Friday, July 13, 2018

No scrubs

I don't actually know what that line in the song means, but I thought it a fitting title for a post on finishing Surg.




Surgery has never been particularly appealing to me. I find anatomy tedious, have zero visual-spatial intelligence, and detest 30-seconds-per-patient ward rounds. Sure, Surg had been great as a student - I learned a lot and had no responsibilities. Also, I was only there for six weeks or something. The idea of living the #surglyfe for three whole months as an intern struck fear in my heart, to tell you the truth. I mentally prepared myself for long hours in a rotation that I cared little for, and bade the sun farewell (you're in the hospital well before the sun rises, and only head home after it's set).


There were some positives, though. I had been assigned to Breast and Endocrine, which meant I wouldn't have to be overly invested in patients' bowel habits/stool consistency (sorry, Colorectal). Breast and thyroid surgeries are generally pretty neat and quick, so no standing in theatre for hours on end assisting with complicated bowel resections or Roux-en-Ys. Also, thyroid and parathyroid surgeries meant at least some degree of medical learning, which this medically-inclined intern was grateful for. I'd been talking to a locum Psych reg (originally a Med reg) about starting Surg, and he said it wouldn't be so bad since interns dealt with patients' medical problems on the ward anyway. It had been a random, brief conversation with someone I might not ever meet again, but this was something I held on to throughout my time on Surg.


As the only non-surgically-inclined person on the team, I did my best to take care of the medical side of things. My biggest triumph was figuring out the cause of a pre-op patient's newly-diagnosed AKI after trawling through their drug chart, bloods, records, and taking a history. I would look through patients' histories and read up on the weird and wonderful diseases I encountered, just to get some medical learning in. Pre-op was great in terms of examination -- I learnt to listen for the prolonged expiratory phase in patients with known COPD, and got to examine Grave's patients with exophthalmos and good-going thyroid bruits. I also picked up a loud systolic murmur in a toddler, who went on to have a paediatric echo to look for structural abnormalities in their heart. And all that was just the non-surgical learning!


In terms of Surg itself, I also learnt heaps. A large part of being a Surg intern is managing electrolytes -- potassium and magnesium are the main concerns, but you're also worried about calcium when you're on Breast and Endocrine. Isaac was constantly writing up minibags, and I soon started calling him the electrolyte king. The other thing you get pretty good at is prescribing analgesia. Initially, whatever your boss says is gold and you just chart that, but then you occasionally overhear anaesthetics raging about charting (or not charting) a particular med, so you take that into account and slowly begin to formulate your own approach to analgesia. My two main takeaways: Long-acting analgesia should not be used for acute pain, and tramadol is the one thing that can definitely be used with a PCA. In addition to all that, I got to help out in theatre a bunch, and once did a close-to-perfect subcuticular stitch closure of a breast lump excision wound. It was beautiful and incredibly satisfying, and that was probably my proudest moment on Surg.


My favourite part of Surg, however, was the people. We had a great bunch of regs this term, and also a great bunch of interns. The doctors' office was always abuzz with activity -- paper rounds, general chatter, and everyone teasing/bullying Sarah. (Things got a bit confusing at times with two Sarahs and sometimes two Rachels, but we got over it.) The office was a narrow, stuffy, usually overcrowded room, but I already miss the good times we had in there. Like when an unnamed individual nearly gave himself a concussion. Or when the same unnamed individual somehow mysteriously ended up having his face plastered over the screen of every computer in the room. Or hilariously awkward Shoot Shag Marry sessions. Or 'superstitiously' planning but not planning basketball sessions. Or asking each other why they were still there and why they hadn't gone home yet. Or commiserating with each other because we were both still there and both hadn't gone home yet. Ah, the memories!


Of course, I'll miss my team as well. Isaac and I genuinely worked so well together -- it got to the point where if one of us was scribing and our phone rang, the other would silently reach for the phone to answer it, no prompting required. Jobs were completed quickly and efficiently, which meant we got to spend time in theatre. Our reg was an excellent leader, and I was constantly admiring his patient rapport. Also, thanks to him, we almost never had to come in before 7am, which is a huge blessing in the world of a Surg intern! The big bosses were an absolute pleasure to work for, and continuously showered us with surgical teaching and homemade food. It was such a fantastic team, and I will miss it very much. This is possibly the last Surg rotation I will ever do (woo!), and I'm thankful to have had such a great experience.


I've just started on ED, and found it to be a stark difference from Surg. Far less walking, for one, and also far more snacking in an attempt to stay awake (thanks, shift work). This does not bode well for my weight. However, I will theoretically have more time for gym, so hopefully this will help offset the extra food intake. My first day on the floor was kind of insane; so insane, in fact, that it actually made the news. I've just finished my second day, which went far better. All the bosses have been really lovely and supportive, and I've decided that ED nurses are my favourite nurses in the whole hospital. It's looking to be a good rotation, and I'm looking forward to the rest of it.


It's sort of ironic that I've titled this post 'No scrubs' as a farewell to Surg, but we actually wear scrubs in ED as well. But whatever. I thought it was clever, so I'm running with it.


NO, I DON'T WANT NO SCRUBS
(Bye, Surg!)

Tuesday, April 3, 2018

TGIH

In a whirlwind of work, work, friends, and more work, a quarter of the year has gone by, just like that. Whew. Thank God it's holidays, indeed.


Work is always eventful, but it started off particularly so -- a(n expected) patient death on day one, a code blue with full resus ten minutes into day two, dealing with an angry patient on day three, cannulating an uncooperative patient with dementia on day four... The list goes on. My first week as a Real Doctor was pretty overwhelming, to tell you the truth. It felt like I was attempting to navigate the stormiest of seas in a tiny boat, armed with a teaspoon instead of an oar. Thankfully, there were supports around that offered help right when I needed it, which was really what kept me going. I will always be grateful for friends, seniors, and the admin staff.


The other tricky thing was work-life balance. I lived with two interns last year, and it seemed to me that every spare moment they had was spent either sleeping or doing laundry (I exaggerate, but only slightly). This was me during my first month of work. Work was an all-consuming creature that grew to occupy every bit of time and brain space I had. It didn't help that I started the year on a notoriously busy ward, and I was determined to keep on top of things at any cost. At any cost. This included physical, mental, and spiritual health, which of course eventually took its toll on me. My diet was atrocious, I wasn't going to the gym, I spent the entirety of some days feeling like I was millimetres away from a panic attack, and I started skipping growth group because I was exhausted. I fell sick (surprise, surprise), and felt so awful and guilty and useless for not being at work that I completed all my mandatory modules instead of resting. Several people told me I was working too hard; I took pride in this, because I was on a crazy busy ward and working hard surely meant that I was seen to be on top of things. Flawed logic, but you can tell I wasn't in the best headspace at that point.


I'm glad to say that isn't really the case anymore. I started making it a point to do things outside of work, to do things for me because I enjoy doing them. Summer was great because the sun and warm weather were perfect for walks at the Gorge (this had the dual purpose of getting in some exercise as well as stocking up on Vitamin D). My housemate got a scoby from her classmate, so I started brewing my own kombucha. It's been fun experimenting with different tea combinations and flavourings! I muddled a bunch of strawberries and chucked them in for secondary fermentation, and that worked a treat. I also managed to finish a book! It was titled The Crazed, written by Ha Jin. I got it secondhand at Salamanca Market because I didn't think I'd ever read anything by an Asian author, so I thought I'd ought to broaden my scope a bit. The writing style was different from anything I've ever read, and reminded me a little of how my Grandad talks/writes.


Speaking of Salamanca Market, little getaways with/to see friends have also been highlights of my year thus far. There have been a few Hobart trips, which of course included Salamanca Market and the Sunday farmers market. I was pleasantly surprised to find some new stalls, and glad to see the old favourites were still there. In early March, a few of us from Launnie and Hobart flew to Melbourne to see Ed Sheeran! We crashed in the living room of a former Burnie Boy (now a Melbourne Man), who was also coming for the show. It was incredible. One man, a guitar, and a loop pedal were enough to draw in and entertain 50,000 people, for three (four?) nights in a row. Unbelievable. Though the hipster in me wants to say my favourite song was something that wasn't released as a single/playing on the radio, the best part of the night was definitely Perfect. It felt like the entire stadium was simultaneously holding their breath, and it was magical. I could fangirl about that night forever.


I've also just been to Brisbane! It turned out we had a five-day break for Easter, and I was only working on the first day, so I had a few days to spare. I worked a ten-hour shift and flew off to Brisbane that night, eager to make the most of the break. Brisbane was so great! The warmth was a welcome reprieve from chilly Tassie, and I adored walking along the wharf and marvelling at its infrastructure. I stayed with a friend with whom I'd been housemates for three years in Tassie, so it was very comfortable. It was great to catch up with her and another friend, as well as make a new one! Went along to a friend's church for Easter Sunday and ended up bumping into a UTAS med student and a lecturer from my college in Malaysia! Small, small world. Anyway, Brisbane was great, and I'd love to go back some day.


Tomorrow works starts again, and we only have three days left of our current rotation. I start surgery next, which I'm a little apprehensive about; I didn't mind so much being crazy busy this rotation, because I love Gen Med, but Surg is something I'm not overly keen for. On the bright side, it sounds like we have a good team, so we can bond through trauma or something, maybe. I kid, I kid. It'll be okay. I'm sure the next three months will go by as quickly as the past three have. It'll be an interesting year ahead!


Not sure when the next time I'll be posting anything will be. I'll have sleep to catch up on, and laundry to do. Not to mention kombucha to brew, and growth groups to attend, and exercise to do. Yay, work-life balance!

Sunday, December 31, 2017

Goodbye, 2017

And all too soon, the time has come for my usual year end post.


This post won't be like the other year end ones in the sense that I won't be doing my usual recap of events...well, I might, but I won't elaborate on them too much. The truth is, I feel like this year has been far more than a sum of its events. In preparation for these posts, I usually look through my Instagram and Facebook pics to get a feel of what to write about. That wasn't very inspiring this year, unfortunately - everything I came across seemed equally important. Also, the more unsavoury events don't get a fair representation on social media (which people tend to forget). Therefore, I'm just going to produce a sort of organised ramble and hope it serves as an adequate memento of the year.


2017 has been a big year for me, with really high highs and really low lows. It's been a year of learning, growth, and preparation for Life In the Real World. Graduation happened, and that was a big deal. Talking about everything graduation would be a blog post in itself - there was grad breakfast, the Declaration of Geneva, actual graduation, and grad ball. Before all that, there was the LCS grad dinner, the class grad trip to Goaty Hill Winery and later a smaller grad trip to Penang. We also had some post-OSCEs fun in Melbourne. Lots of fun times with great people, but also lots of goodbyes. Some friends are leaving Australia for good, and some are leaving for the mainland, so it's all been very bittersweet. Graduation always is, isn't it?


What made it even more bittersweet was news that hit the Kpop scene just days before (if this seems frivolous, it's not): Jonghyun of SHINee had committed suicide. This year has been marred with what feels like an unreasonable number of suicides. Jonghyun, Chester Bennington, two teens while I was on rural GP, another person I don't think I'm supposed to name. It's horrible. It's heartbreaking. I cannot imagine how their friends and family must feel, how they're ending their 2017. Sorry to be a downer, but this was part of my 2017, and I feel compelled to include it here. It's incredibly sad, but it's something we can hopefully learn from. We need to take care of ourselves (which isn't some wishy-washy, fluffy thing like I used to think it was), and look out for each other. Mental health is important, and I think we would all do well to remember that.


Moving on, here are some quick yays and nays of 2017!

Yay:
Spent Chinese New Year in Malaysia (for the first and last time in years)
Took part in a colour run
Hiked Cape Raoul
Had some really good rotations - Gen Med and GP in particular
Passed OSCEs + portfolio interview and graduated!
Volunteered at Teddy Mobile Clinic
Family holiday in Tassie and Melbourne

Nay:
Too Many Suicides
Job/AHPRA/visa applications
Mental health (or the lack thereof)
Not getting to see my best friend this year
Saying goodbye to friends who are leaving


2018 is looking scarily exciting, with it being my first year in the working world. I'm a real doctor now, and looking forward to actually being useful and doing some good! While there will be many new responsibilities and experiences, there are still some things that remain comfortingly the same: my house, the hospital I'm at, church, and always God. Hopefully these will ground me as I navigate the treacherous seas of intern life. They should be enough to ground me, in any case. Everything will be okay.


So long, 2017. Thanks for all the good times and the lessons.


Hello, 2018! Please be good to us all.

Friday, December 15, 2017

A month in Malaysia

I've been home for over a month, and haven't blogged once. How lazy of me. It's not like I've been doing nothing all day, though -- I've actually been really quite busy. It's been a great time of rest, getting reacquainted with my guitar, getting reacquainted with old friends, making new friends, and spending time with family. Reading, writing, exercising, all that good stuff.


And eating, of course. So much eating. I always come home with a mental list of Things I Must Eat When I'm Back, and my family frequently asks what I haven't yet crossed off when we're trying to decide where to eat. I spent a few days in Penang with friends on our grad trip, and came home 1.5kg heavier. It was glorious (the food, not the weight gain). Of course, all this eating has had to be offset by gymming, because graduation is fast approaching, and grad pics (as I keep reminding myself) ARE FOREVER. Do I want pictures of a chubby me adorning the walls of my parents' and grandparents' houses? No. No, I do not. So gym it is.

Another thing I've been up to is helping out at the Teddy Mobile Clinic! It's a pop-up clinic near Segi College KL that provides free healthcare for the homeless and urban poor. I'd heard about it last year, but never got around to contacting them. This year, I met someone who was interested in helping out too, so we did! The set-up is impressive, really. There are registration stations for new and returning patients, an obs/BSL station, a doctors' station, and even a pharmacy station! The pharmacy station is manned by pharmacists who dispense meds like antibiotics, antihistamines, basic analgesia, basic hypertension and diabetes meds (metformin and CCBs, from memory), scabies treatment, and a variety of others, free of charge! Wound care is also provided by members of the clinic. It really is quite impressive.


I've been for three sessions and they've all been great. It's heartwarming to see so many people gathered together, giving up their Wednesday nights to help in whatever way they can. Many volunteers are, like myself, fresh med grads waiting for jobs. There are also non-medical folk helping out, and their contribution certainly isn't worth any less than the medical folk's. That being said, what warmed my heart the most was the MOs. Medical Officers were probably the most time-poor out of all of us there, and some of them you could tell were tired after a long day of work...and yet, there they were. That'll be me in a few years, and I really don't know if I would have the heart or energy to volunteer for something medical in my limited free time, given the opportunity. I can't tell you how much I admire the doctors there. Actually, Teddy Mobile Clinic has sent out a request for more doctors to join the team. If you fit the bill and are interested, have a look at their Facebook page here!

While at the clinic, I also bumped into another volunteer group called Street Feeders. One of their team leaders told me that, despite their name, their purpose isn't actually to provide food for the homeless. Instead, they were more about reaching out, hooking them up with job opportunities, and helping them back on their feet where they could. I've seen them around twice now, and they seem to mainly consist of teenagers and young adults. For this reason, I've found Street Feeders and, to a certain extent, Teddy Mobile Clinic to be incredibly heartening (TMC has a bit of an older demographic). It's so nice to see young people working together to do good things for society, giving up their free time to reach out to and help people they don't (yet) know. It's just made me really optimistic about Malaysian youth in general. Woo, millennials in Malaysia don't all suck! Four for you, Malaysian millennials! You go, Malaysian millennials!


In a few days, I will be leaving Malaysia yet again. It is bittersweet -- I am excited to be starting work as an intern, but leaving home is never easy. I will miss the city and its bright lights and its constant supply of things to do/see. I will miss the food, so cheap and delicious and readily available at any hour of the day. I will miss my family and friends here, whom I really only get to see twice a year. This time will be a little different, though -- my family will be coming with me, to attend graduation and see the sights around Tassie. I'm thankful they're able to be there for grad. Also, I'm thankful they're coming because extra passengers means extra baggage allowance, so I get to bring back more stuff, heheh.


For now, though, I'm ticking off the last few items on my Must Eat When I'm Back list and Must Meet When I'm Back list. I've done a pretty good job with both so far, I'm happy to say. I don't know when the next time I'll be back will be, so I'm soaking up as much of Malaysia as I can before I leave. Malaysia has its faults and many a flaw, but ultimately, it has always been home and will always have a very special place in my heart.


So long, Malaysia. Thanks for all the good food and good people. I'll see you again soon!

Sunday, September 3, 2017

Sheltered Christians

Let me start off by saying that I am not the best Christian. I subscribe to the religion, I have accepted Christ, and I attend church and growth group regularly. However, there is much I have yet to learn about Christianity and God in general. This post is merely my two cents on something I've observed over my time as a Christian, which was made all the more apparent to me, coming from a non-practising 'Christian' background.


I don't mean to offend, but over and over again, I have made the observation that life-long, brought-up-in-Christian-families Christians can be quite...sheltered. I suppose that isn't all too surprising. If someone was brought up in a Christian family, grew up in church, had lots of Christian friends from cell group and conferences, maybe even went to a Christian school, they would have lived their life in a pleasant little Christian bubble where most people shared their values and beliefs. Which is fine and dandy, and I'm sure is great for growing their faith.


However, the real trouble starts once they are exposed to the 'real world', where there are numerous people of different religions and atheists and agnostics and people who are against religion in general. This is probably quite jarring for someone who had never been exposed to people like these. They are quite often horrified by many things, and their tolerance for being horrified can range from a boy and a girl being alone in the same room together to premarital sex with multiple partners. "Don't they know it's wrong!" they exclaim, quite distressed. "How can they do things like that!" The thing is, if you ask the people who practise these things, it isn't wrong. Let me explain why.


For someone who was raised outside of the Christian faith, their morals and values would largely have been shaped by their upbringing and society. With regards to upbringing, I have been told that church attendance today (as a percentage of the Australian population) is but a fraction of what it was decades ago. More and more people are atheist or agnostic, and fewer people identify as Christian. As a result, people's upbringing may not have been guided by the same values as a Christian family's. With regards to society, it's not news to anyone that we're heading in a direction away from Christianity, or indeed religion in general. Many things that are okayed or even promoted by society today are against what is written in the Bible. If someone lives their entire life being told by people around them that certain things are good, then as far as they're concerned, those things are good. Why would they think or believe otherwise?


This then brings into question the task of explaining the Christian view to them. A noble task, as it is an extremely difficult one. Fortunately or unfortunately, I think most sheltered Christians don't realise just how difficult it is, and they seem to be particularly bad at it. I've had these sorts of conversations with non-Christian friends, as well as observed such conversations between others, and have made notes on things you should never do. These include:

  • Only speaking and never listening
    Communication should be two-way. You're not preaching -- you're there to listen to their point of view as well as express yours. 
  • Disregard their point of view because it's 'wrong'
    Never, never, never do this. It's disrespectful and counterproductive. If you're hoping for them to have an open mind and listen to what you have to say, you should do the same for them.
  • Use Christian jargon
    This is a fault many well-read Christians possess. Non-Christians aren't going to really understand what you mean when you use language like 'slaves to Christ' or 'God's design'. At best, it will sound floofy; at worst, it will put them off completely. Using Christian jargon with non-Christians is kind of like trying to explain the colour pink to a blind person by saying "It's like red, but a little whiter" -- it just isn't going to work.

However, before you even begin having these discussions with non-Christians, you should take note of the way you view them. This brings me back to what I was saying earlier about people newly emerged from the Christian bubble. You cannot be horrified by the actions or beliefs of non-Christians, or the way they are. You should not expect them to uphold the same values you do, as they may not even be aware of them. You should not view them as bad or evil, and you definitely should not talk down to them. After all, aren't we all sinful? Isn't all sin equal in God's eyes? It crossed my mind the other day that there is possibly no one as acutely aware of their own flaws as a devout Christian. We have all sinned and we have all had evil thoughts, because we are only human. I think it's important to remember that. 


I've never blogged about anything to do with Christianity, because I've always felt like I knew too little about it to have anything worth writing about. However, the recent goings-on in Australia have allowed me to observe a fair few debates between people of different beliefs, and these sometimes turned quite ugly. I felt that I had something to say about it, and spent a fair while working on this post. This wasn't meant to offend in any way; I only aim to facilitate better communication and discussions, and hopefully encourage some self-refection.


Feel free to let me know what you think, or even call me out on things I've said that you don't agree with. Some healthy discussion is always good, and I'd love to know your thoughts on this. Thanks for reading!