tag:blogger.com,1999:blog-72131352405652309592024-02-08T16:13:08.887+11:00Miss Purple StethoscopeMiss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.comBlogger57125tag:blogger.com,1999:blog-7213135240565230959.post-55437666148412780312011-05-07T13:02:00.007+10:002011-05-07T14:09:24.354+10:00I think I've got it all figured out!Okay, so a big claim to make... but at times, amongst the choas and confusion that comes with having to make a million and one choices about life, career, holidays, etc, there are moments (probably short-lived) when one feels like they've got it all figured out. <br /><br />For starters - application for medical internship positions in NSW opened yesterday. It's been a horrendous task deciding how to preference the 15 or so networks on offer because really, at the end of the day, you could end up with preference 1 or preference 9 (for the past 3 years 100% of first round allocations were within the first 9 preferences). So you have to be realistic about deciding which places you'd be happy working in, even if they're not your first preferences. I chose to preference based on geography (hospitals close-ish to where I live), but also taking into considerations places that have accredited vocational (specialist) training programs that you're interested in. At the end of the day, I wouldn't be thrilled getting preferences 7, 8 or 9, but it wouldn't be the end of the world either. I haven't put in my official application yet as I need to get a letter from the university confirming my enrolment and potential graduation status, so hopefully will do that in the next couple of weeks. Beyond the anxiety and stress of this completely random allocation system, it's so exciting to be applying for a "real" job (and really, for me this is the first job that I have applied for since getting my job at the pharmacy 10 years ago!). <br /><br />Next up - thinking seriously and realistically about specialities. Still a bit early, but it does help to have an idea as it could influence where you preference higher for internship hospitals (ie some hospitals have better a reputation than others when it comes to certain specialities). So I've been going backwards and forwards between emergency medicine and O&G; but since starting my anaesthetics rotation 2 weeks ago, I've disregarded both!! Anaesthetics is it, really I just know it! A few years ago, at the end of my first year of medical school, I went on a 2 week elective to Fiji where, while on a surgical rotation, saw anaesthetics in practice for the first time. It was then that I thought anaesthetics could be for me; but with little exposure since, I hadn't really considered it to any great deal. Having just finished gynae surg in the rotation prior to this, I'm now fair sure that at least the G part of O&G is definitely NOT for me. I was so disinterested and just plain bored by the end of the rotation; even though I applied myself as much as I could (I really did!!).. but it got me thinking and moving away from O&G in light of this. Also didn't help that I went to Phuket straight afterwards, which then got me thinking even more about how much I value my holidays and travelling, that I truely appreciated how offensive a career in O&G would be to one's leisure time :-S Anyway, this rotation couldn't have come at a better time. It's been priceless having consultants and registrars on board to talk to about the training program and what is involved in the way of time commitments during and after training. Also the rotation itself has been a good mix of the practical and theoretical. I got my first ET intubation this week! I tried 3 times without success but can now proudly say that I have done a few (4 in fact!) successful intubations. I've also gotten some invaluable practice in other skills (more essential for an intern) such as supporting an airway and ventilating in the correct way using jaw thrust, sealed mask and bag; as well as some much-needed practice in cannulating. Between cases, my supervisors have all gone out of their way to give me tutorials on the basics of anaesthetic theory which have helped demystify what is otherwise a potentially complex area of medicine. I wish this rotation was longer than just 4 weeks - I would love to go into greater detail with the theory and learn new skills. <br /><br />This brings the third area which I've (sort of) finally organised - my elective term. It'll be my last elective as a medical student, I always thought I would go somewhere totally out of this world; picturing in my mind an imagine of my hands buried elbow-deep in someone's open thoracic cavity, heroically performing a cardiac massage (I have no idea where I even got this image from - I don't even want to become a surgeon let alone a CT surgeon!). Lots of people from my year are going to Africa, some even braving the likes of Bara in Jo'burg - but now that it's come to it, I've found myself not really that ready or compelled to take on such an adventure. So I thought long and hard (well, not that long and hard as you will see) and have decided to return to Fiji one more time, to where it all began, and complete an elective in anaesthetics - this time with a little bit more knowledge and wisdom than last. I'm very excited actually, it almost feels like a home-coming. I made a lot of friends and met some wonderful characters when I was there last, so it will be nice to see them all again. Another thing, this time I plan on travelling around and experiencing Fiji culture away from Suva. I've set my sights on booking a <a href="http://www.tuitai.com/">7-night diving trip with Tui Tai expeditions</a>, to venture out away from the tourist tracks that tend to be quite numerous around Fiji. <br /><br />Anyway, much to look forward to! On a toned-down note - I have a mid-year exam in about 10 days that I have done absolutely no study for. So on that note I will leave you, and probably check back in again before I head off to Mudgee for my third John Flynn Placement.Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com3tag:blogger.com,1999:blog-7213135240565230959.post-23548505671672913482011-05-03T12:42:00.000+10:002011-05-07T14:00:57.872+10:00Review: The Pavilions PhuketSeveral weeks before departing for our week-long vacation to Phuket, one of my well-travelled mentors at work gasped at horror that I would want to venture anywhere near the well-beaten tourist track that is Phuket. This made me somewhat apprehensive before our departure; but luckily all this melted away (making room for some much needed rest and relaxation) within minutes of arriving at The Pavilions. Perfectly situated somewhat north of the island of Phuket, it is well-clear of the chaotic touristy areas surrounding Patong Beach - but relatively close enough of a commute if you still wanted to go there. Also, this hotel does not cater for families with young children which - and don't get me wrong, I love kids! - makes it an ideal setting for those looking for a spot of tranquility and maturity that only a child-free setting can provide.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimladoPhBveB6Do1yiExYibREs6iuPBI15Y7S52JStjvlEF3tYFHrDNSBuYg-FqKX1dcqW860ZqXwM7OoAX6GYJAuVI9X27XZ-r8xTN_cIBH8BuioRl8i8ppbbnQHDQvndA7_kV_SvOq4/s1600/ocean_view_pool_villa_20101101_1334009685.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 320px; height: 218px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimladoPhBveB6Do1yiExYibREs6iuPBI15Y7S52JStjvlEF3tYFHrDNSBuYg-FqKX1dcqW860ZqXwM7OoAX6GYJAuVI9X27XZ-r8xTN_cIBH8BuioRl8i8ppbbnQHDQvndA7_kV_SvOq4/s320/ocean_view_pool_villa_20101101_1334009685.jpg" alt="" id="BLOGGER_PHOTO_ID_5603802644097363810" border="0" /></a><br />Our Villa was wonderfully spacious, very well-appointed and tastefully furnished. We had an infinity pool with breath-taking views of the ocean and the weather was perfect for taking a dip any time of the day or night! The open-air breakfast lounge provided an amazing soul-lifting back-drop to enjoy the very tasty breakfast each morning. Although not as extensive as your average 5-star hotel breakfast buffet; each item had been thoughtfully selected, providing guests with a "best of" range to choose from, with the main items (e.g. eggs, waffles) offered from an la carte menu and thus made fresh to order. The French toast and green mango smoothie made a particular impression on this foodie's tastebuds! We ate at their signature restaurant 360° twice - again, spectacular views of the surrounding hills and ocean provide a wonderful ambience to sample a fusion of traditional and modern Thai food. Other culinary delights of note are the Pavilion Platters that can be ordered to your villa to enjoy as a snack by your pool or on your sun lounge - we tried both the Savoury and Chocolate Fondue Platters and highly recommend both!<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjlZ3HjRGDUt3QkSTfXgdaUUQBhA0v2sjMU4yb5I9IpSTNS8sh6YENbe5mOodERubSgTr7zQfZbn0oqgFQIJIwGAFjjqsfy7hpf8HWPS2-SOohiWz1OGuSn4DLLSwflJzKb5Bk5Y232cLw/s1600/360_bar_20101103_1705415499.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 320px; height: 213px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjlZ3HjRGDUt3QkSTfXgdaUUQBhA0v2sjMU4yb5I9IpSTNS8sh6YENbe5mOodERubSgTr7zQfZbn0oqgFQIJIwGAFjjqsfy7hpf8HWPS2-SOohiWz1OGuSn4DLLSwflJzKb5Bk5Y232cLw/s320/360_bar_20101103_1705415499.jpg" alt="" id="BLOGGER_PHOTO_ID_5603802650004051202" border="0" /></a><br />I also tried two of the spa treatments: a traditional Thai massage and an Aromatherapy Oil massage - both of which sent me to a completely different, blissful place; I cannot even find the words to portray the experience with justice! Le sigh!<br /><br />The staff at The Pavilions are extremely professional and discreet; but still manage to genuinely portray the hospitality of Thai culture with their warm smiles, greetings and interactions such that one feels like they are returning home every evening, rather than as a guest.<br /><br />In conclusion, a word or two on Phuket as a destination. It's easy to see how a well-travelled continental drifter may view Phuket as a predictable destination, not worthy of exploration - particularly if you do go to areas that are jam-packed full of tourists and families that have obviously come on one of those "kids stay, eat, and play for free" budget holidays (nothing wrong with that at all - just company who may not be to everyone's taste). I will be the first to admit - we came to Phuket specifically knowing that we would get more for our dollar than travelling virtually anywhere in Australia - and would be able to stay in luxurious accommodation at a fraction of the cost. Herein lies the challenge for you as a traveller, to create your own unique experience away from the beaten track. I believe that staying in a boutique hotel away from the main tourist areas, like The Pavilions, will serve an ideal setting to help you appreciate this beautiful part of the world. I also highly recommend hiring a car and Navman while you're there to get around - it's so easy to drive here and it means you're not tied down to doing set day-trips with tourist companies. Drive to a fishing village to meet the locals; or have a picnic on a secluded beach - the staff at The Pavilions are more than happy to give you directions. Another activity that I highly recommend is learning how to scuba diving and taking a diving trip out in the Andaman Sea - there are some gorgeous diving sites, the water temperature is warm all year long and the big bonus of course, there will only ever be a handful of other people joining you on these trips! <br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvK3xuNvIQkwcWpJUKMKDpW0Q-tq3fXJhvts0j9o9lL1wfUp-g3uk3ogbuV366Im8Y1q4wtmwXNrzTGmnPA-hUeCh5KH8sij_tLlQahUMC3CxKM0agHSYHppRUXW02kSumBr5m3ijxmZ0/s1600/IMG_0859.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvK3xuNvIQkwcWpJUKMKDpW0Q-tq3fXJhvts0j9o9lL1wfUp-g3uk3ogbuV366Im8Y1q4wtmwXNrzTGmnPA-hUeCh5KH8sij_tLlQahUMC3CxKM0agHSYHppRUXW02kSumBr5m3ijxmZ0/s320/IMG_0859.jpg" alt="" id="BLOGGER_PHOTO_ID_5603802639259643378" border="0" /></a>Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com2tag:blogger.com,1999:blog-7213135240565230959.post-62283541007160935852011-04-14T01:20:00.014+10:002011-04-17T23:49:52.265+10:00Scuba divingThis weekend and last, my dad and I completed an Open Water Scuba Diving course. This is something we've both wanted to do for a long time, but I've kept putting it off because of time constraints, plus I had an inkling of reservation about the (lack of) sense and sensibility involved in plunging oneself deep into the vast, vast sea....<br /><br />Anyway, at the end of last year, while on holiday in Jordan's coastal town of Aqaba (on the Red Sea), we took an excursion on a submarine boat with a glass hull that allows you to have a sneak peak at what lies beneath in the comfort of a dry and controlled environment. The submarine boat passed by a group of scuba divers on its course and I remember thinking to myself, "Far out, that's where the real fun and adventure are!!". It looked so free and liberating that I resolved to get my diving licence the first chance I got.<br /><br /><div style="text-align: center;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" style="font-style: italic;" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgnuN8LjInCZ8Sg-2io_x5vy11BvcsMKXORsHdXsIJFhEF0ziybZdZ9u5RBsxx-L24XopiBysLz3c_qj3maOk5gBVdmOzpzwxY3TGHBhbsyAs6MD9DyUI4YDBahp4AyYmpIJtOXP2kYHps/s1600/Red+Sea+Divers.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 370px; height: 276px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgnuN8LjInCZ8Sg-2io_x5vy11BvcsMKXORsHdXsIJFhEF0ziybZdZ9u5RBsxx-L24XopiBysLz3c_qj3maOk5gBVdmOzpzwxY3TGHBhbsyAs6MD9DyUI4YDBahp4AyYmpIJtOXP2kYHps/s320/Red+Sea+Divers.jpg" alt="" id="BLOGGER_PHOTO_ID_5596544654746208546" border="0" /></a><span style="font-style: italic;">Watching divers from inside our submarine boat in the Red Sea, Aqaba Jordan</span><br /></div><br />We booked with ProvDive in Coogee literally the week before starting the course as they had a one-off half-price offer. We were given a book and dvd to work through before starting the course - I found it really quite useful and informative learning about some of the theory of diving principles before even trying it; and the prac components made sense quite easily after that. We hit the local swimming pool for our first session in scuba gear to familiarise ourselves with some important safety elements like how to breathe using the scuba system; finding your regulator (breathing device) if it falls out of your mouth; sharing air with someone using the second regulator if you or they run out of air; clearing your mask if it fills up with water while you're under, etc. It was weird at first, that's for sure! Nothing was difficult per se, just a matter of adjusting your body, equalising pressures, and the number one rule: remembering to never stop breathing!!<br /><br />Our first open water dive was out at Gordon's Bay last Sunday - I couldn't have picked a better day or site for the occasion. The weather was absolutely gorgeous both in the water and out; and the visbility was a fair 20 metres or so. It's difficult to describe the sensation in terms other than "like flying through water". I was warned by the guy who booked our places in the course that it's an addictive hobby - I can vouch for that! It was just as I imagined it would be and better. The silence, tranquility, and sheer beauty of the underwater world made me feel so calm and at peace; corny as it is, I kept humming Nina Simone's "Feeling Good" in my head.<br /><br /><div style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEim9VGAP-8y2-2PRlvBu81JiHLkYSMQRpPNwq5OFvPeRW7gf2iBEODBo-tB5aHQ_UN48y_XF2BI-4waQsx7FfoHeQe44ilO1KCAQKP8Q-jxsDOn4jl0NQ5W-PINYD1RaUBthFVBOa8gMI8/s1600/Gordon%2527s+Bay+Sydney.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 365px; height: 243px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEim9VGAP-8y2-2PRlvBu81JiHLkYSMQRpPNwq5OFvPeRW7gf2iBEODBo-tB5aHQ_UN48y_XF2BI-4waQsx7FfoHeQe44ilO1KCAQKP8Q-jxsDOn4jl0NQ5W-PINYD1RaUBthFVBOa8gMI8/s320/Gordon%2527s+Bay+Sydney.jpg" alt="" id="BLOGGER_PHOTO_ID_5596545427809453394" border="0" /></a><span style="font-style: italic;">Gordon's Bay, Sydney</span><br /></div><br />The other thing that I loved was the commraderie among our team and enthusiasm of our dive instructor. There were nine of us in total: my dad and I; a law student about my age and her mum; a cute young Ukrainian couple; a cool surfy couple and a guy of New Zealander Maori background who wanted to learn to spear fishing while diving. We all came from different backgrounds; but between us a common desire to travel and explore the world around us, epitomised by our dive instructor - a young, hip Danish guy who left home in his twenties to travel, got his diving instructor's qualifications, and never made it back to Denmark. Le sigh! The life of the young and free! I mean, I'm young right (turning 25 this year); but by God, let me just say that the further along medical training I go, the more restrained and tied down I feel. Once upon a lifetime a ago before starting medical school, I just wanted to travel, drifting from place to place - taking my skills with me wherever I went. I was always going to be either a teacher, doctor or nurse for this vision to work; as these professions would equip me with portable skills that are universal across all borders. Fast-forward to the reality that is medical training and my prospects of continental drifting any time in the next 10-20 years are looking quite grim. I'll leave a complete and unabridged rant on this topic for another day; but let's just say, although I thought I could rise above and conquer this long-held silly dream of mine, it's getting the better of me and I am presently giving a lot of thought to what I'd like to specialise in based on it. Anyway, another thing I was also quite surprised by, was the inclusiveness and unpreteniousness of the diving community and their culture. They genuinely want people to learn to dive and be excited about the underwater world - and it's not financially driven either. When the costs of equipment, staff, insurance, licencing, etc are factored in, I doubt much if anything at all is made on leading a diving trip or teaching a "learn to dive" course. I could explicitly spell out a comparison to the culture of the medical community at times; but you all know where I'll go with that one. Hmmm...<br /><br />So after our first weekend of diving, this weekend couldn't come sooner. We had another geat couple of dives, this time out at Camp Cove. The weather this weekend was a bit miserable, but when you're underwater, you're going to get wet anyway! We finished our course and I have to say I was sad at having to say good-bye to my diving buddies. Le sigh, such is the nature of transient friendships; but who knows, it's a small world and our paths may cross again on day, on land or in the sea.<br /><br />As for my dad and I; our holidays have just gotten all the more exciting and fun!! Our first chance to put to practice some of our newly acquired aquatic skills will be this upcoming week. My mum, dad and I are off to Phuket for a week over the Easter long weekend and I can't wait to get into the water and check out some of the amazing tropical reef and sealife up there. Hopefully will get a chance to take some photos while down there too! In closing, I'm going to highly recommend y'all get out into the water and try diving for yourselves. You'll be amazed, I promise!Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com0tag:blogger.com,1999:blog-7213135240565230959.post-64180021633704171002011-04-04T21:02:00.004+10:002011-04-06T00:33:52.515+10:00Break-it-upI have a load of uni work that is quickly piling up into a mountain. 11 weeks into the (17-week) semester, I'm thinkin', "crap! what have I been doing all this time?!"<br /><br />Doesn't help that, mentally, I just want to cruise through this year and put in the bare-minimum of effort required to scrape through. Still, it's dawning on me, "scraping through" still requires public health assignments to be handed in; journal club papers to be presented; and short-cases to be reviewed. Urgh! <br /><br />One of the habits I've had to get back into practicing, is breaking tasks up into bite-size chunks, and chipping away at a seemingly overwhelming workload one bit at a time. <br /><br />God that I wish for this year to pass painlessly! Pleeeease!!<br /><br />In other news, today as I was walking to the train-station, I found myself becoming a nosy-onlooker at the scene of a car vs pedestrian accident. I watched with much apprehension as the ambos scooped up this poor semi-conscious woman (who was just innocently minding her own business, crossing the road at a pedestrian crossing, as you do..) and whizzed her off to hospital. I considered for a brief second running back up to the hospital (I assume they would have taken her to my clinical school hosp; which was only a few hundred metres from the scene of the accident); checking out her management in the ED and seeing that she was okay. But the sight of the pool of blood that was left on the road from her open head injury made me feel quite queasy.. and honestly, I decided that I preferred not to know the outcome, if there was a chance that it was going to be a bad one. *Shudder!* Anyway, I now have a renewed sense of utmost respect and admiration for ambulance officers. <br /><br />Okay, enough said - time to hit the books!Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com2tag:blogger.com,1999:blog-7213135240565230959.post-28062266752408720922011-03-30T23:31:00.007+11:002011-03-30T23:51:39.639+11:00Inspirational: Dr Susan DownesI came across Dr Susan Downes' story as I was browsing the net this evening, searching for some career inspirations (as you do). She is a GP-Obstetrician who delivers services across a huge expanse of land in Western Australia (extending as far out as Christmas and the Cocos-Keeling Islands in the Indian Ocean!!).<br /><br />The following is an article that was featured in Medical Forum WA Magazine (April, 2006). I hope you enjoy reading about her story and find her work as inspiring as I do!<br /><br /><br /><span style="font-style: italic;"><span style="font-weight: bold;">Multiskilled - Dr Susan Downes<br />Written by Mark Thornley<br />Saturday, 01 April 2006 </span><br /></span><br /><span style="font-style: italic;">They say the genes for multi-tasking, negotiating skills, spatial awareness and acceptance are carried on the X chromosome. Dr Susan Downes is living evidence of these inherent skills, plus more, having pursued a varied career in primary health care while raising three children. Her ability to thrive on diversity, adapt, and break down boundaries has positioned her as an every day pioneer in primary care. Susan was a wide-eyed epidemiology research assistant before she took up medicine at the age of 35. She has excelled since, undaunted by family trauma, and this year her remote GP work in the Pilbara and on Christmas and Cocos Islands earned her the General Practice Prize for Excellence in Population Health, conferred jointly by The Public Health Association of Au</span><span style="font-style: italic;">stralia and the RACGP.<br /><br /></span><div style="text-align: center;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjz4X64GLD3YDhZwsQOq5SC-RfH3zEL7laPAx0mp_8V36FGB6PYqI0qsvQ94AS_J2Zl1Car8xfQtAlzyHJGacmDSMMq31glC2nHqXlkDTYQxaz3Bc6dK0119z0zi7bRxSYlYKC_kVDhWIk/s1600/0604susan_downes_collecting_patient.jpg"><img style="cursor: pointer; width: 370px; height: 205px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjz4X64GLD3YDhZwsQOq5SC-RfH3zEL7laPAx0mp_8V36FGB6PYqI0qsvQ94AS_J2Zl1Car8xfQtAlzyHJGacmDSMMq31glC2nHqXlkDTYQxaz3Bc6dK0119z0zi7bRxSYlYKC_kVDhWIk/s320/0604susan_downes_collecting_patient.jpg" alt="" id="BLOGGER_PHOTO_ID_5589853590164308162" border="0" /></a><br /></div><div style="text-align: center;"><span style="font-style: italic;">Dr Susan Downes on her RFDS run</span><br /></div><span style="font-style: italic;"><br />A self confessed travel junkie, Susan has always had a curiosity for new cultures.<br /><br />"When in London I was working with many epidemiology doctors who inspired me with their stories of different countries and cultures. One in particular had worked in New Guinea and told me how he had to do a caesarean on a tribal chief's wife who had obstructed labour with twins."<br /><br />"The tribe was cannibalistic and he was thinking, ?if this doesn't come off, I'm on the menu for dinner'. He'd never done it [a caesarean] before and was reading the medical book and was on the pedal radio trying to get instructions."<br /><br />Flicking through an international medical journal and drooling over jobs for medicos in exotic locations, she decided to enrol in medicine as a mature age student.<br /><br />Her actual medical career began as a family GP in Fremantle where her strong connection to people meant it was not long before she knew the names of her patients' budgerigars and was "burying their grandmothers".<br /><br />The multicultural Fremantle mix of Greek, Italian and Portuguese provided a solid grounding for her transition to the Rural Women's Female GP Program that now sees her consulting Malay, Chinese and Muslim communities throughout Christmas and Cocos Islands.<br /><br />"I felt I was becoming a bit narrow in the suburbs and just filling out forms and sending people off for blood tests. When you're out in the sticks you're doing everything yourself. You're reading your own x-rays, and doing your own bloods and ultrasounds."<br /><br />She now incorporates Chinese medicine and Aboriginal bush medicine into her consulting, where she can. She thinks any GP who takes on a rural locum might regain some of their inspiration, especially away from bureaucratic hoops.<br /><br />For example, she recalls one confronting incident on Christmas Island, which is so remote even the Royal Flying Doctor Service cannot attend patients unless they charter a special plane.<br /><br />"We had a fracture-dislocation of the cervical spine. No plane could come and the paralysis was getting worse as we watched him. A community plane that used to go to Jakarta happened to be on the island so we took the seats out and a nurse and I got on with the patient and the pilots, and set out into the Never Never and flew to Perth via Learmouth in the dead of night. We really felt we weren't going to make it but eventually we got the patient there and he went into theatre straight away and is now walking."<br /><br />Susan has been attending the health needs of adolescent Aboriginal women in the desert communities of the East Pilbara for five years. She visits these communities for 2-3 days every two months where she confronts sexually transmitted infections, unplanned teen pregnancies and cervical cancer.<br /><br />To do this she must gain the trust and confidence of these shy groups of women, where she helps deliver education programs at medical centres, schools or even creek beds and swimming holes.<br /><br />By preventing STIs, future infertility and its expensive solutions are greatly reduced. By encouraging pregnancy-free years, young Aboriginal women mature physically and mentally and attain higher levels of education.<br /><br />Susan's involvement as Liaison GP at Woodside Maternity Hospital has ensured the hospital's status as the last inner suburban hospital to retain a thriving public obstetric service run by GP obstetricians. Deliveries have risen 12.5% and she assumes a senior role in a team delivering over 700 babies each year. Susan now performs her own caesareans and can offer the full obstetric service in remote locations such as Derby where she does obstetric locums.<br /><br />Twenty-one years after entering medicine, she had recently completed an obstetrics research project and hopes this, plus her work with the WA Centre for Rural and Remote Medicine, will help others providing obstetrical services in remote communities.<br /><br />Enjoying bush walking and bee keeping as hobbies, she has a long term goal to work for Medicine sans Frontiers or Oxfam - when she gets enough money in her super fund.</span><br /><br />(http://www.medicalhub.com.au/, accessed 30 March 2011)<br /><br /><br />I'm trying to locate her contact details so as to send her an email and ask if I can do an elective with her at the end of the year! Would be amaaaazing!!Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com1tag:blogger.com,1999:blog-7213135240565230959.post-70332153649129470412011-03-29T23:39:00.000+11:002011-03-30T23:53:13.650+11:00Full-time all the timeRandom rant that I feel strongly about, so just put up with me for a few minutes here.<br /><br />Dear Stay-at-Home Parents (who think that only they can exclusively call themselves "Full-time Parents" and feel that they have the hardest and most important job in the world),<br /><br />I'm sorry to break it to you, but you don't. In fact, you only have half the job that some others do. Because - believe it or not - parents who participate full-time in the workplace, do not come home to part-time parenting. No, in fact, they come home to full-time parenting: the same job that you do all day, they do when they come home. So they essentially have two full-time jobs. It's called "Time Management".<br /><br />I understand that you may be frustrated by the lack of recognition and financial reimbursement of full-time parenting, but here's the thing: it's even less valued and recognised as an occupation if you are a full-time participant in the workforce, because there is the assumption (by a select few) that you cannot be a full-time parent AND a full-time worker. So they take claim to the title of "Full-time Parent" and take it to define only those who do this exclusively.<br /><br />Oh, and another thing, if full-time parenting was financially reimbursed - I bet you anything that parents who are also full-time participants in the workforce would be excluded from that payment. And you'd all be okay with that. So go figure.<br /><br />Anyway, just putting it out there for the next time someone starts giving me their spiel about how exclusive full-time parenting is "the hardest and most important job in the world".<br /><br />End rant/Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com1tag:blogger.com,1999:blog-7213135240565230959.post-18997827450542104842011-03-27T23:29:00.010+11:002011-03-28T00:39:36.960+11:00GAMSAT Version 2.0 and "meh" talkWeekends always go so quickly. What's with that..?! I had a very bizarre experience this weekend. I did St John First Aid duty for the GAMSAT exam (Sydney Venue). It was so weird right. Last time I was there was four years ago when I was sitting the exam myself. It's funny how even the memory of a high-stress situation can provoke the same sympathetic response as the original event. I so vividly remember not being able to sleep the night before the GAMSAT - I kept dipping in and out of consciousness, checking the time on my mobile phone next to me every half an hour for fear of sleeping-in and missing the damn thing. Not to mention the drum-roll palpitations on entering the exam hall. It's such a b*tch of an exam and I honestly see no correlation between passing the exam and success in medical school. It really is just a high-attrition tactic to wipe out > half the med-school hopefuls so that the bureaucrats and admin people don't have to deal with the effort and paper-work of going through all the potential applications that would come through. Meh. Anyway, thing of the past, can comfortably put it behind me and was oh-so-very relieved to be there as a spectator at the Australian Technology Park in Redfern (venue where the exam is held) this time.<br /><br />On the med-school front, I finished my rotation in Neurology last week. It was a really good rotation; made all the better by the team I was with and my supervisor. I definitely could have been more pro-active and involved, but I seemed to always find the temptation to go home after lunch too strong to resist. So basically I'd attend ward rounds in the morning; then tag along with the registrars on their consults (usually in ED); there would always be a meeting of some sort that was worth attending (especially the radiology ones where they go through scans of patients on the wards); some days there would be a clinic on in the morning or afternoon; and the rest of the time was spent seeing patients on my own or with another student. I tried to see at least one patient a day and do a long-case type assessment of them. Sometimes the interns would ask us to take bloods or put in cannulas which I'm a bit over doing now because the novelty has worn off, from doing so many last year. Anyway, there were four medical students on the team - one of whom was a bit annoying because she would always hang around until really late into the evening with the team. She's interested in pursuing Neurology as a speciality, so I understand that she wanted to get as much out of the placement as possible; but still, it made us all look unmotivated and less-than-keen. It was a bit frustrating too because she would never explicitly answer my questions on what she would get up to in the afternoon/evenings when we weren't there; so it was hard to gauge whether it was worthwhile staying behind or not. Of course we could've just stayed behind ourselves and found out, but I don't know that it would have really been useful as most of the activity seemed to happen during the day, and she would always slip off and do her own thing anyway. Meh. I'm sounding a bit like sour grapes now, so I'll stop. I am actually happy that she's thrown herself into Neurology. Two reasons: (1) every speciality and its patients deserves to have a keen-bean enthusiast who will throw themself into their work - these people turn out to be the movers and shakers of the specialy; (2) last year she was set on pursing O&G, so she would have made some very stiff competition if we were going for the same registrar-level training position. Okay, official freak of sour-grape I am today - will stop! So, um, yeah.. I always assumed I'd fall into a career Neurology myself, because I have a degree in neuroscience - so it seemed like a natural progression. I have to say though, the fascination and general awesomeness that drew me to the theory of neuroscience back in my undergrad days; is numbed by a sobering overtone of helplessness when it comes to the actual clinical practice of Neurology. There really isn't much that can be done for a lot of patients under the Neuro or Stroke-Unit teams, curatively - with the majority of management aimed at stopping disease progression or rehabilitating the body back to a functional state, post-event. The true hero(es) in my eyes, are the clinical research teams that are working on preventing and/or curing neurological diseases. I hope that I can see their effect of their studies in my life-time. It really would be an amazing contribution to society. <br /><br />Tomorrow I start the last of my medical/surgical "selective" terms - Gynae Surgery. I had initially been timetabled for Haem Oncology, but I heard it was a fairly average term to do as a med student, so I swapped out of it. The person who was assigned to Gynae Surg has no interest in this area at all, so she was happy to take anything else. I'm thinking again about going into O&G, so I guess it was a win-win situation. I've heard the supervisor for this term is really nice, but he grills his students on their knowledge of the anatomy of female reproductive organs. So I spent like maybe half an hour (if that) trying to memorise the ligaments that hold various different things up and stop them from falling, if you get my drift. I think I'm okay getting grilled for the first week, and then getting the swing of things by the second week, because I'm honestly finding it too hard to just stare at diagrams of the uterus and ovaries without a clinical situation to slot things into context.<br /><br />Anyway, it's now midnight and I'm wishing I had more weekend time to catch up on sleep, chillax, watch some DVDs and do some uni work. Meh.Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com5tag:blogger.com,1999:blog-7213135240565230959.post-3420799744839578682011-03-10T00:51:00.006+11:002011-03-10T01:36:06.640+11:00Long-lost friendI haven't blogged in a long time. I haven't even read other people's blogs in the time being :-S Of late, I've had a bout of avolition where I've just found it hard to get on with the easiest and simplest of tasks. It hasn't helped that I've had deadlines to submit various forms coming at me left, right and centre. It's paper-warfare I tell ya! So, since November, here's what I've been up to (in a nut-shell):<br /><br />- Sat and passed end of 3rd year exams (phew!). Actually did aright, I got an overall mark of 76% which is the highest I have ever gotten in med-school so far as an end of year grade. <br /><br />- Travelled for 2 months to Jordan, Syria and England over the summer break (although it was actually winter in all of these destinations). I had an amazing time and definitely could've kept going with my continental drifting had I not had to come back to start 4th year in late January (I actually missed first week back, so go figure). I did some hospital placements while I was oversees (O&G in Jordan, ED in England) but have nothing remarkable to report on those execpt that they were pretty boring, uninvolved and student-unfriendly. This turned out to be a good thing as it meant that I was okay not being at the hospital and actually doing some travel. <br /><br />- Returned in late January to commence my 4th and final year of medical school (*squeal!*). I'm so excited to be on the home-stretch run. This has been a long time acoming! I will have plenty more to write about this as the year progresses, so it's definitely going to be an overriding theme throughout my posts this year. As for what I have been up to rotations wise, I am half-way through my 2nd rotation (Neurology). My first rotation was Cardiothoracic Surgery (this is something I plan to write more about as well in the near future) - but suffice to say for now that it turned out to be the highlight rotation of my med school career so far. Bloody mind-blowing, complex, intensely emotional cases - the grand dame of surgical specialties did not fail to impress! Neurology has been quite cruisy but enjoyable as well. Kind of my niche area if I had to pick a medical speciality as I did my undergraduate degree in Neuroscience. <br /><br />- What else? I was made redundant from my long-held (9 years!) job before going overseas. This is something that stressed me out a great deal, especially since I have a maasive loan (~ $20 000) that I took out to buy my car last year... and also because I was just about to go on holiday and the last thing I wanted was to do things on a shoe-string while travelling. Anyway, I dug deep into my savings and managed to budget what I had quite well while on holiday. As for my car, I lent it out to my parents (who sold their car at the end of last year and didn't yet get a new one), while I was o/seas and they paid my fortnightly loan repayments in return. So then when I returned from overseas for the first month I just made do with what I had and brought lunch from home and didn't go out at all, etc. Then I found a tutoring job which was advertised on Gumtree, basically just helping a mature-age "return to uni after having kids" student from a non-English speaking background with her assignments for a Bachelor in Early Childhood Teaching (very random, I know!). It's a few hours work so it's not too bad and it's cash-in-hand. But get this right, in a fortunate twist of fate, my ex-work contacted me last Sunday about getting my job back because they'd culled too many people and were in desperate need of staff that they wouldn't have to retrain. SO now I've got my old job back (on a Sunday too - so extra pay!) AND I have this random tutoring job, which means I've gone from just Youth Allowance income, to > double that every fortnight (and all is well with the world!). This is has been a big relief, especially since I would like to save up to travel at again the end of this year. <br /><br />- Lastly, my sister is now about 21 weeks preggers and getting quite big. Her and her hubby want to keep the gender of Little Bambi (as I call It) a surprise. But I'm very much looking forward to meeting it and forming an awesome friendship with it later down the track! <br /><br />So, that's it from me. I have a few things I want to reflect on, which I will do gradually. One thing I was thinking of doing is switching to a different blog as I feel like this blog was started in a time and place that I am far removed from now, and everytime I log in I think of all the crazy shit that was happening at the time, so it's not always a happy place to come back to. Still, it feels like a long-lost friend that knows all your secrets; but not in a snide way either. Anyway, I will give forwarning of a change if it does happen as I don't want to drop off the blogosphere and have people wondering if I got hit by a car or something :-S <br /><br />Toodles!Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com0tag:blogger.com,1999:blog-7213135240565230959.post-86265089173720496742010-11-08T17:09:00.002+11:002010-11-08T17:21:24.249+11:00Big dreams, little one...So I'm not supposed to tell anyone yet, but since none of you actually know who I am, I figured it'd be okay to spill the beans here: <br /><br />I'm going to be an aunt!! <br /><br />My sister just found out she's pregnant :-D I've just made room in my heart for some big-time love! In my collective culture, a new baby in the family is everyone's child and responsibility. So my sister having a kid, is like me having a kid. Wow! Totally unprepared for this but gosh, I'm so excited!! She's only 6 weeks, so plenty of time to start planning all the fantabulous things we're going to get up to. <br /><br />Little one, you don't know it yet, but Aunt Purple Steth has some big dreams for you. You're going to be awesome, I just know it!Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com2tag:blogger.com,1999:blog-7213135240565230959.post-82402236639233222202010-11-02T20:47:00.002+11:002010-11-02T21:11:36.028+11:00She's a real personI hope I never become jaded. I hope I always remember that patients are real people and not a disease embodied. It sounds a bit obvious - but those in medicine will be able to relate. You spend the first couple of years of med school reading and learning about a multitude of diseases and pathologies. Some of these are essential knowledge; others are vague differentials you push to the back of your mind because you know you'll never see a case like that. The so called "you'll only find it in a text-book" cases. <br /><br />Today I saw a lady who had a transverse myelitis and radiculopathy due to a Coxsackie B virus. My clinical partners and I took a group history and exam; I thought she had Guillain–Barré syndrome - she was almost paralysed from the umbilicus downwards. It's pretty scary shit actually, and something you probably won't even read about in a text book it's that uncommon. As we were coming to the end of our examination, I looked up at her and thought to myself, "oh my, she's a real person..". <br /><br />It's this crazy weird moment that hits you. I've had it happen to me before. On the one hand, it leaves you feeling so inadequate and unworthy of the privilege bestowed upon you by this person sharing their misfortune; on the other hand it leaves you with this fierce desire to repay them, to be useful, to have an answer or something that you can offer them. It doesn't happen with everyone; I guess the mental struggle involved would be somewhat counter-productive - you can't invest too much. But it's a nice reminder that crops up every now and then. Medicine is about real people.Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com0tag:blogger.com,1999:blog-7213135240565230959.post-48159344748230688482010-10-24T19:37:00.003+11:002010-10-24T20:24:40.603+11:00Things are pretty good at the moment :-)Dear Blog, <br /><br />I'm sorry I abandoned you. I have so much to say and yet time - as it always and forever will be - is against me. I've finished O&G, general surgery, paeds and am now on the home-stretch with 4 weeks left of general medicine. <br /><br />O&G was amazing, but very tiring! I have so much admiration for the registrars who continue to pull through restlessly, day and night. It's an incredibly rewarding speciality and I wish I had the energy to pursue it, but I honestly think that the long hours and exhausting on-call roster would get the better of me. The other thing - more than ever, I've renewed my resolve to work in medical aid work (I'm counting down the years until I'm capable of being able to stand on my own and contribute productively in the field)- and I have a feeling that gaining a fellowship in O&G from here would equip me with more skills that what I would need in a developing world setting. Seems a bit redundant being able to perform IVF and high-tech laparoscopic gynae surgery when what I essentially need to know is how to deliver a baby safely and do an emergency hysterectomy (as a last option to resolve PPH). So I've reset my aspirations and have rechanneled my plans towards becoming an Emergency Physician with a Dip of O&G. I'll write more about it later on, as things progress, and especially during/after my ED term next year, but for now, I'm excited once again. Excited about being in medicine and where it's going to take me. Hip hip hooray!<br /><br />The other thing I'll mention is how much I enjoyed Paeds! Absolutely loved it and the characters along the way. The Paeds registrar in particular was so enthusiastic and inspiring; her work-ethic really came through and she went out of her way to make sure we (the students) were included in the team. <br /><br />So 4 weeks left (then 1 week of stuvac and 1 week of exams). I can't believe how quickly this year has flown by! I'm on the homestretch folks! In 6 months I'll be applying for a job; then 6 months after that I will be on my final elective rotation, a few weeks off from finishing. I hope it's come through in this post, but if it hasn't I'll spell it out: I'm really happy, I feel at peace. I'm starting to see the light at the end of the tunnel and feel less like an aimless wanderer than I did when I first started almost 3 years ago. I've learnt a thing or two along the way, and I have a sense of direction of where I'd like to go with this knowledge. If you're reading this and you're still at the beginning of the journey: keep at it. It's seemingly long and endless, but oneday you will reach a point where you can not only look back and marvel and how far you've come; but also look ahead and feel that the road ahead isn't as daunting as it seemed when you first started and that there's no where else you'd rather be than where you are at that point.Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com5tag:blogger.com,1999:blog-7213135240565230959.post-81242197657457228782010-08-03T00:23:00.007+10:002010-08-04T22:02:29.801+10:00In Condé Nast, we (would like to) trustI'm going overseas from December-January for a combined holiday/elective placement. I'll be spending December in the homeland (Jordan) and January in the UK. Most of my time in the UK will be spent in Manchester where I will undertake a placement in emergency medicine at a BTH (this will be in addition to a placement in O&G in Jordan). I then plan on spending a week in London, for obvious reasons (can't go the UK and skip London, especially if you've never been there before!). So far, I've organised the placements; arranged accommodation in Manchester and Jordan (I'm really just going to be alternating between the hospital accommodation and my uncle's place on weekends for Manny; as for Jordan, well, it's the "homeland" with all that that entails :-P); I've booked my plane tickets and now just have to organise accommodation in London. Which brings me to the topic of this post. <br /><br />I want to do London properly. Not on a shoestring. I've heard it's such a grand old city with lots to see and do; so even though I've only got a week there, I want to get the most out of it... and I want to do it in style. My backpacking days are over - I'm going to be earning a half-decent income in less than 18 months' time so I think the time has come to stop worrying about putting aside what meager income I'm making from my casual job + youth allowance for "a rainy day", and start spending some of it. In my quest, I've had to exchange my trusted Lonely Planet advisers to Condé Nast Traveller gurus. Oh to be a Condé Nast Traveller reporter! Forget Runway Magazine, this would surely be the job that a million girls (and guys) would die for! I've spent a bit of my free time over the last couple of days perusing the "Where to Stay in London" section on the website. Some of the places look so amazing, I honestly just wish that money wasn't a limiting factor and that I could stay wherever I liked. I'm determined to have a nice classy experience but cannot by any means justify (or afford) the $500+/night tariff on most of these places. So now I'm in a bit frumpy mood because I'm stuck in the middle - neither here nor there - annoyed with myself for trying to be pretentious beyond my financials means, but also at these hotels for being so ambitious in their room rates. Moments like these I really feel for people with Bipolar Disorder. Urgh! Anyway, will reach a happy medium soon I hope, and then update.Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com1tag:blogger.com,1999:blog-7213135240565230959.post-51428185667737228712010-07-12T17:15:00.008+10:002010-07-12T21:52:33.954+10:00Chance Encounter ("Paradoxically" Part II)The more people you encounter as part of your routine ongoings in medicine, the more people you forget (inevitably, due to statistical likelihoods and all..). Every now and then you meet someone memorable and sometimes find yourself thinking, "I wonder what happened to..?". This is particularly the case, I think, in emergency medicine where the duration of a patient encounter will total a few hours, if that, and then the patient is transferred to someone elses' care, discharged home or (as the case has been for several of my patients), taken from us by the Almighty upstairs. So, this afternoon at the dentist's, I was presented with a chance encounter of the fateful type - I was reunited with the wife of the gentleman who died of a cardiac event a few months ago while I was doing a night shift in ED.. the one whom I had informed of her husband's passing on that tragic night. She recognised me before I had even noticed her standing there, and then when I looked up and saw her looking at me, all she had to say was, "my husband.." for that night to come rushing back. It wasn't an unhappy encounter and not completely awkward like you would expect it to be, but there was certainly an air of unease as we exchanged our greetings and how do you dos. I found it hard to tailor my body language appropriately to the situation - should I smile? should I sigh? should I just nod curtly to everything she says? How on earth does one converse to a deceased patient's family members, many weeks post-mortem? She talked about his death and how the hurt hadn't eased one bit - certainly her affect and tone were as sorrowful as that night, and the painful self-imposed guilt was still there: "if only we'd gotten him to the doctor sooner, if only...". We also talked about the coroner's insistence on an autopsy despite the family's wishes for an immediate burial and other smatterings of small chat, as you do. She cried, I listened and offered her the untested advice that it will get better one day. So then we went our seperate ways, wished each other well and hoped for another chance encounter. A small step towards closure that is often missed in this profession, a little poetic too, don't you think?Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com3tag:blogger.com,1999:blog-7213135240565230959.post-88385253424690167982010-06-25T19:47:00.004+10:002010-06-25T22:05:36.757+10:00HandbagsThere's something about patients' handbags which remind me that before me is a person, and not just a body. You can put all sorts of things that signify life and existence in this world in a handbag: keys, wallet, tissues, mobile phone, diary, random hard-boiled candies wrapped in clear cellophane... you get the point. A few weeks ago, a dear old lady in Ward C passed away. Her handbag was always at the foot of the bed. After the arrest call and proceedings, as the people in the room started to clear away, I noticed that her handbag was still there by the foot of the bed. And then I couldn't help but wander about how her family would feel taking it back home without her. It made me feel quite sad at her passing, even though I'd only seen her a few times during ward rounds. She was a person, with a handbag full of worldly things that are of no use to her in the next journey. And by then, neither are we...Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com2tag:blogger.com,1999:blog-7213135240565230959.post-44061509193273445252010-05-25T00:17:00.009+10:002010-05-25T20:52:24.542+10:00Paradoxically...Saturday morning, 3.30am, overnight shift in ED. I had just gone into the on-call room for a shut-eye when one of the interns popped in to let me know that the ambos were bringing in a middle-aged male in cardiac arrest. There was six of us in ED: an ED physician, 2 interns, 2 nurses and myself. Did I want to see it? "Hell yeah!" I thought, this is the only medicine worth seeing as far as some med students are concerned. Things are somewhat different on the other side now, you'll see what I mean.<br /><br />He looked his age, but a little worse for wear. He'd been intubated by the ambos; and had defib pads on his bare chest. I stood back to watch as the scene unfolded, wanting and unwanting to be involved... it's a hard feeling to describe. A few minutes in, one of the interns told me to grab a pair of gloves and get ready to take over chest compressions. "Wha..? Err, okay.." I took over after from the start of a new cycle - and in that instant, I crossed the line; I became involved, in more ways than I wished to be, as events would later unfold. I'd done CPR before - on a 90 something year old already half-dead, dying old man in Fiji, just because protocol dictated we do so. At the time, I appreciated the practice, felt kind of sorry that I broke his rib cage, and was secretly grateful when they called it. This was so different, so much more intense, so much more <span style="font-style:italic;">involved</span>... I'll keep coming back to that word. It was an intensely highly-sensory experience: I could smell the patient's sweat; hear the ventilator beep, puff and whirrr; feel the crunch beneath my hands as we'd surely broken his ribs; and see his empty eyes staring up at me. If anything, the eyes gave it away - he wasn't going to make it, even I knew that. In hindsight, I wish I didn't have that initial hunch that he'd already left us - I wonder if I would've compressed harder and more wilfully on his chest if it weren't the case? I wonder if that would have made a difference? Several rounds of compressions, a bolus of atropine or adrenaline, stop and re-assess, rotate through and do it all again... we gave him a fair go. Initially because it seemed he was gasping for air though the ETT, and then when that had stopped, for closure. And then we called it, just like that. Machines turned off, ventilator detached. Time of death: 04:05.<br /><br />We stood back for a few moments to quietly reflect on what had happened and pray to whatever we believed in that he was is a better place now. Then one of the nurses looked up at me and said, "he's from a Middle-Eastern Muslim background, I think the family would really appreciate if you're there when Noel (the ED physician) tells them." It wasn't a suggestion, they all nodded in agreement and it was decided. Nothing in the world can prepare you for delivering the information we were about to. Nothing at all. We lead them into the family room - his wife, kids, brother and sister in law. Typical Arab-style, the extended family were all in the waiting room. Noel started to ask a few questions about how our patient came to be: straight-out-of-a-text-book heart attack presentation - so classical, it was heartbreaking. His wife recognised he was having a heart attack and urged him to go to the hospital. Shit! If only... ? Or maybe it wouldn't have made a difference... ? Who knows... ? Noel asked a few more questions, before finally putting it out there that, "we tried very hard..". The message passed over them. Noel looked at me and I said in a faint voice in Arabic, "God has taken his soul, may He have mercy on it". <br /><br />The rest is of inconsequence. Life happens when you least expect it and people react in ways that they know how best to. The outcome is the same, no matter who delivered it, but I hope that being there in this sensitive moment made the situation a little bit easier for them. For me, suddenly, everything else in the ED that night seemed so trivial... <br /><br />To be honest, I hated being the bearer of bad news to this family - worst feeling as far as the future doctor in me was concerned; more so than losing the patient I think. This family could have been mine, easily; the situation was so eerily close to home after what had happened with my mum last year. I was involved in a way I haven't been in a very long time, or ever even, with a patient and their family. But there's a lesson to be learnt in everything we do here. In the past few months before this happened, I'd noticed myself becoming increasingly blase about the people around me as patients and my role as a carer. A lot of the time I haven't even bothered asking the patient's name and I guess I've pushed this concern to the side thinking, "detachment in medicine can only be good", or they say so anyway. And then this. I won't deny that I've felt quite sad for the last few days, but now that the dust is starting to settle, I feel refreshingly at peace with the idea that I've at least felt something towards someone who I was looking after. It's paradoxical, I know. Guess I just didn't realise how much I missed it...Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com4tag:blogger.com,1999:blog-7213135240565230959.post-84614279092583438162010-04-28T23:18:00.000+10:002010-04-29T00:33:49.708+10:00A rough patch on the greener grassHalf-way through my GP-rotation and the honeymoon period is definitely behind me. I never expected my GP-rotation to be so exhausting. This is really due to my main GP supervisor, who is just...so... <span style="font-style:italic;">mean</span>! Today I cracked it. Today she made me cry. I'm too exhausted to write about in great lengths; she is simply just so <span style="font-style:italic;">exhausting</span>! I wrote to the clinical supervisor/mentor of my home-base hospital asking for help:<br /><br /><span style="font-style:italic;">Dear Mentor,<br /><br />I hope you're well. I'm half-way through my GP rotation and wanted to raise a concern I had with one of my mentors. I have several GP supervisors that I work with in the practice - all of them are really wonderful and I love working with and learning from them. My main mentor, Dr X, however, is really quite harsh and strict. Her feedback is extremely helpful - don't get me wrong - she gives great advice about what you need to know to fill gaps in your knowledge; but her approach and mannerisms are quite destructive. If she asks a question and you don't know the answer, she pulverises you in front of the patient and makes you feel like a failure. I don't know if I'm just a little soft in that regard, but some of my experiences with her have been extremely stressful and quite frankly, just downright hurtful. I've been too scared to say anything to her about it because, all things standing, I think she means well and it's certainly not personal. On the contrary, I have thanked her for her feedback and am doing my best to remedy these gaps in my knowledge. But I still feel really upset about her demeaning approach and I'm not sure what to do. I know we're half-way through and if I can disregard any of my personal response to her approach, there is a lot to be gained from the wisdom she is offering. I was wondering if you can offer me any advice on how to approach this situation? I really want to learn from her; but at the same time I don't want to go home crying every night.<br /><br />Thanks for you support,<br /><br />Miss Purple Stethoscope</span><br /><br /><br />She replied straight away and told me she'd call me tomorrow to have a chat about it. Very, very grateful for her support; but still feeling stressed-out that this chat will come after a day spent with Dr X and God knows what sort of damage she'll have done to me by then. Thinking of having a mental health day tomorrow, but also feel deep down that it will be like admitting defeat. I know it seems excessive, but I've been tipped over the edge. And I'm a fairly tolerant person... if that's saying anything...Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com2tag:blogger.com,1999:blog-7213135240565230959.post-82075115127616087472010-04-13T23:10:00.001+10:002010-04-13T23:19:49.092+10:00GP-Land...... is a happy place, with candy-cane and fairy-floss; oh, and no ward rounds or running around a hospital trying to find people: the patients come to you - fancy that?! ... bliss!<br /><br />***<br /><br />*Snap out of day-dream for a bit*: I just found out this morning that one of the students doing the John Flynn Program has been placed in the Cocos Keeling and Christmas Islands! OmG! Extremely jealous!! I do love my rural community of Mudgee very much, but c'mon - outback NSW vs Islands in the middle of the Indian Ocean?! Hmmm, at least I now know it's a rural area of need that I can (and will!) venture to in working off my rural bondage.<br /><br />OK, back to daydreaming...Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com0tag:blogger.com,1999:blog-7213135240565230959.post-47242929866072139652010-04-12T21:56:00.006+10:002010-04-12T21:59:38.955+10:00Dear FMH,I miss you everyday.<br /><br /><span style="font-style:italic;">Come up to meet you, tell you I'm sorry<br />You don't know how lovely you are.<br />I had to find you, tell you I need you,<br />Tell you I set you apart.<br /><br />Tell me your secrets and ask me your questions,<br />Oh lets go back to the start.<br />Running in circles, Comin' in tails<br />Heads on a science apart.<br /><br />Nobody said it was easy,<br />It's such a shame for us to part.<br />Nobody said it was easy,<br />No one ever said it would be this hard.<br /><br />Oh take me back to the start.<br /><br />~ Coldplay, "The Scientist"</span>Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com0tag:blogger.com,1999:blog-7213135240565230959.post-52884980912810047682010-04-10T20:36:00.003+10:002010-04-10T21:03:46.096+10:00Learning how to be a doctor, one step at a timeSaturday night; interim weekend between two rotations. I've just finished the first of my two Surgical blocks (plastics and ortho) - the next one (gen surg) I will do later this year - and am about to start my General Practice block next week. Surgery was pretty awesome, plastics more so than ortho. Despite the early morning starts, the day went quickly as there was lots to do and we normally didn't stay past 5pm (though the surgeries would go past 10pm most nights). There was a pre-med student from the USA doing an "internship" in orthopedics during our time there and she was such as eager beaver, coming in very early and staying late every day; which made us look a bit bad, but hey, it's not as cut-throat here so we don't really feel the need to exert ourselves to excel. My supervisors in both plastics and ortho gave me really positive feedback in my competency assessment form; I feel quite accomplished that after 2 years of getting mediocre marks, my hard work is finally getting some recognition! On a personal level, I feel like I achieved what I set out to do in this rotation in the way of practising my hx and ex skills as well as some basic procedures, particular to a surgical context. I now feel more confident with a lot of bread and butter presentations/skills that I will no doubt encounter again in internship and beyond. Small steps, long way to go.. but I'm getting there, I'm learning how to be a doctor and look after people. Damn it feels good!Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com0tag:blogger.com,1999:blog-7213135240565230959.post-82649058302964547842010-03-31T23:29:00.004+11:002010-04-01T00:40:35.058+11:00Some reflections on psych and surgeryWow, I haven't posted on here in ages. It saddens me to think that I'm losing the ability to reflect constructively. I don't want to write about my trivialities just for the sake of it; so I guess I could also put my absence down to not having anything to reflect about. But here's a thought or two anyway, to fill the silence, if anything. So, of late, I finished my psych rotation and have started on surgery. <br /><br />Psych was interesting, I learnt a lot, especially from my mentor who helped me see things with a bit more clarity, in a compassionate and pragmatic light, when all I could see before me was a damaged-beyond-repair, dysfunctional individual. It takes a very special group of people to be able to care about others in that way; and of that, I am quite envious. One of the things I didn't like about the psych rotation though was a particularly territorial (and often just downright rude) RMO - she didn't want students doing anything and would even tell us off for writing on hospital paper/progress notes! I hope her attitude damages her reputation when it comes time to apply for a training program. And that's all I have to say about that.<br /><br />After psych I went back to my secondary home-base hospital to start on my surgery rotation. I did three weeks of plastic surgery there - which was everything I could have wished for in a rotation. The team I was attached to were amazing clinicians and teachers; and the RMO was just wonderful (*so* different to the psych RMO bitch). She was happy for us to get right in there and help out as vital members of the team. I got lots of practice in doing speedy histories and examinations when a plastics consult was called for in ED; interpreting hand x-rays (most of the cases where hand injuries); ward management of plastics patients; scrubbing and suturing; removing K-wires; as well as the usual cannulas, bloods and plaster casts. It was actually quite a refreshing change to go from the long-winded and twisted complexities of a psych patient to the straight-forward flow-chart style management of a plastics patient. Plus I loved being back in my home-base hospital: everyone is so friendly and there's this lovely feeling of comradery among all the staff. I have to say, these experiences are definitely steering my preferences towards internship at a smaller hospital in a couple of years (still too early to think about that though, so I shan't get ahead of myself). <br /><br />Now I'm back in BTH to do two weeks of orthopaedics surgery (currently in my first week). It's been okay; I feel depressed about leaving my lovely plastics team, but that's not to say that I'm not getting along with the orthopods either. The consultants are very friendly and welcoming (one of them bought us coffee this morning before rounds) and are very happy for us to scrub in on their surgeries and attend their clinics. I scrubbed in on a total knee replacement today, which was tres cool and neat! I guess I don't really have a sensible explanation as to why I think it's "okay" rather than "great"; maybe it's just a relative thing, like, it's "okay" relative to plastics. The teaching has been pretty good though, especially from one of the registrars who (despite my annoyance at him calling me random names like "Billy" and "Med student no. 2" instead of my own name - wtf?!!) is kind enough to explain every process of whatever operation we're doing and talk to us about the presenting disease process. Anyway, I'm glad there's a long weekend coming up, I need sleep!! Will update again soon, tootle-pip!Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com0tag:blogger.com,1999:blog-7213135240565230959.post-29169647918095005852010-02-06T21:30:00.010+11:002010-02-07T00:02:05.865+11:00Mentally ExhaustedHaving just completed the first week of my psychiatry block, I thought I ought to take a minute or two to reflect on the week's past events and experiences. On the first day of my rotation, I was assigned to work in the ED and PECC Unit (Psychiatric Emergency Care Centre) with the psych team at a big tertiary hospital (BTH) in a somewhat notorious area of Sydney. The other members of my group were allocated mentors in the actual psych ward to follow around/work with - I assume there will be a swap-over at the half-way mark so that we may experience both settings. In brief, the experience has been more exciting and yet more exhausting than I could have ever imagined. <br /><br />My shift is from 2pm-9pm everyday - partly so my time wouldn't coincide with other students' from other years/med schools, and partly because that was the busiest period in the day for the ED psych team. My team look after people who present to psych voluntarily or are brought in involuntarily. <br /><br />The voluntary patients form the minority of presentations. These are generally cooperative patients - mainly middle-aged business men and women, or young overseas travellers - who are facing acute psychiatric crises (anxiety, panic attacks, adjustment disorders, suicidal ideations) that they want immediate help with then and there. Once they're cleared medically by the ED doctors (all patients have to be cleared medically before being been by psych) the psych team has a chat to them (read: talk for over an hour sometimes) about what's been happening now and in the past; determine their level of "risk"; before deciding whether to keep them in for observation in the PECC Unit overnight or referring them to the hospital psych outpatient service. <br /><br />Now, in mentioning that the BTH that I'm working in was in a notorious part of Sydney, I really meant notorious for the involuntary pscyh patient presentations. In NSW (and possibly Australia-wide), a person can be scheduled for involuntary detainment/assessment/treatment by a mental health team under different sections of the law. What that basically means is that if a person is deemed to be (acutely) "Mentally Disordered" or "Mentally Ill" and are at imminent risk of harm (to themselves, their reputation, others, or by others) - the police, ambulance, community, or medical practitioner can bring them into/make them stay in hospital for a period of time until further action for their management is decided, against their will (of course the finer points of this are many, I'm just trying to be brief). This is actually a big deal, because there aren't many areas of the law here that restrict a person's freedom in this way and I guess if you haven't really thought about it in much detail, it's quite confronting to see how this arrangement takes place with some of the less-cooperative patients. Mind you, most of these patients are floridly psychotic and have very little insight about what's going on. But a couple of the patients we saw were presenting with first episodes of pscyhosis so the signs were very subtle, and would probably not be given any consideration in a different setting, e.g. laughing or smiling inappropriately during the interview. It's hard to put these signs forward to a patient that there might be something not quite right going on. Understandably, these patients denied having any abnormality, but were lucid and somewhat insightful enough to be upset by an involuntary schedule. <br /><br />Despite all the prep-talks we were given about not getting emotionally-involved or upset by the stories around us, it's really hard not to feel anything, especially with the younger patients who are brought in with first episode psychoses. As my supervisor said, "the worst part is the process of going crazy.. once you're there, you don't have enough insight to realise what's going on". It's quite sad, I think.<br /><br />Everything aside, the experience has been very eye-opening and fulfilling. Hoping to share more thoughts with you later..Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com1tag:blogger.com,1999:blog-7213135240565230959.post-76716647225308221432010-01-23T20:36:00.011+11:002010-01-24T00:32:42.467+11:00My clinical year ahead...Happy belated New Year to everyone! Haven't got any resolutions for this year - I just want some peace and quiet (haha I sound like Oscar the Grouch!)... <br /><br />So, as everyone who has been through med school is aware, I finally start my clinical placements this year! Woot! My placements will be in a variety of settings but my home base where the majority of my rotations will take place is a busy secondary hospital in one of Sydney's (many!) multicultural communities. It was my first preference hospital, as I come from a similar part of the world as the predominant ethnic group in that community (and speak the same language --> no need for an interpreter!). The other settings that I'll be working in is a specialist children's hospital for paediatrics; a mental health institute and a psych ward in a tertiary hospital for psychiatry; the same tertiary hospital for orthopedic surgery; and a medical centre in an affluent area of Sydney for my GP placement. We got sent our rosters and groups last week - I will be working with two very lovely guys, one of whom I am good friends with, the other I don't know all that well but he sent me an email when he found out that we were in the same group, saying that he was looking forward to working with me this year. As for placements, my roster is as follows (each rotation is 5 weeks long):<br /><br />- Psychiatry<br />- Surgery 1<br />- General Practice<br />- Medicine 1<br />- O&G<br />- Surgery 2 <br />- Paediatrics<br />- Medicine 2<br /><br />So, I'm starting with Psych... This is one of the rotations I'm looking forward to, even though I haven't really considered it, as a career. I borrowed two books from the library yesterday to try and start answering questions for the psych short-cases that we will go through on our back-to-base theory days (which will be every Monday). I borrowed <span style="font-style:italic;">Psychiatry At a Glance</span> as I am a big fan of the <span style="font-style:italic;">At a Glance</span> series, particularly <span style="font-style:italic;">Medicine At a Glance</span> and <span style="font-style:italic;">Medical Pharmacology At a Glance</span>; and also borrowed <span style="font-style:italic;">General Practice Psychiatry</span>, which is our core textbook for the rotation but I don't plan on purchasing it as it is quite expensive (> $100) and there are about five copies in the library (plus a couple of copies in our clinical school library). <br /><br />Apart from doing some readings for Pysch before I start uni (on Friday!), I'm going to spend what's left of my holidays just relaxing, catching up with people and cleaning my room. I have work tomorrow and on Tuesday (public holiday = double pay!); I've got a Dentist's appointment on Monday to get braces because I am vain and don't like my crooked teeth; I'm finally going to go watch Avatar on Wednesday, at the Imax, with one of my best friends who has returned from overseas; and yeah, just get ready to do it all again. <br /><br />Before I get going, it's been one year since I started this blog! I know it's not exciting, but I started it to vent about life and the world around me at a time when it felt like no one was listening. Things are a bit different now, but I won't forget the favour that you have done for me dear readers, you who have read and listened - thank you!<br /><br /><span style="font-style:italic;">Post Script</span>. I've decided to change my blog name to <span style="font-style:italic;">Miss Purple Stethoscope</span>, because: <br />a) My name isn't really Sascha Fierce (my first name isn't even Sascha :-/), I just chose it as a random name for my blog because I'd watched an episode of Oprah the day before starting my blog and Beyonce was talking about her new album <span style="font-style:italic;">I am... Sasha Fierce</span> and I thought it sounded cool and trendy and would therefore make my blog (and me) look/sound cool and trendy. <br />b) I love my purple stethoscope, it goes with all my clinical/hospital clothes! and<br />c) A new year should bring exciting new changes with it, like a new name, for example :-DMiss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com1tag:blogger.com,1999:blog-7213135240565230959.post-81708971072130260912010-01-22T20:53:00.006+11:002010-01-22T21:44:59.827+11:002009 : A Series of Unfortunate Events - The Ending...You're not going to believe this, but I will tell you what happened anyway. I was *so* looking forward to today - the day of my final exam for 2nd year Med, the day I can finally put the dramas of 2009 behind me and finally start my 2010 like everyone else has. I had grand plans for the upcoming week to make up for my missed holiday time. I'm not asking for much, I've come to appreciate the small things that are easy to take for granted - some peace of mind, wellness in health for myself and those around me, a bit of free head space to enjoy life without worry. I really just want a week of mental rejuvination before going at it again. But alas, life has happened again when I have least expected it. <br /><br />This afternoon my dad got hit by a truck as he was crossing the street to return to work from his lunch break. He is alive and well. But OH MY GOD imagine the shock of my life when I turned on my mobile phone after finishing my exam, to get that dreaded phone call from St Vincent's Hospital. Oh my dear dear God. <br /><br />Tonight is my last night of 2009, as far as my warped schedule is concerned. Tonight I will give it to them, to do what they like to me and my family in my final hours of 2009. I refuse to start my 2010 this way, so tonight I give you my final vent for my 2009. Stay tuned tomorrow for my 2010 agenda...Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com5tag:blogger.com,1999:blog-7213135240565230959.post-56707737950705542652010-01-18T20:31:00.005+11:002010-01-18T21:02:01.656+11:00Catching upThis week, I sit my deferred exams. One on Wednesday, one on Friday. I'm scared. I don't want to fail. Presently, I have no other skills or useful qualifications that I can fall back on and I don't have it in me to repeat 2nd year. Okay, need to make myself feel better. If I fail, I am going to leave this God-forsaken degree and either:<br /><br />1. Do a Masters of International Public Health and dedicate my time advocating for the implementation of public health programs that will save many more lives than I would have as a doctor anyway;<br /><br />2. Do a BTeach and become a science teacher (children are the future, teach them well, watch them grow, blah, blah..); or<br /><br />3. Become a pastry chef apprentice and eventually open up a cafe/bakery/cupcakery.<br /><br />Feeling a bit better.Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com4tag:blogger.com,1999:blog-7213135240565230959.post-25607373020110304532009-12-24T14:51:00.006+11:002009-12-24T15:55:22.309+11:00Lately...Sorry about the absence - guess I never really left, I was still sheepishly reading all your posts.. but had nothing much to say myself. All is well, I promise. Returned from Fiji 10 days ago, where I spent 3 weeks at the CWM Hospital on a purely optional "elective" rotation. Words cannot adequately portray my gratitude to the patients and doctors who so humbly accommodated me during my time there. It is always with mixed feelings that I undertake placements in communities where I take away much much more than what I give in return. I am yet to reconcile with this morally-questionable predicament and am resting slightly with the hope that one day I can return as a qualified hot-shot and offer my services voluntarily (or at a substantially lower wage than I would be earning here anyway). <br /><br />That aside, a reflection or two regarding my experiences. In light of my sway towards anaesthetics as a speciality, I decided to hang out with the dopers for a fair portion of my time. Having more faith in my abilities than I do myself, my supervisors allowed me to do spinal and regional blocks on pretty much anyone who walked through the OT doors. I also got lots of pratice in cannulating, intubating and inserting LMAs. There was a lot of in-between teaching and general chit-chat as well, which I loved because I got a chance to ask about anaesthetics as a specialty and exchange details about our differing health-care systems. The experience was great for all the obvious reasons, but particularly so in helping me realise that I don't think I'm very well suited to a career in anaesthetics. The challenges are still challenging, don't get me wrong - I've haven't mastered the Art by any means, I guess some part of me is just looking for something else. That's the real value of these experiences - among other things - crossing potential specialties off the list, sort of. I have an official anaesthetics terms in 4th year (if I make it that far!!) which will span for 8 weeks, so hopefully that will shed more light either way... but for better or worse, I'm quite content to be going into my clinical years a little less set on the path I want to pursue. The rest of my time in Fiji was spent scrubbing in on surgeries (mainly gen surg, plastics and obs/gynae). Obs/gynae is starting to grow on me - interesting mixture of medicine and surgery, but still, I'm not setting it in stone like I did anaesthetics! Anyway, Fiji has given me a lot to think about and despite my ethical dilemma, I'm not ruling out another placement there next year. <br /><br />Back on the home-front, I have two exams awaiting me in about 4 weeks' time (haven't been given the precise dates yet). I'm doing a bit of study here and there, but just waiting for the new year to really get into it. I feel like I'm in limbo land, it's pretty scary because with the exam date being so close to the start of semester date, I don't know if I'll even be offered a supplementary exam if, Heaven forbid, I should fail. Of course I'm having slight regrets now about not just getting them out of the way at the time.. but, sunny-side up, my brain might be slightly less rusty than everyone elses' going into third year. Maybe.. hopefully :-S<br /><br />M.C. everyone - hope you have a beautiful day with your family+friends tomorrow!Miss Purple Stethoscopehttp://www.blogger.com/profile/01423798801892283894noreply@blogger.com4