We’re A Team

Nearly done with my rotation on cardiology.

I have to say this has been my most favourite rotation so far. The hours have been long but the consultants have been fabulous and the work has been so interesting.

But the best part of this rotation is my amazing registrar.

Dr. Bradley is the most senior registrar at my hospital at the moment. He is currently the Chief resident.  9 years of experience on him, he is hilariously sarcastic, the best at being a cardiology registrar, and the most supportive colleague I have EVER had.

Without word of a lie, every other registrar I’ve seen or worked with has left me to finish the jobs and gone home at the end of the day in EVERY rotation I’ve ever had. And this hasn’t really bothered me much. Until the bar was raised.

Even if it’s 6:30pm and we’re tired and barely chugging through, and I’ve told him he should go home, Dr. Bradley says “We’re a team! I’m not leaving you behind!” and proceeds to stay there and wait until I’ve finished any remaining jobs and helps me with anything that needs doing.

The amount of difference that makes to the work experience is amazing. It made me want to work harder and be more efficient. Made coming to work that much better.

He even invests a lot in my learning. Teaching me how to do DC cardioversions, Treadmill tests and ward cardiology reviews by myself (reviewing patients referred by other teams to cardiology. This is usually a registrar job) and present to our consultants. He stands next to me and backs me up if the consultant asks something I don’t know. If any consultant or anyone at all tries to undermine me, he tells them I’m a future cardiology registrar and I can handle anything.

Having a senior colleague like that is so important. All of my previous registrars have been good and reasonable enough to work with. But none of them have really given me the responsibilities and support and trust that Dr. Bradley has. He makes my role seem very important to the team, even though I’m just a first year house officer and the bottom of the ladder compared to him and the rest of the team.

That’s what I will miss most about cardiology and why I’m so sad to move on to general surgery.

But I am so incredibly grateful to have met Dr. Bradley and have a role model that I aspire to be when I become a registrar.

High Mountains And Deep Rivers

1 Week of Cardio done. 

Cardio is interesting. Patients with way crazy conditions, some quite unwell, some where there’s just not much you can do. 

It’s been quite busy for me. Not quite finishing on time. But hey the day goes by quickly.

I had a lovely registrar this week. And it was actually his final week as a cardiology registrar. He was nice and included me in discussions and even helped out with a lot of the jobs. 

Today, on his last day. Though we had only been working together for 3 days, he told me that I’ve been a great House officer and he wanted to give me this.

He said he had been saving this book to give to someone who was really good. To use and help them study. He said he wanted me to have it for being so great this week. 

Then I found out that the charge nurse on my general medicine ward last rotation, had nominated me for House officer of the month. 

I didn’t win of course. But it was nice to be nominated.

From my low point last week where I thought I was just the worst House officer in the world having nearly killed someone with my prescribing blunder, this was quite the opposite feeling.

It was nice to feel good about the things I do. And be grateful for people who seem to appreciate me. 

It really is having the highest mountains and having the deepest rivers.

You can have it all but life keeps moving…. 

Gen Med Is Over

Today was the end of my general medicine house officer rotation! 

Stayed late to seal the deal ofcourse.

And I even did some therapeutic baking to finish it off.

Poifect chocolate cupcakes. Well I learnt quite a bit of medicine I suppose. And I was busy. 

But my consultant told me I did a great job this rotation and my medical student said I’ve been very helpful and the nurses on my ward gave me this 

And told me they really loved having me on the ward.

So I suppose even though there are good days and bad days and Fridays and days I want to rip my head off, I still seem to be something right and people seem to appreciate it.

It feels good.

Onto my first few night shifts next week! 

So it goes…

Days Like This

There are good days and there are bad days.

But when you’re driving home tired and low and you can see a sunset like this through the car window on your left

And the rising full moon on your right,

It makes you feel as though the world is reminding you that there’s always something to feel good about.

And tomorrow is a brand new day.

Summertime FeelsĀ 

Summertime is really the best time to go out and reflect in places. 

Chances of coming by a view that is absolutely stunning, while on a walk, are much higher in summer than in winter. 

Unless you live somewhere where it snows and you like going on mid winter walks in a winter wonderland of course!

But anyway. Today I was due some reflection and mindfulness, as I’m 2 weeks off from finishing my first rotation as a house officer. 

I haven’t talked much about what my job actually entails. I deal with all the medicine for psychiatry patients. Often, most of them are perfectly healthy. But occasionally I get someone who is very comorbid so I have to order tests, make sure they happen, talk to a bunch of different departments, trying to piece together their management. And because of where the psych unit is placed at my hospital, people are very reluctant to come over there and do things for patients. And getting potentially aggressive and high AWOL risk patients to different parts of the hospital is also challenging. So getting things done is hard.

On my long days I also cover geriatric wards. Where every patient is liable to crash, the nurses are super nervous and the house officers during the day dump whatever they are unable to do while they’re there, on the psych house officers. 

But I’ve made it this far. And I’m going on to general medicine next. Which is going to be a massive change in pace which I would welcome, but also will be a huge challenge as I feel I haven’t done much medicine in these three months to prepare me for what general medicine will bring.

Lots of emotional highs and lows this rotation. Being told by someone that I lack motivation, that I lack common sense, that nobody would take me seriously, that I’m not trying hard enough to be involved, coupled together with my own insecurities, fears, the feeling of being frustrated that I can’t do more with my life, and the sickening realisation everyday that I know that I will never get what I want….

It brings me down.

But I’ve been chugging along. 

All of the stuff above is just noise I hear in my head everyday. 

But when I’m on a walk and see the omnipresent sea, the gentle lull of waves going back and forth on the shore, sounds of people and birds and boats going about doing their thing, the sun setting and creating the most beautiful set of colours as a backdrop to the city line and the ocean, my eyes and the rest of my senses are pleased. A wonderful stillness and peace comes upon me and drowns the noise out. Just for a little while. Making me feel that I’m part of something much bigger in the universe.

Of course those moments pass and reality and the noise comes back, but I’ll try holding onto that feeling of peace just like in the photo. 

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.

 

Finally Graduated

Here hangs proudly my graduation regalia.

Looks a bit like a dementor does it not? 

Well it looked okay on me. Apparently in New Zealand, the colour of the Medicine degree is Hot pink!…. I’ll never understand fashion.

Anyway! My graduation ceremony was yesterday! After 6 years I sat in a 2 hour ceremony where my name was called and I was awarded my degree to say I am now a Doctor. 

It was a super long day. But it was great. Friends and family showed up. My friend from Wellington even flew up just for my ceremony! It was a great day. 

Lots of people to be grateful for. It’s been a long ride. But I got there in the end. And from Monday onwards, it’s on to work! Officially a house officer. 

I can’t wait! Hopefully I will be a good doctor. 

We all had to take an oath yesterday. One of the lines were “I promise to uphold the reputation of my profession”. Now other than the immediate Taylor Swift reference in my head, I realised I don’t really know what that promise means. What is the reputation of my profession? Have I been holding it up so far? I don’t actually know. Hopefully it becomes apparent when I start working. On to Monday!

My friend got me this cute graduation Kiwi doll! Yay for finally being done!

In The Deep End

Today was my 3rd ED shift. And it was the most challenging 7 hours of my life. 

Mostly because of just 1 patient. 

At the beginning of the shift, my consultant was called to resus to see a 15 year old boy who had come in with 5 days of headache but who had since become unconscious in the resus area. 

He had no other medical conditions. The whole team was working on making him regain consciousness. While differentials such as meningitis and seizures crossed everyone’s mind. 

The mother came in shortly afterwards frightened and distressed as she recounted how he had had only a headache for the last 5 days but today while she was at work, had called and said bizarre things before hanging up. She returned home to find him unsteady on his feet before collapsing to the ground. The mother also brought her 4 year old son with her. There was no father to be seen. 

The young boy regained some consciousness. He was responsive to speech and followed commands. Everyone became confident at this improvement. My consultant decided now would be a good time to CT scan his head for signs of infection or bleed. 

The boy was wheeled off and my consultant and I followed him. 

The CT scan showed a large tumour pressing on the boy’s brain. Causing the brain to be pushed to one side, likely resulting in this symptoms. He would have a large amount of pressure in his skull at that time. 

The consultant took the mother into a room to talk to her. I was present when he told her the news. 

She instantly burst into tears and wailed. Her precious, obedient, healthy boy was going to be taken from her? How could this happen? Will he be cured?

My consultant told her that he would contact the neurosurgeons who would tell her more about the next steps in management. 

She cried harder. She told us she had no one else. That the boy’s father was estranged from when he was 4 years old. That the boy was all she had. 

He younger son was oblivious to what was going on as he quietly played with some puzzles. 

Meanwhile we were again called to resus as the boy had lost consciousness again and was now showing signs of very high pressures in his skull. One of his pupils were dilated massively while the other was small. The neurosurgeons arrived to take him to theatre immediately and they began to put a tube down his throat as he was no longer breathing on his own. 

At this point, the consultant asked me to sit with the mother. And console her and prevent her from witnessing the placement of the tube. 

I was way out of my depth. The mother begged me to be with her son. She asked me whether she had given him some food that may have caused the tumour. Or whether a fall as a young child would have caused it. She told me she worked so hard and had saved money for a house for him in the future. How he had wanted to be a pilot when he was older and how she had arranged classes for him to learn more about this every week. 

She asked me if he could be cured. Or if he was going to die in ICU where he would be taken after the neurosurgeons performed an emergency operation to relieve the pressure in his brain. 

I comforted her as best as I could. Telling her she couldn’t have prevented any of this. That some things just happen. She asked me why God was taking her son away from her. I had no answer. She said she had been a bad mother. 

She eventually decided to call the boy’s father as he was taken to surgery. 

To complicate matters further, the father began yelling at the mother. Saying it was her fault he had gotten cancer. 

This carried on to the point where my consultant had to intervene to explain to him that it was no one’s fault. 

The boy’s father said his nephew also had brain tumour but he’s fine now. 

The mother, who was hurting in a big way, clearly fed up with the father’s accusations said that she was the best mum in the world for her son. And that if cancer ran in the father’s side of the family, he should have mentioned it earlier. 

It was all rather weird for me. 

But it was just

Quite confronting. 

I’ve never seen such a situation before. The reality of what happens if medicine isn’t good enough. And sometimes it just isn’t good enough to answer every question or solve every problem. And what that leaves behind is quite devastating. 

I couldn’t process everything for a while. My consultant asked if I needed a break to calm down. 

How did I react to this? I said I didn’t require a break. I just need to go see the next patient. 

I can’t say why I said that. I guess I needed to feel like even though it was obvious that not much could be done for that young boy, much could be done for other patients. And I needed to see that. And I needed to be part of that. To get over the disappointment and the grief that I had witnessed. 

It all just goes back to what Robert Frost had said:

“I can sum up everything I have learnt about life in 3 words:”

It Goes On…..

I guess I have to also be grateful for my life and my health. And the health of those closest to me. It shouldn’t ever be taken for granted

4 Weeks Later

Well, surgery is officially over. And I am exhausted. 

It didn’t really get better. I was still doing ward jobs all day and staying late even though not much was being achieved.

I feel like I haven’t used my brain at all these past 4 weeks. And that’s annoying.

So I am relieved it’s over. But I am concerned for my future years as a house officer when I have to do surgical rotations. My own house officer on this rotation was flustered 90% of the time, and complaining 98% of the time about her job. She would stay later than me and achieve pretty much nothing as well. No patients discharged, scans and tests ordered but not carried out, and an endless amount of paperwork to do.

She also said she hasn’t used her diagnostic skills in the whole time she has been on this rotation. Sigh. Not looking forward to this in the coming years.

However!

I will say that my registrar and my consultants are amazingly nice people. One of my consultants, while I didn’t manage to see him a lot, he was more than happy to talk to me whenever I approached him, even if he were in a great rush. He was happy to do my report and my reference (all 3 required references done! Woohoo now I can relax).

My other consultant also offered to do any assessments I required for me, and thanked me multiple times for my hard work. Though I’m trying to figure out what exactly that was.

And my registrar was the loveliest person in the world who never got tired of answering questions, teaching, making jokes and just being supportive. 

While the overall rotation was tiring and annoying, I am so grateful to the people on the team for making it bearable. 

Now. Onto ED. Time to turn my brain back on!! 

BRB: Being Grateful

Oh my goodness! One of the things I was stressing about worked out amazingly well!

And I just gotta take a minute to be so grateful! When things work out well, it’s so important to stop and be grateful to the universe and everyone involved.

Ahh so happy! ^^ And uber uber grateful to the universe!!