Politics……..Zzzzz

One of the things that comes with being an adult is pretending to care about politics. No no. You HAVE to care about politics. Why? Because everyone else is going out of their way to make sure you do.

So. The NZ general election is coming up. Over the last 9 years, we’ve had the same ruling party making up the government. That being National. The opposition has always been Labour. Apparently one of them is left wing and the other is right (I forget to care about remembering which is which). They are the two main competitors. Then there are all these random small parties that everyone knows will have no say at all, but people end up voting for anyway. Some do so because they want to waste their vote because they couldn’t care less, while others are very gung-ho about their actual policies.. apparently.

I’ve only earned the right to vote since the last election. Up until then, I, like every other kid out there would consider politics to be just a lot of boring noise that adults make at parties that I would somehow go talk to about my friends as though I came up with an opinion all on my own. Let’s face it.

But since gaining the right to vote, I’ve found just how ridiculous people can be when it comes to politics.

Now. I don’t mean this in an offensive way. All these people are my friends and they truly have strong beliefs and I respect that immensely. But what I don’t respect, is their attempt to force these beliefs on others.

Literally all I heard in my first year of med school was how the current government and our prime minister at the time had failed the entire country and we’re all suffering immensely and we’re all going to die because of the apocalypse that the government started. (Obviously kidding, but they were saying a lot to that effect). It surprised me just how ferocious people could get about this. There were posts upon posts on FaceBook about how everyone should vote for The Green Party (which is supposed to be both an environmental and cannabis friendly party that really cares about the youth. Well this is what people try to convince me of).

What was worse was that each person somehow assumed that every other person was voting for the same party.  I am not kidding. A friend of mine openly asked me who I was voting for. I don’t usually like discussing this, but I told her anyway. She then replied in a horrified tone that she thought I was a supporter of her own party. I asked her why, and she said “Idk I just thought you were that person. Who supports ______”

What the heck.

How? I mean….How?

Other people just add me to their conversations assuming that I’m voting for their parties. “I mean, we’re all voting for Green cuz we care about NZ, but like can you believe how unreasonable National is being??” Without so much as asking me whether I had an opinion.

Though I must say, the easiest conversations to have with people are about politics. It’s easy because all I do in these situations is smile and agree with whatever they’re saying. I mean hey, they’ve already assumed I’m a supporter. Why bother arguing otherwise with someone who is such a strong believer that they rely on transference to gain party votes?

Like I just don’t get it. Why openly hate any one party? Are people actually naive enough to believe that a Single party can fix the entire country and make everyone absolutely happy? It’s as though history has taught us nothing. There’s no way ANY party is going to bring every singly policy they had promised to a letter.

Surely it’s just about the bigger issues. Why do people take these things so personally? And I mean they take it personally because when I ask people about their partys’ policies, they usually just end up going on about how lovely the party candidate is. Or how good a speaker they are compared to that useless prime minister. Eugh. I’m just getting a bit tired of hearing about people’s ferocious opinions.

Regardless of who gets elected, there will always be a group of people negatively affected and who are going to complain. At the same time, regardless of who gets elected, people are not going to wither away and die. Yes the government is important, but it’s still just made of people.

This is just my opinion though. Again, I’m not saying it’s not important to have your own views and beliefs and vote, because of course it is. I have mine. I went out of my way to make sure I was well informed about policies, etc. But I just wish people would be more aware that there are other views out there before posting on FaceBook about who they have voted for, and who YOU SHOULD vote for if you give a damn about your country at all and are not selfish and stuck up like the current government is.

Because that’s no longer support. That’s propaganda.

I want to make a move to make it socially unacceptable to discuss your political ‘opinions’.

But anyway. That’s my political rant. I usually wouldn’t care so much. But some people have been unnecessarily pushy this election and I cannot wait until it’s over. I’ve become indifferent to who is even going to win. I’m just tired of my news feed being filled with people trashing others.

Where is the love? (As the black-eyed peas would say)

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Journal Club Bribe 

How do you get people to come to a 7:30am gastroenterology journal club?

Bribe them with a free all-you-can-eat breakfast from the hospital Cafe!

Nothing says motivation like free food.

Unfortunately for me though, the hot chocolate I ordered was way too sweet. And the Berry yoghurt was far too thick. And the thing in the middle, was too salty.

Still. Free food is definitely motivation for everyone.

Just Out

When your team consultant kicks you off the ward round because “students slow things down” and he wants to have a “working” ward round so he can go play golf afterwards, ditch the ward round, take a long weekend, get on a train to nowhere and see where you end up 



LOL jk. I googled how to get to these places. 

But the rest is true. 

Balance

Do you ever have points in your life where you think that things are going really well at the moment… And that’s suspicious and you’re expecting things to crash?

I never have these points.

My life somehow seems to always be a perfect, and immediate balance. Whenever something good happens, the very next day, if not the same day, something not so good happens. Probably something unrelated to the good thing, but still. It’s instantaneous. And it’s just painful irony most of the time.

I don’t know why. You’re probably thinking what a cynical pessimistic thing to think. And optimists will say that perhaps a good thing is happening after every bad thing.

But with the latency between the bad thing and the good thing, I can kind of tell which is happening first.

Something good has happened, and then the next day, something upsets me. In a big way. Makes me wonder how I am going to stuff up the good thing that happened.

I suppose another way to look at it is that it keeps me grounded. Never too overconfident with myself and never too down on myself. Well…. That’s not really true. I have long moments of down-ness. But it almost always seems that goodness is followed by down-ness. Not really the other way around.

Eugh. I don’t know.

That’s life I suppose. Meh. Must go with le flow.

Intuitive Sensitivity

I haven’t seen any huge differences in terms of medical practice between Melbourne, where I am at the moment, and Auckland my home town. But something I did notice was this thing I like to call Intuitive Sensitivity.

Basically, back home, when doctors see patients, they are super intuitive about recognising what the patient is feeling and what they need. So many times I have seen registrars, house officers, consultants, etc. jump up and move to the patient’s side to put an arm around them or offer them some tissues even before they start crying. They just know when it’s coming. I’ve marveled at this several times. I certainly don’t see it coming. But they do. And it’s pretty great to watch.

But since being in Melbourne, I’ve already met several patients with terminal or extremely disabling conditions who burst into tears on ward rounds or during clinical consultations. But I am yet to see even a single doctor step forward to comfort them. House officers, registrars and consultants alike, just let the patient cry. It just becomes really quiet in the room while the patient cries.

This bothers me quite a bit. I hate standing (or sitting) around watching a patient cry. Or anyone, for that matter. No matter how staunch or independent a person is, everyone but everyone could use a gesture of reassurance. A hug, some tissues, a kind word, etc. Anything could help. But you have got to acknowledge, surely. Not just watch them while they cry.

Of course this could be a cultural thing. Basically Kiwis have a reputation worldwide of being the “softies” in everything. So I suppose it’s not surprising that people cry or people have that innate sense to comfort. And this might not necessarily translate in other countries. But then again, I have seen some consultants back home who just plain ignore patients when they cry.

But either way, I would hate to just sit in a room with a bunch of doctors staring at me blankly while I cry. And so, I can’t watch that. But it’s super awkward for me because (and I’ve said this a million times already) I am the student.

I have no role there really. I can’t just jump in and comfort patients while consultants are around. How awkward would that be. Or if it isn’t even acceptable culturally, I’d be both awkward and culturally incompetent.

But there was one point that I just couldn’t stand to watch a woman cry any longer. There’s this clinic called ‘functional gut disorders’ clinic. And I have to say it’s the most depressing set up I have ever heard of. Basically we just see patients with functional gut disorders that are incurable and are super complex and debilitating and we just tell them to continue their current treatment. Patients just come in to cry about their conditions, basically. So you’d think the doctors at this clinic would be super intuitively sensitive and do a lot of reassuring. But nope. I sat through multiple consultations where the consultant was, incredibly, typing notes while a patient sobbed away. This woman had an extremely disabling functional gut disorder. She cried for a few minutes, stopped, then cried again. Unable to watch her anymore, I had a huge internal conflict about moving towards her to offer some comfort while also not annoying the consultant. In the end, as a compromise, when it looked like she was about to cry again, I picked up the tissue box near me and offered it to her.

She accepted it gratefully and thanked me. The consultant gave me a small surprised look but then smiled and said “thank you for doing that”.

Okay it wasn’t a big gesture, but it was the most I could manage. And I think it kind of helped the lady. Which probably means it’s not culturally unacceptable. But yeah, there were a few more patients after that and my consultant still let them cry. As do the other doctors. And I’m still the med student so I can’t do much. Sigh.

I just don’t know how you can be okay with watching someone cry. Or knowing someone is sad. It makes me feel yucky.

I suppose I am developing this intuitive sensitivity though. I just have to try make as many small gestures as I can.

That One Person 

You’ll meet all sorts of people where you work. There are people who act like you don’t exist, there are people who wear a permanent crown on their heads, there are people who pretend to be nice but aren’t really. And there are people who don’t even pretend. 

But every so often, you’ll meet someone who does care. Someone who actually takes an interest, makes you feel important and has an enthusiasm that is infectious. 

That one person will make all that other stuff unimportant. And they’ll actually make you enjoy what you’re doing. 

And I am so grateful. 

Out And About Melbourne Photos

It’s the first sunny day I’ve had in ages!! Hallelujah! This trip is the perfect time to reunite with my canon. And so the following photos were taken on a trip to a couple of places! Pretty happy with these and it feels so good to use my camera again. xD

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Just getting back into some macro photography. This is at the infamous Victoria Market with some amazing Australian produce. I like what they did with the melon

Antique compass

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The Victoria market isn’t just for produce though! They sell everything from clothes, to boomerangs and didgeridoos, to antique compasses, pocket watches and sundials. I thought it was pretty neat!

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And then I went to a place called Brighton beach with about 70 of these brightly coloured huts! I have no idea what they’re there for but you may have seen them on the previous season of Masterchef.

The beach itself is extremely narrow and I was dangerously close to the water when taking these photos. But mostly because I had to move around enough to make sure I didn’t get any other people in the frame. Which was not very successful. Eugh.

But it’s okay. It was a sunny day at the beach with my camera. A pretty good day overall.

A Week In Melbourne

Greetings from Melbourne!

Apologies for not updating sooner but it’s been a challenging week for me on my first week of selective. And it’s been really full-on with highs and lows. That I shall now recount.

It’s my first week of living in an apartment with two flatmates. Both of whom are super organised but have been very nice and accommodating. It’s taking a while to get used to. When you live in an apartment you appreciate the value of hot water and electricity. You can’t have the heater on all day, you can’t take a shower for any longer than 15 minutes, you have to wait your turn to use the bathroom in general. You have to get used to the fact that everyone has a different sleep schedule and because you live in such close quarters someone is bound to be disturbed. One of my flatmates has crazy work hours and basically comes crashing in past midnight now and then. However, the following day, I crash around trying to make a cup of tea while he tries to sleep. And you’ve got preserve electricity for when you need it.

That’ll be for the heaters.

Melbourne is 9 times colder than Auckland. It’s ridiculously windy and I haven’t seen sunlight in 5 days. And my apartment is lacking in insulation so things get extra chilly at night.

But otherwise, I’m super grateful for my little flat. My flatmates are great and I’m finding this new change quite endearing. Hopefully I’m a good flatmate too.

In terms of my selective, I’ve had an interesting week. The Alfred hospital is where I’m based and it’s pretty huge. But the medical school (as all medical schools seem to be), is completely useless.

I walked up to the clinical school on Monday, earlier than I was expected, and waited a full hour to be oriented. The selective coordinator I had been in contact with told me my “supervisor will come to collect me”. Instead, another doctor showed and took me through the basics of being in hospital. Avoid infections, wash your hands, patient confidentiality, don’t kill anyone, etc. After that he left me with the registrar on the gastroenterology team for a ward round.  After which, I still hadn’t met my supervisor. So I went down to his office, and he wasn’t at his desk. So I returned to the gastro department and asked my registrar where I could find him. A lady nearby said “oh he’s on leave for 3 weeks”

……..seriously? I have to have a pre-selective catch up, a midway catch up and an end of run catch up at which point my supervisor fills in my final report. I can’t do any of that if he’s away for 3 weeks!! And the most annoying thing was, I had told the lady I was in contact with all of this. So when I emailed her asking if she knew this, she said she had no idea and that I should ask my registrar who the “acting” director was and he/she would be my new supervisor. Eugh.

My registrar didn’t know who the acting director was. Double eugh. But she finally introduced me to a consultant who agreed to be my supervisor but could only meet me for 10 mins at the end of the week. Eugh eughh eughhhh.

So until then, I was stuck following the registrar around on ward rounds. It ended okay. I caught up with the other consultant, he was nice enough, gave me a project to do over the next 5 weeks, so that’s good.

But omg the ward rounds.

The ward rounds on gastroenterology are a minimum of 4 hours. I haven’t been on ward rounds since OBGYN. And those were pretty straight forward. All the women were either pregnant or had tummy pain. So I wasn’t used to the burning pain in my legs and feet as I trudged up to the 7th floor to see more patients after 2 hours and counting. But the horrific part wasn’t even the pain. It was the fact that everything about these ward rounds reminded me of my gen med rotation last year.

The rounds where you have no idea what the patient’s backgrounds were but you have to stand awkwardly in the room, turn the lights on, draw the curtains, and listen as your reg talks to the patient about their ongoing care. And they’re moving at a pace such that asking what this particular patient came in with would be the last thing they want to answer. The house officers are feverishly writing notes, so they’re no good either. So as the most junior person, you stand around and think about how you’re not learning anything.

But I am no longer a lowly 4th year student, traumatised and vulnerable, pushed around by superiors, and intimidated by everyone for no good reason. Crippled by the fear of appearing incompetent that I actually come across as less competent than I am. Yeah nah. That’s sooo last year. If I learnt anything from last year, it’s that you are the only person responsible for your learning. And that means ditch the ward round if you’re not learning anything. Find somewhere else to be. If your time is better spent studying, go for it. Better spent in clinic? Go there. Endoscopy? Hell yeah. Don’t force yourself to be in a situation where you’re not gaining anything just because you’re “expected” to be there. I showed up to all of 2 ward rounds this week. I went to clinic where the one-on-one time with consultants is the best to learn about gastro diseases. I went to endoscopy where I saw some pretty cool stuff, but left early when it was a couple of mild reflux oesophagitis cases being scoped. Time better spent reading up on IBD. Of course someone will always try to undercut you, like a consultant who decides you’d learn more about “acute management” on a ward round on the 4th day where the list hasn’t changed, than go to a liver clinic, but even then, don’t be upset. When I’m on that ward round, I do ask my registrar questions and I do persist in learning. And even if I don’t, in useless situations, even if you don’t learn how to practice medicine, you’ll definitely atleast learn how not to practice medicine, And even that, is good learning.

Taking responsibility for your own learning means that you can’t expect anyone else to care or take an interest etc. But it does give you the freedom to do the things to learn the most you can. And it means you don’t have to care too much about them either. Just make your learning work for you. I’ve been following this. And it felt good. I’m more excited to learn on gastro than I have been on previous runs.

But anyway. I shall make another post about the merits of Melbourne as a city. Not just hospital related stuff. Because this place is huuuge.

And in a big city, when you’re having a tough week, the best way to blow off some steam is go exploring at night in the rain and capture some pretty lights.

Melbourne state library

This is the Melbourne state library at night. Finally a picture with my canon. It’s been a while. Very good effect with the rain by the way. Even though I was freezing.

 

 

Psychiatry Review 

Well it’s time to wrap up this run and move on! It’s been a quick 6 weeks. But I think I’ve done more reflecting and pondering on this run than any other. Mostly because I had a heck of a lot of free time when my consultants were doing paperwork work for 4 hours of the day.

But anyways!

There’s a lot of philosophy that I’ve learnt on this rotation. My view of people with mental illness has changed. Especially in forensic psychiatry.

The great thing about people with mental illnesses is that they become a complete version of themselves. By that I mean, they can’t be anything else except them. They can’t put on a fake mask or pretend to be someone else. They’re authentically who they are. And I find that so much easier to work with than normal people. xD

Especially in forensic psychiatry where it’s so easy to assume that a criminal is a criminal because they were born a criminal. But only when you see people who have mental illnesses and are treated appropriately, do you realise just how vulnerable many of these “criminals” are. When treated, the patients I have seen are the sweetest, most thoughtful people. There’s nothing really wrong with them. But outside, they’re considered evil, disgraces and are shunned from society without receiving the help they needed early on in life. And a few of them, particularly those considered “antisocial” were those who attacked others and showed no remorse. But when you find out about the people they had assaulted, many of them frankly, had it coming. They were horrible people who said and did horrible things. Many times in my life, I have had the overwhelming urge to punch someone in the face. Multiple times. But I have the inhibitions and the ability to stop my hand from shooting out and catching Mr. Stuck-up in the face, more than once. Even though he would have deserved it. Or how often have you read in the news about a horrible dictator or politician who treated others in a horrific way and thought to yourself “someone ought to teach him a lesson”? Sadly, both you, and those people are “normal” and free to be around in society, where the individuals who actually act on these feelings are locked up and labelled “criminals”, “psychopaths”, “sociopaths”, etc.

Not all of them fit this category of course, but for a while, I was under the impression that none of them fit that category. I thought all of them were fundamentally flawed. They’re normal people just like us if they received the help they needed. I reflected a lot about the circumstances of a person’s environment that predisposed them to ending up with a mental illness. If I had a dollar for every traumatic childhood case I had heard in the Mason clinic, I’d be pretty happy with the amount. It’s quite sad. It’s not really your fault someone bullied you to the point where you began hearing them in your head continuously telling you what a loser you are. And that makes you lash out. At yourself and others. And that means you’re locked up while the bully is probably still out there somewhere.

Whew. So that was pretty philosophical. In terms of this field of medicine, I’m not cut out for it. I can definitely see that. I think I’d like something a bit more fast-paced and with less paperwork. I also think that psychiatrists have a “trait” that I don’t really possess. It’s this detached trait. One of my consultants is actually quite shady. He told me off for laughing at a joke He made in a patient interview. He told me that I must be more self-aware and careful about laughing during patient interviews as it might upset the patient…………… I nodded politely. He also told me that he cannot give me an excellence grade for ‘professionalism and boundaries’ because I expressed some sadness that my patient Mr. PH left back to prison abruptly. I believe my exact words to my other consultant was “aww I didn’t know he had left”. She told my shady consultant I had said this, and so it was decided that I have boundary issues. He then proceeded to lecture me on “Empathy vs Sympathy” and the importance of “do not feel what the patient is feeling“. Eye-opening lecture, that. It was then that I learnt that the real “professionalism” is making sure you don’t say anything at all to your consultant that is not work related. The best part was when he later told me that my performance is great because I have such a great manner towards patients and I make them feel comfortable. By this point I adopted an emotionless face. Determined not to respond to anything he would say anymore. Yeah I definitely do not have the psychiatrist trait. That sounds like I’m being a bit bitter. But truly, I respect all the psychiatrists. Their job is in no way easy at all. They’re all super qualified and brilliant doctors. I just don’t think I can be one of them.

Anyways! It’s time now, finally, to move on to my last rotation! Hopefully it will be a good way to end the year!

The Blogger’s MSE

Mental State Examination:

Appearance/ Behaviour: The blogger is a man/woman aged between 20s and 30s of medium height and normal build. They are dressed in casual clothing and are frequently dishevelled. The blogger establishes good rapport and maintains intense eye contact with their computer or mobile device. They tend to smile stupidly or frown intensely at the screen when blogging 

Speech: Speech is minimal to non-existent when blogging although occasionally seen muttering phrases to themselves with normal rate but low volume. 

Mood: The mood of the blogger is often subjectively variable before blogging and is objectively euphoric following blogging. 

Affect: The affect is expansive and labile ranging from irritable to blunted to euphoric, and changes frequently depending on the subject of the blog

Thought Form: The Blogger’s thought form is not linear or goal directed. There is often signs of thought disorder including tangentiality and circumstantial writing. There is also frequent flight of ideas evident in the blog posted.

Thought Content: Thoughts consist of grandiose delusions regarding popularity of blog. They also believe they will become a famous author. The blogger is preoccupied with obsessive thoughts regarding their next post and have a compulsive need to log on to WordPress frequently. 

Perception: Blogger has occasional auditory hallucinations of sentences in their next post. Blogger does not report visual hallucinations and is not observed to be responding to non-apparent stimuli.

Cognition: Blogger is alert and oriented to time, place and person. Good recall of previous posts.

Insight & Judgement: Both insight and judgement is impaired as the blogger believes their delusions are reality based and do not believe they need help with their obsession with blogging. 

Risk: The Blogger’s risk of harm to self is deemed moderate and is mostly in the form of procrastination by blogging and hindering their progress and completion of school work. Their risk of harm to others is deemed moderate by causing them to procrastinate also when reading the blogger’s post, and also possibly causing harm by boring them.