Book Review: A Country Doctor’s Notebook

BY ISAAC TANG

During the mid-year break, I came across a book in my sister’s collection that was small and slim (always a good sign!) with a rather benign, if not dull, title: A Country Doctor’s Notebook. I immediately assumed that it was yet another text about the joys and challenges of rural medicine to persuade more people to join its overburdened workforce. However, the blurb surprised me with some unexpected titbits of the book’s exotic setting and thrilling historical account – “twenty-five year old”, “lone doctor”, “depths of rural Russia”, “1916-17”, “eve of Revolution”. Moreover, this “lone doctor” is based off the first-hand experiences of the author himself, Mikhail Bulgakov (1891-1940).

With a large dose of dark humour and raw honesty, Bulgakov plunges into his collection of short but gripping tales. He uses many terms that are familiar to us as medical students but it is the stark differences in time, culture and medical knowledge that set these terms in shocking contexts, making the reading experience a surreal one at times. For example, we all know what an amputation is. But now imagine you are an intern on your first day as the only doctor in wintry, rural Russia without electricity and modern utensils and you have to amputate a girl’s leg. Plus, you have only watched an amputation… once. Some of us who have completed our women’s health rotation will know what a “transverse foetal lie” is and may have hazy recollections of a procedure called “internal podalic version” to help deliver this abnormally positioned baby. Again, imagine you are the same hapless doctor forced to do this for the first time in the middle of the night on an extremely distressed woman with only an obstetrics textbook to guide you.

For me, the anxiety is definitely palpable because I know for sure I would have collapsed under the same circumstances. Indeed, this poor doctor only has 2 midwives and a feldsher for assistance, with the footnotes graciously explaining that a feldsher is “a partly-qualified medical assistant” (emphasis mine). Despite his catastrophising thought processes and persistent self-doubt, the doctor, to my surprise and sometimes disbelief, carries out various surgeries and procedures successfully from pure determination and fortune. But Bulgakov also records some disastrous failures, including an unsuccessful internal podalic version which causes a baby to be delivered with a broken arm – and stillborn. In another instance, he accidentally pulls out a man’s tooth socket when he only meant to extract the tooth. In fact, when he sees the “enormous, jagged piece of gleaming white bone”, he almost “burst[s] into tears”. The doctor, that is. The patient has no idea what just happened as he is not told; he is only instructed to “rinse”.

This gives an appalling assessment of the culture of medicine back then – the paternalism and the lack of transparency. Bulgakov never records disclosing to his patients the fact that he has just graduated from medical school and has never done the procedures that he intends to perform e.g. tracheotomy, hernia repair. He does not even dare to inform his midwives or feldsher about that. Displaying a sense of arrogance and superiority also appears to be an expected part of early 20th century medicine, especially towards the illiterate, impoverished and superstitious peasants Bulgakov encounters. There is no hesitation in directly denigrating a patient and their relations. A patient’s emotionally distraught grandmother is called “stupid” and promptly “pushed out of the room”. The doctor scolds and berates patients who do not accept his advice and he laments patients who present late in severe stages of disease. Understanding social determinants of health was clearly not core learning then, for he fails to appreciate the long distances his patients need to travel and the poverty and strenuous farming that characterise their difficult lives.

However, he does recognise that there are systemic problems that must be solved. Most of his stories are set at night, symbolising the overwhelming darkness of ignorance that he has to fight. He realises that health literacy and education are needed for a population to remain healthy. When he discovers an increasing number of syphilis cases in his catchment area, he begins to record his findings and reflect on how he can better convey the seriousness of the illness to his patients. Written before the discovery of penicillin, the proposed treatment of syphilis consisted of inconvenient, regular application of mercury cream on the skin that the patients had to adhere closely to. He also knows that he must have more doctors working with him to adequately meet his patients’ needs – a request to his employers that goes frustratingly unfulfilled.

His stressful working conditions are shown to have a great impact on his mental health. He never fails to remind us that he passed medical school “with distinction”. Yet he suffers from imposter syndrome, harbouring numerous fears that, out of shame, he feels compelled to hide behind a veneer of confidence and self-sufficiency. Before he runs off to peek at his textbook again, he tells his midwives he is merely gone to get cigarettes. Seeing approximately 100 outpatients a day and caring for 40 inpatients, he feels that he is gradually losing his personality. His irritable outbursts towards non-compliant patients likely signify his burnout. Thus, news of a violent blizzard is received “joyfully” as patients are prevented from reaching the clinic, allowing the doctor and his assistants a short-lived reprieve. In a tragic turn of events, he later receives news of a doctor acquaintance who loses his life after years of battling morphine addiction in secret. What makes things sadder is that Bulgakov does not reveal in this book that he himself had become addicted to morphine. Despite continuing to specialise in venereology, he eventually quitted medical practice to become a full-time writer.

In many ways, A Country Doctor’s Notebook shows us how far medicine has progressed and really instils in me a sense of gratitude for the improved conditions that we work in. But some issues touched on in the book still haunt us today in some way – poor health literacy, underserviced rural populations, the difference between medical school learning and actual practice, doctors’ mental health. Placed in an unfamiliar setting, this short book bursting with thought-provoking tales ultimately gifts us with a unique yet relatable perspective on what it means and what it takes to be a good doctor.

Being lost in (pre-clinical) medicine.

BY ROBIN CHEAH

I’m one-and-a-half years into medical school and I can already say I’ve been lost multiple times.

‘Lost’ is, admittedly, a broad word. It’s a word with a myriad of possible meanings: emotionally, socially, physically, academically, acutely, constantly. But that’s what makes it so powerful. From making a wrong turn and ending up at anatomy 15 minutes late, to feeling utterly overwhelmed by content, to reflecting on what my goals even are – no word has encapsulated medical school quite as well as ‘lost’.

It’s easy to feel lost in the academic rat-race; barrages of content, an increasingly vast repertoire of examinations and symptoms and special tests and eponymously-named signs to not just remember but also understand. One moment, it seems achievable – “I think I remember all of this systems review” – and another moment a revision lecture or practice exam topples all of that down. It’s an erratic tide that rides highs and trembles at terrible lows – the short-term panic attack in a tute where you know utterly nothing –  with no ultimate direction. Sometimes the wave does vaguely point somewhere – “I need to know more about this” – and those moments of curiosity are refreshing when they arise.

From making a wrong turn and ending up at anatomy 15 minutes late, to feeling utterly overwhelmed by content, to reflecting on what my goals even are – no word has encapsulated medical school quite as well as ‘lost’

Adding to the confusion, there are those quasi-clichés such as “preclin doesn’t matter” or “It’s not on the exam” creeping into every second conversation. It instills a constant uncertainty: what truly matters and what doesn’t? Am I wasting my time on things that don’t matter? Am I just wasting my time studying if I’ll learn everything on the wards? Everything academic becomes ambiguous; every assignment is distilled into a weighing scale of effort with outcome. An essay might be pass-fail, but it’s also an opportunity to learn something important – but there are also exams nearing, that group assignment, the new thyroid examination to revise. Is all this theoretical content even important? Doing well on exams doesn’t really matter, right? The questions sometimes pile up into an incomprehensible heap regardless of where you think you are.

But being lost extends to more than just study – life is more than that. Acronyms for interest groups can fly over one’s head, leaving only the question of specialties (harkening back to the “What do you want to study in uni?” of VCE days). Even if there is no expectation to choose or commit or even consider, its ubiquity as a conversation topic makes it seem like there is sometimes. It can feel like a constant reminder that you don’t have goals, that you’re indecisive and God forbid, can coalesce into self-judgement.

It’s easy to judge yourself for being lost, for all its meanings. Being lost academically means you’re not smart enough or hard-working, or that you’re trying too hard or wasting effort. Being lost socially means you’re not good or nice enough to be liked. Even not having concrete goals feels like you’re indecisive. This is perhaps the point where that wave of ambiguity swells into a tsunami that drowns you in doubt. It is truly dangerous, especially when there’s that constant calling to keep revising, keep studying, keep up with the new content and lectures and go to class. It can be hard to stand firmly when you’re drowning like that.

In a way, the idea of feeling lost and unsure grows sobering; it’s somehow paradoxically reassuring to know that it’s the norm

In a way, the idea of feeling lost and unsure grows sobering; it’s somehow paradoxically reassuring to know that it’s the norm. Maybe what one needs is just to put their head down and do what they’re doing, but with conviction and confidence. Perhaps what we all need is to forgo the “It’s up to you” and make a decision ourselves as to where to go and what to do; resultantly, we’ll reap the rewards and pay the prices. Alternatively, you get acquainted with being lost, accept it and understand it’ll be there forever and as a result become numbed to the uneasiness it brings. But those are just two possibilities; the outcomes are infinitesimal, rightfully so for a term that has so many meanings.

Will that seemingly-omnipresent uncertainty ever fade away? Being lost in a hospital definitely sounds like it could happen. Being lost in the content of clinical years sounds more like an inevitability than anything. And it’s not even a medicine-specific struggle, either — there’s uncertainty in university life regardless of course.

Maybe being lost and uncertain isn’t an enemy but rather a friend we’ll get used to.

Worry

BY Nicholas Wilkes

Have you ever found yourself worrying about one specific thing, which somehow leads to numerous other relevant or/and irrelevant worries that you just end up spending hours being anxious and worried? Have your worries ever interfered with your focus on studying and working, which eventually made you even more worried as the deadlines are coming closer but you have even less time left? Have those worries ever followed you till you go to bed, when you feel tired and sleepy, but somehow those worries during the day just cannot leave your mind, and the next thing you know it is almost the time you need to wake up and now you are still awake and left with more sleepiness and worries?  

All of the above situations may sound quite familiar to some of us, and a lot of people may have experienced that vicious cycle of worrying at some point in their life. In fact, worry in and of itself is not as bad a thing as we may tend to think it is, a healthy amount of worries can actually serve to help to motivate us to take action to stop those uncomfortable feelings and thoughts. However, worries can also easily become a cycle of self-perpetuating negative thoughts that are uncontrollable and detrimental to not only your productivity but also your happiness in the long term.

“However, worries can also easily become a cycle of self-perpetuating negative thoughts that are uncontrollable and detrimental to not only your productivity but also your happiness in the long term”

There’s a saying by Corrie ten Boom which I find more and more accurate the more I think about it –  “Worry does not empty tomorrow of its sorrow. It empties today of its strength”. Excessive worries indeed can adversely affect our study and work and put a strain on both our mental and physical health as many studies have shown. So, now we know that it’s bad but how to stop it?

The very first step of tackling worries is to realize and accept that you are excessively worried and you need to do something about it.

The very first step of tackling worries is to realize and accept that you are excessively worried and you need to do something about it. It can be hard to totally eliminate worries especially if your problems can’t be fixed right away, but you can always set aside a designated time for worrying. Instead of staying worried for all day and everyday, set a fixed period of time like 30 minutes a day when you can think about your problems. During this time, identify what is worrying you and try to list out different options of how you may deal with this problem. When you can come up with a plan of what to do, you can then take small steps toward the goal, which would be way more productive than just being chronically worried without a specific solution. This special “worry time” should be far away from your bed time so not to compromise with your sleep, and whenever you catch yourself worrying not during this set time, make sure you try to think of something else or do something to distract yourself. Of course, things are easier said than done, but do not forget to give yourself time to control the worries, share your issues with your loved ones and be patient and understanding to yourself while you are dealing with all the stress and worries. I hope that that reading this may somehow help you to briefly forget about your current worries, and will motivate you to set your own worry time soon when I strongly believe you can also find a way to overcome your problems.

#ChooseToChallenge: Why gender equity is a medical issue

By Sophie Skuza and Dana Boden (MUMUS Gender Equity Committee)

Trigger warning: sexual harassment and sexual assault

The voices of women have dominated the Australian media landscape over the last two months. To recap, we’ve had 4 allegations of rape against one man in our Federal Parliament, a historical rape allegation brought to light against one of the most high profile people in Federal Cabinet, and a petition started by Chanel Contos to teach comprehensive sex education in schools at an earlier age. 

These events, along with International Women’s Day on March 8th, have contributed to the recent widespread outrage felt by many individuals across the country, and resulted in the nation-wide Women’s March 4 Justice held on March 15th.

While, at first glance, these issues – namely gender-based discrimination and the sexual assault of women – might not be strongly connected to the medical profession, the reality is that these issues are still commonplace. Within hospitals and other healthcare settings, to this day, there exists the rampant mistreatment of women, both as patients and as colleagues. Women and people of diverse genders still face challenges every day, which is why the battle for gender equality is so important.

Dr Caroline Tan Source: http://drcarolinetan.com

Take the case of Dr Caroline Tan, a neurosurgeon whose career was derailed after she spoke out against the sexual assault she experienced from a senior colleague in 2005. Despite winning the case against her senior colleague in 2008, Dr Tan believes that her decision to take action against the sexual assault she experienced contributed to her being shunned by other surgeons and repeatedly overlooked for positions within both public and private hospitals. During her VCAT hearing, Dr Tan was accused of fabricating her sexual assault experience as an ‘excuse’ for her poor work performance. She was forced to relive her assault in vivid detail, while her authenticity was criticised when she couldn’t recall exact details about the “colour, size, or shape” of her abuser’s penis. It was also revealed that the individual she initially reported the assault to, the head of her department, responded to the tune of, “What do you expect when you dress the way you do?” after she disclosed the details of her assault to him. Dr Tan’s abuser did not face any disciplinary action, and he continues to work with the same employer (at Monash Health).

Dr Tan’s case was referenced by Dr Gabrielle McMullin, a Sydney vascular surgeon, at a function in 2015. Dr McMullin, who, rather than praising Dr Tan’s strength in reporting her assault, made the shocking and heartless suggestion that surgical trainees should stay silent and complicit if they have been sexually assaulted by a colleague, as speaking up about their abuse could have consequences for their careers. She went on to say; “What I tell my trainees is that, if you are approached for sex, probably the safest thing to do in terms of your career is to comply with the request. The worst thing you could possibly do is to complain to the supervising body, because … you can be sure that you will never be appointed to a major public hospital”.

Possibly the most horrifying part of Dr McMullin’s speech was when she said Dr Tan probably would have been “much better [off] to have given [her abuser] a blow job on that night”.

“This unacceptable abuse of power is unfortunately far too common within the medical profession, especially due to the strength of hierarchical structures existing within hospitals”

This unacceptable abuse of power is unfortunately far too common within the medical profession, especially due to the strength of hierarchical structures existing within hospitals. The entrenched belief that women should simply accept and comply with unwanted advances to further their careers serves only to subjugate women while encouraging further violent and illegal behaviour from men. It also contributes to the attitudes surrounding misogynistic statements such as, ‘she slept her way to the top’, rather than revealing the reality of this statement: ‘she was taken advantage of by men who use their positions of power to dominate women’’. Furthermore, Dr McMullin’s comments disempower women from seeking counsel after they have experienced sexual harassment or assault, causing profound feelings of shame, hopelessness, and trauma.

The case of Dr Caroline Tan is disturbing, tragic and outrageous. Her story is hard to hear, and it is a stain on the medical profession that we should all be ashamed of. But rather than just accepting her story, we have to change the narrative. We must ensure there are no more individuals treated as Dr Tan was, and rather than victim blaming and coercing women into silence, we must encourage them to speak up, and support them whilst doing so. We cannot continue to live in a world where the choice exists between a woman’s career and her safety.

The theme for this year’s International Women’s Day is “Choose To Challenge”: why not challenge yourself to be a stronger ally for women and other people of diverse genders, or challenge others to change their behaviour towards women?

It begs the question: what can I do to help?

The theme for this year’s International Women’s Day is “choose to challenge”: why not challenge yourself to be a stronger ally for women and other people of diverse genders, or challenge others to change their behaviour towards women?

  • Call out misogyny and other gender-based discrimination/prejudice.
    • If you hear others, including your friends and family, speaking about women in a derogatory way, stand up for women and tell those individuals that the way they are speaking is not ok.
    • If you see a woman being bothered or harassed, walk over and support her.
  • If someone opens up to you about sexual harassment or assault, do not victim blame them. Listen, hear, and encourage her to report. Do not get defensive or pass it off as unimportant/insignificant.
  • Advocate for women’s issues and other gender-diverse issues – sign petitions, attend protests, spread information!

————————————————————————————————————————————————

The MUMUS Gender Equity role was founded in 2018, and since then the Gender Equity team has worked hard to bring representation and inclusivity to Monash Medicine through four key areas: curriculum, social media, community building and advocacy.

In the past few years, great things have been accomplished, including:

  • Making the anatomy curriculum more trans inclusive by changing male/female to assigned male/female at birth
  • Introducing asking sexuality into the reproductive history, to avoid assumptions of straightness
  • Introducing pronoun stickers to clinical student name badges
  • Data collection to ensure MUMUS is accurately representing the medical student body
  • Upskilling events with panels of incredible female-identifying medical professionals

In 2021, we hope to bring even more inclusivity to the curriculum, as well as running incredible events, building community through our Facebook group SafeSpace, and spotlighting incredible health professionals on our socials!

Tips for Wellbeing: Global Pandemic Edition

By Molly Maxwell

When I entered Year A, I knew that the hardest challenges I would face would be those that I had not considered. A global pandemic was definitely not something I had prepared for. As today is my first day of online schooling, I feel there is no better time to share some ways we can adapt to our new version of normal and get out the other side to help all of the medical staff who are fighting for us today.

 How to: Pandemic University

  1. Most important (for all aspects of life) is routine. Establishing a routine of “normal” study hours is essential to allow us to maintain our sanity whilst in isolation. This includes actually getting out of bed and getting dressed which can be challenging when you don’t have to.
  2. Make an online study group. Thanks to the wonders of the internet, this is not so hard for us through Zoom, Facetime, or the Forest app. It’s a great way to keep yourself accountable and maintain some socialisation.
  3. Be adaptable. Online learning is not the greatest way for us to learn to be doctors but that doesn’t mean that it can’t be a good way. Accept our new challenges for what they are and use this time to build resilience and adaptability which is essential for our future.

How to: Outbreak Wellbeing

  1. Remember to exercise. With gyms closing around the country, it’s important to still maintain an exercise regime at home. A plethora of online at home workouts exist for free on the internet so you can look after your body whilst in isolation.
  2. Go outside. With social distancing and isolation our reality, remember to still go outside. If you’re lucky enough to have a backyard or balcony, use it. A bit of vitamin D and fresh air can do wonders for our wellbeing in trying times.
  3. Social distancing doesn’t mean distancing socially. Whilst we can’t go and hang out at the pub or with all our friends for the time being it is important that you still make an effort to communicate. This golden age of technology means that remote communication is as easy as ever so find new ways to hang out whether it be a niche PowerPoint night broadcast over zoom or daily phone calls with people you love.

How to: Nurture your mental health

  1. Acknowledge your feelings. This is a scary time for everyone. It is okay to feel frightened or stressed or defeated, but you are not alone. Let yourself be not okay. Remember that this is a temporary situation and that you will not have to feel this way forever.
  2. Reach out. If you are struggling to manage your mental health during this crisis, seek help. If you are already seeing a mental health practitioner, many offer telehealth to attend your appointments from home. There are also many online resources from Beyond Blue and Lifeline that can give you handy tips including this forum to speak with people who are in the same boat as you.
  3. Self- care. Now is a perfect time to incorporate self-care into your daily routine and make looking after yourself a priority. This can be anything from taking a relaxing bath to getting ready for the day. Make sure to prioritise making yourself feel good (easier said than done). We all deserve to go a bit easier on ourselves right now.

Hopefully some of this was helpful to you. If all else fails, download Tik Tok and go on a deep dive. This whole pandemic thing should be over by the time you get out. Wash your hands and be kind to people!

Musings of a Worn-Out Med Student

By Rav Sellahewa 

You’re too harsh on yourself. You have always been your sharpest

critic. You have a strong and over-powering superego, a voice in the

back of your head- that tells you off. You hear it whenever you don’t

study, whenever you don’t gym. It tells you off when you want to

relax. It represents an idealized self-image of yourself. An image

that you no longer have the tenacity to maintain. You have spent too

many years of your life trying to appease it. Too many years fighting

off the urge to laze around and watch Netflix. You’ve finished 4 years

of medical school, a BMedSc(hons), and are nearly done with your first

5th year rotation and you are tired. You’ve earnt a break. You need a

break. Tell your super-ego to go get f****d. It’s time to give in to

your impulses and desires- and let your Id shine. It’s time to watch

that god-awful reality dating show on Netflix and enjoy it, because

you deserve it.”

 

Fifty-Four Years Ago

By: Bowen Xia 

For: The Auricle Writing Competition 2018

Prompt: ‘What is a piece of advice you wish you hadn’t taken and why?’

In a small house, a year 6 student sits in a dimly lit room studying hard all day to prepare in the hopes of entering a prestigious selective school. Surrounding him are boxes of certificates, medals and trophies of various competitions and outside that, on a patchwork couch, his parents and siblings huddle together watching the latest episode of the ‘Simpsons’ on an old box TV. They ask him to join but he has more important things to do. Ha! His family’s periodic bursts of laughter mix over the TV static and he blocks his ears. One day my hard work will pay off and then I’ll be truly happy.

6 years later…

In a prestigious high school, a year 12 student sits in an empty classroom studying hard all day, to prepare for his VCE exams, in the hopes of studying medicine at a prestigious university. His blazer is adorned with numerous academic and leadership badges and his brow is furrowed and beaded with sweat whilst gazing at the citric acid cycle. Bam! A ball hits the window and shouts of his friends playing outside fill the room he shuts the window and closes the blind. One day my hard work will pay off and then I’ll be truly happy.

4 years later…

In a prestigious university, a fourth-year medical student sits in the medicine building foyer silently studying hard all day, to prepare for his end of year exams, in the hopes of gaining an internship at a prestigious hospital. In his bag sits his Netter’s flashcards, four medicine textbooks and his trusty Classic III stethoscope. Slam! The silence is broken as his peers leave the building for their weekly pilgrimage to the ‘Nott’. He stares back at his Anki cards. One day my hard work will pay off and then I’ll be truly happy.

3 years later…

In a prestigious hospital, an RMO sits in the staff breakroom revising hard all day, when he is not on shift, to prepare for his eventual registrar exams in the hopes of joining a prestigious speciality. On the table sits his fourth cup of coffee, a Cardiology III stethoscope, two patient files and a model of the brain. Creak…! Some colleagues leave the room and head off to Zoukis for a well-deserved break, but he resolutely refocuses on his studying. One day my hard work will pay off and then I’ll be truly happy.

9 years later…

At a recently founded clinic, a neurosurgeon sits in a consulting room working hard at night. It has been a long day chock full of patients and paperwork but hopefully, he will be finished soon. On his desk sits a framed picture of his family, a pile of bills, a neatly drafted cover letter and a brochure titled ‘AMA Nominations Opening Now!’. Click…! He opens the main door to his house. All the lights are turned off except a small night light in the lounge room where it shines dimly on the couch and two small sleeping figures are illuminated. He picks up a piece of paper lying next to them and inspects it. A squiggly drawing of his family is on it and underneath is scrawled ‘please come home soon Dad!’. A tear rolls down his eye. One day my hard work will pay off and then my family will be truly happy.

12 years later…

In the nation’s capital, a high-ranking member of the AMA studies some documents in his empty boardroom. When he is not attending meetings all day, he prepares his family’s finances. In his wallet sits a real-estate business card, a prescription for Xanax and a well-worn photo of his children. Ding! A message appears on screen ‘where are you dad? I can’t see you in the audience from the graduation balcony’. As the Prime Minister and his panoply of staff enter the room, the text message is dismissed with a sigh. One day my hard work will pay off and then my family will be truly happy.

20 years later…

In an inviting, large, well-kept house no one enters except for the occasional cleaning staff. On the balcony, a recent retiree idles all day on a sunchair waiting for the clock to strike 5:30 pm. In a bin next to him sit two empty pill boxes, one bisphosphonates and the other NSAIDs, and a torn brochure titled ‘Europe travel guide’. Beep… beep… beep! He unsteadily gets out of the chair and shambles towards his phone. Every movement seems to be painful but made with determination as he stops the alarm. His daily ritual has begun as he calls the two people that matter the most to him. Both go to voicemail but not without him sending two text messages that are left on seen. As the sun begins to set and the darkness approaches, he begins writing a letter.

My dearest angels,

I am truly sorry that I could not make you happy, but I hope this letter can. Fifty-four years ago, I a young, eager boy promised myself that I would not stop pushing forward into the world until the right moment to enjoy life to its fullest arose.  Alas, that day arose too late and I an elderly frail man will bountiful time and material can make neither you nor me happy.

 I blame this on ill-disciplined motivation and determination and insufficient time. If only, my promise was made when I was younger, and I tried working harder, today’s grief would be avoided. Our past conflicts were due to our different outlook on life but as your father, I cannot let you continue making the same mistakes as me. I implore that you resist being complacent and discontinue your premature enjoyment of life. If you do not stop working hard for the future, you may be happy in the end.

 

With Love,

A Sorry Old Man

The Adventures of Pen

By Rav Gaddam

There are many things that bind the medical student community together; our love of stealing food, the ability to still be bamboozled by an ECG, and of course, our innate skill to lose pens at a rate that Ebola has got nothing on.

But have you ever truly wondered what happens to a pen? Where does it go? What adventures does it have? Ever wonder about the people and things it sees?

Well, if you’re reading this article, you can guess that I have.

My pen’s journey began last year, when I lent it to my consultant who snapped their fingers at me and gestured to my pen as they were on the phone. “Do you also have some paper?” I was also asked, while begrudgingly handing over my favourite black pen.

I was unfortunately called away by a registrar, lured away with the promise of being able to cannulate the next patient. As you can expect, I never did get that pen back, and I assumed it had been lost in the depths of the pen blackhole that is a hospital.

At the same time though, I also imagined that my pen saw many exciting things in its life. It would likely have been used to draw up a drug chart to save a patient from a DVT, or sign path forms for a renal patient on dialysis. It could have been used to write down obs on a glove in ED, or provided comfort to that paeds patient who had left their mark on the hospital (likely on the walls, possibly on the bed covers). It could have also vacationed in world of hospital administration, and heard all the juicy gossip about the number of beds that were not available that week. Who knows what the pen could have done; the possibilities are endless!

Well, in some exciting, awe-striking news, I found the pen.

Nearly a year later, as I rocked up to the first day of my new rotation, I found “pen”, as I affectionately now call it, sitting innocuously in a surgical theatre. “It couldn’t be,” I thought to myself. “After all this time?”

Now, I can imagine some of you scoffing at this story, and some perhaps even accusing me of stealing a pen that perhaps did not even belong to me anymore, for it now belonged to the hospital. Pish-posh, I say. This event was a reunion that would have put The Notebook to shame, and made you weep like the time Mufasa died (it’s been 24 years, and I still cry. Every. Single. Time.)

It would have been a reunion story for the ages, a tale so splendid that David Attenborough would have wanted to make a documentary about it.

That is until the consultant snapped their fingers, and off my pen went on an adventure again.


Featured image from user FP Network on The Fountain Pen Network

Dating Medicine

By Ning Yih Kam

My relationship with Medicine has been a tumultuous one. It is very much like I’m dating medicine…

My love for Medicine started with an infatuation – a crush, as some might say. I was attracted to the prospects Medicine offered me. ‘He’ appeared reliable, strong, caring and sometimes even mesmerising. But that is all I know about Medicine. I was attracted to the security he provided me with, the respect everyone seemed to have for him, and his seemingly endless intellect. But that’s not why Medicine was attracted to me. He seemed to respect my diligence, my willingness to make sacrifices for the things I wanted. He appreciated the fact that I could hold my own against him.

Then Medicine asked me out. I vividly remember the day he did so – it was nearly 3 years ago now. Even the fact that he bothered to ask me out seemed like such an honour – people were practically throwing themselves at him – and here I was, a plain Jane, that Medicine asked out. I was elated to say the least. On our first date, he woke me up at 8am in the morning, with a call – telling me not to worry, the first few months of a relationship he said, were always the best – the Honeymoon period, or so he called it. And he was right, Medicine for those months, never ceased to be charming, provocative and ultimately seductive. He could’ve seduced those who were at first, totally uninterested in him, and put off by his demanding attitude. I did not just want to be with him, I wanted to be him.

And then we celebrated our first anniversary. The first of many, I would’ve hoped. He gave me a utilitarian, digital watch and says, ‘I don’t want you to miss any of our appointments – they’re all important’. I was so pleased at the gift – I hadn’t expected any, but at the same time, I was profoundly confused – surely, we will have some time outside of each other?

It was by third year that the cracks in our relationship started to appear. At first, the thought of spending all my time with him had made me so happy, but all of a sudden, as I watched my friends enjoy their social lives, I realised how restrictive our relationship had become. And that wasn’t all. There were stories. People who had dated him before told me to beware of the initial allure, of his initial charms. ‘He doesn’t work out for everyone, you know’, said a friend.

Third year, the relationship had become a chore. He wanted more and more. He was insatiable. My time, my intellect, my life: everything was not enough for him. Nothing was ever enough. Maybe our shabby foundation had started to rattle us. We decided, or rather, I decided, that I needed time away from him – time to do what I loved to do, without him intruding. I just didn’t feel like me anymore – I felt like my life was overrun with assignments, OSCEs, hospital placements and more.

During our time away from each other, I realised how shallow my reasons were for dating Medicine. What had attracted me to Medicine? Was it the unattainability? Was it the glamour? Was it the constant challenge? Was it the allure of making a difference? Perhaps it had been the strange amalgamation of all of the above.

As I contemplated my return to Medicine, I knew I would have to confront all I had learnt in the past 3 years. The reasons that had drawn me to Medicine initially, now appeared feeble – or even slightly repulsive. A return to Medicine would require stronger foundations. I needed to be able to justify the long hours, the years of less than desirable working conditions, the intellectual rigour and the physical exhaustion.

At the end of my deliberation, I decided to return to Medicine. In my cynical moments, I thought I was returning to him because I had nowhere to go. In my moments of positivity, I felt I was returning because of a faith that things would work out between us. But ultimately, the appeal of either of these extremes never lasted. I didn’t want to return to Medicine cynical or hopeful. What I did want to do however, was to return to Medicine not in a way that consumed me; but in a way that allowed me to retain who I was.

This is why we couldn’t date anymore. I look at Medicine now, as an equal. I’m not exhilarated by his presence, and I am no longer ignorant to his flaws. I want Medicine to be part of my life, not my whole life.


Featured image from Four Seasons Hotels and Resorts

 

Clogged Waterfalls

BY SAV MANDAKINI

Hidden in a cave,

Too scared to look out,

Too scared to escape

Heaven seems so far away

Happiness, I can’t attain

It’s a thousand miles each way

Don’t feed the animals

Threatening to break your castle

With iron fists and iron hammers

I gotta find my own way outta here

I don’t know where I am

I don’t know who I am

I don’t know how I am

But I’m too afraid to get on out there

I’m trying to change myself

But how can I when I don’t know myself

The waterfalls are clogging up

But no one, no one is out there

Sitting in my abode,

Flickin’ thru my phone

Doin’ it on the auto

Like a cyborg

Got no place to go

So, I sit here on the low

Waitin’ for someone to find me, oh-oh

Don’t feed the animals

Threatening to make you weaker

Don’t listen to their calls

Telling you to give it up, yeah

I don’t know where I am

I don’t know who I am

I don’t know how I am

But I’m too afraid to get on out there

I’m trying to change myself,

But how can I when I don’t know myself

The waterfalls are clogging up

But no one, no one is out there

When you’re getting down, you gotta find a way up

Getting closer to Heaven’s getting closer to yourself

Let the haters say you can’t daydream, but they won’t help you get to your dreams

Don’t fall into habits that are toxic

Don’t become a phantom of yourself

Find the things that make you tick

The saltpetre that makes you uptick

Then you can turn those feelings into fireworks

And unclog the waterfalls

I don’t know where I am

I don’t know who I am

I don’t know how I am

But I’m following, I’m following the fireworks

Look out for the recorded version of Clogged Waterfalls on Savannah’s Youtube channel, coming soon!

A Wolf In Paper-Thin Sheep Skin

TRIGGER WARNING – This piece discusses issues relating to sexual assault

Dear Eileen*,

I hear that you are dating that man. That man who hurt a few of us.

Please do not delete this message – I seek only to provide a warning.

He is a wolf in sheep’s clothing.

He lured us in because he was ‘hurting’.

“I need you” – he said. And then he hurt us all in turn.

I hear you are dating that man. That man who laughed at a few of us.

Some of us were drunk, and we laughed too.

His dark eyes sparkled at us knowingly.

His tongue formed his words with a caress.

“Please come closer” – he said. And then he pulled us too close.

I hear you are dating that man. That man who cried with a few of us.

While he wept, we shed some tears too.

And then moments later he laughed.

He looked through us, seeing nothing inside.

“You’re actually quite pretty” –  he said with light in his eyes, stolen from yours.

I hear you are dating that man. That man who whispered to a few of us.

He held his palms up in defence.

After he had already violated your space.

And then he held up his phone, he convinced you to say;

“Yes I like your photographs. They’re wonderful” – you felt broken but remained polite.

I hear you are dating that man. That man who is hiding in plain sight.

We feel like we have done something wrong,

That we should have known better.

But his predatory delight,

Knows no bounds – and so how can we be to blame?

Sincerely,

A Friend.

*Not based off any person’s name known to the author.