Having to stop by the post office this morning I had half an hour to kill before heading over to the hospital for my shift at the Emergency Department so I popped in to the bookstore for a wee browse. Normally I stand in front of the new publications stand and flick through whatever looks promising whilst breathing in as much Fresh Book as I can (mhmmm...). Today I picked up an incredible book (the title of which annoyingly escapes me right now!) that profiled "unsung heroes" around the world. One of whom was this Frenchman who worked in Cambodia to set up restaurants/businesses that gave street children vocational training and with that, an education and a chance at an independent life. What I found the most interesting reading this was how he used his experiences working for the marketing department of L'oreal and his education from the prestigious Institut d'Etudes Politiques de Paris to shape his approach in making a sustainable impact.
The term they used in the book was "social business." And it got me thinking. It got me thinking about how Health is (or should be?) a sort of "social business." Don't get me wrong, I'm not referring to universal vs the U.S. model of privatized healthcare -- different topic, different issues, another time, lol. I'm referring to public health systems where most/all is paid by the taxpayer, provided for by the government. Being in amongst the world of health provider, I can't help but see so much waste and inefficiency in our system and how, at the end of the day, that means our patients, our community, lose out. I say this not as a criticism of the extremely hard-working health professionals (myself included!) and I'm not whining or picking faults for picking faults sake. I bring this up because I've been wondering what I want to do, career-wise, and incubating the question I was recently asked, "What gets you out of bed in the morning."
The silver lining of my five-hour shift in the Emergency Department (ED) today was the time I got to spend with the three patients I saw: getting to know them, chatting with them, making them a cup of tea. But that was it. And only partly was it due to do with my issues with ED (walk through the doors, cue: heart sinking; all that uncertainty and potential for serious shit-hitting-the-fan). I know, it makes it sound like I should be a social worker rather than a doctor but were I a social worker I would get too too frustrated having such a limited role in the patient's care.
With every issue, every situation, there's the Immediate. Yet with that there is always The Bigger Picture also. And in my mind the two are inextricably linked. I've always know I was a Bigger Picture person: my fundamental curiosity isn't to do with disease or pathology or medicine, but the Bigger Picture -- how does it tie in with the Immediate? How can the Immediate be improved at a grand scale by tackling the Bigger Picture? And I'm beginning to realise that I really can't change who I am. I can't change what tickles my fancy, my very own brand of immutable curiosity.
What is so attractive to me about the business model is how, when profit is involved, the dictating issues are efficiency, cost-productivity, getting the most out of what you put in. Now, is it just me who sees so clearly how much could be improved in the health sector if this model was applied?! In that sense, I wholly believe that the health should be a social business of sorts as well as non-government/Not-for-profit organisations. What kinds of organisations need efficiency, cost-productivity, getting the most out of what you put in, if not those with limited resources and such a huge need! Health systems, NGOs, volunteer organisations! They are filled with passionate people keen to make a difference, yet struggle in so many ways. I gave up pursuing international law as a career because I got frustrated sitting around talking about The Bigger Picture whilst doing nothing for the Immediate. And yet, now that I've fully immersed myself in the Immediate, I can see so clearly how the Bigger Picture has a revolutionary potential. We are naiive to think that either in isolation is all that is required.
At the end of the day, if a system is improved so that 200 more hip replacements can be done at the same cost -- or, scrap that, even just one -- I see so vividly the transformation, the impact, that it would have on the life of that 70 year old patient with debilitating osteoarthritis I have met oh-so many times throughout my training.
Now that would get me out of bed in the morning.
Friday, April 30, 2010
Thursday, April 22, 2010
efficiency... AT LIFE
My philosophy: it's all about efficiency.
Is it possible, with enough thought and enough planning, to predict the potential pointlessness of everything/anything? Or are there just some things in life which, despite all effort, you just have to find out by experience? Is pointlessness completely and utterly avoidable if you try hard enough, or is it something that my type-A, overachieving, slightly neurotic self is just gonna have to learn to stomach over this lifetime?
Too many questions. I think it's time for some answers now.
Is it possible, with enough thought and enough planning, to predict the potential pointlessness of everything/anything? Or are there just some things in life which, despite all effort, you just have to find out by experience? Is pointlessness completely and utterly avoidable if you try hard enough, or is it something that my type-A, overachieving, slightly neurotic self is just gonna have to learn to stomach over this lifetime?
Too many questions. I think it's time for some answers now.
Monday, April 19, 2010
not so inconsequential?
The older I get the more I start to think life is a not much more than a series of seemingly inconsequential moments and decisions.
I wonder how much of who we are, we who become, over the span of a lifetime is a result of those "little things" which at the time often fails to even register but that which ultimately ends up playing a significant part in the shaping of our lives.
What is life but a cumulation of such moments and decisions?
What is life but an apparently random succession of such moments and decisions?
I flew to Wellington on Thursday night with a clear direction for where I wanted to go in this next phase of my life; I flew home last night with a slate I have since wiped clean.
Moment 1
Saturday was our national leadership development seminar which I have spent the past five weeks organising. During the day I had a conversation with one of our speakers, a very successful business woman. She was brilliant, inspirational, but most surprisingly, there was some"thing" about her that just... clicked with me. Talking to her, it felt like I had spent the past six years moulding myself into a silhouette that just wasn't me, that just didn't fit; and then, all of a sudden, for lack of a better expression, I was released. For some time now I have had this growing realisation that I just think differently from most of my classmates and colleagues -- my approach to situations, my thought processes, my vision just differed. I felt the closest fit with surgeons, but even then there was still something... not quite right, yet I could never up my finger on what it was. You never know what's missing until you've had a piece of something new and different. This conversation was that very catalyst. The dawning of the realisation that yes I could be a clinician... but maybe it just isn't ME, in this most ineffable, visceral, gut, core-of-who-I-am way.
Moment 2
While in Wellington I had dinner with a good friend of mine who is currently doing Emergency Medicine. With a huge smile on his face, he pulled out his iPhone to show me photos of various injuries, pre- and post- his suturing and management. I sat there reacting as I do, with dramatic wonderment (and, to be fair, the photos were pretty cool) but in the back of my mind there was no fundamental curiosity. And as I sat there I realised that his clinical skills most likely far superceded mine but, even with that knowledge, there was absolutely no desire, or drive, or interest... in any of it. And I found myself asking, "What's wrong with me?"
Moment 3
Five weeks of non-stop emailing, organising, and utter craziness organising NCW.
Thursday evening flight to Wellington, six hours sleep.
Friday 6.30am alarm, 8.30am - 5pm Exec meeting; Exec dinner; five hours sleep.
Saturday 5.45am alarm, 7.30am - 6pm NCW; night out; 3 hours sleep.
Sunday 7.45am alarm, 9am - 5pm Exec meeting; flight home.
Sitting in the plane at 9pm on Sunday night, barely able to keep my eyes open, I found myself saying to Kerry, my co-Rep, "You know what? Of all the things I have done in med school, what I've enjoyed most has been NZMSA." And in that moment I realised that I meant it.
So I'm left with one huge question: has becoming a doctor been that one life-defining decision, or, rather, just a stepping stone in the yet-to-be-written Story of My Life?
One weekend away has left me with a million questions.
I love it.
I wonder how much of who we are, we who become, over the span of a lifetime is a result of those "little things" which at the time often fails to even register but that which ultimately ends up playing a significant part in the shaping of our lives.
What is life but a cumulation of such moments and decisions?
What is life but an apparently random succession of such moments and decisions?
I flew to Wellington on Thursday night with a clear direction for where I wanted to go in this next phase of my life; I flew home last night with a slate I have since wiped clean.
Moment 1
Saturday was our national leadership development seminar which I have spent the past five weeks organising. During the day I had a conversation with one of our speakers, a very successful business woman. She was brilliant, inspirational, but most surprisingly, there was some"thing" about her that just... clicked with me. Talking to her, it felt like I had spent the past six years moulding myself into a silhouette that just wasn't me, that just didn't fit; and then, all of a sudden, for lack of a better expression, I was released. For some time now I have had this growing realisation that I just think differently from most of my classmates and colleagues -- my approach to situations, my thought processes, my vision just differed. I felt the closest fit with surgeons, but even then there was still something... not quite right, yet I could never up my finger on what it was. You never know what's missing until you've had a piece of something new and different. This conversation was that very catalyst. The dawning of the realisation that yes I could be a clinician... but maybe it just isn't ME, in this most ineffable, visceral, gut, core-of-who-I-am way.
Moment 2
While in Wellington I had dinner with a good friend of mine who is currently doing Emergency Medicine. With a huge smile on his face, he pulled out his iPhone to show me photos of various injuries, pre- and post- his suturing and management. I sat there reacting as I do, with dramatic wonderment (and, to be fair, the photos were pretty cool) but in the back of my mind there was no fundamental curiosity. And as I sat there I realised that his clinical skills most likely far superceded mine but, even with that knowledge, there was absolutely no desire, or drive, or interest... in any of it. And I found myself asking, "What's wrong with me?"
Moment 3
Five weeks of non-stop emailing, organising, and utter craziness organising NCW.
Thursday evening flight to Wellington, six hours sleep.
Friday 6.30am alarm, 8.30am - 5pm Exec meeting; Exec dinner; five hours sleep.
Saturday 5.45am alarm, 7.30am - 6pm NCW; night out; 3 hours sleep.
Sunday 7.45am alarm, 9am - 5pm Exec meeting; flight home.
Sitting in the plane at 9pm on Sunday night, barely able to keep my eyes open, I found myself saying to Kerry, my co-Rep, "You know what? Of all the things I have done in med school, what I've enjoyed most has been NZMSA." And in that moment I realised that I meant it.
So I'm left with one huge question: has becoming a doctor been that one life-defining decision, or, rather, just a stepping stone in the yet-to-be-written Story of My Life?
One weekend away has left me with a million questions.
I love it.
Thursday, April 8, 2010
The biggest tangent ever award
I'm writing from my office at Student Health, the last day of my four-week placement, and am more than a little sad that I'm leaving. Being semester break it's been deathly quiet here this past week. I'm not even afraid to use the Q-word because there is seriously no way the Q-word curse will have any effect. A lot of the doctors are away too for various reasons so I'm a bit disappointed I won't be able to say goodbye to them all. I bought along my basket of home-baked goods as per tradition which everyone seems to be enjoying (yay!), with one of the nurses trying to convince me to quit med school and try out for "Master Baker" (lol; try saying that fast ten times!). (What she meant was Master Chef and/or NZ's Hottest Baker.)
I gotta say this is the first time that saying goodbye to a placement has been hard for me. The thing I've loved about med school and, actually, a career in medicine in general is that it's great for people like myself who have a relatively short attention span, people who thrive off of change. Since starting clinical rotations the moving around different workplaces, different wards, different teams of people, have always provided that breath of fresh air at just the right moment -- as the initial excitement begins to wear off, four or five weeks later.
Maybe that's why in your early-mid twenties, it's easy to find surgical training exciting and sexy, Grey's Anatomy style. You're young, full of energy, physically at your prime and, for most of us, not tied down in any significant way. We can move around to different hospitals and different cities as we're assigned, work those crazy crazy hours each week, stick around for that extra surgery you hear about as you were leaving at midnight because it's one of the surgeries you haven't seen before and sure you can survive on three hours less sleep tonight.
But... and here's the million dollar question: what happens if/when you find a place that you actually don't want to leave?
Despite being in my early twenties and at a place in my life where the "gypsy" lifestyle remains du jour, I am starting to see what a fragile balance it really is -- how quickly being settled down could suddenly become oh-so attractive. And at this moment I am freaked out simply by the idea, the possibility, that I might actually one day desire being settled down in that oh-so permanent way. I never knew what that might feel like until today when I got a glimpse of how it felt to leave a place I wasn't ready to leave, and the heartstrings that got achingly pulled as I did.
I strive to live my life on purpose, always and constantly forging ahead. But I wonder, is that because that's who I am, or, because it's where I am in my life right now? I've always thought it was the former... but what if it's a little bit of both? Luckily, for now, they're on the same page. But what if that changes? What happens if or when I reach a place where those two elements begin to conflict? What happens then?
I know. I've said it before, and I'll say it again. Man, I think waaaay too much.
It's my older sister's birthday today. She rocks my world. It's strange, this is her second birthday spent in a different city, living her own life, in her own world, with her own cast and crew and background music. Is it just me or does almost everything serve as a reminder of our own mortality? Not in a dark and depressing sense, but in a reflective, nostalgic, grateful, with each day and each year we age, grow, change kind of way...
Life... is like an around-the-world plane ticket. You start at one place with a certain mileage limit, with as many stops in as many cities as you'd like but all in that one same direction, with the one condition of no going backwards... and eventually, you reach the end.
An awareness of our own mortality, for me, keeps everything in perspective. It serves as a reminder to ask myself, really, what is the point of it all? And each day, for me, the answer remains the same: to love our God and to love our neighbour. To love my neighbour. That's basically it in a nutshell.
I gotta say this is the first time that saying goodbye to a placement has been hard for me. The thing I've loved about med school and, actually, a career in medicine in general is that it's great for people like myself who have a relatively short attention span, people who thrive off of change. Since starting clinical rotations the moving around different workplaces, different wards, different teams of people, have always provided that breath of fresh air at just the right moment -- as the initial excitement begins to wear off, four or five weeks later.
Maybe that's why in your early-mid twenties, it's easy to find surgical training exciting and sexy, Grey's Anatomy style. You're young, full of energy, physically at your prime and, for most of us, not tied down in any significant way. We can move around to different hospitals and different cities as we're assigned, work those crazy crazy hours each week, stick around for that extra surgery you hear about as you were leaving at midnight because it's one of the surgeries you haven't seen before and sure you can survive on three hours less sleep tonight.
But... and here's the million dollar question: what happens if/when you find a place that you actually don't want to leave?
Despite being in my early twenties and at a place in my life where the "gypsy" lifestyle remains du jour, I am starting to see what a fragile balance it really is -- how quickly being settled down could suddenly become oh-so attractive. And at this moment I am freaked out simply by the idea, the possibility, that I might actually one day desire being settled down in that oh-so permanent way. I never knew what that might feel like until today when I got a glimpse of how it felt to leave a place I wasn't ready to leave, and the heartstrings that got achingly pulled as I did.
I strive to live my life on purpose, always and constantly forging ahead. But I wonder, is that because that's who I am, or, because it's where I am in my life right now? I've always thought it was the former... but what if it's a little bit of both? Luckily, for now, they're on the same page. But what if that changes? What happens if or when I reach a place where those two elements begin to conflict? What happens then?
I know. I've said it before, and I'll say it again. Man, I think waaaay too much.
It's my older sister's birthday today. She rocks my world. It's strange, this is her second birthday spent in a different city, living her own life, in her own world, with her own cast and crew and background music. Is it just me or does almost everything serve as a reminder of our own mortality? Not in a dark and depressing sense, but in a reflective, nostalgic, grateful, with each day and each year we age, grow, change kind of way...
Life... is like an around-the-world plane ticket. You start at one place with a certain mileage limit, with as many stops in as many cities as you'd like but all in that one same direction, with the one condition of no going backwards... and eventually, you reach the end.
An awareness of our own mortality, for me, keeps everything in perspective. It serves as a reminder to ask myself, really, what is the point of it all? And each day, for me, the answer remains the same: to love our God and to love our neighbour. To love my neighbour. That's basically it in a nutshell.
Thursday, April 1, 2010
pragmatism-curiosity :)
First of April already!! Ever since my last post I've been meaning to write a least one or two more for the month of March, but I find myself taken by surprise by the start of a new month once again. How fleeting are the moments, how quickly it all seems to pass you by.
The past couple of weeks have been a blur of working at my General Practice (GP) placement, and doing NZ Med Students Association (NZMSA) stuff seemingly every other waking moment. I seem to be glued to my email whether at home or in my office at work, receiving/replying to correspondence constantly, almost in real-time. If it wasn't so "socially" acceptable, I might be on the verge of needing an intervention, LoL. Oh man. The reason why I'm so busy on the NZMSA front is because I'm currently organising one of our cornerstone annual events taking place in a few weeks time up in Wellington, a leadership development seminar where we invite the leaders of each of the medical student groups from across the country. Everything is coming together really well: we've secured a significant proportion of funding, a really good response from keen students, and a great line-up of speakers to run workshops... but at what cost? Well, I feel like the Energiser Bunny with a very sore neck. It's getting to the point where LIFE -- and the world around me -- is a bit of a blur, really.
... I feel like a robot.
LoL.
No jokes.
Oh man. But at least it's gonna all come together soon enough, and then one of my main tasks for the year as Vice President(Internal) will be over! It's not just the work itself in organising such an event, but the perfectionist aka overachiever's drive to make sure people will find the day worthwhile, you know? Cos otherwise, well, what's the point?
But it's all good. This year has definitely stepped up a notch in the sense that I'm meeting so many new people, and some relatively higher-ups, what some might call "networking." It's been great, really. I seem to have little time in my life right now for outside-of-medicine (other than running), but within that bubble I'm getting to know so many awesome people and enjoying it very much.
It helps that my GP placement has been the perfect combination of busy and interesting but completely stress-free! I love that place, one of my favourite placements during all of med school I must admit -- I can't seem to stop raving about everyone there! The two doctors I've been mainly working with have been so incredible in their respective ways, and I have so appreciated getting to know them these past few weeks. Neither of them will be here next week so I was getting my evaluation forms signed off, and they individually gave me such encouraging, honest, genuine feedback! Not just about this placement, but life in general.
One said to me, "Anna, you have this mix of pragmatism and... curiosity. You're not afraid to try things on your own, but you also know when to stop and ask; that's what makes you a good doctor, and it's something that will take you far in life in general." A blend of pragmatism and curiosity... it's amazing how just after three weeks, what an incredibly accurate observation that was, yet something that had never registered before. And, well, to be quite frank, the most awesome compliment anyone has ever given me.
You know what? It kind of actually made my day. :)
[Next time, on "Sleep and the middle ground": Why treating your friends or people you know *really* isn't a good idea -- lessons learnt the hard way!]
The past couple of weeks have been a blur of working at my General Practice (GP) placement, and doing NZ Med Students Association (NZMSA) stuff seemingly every other waking moment. I seem to be glued to my email whether at home or in my office at work, receiving/replying to correspondence constantly, almost in real-time. If it wasn't so "socially" acceptable, I might be on the verge of needing an intervention, LoL. Oh man. The reason why I'm so busy on the NZMSA front is because I'm currently organising one of our cornerstone annual events taking place in a few weeks time up in Wellington, a leadership development seminar where we invite the leaders of each of the medical student groups from across the country. Everything is coming together really well: we've secured a significant proportion of funding, a really good response from keen students, and a great line-up of speakers to run workshops... but at what cost? Well, I feel like the Energiser Bunny with a very sore neck. It's getting to the point where LIFE -- and the world around me -- is a bit of a blur, really.
... I feel like a robot.
LoL.
No jokes.
Oh man. But at least it's gonna all come together soon enough, and then one of my main tasks for the year as Vice President(Internal) will be over! It's not just the work itself in organising such an event, but the perfectionist aka overachiever's drive to make sure people will find the day worthwhile, you know? Cos otherwise, well, what's the point?
But it's all good. This year has definitely stepped up a notch in the sense that I'm meeting so many new people, and some relatively higher-ups, what some might call "networking." It's been great, really. I seem to have little time in my life right now for outside-of-medicine (other than running), but within that bubble I'm getting to know so many awesome people and enjoying it very much.
It helps that my GP placement has been the perfect combination of busy and interesting but completely stress-free! I love that place, one of my favourite placements during all of med school I must admit -- I can't seem to stop raving about everyone there! The two doctors I've been mainly working with have been so incredible in their respective ways, and I have so appreciated getting to know them these past few weeks. Neither of them will be here next week so I was getting my evaluation forms signed off, and they individually gave me such encouraging, honest, genuine feedback! Not just about this placement, but life in general.
One said to me, "Anna, you have this mix of pragmatism and... curiosity. You're not afraid to try things on your own, but you also know when to stop and ask; that's what makes you a good doctor, and it's something that will take you far in life in general." A blend of pragmatism and curiosity... it's amazing how just after three weeks, what an incredibly accurate observation that was, yet something that had never registered before. And, well, to be quite frank, the most awesome compliment anyone has ever given me.
You know what? It kind of actually made my day. :)
[Next time, on "Sleep and the middle ground": Why treating your friends or people you know *really* isn't a good idea -- lessons learnt the hard way!]
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