Looking Back At 2018

Whew. The last few posts of mine have been quite depressing. This blog was never about being down or blue. It was about keeping alive something that was very important to me.

So I was looking back at some of the posts I had put up this year. 2018 isn’t exactly ending the way it had started. But I have so much to be grateful for this year.

Kind of like the spirit of Ariana Grande’s new song Thank U, Next. I want to look back at some of the things that really made this a great year.

When 2018 started, I was on a plane heading back to NZ from my family trip to Italy. That was without a doubt, the best experience ever. I hope to return to Italy one day for it’s buzzing excitement and amazing history and culture. And the gelato too!

As soon as the year began, I started my final year at medical school. Kicking off with general medicine. I had actually felt extremely competent and loved every moment of my time on general medicine. I had met Dr. AJ who I adore and am so grateful to have met! I learnt so much during my time on general medicine. It was awesome.

My next rotation was rural general practice. I still think about my time in Warkworth now and then. Maybe when I’m older, I’d like to become a GP and live somewhere similar where people are so relaxed and the lighter side of life can be experienced, eating gelato by the beach and discovering nature walks and driving on roads without traffic lights. The simpler side of life. I miss it.

This year, I hadn’t mentioned on this blog, but I had attended Ed Sheeran’s Divide world tour concert! That was an absolutely amazing night on all accounts. It had stopped raining, the one night he was in Auckland and my sister, friend, and I had a blast in the presence of a real guitar God. Gotta love Ed Sheeran

 

My trip to India. Probably the last one for a while for me. My elective and getting to experience what medicine is like in a developing country and how that affects me and what I want to do with my practice. Not to mention the great food and people I had met and enjoyed my birthday with!

 

Now this picture. Is significant for many things I am grateful for in 2018. When someone you care a lot about, gets what they want, what they deserve, gets the opportunity to be happy, and you get to be a part of that, and you feel like you’ve done something right, and you get to continue to support them, that feeling is priceless. It’s a happiness I can’t explain. I can never be grateful enough to know HD.

Getting distinction in my final year of medicine. After 5 years, much like the tortoise in the Hare and the Tortoise story, I felt like my steady improvement had all led up to this achievement. Where I got a letter from the university congratulating me on being one of 44 people who achieved overall distinction in our final year of medicine. It really made me feel good after years of thinking I was average if not below average.

My mini trip to Wellington which was such a nice getaway at just the right time. Spending time with friends I had scarcely seen all year, was a real gift. Good fun to experience the capital city of New Zealand and its own buzz.

The second concert opportunity I had this year was none other than Taylor Swift herself. I didn’t mention this on my blog either, but man. What an event that was! All this year I had known about the concert. The Reputation world tour was frequently talked about and all its merits were extremely attractive to hear. Reputation is without a doubt the most relatable Taylor Swift album for me. Pretty much every song captured some aspect of my life, and described it perfectly. So I had been hearing all about it. But since I had already attended Ed Sheeran’s concert, and the fact that I didn’t really have anyone to go with, I didn’t jump for tickets straight away. I kept telling myself, if I am meant to go see Taylor Swift, it would work out somehow. As the concert loomed closer, a friend of mine, who is a bigger fan than I am, was also considering going. They also didn’t really have anyone to go with. I pushed them to go. I absolutely wanted them to experience the concert they found just as relatable as I did, if not more. They found tickets and invited me. I couldn’t actually believe it was working out! I had a week’s notice and found some way that I could go. It nearly even fell apart the night before the concert. But going with my friend and going to see Taylor Swift, was meant to be, and it happened. It was all so weirdly fated, much like in her poem “You could never have arrived- so wondrously and brutally, by design or some violent, exquisite happenstance…..here” at the concert. And what a concert it was! She is a brilliant performer and you could really learn a lot about putting effort into something you love from seeing how all out she went for the presentation of her Reputation world tour.

 

Here is a picture of the 50-foot (or thereabouts) snake she brought with her for Look What You Made Me Do. Super grateful for this experience this year.

My graduation. Finally reached a milestone I had been working 6 years for. Everything before this day, on this day, and after this day, was significant for me. And for the people involved. Very grateful.

Starting work. It hasn’t been fabulous so far. But I’m grateful that I’m still surviving. I’m still feeling capable of doing some things right. Looking forward to moving on.

And of course, I cannot be grateful enough for this blog. Over last year and this year, this blog has always made me feel so much better once I’ve come on and posted something up. Often it has been things I am very insecure about or feel that no one really understands in my life. But when people read even those posts and a few of them like it, I feel like maybe I’m not crazy and my thoughts are valid and I can put them forward at least in writing in a way that some people around the world understand.
I never say half these things to real people. But saying it on here, makes me feel freer and more empowered. And for that, I am extremely grateful.
I’m grateful to everyone who reads this blog even when things get a bit weird sometimes.
But I am considering changing the domain name of this blog. I feel like something should probably change. I’ll think about it.

And that is my year in review. There’s so much more to be grateful for this year, I’m sure. But these are the most significant things that come to mind. It’s nice to stop and be grateful. Before the next year comes along and brings more changes to my life. Let’s hope I can keep chugging on and getting through it.

I hope everyone else has had things to be grateful for this year.

I shall end here with the immortal words of Ariana Grande

Thank U 2018, Next.

 

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Busy Not Bored

Thus ends my 3rd week of being a house officer. On psychiatry.

I’ve got to say, (and it’s probably quite clear) that I’m not having a good time with things at the moment.

This is something I have feared for a while. And I’m not sure if I can clearly articulate it, but I’m going to try to on here. As for now, this blog is the only friend/support/confidant I have.

When I was given the chance to choose my 4 rotations for this year, I had chosen a preference of general medicine, general surgery, cardiology, and medical ED. We were asked to give 10 preferences. The other 8 were different combinations of general medicine, general surgery, orthopedics, and geriatrics. My last preference on that list was the one I got. Psychiatry, general medicine, cardiology, and general surgery.

I had given this a lot of thought. I really wanted 4 rotations where I would be extremely busy. By busy, I mean arriving early, leaving late, and running around all day. That’s what I wanted. I even chose the busiest hospital there was. Everyone else I know is saying that’s crazy. If I were that busy, I’d hate it. And I’d wish to be on a more relaxed rotation.

That’s actually not true. I do better when I don’t have time to stop and think about a lot of things.

A quote comes to mind:

“Left alone, my mind is actually quite dangerous”

On psychiatry, I have no work. On most days, I am done with all my jobs by 11:30am. Yet I have to sit at a desk and while away time until 4:30pm. And that, to me, is torture.

I heard this on the first day when I arrived in psychiatry. They told me I have no work. from 8:30am. I read about some of the patients, but that was done by 9:30am. There was nothing to do.

Except ruminate.

So many times I’ve said that there are these frustrations I have in the back of my mind all the time that are actually growing quite painful recently. New developments in my family and other things and I can see it affecting my mind quite a bit. But it’s not anything I can change or influence myself. But that means all I can do is think about it and stress.

Which I hate.

All I know is that the only way to counter it, is to be busy. I know this works because when I actually do have something to do, like seeing a patient or deciding on a treatment, I don’t have the time to think about other things. I become very focused on the work at hand. If I’m ever idle though, it all comes back.

Which is why psychiatry is the worst rotation for me to be on at the moment. I would happily trade lives with my colleagues on general surgery currently. Anything to find relief from the constant thoughts in my head with problems I cannot fix.

I know it’s only 3 months. And then I’ll actually be off to general medicine and will be much more busy. But it’s only been 3 weeks. And I’m already emotionally tired and sick.

This is quite difficult for me to explain and it probably sounds vague and fluffy. But very very few people in my life know what an anxious person I can be. I imagine things way too vividly. I think about things too much, I have a single thought play over and over in my head until it becomes almost hallucinatory. I don’t tell people these things. When I say few people know, it’s if they’ve ever picked it up on their own. I never talk about my own anxieties. Why bother, really. No one is going to be able to fix it. I don’t come across as an anxious person, apparently. But a single thing can keep me awake for days on end. And currently, many things are. The ongoing stress, is draining. And nobody sees or understands that.

But these things are also making me upset at work. Because I have nothing to do except sit around and pay attention to my thoughts.

I need to find things to keep me busy.

Or hope this rotation goes by really quickly.

Or hope these problems will magically disappear.

Why She Disappeared

When she fell, she fell apart.
Cracked her bones on the pavement she once decorated
as a child with sidewalk chalk
When she crashed, her clothes disintegrated and blew away
with the winds that took all of her fair-weather friends

When she looked around, her skin was spattered with ink
forming the words of a thousand voices
Echoes she heard even in her sleep:
“Whatever you say, it is not right.”
“Whatever you do, it is not enough.”
“Your kindness is fake.”
“Your pain is manipulative.”

When she lay there on the ground,
She dreamed of time machines and revenge
and a love that was really something,
Not just the idea of something.

When she finally rose, she rose slowly
Avoiding old haunts and sidestepping shiny pennies
Wary of phone calls and promises,
Charmers, dandies and get-love-quick-schemes

When she stood, she stood with a desolate knowingness
Waded out into the dark, wild ocean up to her neck
Bathed in her brokenness
Said a prayer of gratitude for each chink in the armor
she never knew she needed
Standing broad-shouldered next to her
was a love that was really something,
not just the idea of something.

When she turned to go home,
She heard the echoes of new words
“May your heart remain breakable
But never by the same hand twice”
And even louder:
“without your past,
you could never have arrived-
so wondrously and brutally,
By design or some violent, exquisite happenstance
…here.”

And in the death of her reputation,
She felt truly alive.

-Taylor Swift 

Never has a poem made me feel the way Miss Swift does.

Sensory Deprivation 

The alarm let out a shrill sound that jolted her brain cells. Her eyes flew open.  It was only a second before the thoughts came flooding into her mind like a dam that was barely holding, had broken free.

The thoughts intertwined with the ghosts of the dreams she had the night before. Each thought hammering her consciousness as they had done the day before and the day before, and the one before that.

She moved mechanically through her morning routine. Shutting the thoughts out. Treating them like a prickly ball of barbed wire that she pushed deep within her consciousness. But it didn’t last. It rose up at every turn like a beach ball being pushed underwater by a child.

The thoughts replayed over and over in her head. Guilt, anxiety, stress, fear, and disgust at her own treacherous mind that didn’t let her rest even for a second.

She plastered on a smile. She had work to do. She had to function. People she didn’t know were counting on her. The fear that she may slip up, kept her going. But it wasn’t enough. If she were ever idle, the ball would rise again in her mind. The prickles of the barbed wire scratching the inside of her skull. She rubbed her forehead in frustration and tried to keep going. Hoping that she could rub the thoughts away. But the voices didn’t stop. The memories reminding her of a reality that was too harsh to exist in. The fear of what might happen  or how long this would last, made her breath shallow as she walked amongst others. She looked at the ground as she walked. She didn’t want her emotions to be reflected in her eyes. 

She couldn’t eat. Her mind told her that she had enough to survive. She put the food away.

People walked past her. She envied them. They seemed unaffected. They could function without these thoughts in their minds. She knew this wasn’t true. Everyone had their demons. Everyone struggled. But her mind told her that she struggled because she was weak when others were not. She struggled because her problems meant nothing to anyone except her. 

Nobody cares about the shallow, pathetic thoughts she had.

She rehearsed conversations in her head that she could have with people that cared about her. That maybe she could convey what she felt and have atleast one person understand.

Her mind told her that was futile. They would look down on her with pity. They would scoff that her problems were no where nearly as painful as the real problems others faced. They would reply to her attempts to talk for a few minutes, but ultimately, they had lives that were more important than listening to her problems that there was no real solution to. 

So she kept it to herself. She cried alone and she picked herself up and kept going. Battling with her own mind as though it were her enemy.

She had faced this before. But she had let her guard down just a little bit. Trusting more than she should have. And so she was hurt. And so her mind turned on her. It told her she was selfish. That she only cared about her problems. She feared it was true. 

She dreamt of not feeling. She wished that she wouldn’t hurt anymore no matter what happened. To not be conscious, to not feel. To be deprived of all sensation. To not have hope or be crushed. To not care. To not be able to speak ever again.

To not be awake.

She took to her bed at night and lay there waiting for the closest thing she could get to not feeling. She wanted to sleep. Before she woke up and did it all again. 

Remorse

I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry I’m sorry

I’m so sorry.

……………….

“Yeah that’s not enough”

 

…..Well then what is?

………………

“Living through the devastation that is far too great to live through.”

Survival Of The First Week 

Let me just turn down the drama a bit and tell you about my first week of actually being a house officer.

It was overall, an interesting experience.

Monday: day 1. And long day. As in 8:30am to 10:30pm. I was new to the psychiatry unit and was new on the job but I was expected to go on ward calls until 10:30pm. Lots of new things on this day. I have my own desk in the office, I was referred to as “Doctor”, and I had to chart my first medication. All important milestones. It started off kinda shaky because it seemed like I had very little workload on psychiatry. But as my long day went on, I was called to every end of the hospital to see a patient or sort out something for them. I felt I was actually capable of doing house officer type things. Quite exciting. Down side was that I was all alone on my first ward call day. As new house officers, we were supposed to have a 2nd year house officer buddy to offer advice. Mine never showed up. Which meant for any advice, I had to call the registrar. Which was a major power clash. And I felt the registrar who picked up the phone every time, was less than enthused to hear from a day 1 house officer.

But it’s okay. It had to happen sometime. Better on my first day than later on. So I did survive that.

I even had a pager message at 10:30pm exactly as I was walking out of the hospital about a patient who was short of breath. I had an internal discussion with myself where I asked myself if I would be able to sleep tonight if I ignored this page. The answer was No. So I went all the way back to the other end of the hospital to see the patient who in fact, did not have shortness of breath. I prescribed some paracetamol for this patient who had some MSK pain and went home. Oh well, conscious cleared!

Tuesday: I found things don’t usually go according to plan. And lots of stress. But I felt I actually had learnt enough in the last few years of medical school to do house officer type things! Which is a relief.

Wednesday and Thursday: Kept busy with jobs. I actually had the time to learn enough about all my patients and go around doing things for them that addressed their health. More stress of course, but I think I was getting the hang of it.

Friday: My 2nd long day in one week. Thankfully, it was a quiet day with not too many stressful calls. Actually I had rather strange calls. A nurse called me about a patient who was prescribed fluids but was refusing to take the fluids intravenously, but agreed to drink it. What should she do?! My answer was, let her drink it. She called again asking if it was okay to document that the patient had refused the fluids. I reassured the nurse that she would not kill the patient by not forcing IV fluids on her and by documenting that she had refused it. A few other medication prescribing errors through the night as well. But mostly I was able to sit and reflect on the week.

Overall, I had survived without killing anyone.

I probably do not have the work load intensity of the surgical house officers who turn up to hospital at 6:30am and don’t leave until 8:30pm, only to know that they’ll be back in 10 hours to do it all over again.

Yeah I don’t have that. But I find I do stress and overthink a lot about the decisions I made during each day. I need to work on that.

But let’s just focus on the fact that one week was reasonably well completed. Hopefully the weeks to come are easier as I become more efficient and confident in my practice.

The Flow

These days, I’m just going with flow.

If I have to cry 5 times a day, I will cry 5 times a day.

If I have to feel bad about myself, I will feel bad about myself.

If I have to be lonely, I will be lonely.

If I’m not able to sleep regardless of how tired I am, I will stay awake and ruminate.

If I don’t have the appetite for more than half a sandwich for a whole day, I will keep going while hungry. 

If I have to have anxiety attacks during the day, I will freak out quietly in the bathroom. 

I’m not trying to resist anymore.

I’m not trying.

Everything that’s happening to me is either completely in my control, or completely out of my control. 

I created this karma. 

I accept that. 

So there’s nothing to do but go with the flow. 

My Oath

My first week of orientation to hospital ended. It was a long week let me tell you. Full of as many ups and downs as I can remember every year being. And more joyous times with people. 

I found that I can be extremely introverted when I’m not comfortable with the people I am around. But because now I’m an adult, I need to suck it up and do my job. Why must I be the only person who can’t be fake nice to their co-workers? It’s an important skill. 

Anyway it got me thinking. At my graduation, I took the medical oath. It was a lot of generic stuff about caring for patients and making sure I make good decisions, etc. 

But I need to take an oath of my own. Something relevant to me. Something I must strive to follow no matter what happens this first year of my being a doctor. And so I will write it on here so I may revisit it to make sure I’m keeping to my oath.

I promise to work hard and give my best without expecting rewards

I promise to hold myself high and trust that I am capable of doing what needs to be done.

I will not let anyone intimidate me into doubting my abilities or knowledge.

I promise to be self aware of my strengths and weaknesses and work on them accordingly. 

I will always take full responsibility for my actions and decisions. I will never blame anyone else for my choices.

I promise to realise when I need help and make sure I seek the right help.

I promise to remember that nothing and no one is worth stressing about, to the point where my mental health and happiness is affected.

I promise to remember that I am here because medicine is my passion and I am good enough to be here.

I will also remember that I have other interests and talents outside of medicine that I must strive to maintain those interests.

I promise to always think of the bigger picture. Not just parts of it. It includes everyone and all their perspectives. 

I promise to uphold my dignity and the dignity of patients and people I deal with.

I will ensure I remain happy. 

And I will strive to ensure my reputation is one I create. 



Here’s to being a functioning doctor and adult in my first year and beyond.

Expectations

I find that everyday, people give me new and interesting reasons to lower my expectations of them even further.

I find that I have to really think about why I did things.

But then the answer is clear.

Because it makes me happy.

But that means that I just have to make my expectations fall to a level of zero. If I decide to do something, my intention should always always be because it makes me happy. Because then I can’t be disappointed when others don’t do what I expect.

Initially I thought I was allowed to have expectations.

Nope.

Moving forward, that’s a rather freeing feeling I suppose. If I don’t expect anything of anyone, I can go ahead and be who I am.

And nothing is allowed to change that.

An Irritating First Day

Well it was my first day as a house officer. Orientation day 1. This whole week is orientation. Should be good. Should be exciting.

Today was a total bust.

And I need to vent on here.

So how did my morning start?

Early.

7:30am start was written on the timetable. I’ve been on break for the past 2 weeks so I was already having trouble waking up early. I planned to leave 45 minutes early to get to Middlemore hospital which is a 20 minute drive from my house. I had given myself twice the amount of time I would need. 

And it was useless. I’m not sure what it was as I have travelled on this motorway for a whole year the last time I was at Middlemore. But in 2 years, the development of traffic has been shocking. It took me and my friend who takes the same route, 1 hour to get there. Meaning, I left at 6:45am and got to the hospital at 7:45am. MEANING, I was late. On my first day of a new house officer year. 

Miracle of miracles atleast I didn’t miss much. Actually, I showed up and the introductory talk lasted all of 7 minutes before we were given a 1hr break. 

So what did I rush for? Nothing really. 

The 1hr break was for everyone to go get their access cards and parking cards sorted. I had done this a week ago because a lack of a parking card meant that I had to park in public parking for 10$ until I got the card. So I came in early to avoid that. While I was there, they also gave me my access card. So yay I was organised beforehand. 

But when everyone else got their access cards today, they were also given their meal cards. House officers get free food at the hospital with their meal card. Mine was missing. Why? Because I got my access card early and nobody told the department that issues meal cards this. Or some admin screw up to that effect.

The lady running the session said to me, when I approached her asking for my meal card: ” Oh so you thought you’d be so organised beforehand, but see now they didn’t give you your meal card. Which is the best part really” 

………

Why the heck would anyone think that’s funny? I don’t know you like that. Why would you rub it in?? 

So I was given vouchers for the week instead and told that “hopefully” I would get the card by the end of the week.

The rest of the day was quite slow. So many breaks interspersed with irrelevant talks and a walk around a hospital I was already familiar with.

It was nice to see my friends again, but there were also 54 other house officers in the room that I had to socialise with as they’re the people I’ll be spending a year with. And truth be told, that notion made me quite tired. I need to try be a more sociable person. I feel like I’ve lost that about me. I’m basically only comfortable around very very few people. And that’s not a useful way to be. 

Sigh.

Oh well. I guess in a way it’s a good thing that all these annoying things happened on the first day. Like a good omen for the rest of this year maybe. We’ll see. 

4 days left. I’ll need luck.