Water and earth

It’s 1:28am. I’m sitting cross legged on my chair, fan heater on beneath me (it’s too hot to lower my legs to the ground, which I do when I dash inside from my car). I’m listening to a song called ‘burning river’, by a New Zealand boy that a friend knows. An empty wine glass with red residue, papers, a coffee mug with a spoon inside (used for ice cream), a bottle lie scattered around papers I haven’t sorted yet.

Sorry for not writing. I’ve been sick. But more than that, in my last week of Haematology (last week), I didn’t quite have the heart to. Bone marrow transplant was too depressing in some ways; people’s stories were too personal. This week I started Respiratory in a different hospital. I still see Prof S. around, because he is also working in this new hospital, strangely. I’m so shy, I tentatively wave and hope he waves back, and I know it’s just rude not to talk to him but there’s always a little fear in love for me. Even professionally.

An old high school friend, A, moved to Melbourne this week to start her working life. We go way back, to the very first day, the very first class. To S., who I credit to making me grow up in a short space time, and later after my life came to be here, in this city, to the girl in red scarf.

To be honest, I had been nervous. Catrina put her thumb on it before she left for the UK: when you move to a place for the first time, you become territorial. It’s suddenly your city, to people back home. It’s safe. You go back to this place, live a compartmentalised and somewhat secretive life (secretive only in the sense that it’s impossible to talk about everything that goes on in your day to people back home).

This old friend happens to be the kind of person who has the amazing talent for taking something and making it her own. In school, I would recommend a book to her, then weeks later someone would come up to me and ask me if I had read the same book, because A. had recommended it to them, and that the whole school attributed her for such a fantastic suggestion. Even having dinner with her and her friends, taking them to some of the restaurants I had taken her her previous visit, it was amusing to see her still the same, making recommendations on the menu to the others who had never been. It always used to annoy me a little, but I’ve come to realise that it’s just that we have different personalities - I am quiet about my likes and dislikes, unless conversation happens that way. Even when pressed for a recommendation, I feel uncertain - how am I sure that the other person will like the same things I like? I always make recommendations based on what I think the other person would like, not what I personally like.

It’s strange to see A, and the friends who she knows here, and even girl in red scarf, and the New Zealand visitors going through all the uncertainties, the learning curbs that I had to go through at 17. Except they have each other, and at that time I didn’t really even have my parents (we were fighting that first year I was here, on and off - and we had never fought before, so it was even harder).

I wish I could say that the divide that I used to feel when I went to New Zealand between my friends and myself was removed with this event of immigration, but leaning against the wall or comforting A. (suddenly unsure of herself at times, eliciting rapid cries of encouragement from her peers who had come down to visit her), or offering advice about practical things that had helped me, and echoing the encouragement — finding a flat for oneself, for example — and watching her pick and choose because she was used to getting things with certainty and getting anxious when nobody was phoning her back —

I felt it more than ever.

It’s almost as if I were in a different stage of life. Five or six years beyond where they were. Ready to settle down, get on with my career. I’ve had enough of moving around, instability - the kind that comes from traveling, only spent sadly domestically.

Sometimes I’d even feel absurdly saddened, suddenly placed back to the early days when I was here, and feeling the aloneness. It’s happened. The thing I wrote about all those years ago has come true, so soon before my leaving my life forever for the first time (the first of many times I have left in some form in my life; the first of many goodbyes):

1:34 pm on 02-11-06

”We burn brightly, furiously, incandescently. There is touch - there is the immediacy of life, and its transcendence into the extraordinary. We are not human beings. We are immortals trapped inside these damp skins. Trapped by each cell, and each cell trapped inside a plasma membrane, living. We collide to break free - we yearn.

[…]

I am being torn away from this. When I come back everything that is burning now, that I am burning with now, will have evolved and cooled - become rock, stone. I want to burn here with everyone and become part of the same solidness. Be made out of the same things, and if thrown and blown around, still carry the same residue or the earth that we all made ablaze.”

I am a different person here. The same me, just different decisions. Different people, different jokes. Different stories and quirks. A kind of hardness that may be new.

I have a different life. It made me realise: A. moving here had no impact whatsoever, apart from distance. I had somehow completely separated myself from everything in my life here. Part of it was having no existing contacts when I moved here, unlike A. I guess it’s easy to slip back into the old circles - it’s so funny, R.G. (the primary school friend I had dinner with a while ago) was just saying the same thing. She felt disdain for people who just slipped back into their old crowds; she wanted adventure. She tried not to keep in contact with anyone she used to know.

Don’t get me wrong. I am so happy that A. is here now. That our adventures can be adventures together sometimes; always places to go, life to be created. :)

The city, and Medicine — they feel like it’s a part of me. It’s alive, in my veins, the way I dress, the way I talk. My mannerisms, the things I laugh at. Sometimes I wonder if I’m not made out of the earth here too, baked over the long summers, the indistinct times away from home.

The only things left to me is the strong feelings I have about certain people, certain things. Memories. A love of parks and waterways and a longing for the sea. Empathy, a love of things that grow, bad singing. The same laugh, I guess. I still like laughing. Those are unchanging.

Or perhaps these things were in me all along. A few people have told me I haven’t changed much at all. It always makes me happy to hear these things.

“If you wake up at a different time, in a different place, could you wake up as a different person?”

We used to ponder that question (from Fight Club) — always one of my favourite quotes. The answer is yes, you can. But not in the way you think. :)

Or maybe not at all.

There are days when I think it’s one thing, and then the other.

Interview weeks

It took my little car all it had to get through the gale force wind and rain lashing at it mid-afternoon. I don’t know how the sky got from overcast to angry grey but the world changed, trying to erase all definable lines. It was hard to say where the road lanes were, where one street began and another ended. I kept hurtling forward, hoping I was in the right place, hoping I was heading the right direction.

It’s been a strange week and a bit - Between last Sunday and last Tuesday I’d already been wracked with fever, met my professional idol Prof S. the following day, and been a patient of an Emergency Department quite by accident because I for some reason almost collapsed on ward round a few days after that ever episode. While trying to get some anti-nausea tablets, I somehow found myself admitted own there.

It all started with Sunday, after work, walking back to the car in with the frigid winter wind around me and arms around my stomach to keep warm. The red scarf around my neck was doubling as a second layer, the way I pressed so hard trying to burn the fabric into me. As if force could provide heat somehow. Already then, I knew something was wrong - the world wasn’t in focus, like trying to catch things with great detail but missing all the intricacies that made them clear.

By the time I got home, I spent an entire hour staring out the window of my parked car shivering. The sun went down but I didn’t want to leave and walk the 10 metres into the house, too afraid of the cold.

It was only 7 o’clock when I made it inside but I went straight to bed, put the central heating on - everything hurt, my back especially. I was burning up. The sheets on my skin scorched me, and the irony only occurs to me now how the time I was pressing my scarf into me to turn force into warmth was coming true; except it was the opposite. Everything warm pressed into me. I was hallucinating. It lasted all night and didn’t break, though I was woken up several times by phone calls from my father and a friend - long conversations I can’t even remember.

By morning it had broken. Nothing else was wrong with me. I was exhausted, as if I had survived some kind of exorcism. Maybe I had. It wasn’t the first time these random fevers had happened to me.

I drove to meet Prof S. at  11:30am, so I cleaned myself up the best I could and drove to the institution that he was the head of.

Sometimes I don’t appreciate my luck the way I should: There I was. 23 years old, climbing out of bed and walking into the office of a man who had seen careers make and break, who was known to all the doctors in Melbourne, who had seen the rise and fall of many careers, I had looked up to since I was 20, who had recently been awarded the order of Australia; who I had seen talk to a family about withdrawing treatment from their dying father, who had changed the lives of so many before him and left an impression so deeply imprinted in my mind that I knew I wanted to be a haematologist right then. It was Queen’s Birthday - a public holiday - but he was in his office at the Australian Centre of Blood Diseases, wearing a jumper and in the most disarming way, was wearing the lanyard of the football team that I also supported.

“What have you done?” he asked me, like a father. I missed him, sudden. My own dad.

I told him I was following the haem/thrombosis registrar, and he said with surprise “You haven’t done Clinical Haematology yet?”

“No,” I said. “But I did spend a long time in Haematology at X Hospital when I was in 3rd year. You were my consultant there for a week.”

He smiled suddenly, as if delighted. “That’s right,” he said. “I remember you. I had been wondering where I’d seen you before, actually. Well. It’s good to see you again.”

Then he gave me the most inspiring talk, including about how I should aim to be the head of something, about mentorship, about what to do to be exceptional - about being exceptional, and what that means. About how everyone is exceptional, and only some people really exploit it. I couldn’t find a more amazing person in the world if I’d tried. It made me want to work harder, do more things. Be impressive.

So of course I was terribly embarrassed to be sitting on the ground on Tuesday with my head in my knees and the Haematology consultant (Harvard trained or a few years!) looking on in concern, and my registrar being ordered to get me some water. It was a mistake going through Emergency to get some medication - I’m at a hospital that’s known for being thorough. I should have known I wouldn’t be getting away that easily (it turned out to be nothing, like I knew it would be).

It was the first time I’d had a drip in my arm, and I now know to be nicer to people who are having them because they do actually hurt.

I’m sorry I haven’t written but it’s been such hectic time, running here and there to different hospitals for five or ten minutes’ worth of conversation. I had a rude shock when I returned to the ward after one of them: there I was in a suit jacket, shirt, black skirt with my ward folder (black leather) in hand (stethoscope folded on top), lanyard around my neck, ID, pen torch, ballpoint pen walking through the corridors of one of the oldest and most prestigious hospitals..in the second most livable city in the world. I looked in the glass that lined the corridor on the ground level, between two blocks of the building and saw someone I hardly recognised.

So strange, I hadn’t worn my hair this way for a while in hospital - fringe down but sides pinned back. Pins in my hair, until this year, had been a relatively primary school thing.

How was I so…grown up?

Even last night in Fitzroy, having drinks with a bunch of people I hardly see anymore (medical school kids from my old year, who had graduated and been working for half a year already), it was amazing the lives everyone led.

Going through the interview process for jobs, I’ve discovered two things: sometime in the last 6 years, I’ve developed an intense discomfort for situations of scrutiny. Interviews never bothered me before, and I was fairly ok at them — but now they make me intensely uncomfortable.

The second thing is, I’m definitely not the same person I was 6 years ago when going through all of these things (the interviews for entrance into medical school). What you learn about the world is shocking in 6 years. As a kid I used to wonder why adults were so worried about children changing — how can people not just go back to the way they used to be? 

Now I know: once you know something, you can’t unknow it. Once you learn something, you can’t unlearn it.

I guess I’m trying to say that I miss simpler days, when nothing was too serious and I wasn’t suddenly on the verge of breaking into some incredible institutions of health. I certainly miss S., who is one of the people I will love all my life. I’m also saying, I’m grateful to be where I am, and to have such amazing people in my life like Been, Renny, Catrina, my family, all the doctors who’ve tried made me good at what I do. The shoulders of giants.

Being shortlisted for so many interviews when there are >850 candidates applying to some places and a few hundred interviews offered, I feel so lucky.

Whatever the outcome of my interviews,  nothing is going to change the kind of doctor I am and will try to be.

The places only we know

Day 1 of general surgery: I’m awake, barely having slept. The sky’s an off-putting grey, although I later find out that sunrise is just a slight head tilt away from the window pane I’m leaning against.

I don’t know why I couldn’t sleep - it’s probably the evening shifts having messed up my sleeping pattern. When you arrive home at midnight, it always feels wrong just to crawl into bed without your usual routines - checking emails, eating something, etc. So I lay in bed sighing every now and then, thinking about the oddest things: the colour of hay before it’s fully dried, melted chocolate, the vein at the back of my right hand that moves when clench and unclench my fist…

I take back what I said about Emergency - I met my first mean consultant last Thursday; actually, I’d met him before and thought his choice of sotalol for reversion of paroxysmal AF strange, considering that it was shown to be about the same as placebo in the guidelines. Also, he’s he kind of consultant who will listen to you before he finds out you’re a medical student (the first case I consulted him on) — but as soon as you say you are, he cuts you off half, makes a snorting noise, rolls his eyes and says, “I’m going to see them. Just don’t say anything.” — before I’ve even presented.

After a long process where he repeated everything I did only half heartedly, demanded to be shown the Xray and blood results, before he says he wasn’t sure why she was short of breath, and to admit her under the medical registrar. So of course the medical registrar laughed in a ‘my life sucks’ way when I referred to him and said it wasn’t my fault, but the whole thing was ridiculous.

“Her potassium is 6.0,” he said. “What have you done for it.”

“Um. Nothing as yet,” I sighed. That had been my question too, in my head. Should we do something about the potassium? There hadn’t been ECG changes but I wasn’t sure.

“Does your consultant know?”

“Yes. But he said to talk to you first.” (He’d done so by making a shooing motion with his hand in the direction of the medical registrar and moving off before I’d finished asking if he’d like to lower the potassium in ED).

“I can’t believe this,” the med reg replied. 

So I sighed. I can see what friends have previously meant by disliking how they’re the buffer in between two people — people take things out on you, when you’re following orders of someone else because you yourself don’t have the capacity to make certain orders/decisions (for instance, I’m not allowed legally or ethically to order drugs/initiate therapy on my own such as for this woman’s potassium). Except professionally you can’t say so.

Which makes me all the more grateful that the staff I’ve encountered in all the other days while I was there have been so amazing. On my last day one of the consultants decided to yell out “Everyone, say goodbye to Melissa, it’s her last day!”. There was that awkward moment when I went bright red and everyone stopped what they were doing and looked at me and muttered an obligatory ‘See you!’…some uncertainly as I’d never actually spoken to a few of them my entire life (ward clerks, nurses I’d not worked with yet, etc., med reg, surg reg, plastics and ortho…). 

But the blush on my face made it to the depth of my heart and all of my insides were blushing too. :) A happy, warm feeling.

In my last week of Emergency I’d been thinking a lot about change (I guess I touched on it the last post too). Someone I’ve known a long time, but whom I’ve not seen in years sent me an email (one I hadn’t had time to answer until now) and it made me think about how I’ve changed in the last few years.

You’d think someone as introspective as I am would have thought about this before - and maybe I had. I talk about change lot, I know - about childhood and now, and moving country… but not really how I used to be compared to how I am now. The way I think. My hopes and fears. Certainly not in the last one and a half years, at least. Funnily enough, one of the moments that triggered this was when I walked up to my car at the witching hour, cold, and noticed all the windows fogged up on the outside but thinking that it was impossible that the inside of my car would be colder than the outside (what keeps it so cold?). So I ignored the laws of condensation and tried to make the fog go away by putting air conditioning on and winding down the windows even though it was freezing. The next day I was giving some people I didn’t know particularly well a lift home and asked one of them about it and he said to turn up my heaters and point them at the window which made me feel incredibly sheepish. Well duh. I did senior level Physics and Chemistry at school too. I’m meant to be doing some degree for bright kids.

Wow Melissa, you’ve changed, I thought with a smile in my head. A sheepish, ironic smile. Because it was funny, and because I knew that it’s not at all what that email probably meant (not in the least because I have dumb moments like that all the time).

How human it is to forget about all the horrible bits and remember the happy bits in your life.

I saw two children playing in Emergency before I left, holding hands briefly when one of them wanted to show something the other one. They were siblings of other kids who were sick, who’d found the toy area.

It’s kind of a big question. In five years time, they won’t go a mile within each other - the age of boy and girl germs and all. A few years after that, they’ll fall in love again.

Time changes everything. Although, the more I think about it, perhaps there are some things that time don’t change. Perhaps we just get better at convincing ourselves otherwise. But you gotta reach a point where you’re at peace with it all. And to tell yourself the truth about it at all times. And to live a life that’s fair for you.

It’s easy to forget that we’re creating our lives from scratch every day.

A happy life. :) Long, and full hopefully. Filled with solidifying dreams. :)