There are fish in the Yarra?!?

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!