented something incompletely often plagued me in my sleep. Bed block and ambulance ramping are nightmares.

You can tell that I'm worrying about it a bit already - after all, I have just written this post.

10 years ago (in Australia)

I'm not any good at poignant writing, I'm afraid. I wanted to give a glimpse from another country on that day, from another part of the planet. We will never be able to understand what it was like to be in the USA on that day.

Yesterday I walked to the park down the road from us to get some fresh air. There was a whole park full of birthday parties and children playing. All of them were younger than ten. None of them were on this earth when it happened. Life has gone on, and I don't want to look at those images any more, but I still find tears at the thought of those people who died on that day, and those who have lived ten years without them.

It will never be a symbol for me, just a giant mess of loss. The Bali bombings are the same. So many gaping holes in lives where there used to be people. Some of them stick with you more than others, but they all matter.

I am Australian. I have not yet been to the USA, although it is on the cards. I grew up immersed in the culture of the United States via television, and taught myself to read and spell from Sesame Street. Mulder and Scully were my teenage idols and Friends was a staple at my residential college. Parts of the country are so idealised in my imagination that it would almost be a shame to visit and have that picture brought back to reality.

Like so many of my generation, I feel very close in spirit to the country, her citizens and parts of our shared culture. Ten years ago, we watched and wept, too.

I was in my last months of my first university degree, getting ready to marry the man who is now my husband, in the middle of worrying about the wedding, job applications for the next year and my final exams.

Like the majority of the Australian population, I live on the eastern coast of our country. I was fast asleep when the twin towers were hit. Some of my family had been up watching the late news, but they hadn't contacted me - they are quite practical so I imagine they didn't the point. They knew I would hear soon enough.

The next morning, on our September 12, I turned on the tv as I got ready for uni. I walked across the room and saw the images of the planes and thought it was another promo for a Hollywood blockbuster. As I sat down to eat breakfast, I read the scrolling text and listened to the newsreaders and the reality began to sink in.

Passenger planes had hit the twin towers in the middle of New York, nobody knew how many people had been killed, nobody knew who had done it or why, and nobody knew who would be next. I felt sick, but all we were getting at that point in time were pictures of burning buildings and estimated numbers. I could hardly tell the news to my fiance- I just got him to watch the tv, too.

I still went to university that morning. I caught the ferry into the city, as usual. My route took me through an affluent part of town along the river, and the main stop was the financial district. Normally the ferry was packed with people in suits. That day there were only 4 people on board.

Two others were students and there was one businesswoman. I overheard her on her mobile phone. Most of her colleagues had stayed home because the head office of their company had been in the WTC and nobody knew if any of them had gotten out. Australia has huge ties financially with the USA. Many of the big financial businesses with offices in the city either had head offices in the WTC, or had very close contacts and partnerships with people there.

At uni, everybody was in a bit of a daze. Many of them were in denial, many were avoiding thinking about it, and some, like me, could not get it out of our heads. There were large TV screens in the business school on campus that were normally tuned to the market information. That day they were full of footage of planes repeatedly slamming into buildings, falling bodies, people weeping and crying in desperation, and speculation on numbers. My least favourite part (as always) was crass speculation about whether Australia would be next.

I tried hard not to weep, and mostly succeeded. Most of the crying came later. Sometimes it still does. I cry for those whose family members never made it home. For the sheer and utter cruelty of an act that would attack innocent people and kill them in the thousands, all because of some twisted ideology and misplaced rage.

In the months that followed, so many people wore shirts with the USA flag on them, or "I *heart* New York", even those who had never been to the USA and had no family connections. We all felt so powerless and sad.

One pointless death is a tragedy. I still have no words for the loss on the scale that was experienced that day. It rocked our sense of what was safe, of what was untouchable, of what twisted individuals would actually do in their depravity. It was followed in the years to come by multiple other international incidents.

One year, one month and one day later, they bombed Bali. Having known some of the victims who made it back, part of me shares the sense of rage that accompanies the loss. There is no justice in this world that could possibly be fitting for people who do these acts.

You go about your life, and everyday tragedies happen. God forbid they happen to us or anybody close, but they will and do happen. We all die, sooner or later. The sheer scale, intent and the fact of the occurrences on the 11th of September, 2001, is something that I don't think any of us will ever really get over.

We will never forget.

Life, recent

And now for something a little different, as pictures seem to say more about my life right now than words:

Some things make me too sad for words. But then, I don't have to speak. I can support the foundation that his parents have set up in his memory, trying to make sure that what happened to their son does not happen to other children.

Right now I still feel the sense of sadness and loss whenever I see his parents on the news or at a press conference. What I also feel is a rumbling sense of rage, that somebody stole this life, this future from him and his family, and that this criminal has presumably been kept hidden and protected by other criminals, leaving his family, friends and community in painful limbo for years.

The Australian media and social media have been told to be very careful about what is said in relation to the case, because a man has finally been charged after so long, and they do not want to risk any form of mistrial.

As his mother said, I hope that they can see Daniel buried with dignity soon.

On a lighter note:

At least somebody is enjoying the chives in my garden.

It is great noticing this creature AFTER I have just watered the plant. Really. At least he or she had the good sense to sit very still.

I hate it when they jump. It is so very random. One landed on my face once. Now they scare me. Out of all of the things in Australia, I probably hate locusts the most.

Congratulations, Interns of 2012!

The job offers have starting trickling in for next year's interns.

I can't believe it was only one year ago that this was me. So much has changed since then. My career aspirations are still the same, but a lot of other things have shifted slightly sideways.

So, to next year's interns, I can share with you some things that happened to me, and you may also experience in the first half year of your working life as a doctor:

You will find your feet as a junior doctor. Granted, like me, you may spend the first couple of weeks absolutely scared out of your skull. But you'll get used to it and after a few months, you will manage to have some nights where you don't dream of clinical scenarios and ward rounds all night long . . .

You will face challenges, both personal and professional, that you will overcome with varying degrees of success.

People will find their way into your lives, if you let them, and these people will change the way you see the world.

Some people will loosen themselves from your lives and move on and you may miss them for what they used to be to you, but that is okay because we all change.

You will grow up, some of you will become more cynical, but some of you will become more zen and learn how to enjoy the small things in life, and many of you will do both.

You may go from being terrified at choosing to write and dispense that first script for a drug (probably an antibiotic) to writing them in 30 seconds flat and knowing the number in a box off the top of your head.

You will hopefully come to see that being a doctor is a job, not some mystical calling sent out to you from the universe. I think this is good. If you see it as a job rather than an entitlement or a state of being, you are more likely to realise that you need to work hard at it to be good, and more likely to leave it at work when you can. You may also realise that other doctors are people just doing their jobs, too.

You will encounter death, grief and loss. If you can meet this with compassion, dignity and humility, it will be better for everybody involved.

The first death you need to certify will probably be in a room full of grief-stricken family. Know what you are doing and have a plan before you walk in, and although this is your first time, hide your uncertainty and terror. Be kind.

Document, document, document. This will be reinforced whenever you look back at your notes after something has happened, and you find that you clearly documented what you needed to. Document!

Good luck! And don't forget to take care of yourselves, both physically and mentally.

New

Sometimes things shift in life, and you feel like you have grown a new pair of eyes. Or new lenses.

Things don't look the same, it is as if you have just bought a new pair of glasses and you look at a scene that you thought you understood before and find that there are so many details that you just didn't notice, and you are just now starting to see them.

Life still does that to me - it still surprises with little details that change the whole picture. People aren't always right and they aren't always wrong, they are just people, and life is the same.

Nothing really prompted this post, it is just random. But sometimes it is good to know that you never stop maturing, and you never stop learning. Because if I never stop learning, than I am never really fully grown up yet so perhaps part of me has an excuse to always be immature. ;)

Going wild

When I am at home, particularly when I'm doing medical-related things (like study), I like to do things that are verboten at work. These aren't things that a non-medical person would realise are particularly exciting, but when you aren't allowed to do them all day, sometimes it is fun to go a bit wild at home.

These days I like writing in coloured ink. Yes, I like blues normally, but since starting work as a junior doctor, I like to branch out and go wild at home, occasionally taking leave of all common sense and writing in pinks and green.

(It is compulsory to write in black ball-point pen in medical documentation where I work.)

I like to use white-out. I always avoided the stuff in the past. Now that I am not allowed to use it, it is liberating.

It is nice not having to sign and date every single time I write something down.

One day I will be senior and hopefully in private practice. I will either use a computer all day (and the notes won't go missing after they are printed out because somebody does not realise that all information about a patient's admission is slightly important) and/or I will go wild and write in dark green fountain pen. I can dream.

When I start writing in red crayon at work, it will be time to retire. Unless I'm in a paediatric therapy session. Actually, this is another reason to work in paediatric psych - the promise of using coloured pencils or crayons for work-related activities. ;)

Things I Have Learned During Internship #4

A few brief extras, suitably random:

a) Find a system that works for you. You may carry around a clip-board with printed notes, a card system in your pocket, some big plastic box with everything you will need should there be a mini-apocalypse at the work station that wipes out all of your request forms, an iPad or just a scrap of paper that you keep in your pocket with the salient information on it for the day.

Feel free to change this at any point. Just don't lose all of your patient information and then have everything explode and fly everywhere in the middle of a busy ward round because you won't recover until later in the day and this will throw off your groove completely and not even a big cup of coffee bought for you by a sympathetic medical student will help.

Also, what works for one rotation will not work for the next in the same way.

b) Having a weekend off any responsible adult activities and subsisting on Indian takeaway, toasted sandwiches and Twisties will leave you feeling crappy. Add wine to this list and your mouth will taste terrible by the end of the two days.

c) On-line shopping: Good for a temporary mood boost, both at the time and when that package you have forgotten ordering arrives a few weeks later. (Yes, being in Australia and ordering from the USA teaches you patience.) Unfortunately, it is easier to spend more than your overtime and you may not get paid it correctly anyway, so be a bit penny-wise while having some fun.

On-line shopping where you buy exercise DVDs that you actually use must be a positive, seeing as you don't have time to even see the sun any more, right?

d) Applying for your next job roughly 6 months before you will be starting it is a strange experience. I'm just starting to really feel comfortable as an intern, but not only do I have to start considering where I might go next, I need to actively plan and apply for it.

e) Paying somebody to clean your house is a luxury, but it is a brilliant one, and may save your life by preventing the next super-bug from its genesis in your uncleaned shower. That is my excuse, and I'm sticking with it.

f) You will have loads of tips for other interns, but you may lose the attention span and motivation to write them down on a blog post, and go with random stuff instead. All of the iPhone apps and personal diaries in the world cannot help you, your only saviour is the passage of time and the hope that one day you will be finished internship.

I really meant to write something more useful, but alas my brain is in a field somewhere frolicking in the sun and is refusing to stop playing and come back inside the house, so I'll stop now before this degenerates into a drivel of random words.

Take care.