“We changed again, and yet again, and it was now too late and too far to go back, and I went on. And the mists had all solemnly risen now, and the world lay spread before me.”—from ‘Great Expectations’ —Charles Dickens (via fuckyeahliteraryquotes)
It had been a damp way to end the day - a cancelled tutorial, some bonding time with the other final years (whose year level I was trespassing on my way to graduation). As usually I filtered through all the Paediatric cases when I could, although all the cubicles were packed and I had to see them mostly on the waiting benches. The entire day had a kind of lethargy to it that came with boredom.
There were good moments, like the entire corridor giggling at the exact moment my heart melted: I had, in trying to make friends with a little girl who had head-strike, given her my stethoscope to play with and when I asked for it back she’d insisted on putting it around my shoulders. I’d crouched low like I was being crowned and she knighted me with my own instrument.
The worst part was asking one of the registrars to examine a child with me who I could have easily examined - he was crying hard, so I pretended ignorance about examining children just so I wouldn’t have to play the bad guy.
Before I left I saw a man with a suspected hand fracture, who had travelled a lot of places in Asia, and who (after I had explained to him what was going on) asked me a lot of questions about my heritage. “I’ve been to Beijing,” he said, “So seeing you makes me feel at ease and at home.”
He must have been about my father’s age, but his children had had children too, so perhaps he was more blessed than mine was.
It turned out his injury wasn’t as bad as I’d originally thought, so after filtering it up the ranks we decided just to be conservative with it. No excessive damage done.
I warned him that I was terribly messy at putting on plasters before setting about in what I hoped was a confident way. I disliked things like this because I could easily spend all day trying to make it just right. The same obsessive kind of streak about perfection seen most commonly when I am asked to clean glass.
"A pretty girl like you," he said, "should be fighting off suitors," to which I just laughed my usual kind of laugh - one that meant that I’d only been half listening and had, in alarm, realised that we were getting into uncomfortable territory and that I wasn’t sure how I hadn’t avoided it like I usually did. I must have been tired.
"One would think so," I smiled, finishing off his plaster. "But alas, I’m alone right now. Just falling in love with Emergency room doctors." Then having laughed at my own joke, thought belatedly to add "I’m only kidding."
Which, of course, I was. In a sardonic way. I was really fond of one of the junior registrars, but I often mistake fondness for love. Except I’d been thinking about him all weekend, to my annoyance. Perhaps I had a crush. He liked children in heart-warming kind of way and he was so like a child himself.
I hate the moment that I realise I like someone - I become locked into myself around them. It’s like someone waved a wand over me and cast me into stone. I feel entirely unnatural. That, if I had to pinpoint a moment, was probably it right there because when said junior registrar came on for the evening shift, I lost any IQ I had remaining.
Because I had so distracted, I’d made the thumb patch too tight for just a wrist immobilisation and had to get the plaster saw out to cut a patch that the orthopedic-training registrar drew around the base of the man’s thumb. Most apologetically.
Driving home, the glass on my windscreen was smeared by a light condensation that the wipers couldn’t wipe off. Everything seemed blurry, like driving amongst stars. I can see how people tune out playing follow-the-leader in the dark at 80kph. A dangerous, soothing kind of game and one that I’m fairly good at, it turns out.
I kept thinking, this vicious cycle has got to stop. If I wanted to get serious about a relationship I have to stop being afraid of being seen through by someone. It scares me so much that I forget how to relate to people I had hitherto related perfectly well to.
How is it my enthusiasm for someone becomes so strongly tied to my enthusiasm for life? Discouraged, I’d driven home changing radio channels noisily and trying not to think about my own aloofness. A crush is a crush - they come and go. Being cautious doesn’t.
I miss my father suddenly. I want to go golfing with him. Isn’t it weird? After a decade of him trying to persuade me to play, and of all those driving range nights/afternoons and the hours and hours I spent hitting things out into the middle of nowhere… all those summers I was back and he would ask me out to the country club with him for 18 holes and I’d repeatedly decline. I knew how to hold a golf club before I knew how to do high school Algebra but I’d never ever been.
I think I just want peace these days. Peace and good company. And life advice. When you move out of home, stuff like that you begin to miss.
On Thursday I picked up a pleasantly 70-something demented patient with a working memory of roughly 2-3 minutes. He had no idea where he was, how he got there, what year it was, what month it was, what time of day it was. He knew his full name (except one of his middle names) but couldn’t remember his birthdate. Every third or fourth question I asked was an orientation question, just so I could re-orientate him for courtesy’s sake during the history. His mini mental state examination score was the lowest I’ve ever seen.
Through this whole excise I discovered that either nobody in the UK wrote signage to orientate their patients, or that somehow my signs were bizarre because one of the afternoon staff, upon discovering that the signs he had taken down when coming on shift were made by me in cubicle x, exclaimed they were cute.
They went something like this: YOU ARE AT __ HOSPITAL. YOU CAME HERE BY AMBULANCE. A LOVELY NURSE AND DOCTOR ARE LOOKING AFTER YOU.
The man’s response was hilarious though - every time he read “a lovely nurse” his eyes lit up.
I tried to imagine him through the war era - not the Great War maybe — through one of the subsequent ones, maybe. Korean? He would have been too old for Vietnam. Embarrassingly, I don’t even know the history of Australian involvement in things like this.
Time seems to escape me suddenly. When returning home from voluntary work in the morning, hauling a metal trash can and wicker laundry hamper I’d picked up on the way home. The sun was so strong, I felt hot in the dress and suffocated so I collapsed into bed and fell into a deep, confused sleep in the heat. When I woke up I was sure it was the next day, the sky that white pre-dawn or pre-dusk colour and my body felt heavy, hungry even though I’d just eaten, or maybe thirsty. I inhaled a glass of water, some peaches and felt a bit better.
But that calm kind of confusion made me think of the demented man. A surreal feeling, like nothing I touched was real, or standing with sea legs.
Recently I’ve been driving a lot, trying to log hours. Not having GPS or a map, I’m left only with my strange to memorise cartography - an inexplicable sense of North, and of home. Once in high school, N and I were driving through a place I was unfamiliar with at night, and she decided to make random turns through the suburbs. We didn’t have a map and I was afraid of being lost, so I began memorising the turns she made - second left, third right, etc. When we got to a point when she said, “We should turn back,” I regurgitated all the turns backwards and we managed to get to the main road again.
I keep missing exits and turns off main roads to smaller streets though, being unfamiliar with certain suburbs. I always figure if I head the right direction one of the main roads will crop up. Thanks to excellent town planning, they inevitably do.
One of Tracy’s friends commented the other day, when I had missed a turn off trying to drop her home in Clifton Hill, that I amazingly don’t panic when on unfamiliar roads, or when I take a wrong turn. Actually, my mother’s mentioned that too. Rather, she keeps warning me not to panic if I find myself turning wrongly which I have never understood. Even in the first few days I was driving, I found myself leisurely driving a total of 9 times around a few blocks of one way streets trying to find the entrance to a car-park that I wanted to park in, but just couldn’t find a way into in peak hour downtown Auckland.
Perhaps I’ve just never been lost before.
To be honest, I feel antsy. I want to go away somewhere for a while, travel and meet people in other places. Maybe I could ask somewhere exotic for a shorter elective period, travel on weekends, and round off by going to New York for 2 weeks and seeing friends there. Zoe was telling me about a in-the-works loan scheme by one of the medico-legal companies that might enable this plan.
There are so many places I want to go. Maybe I can spend a year after residency travelling the world - before I have to study for college exams. Not that I’d tell my parents. I want to do something post-graduate before I settle down at an overseas institution. Working with people who did 2 years at Oxford or Cambridge has been inspiring.
This whole thing is as perplexingly strong as the urge to settle down in some corner of the world and lead a happy life. A conflict between a need to be independent, and a need to be well, needed. After a whole day of analysing other people’s underlying issues, I don’t particularly want to explore my own.
As a good friend and I were talking about last night — maybe it’s an age thing.
Or maybe it’s the change of seasons.
I sometimes feel like I’m running out of time. Every minute will be a minute lost. I’ve already lost one year after all.
Summer rolled through this weekend, glorious and rich like it ought to be. Saturday was the most beautiful of days, warm enough even in shade - balanced by a lovely breeze. What’s even more glorious is waking at noon to a lovely kind of silence and sheets that smell like sunlight. Enough to make one arch one’s back in a joyous, broken kind of way and burrow with a smile one one’s face for five more minutes’ sleep.
Unfortunately, sleep was disrupted by the phone ringing - Catrina, wanting to head to the city on one of those quests for single items. In this case, it was a phone - but we did everything else except buy one, including looking at DSLRs, have coffee in the archway exterior of General Post Office, lunch via takeaway Japanese outside state library.
We ended up at Beer Deluxe as the sun wound down its lazy trip around the sky because Hein had called and said he was taking Eleanor to lunch, and that they’d meet us there. Beer Deluxe (at Federation Square) is Hein’s favourite haunt and is conveniently located next to the Book Market (held at the atrium). It’s been almost an exact year since I was last at the atrium, happily buying an old Royksopp album. There’s something satisfying about buying an album - a physical album - it’s about a lot more than the music. The packaging, the album art — all these thing someone has done.
I wasn’t planning on going out that night but it was too warm to stay inside so I trained home and changed and drove back into the city along Kingsway when it got dark enough. I’d never driven into the city before. It seems like a highway of light the whole way and it made me feel like I was going somewhere unfamiliar, even though I had been on this route more than I could count.
The Long Room hasn’t changed much at all, except maybe the crowd. I was used to Friday night corporate drinks more than the Saturday night thing. Less people were in suits, and mostly everyone was at least a decade younger than what I remembered which isn’t saying all that much, I know.
What I love about the Long Room is that there is always — always — at least two men in full suits, in their late 40s, at a table somewhere in the throb of the crowd (all much younger), who look like they’re having a serious conversation about something.
Why do they pick The Long Room? It’s not one of those bars that you’d go to to try and hold anything less than a superficial conversation with someone. The music is way to loud. It’s way too jostly, even though the crowd is very nicely dressed (thanks to a strict dress code for men). Every time an attractive woman walks past or brushes against one of them they don’t even bat an eyelash. They just sip on their drink - whiskey or gin, mostly - and look at each other grimly.
Sometimes I want to lean in to hear what they’re saying but it’s impossible without being pressed somehow to their side and somehow if that’s why they’re in one of these places - for discretion - then maybe I don’t want to hear what they’re saying at all.
When we left it felt like twelve more than three in the morning, except for the slightly forlorn streets. Being Collins Street, there weren’t the usual rowdy drunk crowds that you’d usually expect if you were walking down Swanston at the same time of night. I took my shoes off because my feet were hurting and walked three blocks to the carpark where I’d
I actually like being the designated driver. I like the act of taking people home, and how child-like they seem when they’re sleepy and trying to stay awake by talking to me about the difference between the car air-freshners we use, and how there’s a superstition that when there’s a ghost in the room, it always smells of jasmine and frangipani.
Taking Jan and Dinesh to their place was like babysitting the loveliest couple who upon getting out of the car, clung to each and waved goodnight sweetly.
Drunk people used to frighten me in high school - I used to avoid parties and hurt people by not turning up, simply because I was afraid. I tried to explain once to someone what it was about them and all I could come up with was that they appeared…heavier. Even now writing this I am reliving that sort of indescribable feeling I used to have about intoxicated people. Maybe I was talking about the laxity of their movement. Thinking about how drunk people seem to me now, the difference may be my own ability to take on the weight of them, physically, and probably mentally as well.
Besides which, I’ve had enough of being ridiculously drunk myself [usually when going through a tough time] enough times to know. Like last year, the second most terrible year of my life, getting way too drunk [accidentally] at way too many things (like, two things) and regretting it infinitely.
Such an unattractive mess. Ugh.
I’m settling more into Emergency now. The ED doctors are so lovely, mostly from the UK for some reason - people who just wanted a year off before exams, wanted to travel a little. They all seem to somehow have known each other beforehand which is really funny. Or at least, they got to know each other really fast when they were down here.
I don’t know if ED is for me though. I don’t mind the chaos, and it’s always fun to see interesting things. But I miss seeing the same people every day, working through something from start to finish, seeing a more concrete ending. I just end up seeing a lot of Paediatric patients, who I love. I discovered that I’m in fact competing with one of the UK ED registrars, a very lovely man who apparently also loves children to pieces.
This I have to do on the sly because I have a feeling my supervisor won’t be too happy if he discovers that I’ve dogged past all the crumbly patients to all the adorable ones. Although I did work up a socially complicated case today from two people with communication problems ++ so that might have been a bonus point.
Still, the disorganised structure of Emergency is a bit mind boggling. Even the task of picking up patients has its own sort of chaos around it, where I check in with the triage nurses and the ANUM for a place to put them and constantly find the place that I’m allocated already taken up by someone else. One night I spent 20 minutes wandering to various rooms that the ANUM had put the patient I wanted to pick up in to see if anyone was in it and then walking back with the inevitable answer that yes, someone already was.
One thing I do know though: I’m going to spend a year of my life in critical care, if I get the chance, I’ve decided. Anaesthetics and Intensive Care seem like extremely useful things to have a good grip on. Extremely useful.
That’s all! :) I am rambling so much — blame it on this lovely half-glass of red wine to end a happy weekend. Hope you guys had a great one too. :)
It’s been so long between updates, and for that I apologise. So much has happened. I’ve moved house to Mount Waverley (yes, it’s almost once every three months in the recent times). What a familiar feeling to be in a student house again - not to say I wasn’t in a student house before, but everyone the last few years I’ve lived with spoke almost no English and were fairly well off. As a result the places I’ve lived have been quite nice.
In contrast, this house (also a beautiful townhouse) has character. I opened up the cupboards which were filled with foods expired at various dates and when digging through the lower corner storage spaces I noticed black things that looked remarkably like mouse droppings (I’m buying a trap this weekend).
How could I have ever forgotten the smell of mice? It’s uniquely identifying, like the smell of dogs.
I chose this house because of its proximity to the freeway, and to the small shopping centre which is a stone’s throw away. Walking amongst the small alcove of houses where mine is tucked in is like walking through a dream — new, designer townhouses in a row, narrow roads like just one long driveway shared by this whole block. This whole area seems like suburban paradise, but as soon as I walked inside the beautiful red door of this townhouse I knew it was an investment property. The materials looked basic - the carpets thin, the walls flimsy. This house wasn’t built with love, it was built with lust. Lust for maximised profit.
But what’s there not to love about the perfect location? From the top of the hill the city lights shone down. We make home from sticks and stones - become family to strangers. After all these years there’s still a little bit of that going on when I relocate. So I moved in straight away, and I’m happy here.
I also bought a car - a black Honda Jazz that I fell regrettably in love with at a dealership. It’s the love that comes with exhaustion at having gone to 9 dealerships in a single day, and seen multiple private sales and rejected them.
Driving has been so freeing. I joked with someone last year that I would make a terrible driver, and even a few weeks ago my fellow was telling me that she had a dream about me driving her car badly (I must have accused myself of terrible driving at some point too). The truth is, I’m not a bad driver. In fact, I love the action of driving, and of being on the road. Perhaps I’ve always been antsy. Perhaps I spent too much time in other people’s cars when I was younger that it equates to an atmosphere of expectation.
Tonight I drove home from an evening shift in Emergency. It was my first day, and the consultant let me home early after just 6 hours because he said I had done well. The headlights of the other cars seemed almost like strings of fairly lights and the musty-humid heat of the day hadn’t yet left at 10pm. If I could just have kept going and going I would have, like on an open highway. It seems to make me lonelier, having a car. Almost like I should visit someone all the time. Like I want somewhere to go.
I should say that I finished my Paediatrics rotation without much of a fuss. I’m surprised at how much I miss it. I pass the Paediatric cubicles with longing in the Emergency department. I picked up a 5 year old boy today and was excited. It bothers me a little that I might end up as a Paediatrician - it wasn’t something I foresaw myself doing. I wish I could split into two and do all the jobs that I like - I enjoy Emergency. I enjoy Paediatrics. I enjoy everything that has patient contact.
Adult medicine is so different. People are anxious. Anxious in a complex sense, although I suspect always less so than a child. Children are anxious creatures - always afraid of being abandoned at some deep, deep level and they hide it so well. There’s something pathological about a child who’s aware of his/her own anxieties at that level. It means they’ve understood abandonment at some point in their lives.
I’m lucky in that this hospital lets us see our own patients and work them up like we were interns. A privilege, really - diagnosing things, ordering tests, suggesting drugs. I think I’m a little rusty at adult medicine but seeing simple cases this first day has been a relief. My time in Infectious Disease has certainly helped when people are allergic to certain antibiotics and I seem to know what to use as alternatives.
The first woman I saw in my rotation had cellulitis, and I spent a long time winning her over because she was afraid of needles and as soon as I saw the extent of it I knew she was going to need IV antibiotics. The second woman had gastroenteritis and was worried about her ongoing lethargy (she did need quite extensive fluid resuscitation though).
Calling teams and consultants about admissions is like waging a war although I’ve been lucky today.
I think I’m starting to get back into the pace of things. People are so interesting. Procedures are so interesting. Everything is interesting. I joked about it with the cover Surgical Registrar (a friend of a friend’s) when he asked me if I saw any interesting when I came across him in ED - he’d thought I was being sarcastic - but I genuinely think so.
I don’t want to go home. I want to keep learning. :)