Category Archives: Family

You Should Blog.

This is a blog about ‘how not to hit a golf ball… and other things I’m learning.’

People talk about the learning curve that is internship year – the steep exponential curve of the first six months. I remember exhaustion, uncertainties, frustrations and feeling so, so inept. Stupid things I did. The madness of my first weekend shift. Most of all I remember the security of having colleagues I could trust – nurses, clerical and allied health staff, and more experienced doctors – who helped me find my feet and not screw things up too badly.

I was lucky enough to have the first five months in my home hospital. Starting a stressful new career was made so much easier by not just the familiarity of my surroundings, but by having The Girl there by my side every step of the way. Making me coffee every morning, and dinner every night. Amazing, wonderful love and support. None of ‘all this’ could or would have happened without her.

Which brings me to something I’m still learning, which I can’t really wrap up into a neat set of words. It’s something about family. I’m just writing and deleting words from this paragraph, none of which really make sense, so I’ll leave it there and hope that something coherent unfolds at some point in the future of this post or this blog as a whole.

My grandmother died suddenly in February this year, in my father’s arms, a few weeks short of her 90th birthday. I spent some time with her in December, and I’m so glad I did. She had a wicked sense of humour. I wish I’d written more about her.

I was late to the funeral. I expect I will be late to my own.

That’s enough for now.

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Decisions, Decisions…

I’m overselling this somewhat, as it’s not really a huge decision. Though it could have been. It’s Intern Application time!

In overview for the uninitiated, becoming a registered and fully qualified medical doctor goes a little something like this: Graduate – Intern Year – Resident Year – Registrar (Specialty Training) – X Years Later Qualify as Consultant. Where X is a variable according to chosen specialty training program structure, individual preferences, and clearing of assessment hurdles.

It’s a little more complex than I paint it, but that’s more or less it.

Medical graduates across Australia for the 2013 internship year will exceed the available intern positions. This is exceptionally bad news for our overseas students, who may miss out on a position both here and in their home country. Most states are guaranteeing Australian graduates of the state’s medical schools priority in position allocation, so there is a strong incentive for me to stay in my home state.

The Girl is keen to stay put, in our house, in our home of 3.5 years, in the town we have both grown to love. She’s looking to start a business in the next few months, and we both have great friends here. Our geriatric menagerie is also a factor in any decision to move. We are all happy here.

And so it is that the local hospital network will be my first choice for internship, and being a regional network, the chances are good that I’ll get my first choice. I have no desire whatsoever to go back to the city. The downside is that I’ll be able to do a maximum of only two from five rotations in the hospital here in town, so I’ll spend most of the year commuting. We’re going to practice for that next semester, when I’ll be doing my pre-internship (PRINT) and elective terms at the mothership hospital.

Decision made, all I have to do now is finish filling in the 3,000 pages of application forms… oh yeah and… pass the exams.

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Apparently Crazy Cat Lady

Our two cats are brothers, different colours but with virtually identical markings. They have lived indoors (and within the limits of the backyard, under supervision) for their fourteen years of life. This has given us all plenty of time to bond as a tribe.

McCat is most closely bonded to me, especially since his brother has become irritable with hyperthyroidism. We have a few things in common. We both like birds. We both like my armchair and its lambskin throw. We both like raw salmon and roast lamb (not together). For a while there, unbeknownst to me, we shared a bedside glass of water.

One of us is a little OCD.

At bedtime, McCat enforces the following routine:

1. Human is to brush teeth.
2. Human is to fill cat’s bedside water glass with fresh water.
3. Human is to top up biscuit bowl.
4. Human is to pat Brother Cat.
5. Human is to seek out Superior Cat lounging place; this step to be conducted under cover of darkness, simulating safari conditions.
6. Human is to advise Superior Cat of imminent bed entry.
7. Human is to stop faffing and get into bed.
8. Superior Cat shall drink water; four swipes of paw on beside table to accompany drink, indicating primal origins.
9. Superior Cat shall sit staring at Human until such time as Human switches off light.
10. Superior Cat shall patrol perimeter, ensuring all doors and windows secure.
11. Human is to assume supine position; left arm to be bent like tea-pot handle.
12. Superior Cat shall grace Human with presence between left arm and left flank; Human is to remain motionless until 4am.

The penalty for deviation from any of the above routine may range from gentle rebuke to forced sleep deprivation, with such penalties administered vocally, by strategic bladder-trampling, or by judicious use of paws to ensure Human eyes are open and airways clear.

Every so often I escape desert the McCat for education-related purposes, such as placements away, or conferences. The Girl does her best to meet his exacting standards of bedtime care, however as she has the Yellow Dog of Happiness to care for, as well as Brother Cat, McCat tends to develop abandonment issues and his vocal and paw-to-face admonishments eventually become unbearable. Or so I am told.

And so it is that I find myself on the phone to the cat. I am fluent in McEse, and though it pains me that my communications are delivered via speaker phone for all to enjoy, it does seem to settle him down.

I can only guess at what “Brrt, brrt, micmicmic meow” means, but I think it’s something like “Hello, honeycat, I’ll be home soon.”

Mock me and I’ll scratch your eyes out.

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Conversation of the Week

Her: … So have you killed anybody yet?
Me: No… What makes you think I’m in a position to kill anybody?
Her: Oh I don’t know, maybe you prescribed the wrong drugs or something.
Me: No, I’m not actually a doctor yet, I can’t prescribe anything… But hopefully when I’m qualified, I’ll manage to avoid killing anyone.
Her: Well we were watching Doc Martin the other night and there was a locum and he was giving everyone the wrong medications, I don’t think his training was very good. That made me think of you.

Gee, thanks.

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Possibly Neglected to Mention

In no particular order, since June:
Received a one-year rural medicine scholarship.
Did my first Arterial Blood Gas ‘Stab’ – Easy as.
Still suck at plain old cannulation.
Attended an arrest call and kept out of the way.
Told by patient “You look like kd lang… not in a bad way.”
Got my hair cut on the back porch for $10. Trauma-free.
Started Bootcamp and got hooked.
Survived 12 days at home without The Girl and Yellow Dog of Happiness.
Spent a day as interviewer for Med School applicants.
Started interval training for running, again.
Buggered my knees, see above.
Don’t care, not stopping.
Avoided Med Ball.
Ooh, was in Med Revue. Again.
Remain madly in love with Girl.
Flirty guy doctors. Wrong tree.
Random encounters with mothers of two babies I delivered last year.
Delivered one baby.
Attended 21st birthday party (possibly first since own).
Mistaken for Senator Penny Wong. Sense recurring theme.
Stephanie Alexander’s chocolate chip cookie recipe is exceptionally good.
Jointly disposed of 3x large bin bags of oversized clothes.
Mostly just happy.

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Faultlines

For a long time, I wore a jade bangle. It was a part of my arm, part of me. It had threads of deep and lighter green, red-browns, and specks of white. In Chinese culture, jade has a particular energy and significance, and the jade bangle is believed to protect the wearer.

I was walking home from work one day when my bangle broke in two places. I didn’t notice it break because largest part of the curve stayed on my wrist. I wondered what it had protected me from – a breakage is supposed to represent an escape, a dodged bullet. I retraced my steps and found the missing piece.

I liked that bangle, even though I detest the word ‘bangle’. Something in that stone – its colour, its weight, our shared warmth, a vibration – it resonated with me. It fit.

So carefully, I glued it back together. I let it set. It broke again, in different places. This time I let it stay that way, until the night before my med school interview. Glueing it together, I superglued my thumb… but that is another story. I wore it. It broke again.

All the time I was doing this it I knew it was a futile exercise. The circle was broken. The milk had been spilt. The nature of the thing had changed.

Some things mend themselves. Fracture a bone and the faultlines heal stronger than they started. Slice your hand open and bit by bit the fabric of your muscle and skin will knit itself together until you barely see the scar.

But some things are just broken. They start off broken, they break before their time, or they were always meant to break. No matter how neatly you glue the handle on the teacup, if the porcelain is truly crazed with faultlines there is no fixing it.

Sometimes the nature of the thing has changed for the better, sometimes for the worse, or not at all.

Some things can be fixed. But some things, some people, relationships, lives – some are so riddled with faultlines they are broken, just broken, always broken. They can mend, but they have to mend themselves.

And that is nobody’s fault.

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That Awkward Moment When…

I was reading this post and was reminded of my own recent special moment. That awkward moment when the bank manager suggests you have a baby so that you can borrow some money.

No seriously, he did. And helpfully added “…but even that would take nine months…” Ah, buddy, if only it were that simple.

“Well then, could you lend me eight bucks for a turkey baster?”

Ok maybe that last bit didn’t happen.

A couple of days after the end of exams I zipped off to our mortgage lender to see if we could leverage some of our essential renovations into enough of a buffer to keep paying the bills until I graduate. Sadly for us, government study allowances are not considered a secure form of income. Whereas if we were receiving a family allowance, we would apparently be a much safer bet.

It was a good-natured encounter, and I walked away feeling that I had put my argument well. Plan A, not to be. Luckily we had Plans B through D up our sleeves.

I guess we could develop Plan E, in which E stands for Embryo… It just seems a little extreme.

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Filed under Family, Med School, Sexuality

Yum Cha My Life

I have been boring/busy/uninspired lately so have spared the world the detail. Now however I feel like downloading a sampling of tasty treats from my consciousness. You could probably drink a nice cup of jasmine tea while you read it because I fear I may be about to babble.

It is one month precisely until exams. Starting with OSCEs, which stand for something about Clinical and Examination and other than that I’m still at a loss. Suffice to say that a month from now I will be required to do 13 stations of ten minutes each in which my clinical competence will be assessed.

This week I feel I am completely prepared for the “Close the Curtain Around the Bed During Ward Rounds” station and the “Theoretically Sanitise Your Hands With Stinky Pink Antimicrobial Handrub” station. Other than that, I feel my competence needs some finessing.

Failed attempt at inserting IV cannula today, needs more practice. See above.

Currently on the ward we have a patient who is 101 years old. Day one on ward rounds, she grabbed my hand and clutched it throughout the consultation. I felt some kind of connection with history and a good-going tremor. Anyway, we are clearly friends.

Day two on ward rounds, she asked me if I have any Chinese blood in me. Not that I know of, though people do seem to think so on a relatively frequent basis. In practical terms, this translates to people speaking to me in languages I do not yet recognise, getting chili on my Vietnamese chicken rolls as a matter of course, and not being denied such delicacies as beef tendon or chicken feet when at Yum Cha. Non-membership still has its privileges.

Day three, today, my super-centenarian announced straight up that she owed me an apology for asking if I was of Chinese descent. I assured her that no apology was necessary. Apparently I reminded her of a friend (insert potentially-patient-identifying historical facts here) from some time before the television was invented or possibly the gold rush era. I have no clue as to why this should offend me.

Straight after this consultation my entire team suddenly felt a desperate desire to know my ethnic origins. Which are distinctly unremarkable. I look like my grandma, though not quite as wrinkly or diminutive. Possibly certain of my great-grandfolk came from Wales or Cornwall or the Baltic states, but no, generally I don’t deserve the chicken feet.

Speaking of feet, I have been doing some running in a now-thwarted attempt to get fit, get healthier, decrease my pre-exam stress levels and generally have a low-cost low-maintenance sporting and social outlet. Most of that worked, except that I apparently have done something to irritate my sciatic nerve and now it has been suggested I stop running for a few weeks. Back to the swimming pool. Annoyed.

In January 2010 I had Yum Cha twice in two days and I haven’t been able to eat it since. Primarily because this town does not extend to Yum Cha. But still.

Girlfriend is such a stupid word for someone I’ve been living with/in love with for eleven years. Partner is too sterile. Fiancée is illegal. My Most-Preferred Yum Cha Companion will have to do for today. Naturally I am worried that this is somehow an offensive term. She is probably more worried that it is 10:40pm and I am not yet asleep.

Tonight I ducked out to drop the DVD equivalent of chicken soup to a nosocomially-infected friend (Series II, Friends) and on my return, my MPYCC was casually whipping up a sweet ginger syrup to accompany some silken tofu we happened to have in the fridge.

My life is pretty good.

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Death of a Dad Joke

I had another birthday recently, which is always better than the alternative, but as it coincides with the start of semester I tend to get a bit sensitive about how much older I am than the majority of my fellow students.

Yesterday it was a friend’s birthday and – welcome to Medicine -the talk turned to constipation.

This made me think of one of my favourite M-rated jokes, which goes like this:

Q: Did you hear about the constipated butcher?
A: He worked it out with a pencil.

My friend looked at me completely blankly. It was then that I realised my joke had inadvertently highlighted a fairly obvious generation gap. ‘Young folk these days’ get their meat at the supermarket, and if they do go to a butcher, chances are the maths is done by the register or a calculator. Plastic bags have replaced butcher’s paper. Sigh.

This is unfortunate on multiple levels, one of which is the consequent loss of my follow-up joke, which may or may not have been invented by me or a close member of my family (I really don’t know, I don’t remember).

Q. Yeah well, did you hear about the constipated mathematician?
A. He worked it out with logs.

My father is a mathematician and my father-in-law is a butcher.

Vale, ultimate-double-dad-joke. I regret your passing. So to speak.

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The Things I Missed

Wednesday we drove out to my aunt’s farm. It was an overcast day, and Ma told me to take a jumper. I don’t get to the farm much, so I thought, maybe it’s cooler out there. I was hot in shorts and a tank top. Ma had long pants and a jumper on.

We arrived bearing some fairly solid iced finger buns which had been in the fridge at least six days, and the remnants of a barbecued chicken which had been uncovered in the fridge for at least four. Did I mention Ma was recovering from Salmonella? Thanks to the wonders of text messaging, my aunt was forewarned and thus armed with a fresh chicken roasting in the oven. The old one quietly disappeared.

We ate, I hung out with my cousin, we watched some coverage of the floods, we left. Ma looked peaky. She napped in the car. Overnight I could hear her coughing.

Thursday morning, back to the doctor, No, Doctor, I feel much better. My stools are normal. I feel fine. What about that arthritis in your finger, Ma? It came up overnight. It was red and swollen. No, no, that’s just my arthritis. But I will get my pills in a bubble pack after all. Hurrah! We’d been applying subtle pressure on this for a year. Off to the chemist with all the scripts. Walking up the ramp to the chemist she was breathless and we took it very very slowly. Come back and get them at three? Sure.

Lunch was scheduled with my mother. I thought Ma looked overtired. She insisted she was fine. I insisted it would not be rude of her to stay at home. That I would be fine on my own. She refused.

She ate a bit of soup. We stopped back at the chemist on the way home and picked up the bubble packed pills. We got home. I went to do some washing. She put on a coat and started peeling vegetables.

A coat?

My uncle fetched the thermometer. 38.9°. I grabbed us a bag of clothes and we headed for Emergency. Her first set of rigors started in the car.

The triage interview happened fast and then we sat in the waiting room. When the hallucinations started, we went straight through.

Fluid resus. IV antibiotics, complicated by allergies. I sat with her all night while her blood pressure swirled, her heart raced, and her body convulsed with rigors. She kept trying to send me home. I held her hand through the wild-eyed terrifying half hour that we all thought would kill her. I talked her through the hallucinations and the strange surrounds and the man who was screaming all the foul words down the hall. I talked to the Med Reg and to ICU. I held her hand through her “final indignity” of insertion of the urinary catheter, keeping her eyes on mine while we talked about the beach and old holidays. I bossed her around for the first time: We are not having this conversation; I am not going home until you are on a ward.

She stabilized, more or less, so they sent her to a ward rather than ICU. I went home and cancelled my flight and called my dad and my aunt. When my uncle woke up, he asked what I thought would have happened if we hadn’t been staying.

What would have happened? She would have put on another coat, and gone for a lie-down, and covered herself with all the blankets she could find. And when those rigors hit her and she was wild-eyed and thinking she would die, with her failing heart desperately trying to keep her brain alive, if she thought to call for help she’d have not been able to dial the numbers. There would have been no one to hold her hand. And that would have been how it ended.

Septic arthritis in the finger. Incontinence pads in the bedroom. Increased work of breathing. Intermittent fevers. Thermal flaming underwear. Intermittent confusion, query delirium. Those are the things I missed, even though I saw (most of) them.

The answer, med nerds, is severe sepsis. The bug was e.coli, origin UTI. It’s a damn scary thing to see in your 87-year-old grandma. Especially when she says she’s fine.

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