'I'm free at last' or 'when all is said and done' or some other inappropriate use of a quote.

Exams are done. 

It was like being in a pressure cooker (even though I have never used one) and well it all got too much. For the first time all semester I had to call home (not for fun, but to be calmed down) and ask everyone for a whole heap of support. I would lay awake for 4 hours during the middle of most nights and study feverishly during the days.

On top of my tiredness and stress my neighbour freaked me out just as I was heading out to my last exam. This led to me crying on the train and having the whole carriage offer me support (I don't remember the last time I've cried in public- except for funerals). A middle eastern guy in my year offered to 'have a chat' with this neighbour and another found a shop that sold pepper spray for me. Numerous others kept checking in with me to make sure I was safe. I love my med family. 

To relieve some stress my med housemate and I started eating together and playing 'anatomical charades'. The aim is to contort your body into the shape of an organ or cell until the other can guess what you are. It a very nerdy game that she invented. Play it- it's fun. 

For those interested our practical exam was on the following:

cardiac history

respiratory history

psychiatric history

cranial nerve examination

elbow examination

vitals assessment (blood pressure, pulse, BMI)

The written paper focussed on:

asthma

leukaemia 

pregnancy 

stroke

kidney damage 

The cadaver lab paper focussed on:

Lymphatic system

blood sugar regulation- I think

the heart

the liver

the digestive system

the brain and skull

musculoskeletal

microbiology

 

I can't remember the other few stations! 

Well the exams went well I think- phew!!!!!!!!! 

Now it's time to head home and try and relax. 

:)

Exams. EXAMS. Exams. 

It's that beautiful time of year when that is the pervading noun that sneaks into every thought, conversation and action, and hopefully evades our dreams. 

People have been asking me for my exams times. Here they are:

4/11/11: 2 hour exam in the cadaver lab. It's basically on anatomy, physiology, pharmacology etc. It'll start 10am or 12:30, depending if I'm in group 1 or 2.

7/11/11: 3 hour exam in the exam hall. It's on EVERYTHING. 

9/11/11 12-5 (although it only goes for a little over an hour). MSAT this is where I get to wear nice clothes and take medical histories and exam 'patients'. This is my favourite as it's the easiest to prepare for. I just hope I don't get someone I know as a patient or examiner and freak out in the moment. 

And then.... BLISS. Holidays. This will be spent with as little sitting and thinking as possible. Some of us have given ourselves 'learning objectives' (we get these each week to guide our med learning) for the holidays. This is incredibly nerdy. Still time is precious. Mine are to:

1) write a Christmas puppet show with my cousin 

2) climb mount lofty several times

3) swim as often as possible

4) cook real meals (not stupid- 'let's cook and freeze heaps of foods so I can study meals')

5) make a quilt

6) love my Adelaide friends to bits

7) sleep

Most med people seem to be heading overseas, oh well Adelaide feels a little like going overseas. 

This is my last blog before exams. Lately I've been thinking how med has forced me to stop letting my weaknesses hold me back. My motor skills were shocking so I took up knitting. Now my fine motor skills are good enough to let me consider surgery. Now I am seeing if this method can be applied to my appalling singing ability.  During my study breaks I play my housemate's keyboard and attempt to sing in tune. Maybe in a year's time I'll no longer be ashamed of my voice. Wooohooo for medicine... it seriously is the best medicine. 

(my home for the next two weeks, with my favourite biscuits that are only allowed to be made during exam time. They are full of chocolate and ground coffee) :)

See you after exams. 

Hands are handy

My housemate decided one day she could out do me- both in the cooking with no dishes and being overly excited. Somehow she managed to make mayonnaise inside the egg while only dirtying a teaspoon. Hahaha she makes me laugh. 

There are some things I don't like about medicine (only a few).

I hate it that medicine can act as a barrier with people. Friends who used to think I was normal now think I am incredibly smart (I'm not) and newly met people regularly say 'wow' and then awkwardly walk away. In response to this I unintentionally ramble on about all the silly things I do. Basically say anything to disperse any wrong ideas about my greatness. Oooh and many of my med friends who are girls find that guys are immediately threatened when they find out they're studying medicine. Sometimes I just want to tell people that I'm an OT (nobody really knows what it is, but most people find it to be a satisfactory answer and let me continue with a normal conversation). Perhaps I should just treat med like any other course and normalise it. If I don't act strange then maybe others won't either. 

After people figure out that I'm studying medicine the next question invariably asked 'what speciality do you want to get into'? I feel very silly saying 'hand surgery'. It's just so specific!!! Who knows, maybe I'll end up falling in love with something else, but for now I love hands. Marry up OT and med and you end up with a hand surgeon (science plus functional ability and all that jazz). They go perfectly together- sort of hand in hand. Last week, on my birthday, I had a placement with a hand surgeon (best coincidence ever). Amazingly he let me stay on an extra 3 hours and watch a few surgeries (carpal tunnel, ganglion removal, removal of metal plate from the elbow, removal of golf sized bursa protruding from the elbow joint). I haven't seen any hand surgeries for 2 years now and I was afraid that my love would prove to have diminished. Certainly I didn't have the adrenalin rush that came with the first surgery that I watched. However the 3 hours felt like 30 minutes and and the operating theatre felt comfy just like the scrubs I got to wear. I think hand surgery will be like my knitting- fun, consuming, patient problem solving, creative, intricate, slow and steady. 

Do you have some movies that you watch again and again- finding yourself identifying with a certain character? The last movie Granny took me to see as a special treat (just her and me) was Little Women. I was 9 and incredibly embarrassed by the tame kissing scene and the fact that I cried when one of the main characters died. Over the years I've always seen myself to be like Beth (the girl who died). She was quiet, phlegmatic, shy and too cautious. It was a shock to watch it for the first time in 10 years and find myself frustrated by her and identifying with her older, adventurous, stubborn, outspoken, volatile sister Jo. Jo doggedly pursues her dream of writing, moving away from home at a time when girls ought to stay home and have babies. At first I was terrified. Has med really changed me so much that I am no longer  a 'sweet, quiet, other centred OT'? I began watching myself in PBL. I noticed that I would speak up if I thought others were wrong, even if no one else agreed with me. I no longer sit passively back, but am quite happy to jump in and argue. Friends have noticed that I now take the lead and my family say that I am more decisive. Truth be told I love being more like Jo. Life is more fun and less tame. I think med has forced me to grow up and stop hiding behind shyness and fear of what others think. This is good, but a person newly freed from shackles still needs some restraint. I'm hoping that, with time I'll learn to use my new freedom like a sword, guided by my OT values. This would be better than my random flailing movements!

I leave you with a photo of a scarf I just finished (it's made of lots of little stars) and my desk duck and cat. The duck has been a resident of my desk for many years now to remind myself of who I'm studying for (it looks so vulnerable and I'm sure many patients feel vulnerable). My housemates gave me the cat as a birthday present. It is a lovely wind back toy which is a good outlet when I'm sick of sitting at my desk all day. I love how the duck appears to be looking worriedly at the cat!  At the risk of taking symbolism too far- I think doctors are like cats. They appear to be self determining, confident, and equally good at comforting or harming. Maybe the cat can help me remember to hold onto OT values, which will lessen any harm I may cause in the future.

ps. Exams will be done and dusted in 6 weeks. The amount we must revise by then is phenomenal. I am scared. 

Hidden

I got a shock today, when someone came up to me and commented on my study plan. Apparently he had heard others talking about it (and they had found out about it through my blog). It's a little scary to think that med people are reading this, but they (or you) are very welcome to, although please let me know if my medical explanations are wrong!

These past two weeks have been a little tough. I found out that someone back in Adelaide is unwell (they'll probably be completely fine). Part of me wanted to be the tough medical student and logically reason that everything will be okay and just power on through with my study. The OT part of me wanted to take time out and cry a little, watch movies, go on long walks and basically let myself come to grips with what was happening. I thought I was coping just fine with a lovely balance between the med and OT coping methods. Yet I found myself very carefully refusing to cry when my best friend from back home tried to hug me through the computer screen on skype.

So what is the best way to 'cope'? Is there are good way? There are a few things that I know. I absolutely refuse to be someone who lets my sadness become a method for seeking attention, or even part of my identity (I probably take this too far and don't let people help me nearly enough). I also refuse to pretend that nothing is wrong at all and make no time to grieve. I now know that when I'm upset I have far less reserves for standing up for myself, or simply telling people that I need space. When I am sad I feel vulnerable and hide.

I'm crazy for metaphors, did you know that? This last week pink daisy like flowers have been popping up everywhere. I love them- they happily bob and sway and generally look very pretty. Early one morning I went for a walk/run and saw them. Their petals were all wrapped into a tight little bud, protecting itself from the cold air (I suppose, although I know nothing about flowers). When I feel vulnerable I am like this. People come and, unless I feel safe, I will wrap the petals more closely around me. Sometimes people come and try and rip the petals open. This is dreadful, this is when I close down completely. If only they had come warmly and gently and INVITED me to open, rather than demanding it. This made me wonder about how patients must feel when they are sick and vulnerable. Doctors have to come and ask the patient how they are going- no excuses. I think a warm, gentle, humble doctor (who also gives an air of being competent) would be far more successful in building a good rapport and thus getting a good history than a busy, demanding doctor who fails to see the best in the patient. For all this though, I'm amazed at how kind everyone has been to me.

So enough of trying to be deep and reflective! This week we got to conduct ECGs on each other. In my little group of three, we couldn't figure out why one girl had so much interference showing up on the reading. It took us at least an hour to remember that she is pregnant and therefore has second heart being inside of her!!! Oh dear. We also learnt that the heart beats a little faster when breathing in and a little slower when breathing out. This is for two reasons. Primarily it's because the respiratory control centre is very close to the cardiovascular centre in the brainstem. Breathing in requires the diaphragm and some muscles that move the ribcage to contract. This requires electrical signalling from the respiratory centre. It's proximity to the cardiovascular centre means there's a little bit of electrical over flow and thus the heart beats more. The second reason is that as the lungs expand it creates a drop in pressure, thus sucking more blood back to the heart (venous return). My ECG reading is now proudly decorating my bedroom wall. 

Finally I am so sick of being ridiculously shy. I hate being the only person in my clinical skills group who blushes profusely week after week. This week the tutor said he'd been deliberately avoiding me all lesson so that I wouldn't get stage fright, and could concentrate on learning. Far out!!!  Is there any way of not blushing at the thought of blushing? Is there any way of not being shy? I've moved states, made new friends and still I'm shy!! Perhaps I just need to stop worrying about it, laugh,  and continue to get on with it!

I had a ball (at the ball)

Mmm I just stole my brother's joke- but I'm sure he won't mind.

The last few times I've tried to write a blog, it's been awfully difficult. I've just been way too happy and not nearly stressed enough to write. This is probably related to mid year exams comforting me that med is not quite as impossible as I first believed.

I've been trying to feel more down, but it's just not working. Somehow I'd got it into my head that med is really difficult and that studying constantly should feel like wading through a swamp (an amazingly interesting one, but nonetheless a swamp). This semester studying has felt more like running through a forrest or darting in and out of the treetops. Sleeping is difficult, not due to stress, but simply because I'm so full of joy and excitement. This has made me feel like I am not studying properly. Yet on reflection I am getting so much more done- and understanding everything better too.

We learnt how stress makes it difficult to transfer short term memories into long term memories. So that partially explains why this semester is easier. Also last semester I was learning everything for the first time. Most of the prefixes and suffixes were new. Now I know things such as 'salpingo' means tube and that's why the ligament near the fallopian tube is called the mesosalpinx and the salpingopharyngeus is a muscle near the eustachian tube (between the middle ear and the pharynx) that helps open up the tube when we swallow. You make like to know that testes means to testify and that one of the key cranial nerves, the vagus, means vagrant simple because it seems to wonder everywhere through the body. The body's organ systems are all interconnected and that means that it was impossible to understand all of one system without studying the others. Now that I've studied a few organ systems everything can be understood in context.

Since I last wrote we have studied mental health and the ear. I've always just presumed that serotonin only affected our mood. Yet this neurotransmitter  also affects sleep, appetite, nausea, bowel movements, obsessions, headaches, anxiety and phobias. This is because it is released in multiple parts of the brain. To be honest though I probably enjoyed studying mental health the least out of everything so far. The ear was a refreshing break from chemistry and tiny details that can't be visualised. The ear is a beautiful tool that seems to primarily use physics. I love physics. The ear drum is a thin membrane that divides the outer ear from the middle ear. It's literally like the skin pulled over a drum. It amplifies sound when sound vibrations make it move. Remember the vagus (wandering) nerve I mentioned above? Well the ear drum (tympanic membrane) is innervated by this nerve. This nerve also does a lot of innervation for our gut. This explains a bit why when our ears feel pressure/pain we may feel nauseous.

I really should have checked what I wrote about last time. I don't think I mentioned the med ball. I'm so glad I went. Everyone looked so dressed up and wonderful and there was a massive jazz band with a few jazz singers. I don't think that I'll ever be able to say that I can dance well, but dancing to jazz music is 1000 times easier than other types of music and lots of fun. The med ball was so much bigger and more flashy than my OT grad dinner. Perhaps this is because one of the WA mining companies sponsored it.  Med always seems to do things well- (with med insurance companies always throwing money at all the events).

This is a photo from the ball.

These are some peas from my garden- finally something grew that I can eat!!!

This week I have been lucky enough to see two movies. Plant of the Apes and The Green Lantern. I love it how med seems to attract a few nerds (though perhaps they wouldn't like to be referred to as this!) who like science fiction too. The week before I saw Red Dog- an Australian movie set in WA. It was so quirky and reminded me of the type of movies that I watch with my family. Three movies and a ball in two weeks- I really must get back to study!!!

Relief!

The suspense of waiting... waiting... waiting. We were told we'd have our exam results by the end of last week. Each day the school apologised and made us wait another day.  It got to the point that I was dreaming about opening my results fearing that I had got the dreaded 49%. Today around 11am they were finally released! I did as I had hoped, and so I am glad.

I'm a little bit sad that I haven't written anything deep or profound lately. It's just so much easier to write when life seems terribly hard. So I'm taking it as a sign that Perth is feeling like home, med is feeling doable and I'm feeling more and more like 'Annabel' again and less like a 'med student'.

My new study routine is WORKING!!! Somehow I'm getting through the content and revising and still have time just to do non med things.  It's amazing how taking time out to just 'be' clears my mind to 'do' study and keep me more than sane. Perhaps a day of 'rest' is a good investment after all. Please don't be fooled, med is still hard and sometimes stretches my brain more than I think is possible. However it's a lot more fun to study knowing that I can actually pass, rather than constantly fearing that I don't have what it takes.

Each week we have a class when we practice clinical skills. At the moment we are studying mental illness. We walked into class ready to practice taking a psychiatric history on each other. Instead we had some actors come in. The actress we had was incredible. For a while I got lost in the role play and actually believed that she had schizophrenia. She was responding to voices, paranoid, agitated and afraid. Afterwards I practiced with a friend and pretended to have grandiose delusions- I was 'Annabel the Great'. Although I'm sure mental illness is not at all fun- acting it out is. My tute group talked about an experiment conducted in a psychology class. The professor told his students what symptoms to act out and present themselves to a psychiatric institution. They all got admitted. After a few days they stopped acting and were just their normal selves again. Unfortunately the staff refused to discharge them. The professor had to convince the institutions that they were just students. It's interesting how a label affects people's perceptions. Perhaps first impressions work in the same way?

Tomorrow I start my first placement, observing a GP. I don't know how, but they managed to place me with the only doctor I have seen in Perth! The uni has assured me that there are no ethical implications. I am glad as the doctor seemed to be really kind and he lives very close to where I live. So I'm rather excited about this and the med ball which is on this Saturday. I did not realise when I got into med that it'd involve more than most of my time and brain power. It also involves wonderful peripheral things like wearing lovely dresses and meeting lots of interesting people.

I'll leave you with a photo of my stethoscope case that I made during the holidays and the scarf I knitted during exams.

The caterpillar ate my eggplant.

Last time I wrote was was in the mist of exams and now I'm only a few days off knowing how I went. This is a little scary. To be honest I probably passed, but there is always that doubt. It is weird to go into exams hoping for at least 50%, rather than something over 70%. I guess that is medicine!

These are my favourite memories from the exam time:

1. The cadaver fridge breaking. This meant that our exam which was meant to revolve around dead bodies involved printed pictures and plastic models. This was good as cadavers smell, require a cold room and everything is a pink-grey colour. I prefer plastic models which have lovely defined shapes and colours. That being said, two years back when I was lucky enough to watch some surgeries, I was entranced by the vibrant colours of the ALIVE human body. The red blood, the yellow fat, the white nerves leave cadavers well for ...dead. Sorry bad joke, but I am glad that we have cadavers- it's probably my favourite class of the week.

2. Getting locked in my own house on the morning of my exam. The windows were locked shut. My keys had disappeared and my housemates were interstate and on placement. After some frantic running from door to window to door and desperate prayers I found my housemate's keys and managed to get to my exam and hour early. Two days later I found my keys... in the back door, on the outside! Med brain, it never ceases to amaze me.

3. Practising for my practical exam where we take histories and examine patients. I temporarily stole my housemate's bear and dressed him up as every patient and spent two days talking to and examining him. During these two days a med friend texted me a picture of a teddy bear she'd been practising on. It was the exact same bear.

4. An Adelaide friend was over during this week, she helped to keep me sane and in the evenings before exams. We knitted and watched wonderful med shows such as Grey's and Offspring.

5. Coming home from my final exam to find that one of my housemates and her boyfriend had put all these balloons up in celebration and then we ate a massive feast of curry, naan bread and chocolate pudding.

Exams being over I got to spend two wonderful weeks at home. Two weeks of no study. For the first time in 6 months I felt intelligent again. I also felt so loved. It is rather overwhelming how good my friends and family are to me.

Space away from study gave me room to reflect on my Perth life. I realised that my love of med was perhaps even bigger than at the start of the year. Yet I am more than medicine. My biggest fear when starting med was that I would lose all the little things that I love. That I would no longer get to go on long walks, that I'd stop knitting, that I'd stop learning new recipes, that I'd stop writing stories. I have lost a little of each of these. So if possible I am going to take at least half a day off a week just to do whatever. More importantly this semester I am going to start to make Perth my home, and maybe even build up a community outside of medicine.

Let me end with my beloved veggie patch. Out of everything I originally planted (aside from food ) scraps) only the eggplant remains. I came back from my holiday and picked the one eggplant and cut it open. A caterpillar crawled out. What a tragedy! Oh well, at least it made me laugh. Maybe the newly planted sweet peas will fare better.