Wednesday, March 17, 2010

Namaste... boss?

After a weekend of rest and sleep, I started up at Student Health (=medical practice servicing all of the students at University) for my four-week GP run on Monday, and it has been AWESOME thus far. I cannot believe how much I've been enjoying my placement here, and, were I General Practice-inclined, could see myself never wanting to leave. :)

Top five reasons why this has been my favourite run of the year so far:

Reason #1
A "New" demographic.
Never have I dealt with such a young population in my medical career. We get so used to the sick elderly or, even, just the elderly full stop. Young adults are a rarity in hospital, and in the GP runs I've done, so it's been exciting and challenging exercising that (previously much unused) part of my brain.

Reason #2
It has brought OSCEs/all that exam study I did last year ALIVE. So much of our exams last year was about sexual health, mental health, and the "worried well," but at the end of the day it all felt so... theoretical. You study and practice with classmates but hardly see any of it in real life; and you sit there wondering -- after a full day of study -- whether or not it'll even be of use. I never appreciated how important and relevant all of that truly is until now. So all of second semester last year wasn't just jumping through hoops! Wow, bonus!

Reason #3
I am my own little doctor, with my own little room, my very own little space, to do my own not-so-little thing. I've been working with two doctors, and loving how my days have been setup to run. I have my own list of patients, so I see my patient while the doctor I'm working with sees theirs, and then said doctor will come in, have a chat, and then sign off on my management plan. I'm really thinking through every patient and, now, have an increasing confidence to answer questions and discuss with the patient what we're gonna do. All the while thinking about is there something serious going on, is there something important I'm missing? Why has this patient come in, are they leaving satisfied? With each day I'm feeling more and more confident -- ready -- to start working as a bonafide doctor soon enough.

Reason #4
STEADY BUSY. All day, everyday. Just enough to not feel overwhelmed but with never a boring moment; constantly busy but with enough time to have a breather every once in a while. Like I've earned a hard day's wages and my right to come home to hit the hay.

Reason #5
Brilliant working environment. The staff and working environment is one of the best I've ever experienced. The two doctors I'm working with are AWESOME. They let me do my thing, but at the same time I'm learning so much from them with each patient I see. The workplace itself is HUGE and well set up and you can tell they have great management who keep things running as smoothly as possible, all while keeping everyone happy. It's such a relief to be around people who are happy to be at work, where there's not this "complaining culture" that can be all-pervasive in the public health sector. The nurses, the receptionists, the management, the counsellors, the doctors, EVERYONE is so lovely, so approachable. Plus, staff yoga Wednesday lunchtimes? Come on, that's just freakin' cool. It was a strangely awesome experience, seeing everyone in track pants and t-shirts stretching out, taking deep breaths in and out, taking a break, together. What an incredible equaliser. Truly ingenious.


In short, I'm loving it. What a great week it's been so far. I was so stressed most of January and February with trying to find a GP placement only to face rejection after rejection after rejection. And I remember just praying about it, trying to entrust it into God's hands... and I find myself in awe of His Faithfulness, yet again.

Saturday, March 13, 2010

love seems to be a revolutionary act... or has it always been?

I think maybe it's because I'm getting sick -- a combination of two weekends in a row of travelling, not enough sleep, seemingly event after event I'm in the process of organising right now, and the colder weather -- but I'm in that place again of physical exhaustion and a muckiness of thoughts. The past couple days in particular I've been struggling to have that joy and enthusiasm I seek and thrive off of everyday which comes with centering my day with Christ, a sign that I'm just too tired, full stop. This appears to be a recurring theme in my life the past few years, as I have, almost unknowingly (but not really unknowingly), taken on more and more. I have no regrets, and enjoy it all, and I know my heart's in the right place, but when these (rare) occasions come where I'm just so flat out that it seeps me of my joy, then I'm starting to realise I should see it as a warning sign.

Hello Warning Sign. Message received, loud and clear.

Last weekend I was in Christchurch for our first 2010 Exec Meeting where I was newly elected as Vice President which is super exciting, but with which comes a huge time and work commitment. During that weekend I only got a cumulative nine hours sleep, and then the next day was rushing around organising our first surgical society event for the year which also went well, but after which I was utterly pooped. Functioning purely on adrenaline (+/- caffeine) can only last so long, and I find myself this week just managing to get by. It doesn't help that I not-so-wisely got my flu vaccination on Wednesday, hence those prodromal flu symptoms and in particular, serious body ache all over. But, I mean, I've brought it on myself, and I'll get through it, I always do. I thrive off being busy, I know, but in the past year I've learnt where my boundary lies personally. And that boundary is this: if I allow all that "stuff," all my busyness, if I allow it to rob me of my joy, and my ability to love those around me, then it's too much. It's too much. If I'm not doing it with joy and enthusiasm, and if it's not allowing me to share Christ's love with those around me, then it doesn't matter how "successful" I am being, or what I'm achieving in the eyes of the world, I am no longer serving my purpose. Joy and Love, first and foremost. And on those fronts I've been struggling this past week, and that's not good.

Sooo... I've had these evening After Hours/Urgent Doc shifts and I've been doing some awesome medicine, but it has been really physically taxing. And I'm glad it's over. I had a shift even this morning from 9am - 1.30pm, but I will spend the rest of this weekend just re-orientating myself, back to God, back to what it's all really about. Usually when I get sick (and the weather's bad! and can't go running!) it's like a divine reminder to slow down and just... stop.


Today I met a 2nd year med student who was a post-grad, meaning he'd completed another degree before starting up this year. And as we were leaving the lunch we were at, I told him to get in touch if he wanted to grab a coffee anytime with someone "older" to chat etc. He looked at me, kind of in half surprise, and said, "Well, I'm not that much older, you know. I've just done a degree before."

I felt really bad afterwards because I had made an assumption, but at the same time, I completely did not realise that despite him being post-grad he was still most likely YOUNGER THAN ME. It suddenly dawned on me he was still probably a year or two younger. I mean, I'm in my SIXTH year of university... SIX YEARS! If you round up, that's a freakin' decade. And I've been joking about it, being at *that* end of med school, on my way out... how, when these 2nd years graduate I'll be a REGISTRAR(!!) (=senior resident). I joke, I joke, but it never really sank in... until today. I keep thinking about, what's the next five years going to be like; graduation, cool!; applying for surgical training, awesome! ... applying for surgical training... APPLYING FOR SURGICAL TRAINING! Oh man, I'm officially wigged out now. I know it'll pass, but for now I remain officially wigged out.

And with that, with all that's going on, all I've taken on... with the person I have become these past six years, during this journey that is med school... I look at the person I have become, the person I am as I sit here, and wonder... is this the person I want to be? If 17year old Anna going in to med school or, even before then, coming back from that summer at Harvard with an out-of-the-blue but God-inspired plan to try for med school, if that Anna could see the the Anna today, would she be proud? Would she be excited for what lay ahead, for the person she would become?

I know I have a long way to go in love and kindness and joy and goodness, but if I died today, I wonder what would be said. And would those things be the kind of things I hope to hear? "Well done, good and faithful child"?


I've suddenly noticed in the past few months -- either all of a sudden or I just haven't been paying attention but -- everyone seems to be coupled up. It's like even up until last year the default setting was "single" and the smaller proportion "with someone." But now it's like that default changed over and I'm the only one who didn't get the memo. In true Bridget Jones fashion, now almost every dinner I go to I am the odd number, LoL. I honestly don't mind, cos a lot of where I grew in my walk with Christ the last two years is learning and reconciling myself to what it means to have a Godly relationship and marriage, and an ineffable peace at the core of it all with where I am now. But I still think about what it all means, what God wants from me during this phase of my life. And my recent "revelation" has been this: that all this "stuff" -- our job, money, possessions, relationships, achievements, travels, experiences, hobbies, even our day to day mundane tasks -- all of it is just a backdrop to the fundamental act of loving our neighbour. All this other "stuff" is like the quiet unobtrusive buzzing of the refrigerator that allows us -- gives us a context -- to love, those around us. Strangers, friends; patients, family; co-workers and classmates; near or far.

A friend of mine in Wellington mentioned how some of our classmates up there had asked, or mentioned on a few occasions, that they all knew I was a Christian and with that why I did the stuff I did, why I got involved with the stuff that I am. They wondered about my motives, maybe even in a suspicious way? I don't know. But it got me thinking when I heard this, and I think if they asked me my answer would be this: to love them, the people I work with, and to share with them joy, peace, positivity, encouragement (to build them up), patience, kindness, gentleness, goodness and faithfulness and self-control. Things I am continually working on, but in the process, hoping to share the little I have to the fullest of my ability. My cup daily overflows, and so for that overflow to seep through those around me. And if that's something to be suspicious of then we live in a world that needs love that much more.

With all this thinking about the future, all this planning-for-the-next-five-years business, all this single vs relationships, all this worldly busy-ness, I think I've somehow forgotten the point of it all these past few weeks. And what IS the point? The point is, that there's more to life than this moment, the here and now. And that's that. I don't have to DO so much all the time... it's not all on me... it's not all about me. There's so much more. And I just need to stop for a second and... breathe.



"From the bottom of a bank"
September 12, 2009

Dear friend,

As you know for the past week I have been on my rural medicine rotation in Motueka/Nelson, one of the most isolated, serene and untouched areas in the country surrounded by an indescribable primitive beauty. Myself and two other med students are staying in a bach (= small holiday house) right next to the beach (perfect for my runs!) about twenty minutes drive from the nearest "town." The medical practice I've been attached to has been an awesome experience so far, seeing patients by myself all day, flexing those diagnosing and management muscles, and feeling more and more confident with each day that passes.

Yesterday (Friday) I had the day off and I had planned to get a full day of study done at the bach. After breakfast I drove out to the general store down the road to buy a new toothbrush, having dropped mine into a bit of dust and dirt a few minutes before. Funny how one little thing -- like your toothbrush slipping out of your hand -- can lead to a series of utterly unexpected and unpredictable events.

It was raining quite a lot yesterday morning, for the first time since our arrival here, and the long driveway into our bach from the main road is not much of a driveway at all but rather mud and gravel surrounded by forestry. I don't know exactly what happened next (as much of it remains a blur), but my front wheel must have gotten too close to the edge of the drive in just the right place, at just the right angle, at just the right moment... and, before I knew what was happening, the car was tumbling down the bank of forestry, down a few meters, my seatbelt the only thing holding me in place as my car rolled on it's side three or four times. Even though the events before and after remain a blur, the view from inside the car as it tumbled and tumbled replays over in my mind with freakish clarity -- it felt like I was trapped inside a glass washing machine in an abyss of dark green and brown. I distinctly remember trying to brace myself and figure out whether or not this was all actually happening.

When everything finally stopped moving the car was on it's side (the driver's side). Suddenly the inside of the car felt very small. At that moment I had two thoughts: "Anna, don't freak out, don't freak out, don't freak out. Get back to the house. Just get to the house." So I took off my seatbelt, grabbed the keys, pushed up on the passenger's door, climbed out of the car and up the damp, wet, slippery bank laden with tree branches and forestry, and, without looking back, walked fast but steady up the rest of the gravel driveway to the bach. My heart was racing, my hands shaking. I called Frances, our co-ordinator, and upon hearing her voice at the end of the line I burst out crying.

Thankfully the car was a rental (hence insured), but I was still very shaken up. Frances made a few phone-calls and my classmate-friend, Nic, who was already at his placement Practice drove back within half an hour. A cup of tea and some bad humour later (compliments of Nic), I was feeling a bit better. Despite feeling bad for pulling Nic away from his busy day (although he assured me he didn't mind in the very least!) it was great to have him around, to call the rental company, suss out the tow-truck, and to just be around for some hugs. It took the Tow and Salvage people over an hour to get the car out of the bank, and upon surveying the damage it was hard to believe I came out of it completely unscathed. There was extensive damage to most of the panels including the roof (according to Nic; all I know is that it all looked pretty squished), and both the side mirrors and the windshield were completely shattered.


When I woke up that morning I could never have predicted what was in store for me. I woke up that morning with a plan and a schedule, yet could have never imagined what was to come. I woke up yesterday morning and finished off my quiet-time with God by laying down the day ahead of me at the foot of the Cross of Christ, and by his Grace, asked for his hand to be upon it. Needless to say my prayers were answered.

As I gear up for exams in seven weeks time -- a week that will essentially determine whether or not I am ready to become a doctor -- I am reminded that there is more to life than this moment, this day, this year... more than the here and now. There is more than degrees and jobs, money and property, relationships and friendships, minutes and years. "And now these three remain: faith, hope and love. But the greatest of these is love." (1 Corinthians 13:13) Love for our God, love for one another, love for our neighbours, across the street and across the globe.

It took a tumble down a bank (literally) to remind me of the smallness of a lifetime, and the vastness of eternity. And I guess I just wanted to encourage you, my dear friend, you who fills my heart with joy, to take a moment out of this day, this minute, to pause, clear your mind of the clutter of the day and the world around us, to just revel on the miracle of this moment right now -- the miracle of life; the miracle of all the trillions of things that are working to keep you reading and breathing and thinking; the miracle of what keeps the earth moving and the sun burning; the miracle of the life you've had and the life that is ahead, no matter how long or short that may be. In the noisy world we live in (even in the quiet we have managed to find a way to constantly surround ourselves with noise), we seldom pause to reflect and think about what it is we're really doing... and why. Let us not wait until we find ourselves trapped in a car at the bottom of a bank to search out Purpose and Truth.

Thank you for allowing me the privilege of a few minutes out of your undoubtedly busy day, and in the sharing of our lives these past days, months, years. It has been a true blessing having you in my life and I thank God for you and the friend you have been.

I hope this email finds you well, as always.

Until our next conversation,
With Faith, Hope and most of all, with Love,
Anna

"O Lord you have searched me and you know me. You know when I sit and when I rise; you perceive my thoughts from afar. You discern my going out and my lying down; you are familiar with all my ways. Before a word is on my tongue you know it completely, O Lord. You hem me in - behind and before; you have laid your hand upon me. Such knowledge is too wonderful for me, too lofty for me to attain. Where can I go from your Spirit? Where can I flee from your presence? If I go up to the heavens, you are there; if I make my bed in the depths, you are there. If I rise on the wings of the dawn, if I settle on the far side of the sea, even there your hand will guide me, your right hand will hold me fast. If I say, "Surely the darkness will hide me and the light become night around me, even the darkness will not be dark to you; the night will shine like the day, for darkness is as light to you. For you created me in my inmost being; you knit me together in my mother's womb. I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well... All the days ordained for me were written in your book before one of them came to be. How precious to me are your thoughts, O God! How vast is the sum of them! Were I to count them, they would outnumber the grains of sand. When I awake, I am still with you... Search me, O God, and know my heart; test me and know my anxious thoughts. See if there is any offensive way in me, and lead me in the way everlasting." -Psalm 139

Wednesday, March 3, 2010

Currently addicted to:


More than a few recent twists and turns have led me to the discovery of the brilliance of Dr Atul Gawande, and I find myself with a purist addiction to his words. I will, I promise, elaborate more on the path that led me to this incredible surgeon and gifted public health physician (yes! it's possible! it exists!), but for now I will leave you with this thought.
Today as I was assisting on a simple excision of a skin lesion at Ears, Nose & Throat Clinic, as I watched the surgeon perform facial plastics under local anaesthetic -- each cut comprehensively thought out, each suture made with such precision and care -- I found myself unable to contain a smile as I recalled a scene from Dr Gawande's book:
"Many surgeons elsewhere use Shouldice's distinctive repair method but obtain ordinary rates of recurrence. It's not the technique alone that makes Shouldice great. The doctors at Shouldice deliver hernia repairs the way Intel makes chips: they like to call themselves a "focused factory."... I asked Byrnes Shouldice, a son of the clinic's founder and a hernia surgeon himself, whether he ever got bored doing hernias all day long. 'No,' he said in a Spock-like voice. 'Perfection is the excitement.'"
YES. Perfection is the excitement.

Monday, March 1, 2010

"Oh Canada!" (I wonder how long I'll have the Canadian anthem in my head?)

It has been waaaaaay too long since I last posted, and it's not that there haven't been any blog-worthy events. Rather, I fear that my blog activity appears somewhat proportional to my stress level, i.e. the more stressed I am, the more I retreat into "Sleep and the middle ground." Given that logic, life has been, for the past couple months, pretty darn sweet. I have so many great stories to tell from my O&G run down in the whop-whops in January, and even better, funnier, stranger, more interesting ones from my month on psychiatry this past month -- an acute psych ward is like none other, a real world of it's own -- but I think I'll let it rest solely in my own memory bank for now. Laziness? Maybe. LoL

With psych I've had more than my share of free-time, which has been awesome. I've loved early afternoon finishes and coming home to watch a bit of the Winter Olympics, one of the rare sporting events I actually stay tuned to! And it's got me wanting to visit Vancouver/Canada, so good job all you Canadians, kudos Tourism Canada!

Other than that, making progress on my half-marathon training with my friend Jade. It's week three of our "official" twelve-week training programme which culminates in the Vineyard Half in Blenheim in May. We signed up together in October last year and I have since been mentally psyching myself up for it. I vacillate between, "How exciting!!" to "Holy crap, what have I gotten myself into??" which, come to think of it, goes for a lot of things in my life, lol. But "training" is going relatively well, and at this moment I'm more excited than I am scared, although that tends to change on a daily basis. The weather's been pretty nice lately which helps, but we'll see how long that lasts.

What else? I've almost finalised my plane tickets for my elective trip to West Africa come August, which I'm beyond excited about! I was talking to a friend of mine who spent time growing up in Mozambique with her missionary parents and she was telling me how, because they could only take malarial prophylaxis for six months, after that they swallowed a clove of garlic a day to keep the mosquitoes away! "Ewwwwww!!!" was my immediate response, but I gotta say I can't seem to shake that thought... The ten million dollar question: how much do I fear mosquitoes (a lot), verses how much do I dislike the idea of daily swallowing a clove of garlic (... not as much as the former??). Regardless, I'm getting increasingly excited for my trip, including my two weeks in the States in transit. Wow. Two years since I was last in Seattle, SIX YEARS since my summer in Boston. Can you believe it?

All my extracurricular activities also continue to keep me on my toes. I've been chugging along with NZMSA and DSAS over the summer, but it's all starting to really kick back into gear now. I was in Wellington this past week on NZMSA-related business and, whilst there, opportunistically caught up with some good friends who I hadn't seen in so long; then Christchurch this upcoming weekend; then Auckland two weekends later... then back to Welly in April... then half-marathon, and Conference in Queenstown... and all coming to a head right before I start my med-surgery quarter -- could I have asked for better timing people?

So life is good. Better than good. Awesome. Amazing. Incredible. I wake up every morning and praise God for how good He is, and sit in awe of the day ahead. Fifth year was so hard, such... suffering, but, at the other side is this pure awesomeness which made last year worth it, as difficult as it was at times. And I still wonder how I got through it all. Man. Things with God have been so good too -- I just needed Him so much last year, in this achingly visceral way, and with that just fully entrusted everything, every moment of every day, into His hands. And with my little faith, He was so perfectly faithful in return. Wow. And I'm just spending more and more time with Him, building on it more and more.

A couple things on my mind, I gotta admit, about the future (as always) and about something a friend of mine said to me. I wonder about the difference between Vision; Plans; Ambition; Contentment; and Ambivalence. Do I have all or any of the above? Are they mutually exclusive? Do I fear some of them? Am I ignorant of wallowing in others? It's definitely got me thinking... in a good way. :)

That's it for now. A quick update from my end. But I will elaborate later... and maybe even share a few of my most interesting psych stories. Suffice it to say, I'm still here, enjoying TI year, having so much fun and making the most of it before it all changes, once again, come November 2010 when I start... working. *Shudder* Good night, and till next time.