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

 

Med Student Syndrome

By Mika Sood

I remember sitting in a lecture theatre learning about types of strokes – how it’s possible to have a brain aneurysm just sitting in your brain, how slowly the artery wall can weaken to the point that it can burst randomly and unprovoked and how it could, in theory, happen to anyone – including me. I don’t know why, but after learning more about it that day, I started to relate the symptoms to myself: “Do I have neck stiffness? Am I nauseous? I probably have a headache”. I could talk myself into thinking I had a brain aneurysm, and it wasn’t far-fetched at all.

I think we can all say that at some point so far in our medical education, all of the signs and symptoms begin to sound far too familiar as soon as we have studied a certain condition. This leads to a jump down the rabbit hole with a bit of help from Dr Google, and we self-diagnose ourselves with a condition or disease that had never crossed our minds before.

Medical Student Syndrome is defined as a condition frequently reported in medical students where they think they have the symptoms of a disease that they are studying. Don’t worry if this has happened to you – it’s significantly common and there have even been studies and research done about it. It has many names including “Third Year Syndrome” or “Disease of the Week”, but in essence, it’s a temporary kind of hypochondria based on being extremely aware of psychological and physiological dysfunctions and relating those signs and symptoms to oneself.

The wider community is also not immune to the effects of Dr Google, and in the age of this digital hypochondria, it’s important for us, as future doctors, to realise these effects for ourselves and the general population. It is true that you can find solid, evidence-based information online, but most Google research will not be directing you to the therapeutic guidelines. The easy access to health information is definitely convenient, and it is much less embarrassing than going in for a consultation to ask if it’s possible to have cancer and a brain aneurysm, but it’s also more than likely to be an incorrect diagnosis that can increase anxiety levels unnecessarily (1).

So, I guess this is a big red stop sign to get you to halt your daily activities and call out the irrational thoughts in your head. As medical students, it’s hard not to worry and stress about basically everything, but here is a little friendly reminder that you probably don’t have a life-threatening brain aneurysm or a rare deadly form of leukemia.

Take home message: Close all your google tabs. Stop self-diagnosing. I promise you don’t have the disease you think you do.

P.S. On a serious note, if you are really worried about something, definitely go see your doctor.

 

(1) MedicalDirector. Dr Google Survey 2019 [Internet]. MedicalDirector; 2019 [cited 2020]. 24 p. No: WHI00047Med – AUSV1. Available from: https://www.medicaldirector.com/resources/doctor-google

 

 

The Car

Discuss the quality of the teamwork in your current, or recent clinical placement with one of the clinicians. How do they rate the teamwork? What is their, and your, perception of the main factors that are influencing the adequacy of teamwork in this unit?

The car, by the owner’s own admission, wasn’t reliable at the best of times. It sat in the hospital carpark, a great marooned land yacht of a thing, with its hood propped up, offering a glimpse of the ancient looking mechanics lurking within. Its metallic burgundy paint gleamed in the sunlight, reflecting every cloud in the sky in crisp and deep detail. I looked on in confusion as the psychiatrist fussed about in the engine bay, twisting and tightening and adjusting all sorts of odds and ends. His crisply pressed white business shirt had its sleeves rolled up just above the elbows, as to not get his cufflinks snagged on anything.

It was a 1996 Ford LTD he’d told me, one of very few left. He’d gone on to explain the origin and particulars of the car, using jargon that seemed even more mysterious than the medical jargon he used on the ward. Something about cubic inches and gears and differentials. I’d been sure to nod along during the exposition.

“Right,” he said abruptly, bringing me out of a daydream, “this is where you come in. You have to bring your car up nice and close, close enough for the cables to reach across from your car’s battery to mine.” He walked around to the trunk of the old Ford and produced a set of red and black jumper cables.

“Um, okay,” I responded with an air of confusion.

“Okay, let me explain it one more time,” he said, an edge of exasperation creeping into his voice, “my car’s battery is dead, I’m not certain why, it’s pretty new, but I think something faulty is in the electrical system is sapping it. The only way I can get it to start, so we can all call it a day and go home, is if you help me jump start it. To do that, all we need to do is temporarily wire up your car’s battery to mine. That’s it. Comprende?”

The Spanish he threw in for good measure jolted me into action, and with a sigh I began to move towards my car. I made a quick job of parking it nose to nose with the antique limousine, and propped the hood up to initiate the procedure. At the doctor’s instruction I left my car’s motor running, and it quietly hummed away as he started making the necessary connections. “You’re paying attention to how its done?” he asked as he worked.

“I’m not sure this is in the fourth year logbook.” The length of the day and abnormality of the task at hand lent a frustrated sharpness to my response, but the psychiatrist just chuckled.

“This is more important than almost anything in that logbook, one day you’ll see.” He stopped what he was doing and turned to me. “Look, this is an unconventional form of aid you’re being asked to offer here, but on this team, you’ll see that unorthodox help is sometimes necessary.”

“Is that so?” I was intrigued.

“Of course, I mean we deal with the most confronting, most demanding, most mentally unfit patients with the lowest absolute treatment success rate of any field. We’re under constant stress, and if we’re not willing to be there for each other in moments of trouble, we’ll be admitted as in patients ourselves,” he explained, “every member on that team has something that I don’t have, and I need to collaborate everyday as a result. Whether it’s the social worker’s ability to secure housing for a patient, a reg that can talk a patient into taking their medication, or a medical student that possesses a car battery that can hold a charge, I’m always relying on the cooperation of my team.”

He turned back to the engine bay of his car as he continued to explain, “we’re a team. Lone wolves don’t last too long in this game.” He added a final adjustment to the cables. Happy with how everything was looking, he moved to the driver seat of the LTD, and turned the key. After a few moments of the starter motor ticking away and the engine labouring to turn over, the car roared to life. After a few moments of the V8’s proud roar reverberating through the carpark, it settled into a smooth purr. The psychiatrist removed the cables from the cars and proceeded to drop both of their bonnets.

He produced his fountain pen from his pocket, “in the spirit of such teamwork, I’ll tell you what, I can sign your logbook for spectating ECT. I mean, this was basically Electroconvulsive Therapy, just on my car rather than a patient.” After foraging around in my bag, I handed him my logbook, and he scratched his signature down. He returned the book and moved back to his car. “Adios” he said before shutting the driver’s door.

I looked on as the gleaming red limousine slowly rumbled out of the parking lot and turned onto the main road outside the hospital, and waited for the distinctive vintage drone to recede into the distance.

 

Myocarditis

By Anonymous

I was 9 years old when my youngest brother was diagnosed with myocarditis. He was 5 at the time and had very vague symptoms. He refused to eat anything, he didn’t engage much with anyone at the time, and his overall behaviour was different. One day, when my parents took myself and my two brothers for a routine check-up with our paediatrician, she noticed that my younger brother’s skin colour was different. She urgently told my parents to rush to the emergency department without any delay.

He was admitted to Sick Kids hospital immediately and stayed admitted for about 2 weeks. Those 2 weeks were the worst 2 weeks for my parents. We were taken care of by our relatives while they spent most of their days and nights at the hospital. As a kid, my older brother and I didn’t know much about what was going on, and our parents didn’t share much of it with us either.

To me and my older brother, the hospital was beautiful. There was a hot dog stand right in front of the hospital, a wishing fountain at the entrance, and playrooms on every floor and unit. During each trip to the hospital to visit my brother, we would have hot dogs that our dad bought us, we’d throw a coin in the fountain to make a wish, and spend hours in the playroom.

My younger brother, on the other hand, was constantly being monitored, undergoing a number of tests and taking numerous medications every day. Luckily, he was one of the rare kids who didn’t need a heart transplant and was managed well with medications. Upon his discharge, a nurse made regular, bi-weekly, visits at home to monitor my brother’s health. He was also prescribed medications for a number of years until he was completely cleared of any further check-ups when he was 16 years of age.

Upon reflection, I can appreciate how difficult it must have been for my parents and how scared they must have been to think about the thought of losing one of their kids. Although it has been years since this happened, everyone is very protective of my little brother and even now, my parents refuse to tell us the whole story of what had happened at the time to avoid the feelings from coming back.

One thing I’ve learned from this is that it is really important to be aware of any subtle changes in the way a child behaves that is different from normal. Often, children may not be able to express what’s going on but may exhibit signs of irritability or failure to feed. These signs should be an alarm bell signalling that maybe something is up. In such cases, it is better to be safe and to get a check-up at a clinic or hospital instead of delaying medical attention. Sometimes, it may be more serious than what meets the eye.