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

 

The Meander

In February 2014, I was on top of the world. I just received my offer to study medicine. My life’s hard work had finally paid off. The rest would be a breeze; studying medicine is easy, a bit of memorizing, that’s all, and everyone gets a job at the end. My life was sorted! I became the model student, everyone’s goal, everyone’s dream.

I went into medicine full of joy and excitement, absolutely confident that I had more than what it took to ace this course. I was ready to live the dream, ready to become an excellent doctor…

I am still unsure when the turning point happened, when the dark hour of self-doubt began to settle in. It might have been sometimes before my first end of year exams, when I realised that I could simply not study enough to cover the scope of what could be tested.  It might have been outside the door of many OSCE stations, where I was paralysed by topics that I was not prepared for.

Or it might simply have been the daunting realization that I was not as dedicated, gifted and hardworking as I had thought…As I sit in front of my laptop, too tired to concentrate on studying after a day at placement, I think of my many fellow medical students who achieve higher grades than me, and who through their dedication to juggling uni with extra-curricular and research activities, also enjoy the benefits of having glowing CVs. As I struggled to answer my consultants’ questions, I resigned to the fact that I simply did not have the knowledge to impress doctors and build the social connections that everyone seem to value so highly.

Now, edging towards the end of my time at medical school, I have more questions than ever. Would I be able to cope with the demands of internship next year? How do I determine which one of those multitude of medical specialties suits me the most? Would I ever be good enough to overcome those increasingly difficult challenges that stand between junior doctors and training programs?

 

Through all my doubts and uncertainties however, there is one thing that I am confident about: I have had struggles and self-doubts through medical school, yet I have overcome them. My lists of achievements through medical school may not be less glowing as it was back in high school, but through each and one of them I have learned to strive to be a better version of myself, and these moments of personal growth would allow me to overcome the bigger challenges to come.

My achievements in school have given me confidence and pride, but I was so sheltered that I believed I no longer needed improvement. Medical school has allowed me to know that there is always something to aspire to and strive for, and that is a great feeling.

The journey as a medical student and doctor is long and meandering. Self-doubt and uncertainty are often intertwined with this path. If you ever find yourself feeling doubtful about your abilities, please remember that you have all accomplished so much to get to where you are today, and there is no reason why you wouldn’t continue to do so. Additionally, the greatest achievement is a journey, not an endpoint and I wish you all the best on this amazing journey.

The Wave

It always starts small – like a ripple – before slowly welling up inside. You know what’s coming next, so you brace yourself.

 They’re all just temporary feelings that will pass right?

The tachypnoea, chest pain, palpitations, vision changes, paraesthesia, depersonalization, flight of ideas, and that sense of impending doom. No amount of knowledge can prepare yourself for the wave that comes. It surges through every fibre in your body, filling every nook and cranny, relentlessly striking at every insecurity with more precision than a stressed medical student trying to cannulate a delirious dehydrated patient while trying to decide whether to call a code grey amidst a cacophony of beeping alarms. Its icy grip tightens round your chest, clinging to every breath as you struggle to maintain focus. Through ragged breaths you use every rational thought you can muster to counter your worries and overvalued ideas. And just when it seems you’re not going to make it, you do. You remember to breathe. The waters finally recede as you shut your eyes, inhale deeply and shake it off before ‘resetting’ and picking up where you left off.

 

Five years have passed in a flash and with the end of medical school in sight comes a barrage of different emotions: Joy, relief, sadness, dread. I would be lying if I said it was easy. “Peaks and troughs”, they said. Yet that one line cannot surmise all the obstacles one faced: Mental health issues, challenging colleagues and supervisors, social isolation, insomnia, 4-hour sleeps at night to study for the VIA, the list goes on. One that I found particularly troubling and persistent was anxiety. Here are some tips I found helpful.

 

Seek Help When You Can– You are never alone. Sometimes mates are good and all, but there are times when things can get too overwhelming. There are always avenues for help like Headspace and getting a mental health care plan from your GP. The student services at our clinical sites are also very understanding and always have our best interests at heart. Knowing when we are in over our head and seeking help is a good step in a positive direction. No matter how big or small your problems are, there is nothing wrong with saying you need help.

 

Take Time For Yourself– Never underestimate the power of taking some time to focus on you. Take a break from the books, get out there and take some time to relax. Exercise, treat yourself to brunch (not UberEats), hang out with your friends, visit a familiar haunt (or somewhere new). Remember to pace yourself and not burn out. So… Treat yo’self! J

 

Surround Yourself With Friends and Family – It’s easy to get caught up with work and rotations and lose contact with friends and family. Try and make it a point to spend some time with them. Grab a coffee, have brunch together, share your troubles, or just kick back and binge on Netflix. If not, drop them a call. Sometimes all we need is just for someone to talk to or laugh alongside with.

 

Mindfulness Works– We have all spent time savouring that tiny piece of chocolate, trying to focus on every taste bud as it slowly melted in our mouths – I wouldn’t know, I practically inhaled mine. A chocolate fondue fountain with strawberries would’ve worked better, but I digress. If you ever feel tense and unable to relax, meditation has been a great go-to for me. Taking a couple of minutes to regulate your breathing and doing a ‘body scan’ is a good way to reset and start over. If you’re like me, lacking imagination and would rather not type ‘relaxing music for stressed out medical students preparing for final year exams’ in YouTube search bars, then I would recommend the Smiling Mind app which is completely free and has several pre-set programs to select from (no, I do not have shares in the Developers’ company).

 

I hope these tips are useful for those who need it. Good luck for the rest of the year everyone!

Reflections from AMSA NLDS

What do you want to be when you grow up?

By Rav Gaddam

As a child, people used to ask me “What do you want to be when you grow up?”, and my answer use to differ every time – from a detective palaeontologist, to a ballerina firefighter, there was never a time I would be content on settling for a constant straightforward answer.

So, when I was awarded the opportunity to attend the National Leadership Development Seminar (NLDS) by AMSA, I was beyond ecstatic – an opportunity to hear from a dancer doctor, or a lawyer doctor, or an actor doctor? BRILLIANT, all I needed now was to find that Kathmandu jacket to brave the Canberra winter.

Each day at NLDS was based on a different theme, but every day we got the opportunity to listen and to learn from inspirational and extraordinary people who have done amazing things in their life. From having coffee chats with A/Prof Ruth Stewart to discuss rural health, to listening to Michael Bonning talk about his time in the ADF, or attending a breakout session with Jessica Dean (#monashpride), these people reminded me that doing medicine does not mean that I have to finish medical school and only become a doctor (and if you want to be just a doctor, that great too!).

However, the session that left the greatest impact on me was a plenary session by Dr Emily Isham. Though it has been nearly four weeks since the event, I find myself often pondering over her speech. Emily is an amazing rural GP, who despite having lost her son to cancer less than a month before NLDS, stood in front of us and delivered a speech that made me brawl. I spent the afternoon on the phone to my mum as I was reminded that life is short, and I need to embrace the people, the opportunities and the dreams I have.

In summary, everyone’s journey at NLDS (and life) is different, but my time there reminded me to reflect on my life thus far, the people around me, and on my childhood dreams. So, if anyone asks me now “what do you want to be when you grow up?”, I guess my answer is quite simple really:

I want to be a detective-palaeontologist-ballerina-firefighting-doctor.

 

NLDS Experience

By Bowen Xia

AMSA NLDS has been one of the highlights of my year and I highly recommend it due to the skills, experiences and networks that I have gained from it.

 

My favourite experience at NLDS was the opportunity to interact with and befriend medical students across Australia. We can often be trapped in our own bubbles surrounded by people and opinions that sustain it, so it was refreshing to have paradigms shifted, beliefs altered and the opportunity to see unique and diverse perspectives from presidents of medicine societies to future presidents of medicine societies. I can safely say that when I returned to Monash from Canberra, I carried NLDS souvenirs in my bag, countless photos on my phone and new ideas and perspectives in my mind.

 

NLDS Projects was also a great experience. Everyone was allocated into various project groups that worked on finding a concrete solution to a current issue in medicine. My project was ‘reducing burnout in medical students’. We worked on it for a good part of NLDS and had great mentorship from speakers and members of the AMSA Executive Committee. We got to present and view all the projects at Old Parliament House at the end of NLDS. The result was us winning the award for ‘best project’ but the real prize was the fun that we had by working together.

 

The social activities were also great fun. The ball was an excellent time to socialise with other participants of NLDS over some EtOH and food. The trivia night was a great opportunity to discover that nobody knows anything. Finally, the end of NLDS party at Mooseheads allowed us to celebrate and farewell a memorable experience and then get late night maccas after making closing time.

 

Healthy mind, Health body

I have always been the kind of person who prefers not to talk about their struggles or worries. I prefer to listen to and help other people with whatever is on their mind. Despite this, for a long time now I’ve struggled with my body image and my relationship with food. I have downplayed it because I know that I do not have a serious eating disorder, I am of a healthy weight and I have in a way liked being that “healthy friend” that people know not to bother offering the sweet snack to and that prefers to take the stairs over the lift. But it’s time to out my hidden struggles and recognise them for what they are.

 

I cannot pinpoint when it all started for me but for years, I have been very invested in nourishing my body and only consuming foods that I deem to be healthy. If I was in a situation where I felt obliged to eat an “unhealthy” food, I would be riddled with guilt for hours and this is definitely something that I still struggle with even to this day. I would secretly judge other people for their food choices and in fact very openly judge those closest to me. I would try to convince them that their diets were completely wrong and that they needed to adopt healthier behaviours and follow my strict rules around reading the food packages to ensure that there was no added sugar, no preservatives and that the foods were low in fat and salt. I saw my behaviours as being the right way to live and that everyone else was doing it wrong.

 

These strict rules and restrictions allowed me to justify eating extremely large portions of food and going back for seconds and thirds as long as it was healthy. This led to an unhealthy cycle of binge eating to the point where I felt over full and unwell. This would happen on a daily basis – sleep, overeat, rest and repeat. I had the all or nothing attitude, that: I would either have a good day and eat well and if I failed to meet that standard then I would give in for the day and eat anything and everything and my strict rules would restart again the next day. My days would be consumed about thinking about food and worrying about my body, feeling that I would never be happy in my body no matter how well I ate or how much exercise I did.

 

The world we live in today is a mixed bag of dietary advice. One day we are told that the keto diet is the way to go and the next day we are demonising meat and opting for a plant-based diet. No wonder we are all so confused about what to eat. Societal views on food have definitely impacted my attitudes towards my diet but on reflection so have my perfectionist personality traits. I am constantly striving to be better and do better and one way I thought I could do this was aiming to be as healthy as possible. This sounds simplistic as I know that overall health is not just about what you eat but is related to a whole number of things including lifestyle factors such as exercise, sleep and stress levels but it is easy to get caught up in obsessing over one thing and for me that was and  sometimes still is, food.

 

Over the course of about a year I have begun to realise that my behaviours and thoughts have negative impacts on my life and my relationships. Although the thought of seeing a psychologist about it scared me, I thought it was time that I did something to help myself. I went to my GP who also thought it would be a good idea, however after that conversation I managed to find every excuse possible to avoid seeing a psychologist. Then on another visit to my GP and after conversations with my friends I decided to bite the bullet and book in to see someone.

 

Even though I would have probably been okay continuing the way I have been for many more years, I found sitting down and talking to a complete stranger a beneficial experience. After seeing patients on placement and asking them to talk openly about their mental health struggles I felt that it was important for me to do the same and feel no shame about it. I spoke to my friends about it – something that I wouldn’t have done a year ago and now I have written it down for more people to read and hopefully I can help someone else out there who may be struggling with their own battle.

 

We all have our own struggles and it can be easy to deflect them but the sooner we identify and talk about them, the sooner we can start to heal and realise that we are not alone. I am now a lot more content with myself and have started to focus more on the positives including how amazingly functional my body is. Slowly, I am overcoming my obsession with healthy eating and focusing more on the shared experience of a good meal with loved ones and the power that food has in bringing people together

In Sight

By Michelle Xin 

To perceive is to also acknowledge that there will inevitably be a blind spot. When not conjured by a red hat pin or a side view mirror, there is one more place to check, and that is within. How often do we truly see ourselves from within, for who we are and for who we have become?

What remains in your memory when the days begin to blur with each other, and the granules of time begin to feel viscous?

What reaches within you, and cradles and warms your soul with a compassion that is often forgotten for ourselves?

Are there any ropes of the past which tether you; of hurt, disappointment, unmet expectations, frustration, guilt, of those who are no longer in your lives?

To probe is to also viscerally feel the twinges or perhaps aches of discomfort; the discomfort of confrontation, of facing conflict, of loss, of having room for growth in the first place.

And finally, to begin to understand why your hands are still clenched, perhaps holding onto a thread, a figment of what once was, and when might be the time to slowly let the tension go. To appreciate the beauty of the polaroids of past memory and to acknowledge your own shortcomings. To let go.

To reflect is to also overcome; the challenge of seeing ourselves bare, with the perceived flaws, scars, inadequacies of our bodies and our minds. And to glimpse the mirage beyond our blind spot – through those we are fortunate enough to share our lives with, past and present.

 

Naikan (内観- ないかん), the Japanese word for ‘introspection’, embodies this, and can guide us when we are perhaps lost within the darkness of our minds; as well as to remember that we are never alone in our quest of self-discovery and our forays into the unknown.
What have I received from the people in my life?

What have I given to them?

What troubles and difficulties have I caused them?

In our experience of giving, perhaps we have also received a bountiful supply; an amount that may not easily be repaid, if ever. The generosity is present, even in the most deep-seated grudge – where not even a sliver is initially expected. Crumbling that expectation with a recognition of the gifts received, and turning the conversation within, opens us to forgive ourselves, and to forgive others if need be.

There are days where despite the pen nib touching the paper, awaiting an outpouring of my thoughts, the ink seeps without a destination – an inconspicuous dot on the page. There are days where a familiar face of the past finds its resemblance in passing strangers; to no avail when I glance, unsure of what I am hoping for. There are days where my experience, my difficulties are encompassing, and my blind spot grows once more.

I hope for days where frustration withers, and gratitude blooms within instead. I hope for when that familiar face is theirs, and not misplaced on a stranger, that we mattered, and it is a gift in itself to find our paths wherever they traverse.

I hope that you too, can see within, beyond your blind spot, to see you – and all that you hold, and all that you can give, to others and to yourself.

 

My Superpower

By Evan Kuma 

When I was young, we’d often play a game in the yard that involved a group of us going around in turns and saying what superpower we’d want bestowed upon us in the event of some freak occurrence. A group of friends, we would all come up with the best of powers, and elaborate ways in which to use them. Super strength, so you could lift a car up above your head, super speed so you could dodge a bullet or X ray vision so you could see who was hiding behind a brick wall. But not me, no. I would often wish for invisibility. You wouldn’t need to be super strong, super-fast or have X-ray vision, I reasoned, if you could be invisible. When I look back now, I realise how naive we all were, that is, until recently. Maybe that superpower I had wished for as a young child was finally granted to me in my third year of medicine.

 

It’s like any other day, walking through the wards, stethoscope around my neck and clipboard in hand; have take a history or do an exam today, I remind myself. I walk past the nurse and smile – he’s busy scanning in medications and so he doesn’t realise I’ve walked past. That’s fine, everyone’s busy in a hospital. I know that, so I shrug it off and walk into the meeting area where the ward round team assembles every morning. This is a busy morning like any other – the intern is busy printing lists, the registrar chasing up on night cases, and the consultant – where is the consultant? So, I move to the side and stand, waiting for the bustle of the morning to play out. The team slowly starts to assemble, everyone caught up in their own world, and it strikes me – how is everyone so preoccupied that they forget to say hello? By this point, my superpower is pretty much tried and tested, I am invisible. The consultant comes in and we leave for rounds. There’s a lot of us at this point, so fitting in the room is tough – let me just stand to the side and watch. Rendered invisible again. When we move to the final room, I decide to use my superpower to stand at the foot of the patient’s bed – I’ll be fine here, no one can see me anyway! As the consult finishes and the team empties out of the room, I decide to stay and talk with the patient – she looks sad and I figure she could use some company. And the strangest thing happens – she sees me. As I sit and talk, she tells me her story; why she’s come in, what’s on her mind and where she plans to go. No WWQQAA can guide you in this conversation between two strangers bonding over their shared humanity.  As I get up to leave, I hold her hand to say goodbye. She smiles at me and I smile back, and in that moment something spectacular happens.

 

This is my revelation – I wait for the sound of ethereal bells or some wise old man to float in and give me a cape – but this doesn’t happen – the change is within. I’ve realised something, something that has taken a while to happen – I am a superhero, but my superpower isn’t invisibility. Maybe my superpower is the ability to push through tough days and continue to smile? Or maybe it’s the superpower to know when I’m feeling burnt out and take time to myself. In truth, I don’t know what it is, but I’ve learnt that even in the toughest of days, even in the days when it feels like no one can see you, the patient still does. Maybe it’s because they feel the same- doctors, nurses, physiotherapists and ancillary services all coursing in and out of the room, yet they still feel invisible.

 

I’m glad that we both saw each other that day, I’m glad I was reminded of why I choose the path I did and I’m glad that I finally realised that being invisible wasn’t my superpower after all.

 

One of those days.

It’s one of those days.

It’s one of those days, when you’ve pressed the snooze button on your alarm for what might be the twentieth time. When no amount of cajoling, self-reprimanding and mentally yelling at yourself can get you to muster the energy to put one foot out of bed. It’s one of those days, when the only safe place is the warm cocoon of your doona; where you can curl up in the dark and quiet, and there is nothing to disturb you but the steady thumping of your heartbeat and the soft whooshing of your blood coursing through your veins. When it feels like there is lead in your bones, and in your chest, holding you down, and it is exhausting just to think, just to breathe.

(It is okay to call in and tell them you are taking a day off today. This is not a defeat. This does not mean you are giving in. In an age when it is burn bright and burn fast, what you must remember is that first, you have to last. When the ideal is to strive for machine-like efficiency, you must concede that you are only human.  You need this. You need to recover for the many battles yet ahead. Tomorrow can wait, will wait.)

It’s one of those days, when there is a lump in your throat that won’t go away and a loop somewhere in your head that seems stuck on replay. When you turn up the volume on your headphones to the loudest they can go. When you take the train absentmindedly past your stop and get off and walk the rest of the way back home. When you distract yourself by scrolling mindlessly through social media and stay up late in the morning binge-watching Netflix until four.

(Self-medication is a band-aid solution and numbing or swallowing your emotions does not make them go away. They tend to lie in wait, lurking in the corners of your mind, until they ambush you when you least expect it. When it’s time, let them in. If the tears come, let them fall. You have been carrying these things that are so very heavy for so very long now. It’s okay to put them down for a while.)

It’s one of those days, when you stare into the mirror and practice a smile that doesn’t quite reach your eyes. When you notice every dark circle, every little blemish, everything that feels too large or too small or too asymmetrical and oddly placed. It’s one of those days, when you lie awake at night and suddenly remember every fumble and folly, when you agonise over every word you wish you could take back, every mistake that you have ever made. When you dissect yourself apart, until you can’t tell outside from inside. When you wish you could just resect those silent malignancies of the soul, those parts of yourself that fill you with shame, or loathing, or anger and disgust.

(If only you could remember to try to see yourself the way those around you see you, or moreover, you would treat yourself the way you treat those around you. Nurture; be patient with and forgiving of yourself the way you are for others.  Of course, you are flawed, as are we all. But what is most important is that you are always learning. Your weaknesses and failures make you who you are, and it is in them that you will discover your strength. They are what make you good, truly good.)

It’s one of those days, when you feel a yearning to return home, even though you are home. When you feel utterly alone in a crowded room. When you cannot fight the feeling that others, even those closest to you, do not see you, do not see through you. When you feel the expanse of an ocean between your heart and theirs. It is one of those days, that a small voice whispers in your head that you are insignificant, replaceable, unworthy.

(Despite what you may sometimes think, you are not alone. There are so many who have felt the way you do. There are so many who have loved you, who love you, who will love you. There are so many who you have not even met yet, who will need you here. There are so many connections, whether fleeting or long-lasting, brimming with meaning and potential, waiting to be made. And sometimes it is up to you too to make the first tentative step. There is so much more to gain than there is to lose. You have given so much, and you have so much yet to give. You matter.)

It’s one of those days.

(And these days too, shall pass.)

The Dead Teach the Living

By An Anonymous Author

Embolus feature May

This picture was taken moments after resuscitation. The dried blood on the watch marks the time we took to save the man’s life. Yet, unfortunately, the patient passed away, alone in a room full of strangers he briefly met just forty minutes ago.

The patient arrived by ambulance, with the paramedics pumping on his his chest as we transferred him over to the gurney in the resuscitation room. The paramedics failed to intubate because of a difficult airway. Once the residents managed to intubate him, I was handed the task of ventilating the patient with a bag valve mask. I internally counted the intervals required to help the man breathe, squeezing the bag and watching his chest rise rhythmically as the doctors carried out chest compressions.

With each subsequent breath, however, he became increasingly difficult to bag, as if life was slowly escaping his limp body. And with each squeeze, blood would leak out from the small valve of the mask. Amidst the chaos, I watched as his blood trickled from my fingers down my forearms. It was as if he was falling apart in front of me.

“Time of death, four twenty-five,” declared one of the residents.

The desperate atmosphere of the resuscitation room became suddenly somber. As the residents left, thanking everyone for their help, I overheard a senior nurse asking one of the new nurses whether she’d prepared a body before. Watching the nurses quietly zipping the man into a body bag, I looked at the man’s face one last time. How lonely he was in his last moments without the company of his loved ones.

In clinical anatomy when we dissect cadavers, identify the landmarks, we are told, Mortui Vivos Docent, the dead teach the living. During our clinical years, armed with the anatomic and pre-clinical knowledge, we see the patients we serve pass away and recall what was once said to us, Mortui Vivos Docent, the dead teach the living. But in this case, the dead not only teach us the clinical knowledge, but the human aspect of medicine.

It seems amidst all the time we buried ourselves in books, we have lost the human touch to medicine and forget the humanity of those we serve. With our numbering days we spend in medical school, we realize that time flies so quickly as we look back into our youthful days. Yet, we have a hard time confronting the time in front of us dwindles just as quickly. The deaths of our patients not only teach us the things we could have done differently, but grounds us with the reminder to never abandon our patients and the humanity that embodies them.

And perhaps when we graduate, we will read this oath to re-affirm this promise we once made when we decided to commit our lives in service of others:

“At the time of being admitted as a member of the medical profession:
I solemnly pledge to consecrate my life to the service of humanity;
I will give to my teachers the respect and gratitude that is their due;
I will practise my profession with conscience and dignity;
The health of my patient will be my first consideration;
I will respect the secrets that are confided in me, even after the patient has died;
I will maintain, by all the means in my power, the honour and the noble traditions of the medical profession;
My colleagues will be my sisters and brothers;
I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;
I will maintain the utmost respect for human life;
I will not use my medical knowledge to violate human rights and civil liberties, even under threat;
I make these promises solemnly, freely and upon my honour.” 


(World Medical Association’s Declaration of Geneva)

 

 


 

First published as an AMSA Embolus Feature

The work-life balance: myth or mantra?

By Megan Herson 

The mantra of achieving emotional, physical and spiritual happiness seems to echo throughout every facet of life. From social media and television, to work and study, it seems to be inculcated into our generation that it is necessary to find a way to equally incorporate social life, family connections, hobbies, physical activity, and spirituality into our lives in order to be happy.

Social influencers have been able to make an entire career out of posting photos about their seemingly perfectly balanced life. It was not until very recently that I realised that the components of achieving a balance in life actually makes quite a long list. How on earth am I able to engage in extra-curricular activities while I try to understand the difference between aortic stenosis and mitral regurgitation whilst simultaneously keeping up appearances at my friend’s social events, and remembering to get my daily dose of veges whilst I rush to gym to stay physically active? Just reading that sentence makes me anxious! The components of keeping a balanced life seem attainable, but cannot all necessarily be maintained at the same time. I am not saying that career, connections, physically health, and spirituality are unimportant, but rather that it is difficult to focus on all aspects equally without collapsing under the pressure. It is okay – even healthy (in my humble and not-yet-medical-professional opinion) – for work and life to be experienced unequally.

Having a perfect balance of work and life, in order to achieve a state of wellbeing, seems a fallacy to me. We are all at different life stages with different priorities. Placing more attention on one aspect of life at a time may actually support wellbeing by attenuating the stress of achieving everything in balance. If you are at a stage of life where focusing on career is more important to you than going to parties, you can focus on that aspect of life for a period of time. If you are in a stage where you need a break from driving career and want to focus on personal growth, it is okay to put more energy into spirituality, social connectedness and emotional wellbeing. Of course, it is always important to have some aspect of all components of wellbeing in play; however, it may not be possible to give a hundred percent of yourself to your career, physical fitness, spirituality and connectedness all at once. Acknowledge that you may not be able to balance every single aspect of what makes life ‘healthy’ equally all the time, yet you’ll still be able to make the best decision for yourself at that particular point in your life. The caveat is to remember to limit the amount of time that maximal attention is spent on one component of life, and to alter the focus depending on what your priority is during that period of time.

 

Here are my top tips for achieving a state of wellbeing from one type-A to another:

Let go of some of that medical-student-perfectionism. Okay, this is quite hypocritical because I find this difficult at the best of times… but perfectionism is unattainable, and you cannot give yourself completely to every aspect of your life at the same time. Focus on what you need at that stage of life. Balance is important, but it is impossible to manage everything that is important to you equally and at once.

Have a few phone-free hours every day. Constantly being on our phones makes us available to people every hour of every day, and makes the world available to us every hour of every day. A sense of urgency is thus created, with the constant need for instant gratification producing a need to rush through life rather than enjoying it slowly.

Be kind to yourself – a concept that is perhaps the most important yet hardest one to accept and accomplish. Acknowledging what you need to be happy – and putting your needs before others – not only identifies what your priorities are in life, making it easier to realise where your focus is needed, but also automatically makes you a happier person.

Finally, be kind to others. You never know what someone else is going through, and one seemingly trivial comment or act may have a disproportionate impact on another person. This has been said before but medicine is hard and it may not be possible to give it everything all the time, whilst juggling so many different things at once. However by supporting ourselves and each-other we can give it our best and enjoy the journey at the same time.

 

 

New Medical Student Screening Test Achieves 99.99 % Sensitivity

A Cannula Exclusive 

By Idew Wokefield

[De-identified] Hospital, Victoria – Medicine is a constantly evolving field with ground-breaking research allowing patients to be treated and diagnosed faster. Examples of such research has occurred in very stage of human history such as the 1928 invention of penicillin to treat bacterial infections, the 21st century mindfulness movement to treat burnout and the 15th century BCE ban on trepanning to treat ‘evil demon spirits’. However, despite hundreds of years of research and countless sums of money, people with disease or yet to be symptomatic from it are missed and suffer from the consequences such as a late cancer diagnosis. The Cannula is proud to report that a BMedSci student at [De-identified] Hospital has published a study that will allow human civilisation to enter a golden age akin to the introduction of pineapple onto pizza and has succeeded where countless centuries of the worlds brightest minds have failed.

The single blinded randomised control trial consisting of 300 ‘healthy’ participants utilises the ‘Medical Student Screening Test’ which is based on their unique self diagnosing abilities. When asked about how they invented this ingenious test, the unnamed BMedSci student commented ‘ I once attended an infectious diseases lecture and afterwards diagnosed myself with influenza, herpes and glandular fever. The next day I felt a little febrile with fatigue and an itchy throat and I promptly attended the GP. I told him my diagnosis and we had a 1-hour intellectual debate with him ultimately conceding that I was right and to “never come back to his clinic”. Afterwards I diagnosed my dad with colon cancer and the coloscopy removed a 0.3 cm hyperplastic polyp preventing his cancer diagnosis 40 years in the future.’ The experimental group is shown various lecture slides from the Monash Medicine Program consisting of the signs and symptoms and images of the post-mortem pathologies of hundreds of diseases. While the control group is shown first year slides displaying the Krebs Cycle. Both groups then fill in a 50-page survey, containing all the conditions known to humankind and ticking all the conditions they think they have. Afterwards every diagnostic tool is applied to them discover if they had any undiagnosed illnesses. ‘Basically, we perform an angiogram, 30 blood tests, a whole body X-ray, ultrasound, CT, plus biopsies of EVERY part of the body, a colonoscopy, a gastroscopy, a MRCP and all the physical examinations. Surprisingly the most common condition we diagnosed was white coat syndrome and hypochondriasis’ an unnamed researcher commented. Side effects experienced by the control group include, 28 participants passing out from boredom and one individual gaining an interest in biomedicine. Side effects experienced in the experimental group include 14 becoming naturopaths and 10 transferring their future care to Doctor ‘WebMD’. The results of the study show a remarkable 99.99% sensitivity and when asked about the specificity our unnamed hero exclaimed ‘it is in the 1st percentile for specificity in diagnostic tools’, a truly amazing result.

Our BMedSci student hopes to go to the Rxxxx Mxxxxxxxx Cxxxxxxx’s Hospital and to gain entry is currently working on a panacea that involves every treatment possible simultaneously because ’delayed treatment can be worse than delayed diagnosis’. The trial patients have a defibrillator applied, swallow a beta blocker tablet, inhale Ventolin, have IV Tazocin via cannula, have glycerol enema, whilst going through a meditation session with Monash HEP tutors to treat any potential anxiety. The Cannula reports that the potential panacea is achieving a patient centred approach with none of the trial patients lodging a complaint so far.

 

If you are a writer, fan, hater or corporate lawyer for [De-identified] Hospital, please send your ideas, money, hate mail or cease and desist letter to xxx1.spam.1xxx@gmail.com!