blood and bones, saws and chisels... all in a good day's work

First week of ortho has flown by and it has been the most welcomed change from my previous run. Orthopaedic surgeons are on super, super speed, even compared to their peers of other specialities and I love it! Ward rounds finish in literally a blink of an eye and I'm basically running to keep up with my registra; meetings, tutorials, any conversation, not a breathe is wasted because it's all about efficiency.

For example, Day 2 of Ortho:
-7.25am: handover/morning meeting
-7.45am: ward round spread out over three different floors of the hospital so lots of running up stairs
- 8:10am: Main Operating Theatre
- 8. 25am: first surgery of the day begins
- 8.55am: first surgery of the day finishes

I remember looking up at the clock after our first surgery and thinking to myself, how many people have achieved this much all before nine in the morning?? How freakin' satisfying, how freakin' awesome! By 12.30pm I had assisted my reg on three surgeries including a cemented hemi-arthroplasty (subtotal hip replacement) which was incredible. Man, time flies when you're in surgery; one gets completely absorbed into what one is doing, it's almost addictive. :) Such a high.

Even the tutorials with the ortho surgeons are incredibly productive and efficient, and the only tutorials in my five years of med school thus far which actually succeeds in TEACHING YOU in a way you most certainly couldn't learn on your own. I find myself prioritising tutorials for the first time ever! And the ortho surgeons are articulate and funny and... nice! They really are, it's brilliant. Maybe it's just our hospital?

I'm excited to have almost the entire weekend free -- no plans, no big "to-do" list; just free to knuckle down and do some serious studying. The ortho surgeon I'm attached to does mostly spinal surgeries so this weekend will be all dermatomes, myotomes, nerves and back. But unlike in second and third year, I'm actually looking forward to it!

On another note, the ACE Info Evening I organised went without a hitch Thursday night. All that planning and running around with my head spinning off my body for the past two weeks was worthwhile in the end. And everyone I talked to found it really useful which made me happy that all my time and effort wasn't in vain. I was spot on with my estimation of numbers with just under 70 people coming; I catered the perfect amount of food, ordered the perfect amount of wine (with a bit left over for us to take home! hahaha), and put together a cheese platter all on my lonesome (because it's so expensive to get a cheese platter catered) and did a good job of it if I do say so myself! One of the other student association reps (who is Indian) had put together a platter for our national exec meeting in Auckland a while back and when I complimented her she was like, "I learn from the white people." Hahaha... so, so true. Moi aussi.

All this talk about applying for jobs post-graduation, organising TI year and elective... I'm so darn excited, it's just awesome. But sometimes I feel like I'm the only one who is! All of my classmates are more worried than anything, but I for one cannot wait till I'm a TI on the wards getting knee-deep and beyond in patient care. Sure there's the I-don't-know-anything-right-now thing but I take comfort in the fact that by the end of this year after the inevitable bouts of freak-out I'm going to have and the subsequent non-stop study I'm going to do (hopefully) I will know something... and I will pass the exams... and I will be starting TI year in November... Touch Wood. LoL

II/IV

On the eve of starting orthopedics after a week-long break I think I'm ready to start my second rotation of the year. Not that I have a choice in the matter, and although I'm still physically a bit run-down my mind and, more importantly, my reserve is now at a good and ready place which is not something I could have said a couple weeks ago.

Kirsty flew back to Auckland Monday and most of the rest of the week I was busy working on this movie for the Dean. It took ages trying to find a video camera which would not only work but also plug into my computer, ultimately having a moment of exhausted brilliance when I realised I could use the webcam of my trusty (or not so trusty?) laptop. It took a lot of planning in my head and awkward manoeuvering on the day of filming, but hey, it not only worked but it worked well! Filming was on Wednesday afternoon and I had two "actors" in the end, a classmate of mine and a fourth year volunteer, and they were great! It was super efficient too, thanks to perfectly detailed planning and thinking it out in my head on top of the awesome, impromptu storyboard I drew up the night before on four pages of A4. And oh, we had so much fun in the end, being silly in such "serious" real-life locations: medical library (why in the world were there so many people studying? When I had planned on making a ruckus I didn't think we would be disturbing so many people!), hospital foyer, Student Affairs, hospital staff cafe, Paediatrics Outpatients...lol

Came home after filming on Wednesday around four in the afternoon and was up until 2.30am putting it all together. It's so addictive, this kind of work; well, maybe addictive is the wrong word. What I mean is, you really don't notice time passing when you get so incredibly absorbed into what you're doing, you forget about everyone and everything around you. And that, ladies and gentlemen, is how I know that "Life of Clinical Medicine" is probably not my one and only calling in life: studying -- Medicine -- just does not do that for me. I know it must for some, and I could definitely name a few of my classmates for whom that might be true, who could spend hours getting lost in the endless abyss that is Medical Knowledge... but man... that kind of esoteric life is most definitely not for me. Anywho, I digress. The presentation looks awesome, and although it's certainly taken up most of my mid semester break it was worth it. So damn satisfying.

Thursday I flew up to Christchurch for a wee mini-break for myself. One of my closest friends from high school is up there for the year doing a music/sound engineering course so I've been meaning to go up and just hang out with her. (She's also in a jazz band and I've been wanting to catch them perform but they only play Wednesday nights unfortunately.) I found some cheap flights the other day and I was off. Even though I had more than a few offers from various people to crash on their couch I actually booked myself into a hotel in centre city -- the trip was, like I said, a wee mini-break for myself, and a mini-break for Anna isn't a mini-break unless there's lush pillows, wireless broadband, seemingly endless searing hot showers and, of course, CNN. LoL Nah, but in all honestly it's just mainly the having-my-own-space thing which is difficult if you're staying on a friend's couch, and it turned out that a solo room in a backpackers in central Christchurch was more expensive than this wee funky hotel I've stayed in before. But the wireless and the CNN was most definitely a bonus, and a well-deserved treat for myself. Oh, and did I watch CNN!!! :)

My friend and I went out for dinner at a great Mexican restaurant where delicious food and margaritas, live Spanish guitar, and brilliant conversation were enjoyed! Then we went to jazz bar recommended by more than a few people I know and it was amazing. Definitely my favourite place in all of the city! Christchurch is on a currently not-so-short Shortlist of where I might want to work when I graduate, and the good food and music is definitely in its favour.

The next day I had a wee sleep-in, enjoyed more of the wireless broadband (absorbing in as much CNN as possible all throughout) before checking out later that morning. I got to catch up with a few people during the day which was awesome and finished off the evening catching up again with my friend from high school and doing some productive window shopping. Flew back Friday night, and that was that.

Thinking about first day of ortho tomorrow, I'm excited. Not so much related to the ortho, but because before I know it I'll be freaking about ortho OSCE and exam and then it'll all be over and then I'll be sitting here writing about how quickly half a year went, and how quickly fifth year is passing... And even though I was more than a little wigged out to see a couple people from my group at the library studying (one of them with ortho notes in hand!), like a Trainee Intern recently said to me, "Ultimately, gunning for distinction is a game; I was happy not to play because I knew there were other things I would rather do with the time I would have needed to invest. It doesn't make them a better doctor for playing; it doesn't make me a better doctor for not playing. In the end it's just a game you decide to partake of or not. I chose not."

I couldn't have put it any better myself if I tried.

Here's to Part II of IV.

two quick thoughts

1.) I've been thinking more and more about Elective, and in particular where I wanna "stop by" in transit to and from Africa. It's hard when the world is your oyster so to speak, but I think I've basically made up my mind that this trip will be a completely selfish, just-for-me adventure. And with that there are three cities I have been dreaming about going to since I can remember: New York (United Nations!), Washington D.C. (West Wing!), and Prague (that gooooorgeous Czech guy I met when I was working for Amnesty! hahaha... just kidding... that's not the only reason at least, lol). So it looks like: Seattle --> Boston --> NY --> Washington D.C. --> --> Elective; --> Prague --> home. :)

2.) With it getting so cold lately I've been increasingly layering up for my runs and yesterday while I was in town I saw that Kathmandu was having a sale so I finally got around to buying a polyprop thermal. I'd been thinking they might be a good idea for my runs, especially as winter hits and layering on t-shirts and hoodies as I've been doing feels suffocating. So I finally got a polyprop and I'm addicted. I haven't even run in it yet, but I just LOVE WEARING IT. Why hasn't anyone told me about its sheer awesomeness before?!? It's like the grown-up version of the college hoodie -- so warm, so comfortable, so soft... it feels like you're snuggled in bed, but you're actually not. Powerful stuff...

a spinning compass no more

It's been great having Kirsty down from Auckland over Easter. Mum and dad flew her down for her birthday and it's been so much fun and relaxing. I think I really needed her down here to make sure I did nothing but watch dvds, shop, sleep -- not do any school-related "work." A welcomed respite for sure. Things have started to get better for me and I'm slowing getting back to the place I need to be, in my head and my heart and in life in general. Slowly getting some Light back into my life and with that some Peace. I had been planning on spending this break studying, properly for the first time, all that is Paeds/O&G, especially after my horrendous week of point-blank cramming (which I have never done before in my life) and subsequent assessment results reflecting that half-arsed job. But, alas, I feel like more than that, what I really need is just to take a breather, a step-back, to re-orientate myself. If I know anything it's that I do not want to be forever immortalised in med school gossip as that one girl who was so unnecessarily hard-core that she took on so much and burnt out after first quarter, disappearing off to the woods to live alone and unshaven for the rest of her life. LoL So besides organizing this mess of a room, I've almost decided nay with the studying. I'll just need to really, really, get my act together for what's left of the year.

P.S. 490 days left till medical elective -- YAY! :)

one moment... one second... one day

Yesterday I woke up and decided I wasn't feeling very well. At all. I think it was a combination of things, the biggest factor being physical burn-out. Sure I might have finished my Paeds/O&G rotation last Friday but even since then it's been just non-stop, with flying up to Auckland and running around during Integrative Week doing all these tasks for the various "projects" I have found myself involved with: the next issue of the Journal's deadline is today; immediate action points post-Auckland meeting and co-ordinating with my co-rep; putting together this movie presentation for the Dean. Even as I was agreeing to the latter last week, it was like as if it was happening in slow-motion: as I found myself agreeing I was thinking that I knew I shouldn't, I knew I couldn't handle yet another project; I knew I needed the break to just take a break and organize and wrap up this crazy rotation just passed. I didn't know why I found myself saying yes even as I knew emphatically I should just say no... until yesterday. I met up with a new friend yesterday, one of the leaders of Med Christian Fellowship this year; she's in third year but a postgrad student so a couple years older than me. We've been meaning to do coffee for a while now because we were both talking about how hard it is sometimes to find other people here who were in a place in their lives that was post-"student" but pre-"family." Anyways we went for coffee after the MedCF meeting and talked for almost three hours. And those three hours were just... man... refreshing. For the Soul. Just talking to who was, through Christ, immediately my sister, having that instant eternal connection; and on top of it all, it turns out we're actually quite similar, personality-wise and in the fact that we're both the type to get "in" our heads, non-stop thinking, analysing, etc. It's a rare find, someone who understands and can relate to that.

I now have someone who is, hopefully, gonna keep me spiritually accountable, something I've been lacking for a couple years now, but something I've known I desperately needed yet have refused to do anything about.

The other huge thing that came out of our conversations that was basically mind-blowingly revelationary? My self-inflicted busyness as of late has been me, avoiding, everything and anything. It's so safe and isolating when I'm busy, when I'm rushed off my feet; medicine in general is great for that if you want, for telling yourself you're doing relatively important things for relatively important issues and in the process removing yourself from meaningful interaction and human connection. Sure, my getting involved with so many things this year has meant I've met an endless list of new people and that I'm constantly surrounded by and interacting with people from all areas of life, at different stages of their training... It sounds counter intuitive maybe but that very fact has been great for self-imposed isolation. And that's what I've been doing, unbeknownst to... me. I've "removed" myself from my family and my friends, and anyone and everyone... And the thing is, as my friend mentioned yesterday, because from everyone else's perspective I'm extroverted, organized, articulate, and does well in general, no one would ever think to challenge me in any way, or question if I'm okay; everyone just assumes I'm alright and thriving. And I know this is true because in some ways I have used it to my advantage throughout my life; I've learnt, over the years, how to put on this act, this facade, and I really do keep everyone at arms length especially when I'm struggling... Everyone. Why do I do that? Why do I put up these barriers? Why am I so afraid to truly be honest with another person? Am I even truly honest with myself? Do I put on these different versions of myself for a reason?

I joked yesterday to a couple people that I took a "mental health" sick-day... maybe I wasn't joking. I know I need to sort this out. And at the centre of all this mess is my Avoidance of the Big Fella. But you know what's amazing? I've been running around in avoidance these past few months, trying to go through every door and every avenue besides His, and yet He has been continuing to slam every one of these doors but His. And as each door has slammed shut in front of me it has sucked and it has hurt... and yet, what an incredible God, how much He must Love me if, in the midst of me running around trying to do anything and everything to avoid him, He still keeps trying to bring me back to Him. Who does that? Who Loves you that much to do that?

I think this week, this mid-semester break, I really need to sort things out for me. I'm stuck. And I know now it's not sustainable. At this rate, at this place, how I've been going this past quarter, I now know for a fact that I will burn-out in every way way before November. And that's a scary thought. Something has to change. No more avoiding, no more denying, no more thinking. Just, No More.

a movie without an ending... until the end comes

Life is like the movies. It really is.

One frame, one second: sunlight breaking through wavering tree branches forming this perfectly fragile, glowing mosaic. One scene, one conversation: honest and beautiful, showcasing all that is good. And more and more until, with time, these moments begin to coalesce, forming those millisecond snippets of a life that flash before your eyes as you daydream away one Sunday afternoon.

The only difference is that in a movie when the credits roll there has been an ending. Every loose end, every lesson-to-be-learnt, every argument, every hurt, every relationship, has been wrapped up, tied up, and you leave the theatre with the satisfaction that is in Resolution and Retrospection.

Whilst life? Complete and final resolution and retrospection, I am starting to realise, won't come until I'm 80 years old, sitting at the kitchen table with a cup of tea reflecting on a life that has come and gone. If finality is what keeps life from being messy I do believe I am barking up the wrong tree.

Fin.

(For now.)

Presenting complaint? History of presenting complaint?

Not that I in any way regret getting involved with all the things I seemed to have gotten myself into to; not that I'm complaining at all in regards to my self-inflicted state of being, state of mind, state of everything and anything, because I wouldn't do anything different if I could; but I have a history of the following: self-inflicted busyness begets exhaustion, which begets sleep deprivation and/or absolute fatigue, which begets getting "in" my head, which begets going a bit insane, which begets can't stop thinking, which begets rethinking everything I think about life and man and world and life, again... and the cycle continues.

I can confidently say I don't know what I want, I don't know what I think, I don't know what I'm doing; I think I clicked into Survival mode six weeks ago and there I continue. The difference right now from all those previous episodes? This doesn't end with the end of the run, or end of the semester... this doesn't end until at least Nov 2009 when I will most likely collapse into bed for a good three days, acquiescing, finally, to what my body has been crying out for all year.

Holistic approach to medicine -- damn, they're right. Body-Mind-Emotion-Spirit. In the end they're all connected.

I don't know what's going on with me right now. Hopefully I'll get out of this whatever it is, soon.

another day, another dollar

Sometimes I think I think waaaaay too much...

On a completely unrelated note, on Tuesday a couple things happened that just made me laugh out loud like whoa.

I was in Outpatients Clinic with the Paediatric Registra when we saw a 13month old baby boy from Wanaka who presented with a history of diarrhoea++. The parents told the Reg people had tried taking blood back in Wanaka but that their son absolutely hated it, cried and cried, and ultimately only a very small amount was obtained. The Reg definitely thought more blood tests needed to be done, so after five minutes of trying to get into a vein and non-stop crying, success! Baby stopped crying as soon as the Reg was done; mum was standing in the corridor, holding Baby, talking to the Reg, at which point Baby all of a sudden, out of nowhere, puked RIGHT AT THE REG. Dude, awesome aim, awesome effort, just pure awesomeness. It was like baby was totally sticking it to The Man. I know it was probably more a physiological response to all that stress, but still, it was freakin' hilarious. But good on the Reg for his quick response, jumping backwards so that the puke only hit the tip of his shoes. Even now it still makes me laugh.

Then later on that day we had a Bioethics tutorial on the role of doctors in suspected cases of child abuse and where we fit in regarding Child Protection services, etc. Tangential discussion led to an outburst from my friend and classmate, Luke, who's response to my playing devil's advocate was an oh-so eloquent, "No! Tough titties!!!" A phrase I never expected to hear, well, ever, but particularly not in a Bioethics tutorial. That guy. LoL


And I've been thinking that I should stop thinking so much... so there's that. LoL

Messiness v Productivity

As a result of various events that have slowly unfolded in my life as of late, I've been wondering more and more whether the choices I make in life, love and all that jazz -- the things I decide to do and not to do -- are largely determined by my dislike of disorder and "messy."

It's a newly snowballing revelation, the kind of thought which once planted I can't seem to ignore nor escape, despite an unending list of menstrual disorders and endometrial cancers left to study.

I just hate "messy." It's a fact. I don't mean aesthetically messy or dirty but messiness in Life: unable to predict, unable to plan, unable to rely on Y to occur as a result of X. Maybe that's why I love (or, ? hide in the guise of) Busy? I intellectualise that I'm "too busy" to get into A, or take that risk known as B, or try out C. And I tell myself that not only is A/B/C potentially very time-consuming but it's just counterproductive to a Productive Life.

And so I revert back to my definition of "Productive Life," which is planned and henceforth executed to damn near perfection. And it's fun. It's awesome. And it's indescribably satisfying.

... But, in some ways, could it be just my way of avoiding "messy." Of taking risks? Of... letting go and letting flow?

... Or, does it matter either way? I mean, if I'm truly happy with "Productive" and how my life is, does it really matter whether or not it's partly rooted in that avoidance of messy? Or is that just me intellectualising and justifying, cos honestly I could convince most people including myself of most things if I tried.

There's a line from "You've Got Mail" which I love and I think I've quoted before and it's when Meg Ryan wonders, "... so much of what I see reminds me of what I've read in a book, when, shouldn't it be the other way around?" While that's not what I'm talking about in this instance, I too am sitting here not really seeking an answer but just to send this question out into the Void: Are my choices just a way to avoid that drama and messiness I so, so dislike and fear? Is messiness a fundamental part of what makes living, living, and therefore am I missing out? Or is it merely a question of how you choose to live your individual life? I know there's much more to life than Productivity, but does that mean I should actively introduce "messiness" into my life and in the process become less productive?

... or, is this all just another means of procrastination?