Archive for the ‘Uncategorized’ Category

Convo of the day

September 27, 2011

Patient being investigated for fatigue, vitamin deficiencies and abdo pain. Outpatient department:

Me: …and what’s your diet like?
Patient: Oh, I don’t eat.
Me: Sorry?
Patient: I don’t eat food. I’ve never really cared for it.
Me: Okay.
Patient: I’ll usually just have a juice. You know? Like one of those 600ml bottles with banana and chia seeds.
Me: *blinks*
Patient (oblivious): sometimes I can make one of those bottles last for three days!

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The great cover up

September 5, 2011

Shark tooth.
Piece of white shell.
Opaque moonstone.
Pearl.
And, on more than one occasion my nearly 3 year old nieces shiny baby teeth. Still in situ though.
The replacement options I’ve been looking at…

(I couldn’t tell mother in law.
There is no point.
It would only make her sad.
And probably angry.
And place me further into the irresponsible box.)

Guilt

September 3, 2011

My mother-in-law kept my husband’s first baby tooth.
In the months before our wedding she took it to a jeweller and designed a pendant with the tooth polished to look like a pearl. A row of garnets twisted around it.
Then on our wedding day she presented it to me in front of all our guests. Some thought it was sweet, but most thought it was strange.
I must admit, I was in the strange camp and delighted in the shock on people’s faces whenever the story was told.

Recently I took it to a jeweller to see if it could be placed on a ring, as I don’t wear necklaces very often, and the garnets taken off to keep it plainer. The jeweller kept it for a week, and wrote out a quote of options for me to think over. I placed the pendant in the zipper compartment of my wallet to take home & make a decision. I close the zipper and make a mental note to put it somewhere safe when I get home. “It would be a shame to take it all apart – it is a really well crafted piece” The jeweller looks at me and smiles. She never tries to make a sale. Just tells you what she thinks, tapping her black stained fingers.

I mull it over during the week and decide I like it as it is. I should start wearing it more often. My MIL spent time and love creating it. It’s his baby tooth. It’s kind of quirky.

I look into my wallet. The zipper is open.
The pendant is gone.

Meanwhile…

August 12, 2011

– passed exams. felt great.

– had one week holiday, caught up with old friends. wandered around other cities, art galleries, generally whilst munching on delicious fatty grease and sugar. managed to fly tiger three times during an ashcloud and major airline grounding due to faults without one delay or cancellation. came home refreshed.  felt great

– started three weeks of aged care. got placed on neurology ward. found that the remote knowledge I once had of neurology had forsaken me and buggered off to make room for recipes for cinnamon bun cake. saw stroke patients and sad cases of degenerating nerve and muscle disorders.  felt not so great. felt stupid actually.

– had an intensive week of hands on training at uni. felt great. slightly less stupider than when started.

– started cancer care. got placed on palliative care. felt awful. then spiritually awakened. then awful. then spiritually awakened. had anxiety filled evenings mentally preparing myself for the deaths of all my loved ones. spent the majority of nights staring at ceiling wondering what the point of life is. why are we here? what is dying? how big is the universe? what makes us more than carbon atoms? how do I want to die? who do I want there? what if I don’t get a choice and it happens suddenly and horribly? read about mediating on your own mortality. completely ignored the coursework. decided I loved palliative care.

– started mental health. had fire alarm go off the first week. found that there is very little that is as entertaining and scary as evacuating a mental health unit full of predominantly paranoid schizophrenics whilst sirens blare and red lights flash. Not sure where they evacuated the locked patients to…and I heard later that one poor patient was still in the shower. when he hopped out everyone was gone! overall am loving mental health which is comforting seeing as mental health is a large component of general practice. interesting though as everyone else seems to loathe it. One intern described psych as his ‘own personal hell’. people generally think you’re being sarcastic when you say you’re loving it. like it’s incomprehensible to enjoy listening to someone’s sordid drug history or religious delusions. i find it fascinating and a bit humbling that they’re actually telling me personal details (the ones that are lucid that is….the deluded ones will tell anyone anything if they stand still long enough). but then I’ve always been the crazy drug affected magnet on the bus. I remember one man (off his tree) in sydney yelling at an entire full bus (that was steadfastly trying to ignore him) that “SHE’S THE ONE! AYE AYE! She’s a good ‘un” whilst pointing and grinning at me before sitting down. Another one recently serenaded a friend and I with Natalie Imbruglia’s Torn at a busstop. Yes. I do like mental health. The staff are so friendly. Which I suppose is due to dealing with sad, awful things peppered with some of the strangest behaviours you could imagine.

– had a great chat recently with a slightly older female doctor with small children. Her advice was to delay childrearing until after getting into a training program, as working part time makes it difficult to study for entrance exams or get PHO job positions. So even if I am lucky and get into the GP training program in my first year out, I’m still obligated to work full time for my second year in hospital before going off into the community to continue training (as far as I know…I think you can work parttime but it makes your initial training prolonged, and maybe harder?). That will make me 29 before I can start popping out the 87 babies I want. It’s hard because I am starting to feel that there is a large part of life that we’re missing out on right now. Could be because I’m reading too many baby blogs. Seeing friends with too cute babies.  I know lots of students I spend time with are not even thinking about this. Some are resolute about never wanting kids. That kind of thinking alleviates a lot of contemplation and planning. I wish I wasn’t, but I’m thinking about it a lot. Everyone on the other side of the fence (older doctors, people with families, my mother) are saying “WAIT”. Which is easy to say when you’ve got kids already and am not shit scared about waiting too long and having shrivelled dried up ovaries. ARGH. In the words of one obs and gyne registrar “I feel like I’m putting off my chances of having babies, to look after other people having babies full time for years and by the time I can get time off the training program and be in a position to actual have my own, my ovaries will have packed up and left. Then I’ll spend all that money I’ve earnt on IVF”

– and randomly in another train of thought: have been watching great new show British show Junior Doctors on ABC iview. Makes me feel better about my days in hospital every time I watch.

 

Notes vs real life

May 20, 2011

Exam for paediatrics, surgery and obs/gyne impending in three-ish weeks. The familiar exam lock down has begun (in that I care more about getting a box of A4 printer paper than the fact I have no clean clothes).

Binding, highlighting, reading, cramming. All mixed in with trying to go to as many clinics as possible and sit in with as many doctors as possible to glean as much clinical information as possible in the vague hope that it may be on the exam.

But the normal stress of studying has been tempered into a duller force when, in a clinic with a lovely consultant, I saw a patient who had lost a baby at 23 weeks. Seven days later she would have been in an ambulance with a midwife to a tertiary hospital with neonatal intensive care and a significant hope that care could be given. I had seen a 24 week lady a few weeks earlier in labour ward. But this patient’s baby had been 23 weeks gestation. Not 24.

So many times I’ve written in my notes treatment plans for “<24 weeks vs >24 weeks” or reminders that a loss of pregnancy before 20 week is a miscarriage and after 20 weeks is stillborn etc. Reminders with underlines or highlighted text. Because it might be on the exam.

It was a confrontation to be meeting a woman who has lived with the distinction between <24 weeks and >24 weeks.

She seemed okay. Her partner seemed okay. They asked normal, expected questions. She wasn’t teary. They had grieved expectedly. The consultant asked the name of the baby, and congratulated them reverently on the birth of their child (it seemed strange but they smiled and seemed to appreciate it). The doctor referred to the baby by that name for the whole consult. They were told the results of the tests, that the most likely cause was an infection (chorioamnionitis) and asked if they wanted a copy of the autopsy results. Yes, that would be nice. Thanks so much. Some more information about future pregnancies and they were gone.

I held it together for the rest of the day until that evening when I had a fight with the Dutchboy which ending in him being incredibly confused as to why our argument about dishes involved me ranting about the unfairness of the existence of baby autopsies.

Baby autopsies may be the crux of the reason I don’t think I could do O&G. And entirely the reason I think O&G drs are amazing.

On rebooting.

April 28, 2011

Having been at it since January cracks were starting to appear at the edges of more than a few people. We have a week of holidays coming up in June and a few long weekends sprinkled here and there but ohhh my kingdom for a-undergraduate-arts-degree-timetable. I don’t know how I’m going to cope when I’m a real person working in the real world and have to put in preferences with other interns for the weeks of leave.

The easter weekend was well anticipated. Because I’m now a complete loser I’d planned to “use it to catch up on study”. That’s right. I’d planned to use the only days off I’ve had since January to CATCH UP ON STUDY. But thankfully we went home to my parents and my notes stayed in the bag, as the niece, and family did their magic and distracted me for four days.

I didn’t want to go back to the hospital. It seems that having a little bit of time off is a tantalising reminder of what life would be like if you, say, quit and became a normal person again.

I don’t like the rotation I’m on. I thought I’d LOVE it. I was looking forward to it. Lady bits and birth and women woo! But I miss the security of the team I was on with surgery. Its nothing really against obs and gyne but my preference to be with one group for the whole seven weeks. We get switched around to different departments every week, and I’ve met some lovely consultants and registrars…but thats the last contact I’ll have with them. I’d like to stay somewhere and develop a bit of a relationship.

Where I am now makes me feel like flotsam and jetsam, thrown around to a different place every day. I thought I was an adventurous person…but it turns out I like a bit of stability afterall – even if its just because I’m terrible at reading timetables.

*sigh* back to the two hour online lecture on vaginal discharge….

Anticipating Antenatal Angst or “Awful Alliteration”

April 4, 2011

There is nothing to make you more acutely aware of the emptiness of your uterus than reading obstetrics chapters. Or paediatric notes. It’s a cruel irony that most female medical students are studying this shit when they’re at their most fertile. If I have to read one more cute developmental chart or see another cute neonate photo in a textbook, I’m afraid for the safety of my Pill. There is a tiny sassy pregnant lady in my brain saying “Throw out that silly little pill! Drop out of that silly little prison med school…Join us for mothers group at the park. We can compare slings and talk attachment parenting, and drink chai! Maria baked a slice!” *

I’m off to get see if I can secure prophylactic SSRIs before I start my women’s health rotation because seven weeks of antenatal clinics is going to be a hoot for the begrudgingly childless.

Surgery has been such a delightful distraction.

*am well aware that childrearing involves more than slings and chai at the park but please indulge me here. I’ve been doing study cards on ear infections all morning. I need to dream…

Mental Health Q & A

March 24, 2011

Me: …and do you have children?
Patient: through rape?
Me: ohhh…
Patient: …two.

I haven’t done my mental health rotation but it appears to be creeping, along with tissue boxes, into every clinic so far. Its not just the mental health of the patients I need to read up on. I need to do more mental health study so I can sort myself out after just listening to the patients.

I can be empathetic at the time, keep the conversation going, say the right thing, blah blah blah and go home feeling okay. But a few days later I snap because the toaster is full of crumbs or the washing machine will only wash on ‘hot’…and find myself in a total mess over it.

When really I’m not pissed off about crumbs at all. I’m pissed off that the lovely 74 year old lady who detailed her rape, child abuse, unsuccessful marriages and car accidents to me a few days ago, had to get such a shit lot in life. I’m pissed off that the kid I wrote up for a case study on pneumonia had a file three inches thick with incident reports about being beaten by her uncle and drunken parents with an iron bar. WTF. It pisses me off. I want to do something about it. It’s unfair. Its shit. So I kick the stupid washing machine.

I’m interested to know WHY when people tell you intensely sad things there is a 48-72 hour lag time until the weight of what they’ve said starts to drag and seep into your day, pervading everything. Until you can’t even make toast.

I hear compartmentalising is the done thing. Does anyone have tricks on how to DO that, exactly?

Momentum

February 25, 2011

My dutch boy had his first day of uni yesterday. This was both exciting for him, and sobering for me as I realised I’d been at uni for seven weeks already. The shine of this year is starting to wear off. I’ve lost the momentum I had at the beginning. Its so true that once you stop the hardcore study, its SO much harder to start again.

Combine that with some beautiful women I know having gorgeous babies recently, and being on paediatrics means that I’m more inclined to start daydreaming of stepping off this hamster wheel and into nappies, and curash and baby slings. It seems more rewarding than “calculate this neonate’s fluid requirements”…

Meanwhile, people are being told their loved ones are stuck in a building that’s destruction was “insurvivable” in Christchurch which makes any other problem seem trivial.

Kodak moment (or the one where I get annoyed at cheerful street art)

November 16, 2010

This is what I see when I go for a meandering plod run along the water. There is seriously one of these every 10 metres along the walking track. It cracks me up most of the time. If I’m not having a happy day however, it makes me want to punch the concrete smiley sun face.

Right in the smiley concrete sun mouth.

(This, combined with the soothing classical music they pump out of the bus stop speakers makes me think someone involved in our City Council is doing a psych experiment…)