A long hiatus

No this is not a post about hernias (for those doctors out there who associate hiatus with to the body)

Well it's been a long time in between drinks hasnt it?

Was asked the other day why I hadn't been blogging. Not really sure how to answer that one.
Partly I've been busy and haven't had spare time to compose my thoughts. Partly I've been devoid of anythign profound to say. Partly I've been emotionally drained and not felt like posting anything (sometimes silence is a form of communication?)
But I'm back now and Jimbo v2.0 is now up and running (powered by Intel Core Duo processors)
So a quick summary of whats happened since my last post:

1) Geris Rehab rocked! Having a ward to myself was so refeshing (rather than covering 4 wards with outlying patients) got to know the ward clerk, nurses, physios, OTs and social workers and by the end was really sad to leave. So they bought me a cake to say goodbye and gave me a card. I'll miss their antics and chatting with the neuropsychologist about life's woes. My consultant was really good at her job and I actually learnt a lot more about good patient care from her which I'll hopefully not forget too quickly. My reg started to get used ot me by the end and would finish ward rounds early if he saw I was getting frustrated with hearing about old people's bowel habits.

2) Got hooked on Chaser. This show is one of the highlights of the week as the crazy boys from the ABC tear down every cultural cliche in Australia and attack politicians. It makes me laugh till my sides hurt and at the end of each episode I find myself longing for more.

3) Guy-Love ("There's nothing gay about it in our eyes") Been catching up with lots of the guys and realising the commonality of all life's problems. There's been much frustration and angst and consumption of steak/beer and anything else that bonds guys in mateship and tribulation.

4) Dad's getting worse. Buying turf in a drought. Going up to randoms in restaurants and talking to them. Wetting himself at church and refusing to change his coiled clothing. Week by week he slips further and further. Mum gets worn more and more. Although it sounds horrible, I am praying for a fast resolution to this.

There's tonnes of other stuff but right now I'll leave it as a brief summary and go on to write about my holidays!

Venom

Thank God for Friday and the fact I could go and see Spiderman 3.

Came out of it feeling rather angry. I wasn't sure why... I'd really enjoyed the movie (although it was a bit comic book corny in places) A smart friend noted it was probably cos it stirred up some recent issues that've been simmering below the surface.

Angst at being pushed away. Painful decisions to lie to in order to spare others more hurt. A friend's grudge held for a long ago betrayal. It's stuff we all deal with at some point in our lives.

But there was one addition that I thought made this film better than the prior sequel...

Venom!

Dark, brooding and deadly. At odds with the world because he is at war with himself. Spiderman realises that there is the blackness inside all of us. The humiliation and the loss of control lead Spidey down a dark path... and brings forth the alter ego.

Lately it feels like life just gets darker and darker. The reality of suffering and this broken world just seems to seep into our marrow as the days go by. Do we decide to let it rule us? Or will we rip off the black suit and fight for truth, justice (and the American way*)? The anger and darkness of life can either grow us or grow over us.

I know its corny comic book ethos... but it's true:
We always have a choice... our choices make us who we are.

* What was with the lame shot of the American flag in the movie? Served no point whatsoever!

It's gettin hot in here...

Sitting at my desk doing some paperwork when the sharp shrill of the fire alarm went off. Within 2 seconds all the fire doors in the ward slammed shut and the whooping wail of the ‘Emergency Evacuation Tone” blared from all directions.

Given the number of false alarms in our hospital we sat around and waited for the noise to stop. But it didn’t. The indicator on the wall said the alarm triggered was on our floor.

The nurses eventually straggled out of their meeting to come and reassure the patients they would not die (at least not today) and then I noticed it. 2 of the nurses were peering out the window looking at the street below. “I can see them… FIREMEN!” Next thing I know the nurses are running around checking their hair in the mirrors and straightening the folds in their clothes. Apparently it turns out the firemen are a fine catch in a nurse’s eyes and so the 3 single attractive nurses (aged 23-30) on our ward readied themselves for the kill.

We heard the noises of people running up the stairs and I watched as around the corner lumbered (in slow motion) a large moustache endowed 60+yr old man with a BMI of 30. The look of disappointment in the nurse’s faces was worth capturing on film… their faces dropped through the floor and they started turning to go back to their meeting until…the last fireman straggled in from the stairwell. Younger than his counterparts and not sporting a beer-belly he couldn’t avoid the peripheral vision of the lead nurse who spun around with a beaming smile and said “Hi I’m M and I’m single… and so are these other 2 nurses!”
The fireys soon realised the fire alarm was not set off by someone’s nicotine addiction the door in the meeting room the amount of hot air trapped in the room set off the fire alarm’s heat sensor”. How perfect! Stick a bunch of nurses in a room and they set off the fire alarm with all the hot air that’s blowing around.

As the firemen trudged back to their chariot, the nurses smiled and waved coyly at them. “Nice to meet you… come back soon!”

Short Notice

It was just another balmy autumn day. Skipped breakfast (again) for the sake of another 10 minutes in bed and darted off to start the day.
10am swung by and the temporary consultant waltzed onto the ward. "Don't worry guys, I'm busy today so you can do your ward round alone... oh and J by the way, our team is due to present a case today at the case conference so can you photcopy a discharge summary onto an overhead and present that in 2 hours time? Thanks"

A semi-delerious panic syndrome set in as I realised I had 2 hours to see 22 pateints and somehow find something interesting to entertain the masses at the lunchtime meeting. Last week's case had been a non-stop extravaganze with the team's consultant presenting the case in conjunction with the registrar and intern and with powerpoint slides and lots of cool eosin stained histopathology pics.

The round blitzed its way along the corridor flying through patients with a cursory glance to make sure they were opening their bowels and managing their waterworks. I glanced at my watch as we finsihed in record time. 20 minutes to photocopy some kind of presentation. I found a mildly interesting case (ie one that didn't involve a fall or fracture) and quickly rammed it through the photocopier.

Rocked up to the meeting to find 30 people scoffing down food and waiting with baited breath for me to present. But somewhere along the line the need for an overhead projector had been omitted. And so Dr J was forced to stand up like a kid on speech day and read out his bodgy discharge summary. The physios, the OTs, the social workers and the doctors looked as bored or confused as 1st year arts students. I felt the rush of blood going to my cheeks as they ripened with embaressment. I hoped that by speeding up the reading of the discharge the earth would somehow swallow me up and save me from this public humiliation.

As soon as it was over I darted back to my seat at started muching on some free drug company food. "Such an idiot J!" I berated to myself. Why did the boss have to give me virtually no notice?
Meh!

The Clock Keeps Ticking...

"Life’s but a walking shadow, a poor player
That struts and frets his hour upon the stage
And then is heard no more: it is a tale
Told by an idiot, full of sound and fury,
Signifying nothing" (Macbeth)

Been watching more Death Note. Except it's not the same. One of the main characters has been killed off and its like the show is missing half it's value. They paid no tribute to him, they paused only ever so briefly for his death and then kept going on as if nothing had happened. I found myself aghast that this would happen. Surely the script writers woudl have made more of a big deal? Surely he would come back somehow?

But he didn't. The plot kept moving on and years passsed by as if he had never existed. The cruelty of time - that forgets those now gone.

It's been almost a year now since Dad was fired from his job. Not once has anyone from his office come and visited him. Not once have they called and said hello. Undoubtedly some fresh faced grad is sitting in his desk, the desk that Dad inhabited for decades. Time has moved on and left him behind.

But it's the same with all of us. Next year when I leave hospital, another keen intern or resident will fill my place and life will go on as if I'd never been there. I could move home to the country and my room in the city would be filled by someone else.
It's a humbling existence we lead. We are here one minute and then we're not. And within a year or two our memories are erased from the earth and time marches on.
"Remember also your Creator in the days of your youth, before the evil days come and the years draw near of which you will say, "I have no pleasure in them"; before the sun and the light and the moon and the stars are darkened and the clouds return after the rain...and desire fails, because man is going to his eternal home... and the dust returns to the earth as it was, and the spirit returns to God who gave it. Vanity of vanities, says the Preacher; all is vanity." - Qoheleth

Fear

"Fear attracts the fearful" (Darth Maul)

Everyone's afraid of something. Kids are afraid of the dark, afraid of the bogeyman, afarid of being lost in a shopping centre.
Women are afraid of "abandonment, isolation, loss of love"*
Men are afraid of "engulfment, anything that threatens to rob us of our power and control"*

People fear incompetence, they fear singing in public, they fear being singled out and embaressed, they fear being brainwashed, they fear being targetted for marriage, they fear losing their security, they fear losing their independance.**
We fear growing old, we fear losing loved ones, we fear own own death and build picket fences around death in order to whitewash its true grim reality.
Our lives are plagued by fear. Our lives are lived out in fear.
Why are we so afraid? Is it the expectation of loss? Is it irrational or is it justified? How should we respond to our fears? Is fear always good? Is fear always bad? Can we become desensitised to our fears? Or will they always come back to haunt us?
Fear. Such a primitive response. The sympathetic nervous reaction to perceived threat. An adaptive evolutionary mechanism to ensure survival of the fittest?

If we're honest with ourselves, beneath the layers of protection and barriers we put up, we all fear something.
What do you fear?

* Fire in the Belly, On Being a Man. Sam Keen.

** Why Men hate Going to Church. David Murrow.

Frida?

Chilling at home tonight when a female voice called down the hallway "Um hello? Anyone home?"

Realising we'd left our front door open again and any random stranger could waltz in, I scurried out to see who was invading our den of masculinity (and uncleanliness). Turns out it was a visitor for my japanese flatmate, but someone who I also knew through mutual friends and who apprently my 'other' flatmate knew through aother circumstances. And so we stood around chatting about the random things that can really only pop into one's head when standing in the hallway.

"So you're wearing a T shirt that says "Minnesota"... you ever been to Minnesota?" asked our visitor.
"Um no not really, my sister used to be a nanny there for this guy who worked at Company-That-Makes-Medical-Stuff (CTMMS)"
"Oh really! Cos I work for CTMMS in Sydney and that's why I asked... cos I've been to Minnesota on business!"

Small world...

Turns out her job is to promote the new adhesive material we use to stick down our cannulas (drips) with. It sounds pretty cool. They're even making a see through type dressing so you can see how a wound is healing without havign to remove the dressing and risk infection/wound breakdown! How cool is that! (well I think it is haha - so I told her to send me a copy of her presentation)

Then we began talking about the strange English names that FOBs* take for themselves when they move to Australia. Such as "Wailee" and "Frida" and "Spanky" (what the??)

Anyways, in less interesting news, I am now working in "Geriatric Rehabilitation". And I've never been happier!** Ward rounds start around 8:45 and leisurely cruise up and down the corridor seeing our old bats*** and asking them the ever so delicate questions that distinguish geriatrics from other medicine:
"So who lives with you at home?"
"Have you opened your bowels today?"
"Who's the Prime Minister?"

My consultant is on a personal mission to rid the world of temazepam**** and in her crusade has declared our ward 'Benzo-Free' which means all the patients sleep terribly and look like zombies. But they're happy. Which means I'm happy.

Our ward was recently refurbished 2 months ago and is still looking brand new. We have a proper doctors office to hide in. We have lunch (being able to eat during the day is a cool concept!)

And the best bit is that at 4;59 I can start packing my bag and walk out the door at 5pm on the dot.

Some people say Geris Rehab is awful. That it's too boring and too much paperwork. Those people can have theri crazy hours on cardiology wards or early morning surgical ward rounds and days of holding retractors. I still get paid as much as they do whilst I gaze out the window and stare at the view of the Bridge.

*FOB = Fresh-Off-Boaters. Foreigners (usually Asians) who act so differnet they can be classed as having just hit the shores of Australia.

** Well working at least... med school was always a hoot... and maybe first term last year doing psych.. but I don't think that ever counted as 'work'.

*** On our geriatric ward we have 4 guys and 18 girls - who said there was a 'man-drought' in Australia?

**** temazepam is a benzodiazepine commonly used as a 'sleeping pill'

Personality

The other night at City Extra a bunch of us decided to go online (as they had free WiFi) and do one of those lame personality tests.
Can't say I've ever given much credibility to them before until I read some of my friend's ones and realised they were fairly good assessments. And so apparently I have been labelled an "ENFP - Extroverted/Intuitive/Feeling/Perceptive ("The Inspirers")"

"As an ENFP, your primary mode of living is focused externally, where you take things in primarily via your intuition. Your secondary mode is internal, where you deal with things according to how you feel about them, or how they fit in with your personal value system.

ENFPs are warm, enthusiastic people, typically very bright and full of potential. They live in the world of possibilities, and can become very passionate and excited about things. Their enthusiasm lends them the ability to inspire and motivate others, more so than we see in other types. They can talk their way in or out of anything. They love life, seeing it as a special gift, and strive to make the most out of it.

ENFPs have an unusually broad range of skills and talents. They are good at most things which interest them. Project-oriented, they may go through several different careers during their lifetime. To onlookers, the ENFP may seem directionless and without purpose, but ENFPs are actually quite consistent, in that they have a strong sense of values which they live with throughout their lives. Everything that they do must be in line with their values. An ENFP needs to feel that they are living their lives as their true Self, walking in step with what they believe is right. They see meaning in everything, and are on a continuous quest to adapt their lives and values to achieve inner peace. They're constantly aware and somewhat fearful of losing touch with themselves. Since emotional excitement is usually an important part of the ENFP's life, and because they are focused on keeping "centered", the ENFP is usually an intense individual, with highly evolved values.

An ENFP needs to focus on following through with their projects. This can be a problem area for some of these individuals. Unlike other Extraverted types, ENFPs need time alone to center themselves, and make sure they are moving in a direction which is in sync with their values. ENFPs who remain centered will usually be quite successful at their endeavors. Others may fall into the habit of dropping a project when they become excited about a new possibility, and thus they never achieve the great accomplishments which they are capable of achieving.

Most ENFPs have great people skills. They are genuinely warm and interested in people, and place great importance on their inter-personal relationships. ENFPs almost always have a strong need to be liked. Sometimes, especially at a younger age, an ENFP will tend to be "gushy" and insincere, and generally "overdo" in an effort to win acceptance. However, once an ENFP has learned to balance their need to be true to themselves with their need for acceptance, they excel at bringing out the best in others, and are typically well-liked. They have an exceptional ability to intuitively understand a person after a very short period of time, and use their intuition and flexibility to relate to others on their own level.
Because ENFPs live in the world of exciting possibilities, the details of everyday life are seen as trivial drudgery. They place no importance on detailed, maintenance-type tasks, and will frequently remain oblivous to these types of concerns. When they do have to perform these tasks, they do not enjoy themselves. This is a challenging area of life for most ENFPs, and can be frustrating for ENFP's family members.

An ENFP who has "gone wrong" may be quite manipulative - and very good it. The gift of gab which they are blessed with makes it naturally easy for them to get what they want. Most ENFPs will not abuse their abilities, because that would not jive with their value systems.

ENFPs sometimes make serious errors in judgment. They have an amazing ability to intuitively perceive the truth about a person or situation, but when they apply judgment to their perception, they may jump to the wrong conclusions.

ENFPs who have not learned to follow through may have a difficult time remaining happy in marital relationships. Always seeing the possibilities of what could be, they may become bored with what actually is. The strong sense of values will keep many ENFPs dedicated to their relationships. However, ENFPs like a little excitement in their lives, and are best matched with individuals who are comfortable with change and new experiences.

Having an ENFP parent can be a fun-filled experience, but may be stressful at times for children with strong Sensing or Judging tendancies. Such children may see the ENFP parent as inconsistent and difficult to understand, as the children are pulled along in the whirlwind life of the ENFP. Sometimes the ENFP will want to be their child's best friend, and at other times they will play the parental authoritarian. But ENFPs are always consistent in their value systems, which they will impress on their children above all else, along with a basic joy of living.

ENFPs are basically happy people. They may become unhappy when they are confined to strict schedules or mundane tasks. Consequently, ENFPs work best in situations where they have a lot of flexibility, and where they can work with people and ideas. Many go into business for themselves. They have the ability to be quite productive with little supervision, as long as they are excited about what they're doing.

Because they are so alert and sensitive, constantly scanning their environments, ENFPs often suffer from muscle tension. They have a strong need to be independent, and resist being controlled or labelled. They need to maintain control over themselves, but they do not believe in controlling others. Their dislike of dependence and suppression extends to others as well as to themselves.

ENFPs are charming, ingenuous, risk-taking, sensitive, people-oriented individuals with capabilities ranging across a broad spectrum. They have many gifts which they will use to fulfill themselves and those near them, if they are able to remain centered and master the ability of following through. "

What do you guys think?

Deal or No Deal?

Today finally switched our internet plan over. Every month we've been running out of data limit about 2/3 of the way through and been stuck on slower than dial up speeds for the reaming 10 days. It kinda got annoying and so we upgraded to a bigger plan with roughly 50% more data download to keep Youtube fully functional. I was expecting to pay another $30 but it turned out to only cost us $5 more. I was kinda puzzled until the Indian call operator explained why. "Well sir, the plan you now have is our new plan, but beforehand you had your phone bundled with us and we gave you 100 free local calls to the value of $30 and now you get the extra data for $5 but lose the 100 free local calls" He then proceeded to ask me what the weather was like outside as he fumbled through his computer system trying to work out what button to press to fix my internet. "Um it's been raining?" "How long for sir?" "Um since I WOKE UP????" (kinda becoming a bit too intrusive in his bid to avoid awkward silence over the phone and impress his boss)So now we have full speed internet. But in order to gain that I have had to sacrifice our free local calls. But I calculated we only spent $2.30 last month on that so we really gain more with the internet. It's a matter of weighing up the options and making a trade-off.

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Been watching more Death Note tonight. Now a blonde female character has been introduced who falls deeply in love with the evil killer (aww how sweet!). She too gets his killing powers but she wants more. She wants ot be more powerful and have the 'shinigami' (death god) eyes which will enable her to kill anyone. But in return for this power, she must trade half of her remaining life span in order to win her 'love' over with her new powers. She weighs it up and decides her new boyf is worth giving up half of her remaining years and makes a rather important trade-off (if only she knew what was around the corner! Ah Misa!)

...................................

Life is about trade-offs. We think the toil of studying hard at uni is worth it to get the job we want. We think the pain of slaving away at our job is a worthwhile trade-off to ensure we get the nice big house with the dog and 2 kids we want. We think the time we spend away from our family is a fair trade-off in order to 'have' a family. Sometimes we make good trade-offs (like better internet) and sometimes we make bad ones (like selling your life for power or love). Are our trade-offs worth it? Or have we blindly entered into them without evaluating where we are going?

"He is no fool who gives what he cannot keep to gain what he cannot lose" - Jim Elliot (murdered missionary to Ecuador, aged 29)

Death Note/Nite

Thanks to my Japanese flatmate, I have recently become hooked on a manga-turned-anime series called "Death Note". Thankfully Youtube have put English translated episodes up online so I can keep up to date and not have to bother my flatmate for a word by word translation.

The premise of the show is that a young man (Light Yagami) falls into possession of a notebook with supernatural powers. Whenever he writes someone's name in the book, they die of a heart attack. This notebook is known as a "Death Note" which belongs to the death 'gods' of Japan (the Shinigami) who usually use these books to rid the world of people when their time is up. However, Light-kun decides he can do a better job and decides to altruistically rid the world of all the bad or undesirables. The rest of the world soon notices that the crims are being bumped off at an alarming rate and start to panic. And so along comes 'L', the mysterious international detective whose job it is to outwit and discover the true identity of the killer now nicknamed "Kira". It's a psychological thriller and very well thought out. Each week I can't wait to hear the theme song and get my next installment. The psychology of death and dying.

................................

It was a night shift just like any other. The week of ward nights had so far been a dream run. Averaged about 2-3 hours of sleep interuptted only by phone orders for fluids and sleepers. Dr Z had commented how it was her 'calming effect' on the wards which made it thus. I laughed. And so began the Friday night shift. The beginning of an 3 day weekend (due to hospital days off). The night started with a constant stream of pages asking me to come and review people who weren't doing too well. Someone in pulmonary oedema, a Down's Syndrome guy who needed venous access but wasn't gonna let me anywhere near him with a needle. The usual kinda stuff that fills night shift.

And so as I was pinning down this guys forearm to pop in the cannula, I heard the nurse next door spurt out, "Um doctor... I don't think this lady's breathing anymore."
Argh!"Well do you wanna call a Code Blue for me then!!!!" (Frustration at nurses lack of initiative quite evdient in tone of voice)

Ok J... remember ABC.... ABC! (I told myself again and again)"Can someone get me a bag and mask! And the crash trolly while you're at it!" (just in case they didn't realise we'd need one - can never assume they'll 'get it')
Airway - Guedels airway inserted.
Breathing - bag and asmk commenced and handed over to nurse.
Circulation - pulseless in the carotids - CPR commenced

I put my hands on this 90 yr old ladies chest and with the first chest compression felt the CRUNCH as all her osteoporotic ribs shattered under the weight of my body. I started furiously pumping away, praying that the arrest team would arrive soon.

Thankfully before the first minute had elapsed they were on site with paddles and drugs and I was relegated from team leader to chest compression boy and let the registrars play with atropine, adrenaline and DC shocks.

But it was too late. She had been gone for too long. She was dead.
I had given her the best possible chance I could... but sometimes that's just not enough.

And so I wrote the first Death Note of the night as my registrar called up her husband to inform him of his wife's 'passing awayy. Turns out she lived 4 houeses down the road on my street. She probably walked past my house during the day on her way to the shops.

The ink has just dried on the Death Certificate, when the pager beeped. It was the surgical ward. "Sorry Dr J, we just need to to come and declare a patient dead." I went down and began the same process of 'declaring' death on this patient with a known leaking Triple A. And no sooner had I finished that one then another page... with another death.

By the time that shift finished, within 24 hours, I had declared 5 people dead. My own 'Death Note' episode, except that I was writing their names on paper retrospectively.

NB - this was a post I wrote in the past month that I was unable to publish due to internet problems, so it occurred about 4 weeks ago (sorry for the delay - but better late than never)

How to Save a Life

"Every night around the nation, a small but dedicated group of young men and women leave their homes as the country is engulfed in nightfall and begin their journeys. They are our sons, our daughters, our brothers and sisters. They are the Night doctors of the public health system and this is their story...

Dr J is a 24 yr old resident doctor at The Zoo. Like many other of his colleagues, he has just completed his internship and is currently undertaking his set of ward nights where he will be placed in charge of half of a major tertiary referral centre between the hours of 10:30pm and 8:30am. During the day the hospital is teeming with hundreds of doctors but at night it is just him, the intern covering the other wards and one medical registrar running the wards.

His night begins with a call from the renal ward. They have a patient who was recently transferred out of ICU who needs some attention. He has had a major bleed inside his brain and is now complaining of a headache similar to the previous bleeding. However before our young doctor can asses this man, he is called away to the cardiothoracic ward where a post-operative patient is having an abnormal heart rhythm.

Whilst giving the nurses on the wards further instructions on how to control this mans heart rhythm, Dr J is again called, this time by the cardiology ward to assess a patient who is bleeding profusely.

When he arrives he learns that this man has dementia and today has had a pacemaker inserted into his chest. Dr J carefully peels back the dressing to find that the wound has actually re-opened up and this patient is actively bleeding.

[cut to ad break]

"Welcome back to our look into the lives of young night doctors and their trials and tribulations. When we left our young Dr J, he was trying to save his patient from bleeding to death by applying prssure to his wound, however after 30 minutes the wound is still bleeding and it looks like he will have to take more definitive action
[cue dramatic music]
Dr J has run down to the Emergency Department and gotten hold of some suturing kits to stitch up the wound to stop the bleeding. With careful precision we cleans the bleeding and pulls the open wound together and immeadiately the bleeding stops. Another great save by Dr J. But before he has time to bask in the satisfaction of helping another patient he is whisked off to see another surgical patient who might have a clot in her lungs..."

You'll have to excuse my bad homage to RPA style TV shows... but ward nights have been rough. Compunded by the fact that when the cardiology morning nurses found out I'd stitched up a bleeding pacemaker site the conversation went a little south:
"Um Dr J, you did call the cardiology registrar before you stitched him up didn't you?"
"Um no..."
"Please tell me you asked the med reg first then?"
"Ahhh. no?"
"[Expletives that can't be repeated] Oh no! Dr Cardiology-boss is gonna freak out! He only ever uses pressure to sto the bleeding... he NEVER stitches them up! He's gonna go nuts!"

You kinda feel like you're helping people and doing your job well and then you get a nice big kick in the head to remind you that you're still just a resident and belong at the bottom of the pecking order. I can understand if this boss was annoyed with me cos I did something dangerous, but the fact is that this patient was bleeding and I did what many other doctors would have done... just not to his preference.

The politics of hospital make this job SO worthwhile... only 9 months to go!

The Sound of Music

Recent additions to the CD collection:


Norah Jones - Not Too Late
Back in 2002, I tuned into an alternative radio station and heard this pristine voice singing "Don't Know Why". I waited to find out the name of this artist and promptly bought Norah's first album before she hit the mainstream. I even considered going to her Australian Tour before she became big. Kinda wishing I had now! Either way, her second album didn't impress me as much (although still very good) and so I held out hopes that maybe on her 3rd outing she'd bring back some of her jazz covers and woo me once more. Unfortunately she's gone down the folky road and so it's a ncie album, but not the Norah I fell in love with so many years ago.




Human Nature - Reachout:Best of Motown


Although I am prone to boy band pop, Human nature don't usually do much for me until I heard their covers of my mother's era of musicology. It's nice to hear old classics with a crisp CD quality recording and a new arrangement. Ended up singing along with a mate to these babies on the way up to Mt Tomah the other day. "I got sun-shine.... on a clou---dy day!"








Regurgitator - Jingles


Blast from the past with a band who had some really good snappy hits. I never owned any of their music as a teenager (I think my mum wouldn't have allowed me to) but it's nice to pull out those classic high school hits like "Polyester Girl", "! (The Song formerly known as)", "Happiness" and "Fat Cop". The antiestablishmentarianism* of their songs is sublime, kinda venting my repressed teenage desires to rebel (which was in stark contrast to my bland tame reality).






Robbie Williams - Swing When You're Winning


Not to be confused with a similarly titled pop album by the same artist, SWING is very different from SING. I was amazed a few years ago when I heard Robbie crooning some lovely jazz numbers (a few of which became popularised ie Nicole Kidman and he on "Sumthin' stupid" and his Finding Nemo End Credit "Beyond the Sea") My flatmates all owned the album but when they left I was devoid of these classics and so managed to score it at a bargain $9 price!








The Cat Empire - Self Titled


2 years ago on Australia Day, my flatmate and I went into Darling Harbour and stodd overlooking the AquaShell as thousands of crazed fans moshed/partied/raved themselves silly to these ska/reggae/jazz ditties. Words can't really describe how good one feels after listening to their funky tunes... but it ended up with about 10 crazed fans throwing themselves into Darling Harbour and moshing in the water whilst trying to avoid the water police's tin boat. Ah.. memories!





Music is such a vital part of life. It provides the soundtrack for remembering the past and adds the colour between the lines of events.





"Our weapons were our instruments, made from timber and steel


We never yielded to conformity but stood like kings


In a chariot that's riding on a record wheel"





* I just HAD to use the longest word in the English dictionary at SOME point didnt I?

Scrubs - Musical

What I WISH would happen in hospital each day.

Medical TV

Every once in a while, a non-medical person will enquire:

"So is being an intern/resident really like on E.R./Scrubs/Grey's Anatomy?"

Hahahaha! "You have NO idea!"

Whilst of course the working life of a doctor is not all fun and games and often a lot of paperwork (which doesn't make for good TV), there are often a lot of truth in these depictions of medical life.

The constant jokes about bodily fluids/products/organs, the larger than life personalities, the lack of social skills all stem from a dark reality hidden behind the facade of the blue scrubs.

Medical types are usually quite bright and so where there are doctor's there is humour to be found. Those bizarre topics of conversation on Scrubs? Here's one of my own form the other night in ICU:

"So did you see that guy on the news? He got half eaten by a shark!"
"Which half? Like how do you get half eaten by a shark?"

"Obviously its the top half that's left... cos you can do without the bottom half!"
"Can you? How much of your body could you have eaten off and still survive?"
"That's a good question.. like you'd need heart and lungs and brain... but I guess you could do without legs and reproductive organs.."
"And you could get rid of your kidneys and go on dialysis?"
"Good point... and you only need a sliver of liver... so we can scrap half of that... and maybe get rid of the bowel/GIT and use TPN feeding?"
"Yeah... I wonder which half of that guy is left... I hope he has some liver..."
"Yeah me too"

Sometimes I feel like I'm on TV... kinda like the Truman show. And as night shifts go on into the dark hours before dawn... the conversation get more and more bizarre.

However I must say the following video below really sums up what I feel like doing one day in the Zoo.

Enjoy!

Not-So-Intensive Care Unit

Good morning blog-readers and welcome to the new and improved Dr J!
2 weeks of annual leave have left me a new man; "full of happy thoughts... all the time!"*

In a quirky twist of fate (and a lot of manipulating via multiple phone calls almost bordering on harassment) I ended up doing a 4 way term swap which means instead of being thrust back into ED, I found myself arriving back to The Zoo on night shift in cardiothoracic intensive care (CTICU).

When I found out I would be covering CTICU on nights by myself I kinda panicked! I had done a total of 2 days ICU as a student and learnt nothing from it. I didn't know what the beeping noises or tubes did. I had never done cardiothoracics either and didn't know what a LIMA or IABP** were.

When I arrived I found a big trolley with a drape over it parked next to my patients. It read "Open heart trolley - Emergency Only". Not a good sign! I found the CTICU fellow, a rather nice British doctor who quickly allayed my fears.

"Have you ever done ICU before?" I sheepishly shook my head.

"Sorry, yesterday I was an intern, today I'm a resident"
"That's a bit rough... no worries, how about I sit down with you and I'll teach you in one hour everything you need to know about CTICU"

One hour later I felt comfortable enough to handle anything life threatening and actually understood PEEP, PAP, SVRI, CI, MAP and how to handle inotropes in patients who'd had open heart surgery.

Armed with dobutamine, noradrenaline and a set of the best nurses in the hospital, I felt well armed to deal with anything urgent that may arise during the night. As the fellow left, I was ready to keep these people alive until morning.

5 minutes after the boss left, the nurses looked at me strangely, "You DO know there's a room for the resident to sleep in overnight don't you?"

I looked kinda puzzled... what resident? Oh that's right... I'm no longer an intern!

The nurse in charge took me up to the cardiology department and showed me a small room tucked away with "Staff Only" printed on the doorway. Inside was a lavish bedroom with a nice freshly made bed and an ensuite with shower. Who said taxpayer's money was poorly spent?

6 hours later I awoke. It was half an hour till handover time so I scurried back to CTICU to print out morning blood results and tidy things up. The morning resident appeared right on time and I was home in bed soon after.

Getting paid to sleep. This is the life!

3 nights later it's a similar picture. Sleeping 6 hours average per shift and getting paid to do so. Tonight we might not even HAVE any patients left in the unit.

And so begins PGY2... after this week I get a 'week off' to compensate. This term I will end up working a total of 5 weeks due to working nights. 5 weeks off! And none of them annual leave!

Welcome to residency!

* "Kung Pow - Enter the Fist"
** Left internal mammary artery and Intra-aortic balloon pump

Holidays

The sun is filtering thru my window. The kids next door are playing in their pool. The birds are calling to each other. The planes are flying overhead.

This is the life.

A well earned break and what am I doing? Sitting around in Sydney!

To be honest, it's actually a perfect start to the clinical year. Lazy summer days and plenty of sleep. A beach trip yesterday to check out the 'scenery'. A shopping expedition with the ex-wife. A movie in the evening. A book to read whilst having a bath (ok, it's a drought.. but once in 6 months isn't that bad).

Plans to watch the tennis tomorrow, catch up with some friends, eat good food.

Little things that remind me I am still a human (and thankfully no longer an intern).

Maybe I should learn how to ride a horse so I can meet lovely ladies like the one in the picture?

Coming soon...

Stay tuned in January 2007 for the new adventures of Dr J as he finishes his internship and begins the big bad world of residency.

25% more fun, 75% more waffle and 37% more pay (I hope)!

Only at http://theresidentexperiment.blogspot.com