Oh My Goodness People 

You know how you watch movies or TV shows about people doing things and you think Eugh how dramatic. People aren’t really like that. It’s not realistic at all.

But when you actually hear and see such things in real life of what people do, you can’t help think those movies and TV shows downplayed it at best. 

People can be shocking sometimes. 

Reminded me of what one of my consultants in Melbourne said.

“You just cannot make up the things people actually do”

And that is so true.

He also says “You try to help people and they just screw with you”

Also very true sometimes. 

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I am back in my little ol’ City of Sails! It’s so good to be back home after my selective. And omg the year has ended! I will give a complete recount of this year in another post as it’s quite a lot of information and I need time to phrase it correctly. (as mysterious as that sounds)

But anyway! I am so relieved to be back home! Melbourne was pleasant and gastro was great but there’s just no place like home apparently! And just yesterday I had my last progress test of the year! Whew what a relief! It was okay…. It seemed that it was deceptively easy. But I never have confidence in saying that. I have the worst luck with such things. Sometimes I think I did really well in a test and my marks are less than “really well”, and other times when I die inside walking out of a test, I find I did better than I thought, and even more decent compared to the rest of the class. Some kind of irony I suppose. But yeah. This test left me feeling a bit muddled. I couldn’t remember a lot of the questions I had just answered and I felt a weird sense of happiness. Although, that could just be because omg the year is over!! ūüėÄ

Well kind of. Now I only have my report to submit recounting my 6 week selective in Melbourne, and something called a “prescribing skills test”. Apparently it’s an online test our entire class group has to sit to master the art of prescription writing! It’s formative though but it has been hyped up unnecessarily as usual. Which makes me nervous. But oh well. I’ve got 2 weeks to worry about that. So I won’t!

People kept asking me what my plans were for the holidays and I only had one answer: “Honestly, I didn’t think I’d make it this far”. xD Truly. I have no plans. It’s been an intense year that didn’t leave me much time or energy to think about planning my last summer holidays of all time. Maybe I will figure it out in the next few days. I’m still in post-exam hibernation mode. Sleep is a must at this time.

But there is one thing I made sure to have ready for my holidays:

Dan Browns’ new novel has been released! What could be a better way to spend your summer holidays than go globe-trotting with Professor Robert Langdon?! I cannot think of anything! So excited to get reading!

Will review soon!

 

There Are Some Fantastic People Out There 

When the med student you’ve known for about 4 weeks offers to drive one hour from his house to pick you up and take you to the airport that is 40 mins away around 5am in the morning before turning back and getting stuck in morning traffic to get to the hospital in the opposite direction before consultant ward rounds begin, just so you wouldn’t be stranded taking the bus…. you just know the words “random act of kindness” have been taken to a new level.

How nice of him. I’m so grateful. I declined of course because I could never inconvenience someone like that. But it was lovely of him to offer!

Happy Birthday HD!

Today is quite a special day. I’ve mentioned HD a few times on this blog. HD is the man with the killer angle sense for photography (that I’m forever jealous of), the funny, yet deep and thoughtful quotes about life that have more than once made me think for a long time and appreciate enough to write about on this blog, and the astonishing personality. But more importantly, HD is the reason I started blogging and continue to do so. And for that, this entry will be dedicated to him on his birthday.

It’s quite rare to come across someone who is so unique in everything they do. I’ve never met someone quite so different. And it is even more rare to meet someone who is capable of surprising you the more you get to know them. Even though you’ve known them for a considerable amount of time.

To call HD talented, would be an understatement. Actually, it would be an insult. He’s more than just talented. I’ve talked about his heightened skills in photography. He just knows what would look good in a picture. The frame, the angle, etc. But aside from this, he’s an artist. He paints, draws, designs and creates with the same patience and care he does everything with. He could open an art gallery filled only with his abstract paintings. Don’t take my word for it, he once sold a painting he had done a while ago, online as a legitimate wall painting. Apparently the owner of the painting adores it and has hung it proudly on a wall of their house. HD- famous artist. But of course something has to be sold in a certain way. And I have no doubt that the description of the painting had some part in its sale.

Because, HD is a writer. This is another understatement. He is an amazing writer. I am a reader. I’ve read a lot of books in my time and from a lot of different authors. Since taking up blogging I’ve had the privilege of reading some great blogs on this website. People write in all different ways. Some will make you laugh, some will make you cry. They can be clever, thoughtful, deep, purposeful and convincing. But HDs’ writing, has spirit. The way he writes, you can literally feel the spirit. It’s soulful. It seems to have a realism and passion such that when you read his work, you relate to it on another level. If that makes sense. Again, don’t take my word for it. Aside from excelling in English writing in highschool, HD used to blog. This blog had a very large number of followers to the point where they actually became ‘fans’. Many of his ‘fans’ would write to him saying how inspirational his writing was and how grateful they were for his blog. I am one of his fans. I regret deeply that this blog is no longer active. I cannot explain how much. Great pieces of writing should be treasured. Everyone should have a chance to read it. His writing is what inspired me and this blog. I think all his readers would agree that he writes in a special way.

Oh and he also writes lyrics. Some people are just born with the ability to write poetry. HD is. Somehow, intuitively, he can put words, one after the other in a way that comes together to be a full song. With hidden meanings, catchy rhyming words, and a real feel to it.

Of the million things I am jealous of HD for, his musical talent is something I would kill for. He plays the guitar, does percussion and writes songs. Oh, and he can sing. He’ll tell you he can’t do any of these things. I can sing and play the guitar but I am a true beginner. I know what sounds good and what doesn’t. With HD, he has an ingrained sense for music. He can hear a song and recreate it on the guitar. This song could have been played on a theremin for all he cares. He would know when to play the guitar to it and make it sound good. What’s more, he can write lyrics and hear the music that would fit with it in his head. Then he would compose. Honestly, this is how great composers are made.

What goes along with this music, photography thing are his beyond amazing skills of making home videos. They’re mostly music videos and mock trailers starring one character. But I swear they’re as professional as any short film production company could have put together. Spot on editing, lighting, cinematography etc etc etc. And the clever little additions that tell a story of their own, are perfection.

Okay so I’ve gone on enough about his talents, but it would be unfair to leave it at that. HD oozes originality. Everything he does seems to have his signature. I’ve never known him to half-ass anything. He has the conviction to do even the smallest things right. Even if it’s just a picture of his notes, he’ll make sure the lighting is good, the letters are in focus, and the frame is such that nothing unintentional or unnecessary is captured. Nothing is too small to put effort and care into for HD. Others (including myself) might say it doesn’t matter. But HD never would. He would do everything to the best of his ability. The pride he has in his work is his signature. You’ll know something is done by HD when it’s completed to a high standard with sophistication, and has something unique. Something no one else thought of or noticed. That, is HDs’ work.

His life is a pretty good example of that. He surprises people everyday with his perseverance. HD was a top student in his first degree at uni. He had a promising career in his field. He was an extraordinary professional who was marveled at by colleagues and supervisors alike. He then chose to complete a second degree and is currently excelling at it. I’ve heard people talk for days about what a brilliant student he is and how they want to be just like him. He’s in a position where he could quit. He doesn’t need his second degree to go on and be successful in life. But he sticks with it. And for his level, he doesn’t need to put in effort to pass the stages of his second degree. He has enough knowledge and experience to pass. But he works hard, strives, and won’t settle for anything less than a high level of achievement. He will complete everything to a high standard. As though he loved all of it. He doesn’t always get the credit he deserves. And that saddens me greatly. But that never stops him from giving his best every time. He doesn’t give up. That quality, is rare. It’s motivational, really. With this quality, I just know he’s going to be so successful some day at whatever he ends up doing. 

HD is cool. He’s got style. When HD walks into a room, you can hear the base guitar from pumped up kicks playing in the background, and everything from his body language to his outfit demands respect. He can pull off everything from cool professional (people mistake him for a doctor all the time), to hipster, to even rockstar. Sometimes I wonder if he actually does these things intentionally. Apparently I’m not the only one who thinks so. I’ve heard others compliment his appearance and attire even in casual situations. I guess HD is just cool.

HD is somewhat of a rebel. Maybe that’s where his sense of style comes from. He’s not one to lie down and take anything. That’s another quality I take inspiration from. He’s met some pretty awful people in his life and when he was in a situation where a supervisor bullied him and had the power to ruin his career, HD did not bow down. Even if it kills him, he’ll never let them know. Not only did he stand up to the supervisor and refuse to carry out menial tasks given to him, he was also commended by the university for doing so without quitting, when other students before him had. He’s the kind of person who, when told his next registrar is not the nicest, he’d turn around and say “that’s alright. I can handle it”. He’s not a quitter. I admire that.

You can trust HD to give it to you straight. If it’s wrong, he’ll tell you. I said he’s met some awful people in his life. But that doesn’t stop him from persevering. He’ll go a long way for you. When you least expect it. Sometimes his honesty will shock you. But that’s exactly what you needed to hear. There are times when he’ll be so positive and so encouraging. It’s just what you need.

One of the best things about HD is the kid inside. The one that gets excited about sunsets, the one that still watches his favourite childhood cartoon to relax, the one that remembers every single dialogue from his favourite movie in perfect order including the pauses. That’s what makes HD, HD. And it’s a quality that should be treasured.

If HD read all this, he’d say none of it were true. I wish somehow he would realise that he’s a pretty spectacular human. And accept his great qualities and treasure them. I am so grateful that I had the chance to get to know HD.

And if you’ve read this far, thank you for doing so. I want to ask my readers to wish him a happy birthday. Not any specific way. Just as you’re reading this in your mind, wish it. I hope many good thoughts head his way.

I wish him a Happy Birthday.

 

Spelling Woes

Today I found out that for the last 4 years of med school, I have been spelling the word “pruritus” wrong.

I had been spelling it as “pruritis”

No one had corrected me. In 4 years.

Today I was corrected by my gastroenterology supervisor via email as part of a research project questionnaire I had put together. There were 2 other consultants on this email chain.

“Please note the correct spelling of pruritus” he had said.

Eughhhhhh how embarrassing.

Why did I never know this. I’ve read textbooks. Somehow my mind has accepted the wrong spelling.

Gah. I suck at spelling. It’s so sad. So sad and embarrassing.

Gastroenterology Review

This is probably a bit preemptive considering I’m only 4 weeks into this rotation in Melbourne. But this rotation has been different to the others I have had this year. So I think now would be a good time to talk about my thoughts on gastroenterology.

I had mentioned how it must have been fate that I got accepted into gastroenterology over radiology. I think that was definitely true. It’s been a good run thus far.

Well. Kinda. Here’s the thing. I’ve had consultants here in Melbourne that ignore me and don’t acknowledge my presence (like back home). I’ve had registrars and team members that don’t really teach and don’t really care where I am or what I’m doing (also like back home). Then I’ve had consultants who are absolutely lovely and who teach and take an interest in me and my learning (this is also like back home). So the run in itself has been the same as all other things I have experienced in the last couple of years.

But I’ve been excited to go to hospital. I’ve been excited to go to endoscopes, clinics, ward rounds and to do my own studying. I actually enjoy what doctors do on a daily basis in gastro. Gastroenterology is one of those specialisations which has a good balance between medical management and procedures. And that’s something which I think is great 

I find the pathophysiology interesting and exciting. I find the medical management of patients intriguing. And I find the procedural side of endoscopies challenging and satisfying. I haven’t bad this kind of experience on any other rotation so far. I can actually see myself becoming a gastroenterologist.

And I am so grateful for that.

Now this isn’t 100% obviously. I’ve got a long time to definitely decide. But I am so glad that atleast one run (funnily, the final run of the year) has piqued my interest and has allowed me to visualise what kind of medical professional I would like to be.

And within gastroenterology, there are sub specialties. Liver, IBD, Oncology, etc. I’m not too sure which one of these I’d like. But I find liver pathology more interesting than IBD. So maybe I will specialise in hepatology. But hard to say.

It’s just exciting to ponder these options. To have something to hang off these ideas and consider them seriously. I am so glad. After a lot of rotations where I found out what I don’t like, it’s been nice to have a run I really do like.

Future gastroenterologist Abracadabra? Perhaps!

 

In other news, Melbourne is a huuuge city. But it’s a lot like back home. I went to Great Ocean Road today which has these big rocks on the shoreline. Great roadtrip with my flatmates and I took some photos! The weather was basically not great and we were all freezing and wet, but it was a good day overall!

12 apostles 412 apostles 512 apostles 6

I Am Not A Fish

4 weeks into this gastroenterology rotation, I’ve found that it’s quite specialised again.

I’ve found this on many rotations before and I’ve mentioned it on here. I don’t know what it is about being in a particular department that suddenly means you are wearing horse blinders and can only focus on one part of the body.

As in, you are admitted under gastro so therefore for the time that you are here, you are nothing except your liver and bowels.

One of the other med students and I admitted a patient together. As part of admission we completed the standard history and examination. This patient was being admitted for bowel preparation before a routine colonoscopy. While examining him, I found that his pulse was abnormal. The other med student confirmed this and we were concerned that he may have an arrhythmia. When we reported this back to our intern as part of the admission notes and said that we would like to request an ECG, she gave us a very pained look.

“…Really?” She said. “I mean. He’s just here for a colonoscopy. His pulse doesn’t really matter.. You can request an ECG if you want, but it’s just an extra thing to do…”

We were both a bit disappointed by this. Yes it probably isn’t relevant for a colonoscopy. But if it’s a heart rhythm that could descend into VF at any time during the anaesthetic administration for the colonoscopy, I would imagine the anaesthetist would question why the patient made it this far without anybody picking up his irregular heart beat. The chances of this happening are very low of  course as we did request the ECG and he had a benign RBBB. But the chance exists and I would hate to be the one to fall in that percentage. I wondered why my intern didn’t feel the same way.

Then today, a patient who had an endoscopy for a bleeding ulcer was found by the gastroenterologist to have something pressing on her stomach externally. He had ordered a CT scan to find out what this was. My gastro team received the result and it appeared that the patient had multiple large cysts in her abdomen. There were multiple cysts in her liver, and some pressing on her stomach. My registrar was satisfied with this finding and was glad that we found what was pressing on her stomach. I asked him what would have caused the cysts. He told me he had “no idea”. “Some people just have cysts. We just don’t touch them. We just need to know what was pressing on the stomach”.

I just…. Eugh.

What if those cysts were hydatid? Caused by parasites? What if they become infected? Again, super low chance of this happening. And I appreciate that. But no referral, no plan to monitor further, nothing really.

Ie. Let’s just wait ’till it becomes a gastro problem that needs fixing.

What is this mentality? I’m seeing this in all parts of medical practice that I have experienced. And it really bothers me. I appreciate that once you’ve confined yourself to a specialty, your priorities are the problems that come to that specialty. But surely that doesn’t mean you have to intentionally ignore the patient’s other problems? They bang on and on about ‘holistic’ patient care in med school. I wonder how people interpret this. I am still a student so obviously I’m trained to think about every possible issue a patient presents with. But I’d like to believe I’m not just trained that way for the heck of it.

For me, if you’re the sort of doctor that says “they’re only here for a colonoscopy, don’t worry about their heart”, you’re just not providing good enough care for the patient. Like it’s just not multi-dimensional.

Okay I understand that people are busy. I understand that you cannot possibly be expected to fix every problem someone comes in with. It would be super stressful and will probably shift focus from the problem you’re supposed to fix, but it’s just the attitude. It’s just the way you’re doing your job. Why would you tell the medical students to be just as uncaring about these things?

It’s broken as Seth Godin would say. This sort of thing would come under the “I am not a fish category” Whereby the person who designed the water exit for a fish placed it one foot above the water level. The fish can’t every get up there. Why did they guy design it that way? Because he’s not a fish. He just did what his job description said: To build an exit.

Really interesting talk if you’re interested:

 

Anyway. Point of this is. I want to know which field of medicine I need to be in for doctors to not shrug off certain problems just because it’s not part of the body that they are assigned to. I wonder if there even is such a field.

Maybe I just have to try to maintain my student training mentality.

I don’t know.

Unfair

Stop picking on me.

I have not displayed any features or signs of being that which you accuse me of.

Cut it out.

Why me? When there are all these other people who do fit that category.

I’ve said and done nothing to that effect.

It’s not nice.

Go pick on someone else.

I am not apologising for something I did not do.

I am not going to be made to feel guilty for no reason.

Not anymore.

Not me.