DON'T PANIC

This last week I've had two reoccurring thoughts that suddenly awaken my calm mind like warning sirens. 


Firstly I see Holly from Red Dwarf saying: "Emergency. Emergency. There's an emergency going on. It's still going on. It's still an emergency. This is an emergency announcement."

Secondly I have 'DON'T PANIC'(from The Hitchhiker's Guide to the Galaxy) blazed into my mind. 

I know many second years are feeling similar- though perhaps without the nerdy TV shows invading their minds!

Last year I got myself in a beautiful study rhythm. I was expecting that this rhythm would serve me well in second year. It has not. Last year was like studying a rocket- nice and concrete. This year is like studying the fireworks from a lit rocket. Information is flying everywhere with no obvious structure. No matter how much I study information seems to slip from my mind and somehow I keep forgetting to cover key points. This is so frustrating! Perhaps providing myself with a structure (skeleton) on which to hang all the weekly information (muscles etc) will make study this year more logical. 

Here's my current plan (I'm sure it'll be adjusted regularly)

1. Revise key anatomy/physiology from last year (using Martini)

2. Go over pathology relevant to the current week (using Robins/ Porth/Kumar &Clark)

3. Know symptoms, signs & investigations which lead to the diagnosis (using Kumar &Clark)

4. Understand treatment (using Kumar & Clark, Rang &Dale)

5. Review lectures and other electronic resources

6. Practice clinical skills with reasoning (Using Talley and O'Conner)

7. Review drugs on the train (I hate pharmacology) 

8. Review ECGs, X-rays, Spirometry etc before bed using videos so that I can knit too. 

9. Do 1-5 by Tues night and revise content of current week and past weeks on Wed-Thurs.

Far out- so much work!!!! Hopefully though this stops Holly and HGTTG from trying to turn me into a stress machine (and helps me to pass this year). 

In 2009 I did my final OT placement. My most memorable patient was a lovely old lady, who I had to take a history from. Her family said that she had  a life time habit of stressing. It was like seeing myself in 60 years time. I decided then and there that being stressed should NEVER become a habit with me. This was all well and good as an OT, but then I started the most stressful degree on earth (in my opinion). Nonetheless just as a toddler learns to walk and then grows into an adult who can climb mountains (hopefully) surely I can learn to be peaceful even in a harder environment! It'll just take a bit of practise. We all have stress relievers. Mine are: praying, cooking, knitting, coffee, walking somewhere pretty, and laughing with friends. What are yours? 

Ah- I feel better already! 

On a positive note my parents visited last weekend. It was so much fun showing off Perth to them. Despite missing Adelaide and my easier old life I do love Perth. It's just such a beautiful place to live. I love it how Dad went cycling with a couple of my med friends' cycling crew! Being taken out for so many lovely meals was awesome, as was chatting and laughing with my parents.

Last week we had a tute on ECG's, which ended with our first med joke. The tutor put an ECG of ventricular fibrillation (rapid, irregular, ineffective pumping of blood to the rest of the body) on the screen. He said 'what does this mean?'. We all responded 'it's the end (as it can be fatal)'. He said 'that's right class over'. Hahahahha.

The end. 

ps. if anyone has a better study plan- please let me know!!!!!:)

Wanting to go back... sort of.

Let’s face it, most people write blogs for themselves. I certainly do. I know that many med people read this, because so many random people keep talking to me about my study plan- something I only ever posted on here! This makes me feel pressured to be witty and less vulnerable. I had decided not to write this year for this reason. Yet people asked me to write and I rather suspect that I have an inbuilt need to reflect that this blog fulfills so well. Medicine is so science based that at times it is so easy to lose the art of reflection that OT taught me to love. So here begins another year of blogging:)

Today as I was driving a song came on the radio- one that seemed to echo everything my heart had been feeling over the last few weeks, but had been unable to articulate.

(Sara Groves- Painting Pictures of Egypt: http://www.youtube.com/watch?v=ZcIA4Cnj6j4)

Last year coming to Perth was full of hope and excitement. Finally I was studying medicine- I was living my dream! I knew no one, barely knew Perth and somehow believed that studying medicine wouldn’t be too hard. Life was great.

Ha- such high hopes and innocence! Three weeks later I found myself literally running out of uni (I have a bad scar on my leg to prove it), believing that I’d never make it through first year. Medicine was just too hard. Luckily I had too many lovely supportive people to let me give up. I stuck the year out and passed.

Excessive relief and excitement on finishing first year

This year I came back after the summer break, expecting to slip happily back into my little life over here. Surely this year would be easier, I had friends, knew Perth and now had a more realistic view of medicine.

SO SO SO wrong. Never have I wanted to be somewhere less. I miss home and don’t really relish the thought of studying all the time. Perhaps the 3 weeks of a gastro-like bug (thank you housemates who held my vomit bucket and friends who checked in on me daily) have compounded these feelings. I wish that medicine hadn’t captured my heart, that I didn’t crave adventure and somehow I could crawl back to my old life.

To quote my cousin- I feel like Bilbo Baggins (The Hobbit) who has experienced adventure and now can never settle back into his old life. I’ve grown too much. My old life would suffocate me with ease and boredom, while my new life is a constant, uncomfortable challenge.

My homesickness pervades my mind hourly and I wish it’d just leave me alone. It won’t. Being an OT (and all soft, fluffy etc) I’ll let myself have an afternoon to grieve my old life. Perhaps then, it’ll leave me, or hurt less. More than anything I want to have my close friends and family here. I miss being around people where my shyness falls away completely. I never knew how important it is to be KNOWN until I moved to Perth. My friends who have also moved away feel the same.

Thankfully this year I have a heap of visitors, every month, from home. So I can’t feel too sad! Like last year I’m sure soon enough I’ll settle into Perth and wonder what all the fuss was about.  I’m determined to not let medicine (the thing I love) become my chief hate and complaint.

Why is this year going to be good? Firstly I own a lovely new whiteboard and wonderful pens for study. Secondly the beach is 5 minutes walk away- I go there twice a day. Thirdly I’m determined to take a whole day off a week. Fourthly we now have a bottle class. This is AMAZING. In small groups we look at bottled organs and try and guess what disease led to the patient’s death. Being a detective is so much fun! Finally despite my homesickness, it is so nice to see my Perth friends whom I missed over the summer break.

Here's a blanket I knitted during end of year exams and a jumper I'm finishing off now. Somehow a hobby I took up to give me motor skills worthy of surgery has become one of my favourite things!

My goal for this year is to move beyond desperately trying to pass medicine. Surely time can be found to love and encourage others, forgetting about myself for a while!

'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!!!