Saturday, July 31, 2010

Leaving on a jetplane

So my elective with Trauma has come to an end - I guess I could write a whole essay on my thoughts of this elective, but obviously there's something much more exciting around the corner. It's now 2 days before I jet off to Norway, and this whole week has been a frantic 7 days of meeting up with friends, saying goodbye, calling multiple corporate bodies/institutions, chasing loose ends, running errands and, of course, packing. More accurately, lack thereof.

It's hard to explain my thoughts - perhaps the most accurate word would be restless. I'm slightly nervous and excited about all the adventures I'll have, and I'm so very much looking forward to pushing my boundaries. But I can't deny that little nagging bit of apprehension. I wish I could skip the flight and administration side of things, like getting my student card, finding my accommodation in Sogn, getting my visa (which has thus far caused me much pain), getting a transport card - ie. all the general life-sort of things that I take for granted while I'm at home in Melbourne. It's such a paradox - the one thing I'm most looking forward to on this exchange is change, and yet familiarity is what I think I'll miss most, at least initially.

And so it's now August 1st, the start of a new month and hopefully this time next week, I'll be settled into my room at Sogn and fingers crossed everything goes smoothly. I just need to go now.

(On a side note, how come ticket inspectors never check me for a valid ticket? It's happened twice in 7 days now - inspectors sweeping along the tram like they're on the set of the Matrix, demanding tickets from every passenger - except me?! Maybe it's because I'm clad in professional attire? But then so are many other people... Maybe it's coz of my medical lanyard? Surely doctors don't fare evade, right? Maybe I have an honest-looking face? Whatever it is, they seem to just walk right past me even though I have a ticket in hand. Shame I haven't fare evaded since high school...)

Friday, July 23, 2010

Brunswick Patrol

Yesterday night while I was waiting for a tram, I was passed by two policemen patrolling the main street. Two things. The good part was that if on the odd chance I was being bashed by a thug or bottled by a prostitute, police reinforcement was a stone throw away. What concerned me was the inference that Brunswick has, apparently, become a suburb requiring police patrol at 9 o'clock at night.

When did this happen? I've seen Brunswick (and Barkley Square) change throughout the past 2 decades, but this was the first time I've come across policemen patrolling my streets. True, it's the same street where one of the Moran's was shot dead point blank (in fact, I was crossing the road when the ambulance drove past). I also acutely recall the infiltration of aggressive derros on my tram line, chroming on the tram as kids and elderly passengers watched horrorified. But this whole police action thing is really surprising.

I usually feel relatively safe walking through the streets of Brunswick. I mean come on, it's Brunswick. B for Benign. But lately I've been reading about all these stabbings, rapes, robberies, general thuggery and all occurring alarmingly close to my house. And it's starting to make me paranoid. It's not like I can just go around carrying a vial of pepper-spray or a knife, which would be more dangerous anyway. Maybe I need to get my own car.

On happier news, the new batch of Sem8'ers have officially started clinical medicine. I woke up this afternoon morning with a massive headache, took some panadol and managed to get to my clinical school in time to give a speech on "surviving" the year. I hope it was useful, they all seemed pretty happy with it. I remember being there last year with all these questions going through my mind, so hopefully I managed to answer some of them. They all seem like a friendly bunch, I hope they enjoy Sem 8 as much as I did. Sem 9 is such a yuck semester anyway so it'd be good to make the most of Sem 8. Also, I officially handed over my presidency role within the RMH clinical school to the new committee, so that's over.

Now for Norway.

Tuesday, July 20, 2010

Rat race

So all the final years found out their internship positions yesterday. I know I'm not even in final year, nor have I done my OB-GYN rotation or Paeds or ED or Psych (all those important things) but somehow all the buzz and excitement has made me excited about graduating too.

I can't help but feel a pang of jealousy envy when I think about all the cool intern-y stuff that final years get to do next year. Okay, I need to stop right there. Everyone has been telling me to go home early while I can and enjoy life because it all goes pear-shaped from graduation. And I believe them. But I guess part of me needs to be thrown into the deep end. I need to take responsibility. I need to not eat lunch because I'm too busy with something important like chest compressions or securing an airway (sadly, it will probably be my pathetic attempt at cannulating a forearm for the 5th time, or retracting a calf or lip or shaving someone's pubic hair before surgery). I probably sound ungrateful for all the relative free time I have at the moment, but I guess I'm craving the need to be needed. Sometimes it feels like all I'm doing is lurking over the shoulders of residents and registrars, which let's be honest, is slightly creepy. Sort of like those criminals on NCIS who always seem to be breathing down the necks of female victims and then sniffing loudly like they're snorting a line of cocaine. It's like, Kate Moss much??

I think part of the reason I'm feeling pathologically envious is also because 1) The grads from my year are now finishing up and 2) Monash is a 5 year course, and because I'm meeting all these Monash students at the moment, it seems like heaps of people who started med the same time as me are now moving onto bigger and better things. What I need to do is stop thinking of medicine as a streamlined process whereby internship --> residency --> registrar --> fellowship --> consultant, but rather, a learning journey that never really ends, that has peaks and troughs in terms of quality of life, and that getting to consultancy is not a race. Hard to do with all these universities popping up like Notre Dame and Gippsland (wait, I think it's called Deakin) and their first bunch graduating the same year as I do. Naturally.

On the bright side, I'm looking forward to all the really cool people I'll be working with as an intern in 2012. So all in all, exciting times ahead. I really can't wait!

I am aware that in 3 years time (Kevin = resident), I will probably read this post and think: You fool! Stay in uni!

Monday, July 19, 2010

Settling in

I think I've finally settled into my Trauma elective. It may have taken me 2 weeks to pull my shit together, but I'm starting to think that maybe I'm getting a hold on things now. Naturally, I've also attached myself to the Haematology team whether they like it or not, sort of like a fungus growing on a dead carcass. I suspect the Haematologists haven't quite figured out that I'm not actually one of their students yet, I'm sort of lying low at the moment. Although I think the Director of the unit is onto me...

Anyway. Exciting stuff today:
  • I scrubbed in for surgery. Okay, this may be extremely lame, but somehow I managed to get through an entire year of adult medicine without ever scrubbing in ??? It wasn't because I was scared, or busy, or lacked the opportunity etc. It was an initiative problem (related to surgery) that I'm sort of kind of addressing at the moment. Previously, going to theatre meant hanging out with the anaesthetists. But now I figured, hey, this is my freaking elective. So I scrubbed in. And for that, I got to retract the triple chin of a morbidly obese, obtunded patient as he got himself a tracheostomy (tube into wind pipe). Taking that step today, finally committing myself to the entire surgery (because hey, you can't just walk away from surgery when you're retracting bits of chin, right?), was a step I wanted and needed to take.
  • I discovered what pseudomonas spp. smells like. It's oh-so foul. So as we were prepping the above said patient, this odour starts wafting through the OR. For a second I thought it was from the neighbouring theatre, where the surgeons were busy draining a massive abdominal abscess that was so deep it was like a mining shaft. Literally. But then one of the registrars remarked: "This smells like pseudomonas." So now I know what pseudomonas smells like.
  • I saw petechiae. Yeah...I don't know why I got so excited about that.
  • I had to translate for this Chinese patient who spoke very little English. It was crazy! You'd think medicine, being all Asian and all, there'd be tonnes of doctors speaking Mandarin. Apparently not. So it turns out I was the only one who could speak Mandarin (vaguely), asking questions like where is the pain, do you need to pee, have you peed? Shit like that...
To cap off the day, I got a sign from God, or so I like to think. Unfortunately the vending machine goodies in this hospital are cheaper than those at my home hospital. I'm also hungry before I go home. Ergo = Kevin buys unnecessary trans fat junk food in the late afternoon. Except today I placed my only $2 coin into the machine AND IT ABSORBS MY MONEY WITHOUT GIVING ME MY FRIGGIN CADBURY! I took it as a sign. Maybe it's time for a change. Maybe I'm meant to start going to more surgeries and stop eating out of a vending machine.

Monday, July 5, 2010

Man vs. Cow

So today we had a case of Car Cars vs. Pedestrian (yes, the ratio was 2 cars to 1 pedestrian), and Car vs. Bull. Actually, that's pretty low in terms of new admissions. There were also the in-patients from last week, which include Man vs. Cow (see above), Car vs. Car, Man vs. Pole, Man vs. Ground, Pool vs. Man, Man vs. Bitumen, Man vs. Self.

You know, it was really exciting to see medicine in an acute setting today. So far it's been Diabetes and Heart Failure and Kidney disease, which kill you eventually. Today I found myself in a ward round where patients had life threatening injuries, or at least those with serious implications on their immediate welfare and disability. I'm talking about obtunded patients with GCS of 5 and brain monitors checking their intracranial pressures and CVCs and ICCs with lung contusions and pelvic fractures in ways that defy physics. In fact, I saw a cervical halo being put into an unconscious guy in ICU. It's all pretty exciting stuff, although I must admit as a student I still feel one step removed from the whole process. Maybe it takes some time to adjust to a new hospital and staff. But it sure feels good to be practising medicine without the added pressure of ticking off boxes in our Block Guides. Also, today made me realise exactly how much I've learnt this past year. 12 months ago all this medical jargon would've been Spanish to me. Now it's like a second language. Someone mentions bleeding and I have all these ideas floating through my head, rather than panic and embarrassment for being a "fake" medical student. Now I feel somewhat validated.

I guess my goal for this elective isn't so much about learning Trauma protocols. Sure, the lingo is pretty cool: "26 year old male involved in a high speed, unrestrained motor vehicle accident secondary to substance abuse, suffering a headstrike and brief LOC, with significant cabin intrusion..." But I think what I really want to discover is what it means to be a contributing member of a medical team, about helping out with seemingly trivial tasks and paperwork that is the bane of an intern's career. I think after all this learning and cramming I've done for semester 9, it's time for me to give something back.

Sunday, July 4, 2010

Tomorrow When The Gore Began

Welcome to the first post in my blog: Kevin’s Map of the Universe. It feels quite anti-climactic, sitting alone in my room as I tap away on my keyboard. Because actually, tonight is the eve of a new era for me (kind of like in the movies minus the uplifting score with snowflakes and unicorns and people braiding each other’s hair…). Tomorrow, I begin hopefully the most exciting 7 months of my life.

7:30am, I’ll be starting my 4-week stint with the Trauma service. It’s my elective, which will give me some interesting stories to talk about. People never cease to find new ways to do/say/insert/penetrate inappropriate things at crucial moments. Then I’m off to Norway, on exchange for a semester studying Womens’ health. Now I’m at that stage of frantically learning Norwegian, and it’s funny - I still draw blank when it comes to asking for a loaf of bread, yet I’m well versed in saying: “Are you pregnant?” or “Have you had significant vaginal bleeding?” You you do.

Anyway, so yesterday my friend and I went to watch the release of the new Movie-That-Shall-Not-Be-Named (Cast includes KStewart, RPattz, Taylor Lautner Taylor Lautner’s abs). So during the part where they screen all the trailers before the actual movie begins, I see the trailer for Tomorrow When the War Began. It’s a famous novel by John Marsden, but what caught my attention was this Asian guy who plays a significant role in the movie.

Let’s face it. Asian males are so underwhelmingly represented in mainstream media, especially in Australia. I can’t even think of one TV show/Movie/News Report where the lead role/host/newsreader is an Asian male. Any trivial role that we play is invariably the Joker/Goofball/Emasculated-douchebag, which is ridiculous. Damn, they even got a white guy to play Goku in Dragonball Z. Like, wtf right? So what’s even more surprising is this Asian male starts making out with the lead chick. I wonder if John Marsden actually scripted that in his novel, or perhaps, are times really changing?

I don’t know. Anyway, I should probably go read up on how to clear a C-spine now. Or what to do when a bone is sticking out through skin. Trauma-related stuff. So far it’s been pretty much about chronic conditions in medicine. Hopefully now I get to see the gory side.