Saturday, September 29, 2007

HOLIDAYS!

Omg, how wanky was that last post. I shouldn't write at odd hours of the morning. Annnyywhoo......it is FINALLY midsemester holidays! Even if it's hardly even "mid" and there are 5 weeks to exams. After that, common week for 3rd year preparation and then the proper holidays and summer. Mmmmm. I'm planning to cram up on med over the summer though, cos we're getting to the pointy end where it's not enough to say "b-but we weren't taught about lung cancer! you can't possibly have it!". Time to take some responsibility for learning. We'll see how my good intentions last when there's the temptation of the beach and fun books and movies.

Excitement plus: going to see Miss Ho Chi Minh City with maman and Sideshow with the girls this week for our 5 seconds of fame.

PS Port Adelaide is getting slaughtered, bwahaha. Finally a Victorian AFL winner!

Friday, September 28, 2007

Pretentious rhetoric as promised

I was thinking how I would woo students to the army, instead of the halfbaked incentives they served up to us. Try this for size:

We live in troubled and uncertain times, and the role of Australia's military is changing. We face shadowy threats and shapeless enemies. No longer are there battle lines and gallant charges like in our forefathers' days. And in today's world, armies must not only fight wars but also build peace, often at the same time. More than ever, we need bright young men and women of discipline, courage and conviction to stand between the nation we cherish and chaos, and help build this better world. This is the challenge that your generation faces. In enlisting, you rise to this challenge.

Stirs the blood a bit more than "we will pay for your uni fees and you get to do superfun training" no? Possibly this is partly stolen from the West Wing. Scary, though, how easy it is to fall into the rhythm of patriotic clichés. Scarier still, all of the above is hard to argue against, except with those harrowing field-hospital photos. Oh I know, you can make friends! save the world! go to exciting new places! sans gun. Join MSF and save babies in some godforsaken country, plant a tree, write a freaking folk song.

I wish for once, our better natures might be appealed to. Pollies, stop aiming for our hip pockets and our knee-jerk fears. Speak of grand ideals, make us rise above ourselves. Quote JFK, damnit! I know that a danger of that is of draining language of meaning - is the word "freedom" untainted any longer after "freedom fries" and "Enduring Freedom"? - and manipulating people by pulling at the heartstrings. But I'd be willing to take the risk to be inspired.

I'm not sure how lofty rhetoric would be taken in Australia though. Seems that America and England have a history of oratory, whereas here maybe people would just take the piss. Something to do with tall poppies or our laconic wit or twangy accent or suspicion of hot air, praps. Whether those are indeed universal Australian characteristics is of course debateable! Maybe it's more that, say, opposed to the US, we don't have a national destiny. America appears to retain the sense of its own mission to be a Beacon of Democracy and Freedom and whatnot. I mean right and left might disagree on whether they should lead by example by bolstering civ libs at home or by forcibly removing undemocratic regimes, but it's the same principle underneath, innit?

I'm batting above my weight here. Hoo well, what's a blog for but to waffle. [Oops. You punch above your weight, not bat...duh! Sports metaphors, pfft]

Wednesday, September 26, 2007

Oh. My. Sweet. Jeebus.

Guess where I just came back from? I'll give you three choices:

a) strip club
b) army recruitment
c) Scientology meeting

If you guessed b), you are correct. Even though a) and c) are more likely to have any luck in getting me to sign up! We were told that there would be emergency resus training and hands-on intubation practice and free taxpayer funded food and interesting speakers. Lies, damned lies! Instead, we got 5 minutes of DR ABC in a tent and a 3-hour YOUR COUNTRY NEEDS YOU spiel. In fact, they didn't even tap into our pro patria mori sentiments, they were just all like "oh join the army, make friends and money, see the world, get fit, have lots of fun". They forgot "be a political pawn and conform and suspend your civil liberties and oh yeah KILL PEOPLE". There was a stark reminder of reality when a doctor guy showed pictures of soldiers with their legs and faces blown off. Not immune to that yet.

It's not that I don't respect our troops. Civic duty and self-sacrifice, I tip my hat to that. Both my grandfathers were army, and all the military people I know personally are warm, smart folk. There are several ex-service med students in my year, one of whom is this twinkle-eyed former airman, future obs-gyn whom I call Jolly Dude, cos he's so cheery and cute. Methinks med attracts the idealists, hence the significant proportions of hardcore evangelists and military. Yes, the people themselves, all good. But still I've got some innate aversion to the crushing discipline and uniforms and unquestioning following of orders and parading with guns. Spare me the transparent propaganda, fer crying out loud. They wanted our addresses and phone numbers- um HELL no!

Hm, I am actually a little surprised. When they said that the ADF is an equal-opportunity employer, I wanted to say what about those dirty homos, you hypocrites? Assuming that they had the same "don't ask don't tell" farce as in the US. But I held my tongue, and as a conscientious blogger I Googled the topic before launching into a self-righteous tirade. Found this from the Gay Military Times. It turns out the ADF are rather more liberal-minded than I gave them credit for- the ban against gays was lifted in 1992 (and the sky didn't even fall - slightly biased source, that). So ADF, grudging props from - well not quite a pacifist, but at least a skeptic.

Anyway. This is what happens when you follow free food! You'd think I'd have learnt my lesson by now. There was the free sausage that lead to storming a uni in an anti-VSU protest, the free pizza that lead to half-arsedly helping organise Spectrum, then that fateful lamington that lead to joining DarcySoc before even seeing Pride and Prejudice which lead to giant flaming shitballs, and Albury freeness which lead to JFSS and potentially to A Country Practice. Yep. Soooo basically the price of my soul is a Krispy Kreme or two.

Heh, I forgot. There was meant to be catering except the people didn't turn up so they had to order pizzas in...! Catering logistics...large weapons...security...do I even need to connect the dots?

Tuesday, September 25, 2007

Like an ACTUAL dumb blonde

Sometimes stereotypes are true! Quotes from our clinical tutor:

1) "There are only two people who can make the blind see and the lame walk. One's a neurosurgeon and the other you see on the Sabbath".

2) "Did you see that black car out the front? Anyone? The black turbo Merc bzzbzzbzzbzz 0-to-100kph-in-3.7-sec bzzbzzbzzboycartalkbzzz? Yep, that's mine."

3) "Oh, you guys are still in the caring phase. We neurosurgeons leave the caring to less qualified people."

!!

Monday, September 24, 2007

Wilkommen amigos!

There's something so revealing about writing which makes me feel like I'm standing in the school hall naked.

(Well you didn't need that image, did you)

Nevertheless, if you can't get naked in front of your friends, who can you get naked in front of?

(And now you can wash your brain out with soap)

Thursday, September 20, 2007

If you're wondering,

Herr Metamorphosism or Mamzelle Intueri, you are blogrolled cos I have fangirled you from age 17 off and on and now I'm 21, hot damn, and I still want to be a doctor like one and a parent like the other and a writer like both, if wishing made it so.

And Chris, update yours fer once!

Actually no, gave up Being A Writer cos that is way too intimidating and makes me backspace backspace backspace every second word. That's for people with stories. But not being a writer is no reason not to write, right? (say that 5 times fast)

Rural evangelism

So, I have been touched by inspiration. Dirty thing. No, I had this simple idea months ago at the Albury rural conference, but am finally getting my ass into action. Using pot-banging skills I acquired in rather different circumstances in fact- ta Jerry, ailing bushies will thank you one day (I bloody well hope)!

First I have to explain the plethora of acronyms about to be used. I hold a Bonded Medical Place (BMP), which means that for the privilege of plonking aforementioned ass in the hallowed halls of Newie Uni med school, the government owns my soul for 5 years. I still have to pay HECS fees like everyone else and there are no scholarship cookies. It used to be that I had to work 6 years in a District of Workforce Shortage (which can be anything from outer metro to beyond Whoop Whoop) after my fellowship, or else spit out $100 000 in repayment to the government. That meant I was bonded til about age 36. Yes, THIRTY-SIX YEARS OLD. Now the contract's changing so that the bond is only 5 years AND I can do half while training as long as it isn't inner metro, which means only 2.5 years of post-fellowship servitude (so make that 32.5 years old, still within baby-making range). Hallelujah! God only knows why the government decided to be nice to us. They also put in a new BMP Support Scheme run by the Australian College of Rural and Remote Medicine (ACRRM). It involves online education modules and e-mentorship and the true carrot, conference attendance: travel, accomodation and registration for FRRRRRREEEEE! I already took advantage of conference funding to go to Albury- mainly cos it was FRRRRRREEEEE! And along the way somehow got provisionally converted to the rural cause. Sort of.

The other thing is the John Flynn Scholarship Scheme (JFSS), also run by the ACRRM. You send in an application and from those, people are interviewed for a scholarship. You basically do work experience with a rural practitioner for 2 weeks per year for 4-5 years to get a feel for medicine out bush. And get paid $500 for each week, along with FRRRRRREEEEE travel and accomodation! (sense a theme here?) I got one of these scholarships, by secret fenimine wiles or something.

Who can put 2 and 2 together? My idea is this: they should allocate some extra JFSS places for BMP students. Simple. Same tough application process, but BMP's get a slight leg up from the unwashed masses. Pros: for BMPs, there's the FRREEEEE and the $$$$$ and the mentorship and the experience. For the government, they get potential rural recruits. It's not preaching to the converted because BMP students are not absolutely bound to go bush, we have a choice to go into outer metro areas as well. And even if later BMPs are pushed to rural areas by competition, then the JFSS will have prepared them. Instead of resentful BMP doctors flung blindly into the bush, you get people with some rural know-how. BMPs are ideal targets for the JFSS because many are from city backgrounds and don't know much about rurality, although they are likelier than normal HECS students to have to work out bush. In short, fun and profit for students (who otherwise get hardly any love in this BMP deal with the devil), for the government and the taxpayer, and for the poor sick rural folk.

And how is this all to be funded? Note how both the conference attendance and JFSS involve cost of travel and accomodation. The only difference is the cost of conference registration vs cost of paying mentors and communities, who get a stipend to support John Flynn scholars. THUS. The funding for extra JFSS places can come out of the BMP Support Scheme's conference wallet and redirected to this JFSS-4-BMP thing. Conferences are cool and all, but I would bet cold cash that students would be keener to get hands-on clinical experience than sit and be lectured at for a week, even if it's in glorious Albury-town. And it's better value for the government, since the JFSS plays into their rural conscription strategy unlike conferences which have nothing to do with recruitment at all. PLUS ACRRM runs both the JFSS and BMP support!

It's bloody win-win and cost-neutral and the infrastructure is already in place! How can anyone not see the perfection of this? I've written to the NRHN's BMP rep to try and get their support since they seem a natural ally, but he's a bit cool about the idea. I suspect that he's not even that pro-rural; he just sent me this long letter about the government's Grand Rural Conspiracy which isn't even exactly relevant to the proposal. You'd think the National Rural Health Network (peak body of university rural health clubs) would be all over this, n'est-ce pas. I mean I myself am not fully rah-rah-rah "gimme a R! gimme a U! etc" rural evangelist but I am all fired up about this because imho it is elegant and so freaking obvious. I've also contacted the ACRRM and Department of Health and AMSA peoples and plan to send word out to fellow BMPs to get support, via the BMP newsletter run by the department. I have a mind to bang the pot at the Health Minister Himself and his Labor counterpart; it is an election year after all. This had better work! I will lose faith in reason and democracy if it doesn't. I mean apart from the West Wing.

Wednesday, September 19, 2007

Suicide for breakfast

Today I had suicide (lectures) from 9-10 and again at 11-12, on about 2 hours' sleep from staying up all night reading Child of the Prophecy, the 3rd in a fantasy trilogy that doth murder sleep. Afterwards, I went home and was handcuffed with plastic bags by a crazy Canberran, just because she was bored. I finally had to give in and use my teeth on the plastic bag which is gross because anything in public places in our house is likely to be cockroach-tainted. Then I did laundry, braving the hip-high weeds and bees and unseen monsters lurking in our garden to hang up my clothes. Then I printed off a book and had a nap.

And today was a good day!

We're in that golden period of grace that lasts maybe a month or so, when the weather is warming up and the skies are blue and still the giant flesh-eating mosquitoes that inhabit Newie Uni haven't figured out that people are starting to wear short sleeves again. There are swarms of invisible flying things occasionally, but they're ok as long as you breathe through your shirt. You don't want invisible flying things breeding in your lungs/intestines after all.

Sunday, September 16, 2007

IV caffeine + 2 weeks of darkness

Reading about the goings on at the Toronto filmfest, I've decided that "attend a film festival" is going to be on my life to-do list. Get a pass and spend two entire weeks queuing and watching movies and stargazing day and night, fuelled only by caffeine and popcorn. In total ignorance of film as an art, but hopefully enlightened by the end.

Just my kind of crazy! I've proven that I am ace at the whole "waiting insane amounts of time to see things" thing: New Year's in NY and Sydney, Jazz and Classical in the Domain, Martin-Placing during the Sydney Festival for tix to see Ralph Fiennes. He was determined to evade me, how rude. I want to do Shakespeare in the Park some day as well, cos spending a day hanging in Central Park in summer with drama geek peoples sounds awesome. Not to mention the free tix.

In other news, there but for the grace of god...disturbing.

Saturday, September 15, 2007

Mountains

It's 4am and I just had to purge my brain of the thought that has been clanging about for weeks. The idea is this: the task of becoming a good doctor is a lifetime's work, and an honourable aspiration. It is also something I am still not sure I can accomplish, because to be a good doctor is to juggle mountains (to use a totally obvious metaphor).

On one hand, you must master the vast body of scientific knowledge, numerous disparate fields of both ancient and developing knowledge. Anatomy, biochemistry, embryology, physiology, pharmacology, pathology, genetics, microbiology, immunology, histology. Whole careers are dedicated to subspecialties in these domains; you have to know them all, at least to a basic level. Many things make sense, others must be hammered into your memory by sheer bloody-minded force. You need an almost obsessive thirst for facts and an innate logical wiring. In first year I thought that medicine was in some ways less intellectually rigorous than the humanities which require critical thinking, generating ideas. That's still true, but now I have greater respect for the many fat detailed books that have to be crammed into my small head with its penchant for big-picture intuitive concepts.

On the other hand, there are clinical skills, that ambiguous art of learning from touch and hearing and observation, distinguishing and integrating subtle signs, recalling obscure connections between them, matching them to the sciences, keeping your mind open to rare possibilities while honing in on the most probable, decision-making in the face of uncertainty based on epidemiology and evidence and experience. At the moment I don't trust myself; it all seems so subjective.

Finally, there is the human side. All the above facts and skills must be internalised so that you can see the individual patient as a whole, not a cluster of symptoms but as nothing less than a fellow human being with all the dignity and vulnerability that term implies. You must connect, empathise, reassure, instruct, question, attempt to understand the landscape of their lives. You must see them clearly with both objectivity and compassion, and respect them. What's more, acknowledge your own weaknesses and fears. You have to keep an eye on ethics and its scarier big brother, Teh Law. You have to maintain humility while projecting and indeed having self-confidence. You are privileged to have contact with people in extremis and experience a broad spectrum of the human condition. This is the bit of doctoring that convinced me to take the blind leap from BA/LLB to BMed. We'll have to see if it's good enough.

It is a rare doctor who manages to keep all three aspects in the air at the same time, even in the higher echelons of the profession. Common in our tutorial rooms are the well-intentioned doctors, certainly caring, but a little sloppy with factual details. In our lecture theatres and in hospitals, often you find doctors who have conquered those first two mountains and even create new knowledge - but who lose sight of the person behind the clinical problem. There is also a thread of self-pity among medical students and doctors, I've noticed. Hell, I've been guilty of it myself. The training is difficult and long, the price of mistakes are high...but all the same, as I read elsewhere, it's nothing compared to being on the cold end of the stethoscope or scalpel. And it's an honour to be trusted with someone's health or even life.

I have seen doctors I can admire, though. The latest is a professor I am crushing at the moment (intellectually only!). He teaches eloquently - it's not grandiose, just lucid and precise - and has dry understated humour, but most of all has that indefinable humane quality. It manifests itself in the way he talks to, and not merely about, a patient in a clinical presentation; how he touches her arm gently instead of manipulating her like a lump of meat. I have learned to identify good doctors. Becoming one? I still have many doubts and fears, but insha'allah that's what aquackening will chronicle.

Course, there will also be posts consisting of lists, rants, annoying alliteration, navel-gazing, swearing, pretentious rhetoric, indecision, woe-is-me whining, groanworthy jokes, and abuse of the English language (et français o español si j'en ai envie, porque tengo que les practiquer), etc. Just so you're warned.