anatomy and winter sales

Hello! I've rotated to my option unit now, which is Anatomy. My task is to dissect a hand and forearm and identify as many structures as I possibly can. Most of the time I am alone with the hand-forearm, which is okay. It is a good opportunity for practical learning, and not really all that tedious except when I am trying to work on the hand.

When I leave the room for lunch, I have to walk through the room where we had our Anatomy labs in first and second year. It is coming up to the University exam time, and I can see the stress/curiosity/blank looks on the students' faces... it is almost like stepping back in time for me; the air is exactly the same.

Then there are times when I step into the corridor between the Anatomy lab and where I work, and I can see through the windows above the doors that lie at the end. That's CTEC. The surgical trainees learn there, they are scrubbed and gowned and practice on simulated patients. And in that instant there is that heart-pull feeling again. Just when I thought I'd become too rational and too pragmatic, and too numbed by routine and the currents of a structured assessments and a University degree. I realised I still have passions.

It is mere coincidence that my next topic of discussion, shopping, should follow my last comment on passions. The thing is, I can only dissect for so many hours before my neck is uncomfortably stiff, which leaves me with free afternoons. And this is how I know that the Winter sales are truly upon us; I went shopping three days in a row :/ This is in fact even more terrible than it sounds because my new year's resolution was to not shop (groceries and toiletries are okay) for a whole year. I lasted until the 27th of February.

I think I would have lasted longer had there been a positive component to my resolution. As in, I should have said something like "I will stop shopping in 2010 so that I can give the money I would otherwise have spent on clothes, to children in [insert poor country]". But the fallacy in that statement is that my mother buys my clothes, so in reality my resolution was more like "I will stop shopping in 2010 because I have way too many material possessions and I have just realised that shopping is really quite a meaningless activity".

The DJs and Myer sales start this week *deep breath in*. Here we go.

being a patient

okay now I've learnt:
- not just how to put an LMA down somebody's throat but to do it as gently as possible because waking up with a really sore throat is not fun
- that i should perform jaw thrusts as kindly as possible because the bruising and neck stiffness is going to persist for days
- that how you deal with the patient immediately before the operation (ie smiling, being warm, putting them at ease) is so important

and that's pretty much it because i can't remember the sting of propofol, or what dreams i had, or whether i was even told to count to ten. i blame it on the midaz.

in any case, i can't really claim to have experienced what my patients go through, because getting your wisdom teeth out isn't really the same as having your gall bladder out. and given all my morbid thoughts the day before the operation, i was surprisingly cheerful on the day itself. being pushed around on the trolley was fun, and when i woke up there was jelly and ice cream and all this nice stuff to eat. i didn't really like my drip, but the nurse took it out for me pretty soon after i woke up.

of course, my happiness was short lived. when i woke up yesterday morning, the long-acting LA had worn off. it gave me a new appreciation for all of my ice packs. this was partially my fault because my pharmacological analgesia was supposed consist of NSAIDs and Panadeine Forte but because i'd never had any codeine before the anaesthetist decided i should just have prn paracetamol, and i was too lazy to find my paracetamol so i just ended up having NSAIDs. it's the highest dose i've ever had, so i'm hydrating myself like mad (see: association between NSAIDs and acute renal failure).

this morning when i woke up, my sutures had dissolved, and.. suffice it to say that i had to wash my face and mouth very carefully. and then of course i had to go to my neuro kit and fish out a pen torch so that i could examine the clotting progress. it was still quite a fresh clot which then made me wonder whether i should just skip my morning NSAIDs (see: association between NSAIDs and platelet dysfunction), but in the end i decided that i couldn't deal with the pain.

checklist patients

I'm on my Oncology rotation right now. Part of the assessment requirements for this unit include a logbook of 10-12 patients. The logbook worksheets are comprised of specific questions that have to be answered and as such, directed history taking is very helpful.

Last week, S and I spent time talking with patients with the aim of filling out our logbooks. But some things that the patient told me about their concerns didn't make sense. And I'm not going to write them here because it's confidential, but when I went back and clarified with the patient, I was -ok-not quite blown away, but still stunned by what was then revealed.

It reminded me of the incredible value of asking open questions, and the consistent emphasis on history taking skills.

So whether you're a classmate or a colleague (or just interested), I highly recommend reading the poem "A piece of my mind", by Stephen A. Schmidt.

PS It's also my turn to become a patient on Friday, which should be interesting. Except I'll be going to a private hospital, so I doubt there'll be any healthcare students there.

Hataraki Man

Once, when I was really bored, my brother suggested that I watch this Japanese series called 'Hataraki Man'. I didn't really get very far with it, but the one part I do recall is when the protagonist, a real life office superwoman, asks her colleague 'do you ever run for the train?'. And it turns out that he doesn't, and she does, and that is why she is Hataraki Man, and he is not.

The point of this very random prologue is that I run! When I'm at McIver I run to the the train if it is waiting. And then when I reach the city, I run up the escalators, across the walkway, and down the other escalators to get to my platform. But during all of this, I've noticed that I'm the only one doing any running. Everybody else very stylishly brisk walks.

This is the second time that I've been allocated RPH against my wishes, but I have had the most fantastic week. I think I shall dub this the Hospital Preferences Phenomenon, ie every time I get the allocation I want, I don't enjoy it as much as I thought I would, and I end up loving all the attachments that I've grudgingly accepted.

The highlights of my week:
- pathology microscopy tutorials: seriously awesome
- haematology ward rounds: I went on my dream ward round today
- having a timetable, therefore feeling loved/cherished/not ignored
- meeting all of my old 'friends' at RPH! In four days I've met my 4th year Med Reg, the ex- CCU RMO and intern, my favourite consultant, various sixth years, and church friends... really, I don't know how I ever thought of RPH as bleak.
- more good company; meeting with James for lunch and clerking patients with Simon
- having friday off

Release date: 2011

So it seems The Sending, the final installment in Isobelle Carmody's Obernewtyn Chronicles isn't coming out this year after all.

I'm not very disappointed, because I know and respect Isobelle's desire for perfection. It's gourmet in a world of book fast food. Plus, I waited eight years for the Stone Key (2008) to come out anyway, so another year doesn't seem so bad :P

You can read the interview here.

I love this part where Isobelle says: "...what I like doing is taking a character and making it seem comical or cowardly or silly, and then producing a paradigm shift so that we can see that all of these things can hide incredible courage, depth, and blinding beauty of spirit." So, so true.

The book was supposed to come out during my Obs&Gyn term, so now I am going to have to change plans and read this book instead. Hello, Dymocks!

taking the highway

so after nearly six weeks, i've realised that my initial impression was right- i do live very far away from fremantle. very far, as in thirty minutes' drive away, which is then compounded in my very stoned/tired brain at the end of a long day at the hospital. (or at the end of three hours of clinic, which is sufficient to achieve the same effect).

it is at those times that i have of getting back somewhat this tendency to drive slightly over the speed limit (60km/h) in the hope that i may sooner receive the therapeutic benefits of arriving home and plonking my bag (+ all of its contents) on the floor. i imagine swinging a water hammer would achieve the same effect.

a couple of weeks ago i attended this post-easter camp youth service. we were challenged to be discipled- in all aspects of our lives. to cut a long story short, when i decided to respect the speed limit, i began to notice something. quite often the cars that were overtaking me, would end up immediately in front of me at a red light. or they would cut out of my lane and then end up waiting behind somebody who was turning.

the other day, i got quite attached to this particular p-plater (red P's) who repeatedly overtook me because he kept getting stuck behind turning cars. we ended up traveling quite far down stirling highway together! for the twilight fans, he was also driving a volvo ;)

it got me thinking about the whole journey versus destination thing. we traveled the same length of stirling highway together, in the same amount of time, but in totally different ways. and in spite of my admiration that he can drive well enough to cut in/swerve out/speed up/brake suddenly, what did any of that achieve for him?

in any case, it confirmed my suspicions that no matter what, it is impossible for me to make it home in 20 minutes. not even if i could drive like a teenage guy. but that's okay, because tomorrow is my last day at fremantle. YAY! :D

running after you

i am definitely a morning person. the first thing that comes to mind every morning is either:
1. good morning, God!
2. what a good sleep/:)/i am content
3. my life is perfect

this is not to say that i really do think i have the perfect life, but somehow the morning air/light/smell is optimism and i recall the things that i am grateful for: good health, a loving family (dog included), God's love, education, church and friends, financial security (technically, my parents' finances but i am secure in the knowledge that they will not withhold anything from me :P), car, food, etc.

but sometimes i feel like i am too blessed and it becomes a burden. like, i have so much, and how am i meant to use my life/talents/possessions wisely?

the other day i was having this mini crisis because i suddenly thought about the children who don't have access to education and would never dream of going to university because they don't have the opportunities that i do, and thought: i should be studying harder. i should be making the most of what i have been given, i should be using my opportunities to make a difference.

this was then followed by some heart sinking feeling because of course, what difference am i really making to anybody? and in all my years of living so far, has my life really made an impact on anybody? i am just another overprivileged, but not remotely famous paris hilton. (except not remotely that rich either).

many of us live constantly trying to live up to others' expectations of us- or maybe even our own. but if a parent takes their child to piano lessons, and the child has little interest in the piano, is the child really at fault? is s/he really being ungrateful for the opportunity? (there are many children, perhaps, who cannot afford piano lessons). i suppose it really depends on the child's attitude.

whose expectations are we trying to live up to? and what are God's expectations for us? would someone viewing my life from the outside see a person who is trying wholeheartedly to meet those expectations?

since that day, God has been teaching me new things. i used to love this one verse: I can do all things through Christ who strengthens me- Phil 4:13

wow. cool verse, right? if anything was the matter, it was straight to: don't worry! i-can-do-all-things-through-Christ-who-strengthens-me . if ever i am sliding down into a trough, i had this verse up my sleeve to boost me back up onto a peak.

but i hadn't actually looked at the context in which it was written, and it was this- Paul is talking about what he learned in prison, how (verse 11) I have learned to be content whatever the circumstances. (verse 12) I know what it is to be in need, and I know what it is to have plenty. I have learned the secret of being content in any and every situation, whether well fed or hungry, whether living in plenty or in want.

that verse, i think, is really Paul describing his ability to praise God even in the troughs. thus i discovered a new love for that verse, because how much more amazing is it that we can praise God even in the storms of life! and i have decided, no matter what storms are going on in my life right now, i want to be somebody who keeps running after God, singing praises all the way.