My 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!)...

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):

- Psychiatry
- Surgery 1
- General Practice
- Medicine 1
- O&G
- Surgery 2
- Paediatrics
- Medicine 2

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 Psychiatry At a Glance as I am a big fan of the At a Glance series, particularly Medicine At a Glance and Medical Pharmacology At a Glance; and also borrowed General Practice Psychiatry, 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).

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.

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!

Post Script. I've decided to change my blog name to Miss Purple Stethoscope, because:
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 I am... Sasha Fierce and I thought it sounded cool and trendy and would therefore make my blog (and me) look/sound cool and trendy.
b) I love my purple stethoscope, it goes with all my clinical/hospital clothes! and
c) A new year should bring exciting new changes with it, like a new name, for example :-D

2009 : 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.

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.

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...

Catching up

This 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:

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;

2. Do a BTeach and become a science teacher (children are the future, teach them well, watch them grow, blah, blah..); or

3. Become a pastry chef apprentice and eventually open up a cafe/bakery/cupcakery.

Feeling a bit better.

Lately...

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).

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.

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

M.C. everyone - hope you have a beautiful day with your family+friends tomorrow!

More on life and its ironies

My mum is well. She is in her fourth day of an intensive physio and occupational therapy program at a rehab hospital. She is enjoying the sessions and has made some new friends who have helped her see things in a new perspective, especially her room-mate: a thirty-something year old woman who has just been diagnosed with MS. In a sad (yet slightly ironic) twist of fate, another event that has provoked much reflection among the family has been the death of one of the doctors who was looking after my mum during her time in hospital. A cardiologist, he died of a sudden heart attack last weekend - his wife sent a letter to all his patients informing us of what had happened. For some reason, it feels a little close to home for me. I do feel very sorry for her loss too, and sad that he was not able to be helped: in the way that he has helped so many others. C'est la vie..

And now I bore you with the logistics of my life. I have decided to take up the University's gracious offer of deferring my exams. Sort of. I actually have four exams - two written and two prac exams. I am going to do the prac exams next week with the rest of my cohort and am deferring the written ones, which are going to be held again at the end of January (!). I told my PBL group and couldn't believe the hostile reaction of one of my group members - she felt so personally threatened by the prospect of someone having that extra time to study! I felt like saying to her "oh grow up child, I'm not asking for you permission!". Le sigh. I'm still undecided as to what to do with the research project, but will probably contact the supervisor soon to decline it I think. As for Fiji, my dad suggested that I go for two weeks rather than four, straight after exams.. just to get away from things, if anything. I like the idea of compromise, but I don't want to tempt fate and leave because I feel like something may happen while I'm gone. Guess I'll give it a few more days before deciding for sure.

Don't know how to end this post, usually I'll add some lyrics, but there are no songs for my mood this evening. So instead, something a bit more sinister, that I feel captures a bit of my paranoia and cautiousness (it's a bit long, but fans of Alice in Wonderland will appreciate it):

'O Oysters, come and walk with us!'
The Walrus did beseech.
'A pleasant walk, a pleasant talk,
Along the briny beach:
We cannot do with more than four,
To give a hand to each.

The eldest Oyster looked at him,
But never a word he said:
The eldest Oyster winked his eye,
And shook his heavy head --
Meaning to say he did not choose
To leave the oyster bed.

But four young Oysters hurried up,
All eager for the treat:
Their coats were brushed, their faces washed,
Their shoes were clean and neat --
And this was odd, because, you know,
Thay hadn't any feet.

Four other Oysters followed them,
And yet another four;
And think and fast they came at last,
And more, and more, and more --
All hopping through the frothy waves,
And scrambling to the shore.

The Walrus and the Carpenter
Walked on a mile or so,
And the they rested on a rock
Conveniently low:
And all the little Oysters stood
And waited in a row.

"The time has come,' the Walrus said,
"To talk of many things:
Of shoes -- and ships -- and sealing wax --
Of cabbages -- and kings --
And why the sea is boiling hot --
And whether pigs have wings.'

'But wait a bit,' the Oysters cried,
'Before we have our chat;
For some of us are out of breath,
And all of us are fat!'
'No hurry!' said the Carpenter.
They thanked him much for that.

'A loaf of bread,' the Walrus said,
'Is what we chiefly need:
Pepper and vinegar besides
Are very good indeed --
Now, if you're ready, Oysters dear,
We can begin to feed.'

'But not on us!' the Oysters cried,
Turning a little blue,
'After such kindness, that would be
A dismal thing to do!'
'The night is fine,' the Walrus said,
'Do you admire the view?

'It was so kind of you to come!
And you are very nice!'
The Carpenter said nothing but
'Cut us another slice.
I wish you were not quite so deaf --
I've had to ask you twice!'

'It seems a shame,' the Walrus said,
"To play them such a trick,
After we've brought them out so far,
And made them trot so quick!'
The Carpenter said nothing but
"The butter's spread to thick!'

'I weep for you,' the Walrus said;
'I deeply sympathize.'
With sobs and tears he sorted out
Those of the largest size,
Holding his pocket handkerchief
Before his streaming eyes.

'O Oyster,' said the Carpenter,
'You've had a pleasant run!
Shall we be trotting home again?'
But answer came there none --
And this was scarcely odd, because
They'd eaten every one."

~ "The Walrus and the Carpenter", C.S. Lewis

Above everything, I am...

A daughter? A sister? A distant relative? A best friend? A casual buddy? A medical student? A member of PBL study Group E? A first aid officer? An employee at a pharmacy? A research assistant? A traveller? A random member of society who has made a commitment to serve?

I'm not really sure right now, but my situation demands that I make a decision soon.

Last week, my mum had another stroke. She was taken to the hospital, where, amongst other things, an MRI was ordered. She never made it to the MRI though because out of no where, she started to feel an uncomfortable crushing tightness in her chest, before throwing up, and then suddenly losing consciousness. An ECG and some blood tests indicated a STEMI -- an angiogram further revealed an occluded left descending coronary artery. Two stents were put in, followed by a recovery period in ICU, where she had two episodes of tonic-clonic seizures that night.

We have a saying in Islam: "Alhamdulillah". It literally means "Thank God", but in actual fact the sayer is implying "Thank God, for and in spite of, everything". Alhamdulillah for the blessings and the misfortunes. Alhamdulillah she is still alive. We use this term to accept that which we've been granted and affirm our belief in there being greater wisdom in what happens to us, beyond that which we can foresee.

More imminently and practically (for yours truly, selfishly), I have my end of year exams in three weeks' time; after which, I have a month-long elective in Fiji, completely organised and paid for... then a very exciting research project that I was going to participate in and co-publish which, again, took a lot of time and energy to organise... and then, well you get the point. I won't lie - I'm greedy - I want to have my cake and eat it too. But, in light of the circumstances, this is becoming a seemingly impossible ambition. Furthermore, the University has kindly granted me the opportunity to defer my exams until a more suitable time. On the one hand, I just want to attempt these exams and get whatever mark I'm given, at the risk of failing altogether - but this will leave me with ample time in my holiday break to slot my various activities in. On the other hand, oh to not have to worry about exams for a little while later and just be able to concentrate on being with my family is such a wonderful relief - even if it means having to cancel my plans for Fiji and research in the holidays, as I will be studying for my deferred exams! The answer seems obvious, but that's the conundrum - what IS the right answer?!

Above everything, I am... confused and unsure of what to do.

Life happens when you least expect it

Or so the saying goes...

Two weeks ago my mum had a stroke. My mum is a healthy 47 year old, non-smoker, non-drinker, health-food junkie, exercise-doer. As far as risk factors are concerned she has none. But her's wasn't a typical stroke - it was caused by a spontaneous internal carotid artery dissection, which affected the right side of her brain and manifested in speech disturbances and left upper body weakness. Just like that, so unannounced. One minute we were making plans for what to do on the weekend; come the weekend, we found ourselves confused and bewildered around a bed in the stroke unit of our local hospital. I've been meaning to blog for a while but I've just been so damn busy between hospital visits; my petty attempts to keep up with uni work; contribute what I can towards housework; answer the bloody phone with people (mostly family and friends from overseas) wanting to know what happened; etc, etc. And amongst all the kerfuffle, incredulously, my friends are demanding to know why I can't go out for dinner, attend the Med Ball, come to their farewell party, watch a movie, grab a coffee, reply to their text messages, phone calls, emails, blah, blah.. which makes me think, have I been all-consumed by this and wallowing too much in self-pity? Genuine empathy is a really hard thing to feel because, quite simply, unless you're there and it's happened to you - you don't know what it's like. And so I ask myself with this newly-found insight: is it reasonable to even expect it? People have such short attention spans anyway (either that or they weren't listening to you in the first place) - why even bother trying to explain things when they're going to miss the point anyway. Anyway, enough pulling my hair out.

From an educational point of view, this experience has been a combination of terribly interesting and terribly frightening. When the neurologist told my parents and I the diagnosis, my parents responded as though she'd announced "oh it's just a cold" whereas I gasped in horror. Morbid as this is, sometimes I think, "OmG just die already - get it over and done with and that way I don't have to spend the rest of my life worrying about all the terrible things that can happen to you!!". Clearly I'm a little tired and world-weary. But alas, life goes on. And, perhaps, that's the point that I'm missing, with everyone's reactions around me? Bah humbug!