A dream within a dream. but its not a dream.

"I know you can be overwhelmed, and you can be underwhelmed, but can you ever just be whelmed?"

Poo, wee, blood, tears, various mucous and lots of liquor (pronounced lie-core you idiot). Yes that's right, I saw my first  delivery. Extremely fascinating stuff. But after several hours of waiting for something to happen my over-riding emotions were definitely hunger and boredom/anticipation. Fortunately the delivery was text-book stuff. There's nothing like watching a babies head spin through 90 degrees on its own volition whilst hanging out of someones nether-regions to make you sit up straight.

I really have no idea why people harp on about the magic of birth. It's totally grody, even if it is essential to life. Totally learned a lot though. Was very much surprised to see pethidine is still in vogue in obstetrics. Crazy!

Oh yeah, I forgot about the vomiting. So much vomiting. I dont know how I forgot about that. Apparently vomiting is normal and a good sign. It means 'things are happening.'

After that though I felt rapidly spent. Far too much driving for my liking last week. By the weekend I was feeling quite average. Came home and lay on the couch all Sunday afternoon after a shocking sleep in bed saturday. Nothing worse than feeling mediocre and then not sleeping. Bleah.

And now the week begins again!

The lone 'pine

Had my first epic psychiatric patient encounter. The raised voices, police-involved, blood everywhere type of event. I don't really have much to say on the issue, apart from reflecting on the high social price of drugs and alcohol. I mostly got to stand around and take it all in and keep the scissors out of reach.

A lot of what I do here is 'taking it all in.' Medicine in general I guess. But this time seeing how the mental health act works in the real world, and how country hospitals straddle the fine lines of wanting to help but being woefully equipped to deal with serious acute mental health problems.

It's a tough job and in a small country town there seems to be potential for a high emotional toll, especially in that inevitable circumstance where the patient is your friend or at least well known to you. This rural GP thing has certainly proved quite insightful. There are a lot of super-nice doctors and nurses out here though. It's not the intellectual backwater you fear it might be.

Personally, I still have no idea if I'm learning anything or not. Or whether I'm just accumulating things that fall in to the life experience basket. But at least at the end of the year I'll have a lot of interesting tales to tell. Like this one:

Driving at 110 in the dark, I squashed my first rabbit the other night. Now my air-conditioner has this weird organic smell to it. Luckily the cool change is here. I'm just happy it wasn't a roo that darted out from the bushes.

Red gold

Had a fun day yesterday. Spent it studying for the large part. But it meant I could sit in the ED and see what comes in. Lately it seems there has been a rather aggressive tummy bug going around. There's lots of people looking the worse for wear.

For the second time this week I was able to check out a patient who was looking a bit parched and then sink a cannula in to the back of their hand. Totally felt like a medical rock star because my streak of successful cannulations has blown out to two (an all time high!). Now I just need to figure out how to cannulate places other than the hand!

As others have said though, it's all in the mind. Believe you can do it, and it will work some of the time! But don't die wondering at least.

"Sharp scratch"

To be honest though, the thing I hate most about sticking the plastic tubes in to people is the bit at the end where you have to tape it down. The sticky stuff drives me nuts...

It means I was drunk yesterday

Interesting man: "You know it's easier to get a root in this town than it is a park in the main street."
Me: "Really? I've never had any trouble getting a park in the main street." Awkward pause... "I wouldnt know about the former."
Luckily he gave me some sagely advice about how to make my parking situation look comparatively bad.

After yesterdays feel-good binge, today I was brought back to reality in the clinic. Had a terrible run of answers to rather broad conceptual questions. Whilst they weren't incorrect, they weren't the all encompassing answer my supervisor was hoping for. Compounding this, I had to then ask for my mandatory sheet of paper evaluating my performance to be filled out.

In all honesty, it was a very accurate evaluation. I'm not sure why I was hoping for more. Not that it even counts for anything!

I just don't want to be a mediocre doctor.

Spread your wings

Part of pretending to be a Doctor is dealing with the spectrum of patients that encompass the human condition. Most patients are happy enough. Sometimes patients are just generally unpleasant. Sometimes they are too focused on a problem that they can't see all the functional bits that are left over!

Every now and again though, you find the proverbial diamond in the rough. The sort of patients that justify the existence of the human race. I saw a patient today, elderly but sharp as a tack. A former bomber pilot.

Part of my learning experience is something called 'parallel consulting.' Whereby I see a patient for 30 minutes, then the GP comes in and looks over what I've done and cleans up my mess in half the time.

I really enjoyed talking to the chap today. It was possibly the first time I've wanted the doctor to run late because once my medical is over we usually make chit chat. So we got to talk about the war, flying and life in general. I told him about my love of that era and how I've always wanted to learn to fly. It was great! He sized me up pretty well too

"I like that you're speaking loudly for me, you're at the right volume. But your enunciation is terrible." It may be true, but I'm going to blame the poor acoustic insulation in those cockpits...

I really warmed to the guy. He commended my personality and told me I'd make a good GP. I don't think anyone has ever cast me as a GP before, normally my nerdy and anti-social side shines too bright.

As I passed him over in to the care of one of the practice nurses, he shook my hand and gave me some sagely advice.

"If you want to learn how to fly, get in to a glider. It's only when you can't power out of trouble that you really learn how to fly."

Part of me feels that coming to the sticks for the year has put me in to the pilot seat of a glider. It is as scary as it is exhilarating. Despite my enormous lack of knowledge, I'm really keen to see how we land this thing.

In conclusion, I know those words make for a great metaphor but I fully intend to one day take them literally.

Lanced Armstrong

All I know is this: I wish I was the one wielding the scalpel, because watching the pus explode out of that abscess... and then keep flowing and flowing and then oozing half coagulated blood. It looked like so much fun!

Ohhh the satisfying feeling the doctor must have had! Me wanty!

In surgery this week

Whilst removing a saphenous vein:
Surgeon: "Pass me the stripper please... So [student] are you married?"
Me: "Are you making a connection between strippers and marriage?"

Needless to say, I got torn apart for my lack of knowledge about the vascular system. But in the kind words of the surgeon

"It's not your fault your uni doesn't teach you enough anatomy." The perils of a four year course I guess.

It was actually a really good session. I learned a lot. Got to pull some veins out and work on my needle work. Then came back to my home hospital and sunk a cannula with nobody but me and the patient watching.

I'm still very hesitant to ask to do things though. I just hang around with puppy-dog eyes until stuff falls to me. Hopefully that will change though.