Despite an overwhelming desire to write, write and then write some more about what's been going on lately, I find myself unexpectedly (or not so unexpectedly?) pressed for time!! The Paeds department here was notorious for their assignments/presentations/etc during 5th year and TI year I'm afraid is little different. So in between working on one of four presentations I have to give during this four-week run, not to mention an oral test, AS WELL AS on-calls, I'm finding it a bit difficult to (a.) be sociable, and (b.) get some quality time to jot down my thoughts. A bit frustrating but to be honest, I'm too physically exhausted to care right now. After all weekend on-call, and then back in the hospital this morning to do a blood test before 8am handover, all I want to do is get into bed and sleep.
If the point of Intern year is to give us a taste of what life is like after graduation I believe I am starting to understand... and, well, I have a year to mentally prepare myself for a life of physical exhaustion. LoL But still, no regrets. There is joy in suffering... fo sho.
Okay... back to the literature search on carbohydrate counting. Oi vey.
Monday, November 30, 2009
Monday, November 23, 2009
whoa, what just happened?
I experienced my first cardiac arrest today... in the neonatal intensive care unit (NICU).
I experienced my first death in the hospital... the death of a tiny little baby.
Without saying too much, this newborn baby has been pretty sick and no one could figure out why. They (the consultants and registrars) had spent a while discussing this baby at the morning handover meeting, but I didn't think too much about it myself. Then, having been assigned to NICU for the week, I met this baby and the whole family an hour later on our ward round -- and indeed the baby was unwell but stable. It was pretty hard going for the family who knew things were getting serious and, in some ways to an outside looking in, it kind of felt like they were preparing themselves to say goodbye, like as if somehow they knew in their heart of hearts what was to come.
It was later that afternoon that all of a sudden there was an explosion of beeping from one of the NICU monitors, followed by hushed exclamations of "Where's the doctor??!?" Before I knew what was happening there were two registrars, one house surgeon, two nurses (with the consultant on the way)... and me, standing, just standing there, watching it all unfold in front of me like a scene from a TV show, but this time in slow motion and with hushed voices in an otherwise silent and frozen NICU. And in those next ten minutes it was like everyone else in the room was holding their breath, completely paralyzed, afraid that one wrong movement might somehow change the fate of this little baby, dusky blue, teetering on the edge of the precipice that is life... or death.
I was frozen. I just stood there. They didn't need me, and, frankly, I had nothing to offer. No skills, no understanding, no knowledge. My role, I quickly realised, was just to take it in.
You know in First Aid course when you practice CPR on those mannequins? And on "Annie" (the adult mannequin) you're supposed to use the force of your entire upper body to perform the compressions? (To quote one of the instructors, "You're not doing it right if you haven't fractured any ribs.") But then afterwards they bring out the infant mannequin and teach you to use two fingers? Two fingers. Two fingers of one hand for compressions. I always felt a little ridiculous doing that, like, honestly, would two fingers really be enough??
After my car rolled off the bank in Motueka the image that stayed with me (and remains with me still) is the blurred view of the green and brown forestry through the windshield as my car tumbled on it's side, like being inside a glass hamster wheel looking out. In the same way, the image that haunts me from this afternoon is of the registrar's two fingers pushing up and down on this tiny little baby's heart... and on this tiny, fragile, precious baby, two fingers really were more than enough.
After about fifteen minutes of resus, as the registrars continued to do compressions and bag ventilate, the consultant went over to the family to explain to them that they would now stop doing compressions and that it was time to say goodbye. And it was then, as they started to extubate the baby, that it was too much for me. I stepped outside, left NICU, and in an empty hallway at the back of the fifth floor, started to cry.
It sucks. Plain and simple. And it breaks your heart. I can't even begin to imagine what it's like for the family. I only met the little baby this morning and it was enough to break my heart; I can't even begin to fathom what it would be like had I spent every single moment of six, seven, eight months with a baby that was inside of me, then to watch it die before it even had a chance to live.
Needless to say, it was a pretty intense first day. And to be honest, I think I'm a little shell-shocked.
I experienced my first death in the hospital... the death of a tiny little baby.
Without saying too much, this newborn baby has been pretty sick and no one could figure out why. They (the consultants and registrars) had spent a while discussing this baby at the morning handover meeting, but I didn't think too much about it myself. Then, having been assigned to NICU for the week, I met this baby and the whole family an hour later on our ward round -- and indeed the baby was unwell but stable. It was pretty hard going for the family who knew things were getting serious and, in some ways to an outside looking in, it kind of felt like they were preparing themselves to say goodbye, like as if somehow they knew in their heart of hearts what was to come.
It was later that afternoon that all of a sudden there was an explosion of beeping from one of the NICU monitors, followed by hushed exclamations of "Where's the doctor??!?" Before I knew what was happening there were two registrars, one house surgeon, two nurses (with the consultant on the way)... and me, standing, just standing there, watching it all unfold in front of me like a scene from a TV show, but this time in slow motion and with hushed voices in an otherwise silent and frozen NICU. And in those next ten minutes it was like everyone else in the room was holding their breath, completely paralyzed, afraid that one wrong movement might somehow change the fate of this little baby, dusky blue, teetering on the edge of the precipice that is life... or death.
I was frozen. I just stood there. They didn't need me, and, frankly, I had nothing to offer. No skills, no understanding, no knowledge. My role, I quickly realised, was just to take it in.
You know in First Aid course when you practice CPR on those mannequins? And on "Annie" (the adult mannequin) you're supposed to use the force of your entire upper body to perform the compressions? (To quote one of the instructors, "You're not doing it right if you haven't fractured any ribs.") But then afterwards they bring out the infant mannequin and teach you to use two fingers? Two fingers. Two fingers of one hand for compressions. I always felt a little ridiculous doing that, like, honestly, would two fingers really be enough??
After my car rolled off the bank in Motueka the image that stayed with me (and remains with me still) is the blurred view of the green and brown forestry through the windshield as my car tumbled on it's side, like being inside a glass hamster wheel looking out. In the same way, the image that haunts me from this afternoon is of the registrar's two fingers pushing up and down on this tiny little baby's heart... and on this tiny, fragile, precious baby, two fingers really were more than enough.
After about fifteen minutes of resus, as the registrars continued to do compressions and bag ventilate, the consultant went over to the family to explain to them that they would now stop doing compressions and that it was time to say goodbye. And it was then, as they started to extubate the baby, that it was too much for me. I stepped outside, left NICU, and in an empty hallway at the back of the fifth floor, started to cry.
It sucks. Plain and simple. And it breaks your heart. I can't even begin to imagine what it's like for the family. I only met the little baby this morning and it was enough to break my heart; I can't even begin to fathom what it would be like had I spent every single moment of six, seven, eight months with a baby that was inside of me, then to watch it die before it even had a chance to live.
Needless to say, it was a pretty intense first day. And to be honest, I think I'm a little shell-shocked.
Sunday, November 22, 2009
not just awesome but delightfully awesome
Hi! And hello again! The past few weeks have been such a whirlwind of events and emotions and I have no idea how I'll catch up on writing about it all, but I have decided I must and I will. Maybe not all at once, but there are just so many thoughts, memories and reflections flying around my head that I NEED to get it down on paper.
I start back up at the hospital tomorrow, for my sixth and FINAL year of medical school.
[pause]
My sixth and FINAL year of medical school.
[pause]
My sixth and FINAL year of medical school... yeaaaaah...
[pause]
Did I mention that tomorrow I start my sixth and FINAL year of medical school?
I just can't get over it. And no matter how many times I say it, it still sounds strange and completely surreal. I think once I'm in the thick of it, back on the wards, busy running around and doing work it won't feel quite so strange but for now I remain in the realm of utter disbelief.
The past couple months have been the most intense of my academic career, emotionally, mentally, physically, spiritually... and it just feels all too surreal that it's behind me now, that I actually did get through it. I did what I had to do (although I'm not quite sure exactly what that was -- have they become repressed memories already?? lol) and in the end I managed and I survived. I didn't burnout (although I came dangerously close a couple times this year), I didn't have a breakdown, I didn't give up... somehow I pressed through... through that final, most painful phase of the metamorphosis that is medical school. And here I stand, a Trainee Intern.
Weird.
But delightfully awesome. :)
So much has happened the past few weeks, from the cathartic release of finishing exams, the utter elation and jumping-up-and-down upon receiving the "You've passed" email, to the most epic, relaxing, brilliant road trip back up to Motueka this past week and all that was in between. And like I said, I'll most definitely be putting pen to paper this upcoming week, but for now suffice it to say: Goodnight dear world, I'll see you tomorrow. Yours faithfully, Anna, Trainee Intern Extraordinaire. :)
I start back up at the hospital tomorrow, for my sixth and FINAL year of medical school.
[pause]
My sixth and FINAL year of medical school.
[pause]
My sixth and FINAL year of medical school... yeaaaaah...
[pause]
Did I mention that tomorrow I start my sixth and FINAL year of medical school?
I just can't get over it. And no matter how many times I say it, it still sounds strange and completely surreal. I think once I'm in the thick of it, back on the wards, busy running around and doing work it won't feel quite so strange but for now I remain in the realm of utter disbelief.
The past couple months have been the most intense of my academic career, emotionally, mentally, physically, spiritually... and it just feels all too surreal that it's behind me now, that I actually did get through it. I did what I had to do (although I'm not quite sure exactly what that was -- have they become repressed memories already?? lol) and in the end I managed and I survived. I didn't burnout (although I came dangerously close a couple times this year), I didn't have a breakdown, I didn't give up... somehow I pressed through... through that final, most painful phase of the metamorphosis that is medical school. And here I stand, a Trainee Intern.
Weird.
But delightfully awesome. :)
So much has happened the past few weeks, from the cathartic release of finishing exams, the utter elation and jumping-up-and-down upon receiving the "You've passed" email, to the most epic, relaxing, brilliant road trip back up to Motueka this past week and all that was in between. And like I said, I'll most definitely be putting pen to paper this upcoming week, but for now suffice it to say: Goodnight dear world, I'll see you tomorrow. Yours faithfully, Anna, Trainee Intern Extraordinaire. :)
Thursday, October 29, 2009
low point
It's official: procrastination desperation. That's fifteen minutes well worth of distraction. Now, back to psych...
Post-note: That 0% facebook use in MICN5 October is apparently true for everyone but me... I think it's because tvnz-on-demand hasn't been working for the past two days. :(
Wednesday, October 21, 2009
yes indeed-y, I will most certainly jump through those hoops and I will do so with all my heart and a great big smile
I know I had planned a blog-hiatus in the lead-up to exams but I just got home from my last test for rural GP run and found myself with some seriously unexpected nostalgia.
My last rotation of my fifth year of medical school is officially over and I find myself wondering, has it really been five years??
When I think back on all the incredible, surprising, character-forming experiences I've had, it's both easy and hard to believe that it has been five years since this crazy journey (<-- corney, I know but there's no other way to describe it) began.
I still remember the Anna from four years ago with equal parts cringe, warmth and disbelief, much like unexpectedly stumbling into an old photograph of yourself in the bottom of your closet and wondering what happened to that person staring back at you. Sure parts of her remain, but mere remnants and fragments within the context of this much older and different woman, the product of numerous metamorphoses over the years passed.
I think this nostalgia has been creeping up on me slowly but surely for a while now. A few days ago as I was standing lost in random thought while blow drying my hair I found myself thinking of the "nine lives" I used to dream about as a teenager, the nine occupations I wished I could live out: Anna the magazine editor-in-chief, Anna the journalist for Newsweek, Anna the PhD US history student turned professor, Anna the television producer, Anna the novelist, Anna the US Air Force pilot (I know, laugh, but it was the stepping stone of becoming an astronaut, the ultimate ambition for most of my adolescent life), Anna the diplomat for the United Nations, Anna the food critic, and last but not least, Anna the international human rights lawyer. As I recounted these random (and not to mention, lofty) ambitions of my youth, I found myself thinking how ironic it was that "Anna the doctor" never -- and I mean, never -- once crossed my mind. For someone who constantly entertained a thousand different lives and always feared having to settle on one, I find it more than a little ironic that the one thing I ended up doing was the one thing I could never have imagined even just five years ago.
And look at me now. Nine days away from medical school finals, nostalgic as ever, reflecting on how I couldn't picture myself doing anything else in the world. Man, God is awesome. He really does exceed your expectations every single time -- no matter what you could ever plan or imagine for yourself, His Plan, His Will, is so much more amazing, and brilliant, and fulfilling than anything you could ever dream of or conjure up.
I've been so incredibly at peace the past week or so, and I know it's all because of God. I'm excited for exams because regardless of what may happen, when I look at how far I've come, how far all of my classmates and myself have come it's amazing to see the utter transformation we've undergone. And you know what? I don't need an examiner or a hundrend multiple choice questions to tell me what I'm confident in my heart of hearts to be true, which is that I've studied my butt off for five years and I'm so incredibly excited and ready to be an intern. I'll jump through whatever hoops Med school, Society and Convention want me to, because I can't wait until the day I get to rock up to a patient in the emergency room and say, "Hi! My name is Dr Anna, and I'm gonna do my best to look after you today." That, ladies and gentlemen, is gonna be a freakin' awesome day. :) Here's to the next nine days, and to the rest of our lives.
My last rotation of my fifth year of medical school is officially over and I find myself wondering, has it really been five years??
When I think back on all the incredible, surprising, character-forming experiences I've had, it's both easy and hard to believe that it has been five years since this crazy journey (<-- corney, I know but there's no other way to describe it) began.
I still remember the Anna from four years ago with equal parts cringe, warmth and disbelief, much like unexpectedly stumbling into an old photograph of yourself in the bottom of your closet and wondering what happened to that person staring back at you. Sure parts of her remain, but mere remnants and fragments within the context of this much older and different woman, the product of numerous metamorphoses over the years passed.
I think this nostalgia has been creeping up on me slowly but surely for a while now. A few days ago as I was standing lost in random thought while blow drying my hair I found myself thinking of the "nine lives" I used to dream about as a teenager, the nine occupations I wished I could live out: Anna the magazine editor-in-chief, Anna the journalist for Newsweek, Anna the PhD US history student turned professor, Anna the television producer, Anna the novelist, Anna the US Air Force pilot (I know, laugh, but it was the stepping stone of becoming an astronaut, the ultimate ambition for most of my adolescent life), Anna the diplomat for the United Nations, Anna the food critic, and last but not least, Anna the international human rights lawyer. As I recounted these random (and not to mention, lofty) ambitions of my youth, I found myself thinking how ironic it was that "Anna the doctor" never -- and I mean, never -- once crossed my mind. For someone who constantly entertained a thousand different lives and always feared having to settle on one, I find it more than a little ironic that the one thing I ended up doing was the one thing I could never have imagined even just five years ago.
And look at me now. Nine days away from medical school finals, nostalgic as ever, reflecting on how I couldn't picture myself doing anything else in the world. Man, God is awesome. He really does exceed your expectations every single time -- no matter what you could ever plan or imagine for yourself, His Plan, His Will, is so much more amazing, and brilliant, and fulfilling than anything you could ever dream of or conjure up.
I've been so incredibly at peace the past week or so, and I know it's all because of God. I'm excited for exams because regardless of what may happen, when I look at how far I've come, how far all of my classmates and myself have come it's amazing to see the utter transformation we've undergone. And you know what? I don't need an examiner or a hundrend multiple choice questions to tell me what I'm confident in my heart of hearts to be true, which is that I've studied my butt off for five years and I'm so incredibly excited and ready to be an intern. I'll jump through whatever hoops Med school, Society and Convention want me to, because I can't wait until the day I get to rock up to a patient in the emergency room and say, "Hi! My name is Dr Anna, and I'm gonna do my best to look after you today." That, ladies and gentlemen, is gonna be a freakin' awesome day. :) Here's to the next nine days, and to the rest of our lives.
Sunday, October 11, 2009
i'll see you on the other side
In 25 days it'll all be over folks! On Friday I flew home after five weeks of rural GP in Motueka/Golden Bay (Nelson area!). Countless amazing experiences and many unexpected friendships later, I am back home and now -- in the routine and comfort of home -- well into study hibernation.
Twenty days until OSCEs, 25 days until exams are over.
I promise to share all my awesome, utterly random rural GP stories once exams are over -- Insights, Reflections and Revelations From A City Girl At Heart -- but for now I'll leave you with but one thought: "You will keep in perfect peace him whose mind is steadfast because he trusts in You. Trust in the Lord forever, for the Lord, the Lord, is the Rock eternal." - Isaiah 26:3,4
A few pictures as a prelude of what's to come:
Twenty days until OSCEs, 25 days until exams are over.
I promise to share all my awesome, utterly random rural GP stories once exams are over -- Insights, Reflections and Revelations From A City Girl At Heart -- but for now I'll leave you with but one thought: "You will keep in perfect peace him whose mind is steadfast because he trusts in You. Trust in the Lord forever, for the Lord, the Lord, is the Rock eternal." - Isaiah 26:3,4
A few pictures as a prelude of what's to come:
Friday, September 4, 2009
a feast of geek and good-looking goodness
So I've been trying to do some renal study lately in a relatively last minute attempt to actually understand it five years into med school, and, at the suggestion of my mentor, emailed the renal consultants to see if I could spend a morning with them on the ward during these holidays. I know, ultra geeky, I admit, going into the hospital on my own volition during my spring break but I figured, hey, it's only one morning and I knew my mentor had a point when he said I'd probably learn more from two hours on the ward than two hours of studying renal at the library... plus, in the very least it'd motivate me to actually try to study and understand renal. The renal consultants -- who have a 100% pass rate with their registrars (=residents) in their final specialist exams -- were more than happy for us to tag along on their ward round and then talk to some patients afterwards if we wanted to. I say "us" because when I told a couple friends/my OSCE study group, they decided to come along.
And you know what? It turned out to be an AWESOME morning. Yes, I learned so much more from (what turned out to be) the three-hour ward round. There turned out to be quite a big entourage and furthermore, quite a lot of drama! They had about 10 patients which is pretty epic for Renal, and some really interesting cases, not to mention an almost-code where this really young guy developed sudden onset of severe chest pain and respiratory distress ten minutes after his straightforward renal biopsy procedure. One of the nurses started calling for a doctor and there was a lot of rushing and plugging in of machines, etc, and just standing back and watching the registrars and house surgeons kick into "ABC-mode" was freakin' amazing. So much to learn from! Lesson of the day: just don't freak out. LoL. It's all about being calm and collected.
And man, during the course of the morning, WE GOT GRILLED. And with both the renal consultants there for the round it got pretty intense at times, but in hindsight it was great teaching. You'd think all my renal study leading up to this morning would've helped, but it's truly amazing how in medicine it's all about thinking laterally -- we got grilled on basic pharmacology, microbiology, general medicine, all in the context of reanl issues, plus loads of first principle concepts which we too often (sadly) failed miserably at (yet undoubtedly learnt heaps from). So all in all a very worthwhile morning.
I got home around 1pm for lunch. I was only gonna take a short break before heading back into town to get some study done at the library but I started to read some more Austen and, enveloped by the warm afternoon sun, I got hooked! Four hours later I was done with Northanger Abbey, much to my surprise. And dude, it was AWESOME. Henry is definitely up there as one of my favourite male Austen leads. :) If only I had time to get the video out before flying out on Sunday. I will, however, stop by the bookstore and pick up my next read, Wuthering Heights, which was recently highly recommended to me by a friend of mine. I caught up with her tonight for dinner and a movie, Coco avant Chanel. The movie was pretty good -- Alessandro Nivola... mhmmm... and that's about all I wanna say, lol. And that, ladies and gentlemen, concludes the proceedings for the evening. Goodnight and good luck. :)
And you know what? It turned out to be an AWESOME morning. Yes, I learned so much more from (what turned out to be) the three-hour ward round. There turned out to be quite a big entourage and furthermore, quite a lot of drama! They had about 10 patients which is pretty epic for Renal, and some really interesting cases, not to mention an almost-code where this really young guy developed sudden onset of severe chest pain and respiratory distress ten minutes after his straightforward renal biopsy procedure. One of the nurses started calling for a doctor and there was a lot of rushing and plugging in of machines, etc, and just standing back and watching the registrars and house surgeons kick into "ABC-mode" was freakin' amazing. So much to learn from! Lesson of the day: just don't freak out. LoL. It's all about being calm and collected.
And man, during the course of the morning, WE GOT GRILLED. And with both the renal consultants there for the round it got pretty intense at times, but in hindsight it was great teaching. You'd think all my renal study leading up to this morning would've helped, but it's truly amazing how in medicine it's all about thinking laterally -- we got grilled on basic pharmacology, microbiology, general medicine, all in the context of reanl issues, plus loads of first principle concepts which we too often (sadly) failed miserably at (yet undoubtedly learnt heaps from). So all in all a very worthwhile morning.
I got home around 1pm for lunch. I was only gonna take a short break before heading back into town to get some study done at the library but I started to read some more Austen and, enveloped by the warm afternoon sun, I got hooked! Four hours later I was done with Northanger Abbey, much to my surprise. And dude, it was AWESOME. Henry is definitely up there as one of my favourite male Austen leads. :) If only I had time to get the video out before flying out on Sunday. I will, however, stop by the bookstore and pick up my next read, Wuthering Heights, which was recently highly recommended to me by a friend of mine. I caught up with her tonight for dinner and a movie, Coco avant Chanel. The movie was pretty good -- Alessandro Nivola... mhmmm... and that's about all I wanna say, lol. And that, ladies and gentlemen, concludes the proceedings for the evening. Goodnight and good luck. :)
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