Monday, July 27, 2009


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.

Sunday, July 26, 2009

Oro is a friendly cat


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!

Friday, July 24, 2009

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

Thursday, July 23, 2009

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!

Wednesday, July 22, 2009

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.

Tuesday, July 21, 2009

New blog


This is my new blog. If you would like permission to read it, then please email me in the contact into in my profile.

This blog will stay up for a few months, and then it, too, will go private.

Medicine Exam: Two sleeps to go!

Do you ever just get to the point where you are completely aware that you could know a lot more than you do for an exam, but you have just had enough of studying for it? I'm at that point right now. Occasionally the fear will drive me onwards to learn some other facet of treatment (or at least write it out once or twice) but there is just so damn much to learn and I have a very finite brain.

I am at the end of my medicine rotation and have my exams on Thursday - I have one long case and two short cases to perform and present to two examiners. The examiners are both lovely doctors, so I feel very lucky. It has been a nice, supportive hospital for this rotation and we have a fairly standard set of patients (elderly, COPD, CCF, CRF, stroke, pneumonia, pleural effusion, or multiples of what I have just mentioned) but there is just enough of an interesting smattering of neurology patients for the exam to have a curveball or two in it.

I was surprised at how much I enjoyed the rotation - I expected to like it, but not as much as I did. I love problem-solving, analysis, talking to patients and putting symptoms together to try to work out the process that is happening (and simplistic diagnoses frustrate me - I think that if a case is too simple, then you are not looking hard enough) so being in the hospital and around the patients and the excellent doctors was a treat.

I have seen how incredibly stressful and taxing physician training is, and know that it probably isn't for me, as much as I enjoyed this rotation. You see, I like knowing things about a specific area (such as psychiatry) and learning about things that apply to it. Physicians have to know EVERYTHING, and as interesting as that is, I don't think I have the stamina.

Even now, as I am studying for the long and short cases, it scares me how much there is to know and how much I won't know when I go for the exams. When I went and did long and short cases on patients who had been seen by the physician candidates for the hospital I am at, the patients would often tell me that the physician trainees hadn't gotten their diagnosis right, either. To me, this is more of a reflection on the massive breadth and depth of knowledge required to see and diagnose a patient on the spot, than on the quality of the exam candidates.

My supervising physician told me that I had an excellent level of knowledge but that I need to focus on management, and I agree. The problem is that there is just so much to learn, and I am just one girl with only so many hours in my day.

My hospital has the reputation for choosing sensible examination patients for their student exams. I will be happy if it is something that presents regularly (common things occuring commonly). 'Tis the season for pneumonia and URTIs, and I'm happy with almost anything respiratory, so fingers crossed.

Now back to study. My brain has stopped overflowing for the moment, and the (decaf) coffee is calling me.


This is my new blog. I will tell a couple of stories soon about why it is now private, but for now, welcome. :)

A quick post from the ether

It is a strange and exciting time as a third-year. The fourth-years are all getting their intership placements and are finding out where they will be for their first year of working as doctors.

Not all are happy, of course, but I think that on some level we are all grateful to live in a country where there is still work for the local graduates. (This may change in the next couple of years as local intern numbers increase even more, but I'm not going to go into that now.) Internationals used to be assured of a place, but now they have to be quite lucky to get an internship in this state, and their chance of getting a spot at one of the big popular places is pretty much zero.

I am getting excited at the prospect of actually getting out and working again, but that thrill is dampened by the constant exams that we sit before we can get there. I know I will get there, but so many smart people around me have had to repeat exams from other rotations this year, and I wonder if it will be my time to do so soon.

It always confuses me when a supervising doctor describes my knowledge as excellent, because in my head it really isn't. When I read drug charts I have to think to work out what the drugs are because I haven't seen them that regularly, and when they write the brand name rather than the generic one it can throw me off.

In addition, in my earlier years of medical school I was surrounded by people who I think are a lot cleverer and know more details than I do. That said, on the bright side, I think I'm pretty good at remembering details when they are actually cemented into my memory. I remember stories that people tell me at parties from years ago, because I find them interesting and because they just stick.

I'm no good at learning lists, so when I list things off it is because I'm working it out on the spot. This works for me, as I like contemplating things and analysing them. Luckily it has gotten me this far.

I was thinking the other day that I'm actually proud of myself for getting this far. I'm in a really good place, and am happy with things, in spite of the stress and challenge (or maybe because of it).

Anyway, I am going to keep blogging a little more after a little break, but have decided to make this blog private, so that I can share my thoughts but in a more controlled manner. If you would like to continue to read the blog, please email me via the link in my profile. Thanks!