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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.

In the midst of it

I feel like an athlete near the end of a long long race-  surprised that I'm actually near the finishing line. Also though, struggling to gather the final oomph. My first real exam is in 6 days and yes I am calmly studying away, hour after hour, day after day, but I am so very ready for a break.

Every day (bar Wednesday nights) is like this: Wake up. Breakfast. Study. Lunch. Study. Exercise. Dinner. Study. Bed. 

I used to laugh at med students and think surely it is not necessary to study every night or all weekend! However it is. Of course not every med student studies this much. Many people in my course have come from undergraduate degrees in biomedical science. They've been lucky enough to do some learning and lots of revising this semester. OT although wonderful in so many areas, has not really helped with medicine so far- I'm hoping it'll shine forth when we're actually relating to patients. I'm still overwhelmed how much my peers know, but at least now I feel like I can hold my own. Finally in PBL I understand what they are talking about and can contribute! 

It seems like all us med students are feeling a little sorry for ourselves at the moment. Sometimes though, we discuss the greater horrors of applying for medicine and not getting in. This cheers us up immensely. 

We had our first exam on Thursday. It was theology and it's pretty difficult to fail. As we were filling in the cover sheets everyone was whispering questions such as: 

'What's the date?'

'Is it June or July'?

'Is it 2010 or 2011'?

'How do you write numbers in words'?

Hahaha. Oh dear our poor poor tired brains!

We are all a little crazy. I'm pretty sure 90% of us are studying in track pants and/ pyjamas and ugg boots. I'm so cold that I've taken to tying a hot water bottle to my stomach with a scarf! Procrastibaking is a new favourite hobby of many of us, much like watching 'medical' shows such as Grey's Anatomy and Scrubs and classing them as study.  As I sit and study  I have the misguided words of Abba in my head- ''study study study, must be funny, in a non-med's world''. 

MUST KEEP STUDYING

Some people are asking me for my exam times so:

• 24/06/11, sit in a lab and rotate around cadavers and models and answer science questions
• 28/06/11, sit in an exam room and answer some science (eg. this person is lying in the middle of the road why could this be??) and some population health (prevalence, statistics) with medical issues (eg. a mother wants to donate her son's kidney to her daughter is this allowed)
• 1/07/11, rotate through 4 stations where I take a medical history or do an examination on an actor. This could be: gastrointestinal, skin, reproductive, renal.

Too relaxed.

If you were writing a blog every week or two what would you include?

Medicine is getting harder to write about. I think perhaps this is because I am now a med student- and I know this to my core. There is no doubt about it- my uni isn't going to suddenly realise that my place was a mistake and ask me to leave the course!

When kids are little they seem to have the need to let everyone know that they go to school or that they are now a 'big' kid. However as they grow into being a student and an actual big kid there is no need to dwell on the fact. Studying medicine is beginning to feel normal and I am starting to feel secure in my ability to 'make it' as a doctor.

This feeling of security is a little bit of a shock. I know last week that I made the decision not to stress about passing exams anymore, but this is ridiculous. I haven't felt this peaceful or full of joy for months, possibly since I found out that I got into medicine in October last year. Exams are in two weeks and everyone is freaking out and me the 'stress head' is laughing, skipping and relaxing. I feel like I'm on holidays. Don't worry though I have revised everything at least once and have a plan to revise it all again, with a special focus on pharmacology (which does my head in).

This brings me to my big 'ah ha' moment for the week. Oh dear what an occupational therapy phase- 'ah ha moment'! Perth is pretty sunny during the day, but nights are freezing. I literally study with my winter coat on, uggboots and a granny lap blanket and sometimes even a warm hat. A couple of nights ago this cold was so penetrating that I couldn't sleep for two hours despite numerous socks and blankets. In the end I put on uggboots and crawled back into bed. Never before have I had to sleep with shoes on!!! The following day I purchased a hot water bottle and my house no longer feels cold. The hot water bottle was so simple and yet it solves everything. Maybe medicine is like my house- yes it is harder than most degrees, but perhaps there is something simple (like a hot water bottle) that will make it more possible.

The wonderful thing is I think I've discovered it. A simple yet comprehensive routine makes medicine quite easy (we'll see if I pass these exams if this is true!!). This is my recipie for passing medicine next semester.

1. Always go to bed around 10/11pm. Get 8 hours sleep.

2. Always get 30 minutes of exercise each day- preferably through running

3. Always complete the core learning material for each week on the weekend

4. Always cook one big meal each week and freeze lots of serves

5. Always revise the anatomy pracs and do readings on the train

6. Always revise each week (Thursdays) in this order:

• The week before's content
• an earlier week (starting with the first week of the year and then the next the following week and so on)

7. Give my self a quick pharmacology test or clinical skills test every week night that I study

8. Always take one night off each week

9. Stop being a fool and use my OT skills to buy an office chair that won't hurt my back!

10. Stay in regular contact with people back home

This means that I'll be healthy, happy and have revised everything even before exams hit. Yay!!!!!!

Can you now see why I feel so happy? I finally have a plan- and a plan that is GOOD.

This week we've continued studying reproduction and the urinary system. I had no idea how complicated the whole system is. Things I do like though is that the prostate gland makes an antibacterial substance to help protect the sperm and the oviduct makes glycogen (stored sugar) to feed the fertilised egg. It's also amazing to hear how wrong our previous understanding of the system is. Some of us used to think that the egg exploded inside the uterus and that's where periods came from. Other people thought women laid the eggs a little like chickens and yet others thought both females and men make sperm. Ah how fun our tutes have been this fortnight!!!

Let me leave you with this cartoon. I think it's pretty obvious which one I am!

Teddy bears!

Gah life.

I really want to capture the small wonderful bits of med life. One day I'll look back on this and laugh.

Everyone at uni is slightly hyperactive, manic and basically a little on edge. Friends can be snappy and those who never ever get stressed say things like 'Ahhhh I'm just so stressed', just to fit in with the mood. Exams are looming and so the atmosphere is tense with electricity like the sky before a storm. 

Conversations have therefore become a little weird. One lunch break was spent discussing what type of cell we'd be- any cell in the human body. I said a neuron as I'd always be excited. Guys tended to say sperm or macrophages as it'd mean they could go on adventures and eat lots of stuff (even though it's mainly rubbish and germs). My favourite though was the student who wanted to be a cancer cell- as they are immortal (if not treated).

Despite they craziness of this pre exam rush- I've taken today off from study!!! Since starting med in January I've only had 6 full days off (including today). I'm beginning to think that so much study is a little counter productive. Hopefully the day off will end in amazing study tomorrow and on the weekend.   Today was a little special as I got to be a teddy bear doctor. 8 first year and 3 second year students went to a primary school to treat around 60 teddy bears. We walked in wearing our white lab coats with our stethoscopes around our necks. It was amazing have kids scream excitedly 'look at all the doctors, doctors, real doctors' and then the teachers gently correct 'teddy bear doctors'. Seeing 60 patients in 2 hours was exhausting (even though we only did around 6 each).  It was amazing how many teddies had sore tummies or broken legs. The camel with the four broken legs and broken tail who got hit by a car was my favourite. To help kids overcome their fear of doctors we tried to involve them in the treatment. This kid was quite pleased to inject antibiotics into the poor camel. At least 20 injections were given. 

Last night I went to a dinner with 20ish female med students and three female surgeons. The food was delicious, but I was more excited to be sitting next to a colorectal surgeon. She said earlier that day in theatre poo had got everywhere- but she'd managed to squeeze in a shower before dining with us. It was nice to hear that surgery is a very real option for females and that being enthusiastic is the key to being remembered by consultants and being given opportunities. It was also interesting to hear that surgeons are generally not allowed to operate for the rest of the day, if they lose a patient on the table. Finally girls can be surgeons and have kids- they just need to have a nanny and possibly a cleaner and maybe even a cook. 

Each week I talk a little about something I learnt that is medical and something that is not. Why do I always go through a crazy stressed period where I think I'm going to fail? Yet I never do. I march around telling everyone, including myself, that there is no hope. It makes me miserable. This year I'm going to try and break this stupid habit. I know I use it a little like sharks use blood- it razes me up into a study frenzy. It's not worth it though and others shouldn't have to put up with it either. 

This week we studied the male urinary system. I'm not going to discuss it too much here. I know I have to have frank discussions about such things with patients- but it's not normal to do so with my non-med friends or family (well not in a blog anyway). It was pretty funny though to be reading my lecture notes on the train- to suddenly realise that all the school girls were giggling! I forgot that the lecturers like to include lots of photos. 

I love medicine- it's full of funny moments.