Changes.xoxo

Today is moving day part A
Believe it or not, I have a life away from the hospital.
The most awesome boyfriend in the world and I have bought a house together.
I know....we have only JUST moved in together. I know....we have have ONLY been dating for  just over a year.
My response? So what! Does it matter? As long as it feels good, we support, love and accept each other, what does time matter?
The house by the way is awesome.
So jungly, liveable, peaceful and earthy. We will have chooks, solar power, water tanks and a vege garden. We have a easy going friend and colleague moving into the flat downstairs and life will be good. Full of positive karma fresh food and love.
What more could one ask for.
Tonight we will have drinks and food on the deck of our yet unfurnished housed with some UTARD friends my daughter and Rizzo's son.
Feel free to drop by for bubbles if you wish. BYO fro drinks and BBQ.
Peace and Love.
Dr. Trace.xx

The Jungle

I am fighting with Gorillas.....and I'm tired.
What to do?
Take some wisdom  and advice from a good friend and fellow blogger.

http://mindthemineshaftgap.blogspot.com.au/

The Gorilla rule. Don't Give up.
"Success is a little like wrestling a gorilla. You don't quit when you're tired. You quit when the gorilla is tired."
So I guess I just keep going....after I get some sleep!

Chapter 2 - Ortho(awful)peadics

The first day of my new rotation....Orthopeadics.  An elective (meaning it was my choice....yeah right!?)  12 weeks of it and so far so good.
It's interesting that the very registrars I fought with to get patients admitted to their service when I was in ED and it was going to create them work, are now so nice to me that I am on their team and will DO their work!
It seems a lot less stressful than ED in that, there is a finite number of patients. There are patients on the ward, in fracture clinic, pre-admission clinic and "on the board" - awaiting emergency surgery. The numbers vary a little day by day, however clinics come to an end and eventually there is no-one there.
In ED, they never stop coming, and neither does the pressure.
So today another new learning curve begins.
I know very little about orthopaedics and bones in general. In fact as in intern I know a little bit about nothing in medicine and surgery in general!
What the hell do they teach us in medical school??!!
Anyway I muddled through the first day with much thanks to the very patient clinic nurses, until a family medical problem took me home early.
A problem that weighs heavily on my heart tonight.
It is sooooo much easier to be a doctor and sort things out for people you don't know and infinitely more difficult and emotionally exhausting to want to fix the problems of family and friends.

PACE- Graded Assertiveness - For the safety of the patient......and the Med Reg

This blog entry has been put on hold pending a formal investigation. In an effort not to get sued or  bruise peoples fragile ego's, I will refrain posting my thoughts.
CRAP!
Why am I always a heat seeker??
Why can not just accept the incompetence, ignorance and ruddiness of others and let things slide?

Mind movies and other madness

Finally! Some time to sit and write again! This and the next post were prompted by events that happened over two weeks ago and apart from time constraints I have written because I am so conflicted by one of the events I simply haven't known what to do, say or write. So I'll start with the easy one.

A couple of weeks ago, I dreamt a block buster movie. 

I'm  not talking just a good movie , or a movie to win an Oscar. I dreamt the kind of movie that  makes people involved in it so rich, that their offspring will live off the royalties forever, the kind of movie people talk to their grandchildren about.

I dreamt it in absolute vivid detail...the music, the storyline, the set design, the characters....an incredible story, sort of a cross between Contagion, Independence Day, Gattica  and Forest Gump.

Now if I had the time and talent to sit down and reproduce the movies in my mind into an actual script that would be wonderful.
What would be even more amazing though (and possibly still make me millions) would be if I had the ability to understand the mind.

My "mind movie" came from somewhere. What did it mean? Is a way of processing the events of the day? Is it a way of escaping the events of the day or is dreaming some kind of madness?

The day preceding this particular movie dream was indeed madness in the ED.

Not a bed spare, patients spilling out of the waiting room, ambulances lined up in the bays outside like a drive through, patients threatening staff, Doctors making decisions that still leave me shaking my head in disbelief and staff looking bewildered and shell shocked.

An evening shift in the ED....I can't remember what night it was but I remember it was a full moon.

There are many theories about the full moon , crazy people, psych patients and even multiple research studies done on the number and type of patients in the ED when it is a full moon. I don't care what anyone says, until you have worked it you don't believe it,  but it's true.....the full moon makes people crazy and sometimes it's the staff!

On this particular night we had so many weird, bizarre, funny and frustrating patients, that at the end of the night when  all 12 doctors stand around to give hand over we were in tears. 

Tears of laughter, all of us...shaking our heads in complete disbelief as we recounted the stories of the shift. 

As the evening staff walked out and wished the night duty staff a calm night, they wished us a good sleep. It seems I took the madness home into my dreams that night, but sleep I did.

Some people don't. The don't sleep because they hear voices, either their own or  those of other people in their head. They don't sleep because they are anxious, depressed, lonely, scared, psychotic, delusional and sometimes just plain crazy.

For those people, I wish I had a key to unlock the secrets of their minds and set them free.

Sshhhh! This is a hospital!

I had my midterm assessment the other day, first one as an intern.

It was one of those stupid things where there are 6 billion things you have rate yourself on. 

Did I think is was average, above average, outstanding, below average, well below average or suck so badly I'm in the "find a new career category"?

I seriously couldn't be bothered actually thinking about where I really thought I was and grading myself for each criteria, it's just another jump through the hoops exercise. 

I asked a couple of Junior but more senior than me Drs in the department what they though I should do, and was told "everyone just ticks the middle boxes for everything" so I did.

Then it was time for my interview.
I thought this would be a time where I would get some honest, practical feedback and constructive criticism.
Being a new Dr has been terrifying, humiliating, a steep learning curve and so bad for my self esteem. I was really hoping I would have a performance appraisal where they told me something I did well, discussed areas I could improve in and then finished with another positive note...nope!
He ticked every box, right down the middle, just as I had done and said we are happy with you.

GREAT!! I don't suck! But what are you happy with what can I improve on, I wanted to ask but was afraid to, then came the BUT...we are happy with you BUT........

You just know that anything which comes next is never going to be good.

So what was it? 

BUT...you killed someone?
BUT....you don't know one end of a stethoscope from another?
BUT....I'd never want you to look after my relative?
BUT....your documentation is so bad you WILL be sued and no one will defend you? 

Nope. None of those things.
The BUT was....when I first arrived...they thought I was a bit loud. I'm sorry?
I beg your pardon? I don't think I heard that, could you please repeat what you said?

"Tracey, when you first arrived here we thought you were bit loud, and wondered, what on earth do we have here?"

You can't be serious? Out of all the things they could make comment on it's not my skills and knowledge as a junior doctor BUT my volume control!
I walked out of the interview  wondering if my boss had on OFF switch I could flick.

The Good, The Bad....and the Angry!

It's been a while since I had the time and the inclination to write, which just means so much has been going on that I probably should having been writing about it, just to help process things.
Sometimes I feel like I all I ever do is come home from work and complain. To those who are unfortunate enough to live with me, they have probably worked out that I am NOT loving being a Dr.
And yes...it is exactly what I thought it would be....I just thought I'd enjoy it more!
But there are good days.
Sometimes it is a patient that makes part of your day so good that it acts as a life-ring and gets you through the rest of the day until there is wine.
Recently I had the pleasure of treating a truly inspirational man in the ED.
76 years old, fit, normally healthy, just a little dehydrated with some gastroenteritis, nothing exciting about his case. The morning I met him it was unusually slow in the ED, I had managed a run before work and a coffee without getting in late, so far he was my only patient for the day, so I had time.
I had time not just to take a history, and ask about his past medical problems and surgeries but I had time to actually talk to him and find out about the man behind the patient.
I think it started when I was ordering a medication for him "STAT" and he piped up to ask me if I knew the origin of the word...and went on to tell me. (I already knew, it's short for Statim which in Latin means Immediately)
It turn out my patient had studied Latin...why? Because he wanted to read Caeser's Letters to the Romans and did not want anything to be lost in translation...so he studied Latin. It sounds like a very interesting read and is going on my essential reading list...in English.
He also reads and speaks, Spanish, German and French and is the kind of guy I would not like to challenge in a game of scrabble. He has pitch perfect tone, plays multiple musical instruments...in fact was a concert pianist and once upon a time made a living as a piano man.
Like most musicians he had some groupies and was engaged at least once (to a demanding German girl) before he settled with the lady to whom he is still married to today, nearly 40 years later.
He has traveled the world, held interesting jobs and taught me something about "listening" to thunderstorms rather than watching them.
In itself, this would be enough...but he his blind. Totally blind.
The victim of domestic violence at 8 months old,  which resulted in him losing his sight, he was placed in a blind institution as a baby.
Intelligent, educated, worldly, passionate about life, humble, a true inspiration and so different from my everyday patients in ED.
He and I hit it off well and he has offered me free piano lessons!
The day started of good....quickly got bad and deteriorated to ANGRY.
Not me, but the waiting room.
People do 'waiting' for some things better than others. They generally wait well for buses, trains planes and for movies to start, but not for doctors.
They don't like waiting for 5 mins, let alone 3 hours. People expect  free and expert  medical care, which is exactly what they get, just not immediately.
Part of the problem is that  the waiting room is separate from where the ambulances arrive, so patients never see the people more seriously ill or injured arriving that may be seen before them.
The psychology of waiting though, is such that even if they did see someone arriving with both bloody legs hanging off, because they were there first with the splinter in their toe, they should be seen first.
Occasionally tempers flare, people become angry and take it out on staff. It's not uncommon for triage nurses and Drs to be yelled at, verbally and physically abused, and this was what my day deteriorated to.
I just want to say.... it's not called the "I will be seen immediately room"!
Perhaps if people had to pay for their visits to the emergency room they would not come for splinters, colds and GP type problems, then the waiting for the real emergencies to be seen would be less.
More on that later, for now I just want to remember the good in my days...and I have wine!