Sunday, November 23, 2008

Two tongues = handy

My cardiologist "aunt" from Hanoi came to visit for the weekend. It was entertaining. She took me to an exorbitant but mind-blowingly awesome buffet at a 5 star hotel yesterday. Srsly, there was like foie gras cooked on demand and a chocolate fountain. Then today we ended up at a "binh dan" restaurant. It was hilarious cos she was visibly, like, "holy shit this place is SO LOW CLASS". Whereas to me, a place with chairs that are more than stools 10cm off the ground and tablecloths is woah break the bank already. I've been eating at pavement stalls. She said it was the first time ever she'd been to one - having spent her whole life in Vietnam! I'm not sure whether she knows she's in the 1%. I wouldn't say she's a snob, just...removed. I'm still fascinated by her, though. Such a dynamic, complicated yet endearing modern woman in a society that's not really caught up yet - the stuff heroines of novels are made of. Her family's interesting too. Her mum was a ballet dancer, then joined the army's arts corps (who knew such a thing existed!), then switched into medicine and later Eastern medicine. She knows Portuguese fluently, having worked in Africa for some time. Her dad was a famous architect, and went to Cuba and France to work. Like, wtf, I didn't know there were people like that in Vietnam.

So I was farewelling her today when I got into a conversation with a xe om driver. He's a good bloke. Then one of his regulars came round, an Aussie. So began one of the funniest, most disjointed conversations in my life because while neither party could understand the other, I got both ends.

Dramatis personae:
1) Aussie: 61yo, Vietnam Vet, big, bluff, rough-house Queenslander with tatts and a beer gut. Doesn't speak any Vietnamese and probably thinks everyone should understand English. Likes giving the driver punches in the arm, the only way he can communicate.
2) Driver: 40ishyo bone-skinny, chain-smoking, gap-toothed. Doesn't speak English except for "yes", "no". Ducks when Aussie comes, having been smacked too many times.
3) Me: bemused and amused, in PJ shorts because wasn't planning to stay downstairs for long.

Driver: I have no idea where he wants me to take him! And he never pays me enough. He only pays 70 000 for a whole day's driving, I barely break even with the cost of petrol these days. I might as well stay at home. It's no holiday, being his driver.
Aussie: He keeps taking me in circles and asking for more money, the greedy bastard. I always shout him meals and cigarettes. It costs me 150 000 a day!

Driver: There was this girl who kept wanting money from him...she wanted him to buy her a motorbike! I tried to tell him to stay away.
Aussie: There was this girl - she's 38 but looks lots younger. Isn't she cute? *whips out phone*

Driver: I feel sorry for him despite his cheapness, because without me he'd have to take taxis everywhere. He's a good bloke.
Aussie: I'd punch the lights out of anyone who tried to lay a finger on him. He's a good bloke.

Driver: Did you see the powdered pills he put in his coffee? Can you ask what it is?
Me: Shit, I hope they didn't give me the wrong cup! I'm scared! I don't want to ask. He wants me to come up to his room to "fix his computer". I don't know what to do!
Driver: Oh my god. He loves flirting with girls. Don't go!
Aussie (oblivious): Can you ask him how I can buy some fairy lights, like up on that tree there?
Yes, I did drink from a cup potentially with white powder in it AND went to his room. I KNOW!!! I can feel the disapproval coming down the mother-daughter psychic connection line as we speak! But he left the door open in his room, and I poked my keys between my fingers as makeshift brass knuckles just in case. Nothing happened, thank Jeebus...I'd have no one to blame but myself. Fortune favours the extremely stupid sometimes.

Wednesday, November 19, 2008


(drafted a few days ago)

Apparently I've been tagged for a meme. Too uncool and blog-orphaned to tag anyone else. Does Not Play Well With Other Children here! heh. But anywho...

The instructions:
  • Grab the nearest book.
  • Open it to page 56.
  • Find the fifth sentence.
  • Post the text of the sentence in your journal along with these instructions.
  • Don’t dig for your favorite book, the cool book, or the intellectual one: pick the CLOSEST.
I was hoping it'd be some random Viet book, but sitting here on my dining table / dumping ground (along with socks, a surgical masks, souvenir koalas, toilet paper, a Shins CD, my CV and Keo Mon Sua) is Jonathan Harley's Lost in Transmission. You may know him as the husband of the chick who wrote Holy Cow, or the ABC's South Asia correspondent. The book's about his travels - he was in Afghanistan on September 11th and such. Eh, worth the $4 it cost me as part of a travelogue box set (do I hear a "hell yeah!").
"On both sides of the divide, more than fifty thousand Kashmiris have fled their villages and the raining shells."
Meanwhile, just back from Le Cambodge. Angkor totally deserves the hype. I travelled with my ex-PBL-groupmate and another Aussie student, and collectively we decided Cambodia wins at temples and city architecture. Phnom Penh is a classy joint. Vietnam is bogan in comparison, but at least we win at food! Bun bo hue shits all over your amok! (er) That said, Cambodia is definitely more developing world - complete with the trademark Pong of Asia stinky markets, vehicles overloaded with cargo and people (today we saw a guy clinging for dear life on the boot of a car as there was no space inside), and undernourished, unbelievably cute half-naked children begging for money. Guilt. Trip. As a rule I don't give money to beggars, but sometimes I forget why that's a rule. Well, if you give a man a fish, you feed him one day. If you give an international charity $40 a month, 20% of which goes to glossy advertising and Administrative Costs, and they teach a man to fish, then you feed him for a lifetime. Or something.

In Phnom Penh we visited the Genocide Museum and the Killing Fields. The latter is really just a field, with ominous ditches and signs saying "Please don't walk over the mass grave!", and a monument filled with skulls. The museum is at the school that the Khmer Rouge took over and used as a prison. There are no tastefully lit cardboard placards, few glass cases in this museum, no multimedia whizzbangs - quite a contrast from the Holocaust museum in Washington DC. That's not a political's just that this shabby place doesn't allow you much historical distance at all. The first thing you walk into is a series of cells. It was late afternoon when we got there, and the cells were unlit. In these dark, bare rooms, there's nothing but a metal bed frame on which sit iron shackles and other sinister implements. On the wall, a picture of the victim found there. Dead or alive, it's hard to tell. No words of explanation. There's only a sign in Khmer outside, with a drawing of a smiling man crossed out. We couldn't figure out what it meant..."no photos"? "No smiling"? I think it's perhaps "no smiling and posing for photos in this place where people were tortured and killed". The next building is the gallery of the dead, photographs of the prisoners at arrest, and sometimes after being beaten. It's the "befores" that were especially haunting, though. Rarely do they show fear or cry, some even half-smile for the camera.

For some reason we decided we'd go see the war museum today upon our arrival back in Saigon. I wrestled with a lifetime's worth of indoctrination. See, the version of the VN War I got as a descendant of soldiers and refugees, was vastly different from the Western notion - all that stuff about guilt, quagmires, good old hippy days, "Communism roolz (in theory)", American imperialists interfering with the nationalist struggle by the valiant VC, etc etc. It blew my 14-year-old mind, that the story we were taught in Year 9 History differed so much from the story I got at home.

So yeah, the museum is an obvious propaganda tool. Captions say things like "American GIs [grinning] after beheading Vietnamese patriot". And yeah, there's a Hanoi Hilton-sized elephant in the room... indeed all the exhibits are of American weapons and their consequences - I didn't see any VC artefacts. But, man, the pictures. Napalm, Agent Orange, land mines... bodies, burns, birth defects, dead kids. "They did it too" is no answer. There are no answers.

Thursday, November 13, 2008

West Winging it

The West Wing totally called the US election. Matt Santos, token ethnic president based on Obama, campaigning on a message of change, wins against maverick Republican partly based on John McCain - check. Chooses Josh Lyman, based on Rahm Emanuel, as chief of staff - check. The only thing that's missing is the theme song.

I had a post-election squee post but my wifi died and I lost the nerve to press "publish" afterwards. Luckily for you: I was kinda delirious after 150 hours of election coverage. Gotta admit, this Australian shed a little tear. Democracy in action, yknow? And hope in the face of one screwed up world.

Been obsessively following the news, far more than is healthy for someone who's NOT AMERICAN. SMH, Huffington Post, New York Times, New Yorker, Guardian, Washington Post, Politico. This real time thing is too slow, I wanna know what happens in the next episode NOW! Where's the DVD box set?

For your perusal:
  • The rise and fall of John McCain. New Yorker.
  • An oldie but an of coursie: a conversation between Jeb Bartlett of WW and Obama. NYT.
  • Tears along with the joy. NYT blogger.
  • Can Obama be the next FDR? New Yorker.
(what, you got something against New Yawk?)

Wednesday, November 12, 2008

It's a....squalling purple thing!

So I've been pretty crap at blogging Vietnam! I blame the shitbox wifi in my room. Sitting downstairs now glaring at my battery meter.

GUESS WHAT. Today I went to an obstetrics hospital. Borrowed scrubs and a student ID so I wouldn't look too conspicuous. What, that's totally legit!

It was awesome! And a little bit icky. But mostly awesome. I saw four births: one immediately afterwards (placenta still on the way), one C-section and two from start to finish. That is, we had a look of them before the "pushpushush!! HARDER! you can do better than that!!!" started. I even, ahem, assisted on one. That's to say, I felt the belly to see when it was taut, and was meant to yell at the mother to push and tap on the belly to help the contractions, except I was kinda shy and didn't fully understand the instructions.

The actual process of childbirth looks, um, kind of painful. When it's my turn, give me the frigging drugs already! And the cutting and sewing bit - only under lidocaine here - seems like torture. Eww. And the delivery suite wasn't very friendly. Women just lying there with their legs open, no one paying much attention to them. Is that the way to welcome a new life into the world? I entertained notions of having a hippie, birthing centre, water-birth, midwife type of thing, but then I can't be a doctor and forsake western medicine entirely hey. Maybe a hippie birthing centre next door to a major tertiary hospital. Also, yknow what? Newborns are so not cute. Maybe after they're cleaned up and oxygenated, not so much when cone-headed and purple and covered with dodgy slime and being held upside-down by the legs by a midwife who's suctioning said dodgy slime from its nose, mouth, and anus by the same apparatus (yes IN THAT ORDER, thank god).

My Viet student friend ultrasounded another woman's belly and after mucking around for a while trying to find it, we finally got the heartbeat. The mother's face lit up, as no doubt mothers' faces everywhere light up. My "omfg that rocks!!" grin was reflected in her face.

Tuesday, November 4, 2008

Indecision 08

A German and an Aussie med student in a Vietnam triage room.
German: What day is it today?
Aussie: Umm let's see...tomorrow is the election. I mean, The Election.
and previously
Aussie 1: I haven't been following the elections recently, but yesterday I went on a mad spree and stayed up til 2am looking up the candidates on Wikipedia and reading the blogs.
Aussie 2: Dude. ME. TOO.
Conclusion: don't fuck it up for everyone, America! Kthanx.

I've had a bit of election fever for a while actually. Huffington Post is my drug of choice, although it's funny how it's so overtly Obamamania. Reminds me of how my Flynnie mentor only watches Fox. All the cognitive bias you need in one place!

CNN and BBC don't work here properly, with only sound but fuzzy wuzzy pictures. I would like to attribute that to Our VC Overlords, but it's more likely due to crappy reception. So my options for fulfilling my "WOOO! WEST WING SEASON FINALE!" excitement are listening to the news (so retro! cf people in WWII listening to the wireless to see whether their city's going to get bombed) or obsessively surfing the blogosphere.

Monday, November 3, 2008

We sing with one voice

Remember how I was feeling like a stranger here? I've discovered these really are My People. See, in Australia, people look at me like I'm a weirdo whenever I randomly burst out singing in the street. Haven't they seen musicals?! But here in the motherland, EVERYONE does that. Bus drivers, roadside stall owners, cleaners, doctors in ED or surgery - elbow deep in someone's belly. They'll just be working then suddenly break into folk song mode and no one blinks an eye.

A genetic excuse!

(and a one, two, one two three four...jazz hands!)

Friday, October 31, 2008


I've been wondering why on earth there are clip-clopping high heel sounds above my room at the hotel at odd hours of the night. This evening, I get in the lift with a very cheerful man in business attire. My gaze wanders from him to the sign describing each floor. 1st & 2nd: wedding restaurant. 3rd: stock market company. 4th & 5th: hotel floors. 6th: massage parlour. 7th: sunset cafe.

I see the 6th floor button lit up, look back to the grinning man, remember the night-time clip-clops...and totally crack up in his face. Heh.

Wednesday, October 22, 2008

Lost in interpretation

How could I forget this one? It's from Flynnie.
Dr (to nurse): You know, we really shouldn't take drug samples.
Rep: Why??
Dr: There's no such thing as a free lunch.
Rep: I'll bring some next time!
Dr: That's not what I...sigh. *takes drugs anyway*
There was more lost in translation at the conference I was just at. I died several times in lectures when Vietnamese audience-members would ask questions in heavily accented English, and the Australian or American lecturers would be totally "wtf?" but gamely give a detailed answer about a completely different topic and then say "did I answer your question?" and everyone ended up completely confused. I was tempted to offer my services as a Vietglish to English interpreter, but it was more fun silently cracking up. Heh. Bilingualness is so worth it for those moments. And then there was the hilarity of the simultaneous interpretation, with two waves of reaction to every joke, one delayed by half a minute, like an in-person satellite delay. The UN must be a barrel of laughs.

Monday, October 20, 2008

Broken hearts &c

No, not dead, arrested or deported! I'm in HN now attending this regional cardiology conference. No extremes of life and death to report - my days are now filled with lectures about things like the electrophysiological diagnosis of atrial flutters (who knew there were so many types?). Apart from bits of extreme detail about randomness such as Takotsubo "Broken Heart Syndrome" Cardiomyopathy, the main messsages I've gotten are: smoking bad. Fat bad. Exercise good, immobility bad. Vegetables and fruit good. Diabetes bad. Hypertension bad. Prevention is better than cure. Not a whole lot different from cardio week. It's weird, because some of the new research they're presenting seems to basically confirm the same old conclusions about risk factors rahrahrah. Surely the problem is WHAT TO DO about it.

Anyway, I was mentally drafting a post about discovering a whole new branch of my family tree for the first time ever but then I was distracted by someone else's family (Jerry is enbumped again! hehe awww). I'm related to a guy who's an instructor in the VC army, a paediatrician and an artist who moved to Germany and married Aryan. I bonded more with my grandfather's sister in one day than I have with him for my whole life, and now he's not well. And I have all these people looking out for me in VN, including my new aunt who's not the man-eating "I use you for citizenship! ha! ha!" she-devil we all automatically assume Vietnamese brides are.

Sleep now. More later maybe.

Wednesday, October 15, 2008

Lost in translation

Scene: conversation with a mumbly patient with a jacket covering up her mouth.
Her: Doctor, I have pains / a fever / seizures / am pregnant with octuplets.
Me: You want a blanket?
Her: ???
Her: ???
Me: ???
(Both: Weirdo.)
Scene: friendly, nerdy (does Vietnam make them otherwise?) and extremely loquacious Viet student accosts less friendly, less nerdy, taciturn Oz-Viet student. Note that he'd already talked to (= at) me about a) the cathedral in Dalat, b) his goldfish, c) how his parents met, d) how to read an abdominal ultrasound (appreciated) and e) domestic violence in VN. And asked what my religious convictions are and whether I was sad at my parents' divorce. Boundaries already! He got my e-mail and mobile number, mis dios.
Him: Talking to you, it's like honey is melting in my mouth.
Me: Errrr what?
Him: Like honey, you give nourishment to my voice.
(Me: But all I did was nod....twenty minutes ago!)
Scene: a discussion about how (un)likely it is my children will speak Viet.
Five Foot Nothing Ortho Surgeon: You probably will marry a Westerner, right?
Me: Maybe, but possibly an Australian-born Vietnamese like me.
FFNOS: Not a Vietnamese-born Vietnamese?
Me: Most only come up to my shoulder. [forgetting his stature, as we were seated]
Others: LOL!
FFNOS: Some of history's greats were short! Napoleon said that a man's stature should be measured from his head to the sky, not from the ground to his head. Napoleon! Who else?
Others: Hitler?
FFNOS: Hitler! And Charlie Chaplin.
Me: I'm not really looking to marry Hitler or Charlie Chaplin.
Scene: a man lying in bed, bored.
Me: So, what's wrong?
Him: Nothing.
Me: I mean, why are you in hospital?
Him: No reason. Nothing at all.
Me: ... You're here for a rest?
Another time I thought that weedkiller - "thuoc co", literally "grass drug" - was some kind of herbal medicine. And I puzzled for ages about a lady with a presentation suggestive of gall stones, but who'd just had her gallbladder removed recently...until I realised that she'd said she'd just had her pancreas out, not her GB. Same difference right?

We had an Aussie in today and basically I was the language monkey, which I was happy to be. Me with my crapola Viet! It was a good day. Learned a few things, got the same provisional diagnosis as the doctor a few times, was useful to at least one person ("the toilet's outside on the right"...heh), didn't witness any more dust to dust, talked to people. Had delicious variation on bubble tea. And my new tailored pants fit well, MOST importantly. Still secretory though. Are lungs really that necessary? Can I just do away with mine?

Going to the enemy capital tomorrow. Yes, where they captured and tortured John McCain! Except I don't get to stay at the Hilton.

Monday, October 13, 2008

All in a day's work

Meals eaten in the last 48 hours: 2.
Sleep in the last 48 hours: 13. (3 + 10)
Self-medication (opiates! wheee!): lost count.
Dead people seen: lost count.
Open heart surgeries witnessed: 2.

I got up - note, not woke up - this morning. Showered. Put on my pants. Took off my pants because they had a dead woman's blood on them. Rummaged the laundry basket for my relatively cleaner white coat, the one that's not also contaminated by bodily fluids (at least not visibly). Swallowed codeine. Jumped on a taxi.

I was wrong, or unconsciously taking poetic license, because the floor and walls of ED are not white, but light grey, though they are indeed reflective. When I first came in the room was quite empty. God must've wanted to punish me for thinking so because before 9am there were already at least two brain-dead (I checked their pupils), a swathe of old people, five or so parties involved in a stabbing, an emaciated 30-something with massive cirrhosis, a maybe renal colic and more. One of the patients was about to be certified dead until he started breathing on his own! But I think he was still gone. All that before breakfast.

I haven't learned enough about death. I mean the clinical side of it. There was probably a learning target in first year that I pooh-pooh'd as fluff, but it's critical. When to stop CPR. When there's no hope of return. This is something that happens daily here. The first few days I just walked by the mini-ICU in ED a few times, not really knowing what was going on, but now I realise that the air pumping and chest thumping is most likely to be fruitless. My PBL training leads to determining causes, mechanisms and solutions, but leaves me high and dry when it comes to The End. As for the personal side....seeing the relatives grieving shook me up a bit, but the thing is, when someone's brought in barely alive, the transition to mostly dead isn't that obvious.

There wasn't a whole lot for me to do and I think Mr Intern wanted to give me a break from, yknow, death and destruction, so he took me upstairs to the cardiac surgery department. So, c'est vrai, surgery is just cutting stuff up then sewing it back together...but when the "stuff" is a LIVING BEATING HEART....dude, that is wicked rad. The heart guys are cooler than the ortho surgeons as well - the professor (God Himself) joked with me in excellent English and another one explained the repair of a Fallot's Tetralogy. When I started hacking up my lungs and swaying, I thought that was time to retreat.

My intern is becoming a friend. Imagine a small, deft, fine-fingered fellow with blinky myopic eyes behind thick glasses, square-cut hair, conscientious, finicky with hygiene at mealtimes and in surgery as befits an open heart surgeon to be. He spends his spare time studying (I KNOW!) and playing soccer and stuff with his friends, sometimes martial arts. He's so cute and gentlemanly - took me to the coughfakebookshopcough today and even offered to pay, and then drove me home. And he's a role model now too. He actually cares for his patients, in a setting where that's hard to do, and he is always seeking to learn more. Now I go around stage-whispering "he's a darling!". I sense he's got a little in reserve but I don't think this idol will turn out to have clay feet.

You know what I've been thinking about? Here doctors are really poorly remunerated, yet patients can still get an excellent standard of care. I have to give Mr Ortho props for the six gruelling hours he spent on that only garnered him about 75 000 VND, which is about $7 AUD. The buying power isn't a lot either, given that a hospital lunch is about 30 000 VND. He could've just stitched the thumb on for aesthetic purposes, but instead took great care in connecting each tiny vessel and nerve. And Mr Intern probably gets paid even worse, but he stays overtime to make sure that his patients survive the handover and is meticulous in examining them. I've been taught (brainwashed) to think that a nation without rule of law must be corrupt and collapsing, each man for himself - and indeed there are horror stories about doctors giving sloppy care or sending patients for unnecessary operations because they have side deals with specialists. But there remains the integrity of individuals, the drive to excel at one's work and do good. It's heartening.

Unbearable whiteness of being

Home from my first ever graveyard shift in ED. It was a warzone last night. The combination of weekend drink-driving, rain and a motorbike nation is deadly. The room was full of head injuries, people vomiting and seizing and yelling and moaning and banging on their stretchers, many crudely restrained with their limbs tied to the the bed. Ears ripped off, partly severed fingers dangling, faces disfigured from swelling. Twice, power failures plunged us all into darkness. Patients and relatives kept clutching at me, "doctor, my arm is so sore, what can you do doctor", "doctor, help my son, please doctor", "doctor, the drip doesn't work". I don't know why they chose me out of the other students there - maybe because I look older, or because I'm not wearing the blue-striped coat that Viet students wear, or maybe because I haven't learnt the art of ignoring yet and still make eye contact. I felt helpless before such need, not having any answers, not knowing who to tell - just starting to get to recgonise the staff here. I didn't know whether to pass on their pleas or not? To my shame, in some cases I didn't do anything. But in the end I decided this was cowardice; it cost me nothing to ask. I napped a few fitful hours in the nurses' change room and wondered at how they could wake up immediately, get themselves impeccably neat, and head back into the fray at ungodly o'clock. It's practically heroic.

I did CPR for the first time on a real person. She was a middle-aged Jane Doe, with hair and skin tone revealing that she was probably a daughter of the war, half GI, half Vietnamese. Her feet were already blue. She had blood coming from her face; I couldn't tell if her upper lip was still there or not. The contents of her pockets were thrown on a tray: a wad of paper money, some silver jewellery, but no ID. I got some of her blood on my coat. When I returned from getting a scrub top from theatre as replacement, she was under a white sheet. Another first.

If this sounds emotionally flat, it is because I am. I'm washed out from the flu and from...I dunno, what's the noun for overwhelming? That. I'm curiously untraumatised. The glaring clinical whiteness of the ED - white-uniformed nurses, blinding white lights, reflective white floor, white walls, white doctors' coats - contrasts weirdly with the broken bodies lying there in pools of their own blood. It contributes to a sense of removal. Sure, I connected to a few people I interviewed and examined, but the innumberable semi-conscious head-injured started to blend in to each other, an undifferentiated mass of Them.

I'd like to say I feel that I've lost something, but I'm just tired.

Saturday, October 11, 2008

Bones and groans

Well I had a long rant yesterday that is Saved As Draft, and there shall it remain. Long story short: morning spent wrangling with bureaucracy. Brief period of awesome when I finally got things sorted and was introduced to ED (English speaking! program for international students! assigned to people who are keen to teach!). Invited to "dinner" by a young gentleman - actually lunch at about 10.30 in the morning. Nerdy, nice, semi-weird (check check check) but alas, a foot shorter than me. Then I was hauled off by Mr Ortho to see hand surgery. Ok, so seeing a thumb COMPLETELY SEVERED cleanly like an anatomical diagram, with the loose bit covered in ants, was pretty cool/gross. And the patient semi waking up mid-surgery was...interesting. But most of the SIX HOURS was watching someone poke at something invisible with something invisible - microsurgery. And then the rest of the night was also spent in ortho feeling like a useless sack because I can't for the life of me understand mask-muffled franglovietnamese instructions. Didn't help that the flipside of Mr Ortho's Alpha qualities (decisiveness, vigour) is impatient assholicness that rears its fugly head in theatre. At the end - 11pm, because I was going to stay with him on 24 hour call but threw in the towel - he said "the best thing I've seen you do all day is holding legs". A job a block of wood can do! Could've been more useful with a five minute tutorial on what's expected of me and what the bits and pieces are called, but no, I'm sure letting people know they're tards is a better way of getting things done. Well screw you, Mr Ortho, and screw your specialty. It's a waste of intelligence - glorified carpentry. After something like twelve hours, I'd be happy never to see any ortho surgery again in my life. I came home pissed off and depressed.

Did I say short? Heh. Still had some rant left in me.

However, today was fantastico. Worked the 2.30-9pm shift in ED, which meant yay extra sleep! But really, I heart ED. Instead of cursing my lack of Viet abilities, for once I was glad of what little I have, as I was able to take pretty decent histories. Really don't know how international students cope here, when history is like 80% of diagnosis, and so much learning requires explanation. (Not to discourage anyone who's planning to come here! depends on the program, staff and department I guess). I got to do a few procedures like blood-taking, IV cannulation (1/2 tries - better than my 1/6 record in Armi) and suturing, which is always funzies. And saw stuff like a pneumothorax, CPR, CVP measuring, emergency intubation, acute glaucoma and paraquat poisoning. ED is where the medicine is: a bit of everything, fresh patients, mysteries to figure out. A thrillion times better than bones bones bones!

Wednesday, October 8, 2008

Hog thoughts

This blog is going to be more of a pressure valve than ever, given that it's one of the only links to the English-speaking world I've got here. Translation: aquackening will be even more wanktastic than usual! I find when I'm isolated for too long I get all self-loathing and angsty. Will ask training dude about international students to befriend.

Musings from the back of a motorbike:
  • From the Idiot's Guide to Idiocy: riding a motorbike just after you've come from a ward full of people with pins and contraptions on their limbs, and surgery where you saw hammers, chisels, screwdrivers, power drills, pliers and nails applied to a HUMAN BODY - most as a result of motorbike accidents. Own damn fault if anything happens. But taxis are hard to catch back from hospital and slow and you don't get to ZOOMZOOM with the wind in your face.
  • Orthopaedics is just like mechanics except you're not allowed to scratch your nose. Ohmygod. The no-scratch thing should be used in Gitmo, it is serious torture. I'm going to invent a surgical itch stick.
  • Finally I know why everyone always think my name is Thuy Tien instead of Thao - for some reason Thuy Tien is the preferred name for dozens and dozens of restaurants here. FYI people: I do not serve pho.
  • Are you supposed to lean into bends or against them?! I reckon the former, but that's based on a half-remembered bit from The History Boys where the smarmy new teacher gets paralysed because he's unused to riding on the back of Mr History's bike (on which Mr History takes boys and feels them up). Um. I think. Alan Bennett: my life is in your hands.
  • My Viet is sometimes taken for native, and yet at other times entire sections of conversation whizz over my head because I don't understand key words, or I misunderstand and answer some totally different question. In the Romance languages, even those I don't know well, at least educated guessing is possible, but in Viet the etymology is often from Chinese, so all that's possible is a dopey Huh?! face. Serious damper on personality.

Friday, October 3, 2008


My saviour has come. I should have known, he makes the lame walk! He is an orthopaedic surgeon at Choray, a ginormous hospital in Saigon town. He is tall and quick-eyed and is a man of action, which you can tell from his gait - I practically have to run to keep up with him. He's married and is, um, "friends" with my mum's (also married) cousin. Is coveting thy neighbour's (wife's) ass genetic?! My family is McWeird.

BUT, the good news is....drumroll, ladies and gentlemen...Mr Ortho has agreed to be my new supervisor!!! Get this. My old supervisor tells me to come in at 8am. I drag myself out of bed and go by xe om to the hospital, only to find out he's out at breakfast. So I pull out my laptop (having learned that long waits are to be expected). Finally he comes back, only to sit there twiddling his thumbs, deep in thought. So I sit there doing more laptop crap, breathing in more iatrogenic smoke, waiting til he decides to do something with me. Finally it clicks when he starts folding up his white coat...he's actually quitting his job TODAY! He takes me home again.

Compare this to Mr Ortho. Once I get back, we call him at around 10am. At 11.30, we meet him at the hospital. He asks what I want to do. On the spot I decide on Emergency, since that's where you get a bit of everything, plus I'm sure to see crazy stuff that I never would in Oz. He takes me there, introduces me to a guy who I'll follow around in ED, asks the lady in charge for permission, and takes me to the staff caf for an iced tea (yeah, I didn't follow my own advice about the ice and will probably pay for it! DIY oral rehydration, woot) while we wait for the training office to re-open. By about 1.15pm, it's all set, I just have to get an introduction letter from uni. Three hours after we started the ball rolling. You can understand why I walked around stage-whispering "I LOVE HIM!" and grinning.

This means I have accommodation, I have exciting stuff to do, I have a trustworthy supervisor, I don't have to breathe in any more slack doctor smoke, and I'm far away from a certain Shakespearean crackpot. I get to stay in the comfortably uncouth South, with the familiar accents and frank manners and plenty of contacts to rescue me if anything happens. All because Mr Ortho fancies my second cousin! Heh.

This is a REAL VN hospital, unlike the cushy semi-private one I was at previously. We arrived by taxi and could hardly even get off - it took ages to get to the curb because of the throng of motorbikes, bikes, pedestrians, peddlers, officials and other sundry bodies. Across the street, there's a booming side trade in quick meals to feed the hungry relatives (and indeed patients, because they often rely on outside food - not sure if they're even fed in hospital). You walk in and there are people on almost every available horizontal surface - there was a woman lying down on some newspaper right at the entrance, centimetres from being stepped on by the entering and departing crowds. It's often hard to tell the patients from the relatives. When trying to find Mr Ortho, we went on the scenic tour of the hospital as we were directed and misdirected all over the place. On the ortho clinic side, patients sit or lie in the coridoors, surrounded by anxious relatives, clutching whatever limb they've damaged. To go up or down a level, you have to brave the chaos of the elevators - the battle between wheelchairs, stretchers and doctors in a rush - or else take the stairs, which are also packed with people. In the ED, there aren't six beds as in Barmy or twelveish as at the hospital I was at previously - there are dozens and dozens of beds in rows like those shots of maternity wards, except instead of gurgling babies there are people in various states of silent distress. My home for the next seven weeks. Scary? Hell the frick yeah. Am I up to it? Errr....probably not. But who cares. Bring it on.


Ok, so Plan A was this: 2 weeks in Saigon, 6 weeks in Hanoi. However, after the Othello explosion, I was debating whether to continue with the original plan to go to HN, what with the risk of him going spazz at the thought of DevilSpawn (yours truly) working with Des. My presence cramps Des' style - she can't get out in case he tries some shit with me. Plus there's the added inconvenience of not having anywhere to stay - we do have some distant contacts (my mum's brother's soon-to-be-ex-wife's cousin twice removed or something) but a) I'm not keen to share a room and b) it's a big ask to have me for almost 2 months. Could stay in a hotel, but transport is a bit tricky.

Thus, Plan B was to stay in Saigon. Here, the doctor I'm with is my great-uncle's friend. Their family has a nice big house with room for me, plus kids to play with, and they have an English school which I could help with. I was only hemhawing about going here because we didn't know them well and because he's less in the loop about what the purpose of the placement is. The time here so far has been patchy: long periods of waiting around doing nothing, but then again yesterday I went with him on call and got to do some cool things, like take part in laparoscopic surgery, sew people up, test for appendicitis. Even got a case of subcutaneous emphysema (air under the skin from a broken rib stabbing a lung...the guy seriously looked and felt like a squishy balloon!). This kind of stuff convinced me that it'd be ok to stay here after all. Last night I was preparing to do the paperwork with the uni and hospital to make it official. I like the South, despite the heat, cos the people are straightforward and easygoing, as opposed to the Northerners' veneers and status games. But wait, there's more! Today we find out that this supervisor is resigning his job. He handed in his letter just this morning.

To think I went to VN partly because it'd be easier to organise. What a country. It's got an unique ability to drive one nuts. I think the problem is that we're entangled in a web of obligations, debts and favours here, at the mercy of others, and there are all these unwritten rules and traps. Bearshit is the inevitable result. In Oz we have atomised lives, not relying on anyone except nearest friends and family. Perhaps it's lonelier, but it's a hell of a lot more peaceful.

Wednesday, October 1, 2008

Vietnam travel tips

  • Go to Saigon, Hanoi, Ha Long Bay, Sapa, Nha Trang, Hue and Dalat if at all possible. Take the train from Saigon to Hanoi, there's great scenery of rice paddies and hills and buffalos.
  • Don't drink the water or anything with ice, for this will end up with you hugging the toilet bowl, or worse, the squat toilet on the side of the road where the plumbing is a hole running down the mountain. FYI, a litre of water with one teaspoon of table salt and eight of sugar plus lime for flavour makes for a decent rehydration solution. Says Wikipedia, so it must be true.
  • Speaking of which, always bring your own supply of tissues and toilet paper. And work on your thigh and ankle muscles, you'll need em for squatting.
  • Do buy one of those face-mask type things that everyone wears. Helpful if you want to take a ride on a xe om ("hug taxi" - hop on the back of a motorbike and hold on for dear life. Quickest, cheapest, funnest, most lung-blackening and dangerous mode of travel). Also helpful if you're in the doctor's lounge in a hospital, and a senior surgeon is chain smoking in this small closed room with the windows shut, and you're too polite to leave. (PS. ERECTILE DYSFUNCTION!) If you're a smoker, this is your paradise.
  • Avoid raw vegetables and seafood if you're careful. Do try some of the street foods like sticky rice and noodle soups.
  • If you're on a tour and stop at a beach resort, remember to bring get your bathers from your suitcase, especially if the bus is parking 20 minutes away. Otherwise, an XXXL men's souvenir t-shirt will suffice, though beware of transparency and cling when wet. Whether you wear knickers with this ensemble is up to you - you need to make the choice between modesty in the ocean vs sitting on a bus for the next five hours with a wet bum - or commando. (hint: breezy!)
  • If you're an Asian girl, be prepared to be stared at like you're some kind mutant freak because of your Australian Weetbix-and-Vegemite-fed height ("are you a basketballer?" at 165cm!) - and, alas, girth.
  • If you're white, be prepared to be stared at like you're some kind of mutant freak...just because. And be prepared to be ripped off by every friendly-seeming local. There are actually different price lists printed for "international guests", and that's when they're being nice. Travel with a trusted local if you can. Take Vinasun taxis, they're the most reliable.
  • When you're feeling like a stranger in a strange, busy, hot, dirty land full of skinny little people who speak a language that's half familiar and half gobbledegook (racistpunlol), whose culture seems alien, and you are reduced to nodding and smiling like a dimwit bobblehead reassured that some things are the same everywhere. Anatomy. Hospital politics. The fact that surgeons wear those bandanna-like caps in theatre, while nurses and others wear the much less badass, but much more hygienic shower caps. The questions general surgeons always ask post-op: "have you been eating? pooing? peeing?".
  • If you're working in a hospital and you thought you knew Vietnamese, you don't. Buy a medical English-Viet dictionary. Curse yourself for learning a dead language for six years (no, not French! heh) instead of something useful. (ahh it was fun though)
  • You may want to reconsider going to Vietnam for a rotation if your patership is a very visible dissident in exile, because your host's pathologically jealous and delusional husband may follow her to a (chaste) nocturnal meeting with your uncle and accuse him of bringing news from patership with whom she's (falsely) alleged to be having an affair. Othello may then raid all of his wife's emails and mobile phone, call up her family and colleagues to badmouth her, change all the phone numbers in the house so no one can contact her, and forbid you to stay with them for you are the spawn of That Man. Worst of all, poor Des can't leave because if she does, he threatens to denounce her to the cops for her (non-existent) political connection with said armchair revolutionary - and people have been imprisoned for less in this land of justice and freedom for all (*cough*). Seriously, one of patership's colleagues - an Australian citizen! - was recently hauled in for questioning. Consider writing to the Australian embassy to explain the situation in case Grand Frere decides to mess with you or Des for shits and giggles.
  • An iPod or similar is a must if you're touring in a bus in which the driver plays Vietnamese folk music at full blast. Earplugs are recommended if you're staying in Saigon, because the blast of motorbike horns never stops, even in the middle of the night.
  • Wear sunscreen. Don't wear any precious jewellery or carry a handbag - try putting your stuff in a strong shopping bag. Keep a sharp eye on your belongings when on the move.

Monday, September 29, 2008

Just because I'm paranoid

...doesn't mean that the television isn't watching me!

For serious. Day 5 in VN and I'm wondering whether I'll have to get out by those same rickety boats. Man! All I wanted from this trip was to a) never enter a VN hospital lying down (and you thought the Australian public hospital system was bad...) and b) no melodrama of the hair-tearing variety.

One of the above is going well: I'm still standing, though mothership is currently undergoing the South (East Asia) Beach Diet...that's to say, massive gastro.

The other thing, not so great. My placement plans are in shambles due to a shitstorm that is some bizarre variation on Othello complete with misguided accusations of adultery and political intrigue. I'll write more when I can figure out how to protect the innocent. So far Desdemona hasn't copped it yet, but it's a possibility, and I could get dragged in as well.

Wednesday, September 24, 2008


Hello from Sydney Airport, waiting for the plane to Vietnam. Yes, already! I barely got off the plane from Airlie Beach!

Too brain-dead at the moment to think. More later from the behind the high walls of state-controlled internet! Woohoot. Can you believe I"m going back to the country from which my relatives had to flee in rickety boats, only thirty years ago? And am going to be living in the enemy capital? Then again I also learned the language of the foreign devil colonialists to tertiary level...while barely speaking  my alleged mother tongue. Irony lives!

Friday, September 19, 2008

Before and after

One thing I've been noticing lately is that I have to stop and concentrate hard to remember what it was like being a layperson. Did I know what a clavicle or myocardial infarction was? How lungs work? What viruses and bacteria are? A lady recently asked the doctor how you get oxygen into your blood, and a guy asked whether you can trace the source of bacteria from a swab. Certainly the fact that antibiotics are for bacteria only clicked in med school for me.

It goes further than just knowledge, though. It's being grossed out - or not - by certain things. I don't blink an eye at blood or guts or vaginas, but purulent wounds still make me go ick. Can't remember if I used to be affected by such things. It's how I feel about hospitals nowadays. For normals, they can be a place of fear and grief. The feelings of claustrophobia, displacement and unease from when my grandma was sick occasionally come back to me: all those depressing neon lights, haggard faces and barely masked smells. After Armidale though, I feel at home in hospitals - even theatre is now familiar and cool. They've become a place of learning, where we seek out interesting and fun experiences - and some of those interesting and fun things are other people's illnesses. Kinda twisted really. I've never been an inpatient before (except as a hairy-backed preemie), and I imagine it's got to be disorienting. I remember, in law we read some Foucault, about the parallels between hospital and prison. You're stripped of power, put in a uniform, your movement is restricted, you live by others' schedules, people do things to you which you mightn't fully understand or consent to, and you're surveyed day and night.

In politics one of my lecturers talked about how it's difficult for democracies to fight in asymmetrical wars because citizens generally aren't happy to send their sons off to commit the brutalities that are often unavoidable when you're fighting unconventional forces (NB: much is debatable there bien sur). Obviously, this theory was derived from Vietnam-type conflicts. The way around this is professional standing armies, as opposed to concripts. You separate citizens from civil society to a boot camp in the bush, teach them loyalty to each other and the institution, show them how to function in extreme circumstances.

I find this an apt analogy for med school, in particular clinical rotations. Besides the teaching of facts and skills, they help to transform us from wet-eared civvies into hard-assed troops. You learn the ethos, conventions, secret language, and see and perform things that would be considered horrors in other settings. Sticking a needle in someone's back or a finger in their bum. Cutting them open, exposing organs, then shoving everything back in again. Kinda absurd if you think about it. What's amazing is that this sort of initiation isn't uncommon. Nurses, undertakers, cops, firemen, carers, social workers, vets, soldiers, hell even dunny cleaners! Entire classes of otherwise normal people to whom weird-to-Joe-Average things are routine.

Some of the hardening is necessary of course. You can't have a doctor getting disgusted or freaked out every time they come across an anal abscess or something. But it's also a bit dehumanising, because dodging the discomfort of the situation also disconnects you from the patient's experience. I reckon it's a good thing to stand back once in a while and think, yeah, to normal people, this here is weird, embarassing, absurd, scary or gross. Like taking your own pulse, it tethers you back to your own humanity, the kid who lurks behind the professional.

Wednesday, September 17, 2008


In the waiting room:
"I've been having trouble with Bubba - he throws a tantrum and cries and spits when I try to breastfeed him!"
"Really? I've heard of babies that couldn't latch on well, but never one that actually hates breastfeeding..."
"Do you reckon it predicts whether he'll be a boob or butt man when he's grown up?"
More from Doc:
"All the Muslims want to take over the world and kill're not Muslim are you?"

He also wants to invade Mexico and to tell his friend Malcolm Turnbull (our new Liberal [actually conservative] opposition leader, FYI non-Aussies) to scrap "socialised medicine" cos it creates too much paperwork.

We also had a patient today who was a former SAS officer (the CIA apparently wanted to recruit him once). His theory is that Muslim society is afflicted by inbreeding and the recessive genes make tards who are recruited as martyrs.

Monday, September 15, 2008

Teo and tangents

So I just finished watching the Enough Rope interview with Maverick Neurosurgeon Charlie Teo. Thought-provoking stuff. If you don't know his background, read on at Australian Story and Enough Rope.

The name Charlie Teo first crossed my consciousness this year, when I met one of his patients during my rural GP week. She'd had a tumour on her spinal cord and was handballed between various surgeons who told her it was impossible to remove. None of them mentioned Teo, the surgeon who was willing to operate on the inoperable. They were finally referred to him when the tumour was far advanced. They got to him just in time to save her life, but she was already a quadriplegic at that point. This lady and her husband were fair dinkum Aussie Battlers, and I say that without irony. Her husband had his own health problems - chronic severe back pain, multiple injuries from past car accidents, and was visiting the GP with pneumonia, requiring hospitalisation - but still managed to care for her full time. Despite their ordeals, they were philosophical, not at all self-pitying, and deeply committed to each other in an unsentimental, no-nonsense way.

To me, the Outcast Teo vs Medical Fraternity fracas highlights the contradictions in our noble profession. Questioning the validity of Teo's techniques is justifiable, but the visceral hatred he seems to evoke from the establishment goes far beyond the scientific. It comes from something baser, something like insecurity and jealousy and resentment.

See, on one hand there are the bright lights - doctors who inspire with their integrity, passion, intellectual precision, curiosity, compassion, humility, dedication and conscientiousness. I've seen these qualities in doctors at all levels, from humble residents, to GPs, to consultants (ie. Gods). I see the potential in many of my fellow students. The docs I had in Armidale were awesome. Being a small hospital, the structure was really flat - consultants actually deigned to talk to us lowly students and treated us as really really really junior colleagues. And they could teach, hallelujah!

On the other hand, I'm always wondering what patients would think if they really knew what doctors are like backstage. They are given so much trust, and abuse of that trust is so commonplace. Not so much the Dr Evil "mutilating genitals during surgery for kicks" kind of thing, but insidious, small betrayals. Using big words to take advantage of patients' ignorance. Never, ever saying "I don't know". Making referrals to specialists who've been nice to you, or not making referrals to specialists who've slighted you once. Putting on a façade of professional reassurance, only to talk crap about them behind their back. Using bias-based, not evidence-based medicine. Blaming patients for depression or addiction. Being careless with infection control. Doing tests or procedures that aren't strictly necessary to cover your own ass or make a bigger buck. Never admitting mistakes. Writing off some patients as basket cases, too hard, or not worth the bother. Aiming for "good enough not to be sued" rather than best care. I could go on and on. And the personalities, god, the personalities. Impenetrable vanity, arrogance, selfishness, apathy, laziness, bullying. I mean, I'm sure these things occur in all professions - petty rivalries and so forth. But people's LIVES aren't at stake in other professions, people's lives don't depend on whether Dr X's pride has been wounded or not.

I'm on Flynnie placement yet again, and in moments of particularly brain-numbing boredom I fantasise about the scathing portrait of my boss' foibles I'm going to write. A by-product of observing him for most of my waking hours. Let me try to capture some of his flavour. Our protagonist is a late-40's American ex-surgeon, a footballer who injured himself out of a career in college, dressed in all-American blue jeans and polo shirts. Adopts a folksy straight-shooting manner but bullshits his way around questions he can't answer ("What's idioventricular mean? It's something that's not working like it's supposed to. Like idiopathic, idiosyncrasy, one of those old Greek word things"). FoxNews devotee, son of a blue-collar worker, now multi-millionaire, casually racist ("Med school was so hard back in the day that two guys from my class killed themselves. Just couldn't hack the pace. They were both Arabs from Pakistan or something. Good thing too. Those people are all terrorists in the making"). He's threatened by and contemptuous of anyone who dares question his authority by showing any knowledge about their condition or using alternative therapies . Starts lots of sentences with "In medicine...", eg. "In medicine, this is called a puritic [sic] rash". Writes referral letters with really bad spelling and grammar. Asks "guess what I'm thinking!" kinds of questions to show off his knowledge or exert his power rather than actually discussing or teaching. Is impervious to student's eyes glazing over during his lengthy Pearls O' Homegrown Wisdom About Medicine - which he repeats. A lot.

A recent consultation went like this. A gentle, child-of-hippies type of woman comes in with diarrhoea and constipation.
Her: I had a look on the internet...and I know I shouldn't try to self-diagnose, but I was wondering if it could possibly be IBS?
Doc: Impossible. Can't believe anything on the internet. Inflammatory Bowel Disease is a very serious condition and it is very unlikely you have it...(etc etc etc etc)
Me: Um. Didn't she mean Irritable Bowel Syndrome?
Her: Yes, that's it. So I tried some natural medicines they recommended at the shop over there...
Doc instantly bristles, patronises her ("Cactus extract? What kind of cactus? There are many many kinds of cactus"), contradicts everything she says, and boots her out. After she leaves, he launches into lecture mode.
That there was a good lesson for you. What they don't teach you nowadays in medical school, which they did back in the days when I was training, is that you should never, ever let the patient take control. You'll see. When you've had 30 years of experience like me, you find out all patients want to use and abuse you. They'll come in with some scrap they've found off the Google and try to sell you some bullshit. Like that girl just then, she just flung piles and piles of bullshit all over the room. I picked it up right away, as soon as she came in - I've got my observations honed to perfection, it'll take you 30 years to get that kind of skill. Cactus extract! You saw how she tried to get her agenda on, but no way, I don't stand for that shit. You gotta learn that you're the doctor and you're the boss. She's a massage therapist - probably flunked out of high school - and she wants to tell YOU what to do! (etc etc etc etc)
Somewhere, an artsy-fartsy tie-died hippy-dippy anatomy-sucks ethics-roolz Newie lecturer is weeping. To be fair, I don't want to completely vilify him. He's got his charm and is great with babies. He works up his patients really thoroughly and goes the extra mile for least the ones he likes. I can tolerate him...and occasionally learn a thing or two, though I now take whatever he says with a fistful of salt - he's quite capable of making up facts.

Praps I have this impossible ideal of Perfect Doctor - one that others, and no doubt I myself, will constantly fall short of. But the standard's got to be at least: "how would I like to be treated? what if it was my grandma?".

Tuesday, September 9, 2008


First you have to get through the negotiations. You introduce yourself as a student and exchange pleasantries and nervous jokes. You put on your shiniest Bedside Manner, perky and polite. Almost invariably, they consent with self-deprecating good nature. Everyone's got to learn some time, right? I'm happy to help if I can. Yes, thank you so much - I really appreciate it. If you feel uncomfortable at any time, please let me know and I'll stop. Your group and tutor are standing around you, sometimes participating in this exchange, but often just silent spectators at the show.

It's a shifting of power. Once you have given them the semblance of control, you proceed to command them to perform all sorts of bizarre manoeuvres. Could you take off your shirt, please? And would you mind if I pulled your pants down a little further? Is it ok if I put my hand here in your groin? This is someone who could be your grandmother's age, or your father's. In everyday life, you would perhaps nod at each other on a sidewalk, or if you met, you would defer to them as your elder and better. Now, circumstances have contrived that you both meet here, in this place of delicately balanced vulnerabilities. You have to get past your own anxious voices. Am I doing it wrong? Do they all think I'm a tard? Am I making it up, or do I really feel this? Am I hurting them? This is embarassing.

But when you're in the zone, when you've passed all the awkwardness and anxiety and come to focus, finally the physical examination becomes an oasis. The laying on of hands, the strict order of the tests and the calm solemnity recall the rituals of the ancients. Feel a pulse - make sure it is not your own. Put your hand on a heart. Listen. The room is quiet, the clatter of the hospital fades into the background, and all you can hear is the heart beat and breathing. A steady rhythm, almost music. One-two, one-two. It is a moment of strange intimacy.

Wednesday, July 23, 2008


Was that really less than a month ago that I was considering failure and running away and hiding? Btw I PASSED I PASSED I PASSED!!!! Victory is a little diminished by the suspicion that they wanted to pass us all because of the change in the curriculum. Whatever. The hell of academic semester is over.

Global Health Conference was full on. I can't remember the detailed stats about climate change and AIDS and the exact Millennium Development Goals, but I'm left with the troubling sense of the enormity of the challenges facing our generation, and the necessity of finding out how my own small life can fit in with the solutions. Nelson Mandela, that old fella, has a nice turn of phrase. It's all a bit overwhelming really...fuel crises, food crises, global warming, conflict, epidemics. It'd be easy to throw up your hands and succumb to fatalism, but as one of our speakers said, "we cannot afford the luxury of despair".

After that was Convention...a little ironic, after the heady inspirational rhetoric of global responsibility, to spend a week in drunken stupor and mindless hedonism. You know those Clubbing Montages in movies with the DUBDUBDUBDUBDUBDUB music and the flashy lights and jam-packed semi-naked bodies writhing rhythmically and making out and you go "pffft I'd rather be reading Jane"? Yeah. A week of that. Don't get me wrong, those nights were a blast in a "what inhibitions?!" kind of way (slightly afraid of and slightly looking forward to what photos surface on Facebook), but it's definitely a one-off for me.

There were other things. GP week was good. I didn't want to stab myself in the eye, the work of a rural GP is actually interesting and the area is one I can envision myself working in one day...although occasionally I do panic at the thought of the vast as-yet-unexplored wider world out there, countries I've never seen, whole classes of people I've never come in contact with. The peaceful country life appeals, but so too the call of adventure and worldliness that once made me want to be a languages, politics and law major aiming for DFAT or the UN or whatever the pipe dream of the moment was.

Anyway. My grandma is wise. Whether or not 2008 is actually celestially destined to be a good year, telling me that makes me determined to make it so.

Thursday, June 19, 2008


So my brilliant idea of cramweek, aka insantorium, was simply this: a blog about learning. One thing that I was procrastinating about leading up to these Exams O' Doom was how to do learn more efficiently and I came across heaps of different approaches - photoreading, memory pegs, holistic learning, etc, but there was no one resource collating all this. There are blogs for students, but I'd like to focus on the principles of learning and not crap like "sleep before the exam" (pshaw! overrated!). Interesting to me at least, and I'd hope to make it practical.

Will it actually happen? Perhaps. I'll check it out more carefully, see what's already in the field. Been reading up how to monetise blogs as well, and if I do venture out and do this, I want to start if off properly...and that involves learning about SEO (Search Engine Optimisation) and blog techie stuff (CSS and server management crapola) and marketing and all that.

I've recently realised that if I ever do write a book, it'd probably be non-fiction as, alack, I cannot plot and my visual imagination is pretty crap. This is a potential topic. And I've decided that writing a book is one of my life's goals. It doesn't even have to be published. I just want to have the satisfaction. That's the liberating thing about non-fic - it's not a matter of talent. Beyond being able to string sentences together and structuring things, which I believe I can do, it's just perseverance and discipline and finding the right questions to answer.

Damn it's uncomfortable to air ambitions in public, even with, what, 2 readers? This is idle speculation at this stage.

Tuesday, June 17, 2008

66.66% done!

Today I...
  • Had 3 hours sleep before my exam
  • Sat one of my first OSCAs where I had to actually TALK to PEOPLE which I was scared about because a) I have not talked to humans for like a whole week and b) my sex counselling video was a total disaster and c) hello I'm an INTP! I hate people! hehe
  • Was so nervous at some points I wanted to spew my Weetbix
  • Counselled a fake patient about their herpes test results. I am in love with my tutor right now, because she STRONGLY HINTED that Breaking Bad News would be on the exam, so I actually looked up how to do it and had a framework for what to talk about and was practising "sorry, I'm afraid the HIV test is positive" last night in fact (aloud to myself). It went better than I thought it would. Was grinning all the way out, probably just the adrenaline. But it was like....maybe I'm not actually not as inept as I'd thought. I can do this stuff. I can do people. I listened reflectively! I empathised! And it didn't feel too fake!
  • Completely blanked on how tiredness would relate to indigestion. Well actually the question was, "how would this change your thinking?" but I was too stuck on reflux to expand to cancer and systemic diseases and haemorrhage. STUPID!
  • Had to scurry from the main exam room to the counselling rooms twice. Felt so sorry for the year manager because it's a huge logistics nightmare..they had to shuffle students up and down the corridoor like ten times, and sometimes people were too dumb to realise it was their turn, or went over time. There were walkie talkies involved and they had to co-ordinate timing and stuff.
  • Took lollies from a stranger
  • Took free tea
  • Got into a car with an acquaintance on a whim, cos he asked if we wanted to go to lunch. The food was semi ok though we did have "what meat is this?" *taste* "I still can't tell" issues, but it was fun talking to people I don't know well.
  • Told a guy he reminded me of my seedy uncle. hahahaaha he so does. He's our The Todd...a wannabe beefcake, real Alpha Macho "I like beer and cars and guys who don't are faggots" type. So closeted. Hilarious though. He smokes! We just did lung cancer, emphysema, ERECTILE DYSFUNCTION, diabetes and osteoporosis, and he smokes!
  • Had to amuse myself on blank OSCA stations. I did half a sudoku and some word thing, but that somehow made me more stressed when I couldn't think of a three-letter colour ending in e, so gave up. Then I made a paper plane which I really wanted to fly, but that would probably be against the rules or something. So lots of the time I sat with my eyes closed and played air piano. That was calming. Also this breathing technique I learned from Mind Performance take deep tummy breaths in for 3 counts, hold for 3, out for 3. Stops the hyperventilation.
  • Surprised myself at being slightly disappointed that this guy I know has a girlfriend. I never thought of him as potential! Not that he's that attractive, he's just the nerdy semi-weird but nice type I'll probably end up with.
  • Wondered if the faculty made the questions less demanding this year because they don't want to fail anyone since they're changing the curriculum next year. They're dropping the Regional Rotation would you believe?! This is "We Need YOU to be a rural GP!" Newie we're talking about! And it's entirely for logistics not educational rationale. What a shame. The clinical stuff is, I hope, what will make us think of ourselves as Doctors to Be for the first time, and prepare us more for the real world than this "sit in a room for a week and cram" bit. Shame on you, Newie! This is partly a result of government policy I think. Making new places in med school sells well politically - "look, new doctors on the production line = totally the solution to the shortage!" - but there's the small matter of the hospital system accommodating for the extra training that we wide-eyed wet-behind-the-ears types need. And seriously? GP community placements won't cut it.
  • Practically danced out of the exam. Such a weight off my chest. The written parts were ok, and regardless, having the two OSCAs out of the way means this hell is almost over.
  • Asked someone how they coped with failing last year. I'm surprised at who fails. Some of them are obvious slacker "I accidentally got into medicine" types, but then there are also the really studious and serious Malaysians, as well as the outgoing and at least verbally impressive types who teach anatomy and stuff.
Ahhh. Such a turnaround from last week. Some of the conclusions I drew then are still true, but I'm on less of an emotional hair trigger now. There is hope. There is life beyond Wednesday. This career is not a trap.

Holyfuckingshit, if I pass these exams, I am HALF A DOCTOR. Or at least half an intern. Dr T-Dizzle. Snort.

Sunday, June 15, 2008


A portrait of a nervous breakdown. In the past week, I....
  • Attempted to cram: dermatology, ophthalmology, diabetes, endocrinology, hepatology, nephrology, orthopaedics, immunology, infectious diseases, cardiology, neurology, respirology, rheumatology
  • Burst into tears multiple times, including weeping at the piano
  • Seriously contemplated skipping the joint and running away to do volunteer English teaching in South America, to Find Myself and fucking rebel for the point of wondering how I can get a debit card and what kind of camping gear I need
  • Stayed up til 6-7am
  • Studied in bed, in the bathroom, in the kitchen, on the dining table
  • Did not do any exercise beyond going downstairs for food
  • Read about 1000000 pages of notes and realised just how many lectures I napped in...the handwriting would start off impeccable and then deteriorate to scribbles by the end, heh
  • Relived some of my and Ru's intra-lecture exchanges via our margin graffiti
  • Thought about what I wish I'd told my first-year self: 1) from the beginning approach med as if you were gearing up for the physician's exam, to be a Real Doctor...rather than studenty "I just wanna know enough to pass" or "this isn't on the curriculum" attitude, 2) COLOURFUL PENS and highlighters make a world of difference to how much you feel like studying....typed notes in table format are boring, 3) reading up BEFORE the week starts makes you feel smart and feeling smart makes you study more and studying more actually makes you smarter.
  • Drank a LOT of Irish Breakfast, English Afternoon and Earl Grey tea
  • Obviously peed a lot
  • Wondered if I should take the USMLE boards just to solidify my knowledge in the basic sciences
  • Learned that apparently bee venom is good for fatigue in MS
  • Wore the same clothes for about 4 days straight
  • Undressed to go to shower only to realise that my mum had set the house alarm and had to run downstairs, redressing on the way, to turn it off
  • Practicised that Granados Oriental piece a bazillion times. Still got to do the middle bit, but am getting pretty good at the first bit except for that fiddly trill
  • Did not leave the house for an entire week
  • Drank about 12 boxes of lactose free chocolate milk (not that I'm intolerant, it was just free at the GP convention)
  • Hit my head against desk
  • Snapped at my mother
  • Talked to myself, a lot
  • Ate a lot of mandarins and bagels
  • Wondered if Jerry blogging was a three-year cry for help
  • Invented retarded mnemonics like "quatre femmes sit on your lap doing high kicks" (quadriceps, femoral nerve, anterior thigh, extension) (ok, I'm actually proud of that one. the stupid ones are the ones that I make up and then promptly forget)
  • Realised that I hate medicine and the only things stopping me from ditching it are 1) debt - this bonded thing is a MORTGAGE ON MY SOUL, 2) all these textbooks going to waste, 3) my grandma would be really sad
  • Realised I actually enjoy some of medicine and want to be good at it and in my dream "running away to S. America" scenario I'd bring my OHCM
  • Discovered that I like pathology (though not the microscope aspects, the mechanisms) and microbiology (cos bugs have identities) and immunology (very logical, fits warfare metaphors well). I hate rote rote rote learning anatomy and drug names
  • Went outside at 5am, thought about jumping in the pool with my pyjamas on
  • Considered my extra-academic marketable skills and came up with...diddly squat. Well I can type, write ok, speak French halfarsedly.
  • Prayed to, and railed at, god...who, by the way, hates humanity, going by some of the horrendous diseases I've seen
  • Did nothing but eat, drink, poo, pee and study for days on end
  • Told myself I'm a fucking idiot because I'm 22 and all I've done is study and I'm going to fail at that which means I fail at life
  • Realised that failure could be liberating and motivating and a Life Experience because I've had it all my way til now...a test of character
  • Napped on the floor of my study
  • Decided I need a life: closer friends, diverse interests, a job, LOVE SWEET LOVIN'
  • But decided I'm not really ready for the latter til I'm totally happy with who I am, which is not yet
  • Realised that I have never strayed from the path of least resistance in my life -- never made an autonomous choice, never acted against the destiny set out by my milieu (school, uni, make money, consume)
  • Was cheered by reading silly forum posts on the internet
  • Helped a friend do her job application letter
  • Wondered, in the darkest depths of 5am self-pity, who I could call for Listen&Support at such an insane hour...but as always, kept myself to myself
  • Got really excited about a potential new blogging project and procrastinated for a bit drafting up ideas and posts and thought about how I could even maybe turn it into a book
  • Woke up the next day and reconsidered it and thought it's probably stupid
  • Wrote half a post about how my family is totally fucked - >80% divorce rate, some multiple. Also realised I have no blood aunts! Well only one, but she's estranged.
  • Tried to meditate
  • Realised that this is all bloody self-indulgent and melodramatic because I have had it so damn easy: parents and grandparents who love me, money, education, health, opportunity...a giant big fat cushion of privilege...not that it was much comfort at the time
  • Realised that one day I'd look back and laugh in disdain at myself for thinking that THIS was stress
  • Was told by my grandma that according to astrology this year is meant to be a good one for me....hahahahaahahahaha right.
Phew. Catharsis.

Friday, May 16, 2008


And possibly fingerworm as well, I just spent an age digging up a free score for this piece. Tis Granados, Danza Española No. 2, Oriental. It kills me.

Piano: the first one I found was by this 11 year-old girl. While it's prolly a bit less polished than this other woman's version, I love how she's really into it. Also, dudes, 11.


It's great being able to compare versions on different instruments. I reckon the guitar one is more romantic and soulful, cos they make up for the instrument's relatively limited dynamic range with sensitive phrasing and flexible timing. Or something. I'm only just beginning to work on my classical ear after x million years/dollars of music tuition. The slides on the guitar make it more lyrical as well. Sigh.

Why is this piece so familiar and haunting? I have a feeling it's from a movie. Godfather? I've definitely heard it before. Only came upon the title by chance, listening to ABC Classic FM: Up Insanely Late. Digging that channel lately. In my car I've got it programmed along with Triple J and Today FM. In company the cooler ones are chosen; alone I wind down the windows and blast me some harp action.

PS for Chris: I SAW A MOUSE IN MY ROOM!!! The first time it was exiting. The second time it was coming in. Errrr.

Tuesday, May 6, 2008

Candles and other obvious metaphors

So, radio silence.

What I haven't been saying here, or rather what I've been saying by not saying anything here (are we following?), is how I'm terrified that med is not my One True Vocation and that I'm going to turn out to be a incompetent doctor, bitter and resentful at how it's taken up my life.

I think it's partly because of our lack of clinical stuff this year so far, with hardly any patient contact. Buried beneath the books, the weekly grind of Working Problems, it's easy to lose sight of where it's all leading. I fear that I still don't own medicine; being a student doctor isn't part of my identity. Compare this with learning French- it is a part of me, it was my passion (at least for a while). Whereas with med, part of me is standing to the side, half amazed at what knowledge I have managed to pick up, half bemused and terrified at the thought of one day being Dr Tina. Who, me? What a ridiculous notion. With my heart not really in it, I was afraid that I would be a half-ass doctor, knowing just enough to get by, fooling the less critical of my patients. And that's just not what I want out of life; I want to be brilliant at what I do, passionate, absorbed. Sure there are doctors who can do other things at the same time, like my hero Oliver Sacks, the great neurologist who's written about things as diverse as music and botany. But I don't have that kind of protean genius; I know that just getting to grips with the mountains of med knowledge will take up most of my efforts, leaving my other interests by the wayside.

Also, med frustrates my desire for creativity and Making a Difference. You're at the coal face, applying other people's technologies and research, with your impact being limited to the patient in front of you, basically working as an algorithm-churning machine. Yes, it is a noble and important job and satisfying in its way, too. But it's constrained. The scientist who invents a new vaccine, the politician who brings in universal health care, the teacher who shapes a class-full of young minds...that's how you multiply your impact. Yeah I realise how grandiose and naive that sounds. I know my limitations, but I want to use what I've got for the greatest effect and satisfaction.

In short, I felt trapped. Trapped by the 5 years I've already spent at uni, the $100k debt, the expectations of family, the 5 years of Bonded practice and at least 7 years of advanced training awaiting me. So I've been idly surfing for alternative lives. An English-for-foreigners teaching diploma, a correspondence course for a Grad Dip Psychology.

These worries have been sloshing around for months now, and I never thought to speak them to anyone. It's taboo. Then yesterday had a chat with Chris. A light of hope! She told me that she too has doubts about clinical med being her life's work. I'm not alone. She's interested in business, finding a niche to fulfill future healthcare needs. Now that is exciting stuff, where new ideas are possible. She wants a non-profit branch to her biz too, and suggested that I be part of that, doing some kind of travelling medico-journalism kinda thing. What a pipe dream, what perfection! It's so obvious. One of my main objections to Being a Writer (ooh la la) is that I'm crap at making up stories. But lo, there are many stories in med. As I was reminded today- we had a palliative care placement, and oh how it was lovely talking to a patient. With 10 years of cancer but still seemingly well, he told us about his love for the bush and his career as a forrester, his worldwide travel, his passion for Schubert and art. In fact he's going to Sydney tomorrow to buy a Schubert CD of the most beautiful piece ever, he says. So among my notes about his medical history of hip replacements and diabetes is a citation for Piano Sonata in B flat, D960. Have a listen (I downloaded the Lipkin one). I dunno about "best evah", but it sure is beautiful, especially the second movement. For Friday I've volunteered to be the one quizzing him about the psychospiritual stuff (what a silly term for "what do you think about dying?").

Whether or not these are impossible dreams, suddenly the trap seems less deathly tight. The inevitable bitter end - haggard repressed half-assed GP - doesn't have to be that. There's something to work towards and hope for. I'm reminded how I convinced myself to get into med in the first place and it doesn't seem quite so self-delusional- that people and their stories are pretty damn awesome.

Now for the "study and pass" bit.

Tuesday, April 29, 2008

Neurosis alert

Current stressors:
  • EXAMS IN 7 WEEKS. 10 weeks' work to catch up on. Motivation level: subterranean. The exams are on 3 consecutive days which translates to: pass the razor. Small consolation is that I get to see Phantom after all- accidentally booked it during exam period, but luckily we will have finished by then.
  • Recurring doubts about What The Flying Fluck I am doing in this course. Why did I ever say I wanted a challenge? How did I ever convince myself this was my vocation when as a kid my ambitions included psychology, anthropology, journalism, language teaching, &c &c but NEVER EVER medicine?! How did I even get admitted? Still waiting for the letter that says "Just kidding. *BOOT*".
  • HES project. I've got a supervisor lined up, but he's a frigging big shot lecturer and epidemiological researcher. His field is exactly what HES is meant to be about. Seems like a nice guy too. One problem. He wants me to do publication-level research! Which is cool except for the fact that the last time I did field research was...........NEVER. Know jackshit about it.
  • HES in Vietnam. I'll be staying with a family friend previously mentioned. I'm stressed out about all the etiquette and language barriers cos this is in the very politesse-conscious North. I'm afraid I will use the wrong honorific for some Head Honcho, thus condemning my host to social exile and and bringing SHAME AND HELLFIRE upon seventeen generations of my ancestors and progeny who will spit on my grave!! I will also be a small lonesome English-speaking island wanting my mummy, in an ocean of streetsmart Vietnamese who eat Australian-Vietnamese Traitors for breakfast. Why oh why didn't I go to Viet school? Should've known. Blood will out. And how come at 22 I'm still not self-sufficient or confident or grown up yet? Hurry up already.

Ok feeling better now.

Monday, March 31, 2008

The Seed

The things I suffer for other people's art. On Saturday, I had to wake up in the MORNING (gasp! 9am) to take the 2.5 hour train to Central station. From there I had to lug my overstuffed bright green backpack like a studious turtle over to the Belvoir St Theatre. All this to see the second-last performance of an Australian play, my first without any Big Names or familiar authors as risk-mitigation.

Totally. Freaking. Worth it.

It was The Seed by Kate Mulvany, a semi-autobiographical play about an Australian ex-journo-turned-aspiring-writer-(the-real-kind), Rosie, who goes to Ireland with her Vietnam veteran father to meet her ex-IRA grandfather. The playwright is also the lead actress playing her barely-fictional self. This isn't a big-R review, so go elsewhere for the plot synopsis. There are several spoilers that aren't included out, cos I'm going to blow it for you. Basically, the dad got hit with Agent Orange which meant that he and the mum had four miscarriages before Rosie...who was born with kidney cancer, the treatment for which made her unable to have children. Her fiancé's just left her because of that. The other big reveal is about the grandpa. Throughout the play he paints himself as a devoted bomb-maker for the IRA, regaling them with stories of how many English pigs he's killed. But in the end it turns out that it was all a myth, that the "meetings" were just drinks at the pub with his mates and that the fundraised money was spent on the bookies. His lifelong lie had sown a (lo!) seed of guilt in his son for deserting his family and The Cause, driving him to Vietnam to prove himself. Dominoes and reverberations.

I laughed, I was sucked into the story, I blinked a whole damn lot. Kinda embarrassing when you're in the front row and one of the actors seems to be staring right at you. The emotion lingered for hours afterwards and I'm still thinking about it today - that's how I measure the impact of a play. Wanted to give a standing ovation at the end but, well, again with the self-conscious front-row squirmies.

Of course being a INTP equivocator type, I had to find some flaws with it as well. Can't let pure emotion go unchallenged by nitpicky thought! The "VN war = bad....just like IRAQ" thing was a little heavyhanded. You don't need to convince me that war is bad, you only have to do it elegantly. "What the fock is Agent Orange?!" and the list of PTSD symptoms were like being hit on the head with a giant expository hammer. The drama of the final confrontation flagged a bit - can't put my finger on the reason - and a reference to old and new, literal and figurative scars was a tad obvious at the end.

On the other hand, most of the writing was gorgeous. Occasionally in between the segments of family reunion dialogue, there are bits of monologue by the author-as-herself about a crayfishing trip with her father as a kid. There was a moment about how her father pulled the ropes to lift the pot as if he were dancing with himself. Mulvany's reading is dream-like as she acts out the hypnotising motion...omg. I won't forget that soon. What did Tom Stoppard say about moments that transcend text? That was one of them, even though it was so verbal. The other bit that made me sniffle like crazy was when Rosie tells her grandfather she can't have children (after his long spiel about how Malloney women are made to be mothers). She says maybe she doesn't deserve them and rips into this speech about the envy, rage and desire that she has when she sees pregnant women and soon-to-be fathers and babies. The violence and spite shock you, the wrenching yearning draws the blinkage. It is so painfully raw, made more so by the realisation that maybe this is the actress/writer speaking from her own experience. Chills, man. It takes real balls to put yourself on the line like that, and everybody appreciated it.

It's definitely nudging the top ranks on my "Theatre Bests" list, even accounting for recency bias. See if I was a real reviewer I'd end this with a crappy extension of the seed metaphor, blooms and trees or something, but instead I'm just going to brush my teeth and go to bed.

PS. I have this ultra-sexist crackpot theory that while men may be better at writing about great ideas and the sweep of history &c, women, even authors of teen fiction and other low-brow genres, are better at psychological and emotional realism. I mean much as I revere Sir Tom, with his piercing, crystalline turns of phrase, sometimes his characters' changes in mood are abrupt and seem contrived. Victor Hugo was one of my favourites as a teen, but a couple of dudes in Les Mis are impossibly saintly or heroic or villainous. Michael Ondaatje's English Patient is beautifully poetic but strange; people do inexplicable things and they all talk in this oblique manner. For shiz this is gross over-generalisation - Henry James' Washington Square was a masterpiece in minutely detailed character development. Emphasis on the "crackpot" part of the theory.

PPS. AMSA, you suck.

PPPS. My grammer and speling also suck. Fer shame.

Friday, March 21, 2008

Who's got the map?

"We need wit and courage to make our way while our way is making us."
- Salvage, Stoppard
Spoken about historical necessity, but also conveniently applicable to this one small life. Not blogging lately because everything comes out in angst. Who am I? Where am I going? Who stole my socks?

Thursday, February 28, 2008

Cut-loss week

My second "shouldn't have gotten out of bed this morning" day this week. On Tuesday I was going to go swimming so drove to uni instead of walking, only to circle the campus for half an hour in fruitless search for a parking spot with the petrol meter already in the red. Then decided to screw it and went to find fuel. The first place I went to, as bad luck would have it, was completely out, so had to cross the suburb to fill up. The punchline? Couldn't have gone swimming anyway, because there was a school carnival on that day at the pool. I managed to tun the day around by treating myself to an icecream - panacea! - and it was actually quite productive study-wise.

Today we had a derm clinic: utter waste of time. There were about two patients in two hours. We ended up getting taught stuff off the internet, no joke. And got my first taste of hardcore pimpage from this toolish Viet reg who quizzed us on all the obscure immunomodulator drugs you can use on BCC's while he cut one out of a lady's neck. The other reg, on the other hand, was the one who had given us a lecture yesterday, and he only expected us to know how to identify macules, papules, etc etc. when we split up I made sure to be in the latter's group! Har.

Luckily we got to leave early so did a bit of study in the library and got a gross but cheapo lunch from the subterranean caf. Whose idea was it, by the way, to put the poor paeds wards underground, circles-of-hell style? Then left to drive to the city where they randomly scheduled two lectures. Foiled by bearshit again, this time in the form of a frigging monsoon. Guess who didn't bring an umbrella? And wore a white shirt? And got soaked down to her unmentionables? Gah. The car was no refuge either as could hardly see through the fogged-up windows and had to drive illegally sans glasses because they made my vision even worse. Was gung-ho at first and was going to soldier on to the lectures but finally decided that listening to two dudes read off Powerpoint slides wasn't worth indecent exposure, pneumonia, or a ten car pileup.

IV icecream please.

Wednesday, February 27, 2008

Why there will never be Grey's Anatomy: The Med School Years

Actual conversation today.
R: So what did you do yesterday?
Me: Mmmm nothing much. Studied. You?
R: Meh, same.

[5 minutes later]

Me: Any plans for tonight?
R: Study probably. You?
Me: Yeah, gotta cram for derm tute tomorrow.
The glamorous lives of medkids, ladies and gentlemen. Where is the sex in anatomy labs I was promised?!

This is just in case you were wondering why the posts about the actual process of aquackening are rather sparse here. Want to hear about, um, the textbook I read yesterday? Ophthalmology Made Ridiculously Simple, if you must know. Don't mock, it covered 90% of the stuff we got in lectures today. I bite my thumb at fat textbooks. Why get bogged down in detail when a skinny book with cartoons can tell you the basic essentials like: don't press on a possibly burst eyeball, for that will make the goo come out. Good to know.

Ophthalmology week has been pretty interesting actually. I like the anatomy and physiology of it, probably because we did heaps of vision stuff in psychology so it mostly makes sense. Briefly wondered why I didn't do optometry and then remembered that their whole job seems to be "now which lens is better, one or two? two or three? three or four? four or should I go with the gas oven or the razor blades?". Wouldn't mind ophthalm as a job except for the apparently crazy competition to get in...who's got that much ambition? The ophthalm lecturers we've seen so far seem cool. I've decided that I will probably choose my specialty based on whether I like the type of people who are in it. it is!

(cut to: Satan getting frostbite)

Monday, February 25, 2008

Why this blog is like safety scissors

It has no point.

(Do I see eyes rolling?)

Anywho. So there's been this story/play idea rumbling around ever since Vietnam, based on a family I met. I've talked about the wife (H) a bit before here, she's the doctor and "family friend" who saved us from evil Bac Q's house in Hanoi. She won us all over, including my mum, who isn't the easiest to please, with her sweet disposition and gracious hosting. I was intrigued by her.

On the surface, especially in public settings with parents and elders around, she's the perfect well-bred Vietnamese lady. Considerate to a fault, always tends to other people's needs, says all the right things- lavish with praise, slow to criticise, self-deprecating. For example, my dad mentioned once or twice that he had trouble sleeping, so she bought him some herbal sleeping tablets for me to bring back to Australia. I found myself taking everything she said with a grain of salt because she took so much care not to hurt anyone's feelings that white lies weren't beyond her, like saying how much she loved our crappy presents.

Besides this Jane Bennet aspect, there's some Lizzy as well, in her quick-eyed observation, an instantaneous understanding of people and situations. The first time she came to meet us, my mum grabbed her in the alley moments after she arrived and told her to pretend to be my aunt to simplify things with Bac Q's family. Once inside, she understood immediately how to play along, and how her Specialist Doctor Aunt label would give us a boost in that status-conscious household/hell-hole where we were lower than dirt. Also Lizzyish is her lively, occasionally cheeky wit. I got to see more of this the day we went to hospital together. In our halting half-English half-Viet we managed to joke around a bit- I teased her for being so paranoid that she made me call my (pro-democracy shitstirrer) dad from a phone booth instead of from home, for fear of Big Brother; she jokingly asked whether I wanted to shoot her for being a puppet of the Commie state, as a government-employed doctor. That day was strange, because we kept shifting from egalitarian English to tortuous etiquette-bound Viet, from student-teacher roles to guest-host to joshing equals. Stressful but interesting. Though I appreciate observant and sharp-minded people, it's so much easier dealing with the thickheaded ones who don't notice all your gaucheness!

The comme-il-faut manners, the gentle tact, the lively eye and humour - these are still the outer layers of the onion. As the day progressed and she grew more tired and strained, I noticed impatience, though of course not with me. With her housekeeper, daughter, husband and mother she had a quietly sharp tongue. In this setting she's no longer the demure hostess, but the exacting head of the household. Underlying these contradictions - or are they really? - there is a deep sadness.

See, the reason we know her is through my uncle L. She came to Australia for a 6 month study visit last year and somehow befriended L. It was a weird relationship. He was estranged from his unfaithful wife at the time. H too was apparently in an unhappy marriage. According to my grandma, husband and wife lived on different floors, just staying in the same house for appearance's sake, and for their 7 year-old daughter TH. When H and L came over to my grandparents' house, they acted like lovers, flirting and joking. I assumed she was his girlfriend. Everyone accepted that. Although before we went to Vietnam L's wife had returned - somewhere in the bargain a new car was included! their sorry story will have to be told another time - the understanding was that H was still kindasorta his girlfriend. I admit I judged them a bit for that, she had a little kid and husband, he a wife, what were they thinking?! Though the "internally separated" explanation on her part seemed fair enough, and the husband and kid were only abstract concepts.

It was seeing H in her world that made the tragedy and complexity of the situation more real to me. They live in this perfect display-room house, with modcons and luxuries impressive even by Western standards, staff to take care of everything. Her husband T is a high-level engineer for the state. A sophisticated, soft-spoken, gentle-mannered man, he would appear to be a good match for H. Their daughter TH is precocious, whip-smart, destined to follow in her parents' high-achieving footsteps. From the outside they look like a model upper bourgeoisie family. The only thing missing in this picture? Love. Well it is there, but only for the daughter, which is probably why she's spoiled rotten. I think TH may not even know that her parents are semi-separated; they still go on family outings together and everything. You have to squint to spot the cracks. It's in how H and T call each other "Mother" and "Father" instead of the standard "Anh/Em" endearments, how they never touch or joke or speak to each other except about practical matters- Stepdork and mum looked like lovebirds in comparison, holding hands, feeding each other, scolding. But this is on close observation; otherwise, it's an unnervingly smooth pretense.

I see now why H went for my uncle, with his boyish mischievous charm and rough romance. It's also clear why she likes my family and is in regular contact with my grandma and dad. Despite our Bac Ky origins, we've adopted the frank and direct style of the South, so different from the frigid Northern politesse that rules in her house. At our dinner table everyone talks and debates politics and jokes, food is passed to and fro, and even with my crazy grandpa stirring trouble and my uncle's abrasive teasing it's warm and lively. In contrast, I imagine meals are a lonely time for H and T, as TH eats alone with her nanny and the parents both work late.

My grandma said that H's parents had divorced and she had suffered greatly for it, which is why she won't split with T. Grandma has advised her that she's doing the right thing by staying with him for TH's sake, giving her a stable environment. I don't agree. My uncle in Canada did the same thing - stayed in the same house with his ex until his kids were in uni. The last time I met him he was bitter and disillusioned. At 50-odd, he had nothing: no one to grow old with, kids he thought ungrateful and disobedient, his assets chipped away by a war-of-attrition divorce settlement case. And who's to say that having two parents in the house is going to make the kid any better adjusted? Bearing the burden of guilt later on, not having an example of a happy relationship, being stifled by love that has no other conduit...that can't be good for a kid. For all the dark twistyness and slow-healing scars, both parents and I are better off after their divorce I reckon. Look at how normal and well-adjusted I am! (spluttersnort). No but according to grandma, there are other barriers to H and T's divorce as well - something to do with losing face and lessening of a woman's worth. Even worse reasons, to my banana mind...though I can see how divorce would seem an ugly black mark and a failure to H, who's worked so hard for perfection or at least the appearance of it.

It's vaguely obscene to plunder someone's life for a story, but I can't help imagining how it'd play out - it's so inherently dramatic and tragic. Our layered heroine in her tangled dilemma - mother vs woman; an apparently idyllic family that is a sham; two lovely, lonely people seemingly so well suited, unable to live happily together, unable to break away to make their own lives. Is a happy ending even possible? In literature the poor woman always seems to shoot herself or go under a train or something. But just as terrible would be the more realistic end: long years of status quo, resignation, unfulfillment, bitterness. They both deserve more.