Need To Know Basis

If you’re anything like me, things that frustrate you to no end are when people say things like “ugh I’m upset” and then when you ask why, they say “doesn’t matter” or “too hard to explain” or they don’t reply or they change the subject abruptly. 

Excuse me how rude. 

First of all, if you’ve got a problem you would like to share, then for heaven’s sake share it! If you don’t want to, then don’t. Please do not come by and hint that you’re dying on the inside but don’t want to share the full story. Don’t hint it at all. Like ignorance is bliss. I was having a perfectly good day until someone says “I’m really upset” and then when I panic enough to drop whatever I’m doing and ask them what’s happening, they decide they don’t really want to talk about it anymore. 

That stuff messes with people you know. Decide whether you would like to talk about it. People like continuity. I do, anyway. I even try following up. I mean, I can appreciate if someone is too emotional, etc to discuss it right that instant. So I normally make the effort to remember who said what and try to follow up and make sure they’re okay. But nope. I get rewarded with a “too hard to explain”, or just plain change of subject. 

You know to be honest, I’d much rather appreciate a person saying “hey I’m upset and I thought I wanted to talk about it with you, but I changed my mind for these reasons so I won’t be talking about it. Nothing personal” or something to that effect. Because otherwise it’s like being left on the cliffhanger of game of thrones with an indefinite time period as to when the next season will be up.  (Or so people tell me. I wouldn’t know) 

It’s really not that hard. 

But anyway, I’ve learnt to cope using my technique of the need to know basis. As in, is going to kill me if I don’t ask about this or if I don’t know what’s happening? Probably not. Can I live with just hands off methods of interacting with them without bringing up these issues? Yes I think so. 

It’s just for my peace of mind really. I ruminate far too much on what people were Going to say, but didn’t. There’s just no point. I mean yes I get curious, and I try asking maybe once, but after that, I’d rather join this person in pretending that conversation never happened than putting myself through the trauma. Just gotta accept that’s what people do sometimes.  

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Not So Rural GP

I have just completed my first week of my “rural GP” rotations. The quotation marks and the title should suggest what this post will be about.

My rotation is in a place called Warkworth. Warkworth is actually still in Auckland. The point of a rural placement is that I should be placed in some tiny rural town deep interior of the North island. But I’m actually in the northern most part of Auckland which is so unnecessarily big that a part of it is actually considered “rural”. Warkworth is an hour away from where I live. Even though it’s still in Auckland.

I mean of course Auckland is not as big as other cities, like Melbourne for instance. But I don’t think any part of Melbourne is considered “rural”. Whereas, Warkworth is. Isn’t that weird?

Anyway. I’m at Warkworth medical centre for the next 6 weeks. It was an absolute nightmare trying to find accommodation at this place. Luckily we live in the age on things like AirBnB and what not. So it should be easier finding accommodation right? 

Well, no.

There was another student at the same practice before me. And she was staying in an AirBnB quite close to the practice for 45$ a night that she recommended. So I thought I would check it out. I went to the owner’s house and the lady there took me downstairs, opened the stair closet, and there was a bed in it. 

Yep. Not kidding. No Windows, no space, literally a stair closet that this other student was paying 45$ a night for. And there wasn’t access to the kitchen either because this was someone’s house. I was very concerned. I could die in there. Someone could close the door and I could literally die. I was genuinely concerned for this other student who spent 6 weeks there. I wonder if she was hoping that if she stayed there long enough, she’d receive a letter from Hogwarts. 

Blech. But yeah that wasn’t going to work for me. And everywhere else was extremely expensive. I ended up finding a studio beach house about 10 minutes away from Warkworth. Yep 10 minutes away is basically another town. But anyway. It’s a bed, a kitchenette and a bathroom. Which was pretty new and pretty decent however, it’s 260$ a week to stay there. Eugh. Expensive. But decent I suppose. I decided to drive back home on Fridays so that’s good. 

But oh my God is it hot in the studio. It’s extremely hot in Warkworth in general but there is no air in the place I’m staying. I tried opening some windows and a bunch of bugs flew in so I spent an evening hiding in my bed scared that bugs would crawl into my ears. So I decided never to open the windows again and die of the heat instead. Blech. 

On the bright side, the actual rotation is great. The practice is pleasant and all the GPs I’ve worked with thus far, including my supervisor, have been really nice. So that’s really good. I saw some patients on my own aswell and they were really nice too. I guess 6 weeks won’t be too bad. 

It’s challenging though. In any one day I saw patients with illnesses from every single medical specialty. Cardiology, rheumatology, orthopedics, gastroenterology, psychiatry, etc etc. In hospital, you refer them to wherever they need to go in a heartbeat. But in general practice, you have to deal with it all. Which means you have to know it all. I do not. Yet. So I basically have to study everything again. 

And Warkworth is quite nice. It’s part of a region called Rodney and they’re famous for beaches and nature trails. So of course I had to go for a walk. And of course the most interesting thing for me is sunset.  

So here are some pictures from Warkworth

The Poison 

Do you know what the funny thing about anger is? It’s the most aggressive slow-killing poison in the world. 

Anger at someone else, grudges, revenge, negative thoughts, etc etc. Are all ingredients for the perfect poison. 

But the real funny part.. is that you can only use this poison to kill yourself. 

Someone upset you. Someone annoyed you. They hurt you, offended you and so on. You get angry. Your muscles all start contracting, your heart starts pumping like crazy, the adrenaline seeps through your body and brain causing every nerve to tense up in response and puts strain on your body and your mind. The Poison has entered. 

It leaves behind a trail. The memory you have of this incident. Every time you remember, it all starts again. You see someone or something and it just literally burns you up from the inside out. 

Meanwhile, the other person walks away. Completely healthy. Completely unaffected by all the detrimental effects going on in your body. Endorphins flowing freely through their system no problem. 

Isn’t that funny?

When someone makes you angry, don’t you want to hurt them in some way? Sure. But what do you end up doing? Just taking more of your slow poison. Again and again and again. 

You getting angry isn’t going to change them. It isn’t going to change what happened. It’s just going to stress you and your body out every time. 

Especially if you hold onto a trace of the poison somewhere in your memory. It’s pretty much an unlimited supply. 

It’s a slow and painful suicide. 

Yes I can appreciate it’s not exactly something you can control. But you can atleast try to stop taking the poison multiple times. It’s just not affecting anyone except you. And not in a good way. 

I don’t wanna die that way. It’s just not worth it. 

Hurdles Crossed 

Today was the last day of my first rotation of 2018! Never had I known Gen Med to be so tolerable as I had this year. Of course it may have had something to do with the fact that I am a final year medical student and as such I am a legitimate member of the team not just the awkward appendage that opens curtains and turns lights on as a 4th year student.

No more. I am needed. I am important! I am a Trainee Intern and I am second to the house officer.

It’s been really great actually. My house officer had been extremely helpful in teaching me how to be a house officer next year. I was doing jobs and learning the ways. My consultants were lovely and actually took an interest in me, making an effort to teach, etc. It was such a change to the experience in my 4th year.

But it’s been 6 weeks and it was time to end. I had my long case assessment which was entirely horrendous. Basically I had to take a history and do a focused examination on a patient with a long-term issue. These usually being medical issues like diabetes or heart failure or something along those lines. And these patients are supposed to know the drill and know quite a lot about their conditions. I however, got Mrs. Vague from Lost Town in Shadyville.

Me: So, what concerns you mainly about your health?

Patient: Well I had a fall 50 years ago. I hurt my back. And I haven’t been able to walk since.

Me: Oh I see. Could you tell me a little bit about that?

Patient: Well, I fell over and hurt my back. I had a surgery, and I haven’t been able to walk since.

Me: What surgery did you have?

Patient: A surgery on my back which took the pain away but left my legs feeling like lard. I couldn’t move them, couldn’t feel anything, and I had to have physiotherapy for 1 year.

Me: Oh so you’re able to walk now?

Patient: Yes I walk fine now. I don’t need supports or anything.

Me: Okay and how is the feeling in your legs now?

Patient: Oh much the same. They feel like lard. Like I can’t move them at all. And I have foot drop in both my legs. But I can walk fine. Everything is fine!

Horrendous. She kept talking in circles and I had no idea what her problem was. When I presented to the consultant, he told me that she actually had a failed spinal surgery where a few nerves were accidentally cut!! I never would have gotten that out of her. Meanwhile, the other students had garden variety patients with diabetes and atrial fibrillation.

I had this awful 10 minutes before presenting to the consultant where I was sure I had failed. Fortunately for me, both the examiner in the room, and the consultant I presented to recognised that I had a particularly difficult case and said I did well, and I passed!

Thank you Universe!

And then on my last day, my own consultant gave me a good report. She told me I had been a wonderful addition to the team and I would make a great doctor. Which was so nice to hear. It just gives you that boost of confidence. After two years of being unsure about everything, it made me feel good. That maybe I’m finally doing enough to come across as someone competent. Who does belong in medicine. But anyway, as I’ve mentioned before, I’m useless at receiving compliments still, so I just sort of smiled and said thank you. Hopefully she didn’t think I was being weird.

The Gen Med rotation and the long case are huge hurdles for this year. The long case is the major assessment 6th year students are expected to pass. I’m really grateful that I was able to get through it and feel competent doing so. 

But anyway. I’m properly exhausted now. Gen med is the most tiring rotation to be on. I’m moving on to rural GP starting Monday. So hopefully that’ll be a good change of pace and I can get some decent rest. Hopefully not famous last words. xD

 

The 20s

Sometimes I think that being in your 20s is a very frustrating time in life. I mean, I have no frame of reference, but I just think it’s hard to be in your 20s.

When you’re 20 whatever, it’s a rather crucial point in life. You either have a lot of ideas of things you wanna do and places you wanna go but are frustrated because you can’t just get all those things done straight away. It takes time, money and freedom. Which very few people have if they’re still in uni or just starting out in a job they know isn’t where they want to ultimately end up.

Or you don’t have any sense of direction and no real plans because you’re sort of stuck in a position with multiple factors in limbo and are equally frustrated.

I mean. Career, future, friends, family, relationships, etc etc etc. It all starts now-ish.

And nothing makes it worse like when relatives or family friends ask you what your “plans” are.

I hate that question. Not because I don’t have any plans, but more because it’s annoying that they think I’m going to sit there and explain each bullet point of my 10 year plan that I have taped to the wall of my room or something. I don’t have anything like that by the way. But I don’t know why people think I do.

The expectations are high and things are changing rapidly. I remember less and less of my school days. The people especially. Some are gone. I have no idea where. Some are in the same situation as me, some are living large by travelling, etc. Some have turned into wild people (If you know what I mean). But we’re all the same age basically.

Oh God and some people are getting married. Which I suppose doesn’t mean much. Like I’m not going to over hype marriage like it is an achievement. If you found someone you want to spend the rest of your life with (hopefully), that’s great for you!  But that’s another expectation when you’re in your 20s. Start thinking about “settling down” (whatever that means). I think that’s an awful expectation. Like it is hard enough to work with some people in a professional sense let alone like them enough to talk to them outside of professional arena. I mean, if that’s how it is in a professional sense, how on earth are you meant to find someone likeable in general? I assume this is why we have things like Tinder these days. Like I literally have 4 people whose company I enjoy. Of course that might just be me. Because I hear that quite a few people my age are engaged, planning their weddings, deciding honeymoon locations and where they should work next year so that it best works with their wedding plans.

How weird is that? Well maybe it’s not weird. Maybe it’s normal. I wouldn’t know.

And that’s another thing when you’re in your 20s. You’re just starting to work. And everything that goes with that is a big shock. Working with others, the hours, the demands, etc. It’s all overwhelming. But also, you start to learn a whole bunch of things like learning when to say what, who to say it to, how to carry yourself, and you feel like you can do a lot, but you just can’t.

Where am I? I am frustrated. I sort of have ideas of things I would like to do. But no way of executing them any time soon. I’m still in uni. I have a huge student loan piling up. I have my parents to look after. My dad had started working when he was younger than me. He still is. I’d like to get him to retire. I would like to move. But little idea or potential of that with all the other plans. Sometimes I wonder if I’m too idle. Maybe I should take on extra things. Sometimes I envy those people who have done all of it and have their lives sorted in their 20s. Eughhhhhhh.

What am I doing everyday? the things that need to be done. Waking up, going to work, studying, watching videos, talking, and stressing. I feel like I’m waiting for something to happen. But of course it won’t for a while.

How am I supposed to deal with this frustration? I wish I could fast forward this messy part of my life. And skip to the part where things fall into place and everything will hopefully be okay.

Yeah. And I also want Santa Claus to be real.

Wishful thinking is not a good idea apparently. I’m basically doing each day as it comes. But meh. There’s always the underlying frustration of being stuck. It’s probably not eternal. But it is worrying how much might be different when I come out of it.

This isn’t to say I’m miserable. There are a lot of great things happening for me which I am always grateful for. But yeah. This is a weird time period for me. I guess I’m dealing with it by writing on here. 

Kinda helps. 

 

Shut Out

Consider the following scenarios:

1. Friend A was in a relationship that ended badly, with the other person continually harassing them. Friend A blocked them on all social network and deleted their number so they may get on with their life. 

2. Friend B blocks people on Facebook and other mediums who “annoy” them 

3. Friend C had a fight with a friend they had known for years. This resulted in the friend blocking them on everything. Friend C was so upset that they deactivated their Facebook, and went off the radar for a few months. 

4. Friend D was in a relationship where their partner had cheated on them. When they confronted their partner, their number was blocked. And they were unable to talk to them. 

5. Friend E was receiving messages from someone they didn’t know continually. So they proceeded to block them.

6. There was a meme on Facebook that said in order to get revenge on someone or “hit them where it hurts”, you simply have to unfollow them on Instagram and block them on Facebook. 

You know, in this day and age, communication is so easy. There are millions of ways you can talk to someone. And there are ways to know when someone has seen your attempts to contact them. Which is all a good thing really. Because I cannot imagine how agonising it must have been in the days when everyone would communicate through letters. And in the days/weeks that followed sending that letter, wondering whether the other person had received it, had read it, when they would reply, or if they were even alive. There was just no way of knowing. 

So it should be a blessing that there are now so many options to reach out to someone else. Your friends/family, etc. 

But with anything, there’s a dark side. Off late, I’ve been hearing from people about this whole “blocking” business. As in the act of clicking on someone, going to options, scrolling down and hitting “block this person” on whatever app you use to communicate with them on. Then sitting back and feeling triumph. 

And I say that last bit because that’s the kind of blocking I hear about. When websites such as Facebook were first developed, the blocking feature was most relevant to people like friend E. It’s basically a way you can avoid the less than great people in the world you don’t even know. Which is fair enough.  And then after that, it was next most relevant to Friend A. Who was being harassed by someone they knew, and wanted it to stop. Also reasonable. 

The problems, are with Friends B, C, D, and the meme I mentioned. Blocking someone out of malice. For revenge. Intentionally to hurt that person. Yeah. That’s not cool.

Like yes it means you don’t want to talk to that person in that instance or for the foreseeable future, but essentially what you’re saying is that they meant so little to you that you basically can delete them from your life at the simple click of a button. 

And that’s what hurts most people. Of course 20 years ago that wouldn’t have made sense to anyone. And it wouldn’t have been possible anyway. To stop someone communicating with you, you’d usually stop replying to letters, stop answering the phone multiple times when they call, or in extreme cases, move.

But this is slightly different. Blocking is like going out of your way to make it clear to someone that they are no longer privileged to attempt to contact you. To be in your life. In that one click, it’s all literally over.

Which is so weird. We live in a time where this is possible. Friend C had a terrible time. To the point where another friend and I had to go visit her to make sure she was okay. She began to spiral quite a bit and all because her “friend” had blocked her and she was beyond devastated. 

I can understand that. The feeling that you spent time/effort/feelings on someone who only cared about you as much as the effort it took to flex the MCP joints of their finger and apply pressure to click the “block” button. And then carry on with their life. 

What would motivate someone to do that? Well. As in Friend  C’s experience, someone can just be angry and act out by blocking. The equivalent of hanging up or slamming a door in their mind. However, if they perpetuate that, it becomes worse. As adults I think that if you’ve known someone for long enough, you should be able to face them and work through whatever problems you have. That’s not an unreasonable expectation is it? 

Unless you’re one of the people that Friend D encountered. Who had clearly done something wrong and chose to deal with it in that pathetic way. By running away from the confrontation. As though that would solve everything. Honestly I can’t imagine what this person was thinking. But the word despicable comes to mind.

And then there’s friend B. Who blocks people who annoy them. Basically friend B told me that if someone posted unnecessary things or messaged them for no reason, they would be blocked. I didn’t quite understand this. They were usually people who friend B didn’t know very well. And yes sometimes people can be extremely annoying on social media. But that’s why websites like Facebook came up with an “unfollow” button. So you don’t see their posts and they don’t know it. That to me, is less damaging then telling someone that you went out of your way to make sure they know they’re so annoying that they are no longer allowed to be a part of your social platform. And they will know. I don’t care what Facebook tells you. If someone’s posts and comments mysteriously disappear, they’ve blocked you. 

And the meme suggests that this is actually something you can use to intentionally hurt someone????

Who came up with that?? And why on Earth would people endorse that idea? As though it’s acceptable?? Basically you’re admitting that you are a petty enough person who would resort to revenge and that you’re incredibly immature that you would choose these means to hurt someone, and that you’re cruel enough that you’re okay with doing that. 

I’m sorry but I think that’s unacceptable in every sense.

But the more I think about it, it occurs to me that the only reason someone made a meme like that and the reason people continue to do such things is that we all give a lot of importance to this blocking idea. Like friend C who was very hurt. But if you think about it, if someone told you 20 years ago that there was this website where you could talk to someone, but they could “block” you, you’d probably not care very much. And say something to the effect of I’ll call them or go over to their house . And 20 years from now when Facebook becomes obsolete, no one’s ever going to care or remember that person who blocked them. 

So really, it’s all a matter of perspective. If you know someone beyond Facebook and you know about them as a person, all of that should matter more than being blocked. 

And for those who block people just to hurt them, please remember that karma is a witch. And it’ll come back threefold. You never know who’ll become a serial killer, you never know who’ll be the doctor operating on you someday, and you never know who’ll approve that loan you desperately need. As Ellen Degeneres would say:

Be kind to one another

Worthwhile

Today I was on my long shift and feeling the blues as usual when I was asked to see a patient as part of gen med review. 

She was a lovely elderly woman who had come in for some obstructive jaundice 

As I began to examine her, she looked at me and said 

“You have healing hands. I can feel it.” 

She then turned to her relative in the room and said 

“She’s the most gentle doctor I’ve seen you know”

And as I was leaving, she asked me when she would see me again.

Sometimes I wonder if I’m really helping anyone. When I’m tired, I wonder if I’m good enough to do the things doctors do. Sometimes I feel like maybe I’d be suited better somewhere else.

But when I interact with patients like this lovely woman, and they tell me the smallest things make a difference for them, I am so incredibly grateful for me and being in a position to impact someone in that way. It makes me strive to be better. It makes me appreciate my apparent skill of treating people in a way that makes them feel comfortable. 

I am so grateful to have met that woman and to have made her feel that way. It made me smile. It makes other things seem less significant. 

I’m glad.

Pressure 

Whenever anyone says “No pressure”, even if it is genuinely in the setting of very low stimulus for any kind of pressure, my mind still tends to build up a few thousand Pascals. And it doesn’t usually end well. 

Blech. Why. 

Is it just me? Or does this happen to a lot of people?

People should just stop using that phrase.