Getting under my skin

Finally med has got 'under my skin'. Now if you are a fellow med student you'll know that I'm making a very bad metaphor- as this week as been all about skin.  It's such a relief that med is now finally drawing me in and captivating me, not just throwing me into a panic with how much we have to take in. 

Perhaps in my last few posts I have tried to focus on how awesome med is rather than being completely honest about how overwhelmed and scared I have been. 

• This is the first week that I haven't called home crying. 
• This is the first week that I am beginning to wonder if I do in fact have what it takes to be a doctor. 
• This is the first week that I have come to grips with the possibility of failing. 

Really what does it matter if I fail? If I fail I'll cry etc and then I'll pick myself up and do first year again. 

Aside from that I'm looking after myself- I'm refusing to let med take over. I've found time to start knitting again (how I've missed it!). Today a med friend and I decided to pretend not to be med students for two hours and do normal things. It so special just to wander through lovely clothes store and sit and have food in a real cafe. We couldn't resist talking about our favourite med things from the week, oh well so much for forgetting med!! 

So what can I tell you about this week? My favourite things of course!!

1. The skin is covered in pathogens  (microoganism capable of producing disease). This is... good. They happily live there in safe numbers basically taking up the space and food so that no one pathogen can take over and cause oh no... disease. The immune system also gets daily practice at killing off and keeping these pathogens in check. Finally the microorganisms sometimes produce vitamins that the body needs and toxins that kill bad pathogens. We have around 100 trillion of these microorganisms on our skin, in our gut, eyes and noses etc. Beautiful. It's only when a microorganism that is usually found in one place and moves to another- say from the gut to the mouth that problems happen- it puts the whole beautifully balanced normal skin flora out of whack. Taking broad spectrum antibiotics can also clear off the normal microorganisms letting the more resilient microorganisms take over. 

2. So yes that is all cool, but I particularly like the gore. Learning about abscesses etc this week was awesome. If you aren't too squeamish you may enjoy the following link: 

http://www.facebook.com/l.php?u=http%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3DXf8G-c_eAhs&h=cac7a

Abscess: I hope my understanding is correct. Here I go. Something gets through the outer layer of the skin. This could be a  pathogen or splinter etc. The body sends in white blood cells to kill it and eat it up and clean out the wound. These cells struggle as it is not an easy war. Many die as do some of the invading pathogens/bits of the object. This creates a pool of dead fighters from both side= pus. The body is also sending in fibroblasts (builders) to rebuild the damaged war zone and isolate the infection. Now the pus is completely isolated. There is no blood supply and the nice alive good body tissue is dying inside the capsule. The pool of pus is getting bigger. Antibiotics won't help as they can't get through the capsule. This is a dreadful situation. What if the capsule fails and the infection, which is now big, gets into the blood and goes EVERYWHERE??? So what happens? Cool doctors comes along and open it up and let out all the pus, clean it up and all is well again. Although it would be temping to do it at home just like the people in the video above!  

Now I must go and do my share of the cleaning and SLEEP. Is not sleep the best invention in the world?! 

uprooted

Going into med I was under the impression that med would make me more smart. Unfortunately the opposite is true. My brain is fried. Kaput. 

Let me give an examples. Coming home from uni I thought I'd shower my neglected garden in affection. I pulled up many weeds. Sadly the next day I realised that the 'weeds' were the tomato plants and the plants that I had rescued were weeds. I have replanted the tomatoes and am hoping and praying that they somehow live. 

This leads to me to my title uprooted. In a sense I am too uprooted. I have been pulled up out of the clay-like soil of Adelaide and planted in sandy Perth. Weirdly this did not hit me until three days ago. All night my dreams were filled with searching for missing friends and attending the funerals of my family and close friends. I woke feeling disorientated, wondering why my quilt was black and my bed was facing a new direction. I had a little cry and then had a good day of study. Plants, no matter how tough, cannot be uprooted without a struggle as they adjust to their new environment. 

Still apart from a fried brain, missing home and still not taking in nearly enough information each week I LOVE med. Each day I fall more deeply in love with med. Seriously it is the most special, unique degree  ever. We all attend classes four days a week from 8amish to 5-7pmish. It's almost like we're all living in a giant mansion together (going home to sleep seem to be insignificant). Apparently next week we all have to weigh each other and strip down to our underwear (or bathers) as we practise clinical skills. I am not looking forward to this! I think we'll all know each other in quite a different way by the end of the four years than we know our non med friends. 

On Mondays we hangout at Curtin uni and do all the core science stuff. (we're extra nerdy as we have student cards from TWO unis). On this day we done white coats and spend two hours exploring the anatomy of cadavers. Despite the smell that makes me disconcertingly hungry and the chemicals that make my eyes red and watery, this is the BEST two hours of the week. I am SOOOO thankful to the people who donated their bodies to help us learn. Seeing the body parts in real life blows me away. Let me tell you of the two best things I saw this week. The area beneath the heart and above the pelvic floor is the peritoneal cavity. The guts are all shoved in there as I thought. Instead there is the this sheath like thing that is interspersed in the cavity that hold every thing in place. The tissue is called the mesentery and is connective tissue that has an awesome blood and lymph (can hold germ killing agents) supply. The greater omentum hangs down from the stomach and flaps over the small intestines. It is described as the watch dog. When an organ is infected it wrapped around it. This means that the infection is isolated and can't spread. It also means that the lymph supply can FLOOD it with germ killing agents to fight the infection. This BLOWS me away. On a lesser note the same material is attached to the small intestine like a pretty frill. I've attached a gruesome picture below, which I found with google. Also see my beautiful garden- this is a photo of my pumpkin plants.

MED IS DREADFULLY DIFFICULT BUT NOTHING COULD BE BETTER. 

Crisis.

Imagine that you are a canon ball. You have to be shot over a vast ocean to land on an island. There are crosswinds.

Med is like this.

Flying over the ocean and hitting the target is the most incredible experience in the world. Just think of the views and the rush of flying.

Imagine if you don't bother to take into account the force of the wind and align the cannon correctly. This is what the first two weeks of med is like. It is very hard to make a cannon ball that has missed its mark float to the island.

Sooo... tomorrow I'm going to stop ignoring the crosswinds, face them and design a workable study plan. No more land plonking into the ocean and having that horrible sinking feeling for me!

I always knew med would be so full on, but lectures from 8:30 am to 7:30 pm four days a week, with only 30 minute breaks is slightly ridiculous (especially with study thrown on top). I've been so so so tired. Twice I've attempted to get off the wrong side of the train, much to the amusement of the school kids. Once I ignored a man who was trying to talk with me (thinking he was one of those men who gets a bit too friendly with girls on trains), only to find out he was a fellow med student!

Okay so apart from freaking out and crying on the bus and momentarily considering quitting med and going home- med is still pretty special. Already I've had three hours of exploring cadavers. The smell is dreadful and the worse thing is it makes me hungry. I've grown cultures, learnt how to put gloves on and wash my hands.

Yay for med!!!!

ps my veggie patch is growing pretty well- despite it being more sand than dirt.

Adelaidian to Perthian or as I prefer Perthite.

A week ago I was all geared up to leave Adelaide to study medicine- when I suddenly began to vomit every 30 minutes. At first I thought it was nerves. After all I did vomit on my first day of school and of OT. Six hours later I was diagnosed with gastro- with a delayed flight. For the first time ever for a domestic flight I’d got insurance- phew!

While lying on the couch I managed to squeeze in some Doc Martin viewing. I’m probably the only person under 50 (apart from my cousin Emma)  who enjoys it- but what does that matter? In it the main love interest was single and pregnant and was a little tired of everyone offering to help. ‘It’s about time I learn to manage on my own don’t you think’ she said. How silly! Sure she needs to learn a whole heap of new things, but most of all she needs to learn to ACCEPT help.

This past week has been just that for me. Strangers put me up in their study for 3 nights and leant me (for as long as I need) important things such as chairs and saucepans. A friend lent leant me a bed, linen, desk and a printer for the year. My landlord drove me to my house to see if I really did want to rent it. My new housemates (not yet in Perth) message and call me every few days even though they don’t know me (yet). A friend took me out for lunch and yummy Spanish chocolate and donuts. A stranger watched chick flicks with me and took me (and another Perth newbie) to Kings Park for a picnic. People are amazing.

Oooh now for the exciting things. The garden at my house is DREADFUL. This is a BRILLIANT thing, for the landlord said that apart from ripping out the trees I could do anything. She even pointed out a bed and said I could get rid of the ugly rosebushes. This is a dream come true. For years I’ve wanted to plant my own veggie garden- but wasn’t allowed to. So… the rosebushes are gone and I’ve planted tomatoes, eggplant, pumpkins, basil, lettuce, and zucchini. After doing this bare foot I saw all these baby brown snakes slithering through the bed. Thankful to be alive I rushed in doors and emailed a picture to my parents. They asked my trusty botanist uncle and it turns out they are sand sliders (I think). Either way I now wear shoes and gloves while gardening!!!

I have also bought new sneakers and a book of funky squares to crochet. What better hobbies could a med student have?! Crochet for fine motor skills. Gardening for healthy food and stress relief and running to stay fit despite spending most of my time on my bottom studying. 

Each post I’m going to give a tip for being a med student. This weeks: Do all grocery shopping (apart from perishables) prior to the term. I have a farmers market on my street every Saturday so that’s all the shopping I think I’ll need to do for the next 8 weeks.

Finally I can’t wait until my housemates come- it’s hard making myself believe that no one is about to sneak into my room and kill me. I should probably stop reading Half the Sky before bed (all about terrible things done to women around the world and how to help them). 

The West is Best. Really Perth is GREAT. Everywhere is near the beach. The spanish chocolate cafe chain is better than Bracegirdles. Still I miss the Adelaide hills. Does Perth even have hills? I also hate the feeling that if I just stop and sit I'll start missing my friends and family like crazy. Perth feels further from home than Scotland. I keep thinking that i need to change my money into perth currency! 

One week until med actually starts!!!!

Are we there yet?

I'm going to be a med student. 

For the first month after getting into med I would wander around the house telling family members this. It was just so unbelievably good- it had to be said out loud (again and again). My poor family!

It's still so hard to believe. I even have a fear that a letter will arrive in the mail saying that it was all a horrible mistake and that I was not offered a place after all. This is silly. 

Ignoring this stupid fear I'm going to focus on what sort of doctor I want to be and how I'm going to get there. 

This was all put into focus with my Granny dying on Christmas eve. It is incredibly sad- but long expected. What touched me about Granny was that she was the best granny possible. Throughout my childhood I knew that she loved and delighted in me. Many others would say the same about her. She loved in word and deed. Always she was telling me that she loved me. She also took me to movies, left a fredo on my pillow when I slept over, hugged me and knitted and wove me blankets and toys. 

A bit before her death I wrote my own Eulogy (pretending it was 50 or so years into the future). It was interesting to see what really mattered. For instance the following is ridiculous!

..... was a stunning girl who never went above a size 8 her whole life. Her sense of fashion was impeccable.  She had hundreds of friends and everyone admired her. ..... was very wealthy and she was renown for being a great doctor. 

Seriously what a waste! More than anything it is the heart that matters. I too want to be remembered as someone who loved and loved well consistently over a lifetime. I don't mean that I will be obese and frumpy and hug everyone while smiling inanely. 

This is how I want to be remembered:

1. A person who made time for people, who was generous, who encouraged people to be the best they could be, who was faithful and loyal and consistent. 

2. A dedicated doctor, who was excellent in their field and used it to serve those who otherwise would not receive the best standard of care available in the world. Who also valued teaching and passing on skills patiently to others. 

3. Someone who had a quirky sense of humour and loved life.

So.... how can this be achieved? Can it? YES. 

Firstly med is going to be HARD and BUSY. I will have to be focussed. I choose to focus on:

1. Being a good student with a thorough knowledge of anatomy and physiology and practical skills and problem solving. This will require regular revision and a lot of time (even my evenings and weekends).

2. Being healthy. I had the flu last year- I never knew it was possible to be so ill for so long. At one point I even hallucinated and thought I was a building with broken plumbing! This must not happen again. I will eat lots of fruit and vegetables and meat. I will have a good routine for sleep. I will take Sundays off, just to rest and let my mind relax. I will build up my running until I can run for 30 minutes every day. I will knit to have good fine motor skills. I will buy a basket ball and practise shooting and catching to improve my sense of my position in space. (Excellent surgical skills are nothing if I then accidentally knock the patient off the bed). I will keep away from sick people (except when on placement). I will wash my hands incessantly. 

3. Friends. I will build up friendships in WA. I will also keep in contact with all my SA and overseas people. For this I have begun collecting addresses, cards and stamps. Sunday afternoons will be spent lying in a park sipping coffee and writing letters. 

4. I will remember daily, with thankfulness, how I got into med. 

I will need all the help I can get. If I every begin walking away from who I want to be- please tell me with a hug and a laugh. 

Now I will go and make the most of my last few days before I leave SA, perhaps forever.  :)

twilight zone

Guess what sort of person I am. Do I love going with the flow, taking life as it comes, or do I thrive on order and planning?

As a little girl dad remembers me enjoying making sure all the pink plastic cups and saucers precisely lined up with my little table. This was more important to me than the actual tea party game.

This is still somewhat the case, which is a shame. Order should serve a goal of being and doing wonderful/ or boring but needed things. It should not be the goal.

I wonder if this is why I am finding this final holiday before the onslaught of med so difficult. I feel more tired and stressed than when I was working!

The key issue is that there are so many unknowns about next year. I want my questions answered. Then I can plan and have everything settled. Perhaps then I could relax. However I have an inkling that once everything is set in stone, I'll focus on what things to bring with me, how to budget for med, etc etc.

This temperament is a real asset for getting ready for med, but it is so annoying with holidays.

So from now on I'm letting go (apart from checking up on vaccinations and my GP sign off for med). I am DECIDING TO REST. I am resting so that I am at my optimal to study med and become a great doctor.

I'll rest by watching House, by knitting, by bush walking, by cooking, by sipping coffee and watch the kookaburras that love my gate, by reading and by sleeping in.

Within this resting I'll say goodbye. I'll have final coffees with friends, I'll have my 'dress up as your favourite medical condition party', I'll wear my 'heaps good' tee shirt with a map of SA on it. So far I have visited the pandas at the zoo, been in a hot air balloon ride over the Murray river and gone to Haighs. What a joy to finally realise  that I love sleepy Adelaide!

Once an OT, always an OT

A while back I didn't get into med. Needless to say I was pretty upset.

Being very practical I chose to study..... electrical engineering. Guess you didn't see that coming! I love maths, I LOVE physics and I love the potential of engineering. One lecturer said that engineers have saved more lives than medicine ever will. I guess with the inventions of sewers etc, this is true.

Unfortunately all these practical reasons did not convince my heart. After three weeks I dropped out. My heart demanded me to follow my passion for working with people and blood and guts. I tossed up between occupational therapy and psychology. OT won out because I figured that even if I never worked as an OT it would teach me skills that would be an asset to life in general.

Studying OT turned out to be one of the best decisions of my life.  I'm now heading in to my very last week of working as an OT. I want to reflect on the profession's incredibleness as a way of saying 'thank-you' and holding onto all that I have learnt.


This is the quote at the beginning of my core OT text 'The tools of our minds and the tools of our hands are of meaningless use without deep and personal reasons of the heart to set their purpose and guide their use' (Paul Brockelman). Basically that is OT. An OT comes alongside someone or a group and 'enables' them to integrate their minds, physical abilities and hearts to perform a task that is deeply meaningful to them. How beautiful, how wonderful, how simple.

Of course my OT friends would also joke that we should be called occupational thorough-pests, or that we have a degree in common sense.  Still simplicity should by no means remove some of its worth.

Personally this it was OT has done for me:

• I desperately needed to increase my motor skills to even consider being a surgeon. I took up the 'occupation' of knitting and crocheting and my motor  skills have improved out of sight. I also now have made some lovely blankets and a rather hideous jumper. 
• I wanted to save up for Europe, get fit and have time to reflect. Using the PEO model I worked that that if I stopped catching the bus and got up just a little earlier I could walk the 5ks and achieve all three.
• It's taught me the importance of occupational balance. There is such freedom in this! Everyone needs time to achieve, to exercise, to eat, to sleep, to just be and to have fun and good friendships.
• It's taught me that most people who tell you something secret and dear to them are not after advice. They simply want a witness, someone to listen. 
• The list goes on and on including words such as: enable, facilitate, just right challenge, counselling, observing, listening, teaching, empathy, creativity, lateral thinking, running groups...

OT THANK YOU!!!! YOU SHALL MAKE ME A MUCH RICHER-ROUNDED DOCTOR:)