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

 

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!

On apples, oranges and ripples

By Natalie Liu 

In an education system which intrinsically pits us against one another, which ranks us on how many marks we lost in some exam or assignment, it’s hard not to compare yourself to others.

In a high-pressure course where every single person is smart, driven and high-achieving, it’s hard not to diminish yourself when you don’t measure up to your peers.

In a world where success is praised, promoted and shared, and ‘failure’ is kept to yourself, it’s hard not to feel ashamed if you didn’t quite make it. Especially if others have.

It’s that clench in your jaw when you can’t grasp a concept that everyone else in the lecture theatre seems to get, the tension in your shoulders when you hear your friend has finished the matrix and you’ve barely begun picking your way through Cardio, the twisting in your gut when you’ve struggled to just pass the year, while others seem to sail through with ease. Thoughts like “what am I doing in this course?”, “how will I ever make a good doctor if I can’t even do xyz?” begin to swirl around; crippling doubts, fears and insecurities seep into your day-to-day psychology.

Is it impostor syndrome? Probably. Med student type A personality? Definitely. The good news is, if all this sounds familiar, you’re not alone. Not at all.

We all have defining moments in our lives. Like ripples in still water, they travel unchecked and gradually affect every part of our lives. I’m not sure exactly when or where I picked up the habit of comparing myself to others, but it was making me miserable, and I wasn’t even aware of it.

My epiphany came one fateful afternoon during a delightful Digilab on neuroanatomy (that one where Lazarus maps out all the cranial nerves and their function). I was sitting with a friend – let’s call her X. As X and I struggled to keep up, the other members of our table seemed to pick it up just like*that*, and cruised through. Again, that prickling feeling of panic and frustration began to rise within me; soon enough, I wasn’t even taking in what our professor was saying. I glanced over at X, and was completely shocked to see that she was smiling. I questioned her about the little grin, to which she replied, “all these people are so smart! It’s inspiring, I want to be like that.”

Mind. Blown.

To X, what she’d said was probably just a comment in passing, but to me, it formed the basis of a completely different psychology. It got me thinking- why not let these moments inspire you, rather than highlight your deficits? Why compare yourself to someone whose brain is wired completely differently? Or to someone whose life and circumstances are entirely different? Isn’t it like trying to compare apples and oranges?

And just like that, I created my own ripple, and consciously directed it towards something more positive and self-accepting.

So, here we are, almost a year later. Breaking down habits, especially ones that’ve been rooted within your mindset for years, is like bulldozing a mountain. But I continue to chip away at it at my own pace, and hope I’ll build a new one, with a sunnier view.

At last, here’s my guide to combatting those moments. Can’t say I’ve mastered it, but I’m trying at least.

  1. Acknowledge: When you feel that panic start to rise again, acknowledge it. It’s normal. And whether you believe it or not, everyone else around you is probably feeling the same deep down.
  2. Breathe: Take a deep breath in and out. Let that tension dissipate.
  3. Mantra: At this point, I’ll say to myself- “apples and oranges”. (But if your thing is tacos and quesadillas, well, you do you.)

 

Then, put those blinkers on and move forward.

 

“Comparison is the thief of joy”

-Theodore Roosevelt

A Monash Love Letter to the Jaffies

#8519

Clayton/Medicine/Being a first year

 

Scrolling through Monash Love Letters has become a part of my daily routine. Reading through the sad breakup messages and hopeful love letters to strangers with the excitement that maybe one day I will come across one for myself. It’s funny how I treat it as light-hearted banter, until I read one that I can personally relate to.

 

Over the past semester, several letters written by first year Medical students have appeared on my newsfeed, many hitting close to home. Starting university was most likely a daunting process for many of us. Even having grown up in the area and living close to campus, the thought of having to leave my old friends and start a new chapter of my life amongst strangers in a course I was interested in yet uncertain about was nerve-wrecking.

 

First year is the start of a long journey, and as a second-year student looking back, I too remember the feeling of not quite fitting in. I remember feeling disconnected from my peers as they greeted each other every day with hugs and excitement. As someone who is naturally introverted, I often felt uncomfortable around large groups of people I did not know well, mostly whom seemed extroverted and enthusiastic. As many students know, compared to other university courses, Medicine can be ‘cliquey’ and as semester passes by, it can seem difficult to make new friends once everyone has settled into their own groups. If you are in the same shoes as I was, it is easy to use study to escape the insecurity and anxiety associated with the stress of the course.

 

Eventually, I decided I would be the one who had to actively get to know my peers, even if the thought of making small talk was something I dreaded. I did not want to make superficial relationships just for the sake of making friends in my course; rather, I decided to get to know people who I felt I could ride out my medical journey with. When you find people you can click with you don’t feel the need to change yourself to fit into ‘the group’, rather you feel comfortable being your complete self around them. Thankfully, I have a small but close group who I can study, party and have fun with. Get involved, stick around after classes and lectures, go to events and even if it seems lonely, you are not alone with this feeling.

 

It is important to note that medicine can be one the loneliest professions. It can be difficult to maintain long-lasting friendships while studying full time at university for long hours, continuing into residency and clinical training. As much as it is rewarding, medicine is a demanding and competitive career where much of your study is reliant on working and spending time alone.

 

We all know medicine is a hard and stressful course, so we have to do everything we can to look out for one another. I encourage you all to check up on your friends and to be inclusive and welcoming. Although you may be comfortable in your bubble of friendship, go to events and get to know new people, approach your peers if they look like they would like some company and shoot your shot with the person you wrote a MLL about, because we are all in this long journey together.

 

 

 

 

 

 

Humans of Medicine Issue #1 Featuring: Maya Moses

Welcome to our inaugural addition of Humans of Medicine!

Our first featured human is a 4C medicine student, a pro-vaccination advocate and a previously unvaccinated teen – Maya Moses

 

Tell us a bit about yourself

I grew up in Mullumbimby, which you may recognise as being number 1 on that list of “places with the lowest rates of vaccination in Australia” that always seems to be in lectures about vaccines. It is a very alternative area, which has some really awesome aspects to it, like being very socially progressive and ahead of the curve on environmentalism. It does have some really negative aspects like measles outbreaks and giving us Iggy Azalea.

Despite the sometimes science-sceptical nature of people in my hometown, I’ve always been very drawn to it, and rational explanations for things. I’m a very firm believer that a scientific explanation always makes something more interesting and magical, rather than detracting from it. Ironically the only science I didn’t do at school was biology, and I got really queasy during the dissections you do in like year 9 or 10. Somehow, I just decided in about year 11 that I wanted to be a doctor and applied for Biomed at Monash.

I would say at the time it was a pretty arbitrary decision when I made it, but I really love medicine and find it super interesting. You can take it in a lot of directions which I appreciate. There is always more to learn which is kind of awful and amazing at the same time.

Tell us about your vaccine journey

So, at the time I was born my parents were pretty much only exposed to anti-vax rhetoric and so didn’t know much better. When I was a year old I got whooping cough, and thankfully my parents reconsidered their views. You might think that’s how anyone would react, but I do have friends who had the same experience as me, and their parents are still vehemently anti-vax.

My brother, who is 10 years younger, got vaccinated and at the time my parents attempted to start catching me up on vaccines. I, however, was resistant to it because I was afraid of the needles. The first vaccines I got properly were the ones you get in high school.

I remember always being pro-vax, but I was a bit slow to get them done because of my mild needle-phobia, and the costs associated with it. But I did need to get them done for medicine and that gave me the final push. It was surprisingly a lot more confusing to navigate than I had expected.

Why do you think some people are against immunisation?

Some people – your tinfoil hat types – are pretty much against anything mainstream. I think these people are the most vocal, but also the minority. I believe most people are just scared, and if you’re scared and uncertain about a particular action it is easier to not do, than to do. A lot of fear mongering and very biased “science” from strong anti-vaxxers creates this hesitancy.

It’s easy to think “the truth is so obvious, how can’t they see it”, but a lot of people don’t learn how to navigate scientific evidence and filter out which sources are reliable. A lot of people don’t really know things like dose-response, or relative risk, or risk-benefit analysis so they’re much more prone to believing the misinformation around vaccines.

How do you think we as future doctors can help get people vaccinated?

Educate them! And do it nicely and respectfully. If you talk to an anti-vax parent and act like you know what’s best for their child, and they don’t, they won’t ever listen. It doesn’t really matter how right you are, if you can’t communicate it effectively.

But also educate yourself, be prepared to answer the questions people have, and know how to help someone get vaccinated if they want to. I had a doctor print off the infant vaccine schedule for me and that was the whole consult – which was useless to me as an adult who had a very short time frame to get vaccinated (before med started).

If there was one thing you would do differently back in first year what would it be?

I think the obvious answer is always “study more”. But really, I’d tell myself to eat better. I get a lot of pleasure from cooking and eating nice food, and I didn’t do that at all for first year. First year is taxing, mentally and physically, and it’s a relatively easy form of self-care. It doesn’t have to be gourmet meals but make it diverse and nutritious if you can.

What advice would you give to first year medical students?

Carrying on from the last question, eat well. But also, find what you enjoy and study that first. Most people never cover all the content, and don’t save what you enjoy until last thinking you should tackle the hard stuff first. You may never get to your favourite parts, and medicine is a marathon – you’ve got to enjoy it.

Also, for graduate entry kids, the staff at Churchill are incredibly supportive if you ever need it. Especially Shane, who is a gem.

What speciality do you want to do?

Radiology! Which people always are shocked by because my strongest skill is usually bedside manner, and not anatomy. I’m actually taking a break this year from my studies and doing some research with the Radiology Research Unit at Alfred Health.

Pineapple on pizza, yes or no?

Definitely yes, pineapple on pizza to the grave.

A Lesson in Shark Physiology

By Jasmine Elliot

Moving. From lectures to tutes to study to home to work. From ward rounds to volunteering to that friend’s 21st party to spending time with family. We’re ticking off our to-do lists, reaching deadlines and staring at our rainbow google calendars.

If you’re like me, you feel anxious or guilty when you’re not working towards something, with busyness an undying static sound in the background of life. It sounds counterintuitive but being busy has always been a bit of a coping mechanism, with the hope that if I stayed busy enough, the rest of my life couldn’t catch up with me.

Some of us feel a little like sharks, with motion filling our ‘gills’ with oxygen and standing still associated with a feeling of asphyxiation.

Somewhere in a downward spiral of procrastination, I did some research on shark physiology…

Fun fact #1: Not all sharks have to move to keep breathing, in fact, only 12 in 400 species do. The oldest sharks breathe by ‘buccal pumping,’ and spend time resting at the bottom of the ocean- some do both this and ‘ram ventilation’ (the type of breathing that requires motion).

Fun fact #2: We aren’t sharks. We don’t have gills, don’t breathe underwater and while our attention may be drawn to swimming dogs, we probably don’t want to eat them.

Sharks aside.

Some of us thrive by being busy, it gives us a target to shoot our metaphorical arrows at… but sometimes there are too many targets, our arms get sore and our arrows start splintering. We’re still hitting the targets, but not getting the bullseyes. From a practical standpoint, we’re not doing as well. From a more personal one, we become unwell.

Burn out is something we hear so often about, but often don’t consider properly; we know that ‘burnout is a symptom of burnout,’ but what does it actually look like past a mark in HEP on a preclin exam? It’s when I’ve measured my life by a paralysing never-ending list of tasks, paying no attention to my own mental or physical health which inevitably deteriorated. The list of tasks lost meaning – I was chronically stressed and at the end of year 12 I had nothing left to give to myself or others.

But it wasn’t study that pushed me to this point, it was my voluntary busyness. I recently read a report that people don’t enjoy spending time alone in a room with nothing to do but think. Many would rather do something than nothing – even if that something is nothing. These people opted to receive an electric shock during this time alone – an electric shock which they would pay $5 to avoid. I’m not saying getting involved and having a full life is that same as choosing an electric shock. But I was at the point where I knew that my overcommitment was detrimental, yet I kept pressing that electric shock button.

As medical students now and as medical professionals tomorrow, we’re undoubtedly busy people. But I think this notion of “crazy busy” is a cult that is so difficult to escape from. We’re defining ourselves by what we do and not how we’re doing. We answer ‘busy’ to ‘how are you?’ as if this gives some reflection to our internal being.

In a world where everything is moving, stopping for a moment might feel synonymous with not breathing but unscheduled time isn’t meaningless, nor does back-to-back scheduling enrich ourselves.

Idleness gives us the opportunity to check in with ourselves; to reconnect with our targets, replenish our arrows and restring our bows. This article is probably one of many tabs you have open right now. I would encourage you, at some point, to close all of these and take a minute or two to stop and breathe. Bake something, go for a run, mindlessly float around the internet. It’s time we applauded people for looking after themselves rather than wearing busyness as a badge of honour… because we aren’t sharks.

Idleness is not just a vacation, an indulgence or a vice; it is as indispensable to the brain as vitamin D is to the body and deprived of it, we suffer a mental affliction as disfiguring as rickets.

-Tim Kreider

 

 

Advice from one very tired person to another

By Nicola

Oh, sleep… that really great thing we all wish we got more of! This week’s topic is all about sleep, it’s function, and some tips to help get more of it. We’re going to get educational here, so buckle in for some good ol’ VIA revision that will hopefully convince you to stop studying/watching Netflix/playing LoL and get some shut eye.

Sleep has three main important functions. One, NREM (non-REM) sleep is for restoration and repair, it allows for tissue repair and energy recovery. Two, REM sleep has a big role in memory consolidation* (*pro-tip: study something really important just before bed!). Three, sleep overall is a method to conserve energy and hence is a protective mechanism, something we can observe in hibernating animals.

When we don’t get enough sleep (which, mind you, is so often with all of us…), there are a plethora of consequences that accumulate. We have the real obvious one – we don’t perform as well the next day, yawning through a 8-10 hour day of placement and lectures, and making more errors in seemingly easy tasks. There is an increase in our sympathetic nervous system drive, which over time predisposes us to hypertension. A change in dietary and hunger hormones causes a higher appetite and probable weight gain. Lastly there is higher levels of nocturnal cortisol secretion which can lead to insulin resistance.

Have I convinced you to go to sleep yet?

The balance between our sleep drive and our wake drive (i.e. the Circadian rhythm), plus the role of melatonin, promote sleepiness when we need sleep and will wake us up when we need to get up. Things like, having varying sleeping and waking times make it difficult for this homeostatic mechanism to work effectively, explaining partially why sometimes we wake up feeling absolutely awful (some of it might also be because it’s 5:30am and we need to be on ward rounds by 7am). This kind of imbalance is seen with shift workers or in jet lag, and have been demonstrated in a multitude of studies to be associated with impaired attention, poor decision making, mood alterations, and even higher incidences of cancer long-term.

How about now? Are you feeling sleepy?

One of the biggest contributor to our poor sleep patterns, other than staying up to all hours studying, is being on our screens too late. The effect of blue light on our Circadian rhythm and melatonin secretion has been researched by Harvard University, and even dim light can mess it up. Blue light isn’t all bad though, during the day it’s awesome – boosting attention, improving reaction times, and mood. With blue light in our faces all night, our poor brain thinks it’s still daytime.

But just filtering out our blue light emitting screens isn’t going to solve all of our sleep issues, it helps a lot though. The best thing to do is have great sleep hygiene. This is defined as “recommended behavioural and environmental practice that is intended to promote better quality sleep”.

Here’s a (not exhaustive) list of things which are associated with a better night’s sleep:

  • Sleep scheduling, this is having a set time to fall asleep and wake up every day. This is difficult with the changing schedule of clinical placements and classes, but I found that at least trying to get to sleep at the same time every night helps!
  • Aim for that 20-30 minutes of exercise every day, but no later than a few hours before bed. You get all the fun, no-metabolic-syndrome-benefits of exercise but it’ll also tire you out enough to sleep.
  • Meditate! (I am so so so sorry that pre-clin ruined it for you, I promise it’s good). Apps like “Calm” or “Headspace” have specific guided sleep meditations.
  • Read a book before bed (and I mean a paper back one, e-books have no place here).
  • Avoid caffeine later in the day. Say… no later than 3pm… I know, shocking right, but that stuff hangs around in your system for ages! That includes caffeinated teas too! It’s suggested to not have any caffeination 6 to 8 hours before bed.
  • Try and have your bedroom for sleepy times and sexy times only, no study times. Again this is super difficult if you’re in student accommodation (read: a shoebox), but maybe try studying at the library or in the lounge room.
  • Don’t lie in bed awake, get up and do something else and come back to bed once you’re tired.
  • Listen to a sleep podcast, this is a really good one – Sleep Restore.

Good things come to those who wait – change isn’t going to happen overnight. Sleep hygiene and consequently improved sleep is a habit you need to work on. Did you know it takes approx. 4-6 weeks for form a habit? Good luck, and enjoy your new-found good nights of sleep 💤

 

P.S. in all seriousness, if you’re having trouble with getting to sleep, staying asleep, or having daytime sleepiness, especially after trying the above tips, please see your doctor 🙂