Archive for the ‘Medicine’ Category

Anaesthetist’s Hymn

March 26, 2011

Sometimes I really get why people want to do anaesthetics 🙂

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Careless Surgeon

March 21, 2011

Because I’m on surgery this rotation:

Stepping on toes

March 21, 2011

Uh oh.

I recieved an polite email from an acquaintance who is a chiropractor regarding the studies done that show the minimal risks of spinal manipulation of the neck. I was slightly confused until I  read further down what had happened.

A few months ago, a close friend and I were having dinner. She mentioned how much she hates having her neck ‘cracked’. I told her about a funny lecture we had from a radiologist who declared that we were never to go and let a chiro or osteo touch our neck unless we ordered an ambulance beforehand – he’d seen way too many vertebral artery dissections leading to strokes and death all from patients having their necks ‘cracked’.

That was the radiologist’s opinion. He got a laugh out of the lecture theatre and then continued to show us head CTs of strokes.

I didn’t think anything of our neck cracking conversation until I opened my email recently. My close friend had been with this acquaintance a few weeks ago and had complained of a headache. The acquaintance had casually attempted to put her neck back into alignment. My close friend protested a little too much and then spilled the beans on what I’d told her. Thus acquaintance felt it necessary to defend profession and send email.

AWKWARD.

Is this a trend to come? My instinct is to keep my mouth zipped from now on, and not mention any of my opinions to anyone ever again, even if it is just over dinner (a slightly lonely prospect). Yet at the same time, I feel that if my friend was inherently uncomfortable about a procedure, then she should not have to protest and cite arguments to avoid it happening.

Still, I feel awful about stepping on toes. No one would like to feel like their profession and livelihood is being derided. That was never my intention. Yet no matter how many ways I phrase it in my reply to this acquaintance, I still sound like a stuck up medicalised square. I think I’m going to stick with “Thanks for the info. I found it a great read”.

Then avoid eye contact at birthday parties for the next ten years.

Niece

March 20, 2011

My niece was born a few months before I started medicine so I tend to be simultaneously amazed at her development, whilst comparing it disparagingly to my own. It occurred to me that she would be four by the time I graduated, and would be someone I could have a CONVERSATION with. It blew my mind at the time. It still does. As uni revealed itself to be, uh, quite difficult, it occurred to me that she may be much older before I actually graduated. I began to count time by her clock.

In two and a half years she has learned to hold her head up on her own, to focus her eyes, to follow sounds, to grasp objects, to roll over, to crawl, to gesture, to feed herself, to communicate using language, to walk, to scribble,  to crack a joke, to demand things of bigger people, to hop on one foot, to hide her messes, to use a potty, to hold her pencil properly, to dress herself, to refuse to wear things she ‘no LIKE!’, to have a voice, to name everyone in the family, to have a proper tantrum, to stomp, to dance, to jump on beds, to slurp spaghetti, to burp loudly, to use a mobile phone, to work the ‘moooo-veee’ machine, to twirl around with a big full skirt, to get dogs to ‘sit DOOOOWN’, to jump through puddles in big yellow duck gumboots and to laugh manically whenever someone on TV gets hurt.

Two years ago I couldn’t locate a femur. Lately, I’ve been allowed to see patients on my own. Without anyone. BY MYSELF. Having a chat, taking their history, doing a rudimentary exam and playing ‘doctor’. Of course I have to then get the registrar…who then has to go and get the consultant. But for those few moments when it’s just the patient and I, I feel like my niece when she’s clunking around the house with ladies size 8 shoes, a mobile phone and a handbag, announcing to everyone she’s going “OWT”. I feel a little teensy bit grown up.

Then later when talking to the reg or the consultant…and we’re actually having a medical conversation about the patient, a disease process, a prognosis…it catches me: I know these words, these nuances, these unsaid implications. I’m having a CONVERSATION.

 

 

So Ronery…

March 13, 2011

This year is hard. Not because of the hours. The workload. The early mornings. That’s fine. Whatever.

It’s hard because none of us can get our shit together to have coffee or decent catchup when we used to run each other multiple times every day. I miss locker room chats, library chats, before lecture coffee chats. I miss seeing my friends. We’re all split up and doing long hours, looking stupid, learning heaps, getting stressed, comfort eating, being grilled on shit we should know but don’t, and running up and down the stairs every day because those goddamn lifts would have to be the slowest in the southern hemisphere. Some of us are within walking distance of each other but shut up in different clinics, different rooms, different wards. Occasionally waving hi in the corridor. Others are up to three hours away at different hospitals.

Its great and a huge sigh of relief after pre clinical years, but it’s strange to go from learning the same thing every day as a cohort to being split into pairs or groups of three. Sometimes you’ll go the whole day only seeing your partner, or if you get split up, then only seeing your registrar, occasionally your consultant and the interns. I don’t think I really contemplated how big of a change clinical years would be…I’m a teensy bit jealous of the first years and second years with their days off, and their bbq and beach filled facebook photo albums.

But then I did get to take staples & stitches out of a weeping arsecheek wound last week.

Who needs bbqs?

No Doubt (or why Gwen Stefani was onto something…)

November 15, 2010

There isn’t a single one of us who has overcome the human condition of self doubt. Whether you’re a supremely confident person, a content Zen monk, a successful writer … it doesn’t matter. You have doubts about yourself. The question is whether these doubts stop you from doing amazing things, from leading the life you want to lead.

– Leo Babauta

I started reading zenhabits about 3 1/2 years ago when I was working in one of those jobs you work in because you need to pay your rent. My job involved lots of screen time and we couldn’t really leave for lunch so I’d flick over zenhabits articles instead and drink a green tea and pretend I was in a park with fresh air and not in an industrial estate office perched next to a major highway exit. It was an escape.

I had a lot of doubts about what I was capable of. I didn’t have a huge interest in what I’d just graduated in. And if I did, there were no jobs to be had. I could see myself working in the industrial estate call centre indefinately, heating up my lunch everyday in that dingy microwave that smelt like tuna. I’d started to answer my mobile with the company phrase “WelcometoBlahBlahmynameisblahblahowcanIhelpyoutoday? uh, hi mum…” The pay was good and there was talk of a promotion. Growth. You can go places with us.

It was articles like this, about overcoming those doubts, that convinced me I could sit the GAMSAT. Just give it a go. Have a crack. Or as my brother always rambles “You don’t know what you don’t know” (although I’m not sure he knows exactly what it means because he’ll say it in response to anything…I think he thinks it makes him sound deep)

It was a chance to get off the treadmill of 14 hour+ shifts working for someone else. I’m sure one day I’ll dream of the days of 14 hr shifts. I know that for the best part of the next decade I’ll be someone else’s shit kicker. But it feels different. It still feels like I’m doing all the hard work for me.

The doubt is still there. The inability to answer the simple question “how did your exams go?” is there. I don’t know if I’ll ever feel ‘great’ about finishing something but with these last exams I’ve felt the, uh, least shit? I hope feeling the least shit counts for something.

My brother-in-laws girlfriend had been trying to get into med in the Netherlands for a few years (they have a lottery system). She finally won a place this year. There were celebrations. She had wanted to do it since she was a kid. So she left her economics course, moved herself over to the med school and started.

Then she quit. Because she fucking hated it and it squashed all her light and twinkle and happy times.

Now she’s back doing economics and my mother-in-law says she thinks she had done the right thing because she “is back in herself” (I live for these dutchlish conversations of ours…). The twinkle is back. She has no more doubts about if she’s missing out or not. While I might have background doubts about my performance, or my ability, I don’t have doubts about if I’m doing the right thing. I felt like I wasn’t myself for a few years before I sat the GAMSAT.Within a few weeks of starting med, I felt…back in myself.

Sooooo, go read zenhabits. Then try and tell me you don’t want to follow your dreams and shit.

 

 

Wanna be best friends?

November 6, 2010

The single most important thing you need in medical school is not the Oxford Handbook of Clinical Medicine (although I highly recommend it).

It is not an unlimited account at Officeworks.

It is not the brain of a ninja mensa prodigy child.

 

The single most important thing you need in medical school is friends.

If I could urge new med students to do one thing, it would be to make friends with as many people as you can. Get your nice face on. Go to every social occasion, party, drinks after pbl. Channel Jim Carrey in that B-Grade movie that I never saw but could get the entire synopsis by watching the trailer – “Yes-Man”. Say yes to everything. Be NICE to everyone. Don’t write anyone off as weird or creepy, or boring. They’re probably just shy, or tired or on drugs or poorly socialised as a child and kept in a box under the stairs. That doesn’t mean they can’t be your friend right? EVERYONE is going to be your friend.

Why? These people will save your life one day. They will send you an amazing flow chart. They will offer to explain blood pressure regulation. They will bake. My god, will they bake. They will swap notes with you even when yours are terrible. They will explain things in anatomy through song. They will forge your name when miss sign on for a compulsory class. They will go crazy with you during study week and think it’s perfectly normal when you walk into their study room, touch their arm and exclaim desperately  “I just need human contact”. They will kill themselves laughing at your ridiculous musculoskeletal exam and then teach you how to do it properly. They will silently place a hot chocolate in your library cubicle. They will go with you to exam feedback meetings and sternly argue your case. They will conspire to ‘acquire’ as many cannulas as possible to facilitate extracurricular learning. If they’re in the year above, they will give you all their notes, past exam papers and genuinely enquire how you’re doing with each block (and you will do the same to the year below you). They will make everything about this workload, this course, this shitload of note taking and struggling, easier. They will save your life.

And you will find yourself willing to jump off a bridge for them.

If you’re not sold on the warm and fuzzy angle consider;  mathematically, the more contacts you have, the larger your resource pool, the larger your board to bounce ideas off, the larger your support network and the larger your tequila-appreciation circle.  If you want to really step it up, get friendly with the staff. A friendly face as an OSCE marker can be enough to calm your heart rate so that you don’t kill the resus dummy.

Maybe it’s my perception of the culture  in our particular cohort. Maybe it’s the emphasis on our course being ‘non-competitive’.*  Maybe I’ve been reading too many “Buddha’s Tips for Life” pocket books and am slightly delirious at the end of an epic study week. Whatever the reason, I would like buy most people in our school a drink.**

I kind of love you.


*we don’t get given our marks, and are not competing against each other for glory, high ranking places or anything like that. It is US vs Medschool and we are eternally bound together by our incessant fight against admin.

**uh, and I totally would, except my funds from Julia Gillard et al are not quite sufficient right now. raincheck?

Path of least resistance

October 28, 2010

or “How to easily climb a hill”…

I have been climbing hills the wrong way. I’ve been trying to sprint up the highest points because that path looked the quickest, but it ends up being in full sun where I get horribly sunburnt and out of breath in no time with a hideous red face (uh, hills in this case being exams).

No more.

It seems paradoxical that the ‘easy’ path of least resistance is to study every day but it is. There is less stress. I’m not trying to cram things. By taking time to try and understand each concept I’m no longer having anxiety-filled sleepless nights. Its taking longer and requiring more rest stops, but its nicer. Climbing the hill, slowly and steadily but without breaking into a sweat.

Although that’s not to say I look beautifully calm and peaceful.

Au contraire.
I look homeless.
(But maybe leaning towards a homeless buddhist…)

Putting in the hours.

October 25, 2010

A pearl of wisdom found in this post from “The long road to medical school”

there is this myth that you have to be “smart” to do well in hard science classes. The truth is that they just require more solid knowledge and practice than social science/humanities classes and leave very little room for BS. But in the end, I think hard science classes are easier in a way because you won’t get a B+ if your professor disagrees with your interpretation of the text. You either know the material or you don’t, and that is completely within your control.

 

You just have to put in the hours.

I haven’t been posting much because I’ve been putting in the hours. Neuro, psych and musculoskeletal hit me for six. Despite putting in the hours I had to sit a supp.

So, I put in more hours.

(passed the supp)

Now, we have three weeks until our last exams for the year. There is a computer chair in the library with the exact impression of my butt from the hours I’ve been putting in.

Last year I had no concept of the hours required to learn this volume of information.I think emotions and a sense of entitlement to some form of creative-god-given-freedom hindered my ability to be a solid studier last year. I would get upset about the idea of spending all weekend in the library. It was unthinkable. Torture. A huge sacrifice.

I even printed off Albert Einstein’s quote “Never regard study as a duty, but as an enviable opportunity to learn” in an attempt to boost my productivity. But it was only recently that I “got” it. It isn’t a duty at all. It is awesome to study this stuff. It’s amazing I was able to dissect a body part this semester. It’s incredible that in two years this “torture” and “sacrifice” has turned me  from someone who couldn’t stand blood into someone who strokes non-med friend’s hands at dinner and says hypnotically “you have great veins…I’d really like to practice cannulation on veins like that”

Last year I was fearful of exams, anxious about results and full of self doubt. I felt like I’d scraped through to second year without deserving it. This year with this weird enthusiasm that’s started to bubble up, I feel like I want to put in more. Study more. Spend weekends reviewing. It makes me feel a little more in control and less likely to periodically fall in a heap.

I just can’t believe it took nearly two years to realise what my mum has been telling me for years.

Just go to the library. And then study. Repeat.

It is possible…

May 22, 2010

Holy mother of god on a stick, it has been done.

I passed a block of exams.

In one go.

Without opening the ‘you will be sitting a supp’ email.

Without the quiet waiting outside the office moment.

Without the knotted gut feeling.

Without the hugs, reassurance and supportive study sessions from friends

Even though that was the only part of the failing process I liked,

it was really quite nice,

not to need it.

A few weeks on and I’m still pinching myself. I have passed something and that’s really all I need. Even if I fail every single block for the next two and a half years and sit every supplementary exam available…

I passed GIT, Endocrine and Reproduction.