You’d think I’d have learnt not to sit next to windows in the library, given what I said last time, but it was too tempting to be close to the light. The morning had been unexpectedly busy one, trying to organise some things for next week, so I didn’t end up leaving the house until noonish (a shame, because I kind of wanted to go to the case presentation).
By that time, everything was perfectly sunny and blue - it really made no sense to be inside.
I dragged my feet and had lunch with Jess and Fran. As it turned out, their registrar (from child psychiatry) was there too — Jeremy, a tall man who spoke very eloquently as most psychiatrists seem to do. Lunch was mostly spent deliberating how to go about going private and thoughts about working one day a week pro bono (or seeing “have nots”, as he called it).
He intellectualised a lot - you could tell by the way he spoke, using big words that weren’t necessary in normal conversation. It’s odd to hear someone use ‘locquacious’ in casual conversation when they could just as easily have used ‘chatty’ or ‘talkative’. It reminded me of girls in high school who sat outside the library, in the shade, philosophising about life - from the meaning of it to the functions of ordinary kitchen appliances. They spoke in that pseudo-intellectual way that in adults, would have appeared pretentious.
Many years later, I met S - a friend of N’s, who’d moved to Melbourne, and who belonged in that library group. She hadn’t known many people here, so N had asked me to show her around.
To be honest, I’ve never heard someone speak with so much hatred about anyone. The people she went on tirades about were people I knew - prefects, head girls, people who got good grades, people who got along with other people and teachers.
"They’re so fake," she said.
I chewed my lip. All this bitterness…for what? Something that happened years and years ago? Weird how she projected her own judgement of others onto everyone around her. Also a little sad.
"I didn’t play the game, and they hated me for it," she kept saying.
I didn’t have the heart to tell her that there wasn’t actually a game.
The library was filled with heaps of AMC candidates as usual. By the time I got there, everyone seemed to be in that post-lunch lull, sleepy and slow moving. I think I’m getting better and better at skim reading, which is saying I’m getting worse and worse at real reading. There seems to be no winning.
Trying to see if there was any paper in the downstairs printer, I ran into Mike, who frequents the place Wednesdays before half past three, waiting for his resident to go home.
"Hey, do you think this came out crooked?" I asked, gesturing to something in my folder.
"A little," he replied. "But it’s not significant."
As soon as “not significant” left his mouth my brain threw up p is not less than 0.05. I was confused — how did the p value fit in with this..? Oh wait..he meant.. oh wow. Ok.
Moment of awkwardness there (or of horror, if you were me).
It’s so hard to concentrate when all you want to nap in a sunny place.
Staring outside at nothing in particular, I thought about the Easter break. Easter’s my least favourite holiday. Why celebrate someone dying? It seems like a rather weird thing to do, even if they were supposedly reborn and resurrected into heaven to absolve human sin.
As a die-hard Christmas lover, it makes sense I would dislike this particular season.
Hmm. Maybe that’s why I hate April so much. Easter ruins it.
I’d been trying to write an email Friday evening when Hein called to say that it was S’s birthday, and that everyone was going to Beer Deluxe. It had been a so-so week uni-wise, and a drink did sound nice, so we drove into the city met S, Ian and some of their friends.
It’s weird, hearing everyone swap intern stories. It’s not really medicine or cases, more admin complaints that lay ahead, and talking about people who were horrible. Hein talked about being on the phone with a nursing home manager. “You know what I did? I said, “hold on a minute, sir, sorry’” and pretended I was talking to someone next to me. I said, Yeah I’m talking to the nursing home manager. He’s being an irreceptive asshole, I can’t believe he thinks he knows what’s medically best for the patient in terms of where he needs to be right now. He’s just being so obstructive. Then I put the phone back to my mouth and was like “Oh hi! Sorry, so the patient -.’”
Driving home via Kingsway, we stopped to get food at the drive-through. In the dark, the corregated grooves of my garage door loomed over us as we ate in the car. Whenever a car drove past, the spattered shadows of leaves from overhead trees moved across the glass, like leopard spots and mottle print…
So many stars! :)
Cut to Tuesday morning: cold, harsh reality of a working week. I’m in a tiny room made of concrete. Had I really dragged myself out of bed for a 9 o’clock meeting? A pile of papers in front of me with red pen scattered through it tells me I had indeed.
The third floor of the Monash building at the Alfred is a narrow corridor with a single window at the end of it. Next to the research students’ office, In an unmarked room, a dog dies weekly for 12 hours at a time. I’d been there a couple of times, to see Yi-Wee or Jono. There’s a little table draped with surgical drapes, dog-sized there, and so many glass tubes and drip sets, it’s like a chemistry lab. Yi-Wee and Jonathan say that in animal experiments, there’s no measures taken for sterility. They’d seen a research registrar touch the excised heart with ungloved hands.
There’s a metallic taste in my mouth. Habitually, I check if I’m bleeding somewhere (Skimmed knees and papercuts gave the same coppery taste of blood gum bleeding did as a kid. I’d look all over the place and sure enough I’d always find somewhere I was bleeding if my mouth was clear. I can’t explain it medically).
It’s looking like a blah kind of week: only Grace had turned up for the yesterday, bouncing into the foyer of the Monash reception her usual good cheer. Radio-femoral delay and a 7cm abdominal aortic aneurysm later, I drew and labelled the waves of the JVP for her in a sunny overpass. Zimmo (who’d come with us for the bedside) kept trying to teach her new things or supply random medical facts so the half an hour that I’d left before lab meeting to do something slimmed down quite a bit.
I didn’t mind. I’d left half an hour, but I was procrastinating.
You know that saying about ignoring the elephant in the room.. have you ever purposefully sought out a room with an elephant in it for the sole purpose of ignoring it, just to see if you could?
It’s a weird way of putting what I’d left the half an hour for. Not that I even knew it until afterwards. Staring at skyscrapers, we - the person, the elephant and I - leant on the banister and made small talk. It’d been nice. The elephant sort of evaporated. Only later, in a boardroom listening to the results of a cardiac wellness study, did the niggling feeling begin. I can’t describe it specfically. Just an uncomfortable horrible thing rolling around in my stomach.
You should really stop doing things that make you feel bad, the sensible voice in my head said.
Yeah well, if I’d known I wouldn’t have.
Sigh. A lesson is learnt.
Elephants exist for a reason.
Outside, the longest whitest cloud in the world is passing by the blue sky. I think it’s from a jet plane or something, those things that write messages. I’m pleasantly reminded of home (“land of the long white cloud”, a translation of the Maori name for New Zealand).
Invariably, the patient was late for his appointment yesterday. Libby took pity on me and told me to get myself a cup of tea, so I bought myself some yoghurt and read some papers on micronutrients in the middle of morning bustle.
Everyday’s been so temporate this week - so not like how autumn at all. I’ve been going through echo results in the library, trying not to be distracted by the world outside. It’s my own fault - I always sit near the windows.
(Echo reports are so conducive to sleep.. why do they never include normal ranges and volume measurements, for example..? Clinically it’s ok as long as you have a summary, but it’s so annoying from a research perspective).
The Wednesday lectures were ridiculously short. I was almost half an hour late because Padma had called me while I was asleep and asked me to go pick up the patient samples in the morning. That in itself didn’t make me late - I got up, changed into jeans, grabbed a box of cereal to hide in my bag, and stumbled to the E block in good time. The being late part came from having to go home to shower and look relatively presentable, especially given that I was supposed to meet Kirsti for dinner that evening.
The lecture after the case presentation seemed really wishy washy, so Jess (my lunch date) and I left in a flurry of hand gestures to signal “abort!” from across the lecture theatre.
Zouki was packed with people who felt the same way, including D and R who joined us for a bit of lunch.
You know it’s weird..Catrina, had said something just last Sunday about people who hadn’t changed at all in the 5 years she’d been at medical school. There are people who I feel that way about in my year, R being one of them. She’d been good friends with K at the beginning of first year. I hadn’t known her long then when one day she said “I’m going off K now. M’s my new favourite thing. Might try him for a bit.” like boys were pieces of clothing. I had never talked to either K or M, but I remember feeling uncomfortable for them at the time.
The R of today is pretty much the same R of 4 years ago. I remember one holiday doing interview buddying with her and a whole table of male medical students from various years and watching her flirt with every single one of them, then change her mind constantly about which one she liked. I sat at the table watching everyone there respond to her in some way, becoming interested in her - it was like watching some kind of documentary on animal behaviour or something.
I fiddled with my shirt a bit, looked at Jess in a baleful way, talked to D or Laura or Natasha. I’d made it a point not to have much to do with her in the last few years - not that she’d done anything to me personally.
I just don’t think I could ever treat people like that.
Lunch with Jess turned into a 4 hour long chat. We literally sat there for that long after D and R left, neither of us wanting to go back to work. I saw the whole of the Gastro team walk past three or four times. Dinesh didn’t see me, but he seemed absorbed in his conversation about a patient or a case.
Hein and I were speculating which of our friends were good interns, and Dinesh (currently the Gastro intern) was high on our list. I’d been talking to Greta the other day and apparently he actually is quite efficient. Having said that, we’d decided that Elle would probably struggle, but I overheard some third years saying how awesome she was. The definition of ’awesome’ definitely changes as you get closer to graduation, or when you start working so I’m not sure if those comments counted.
"I’d like to see you as an intern," Hein told me last week, over beer. It was his day off, and both of us had been bored. "See you broken and bitter about the world. Admitting people you don’t believe need admissions. Bosses who are jerks, who don’t care about patients. Medical students who try to push ridiculous answers on you but say it with so much confidence that you start to doubt yourself. The other day I was typing up a discharge and a post-grad girl elective student says ‘shouldn’t it be ‘cholepodolithiasis’ with so much confidence that I actually actually changed my report before I changed it back. I’ve had so many people telling me to order unncessary sounding tests, or telling me I had to cram some demented lady with a clearly broken arm into a CT scanner even after I Xrayed them. Have they tried to shove a demented person into a large tunnel when you have to stay still? I’m trying to be the Fat Man."
"Probably shouldn’t make a habit of calling myself the Fat Man," he said in afterthought. Hein was a fairly large person and he knew it.
At 4 o’clock I wandered back to the common room to do some work.
Some of what Jess said about the last few years was a rather disturbing. I feel a bit young and naive. Did all these things go on, with people hurting each other (people I respect) and making each other cry and being awful and jerkish without others knowing?
It all goes to show, once you begin to know things about others at a personal level, you find that there are common events in everyone’s life.
In comparison to all of that, I’m really lucky! Life’s so simple.. just teaching and research and friends and music or medicine, or daydreaming about playing cricket with my little brother next summer (I hope he uses that cricket set even though I’m not there), or outings, or listening to other people talk about their lives…
Went to the semi-finals of Last Band Standing last night, a competition run for band newcomers with a cash prize at the end.
We were supposed to grab dinner beforehand but starving, we ended up in the drivethrough at McDonalds and parking in some random street on the way to Camberwell. Ironically the street we randomly decided to swing into was ‘MacDonald Street’, though we ended up on another street, facing a reserve near the freeway.
It was sunset - dusk was hitting the bridge and trees and swingset, elongating shadows until they all rolled into one thing. A man taking his family of three boys arrived - the boys rolled down the steep bank and a golden retriever bounced after them and I swooned a little on the inside. They could have popped out off an advert for laundry detergent or soap or kitchen ungreaser (you know, how they always portray the perfect family in the background so that as the female consumer you associated the product with domestic bliss).
I’ve missed the eastern suburbs, the life of their own that they seem to have. Waiting for Meng at a Bourke Street cafe, I fell love with vanilla panna cotta and figs in basalmic vinegar, and rolling the ladder behind the bar that the bartender was using.
The reason I was at Last Band Standing at all was because Meng’s boyfriend’s band was competing. They call themselves progressive psychodelic fusion. When I mentioned psychodelic on Friday, Eddie had been confused. “What, hippy?”. Ravi sort of corrected him with, “no, Hendrix”.
They were actually much better live - that is, much better than what they sounded like on their webpage. I’d checked out their myspace a month or so ago and decided eventually that they were ok…(I know nothing about progressive fusion so I had trouble judging). Just that I didn’t like their music — I was mostly there for Meng.
With the confidence of people who had been doing this for a while, they drew a crowd of friends and fans too - including an enthusiastic one man air guitar band standing in front of us who all but rolled around on the ground in his head banging/I might be having a seizure state.
Rex, Meng’s long time friend, and I got increasingly uncomfortable, especially as the crazy person kept backing up and got so close that he could have whacked us with his arm.
"It’s like ‘The Exorcism Of Emily Rose’" Rex said.
In the car, sleepy, everything seemed to be on mute. As we drove on, the radio became progressively louder, a sign of return of hearing.
I wonder what it’s like to be a groupie, just following the band around. I love Meng, with her sensible clothes looking like she’d come straight out of lab. She looked every bit like an anti-groupie; someone who could have been a reluctantly proud family member. Speaking of which…at some point in the night a girl grabbed her arm and said, “Meng, this is Jarrod’s mum”. Way to get introduced to your boyfriend’s mother for the first time.
Cheerful, I woke up to someone vacuuming vigorously.
A friend on rotation in Traralgon wanted to call me to complain about the public transport down there. Not a huge surprise, really. I can’t believe Renny and I were there for half a year in hindsight. There were moments bordering on horrific that in hindsight, we laughed about.
I’ve been thinking of dariole moulds all day. I wish I had my mother’s talent sometimes - she goes to a restaurant, eats something, then the very next day she is somehow able to reproduce it at home. It’s actually really creepy and amazing - meaning that I have eaten well all my life. :)
Panna cotta isn’t hard to make. Just requires some equipment..
..Hmmmm I wish I were in New Zealand. I’d throw a dinner party.
I spent most of the morning trying to pick stains from my finger-nails. It looked like I’d worked in a coal mine or something, or just not washed my hands for ages - the product of blueberries and French wine last night, on a stray whim.
It’s barely March and I miss summer already. Soon it’ll be April - my least favourite month of the year.
The Alfred was as busy as ever this morning. I took some third years to see a patient on 5 East who had a classical exam for [idiopathic] pulmonary fibrosis. To my surprise, it became apparent they didn’t know how to do a respiratory exam at all.
The poor girl was looking in his mouth for gum bleeding. She also tried to examine the chest from the front and was surprised when I said that generally they should go to the back first, and the anterior chest is done after that. (“Really?”)
In light of that, I tried to summarised the main findings that they’d found on the exam (which they eventually completed after a very long time) so they could maybe work out a logical process to connect everything together (restrictive or infiltrative or interstitial lung disease or scarring would do).
Nobody had any ideas.
"Are you sure it’s not consolidation?" asked one person, for the fourth time. I asked them what the signs of consolidation were and they listed them off haphazardly.
"Did he have any of that?"
"Ok. One more time: He is short of breath and his heart rate’s up because he is not getting enough oxygen to tissues despite normal haemoglobin. His other vitals are fine. He’s clubbed. He’s breathing really hard (he’s using accessory muscles) to get more oxygen in but clearly it’s not working. Our exam excluded infection or consolidation. There doesn’t appear to be fluid in or around his lungs. Something is stopping him from expanding his lungs properly on both sides and when we did the forced expiratory count we confirmed he was unable to get the same amount of air into him that normal people could because he couldn’t count out for as long. He had this fine crackles at the end of his inspiration, almost like the alveoli weren’t expanding properly and making crinkly noises. Like they’re being held back or something. If it gets really bad he could get pulmonary hypertension and right heart failure. What process couple be causing that? You don’t have to have a diagnosis.”
Maybe it’s a little too early in the year. Sigh.
Still…I’m worried. Week 7, and no clue how to examine the lungs. C.T. told me that his third year group had never heard a heart murmur yet. Amazing! It’s not even their fault. The amount of patient contact and bedside teaching must be attrocious. The Alfred isn’t very student friendly that way.
It’s a shame because the lot I have are all lovely, bright kids. :(
The good weather made me want to be outdoors so I went home after checking in at the lab.
In the park opposite the hospital, there were tiny figures dressed in white playing some serious cricket - the annual Residents vs Consultants match. I tried to spot Professor R there. He is a distinctively tall figure, hunched with a childlike walk that scissors all over the place. All in all, a wiry looking fellow with an inquisitive air about him.
By chance I saw him walking back toward the hospital just as I was crossing the tram lines and when he approached, asked him who was winning. The consultants were, naturally. I’d already heard from another resident that the residents’ team hadn’t won in 8 years.
"Surely it’s intentional," C.T. had said. "Would you really want to be beating your bosses?"
"If it were me I’d go hard out," Eddie said when we bumped into each other on the tram to Toorak. "No mercy."
Depends on who you are I suppose. I would hate losing (recently I figured out that while mellow most of the time, if you actually engage me into something I am get really involved! The trick is, I’m hardly ever engaged into something like that because I dislike that need-to-win feeling. One of the reasons why I generally dislike playing chess, I realised last month when Alby good naturedly decided we should play outside State Library).
Would I still lose a game though…?
Yeah probably. At most, I’d draw.
I’m at MMC now, checking some emails (if I went home I’d just end up eating). It’s weird. It feels like I haven’t been here in ages. There’d been a public holiday on Monday, lab meeting on Tuesday, going home on Wednesday and another meeting on Thursday.
It was nice to see the same faces popping in to check emails on the way home or coming in to drop things off. Hope I wasn’t too vague — was a bit distracted by organisational things popping up in my uni account.
Strange, how routine this place has become… and how sometimes even minor encounters with some people can make my day.
Outside, cicadas are screaming; all the buildings are pink.
Padma woke me at 8 from the cocoon of bed to say she couldn’t go to clinic and could I please pick up the patients today…?
Of course, I said, enthusiastically. Inside, I died a little. Disruptions from drunken flatmate, social things and rushing presentations the last few nights made me approximate 8 of sleep hours in 3 days. I’d planned to take the day off to catch up on sleep.
When you’re tired, you live in a kind of dream-like state. Everything is just an approximation, and thought becomes tunnel-like.
By 12 o’clock I had already splattered serum over my arm while transferring spun down samples, burnt myself with coffee and 2 seconds later forgot it was hot and did it again. I’d actually die if anybody saw the quiz paper I wrote (there are some really weird answers on there from times when I was trying not to microsleep). When you start forgetting to add % marks to equations and reading “non-smoker from Cambodia” as “smoker from Canada” (at least they both start with C and end with A) you know something is wrong.
Out of self-respect, I went home to bed straight after lunch.
Woke up well after dinner feeling so much better. Ahhh bliss!
At least this is the end of my sleep deficit. I’ve caught up on all the work for the week :)
Think I deserved it, really. Today was so embarrassing :(