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.

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 them...at 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?".

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 Hacks...you 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.

Rosebush

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 once.....to 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.

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.

Nam

Sweet jeebus it's great to be home. So, so many stories to tell, I'm a bit overwhelmed by it all. Never fear, trusty unordered listage to the rescue!

The Good

• Langkawi. I spent whole days lazing by the pool reading (The Kite Runner, thanks Chris' brother) and occasionally going for a dip. Gorgeous wide beach, not too overrun with tourists.
  
• Cheapass and delicious Malaysian cuisine. Roti canai, Rotiboy buns, ice kachang, teh tarik, coconut, fruit smoothies and juice.
  
• Cheapass Vietnamese food and drink.Best was banh mi thit (at Saigon's famous Nhu Lan bakery).
• More cheapness: got a stack of fake Moleskines notebooks and sketchbooks, stationery, drawing pencils, some medbooks and a supply of DVDs to last me the whole year and then some. West Wing here I come!
• A lot of fodder for an Amy Tan-esque novel that will never be written, about the flaming batshit that is Vietnamese family life.
  
• My Viet improved. I was thinking in Viet and even managed to write a letter (unsent) even if I managed to misspell "I" every single time, frigging diacritics. Remind me to bitch some time about the ridiculous grammatical caste system whereby there are no fixed personal pronouns so that at EVERY SINGLE ENCOUNTER you have to work out your interlocutor's age and status relative to yourself and thus a simple question like "can you please pass me a pen" turns into a tongue-tying etiquette death trap.
• Bonded with the mothership against common enemies. We're a team. I realised that for all the usual mother-daughter bickering, I'm fiercely loyal to her and vice versa.
  
• Motorbike rides, baby! Too bad that they've just brought in helmet laws meaning that my hair doesn't get to blow sexily in the polluted wind.
• Met some lovely people. Primo, Co H, a family friend of sorts, who gave me a personal guided tour of a Hanoi hospital and sheltered the five of us when we were kicked out of / ran screaming from Bac Q's house. I like her a lot - spirited, very sweet, with a cheeky humour. She was an almost painfully thoughtful and considerate hostess so that I was slightly stressed out at being on my best behaviour the whole time. Her husband Chu T was sweet as well. Probably will write more about them later - intricate and sad family circumstances. There was also Bac T's family in Hanoi. He gave me another hospital tour and kept teasing me in his incomprehensible northern accent. A good-natured bloke - I think he might be useful in dad's pro-democracy work. He's Everyman, made some astute and witty jokes about the political sitch. In Saigon there was the orthopaedic surgeon who took me to yet another hospital and patiently taught me how to stab people with sharp things. Basically did more hands-on meddy stuff in two days than in the whole of last year. Plenty of nice nurses there too who each taught me their own special technique, thoroughly confusing this hapless medkid. There's quite an art to getting drugs out of an ampoule I tell ya. Also in Saigon was another Bac T, an anaesthetist and Stepdork's childhood friend. Jolly and straightforward, such a change from the poisonous peoples in Hanoi (below).
  
• Personal Growth. Learned plenty about my own numerous flaws (temper, acid tongue, impenetrable reserve, selfishness, etc etc) and hidden strengths (2008 = Tina takes no more shit year). Learned what kind of person I respect and want to be like (see above), and what kind of person I have to avoid becoming (see below).
  

The Bad

• The initial awkward icy silence between me and the stepsisters. It lasted more than a week, but through our shared misadventures it's now thawed to a warmer truce. Not BFFs by a long way, but we can trade the odd joke or comment.
• Learned to give injections ie. caused already sick people more pain by my clumsiness. Oh and managed to spill some poor patients' meds and make a mess. Worse still though, was how I found my compassion gland switching off. I couldn't see every single person as an individual human being - there were so many, with such horrific injuries (ortho ward), and there was the language barrier, and they just lay there passively. Not that any of that is an excuse. I didn't engage with them, I broke every rule of bedside manner that Newie has so carefully taught.
  
• I'm a generally chilled out person, but somehow the stress of travel and family political bullshit reset my baseline mood to a constant pissed-offness, sometimes elevating to full-blown stinking rage to the point where I'm imagining smashing brick walls with a baseball bat and/or running into traffic.
• Vietnam bathrooms. It's called SHOWER CURTAINS people!! A piece of plastic to stop the water splashing everywhere so you don't get a wet ass every time you go to the toilet! It's not rocket science!
• Bac Ky (Northern Vietnamese) politesse. Related to the stupid pronouns above and also other linguistic formalities like forms of greeting and polite phrasing. But extends to how people are judged by their status - wealth, family position, education, age - and then treated accordingly (ie. like shit, if you aren't deemed worthy). It's bloody mediaeval. Even the nice northern people freaked me out with their politeness. God bless the frankness of English. NB. My paternal side is from the north but moved south after 1954 (fall of the French); my dad has never even been to Hanoi.
  
• Vietnam street juice ie. the dodgy patches of wetness on the street that are a mere centimeter of plastic from parts of my body. Definitely not pure water either - one time we caught a dog nonchalantly pissing in the middle of the pavement.
• Vietnam crowdedness and rule of the jungle. Spent Christmas eve in the middle of a throng of motorbikes and pollution. You risk your life every time you cross the street. You're a target for pickpockets and cheats wherever you go. Stepdork got his pants pocket slit (nothing important was in it) and at Saigon airport, the taxi registry guy stuck his hand into Stepdork's backpack and stole our camera! Huge screaming match shitball. Luckily mum had the presence of mind to look under the taxi and found the camera where he'd ditched it upon hearing Stepdork accuse him. This was about 15 minutes after we'd touched down in Saigon.
  

The Fugly

• Staying with Bac Q in Hanoi. Oh my flord. I never knew there could be so many incredibly duckwitted jerks in one family. I thought Chu H, Stepdork's brother in Sydney, was bad enough. His mental age is about 13. He's a doctor, "just a GP" but has made shitloads of money and lets everyone know about it. Buys (and boasts about) the most expensive of everything- he gives his kids Louis Vuitton bags and $20k first class plane tickets and zero parenting or attention. I've watched him for ten years and have never seen him show any evidence of thinking about anyone but himself. BUT WAIT, THERE'S WORSE. Bac Q. He's Stepdork's 60+yo cousin and a former maths professor. Oh my god. I had a bad first impression as soon as we came in- barely a nod of welcome. I started disliking him when in his first conversation with my mother he asked her point blank "what do you do? I mean, what did you study at university? what do you mean, you didn't even go to university?!". I left the room at that point. I started hating him when he started to patronise her while at the same time bossing her around the kitchen and telling her off like she was his servant or a child. This is my mum, who can turn men to quivering jelly by the mere force of her glare! And my contempt for him was cemented when he made a speech on his wife's birthday. A masterpiece of vanity. He managed to spare about two sentences to grandiloquise about her virtues and then proceeded to talk for twenty minutes about his own qualifications and the glory of his family line. He actually brought out the equivalent of a Viet Cong Who's Who and pointed out his father's entry and then catalogued all his children's academic achievements and the dollar value of his properties. I didn't know whether to laugh or bash my head into a wall. In fact Stepdork was filming the occasion and thinking it was our video camera, I pulled magnificent faces and eye-rolls - only to find out later that it was Bac Q's vidcam! Apparently he thought I didn't understand Viet and was just bored at the length of the speech. If only he knew. Even more contemptible was how there was an abrupt about-face in how he treated me and mum after he found out that my "aunt" (Co H) was a cardiologist and that I was a med student. How he started fawning then. There's more to the Bac Q story that lead to us fleeing his house, let's save that for next time.
  
• Ba Noi (stepgrandmother). Or, as I like to call her, B-I-T-C-H (to the tune of "Bingo was his name-o"). Dominates her husband and treats him like an infant- she actually forbade him to go get a coffee when he'd already gotten his coat and was almost at a door. "You won't be able to sleep so you will get skinny and then everyone will think you're a drug addict! And who will suffer? ME! Everyone will laugh at ME! How dare you be so selfish!" He's this gentle, quiet, harmless little man for whom coffee is the only escape from the witch. The worst was when we were leaving - both Bac Q AND she had to do some more speechifying. In her bit she repeated the whole "oh HOW I HAVE SUFFERED because of my husband" spiel again and then added a dig at my mum, who had taken pity on stepgrandfather and made him some coffee. She said she'd never liked my mum from the beginning but noooo, Stepdork was so disobedient. She also snarked at how having a university education was THE most important thing. This was in front of everyone, with mum and me and stepgrandfather all present! This was one of those internal baseball bat moments. I slightly regret not saying exactly what I was thinking. I did manage to finally interject "RESPECTFULLY, THAT'S ENOUGH WE GET IT GRANDMA, WE ARE GOING TO BE LATE FOR OUR APPOINTMENT". Later we heard that she'd bitched about my mum behind her back saying that she was a money-grubbing home-wrecker, which, if you know the history of my parents' divorce, is not only the worst insult but also the greatest irony. Apparently she also said I dressed like a beggar and that she'd slap me in my face for my intervention in a certain family crisis (more later on that). Just before we flew off, Stepdork phoned her again. Of course she was all hypocritically saccharine to us. I'm very proud to say I suppressed the urge to curse and instead beat her at her own slimy Bac Ky game with the following exchange in Viet (B = her, T = me):

B: I wish you happiness in the new year and hope you study well and get great exam results and--

T: Oh THANK YOU Grandma. You know I have to say how grateful I am that you have treated me JUST LIKE your very own grandchild.

B: You're welcome dear. Now when I come to Australia you have to promise to give me medical treatment!

T: Alas, I am a very stupid student. SO, SO STUPID. I guess you'll have to wait til S2 [ie. younger stepsister] graduates, she is far smarter than me.

B: No no no, [stepsisters' mother] has told me how brilliant you are, the girls always go to you with questions.

T: Oh, [stepsister's mother] and you are both TOO SWEET.

On balance, it wasn't THAT bad of a trip. Touristing-wise it was all deja vu since we basically retraced the trip mum and I took in 2004-5, only Langkawi was new. It was the people that made it maddening and interesting. The bitter drama just made more of an impression on me than the good stuff, but I'll take lessons from both. I've said it'll be a long time before I go back to Vietnam...I dunno now. Travelling in other countries, we only see the outside, have contact with other tourists and those who cater for tourists. More or less moving postcards. Only in Vietnam do we get plunged into the bubbling stew of human relationships with all the ensuing pain and humour.

A view of a room

Yeah, nudging the world's going to have to wait. The whole universe has shrunk to the size of my study. I've got to figure out a way of passing exams without locking myself indoors for a month and going mad and fat and reading for 16 hours at a time. Seeing as I'll be having exams until about age 30 at the very least, god help me. It might involve...hmmmmmm...not procrastinating until the very last minute? Duh! I say this every semester.

Things keeping me sane:

.....I got nothin'. Actually, the piano and geetar. Today I realised I am grateful to my folks for all those years of lessons. It's a great thing to be able to sit down at a piano and play something randomly for yourself.

I had an idea once for a short story set in the future when instead of getting a jail term, criminals get sentenced with a neurological condition. Like bank robbery: Parkinson's, 3 years. Paedophilia: life with ALS, aka what Stephen Hawking has, with a sadistic robot carer. I did a science assignment on that in Year 10, and I don't know how people can stand it. You gradually lose the ability to move, while retaining your senses and intelligence. You can live like that for decades. The cruelty of it. If there is a deity: what the frig?!! Our teacher made us look into how neuro conditions affect people, and I came across a blog by an ALS patient (though I didn't know to call it a blog then). He'd begin every post with "things I can't do" and "things I can still do". One list kept getting longer, the other shorter. Tried to find it again and couldn't, but there are plenty like it, just google. It's almost unfathomable. Going from being an everyday person with a mortgage and job and kids and hoping you have a quiet, decent life, to your existence revolving around things like...how to swallow food. How to shift yourself in bed. Whether your wife who cares for you 24/7 is about to crack. Or you are that wife and this wasn't what you dreamed of being when you grew up. These could be people two doors down from you going through this hell. The heroism and bizarreness and tragedy and sheer unimagineable variety of normal human lives...bloody baffling, innit?

Baaaaack to the grindstone.

*PC disclaimer (I believe it too) - I know disability isn't all helplessness and despair. Diving Bell and the Butterfly much.

That is the question

1. Why must I rediscover the awesomeness of GarageBand in the middle of exam cramland? That's a Mac music editing program thingo, for you WinTel peoples. I could play with it for hours. You can compose songs with a ton of different tracks and there are built-in licks or whatever they're called. Plus you can record real instruments and then monkey with them- I got my humble acoustic to sound like Santana. Too bad it doesn't actually improve your playing.

2. Given GarageBand's awesomeness, why does the iBook not come with a microphone jack? Stupido.

3. How can tomatoes possibly be a fruit? I refuse to believe it. Biology be damned.

It's t-7 and I've still got like 3/4 of the course to slog through. My bargain with Allah is that if I pass this semester I will study hard over the summer. No really, I will. Not out of dedication or love of humanity, just to attenuate the soul-crushing humiliation that will inevitably come with clinical rotation pimpage.

Actually, haven't really been stomped on that badly so far, even with Mr "Nystagmus? I don't deal with that shit!" Neurosurgeon. He did torture a guy in my group, but I was spared. I wonder if it was because I bluffed my way through some obscureish questions (L'Hermitte's phenomenon was one of his pets) or rather because I'm quiet, Asian, female, and wear glasses. Probably the glasses.

PS. Tarisai is off! Muahahah yes! heh

Oh. My. Sweet. Jeebus.

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

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

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

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

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

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

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

Rural evangelism

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

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

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

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

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

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