It's my last week in mildura this week, and since I have Wednesday and Thursday off, I decided to pop back to Melbourne for a couple days break. But so many things have changed - the Commonwealth Games on, the Grand Prix around the corner - and there are fish in the Yarra! Yes, fish in the Yarra! 72 to be precise, and well - not in the Yarra, but floating on the surface (I guess if there were ever fish to be found in the Yarra, floating on the surface would be exactly where they'd end up rather quickly). But it's quite a display, each fish a unique piece representing a country of the Commonwealth. How Australia ended up with the eel I don't know - what happened to good old barramundi or Murray cod?
I have to say, I've had a pretty good first rotation as an intern - I've done my fair share of ranting, and I definitely haven't liked everything I've seen so far, but there's a strangely good feeling about having (nearly) completed the rotation and having come quite far as a doctor in this time.
One thing I can't help but notice though, is that things seem to come in waves. I distinctly remember early on in my rotation, I saw three patients with fractured femoral necks in very quick succession. Then came a run of wounds that needed suturing - well, they're quite commonplace, but there were a few very tricky ones (places like the scalp, face, fingers) in a short time. Then there were the dreaded abscesses - painful for the patient, not particularly pleasant for those of us who need to cut them open either (although Sharon claims to find it a strangely satisfying thing to see the pus ooze out - I don't quite understand, unless she means in the same way you feel "satisfied" after visiting the bathroom for relief). The epidemic of abscesses might well have been explained by the run of 40+ degree days that sent all of Mildura packing to the Murray and diving in. Including me. But I guess I got lucky, spared the trauma of developing any horrible pus-filled lumps. Then towards the end of the rotation came a run of positive troponins! I went so far, sending troponins off for any chest pain suspicious of AMI, none turning up a positive result (happy for the patient) until just last week. We had a standing joke that anyone with chest pain ought to see me - and it would turn out not to be a heart attack. Then, all of a sudden, two patients in a row return with positive troponins! Into hospital with the diagnosis of NSTEMI, and the unfortunate news that they've had a heart attack.
One drawback of working in the emergency department is that there is very little opportunity to follow up patients over time and see how they go in hospital. So, I had the unique opportunity to carry on some continuity of care when I moonlighted as the medical ward resident last weekend. I was happy to see how the patients I'd seen in emergency were improving, even to see that the patients remembered me and seemed happy to see me again. The poor guy who I had to inform about his metastatic cancer was still all smiles - understanding the weight of his diagnosis and prognosis, his friend took it much harder than he did. I don't know that I would be so stoic, if I were given the same news.
The negative things I've seen during the rotation, I hope will serve as teaching points for me. I've learnt the destructiveness of rumour-mongering and harbouring complaints. I hope that I don't fall into that sort of behaviour - it's unfortunately all too prevalent in the stressful, competitive world of medicine. I'm glad to have been blessed with good friends and understanding peers - and a caring, loving soulmate on the other side of the world! It's true, if we don't seek help and understanding from true friends, it'd be easy to get swallowed up in the culture and spiral down a black hole. There's almost no wonder that two registrars recently took their own lives - self administering lethal quantities of drugs found in the hospital (although one of them, it seems, was after a relationship breakdown).
In the end, I am thankful to God for the opportunities He has given - I just hope that I can embrace them, know His will, and make the most of each one. Till next time, God bless!
Wednesday, March 22, 2006
Thursday, March 09, 2006
Nostalgic timeglass...
Tonight, for some mysterious reason, I decided to look back upon my blog to its humble beginnings over a year ago, and think about change. This is the beauty of blogs, or of diaries, indeed - of any written record of thoughts contemplating the future. One can look back, reflect, and gaze as if through a timeglass, into the thoughts of the one that was. And predictions are borne out or falsified, resolutions are kept or broken, moods and thoughts develop. All these things seem far more interesting than a simple snapshot, a cross-section in time, that flashes a vivid picture and then is suddenly no more. But it's amazing to look back and see change. And it's even more amazing to think that our God, who transcends time, has view of all these things at once!
This bug has undergone a lot of change in the 14 months since this blog started, that's for sure. Now no longer "just a student", but a "doctor"; perhaps a couple of kilos lighter and less obsessed with chocolate; in Mildura and not Melbourne; with Sal on the other side of the world; owning a new car. The list could go on for a while. But so many of those changes are far less important than the changes inside - although it would be wrong to say that changes inside are independent of these external ones.
I think one of the biggest changes is my becoming far busier. Being busy, I think, has caused me to grow in the world's sense of the word "grow". This far into work as an intern, I've had to take a quantum leap in mindset to deal with being directly responsible for patients' welfare. Working life is also time consuming with most shifts lasting ten hours, and some lasting well over that. Sometimes, I'll come home from work and simply be so exhausted that all I'll do is flop on the bed and dream of sleep. And then I'll wake up in the morning, lights still on, my clothes still on, and look at the clock - panicking at the fact I need to be at work in under half an hour! Thanks to God, I haven't yet been late for a shift (well, not excessively so, anyhow). So far, I've learnt to deal with these things, and I'm definitely improving with regard to time management. Certainly, in the emergency department, one learns how to be efficient (although it may not seem so to the patients - who, understandably, have to put up with exorbitant waiting times while we wait for beds to become available, and for pathology to process our blood results, or radiologists to report scans - leading to the prevalent sighs of doctors in the department, "oh, where are my bloody bloods!") Indeed, times can be frustrating - but we grow up and learn how to deal with frustration, become desensitised, and become far more machine-like. Even out of work, there is little time spare to cater for our domestic needs (some would argue cravings) - time spent shopping, eating, sleeping, and surfing the net (probably one of my worst timesinks!). It leaves little room for thought, for dreaming, for imagination - the things that cause one to be both interesting and interested at the same time. And so it is with being busy.
I can't help but think that in all this, I've fallen a bit into a state of thought poverty. Instead of being busy thinking (as I was when I started Elkandren's Whisper), I find myself busy with a whole host of other things. Now, thought tends to take a back seat. Far from being foremost in my mind, the quest for meaning, for answering interesting questions like "what better things are there for me to be thinking about than this?", takes a back seat to the incessant worries of how my patient from earlier on in the day is coping with the antibiotics I prescribed. Even dreams are themed on decisions about a patient's management. And then, as exemplified by one of my patients just yesterday (who spontaneously reverted from atrial fibrillation back to sinus rhythm), the vast majority of patients we deal with would get better anyway, and 90% of the time we're intervening for no good reason.
And see, as I grow older, I become more cynical. Kids don't have this same level of worry, and they are full of the most interesting thoughts. Adults are weighed down by terrible grievances, age only wearies them, and woe betide them about every little thing that goes on! There's no wonder that ketamine is such a great drug in kids, and such a poor drug in adults. It's an anaesthetic whose effect includes that of inducing dreams. And it's the adults who come out from under its influence complaining of the worst nightmares, while children enjoy floating on clouds, seeing fields of flowers, and their favourite animals. Kids set for us an example that goes far beyond their cuteness and innocence, what adults often call "ignorance". We should be more like children, with an open mind - as Jesus taught us, we ought to come to Him as children, for theirs is the Kingdom of Heaven.
Perhaps in the end, I simply need to look at myself, take a breath, take a step back, and reflect. Jesus took many sidetracks along His journey to the cross, paying attention to things around Him, taking time out for prayer and contemplation, all the while on a life mission infinitely more important than my medical career! I need to follow His example more closely, and make once again more time for thought and reflection, for attending to the details that He has put in our lives, the many ways He reveals Himself to us every day. When I look back at the start of my blog, I realise how I was able to grow (in the true sense of the word) so much at the time - through reflection, reading God's word, and really seeking to dwell in Him. Although I have grown, it's important to know that now is no time to stagnate. I pray that God will help me continue to seek Him earnestly, and free up time to do so, to think on things which are important. I pray that God will help me continue to grow in the true sense of the word, God's wisdom, rather than in the worldly sense. And I hope that this blog, my public thought forum, will become far richer for it!
This bug has undergone a lot of change in the 14 months since this blog started, that's for sure. Now no longer "just a student", but a "doctor"; perhaps a couple of kilos lighter and less obsessed with chocolate; in Mildura and not Melbourne; with Sal on the other side of the world; owning a new car. The list could go on for a while. But so many of those changes are far less important than the changes inside - although it would be wrong to say that changes inside are independent of these external ones.
I think one of the biggest changes is my becoming far busier. Being busy, I think, has caused me to grow in the world's sense of the word "grow". This far into work as an intern, I've had to take a quantum leap in mindset to deal with being directly responsible for patients' welfare. Working life is also time consuming with most shifts lasting ten hours, and some lasting well over that. Sometimes, I'll come home from work and simply be so exhausted that all I'll do is flop on the bed and dream of sleep. And then I'll wake up in the morning, lights still on, my clothes still on, and look at the clock - panicking at the fact I need to be at work in under half an hour! Thanks to God, I haven't yet been late for a shift (well, not excessively so, anyhow). So far, I've learnt to deal with these things, and I'm definitely improving with regard to time management. Certainly, in the emergency department, one learns how to be efficient (although it may not seem so to the patients - who, understandably, have to put up with exorbitant waiting times while we wait for beds to become available, and for pathology to process our blood results, or radiologists to report scans - leading to the prevalent sighs of doctors in the department, "oh, where are my bloody bloods!") Indeed, times can be frustrating - but we grow up and learn how to deal with frustration, become desensitised, and become far more machine-like. Even out of work, there is little time spare to cater for our domestic needs (some would argue cravings) - time spent shopping, eating, sleeping, and surfing the net (probably one of my worst timesinks!). It leaves little room for thought, for dreaming, for imagination - the things that cause one to be both interesting and interested at the same time. And so it is with being busy.
I can't help but think that in all this, I've fallen a bit into a state of thought poverty. Instead of being busy thinking (as I was when I started Elkandren's Whisper), I find myself busy with a whole host of other things. Now, thought tends to take a back seat. Far from being foremost in my mind, the quest for meaning, for answering interesting questions like "what better things are there for me to be thinking about than this?", takes a back seat to the incessant worries of how my patient from earlier on in the day is coping with the antibiotics I prescribed. Even dreams are themed on decisions about a patient's management. And then, as exemplified by one of my patients just yesterday (who spontaneously reverted from atrial fibrillation back to sinus rhythm), the vast majority of patients we deal with would get better anyway, and 90% of the time we're intervening for no good reason.
And see, as I grow older, I become more cynical. Kids don't have this same level of worry, and they are full of the most interesting thoughts. Adults are weighed down by terrible grievances, age only wearies them, and woe betide them about every little thing that goes on! There's no wonder that ketamine is such a great drug in kids, and such a poor drug in adults. It's an anaesthetic whose effect includes that of inducing dreams. And it's the adults who come out from under its influence complaining of the worst nightmares, while children enjoy floating on clouds, seeing fields of flowers, and their favourite animals. Kids set for us an example that goes far beyond their cuteness and innocence, what adults often call "ignorance". We should be more like children, with an open mind - as Jesus taught us, we ought to come to Him as children, for theirs is the Kingdom of Heaven.
Perhaps in the end, I simply need to look at myself, take a breath, take a step back, and reflect. Jesus took many sidetracks along His journey to the cross, paying attention to things around Him, taking time out for prayer and contemplation, all the while on a life mission infinitely more important than my medical career! I need to follow His example more closely, and make once again more time for thought and reflection, for attending to the details that He has put in our lives, the many ways He reveals Himself to us every day. When I look back at the start of my blog, I realise how I was able to grow (in the true sense of the word) so much at the time - through reflection, reading God's word, and really seeking to dwell in Him. Although I have grown, it's important to know that now is no time to stagnate. I pray that God will help me continue to seek Him earnestly, and free up time to do so, to think on things which are important. I pray that God will help me continue to grow in the true sense of the word, God's wisdom, rather than in the worldly sense. And I hope that this blog, my public thought forum, will become far richer for it!
Tuesday, March 07, 2006
Quick update...
It's been a while since my last instalment, so I might as well take this pre-slumber window of time to write a quick blog update. I guess, basically, I haven't had the most exciting couple of weeks lately, hence haven't felt the need to write anything - mostly been working (did a hard seven day stretch last week, which was exhausting and depressing), but on the up-side have had a little time to catch up with some old friends who are in their final year of med school, enjoying their last taste of relative freedom before the relentless holiday-less stretch of work as an intern begins.
James and Eric spent Thursday evening up here in Mildura, unable to resist the temptation of good food and wine to be had at Stefano's! It was a real treat, six courses of really well prepared mediterranean food, ranging from the entrée cold meat and salad, to stuffed calamari, to lamb roast, and the almost oversweet caramel dessert. Each course was accompanied by a glass of hand-picked matching wine, whether they be local or imported from Italy. After the wining and dining, the food was allowed to digest while we turned our eyes heavenward and enjoyed the country starscape featuring Jupiter near the horizon - you can see jus so much more in the country!
Spent the weekend in Melbourne - the drive so tiring and exhausting, just over five hours by the most direct route, precluded me from fully enjoying the time. I'm sure it didn't help my attempts to play violin again. The last time I played would have been about two months ago! Even so, I had fun reacquainting myself with it, battling through the Mozart A-major concerto. Also, popped into uni - found out I'm going to be giving tutes in physiology, so I thought to brush up on that with a copy of Ganong - and at the same time got some Chinese books to start learning Chinese with. Am enrolled in evening courses, so I'm really determined to get started and learning again (I haven't taken Chinese lessons for 14 or so years now!).
Uni brings back so many memories of my time there. Even though I'm so new to working, it still feels so nostalgic, as if it were years and not months ago that I was there. More vividly, it reminds me of Sal - as we first met at uni, and spent a fair bit of our time together at uni, doing activities, or jus hanging out. I know that my time at uni wasn't always happy, but it remains that almost every memory I have as I walk around is a happy memory. I guess that's the same for most things when I try to look back - mostly the happy stuff stays in my head, and not many stressful or negative emotional memories at all. I wonder whether we are simply selective with what we remember? Or perhaps it's just that each time a stressful or negative event occurs, we magnify it so it dominates our thinking at the time? (and therefore, they aren't seen as significantly when we look back upon them) Or maybe our negative memories are selectively suppressed.
Am missing Sal heaps, more and more each day. Even more so when we webcam - somehow instead of necessarily bringing us closer, it manages to jus reinforce and emphasise the fact of our physical separation. Looking forward to the day when we don't need technology to see each other again.
Anywayz, off to sleep - haven't really said much this time, and am too tired to say any more really. If you're bored in the meantime, check out this set of riddles! Good luck!
James and Eric spent Thursday evening up here in Mildura, unable to resist the temptation of good food and wine to be had at Stefano's! It was a real treat, six courses of really well prepared mediterranean food, ranging from the entrée cold meat and salad, to stuffed calamari, to lamb roast, and the almost oversweet caramel dessert. Each course was accompanied by a glass of hand-picked matching wine, whether they be local or imported from Italy. After the wining and dining, the food was allowed to digest while we turned our eyes heavenward and enjoyed the country starscape featuring Jupiter near the horizon - you can see jus so much more in the country!
Spent the weekend in Melbourne - the drive so tiring and exhausting, just over five hours by the most direct route, precluded me from fully enjoying the time. I'm sure it didn't help my attempts to play violin again. The last time I played would have been about two months ago! Even so, I had fun reacquainting myself with it, battling through the Mozart A-major concerto. Also, popped into uni - found out I'm going to be giving tutes in physiology, so I thought to brush up on that with a copy of Ganong - and at the same time got some Chinese books to start learning Chinese with. Am enrolled in evening courses, so I'm really determined to get started and learning again (I haven't taken Chinese lessons for 14 or so years now!).
Uni brings back so many memories of my time there. Even though I'm so new to working, it still feels so nostalgic, as if it were years and not months ago that I was there. More vividly, it reminds me of Sal - as we first met at uni, and spent a fair bit of our time together at uni, doing activities, or jus hanging out. I know that my time at uni wasn't always happy, but it remains that almost every memory I have as I walk around is a happy memory. I guess that's the same for most things when I try to look back - mostly the happy stuff stays in my head, and not many stressful or negative emotional memories at all. I wonder whether we are simply selective with what we remember? Or perhaps it's just that each time a stressful or negative event occurs, we magnify it so it dominates our thinking at the time? (and therefore, they aren't seen as significantly when we look back upon them) Or maybe our negative memories are selectively suppressed.
Am missing Sal heaps, more and more each day. Even more so when we webcam - somehow instead of necessarily bringing us closer, it manages to jus reinforce and emphasise the fact of our physical separation. Looking forward to the day when we don't need technology to see each other again.
Anywayz, off to sleep - haven't really said much this time, and am too tired to say any more really. If you're bored in the meantime, check out this set of riddles! Good luck!
Who am I in Christ?
I am...
A Child of God (Rom 8:16)
Saved by Grace through Faith (Eph 2:8)
Redeemed from the Hand of the Foe (Ps 107:2)
An Heir of Eternal Life (1 John 3:11-12)
Forgiven (Eph 1:7)
Led by the Spirit of God (Rom 8:14)
A New Creature (2 Cor 5:17)
Redeemed from the Curse of the Law (Gal 3:13)
Kept in Safety Wherever I Go (Isa 46:4)
Strong in the Lord and in His Mighty Power (Eph 6:10)
Living by Faith and Not by Sight (2 Cor 5:7)
Rescued from the Dominion of Darkness (Col 1:13)
Justified (Rom 5:1)
An Heir of God and Co-heir with Christ (Rom 8:17)
Blessed with Every Spiritual Blessing (Eph 1:3)
An Overcomer by the Blood of the Lamb and the Word of My Testimony (Rev 12:11)
The Light of the World (Mt 5:14)
An Imitator of God (Eph 5:1)
Healed by His Wounds (1 Pet 2:24)
Being Transformed by the Renewing of My Mind (Rom 12:2)
Heir to the Blessings of Abraham (Gal 3:14)
Doing All Things through Christ who Gives me Strength (Phil 4:13)
More than a Conqueror (Rom 8:37)
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