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 🙂

An Uncomfortable Truth

By Natasha Rasaratnam 

I was lucky. I was lucky that my grandparents left Sri Lanka to seek a better, more hopeful future for their children. I was lucky that I did not have to grow up in a war-torn country whose scars are only beginning to heal. Yet for those who lived through the 25-year civil war, the trauma is everlasting, hiding under the facade of a country that wants to forget the legacy of its conflicts. It is no surprise that after these decades of violence, mental health issues have risen dramatically in Sri Lanka. Yet this spike has not been adequately met with appropriate treatment and education. At its core, this crisis is underpinned by an entrenched cultural stigma towards mental health conditions.

Stigma is when there is a negative perception of someone based soley on them experiencing a mental health issue. More often than not, stigmas aren’t born from malicious intent rather due to a lack of understanding yet nonetheless they create a barrier for people to seek help. In Sri Lanka, it can sometimes be thought that having a mental illness or being associated with someone who does, negatively affects your employment and marital opportunities. This is exacerbated by a lack of mental health workers and information that is not readily available to the public. As a result, particularly in rural areas, it is more common to take people to faith healers or temples rather than seeking professional help. There are also cultural associations that link these illnesses with the notion of ‘karma’ and resulting in them being considered as fate with blame being laid on the person themselves. There are also some views that mental illness simply doesn’t exist and people “just need to get on with it”. This dismissive perception associated with mental illness is deep-rooted and spreads beyond South Asia to immigrant communities worldwide.

Closer to home, despite all the ‘R U OK days’ and mental health awareness events, there are still communities in Australia in which mental health is a stigma. Although we’ve made vast improvement to tackling the stigma surrounding mental health conditions, we must not be complacent in thinking we have completely solved the problem.

Growing up in a migrant community has its ups and downs. Everyone is friendly and wants to know about you… maybe too much at times. Coming from a Sri Lankan background, it is not unusual to hear older members of the community dismiss depression as a weakness of character and not a valid health condition. Similarly, suicide is often mentioned in hushed tones, more a source of shame rather than the tragedy it is. Of course, these attitudes cannot be generalised to all members of the community and I am lucky to be surrounded by a family that understands and values the importance of mental wellbeing.

Yet the consequence of this underlying stigma can have devastating effects on those already isolated due to their mental health. A friend was told to “just pray it away” by family members as a cure for her severe depression. Although faith can be a healing force, the dismissiveness of these comments resulted in a toxic environment at home of further isolation and distrust. Mental health stigmas not only stop people from speaking out about their health but can also worsen the situation perpetuating a vicious cycle.

These perceptions are so ingrained in the older generations of migrant communities it’s difficult to weed them out. Unlike Sri Lanka, Australia has the resources and educational tools to reform and erode taboos such as these. However, despite their admirable aims events run by organisations such as Beyond Blue and Headspace can have little reach to address older members of the community.

To an extent this is also a generational problem rather than a cultural one. Hence, it falls upon us as the next generation to strive to engage in a conversation with our parents, grandparents, aunts and uncles about mental health.  For all their flaws, migrant communities are tight knit, and it is this support which can be utilised to help those struggling the most rather than demonising them. Cultural leaders have the power to make change and it is only through our conversations with them that we can start to see this stigma being overcome. We’re the lucky ones – we have resources and information at our fingertips. Our communities’ ignorance can no longer be an excuse.

 

Kicking Goals for Mental Health

By Kit Ming Foo

March: the time of year when footy fans around Australia rejoice after 6 months in the wilderness finding creative ways to spend their weekend. However, when the first bounce occurs, all eyes are on the players. Every little thing that they do is examined under a microscope. Every goal is celebrated but also every dropped mark or skewed kick is met with sighs of disgust and for some, even boos. Such is the life of an AFL player, where everything they do is in the spotlight, good or bad. Everything gets scrutinised and what the fans and media fail to realise is that at the end of the day, there is still a human being behind these athletes, someone who has put in so much to end up where they are now.

 

On the 17thof December 2018, news broke that one of North Melbourne’s players Majak Daw, had an incident on the Bolte bridge where he fell and sustained serious injuries. Suddenly there was an immense focus on not only Majak’s well-being but also that of the wider AFL population. In the months leading up to this incident, many other players such as Richmond superstar Dustin Martin discussed their battles with mental health, yet many felt that not enough was being done by the central administrative body to look after the wellbeing of the players. This all changed in the aftermath of Majak’s bridge fall as the CEO Gillion McLachlan introduced a mental health manager for the league and highlighted that mental health was the “No 1 issue for the playing groups”.  Whilst the AFL has taken some encouraging steps in addressing this issue, it is unfortunate that the catalyst for change from the status quo was such a devastating event.

 

Now some of you may be thinking, this is the Auricle, a medical student journal so why is AFL being mentioned? Taking a closer look, you can draw many similarities between being a player in the AFL and a member of the medical profession. Many of the things that were mentioned above apply to medicine too. Both professions require high levels of dedication to be successful. Both come under heavy scrutiny when things go wrong. Both have the capacity to place massive amounts of pressure on players and practitioners alike. Finally, both have started the long journey to make mental health a priority.

 

In recent years, prominent doctors have started social movements such as Crazy Socks for Docs. With this, medical student mental wellbeing has also been brought into the spotlight and this is something that needs to be taken seriously. For many of us, this is a topic that we have all heard about but until we personally have to confront it, either through our own                    experiences or a friend’s, it is in a way something that is hard to relate to. Problems with mental health are actually more common than we think. A study published by BeyondBlue in 2013 involved the responses of 1,811 medical students and revealed that around 10% had very high levels of psychological distress. This is three times as much as the general population, so why do we not hear more people in the medical profession talking about their struggles with mental health?

 

Much like AFL players, few medical students ever share their stories publicly, meaning that countless more go through these battles in secret. Admitting to one’s own mental health struggles to the world is not easy, let alone telling the people closest to you. As a result, like many footy players, medical students try to hold it together whilst they are in the eye of the public, whether it is on the hospital wards or in tutorials. Because of this, a facade is put up, tricking everyone into thinking that everything is fine, when in reality the opposite is true. If a star player like Dustin Martin can do it, so can many medical students.

 

The aim of piece is not to say everyone should have the courage to tell the world everything, but rather to try and make having a conversation with trusted friends easier. We as a profession need to improve the way that we all think about mental health. We need to accept that it is a problem that all of us have a responsibility to deal with. Breaking down the barriers to seeking help is one way to start and to do so we need to remove the stigma that many of us associate with doctors asking for help. Our profession is built on being empathetic towards our patients but why are we not the same towards our colleagues when they are in times of need? If we do not change our response to this, the topic of talking about mental health will never be made easier. People will continue to avoid seeking help and this problem will continue to grow. Such changes in mentality obviously take time to transpire and it is unrealistic to expect a change overnight amongst the medical profession. However, much like how we have begun to see shifts against bullying in the workplace and safer working conditions, everything needs to start somewhere and we all can have a role in championing a change to make talking about mental health easier.

 

Medicine is a team game and much like being on the footy field, we need to look out for our mates. Battling issues with mental health can make a person feel isolated and often the onus is on them to make the first move and talk to someone about it. At the end of the day there is truth to this as it really is up to the individual and whether they want to share their experiences. Sometimes though, people are just waiting for an opportunity to open up. Simple questions such as “are you alright” or “is there something that you want to talk about” may be all they need. Let’s all make sure that we look after our friends and get through this season together.

 

The Cannula Volume One

Editor: Idew Wokefield

BMedSci Insight

New research by medical students determined the optimal free food to faculty disciplinary meeting ratio. The non-blinded non-randomised ‘randomised control trial’ was held over 8 weeks and involved a cohort of 100 third year medical student participants at [De-identified] Hospital. Participants were given the choice to grab a slice of pizza, fruit or ‘whatever they could get their hands on’ from a ward meeting or conference. In total the experimental group had participants ranging from obtaining 1 slice of pizza a week to 2 whole pizzas, 3 sandwiches and a slice of garlic bread. Side effects experienced by the experimental group included 5 participants forced into a research paper seminar, 6 roasted by consultants and 12 experiencing faculty disciplinary meetings. Side effects experienced by the control group included 20 experiencing FOMO for missing free food and 1 unfortunate participant that was roasted by an intern for standing within 1 metre of a tray of chicken nuggies. The results show that there is an exponential relationship between ‘amount of food obtained’ and ‘number of faculty disciplinary meetings’ but there were a few outliers from the experimental group that had escaped the notice of faculty. Comparing ‘number of faculty disciplinary meetings’ against ‘general wellbeing/ number of nights drunk, there was no correlation. Therefore, the results of the experiment can be summed up by the words of one participant, ‘Faculty disciplinary meetings are a small price to pay when you get provided three meals a day at the hospital’. Shortly after the statement, he was expelled from the hospital after ‘accidentally’ eating the Clinical School Dean’s lunch.

[De-identified] Hospital In-focus

A new report has found [De-identified] Hospital productivity has decreased by 50% after the introduction of PebblePad. We have an exclusive breakdown of the situation from one doctor that did not want to be named, ‘It was 12pm and I had just finished up the ward round when I was accosted by a gang of medical students after a cannula. After multiple successful attempts of acupuncture and one successful cannula, I was getting ready to head off to lunch when they pulled out their phones on me. I waited through my lunch break, my unit meeting and a MET call for the students to get PebblePad ready and in my haste, I accidently closed the browser. I left the hospital in the dark that day’. An emergency hospital executive meeting was called to discuss how to deal with the threat of increasing use of Pebblepad by medical students. The most popular agreed option was the ‘pretend they don’t exist’ solution which is practised by 20% of doctors and 80% of neurosurgeons. This option is also known as the ‘neurosurgery triad’ where medical students are never spoken to, looked at or acknowledged to exist. Other solutions discussed included the expulsion of all medical students including students that have never used Pebblepad and the introduction of ‘Safe Pebblepad Use Rooms’ where Pebblepad use by medical students is supervised.

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!

 

“So tell us, why do you want to become a doctor?”

In the months of my final year of school, the question of ‘Why’, of ‘Why medicine’ occupied my mind with an almost irritating intensity. I was in two minds regarding this question, seeing it as both deeply important and as yet another obstacle during that frenetic period, something for which an appropriately polished response had to be crafted. From the paranoid searching on annoyingly cheery sites with titles such as ‘What med schools love to see in applicants?’ to a final medentry ‘workshop’ before the impending interview, I’d formed a rigid notion of what the ideal reasons ought to be. Perhaps mistakenly, although I would say not uniquely, medicine seemed akin to a fortress of sorts, to which admission was reserved for the near saintly, those of faultless moral character, to those fuelled by purely unselfish motives, in short to those among us for whom this was a vocation, an intense, abiding calling.

 

In the face of these rarefied ideals, I felt the sharp sting of unworthiness, the feeling that I was an alloy of jostling motivations that couldn’t possibly be allowed entry. As I look back now, I think that arriving at the decision to really pursue medicine was, at least in the beginning more of a process of subtraction and elimination rather than one arising out of a deep-seated conviction. I knew what subjects I enjoyed and tended to do well in, and those, to put it charitably, in which my aptitude left a little to be desired. Considering this, I knew I had little interest in pursuing a math heavy field such as engineering or something similar. My passions and perhaps just as importantly, my strengths (I hope your eyes haven’t just glazed over) resided in the bio-chemical domain, in that ‘soft machine’ of the human body. It was this fascination, part scientific and part motivated by a certain paranoia about the inevitable propensity of cogs within this machine to malfunction that impelled me, to commit to the path of medicine. However, this interest was the original impetus, by choosing medicine, I wanted this nascent passion to intersect with humanity. To use the little knowledge I had or perhaps I should say still have, and build upon it, in hopes that ultimately it may be of some use to someone, that it may ease their suffering or sickness, in hopes that perhaps it may make – and I use this well-worn phrase unashamedly- a difference.

 

However, this doesn’t represent my motivations in their entirety, it would be wrong of me to cut out the less lofty reasons for my decision; in this case let us not separate the wheat from the chaff. To admit that one might in some small part be driven by the likelihood of a monetarily rewarding profession (eventually) or by the prospect of healthy career options, although after an ominous lecture concerning the internship crisis I am not so sure, was close to profane. Yet I recognise motivations such as these along with a subtle familial encouragement did play a role, a junior one but a role nonetheless and I would venture to say that these more material considerations may have in part influenced others too, at least judging by the number of biomedical memes we make. However, I don’t mean this as criticism, we as medical students or as prospective medical students do not live in a vacuum. Instead we’re shaped by the environment around us, by familial expectations: hopes that their children might enter a few select professions are so common in certain families, perhaps in some of those from a migrant background that they border on sociological phenomenon, by professional aspirations, by financial prospects, these can all seep into us via a sort of osmosis as we decide what it is we want to do with our lives.

 

Yes, it’s true that being solely or largely motivated by more worldly reasons, those of security or prosperity would be unwise in the long term as the path to and of medicine is lengthy one. A path of training followed by more training, of assessments succeeded by more assessments, in short, one of ultimate deferred gratification and if someone doesn’t feel a degree of passion for the material and its application in aiding others in their time of need then they’re at risk of deep dissatisfaction. A worrying prospect for both the individual and especially their patients.  However, I maintain to ask that we completely void ourselves of those prior concerns is requiring, in my opinion, the impossible. It is asking us to be a little more than human.

 

On a final note, I would add that although I still hold the core of those same motivations, I did prior to beginning medicine, in the months since then, something else has been added into that original foundation. Through seeing and interacting with patients if only in a rather limited capacity, I am at times filled with a terrible, and I don’t mean that in the pejorative, sense of responsibility at what will be expected of me in the future. That I will be privy to individuals at their most vulnerable, through sickness and malady and that they will place a dizzying amount of trust in my and the profession’s ability to steer them through their illness. It is the knowledge that at this moment there are people, some well and some ill, some young and some old and some who are as yet unborn, none of whom are known to me but whose paths may one day cross with mine that impels me to continue. It may be a brief encounter or a more prolonged liaison, however in that time I will have to honour and live up to the trust that has been placed upon me.

 

 

 

 

 

 

 

 

 

Some unexpected lessons on exercise

I have a body that was ideally designed for sitting on the couch. My legs are not all that long, my reflexes are subpar, my cardiovascular capacity is below average, and my muscles are equivalent to Steve Rogers’ prior to his Captain America transformation. Physical education classes at high school consistently resulted in my lowest grades. By Year 11 they had become more of an occasion to gossip with friends, rather than engage in ‘sport.’ So, it’s really by some sort of miracle that I stumbled upon an exercise regime that works for me – and yes, it actually does involve moving.

 

For me the key to starting to enjoy exercise was to completely change my attitude towards it. Sport and exercise have typically been something I was not naturally adept at, and thus typically avoided (subsequent to the fear of failure so often present in perfectionist medical students). My fear of failure had to be overcome. I started viewing the mere attempt to exercise as success. If I was aiming to run five kilometres but only made it to the corner of my block, then I congratulated myself on at least leaving the house in my activewear. My perspective on sport and exercise evolved. I realise now that the only prerequisite to exercise is to move your body – no actual skill or talent is required.

 

After coming to the revelation that yes, we can all in fact exercise, I have gained a few more insights into physical activity.

 

Firstly, exercise is integral to maintaining my mental wellbeing. While many had told me of the benefits of endorphins and the mythical ‘runner’s high,’ I started believing that they weren’t talking rubbish when I regularly started exercising myself. Or more accurately, I realised it when I stopped exercising regularly. An injury had halted my routine for a couple of weeks. Soon enough, my weekly running mileage was being made up for by anxious thoughts running through my head, rather than my feet striking the pavement. Furthermore, it was noted that I was more consistently in a bad mood. I felt wound up and on edge, with an excess of energy manifesting itself through unproductive emotions. As soon as I recommenced exercise this all went away. It was then I realised I needed to exercise to stay sane.

 

Furthermore, exercise provides the perfect opportunity to create a sense of achievement. Since starting medical school, I have found that I more often feel I am sinking under the course content, struggling to keep abreast with the fire hydrant that is medicine. Instead, I have started setting physical goals such as running a certain distance or going to the gym a certain number of days a week. When I achieve these goals, it gives me a meaningful sense of satisfaction that feeds into and nourishes the academic aspect of my life.

 

Finally, starting to exercise has helped me appreciate the importance of taking care of my body and my health. At times, I think we can take our health for granted. I, at least, didn’t realise the strength of the human body, and its incredible ability to adapt to new activities. This is what makes exercise and sport so enjoyable, and this is what can be easily taken away with sickness and ill health. So, beginning exercise has emphasised to me the importance of taking care of my body, to ensure that it can perform to the best of its ability.

 

I can’t pinpoint a reason why I decided to get my body off of the couch and force it to do physical activity, but I am incredibly glad I did. I have learnt about the strength of the human body, the link between physical and mental health, and how one can find a sense of achievement outside of their normal activities. So, while not everyone has the perfect athlete’s physique, I certainly cannot claim to, I believe the benefits and lessons one can learn from physical activity and sports are far deeper and richer than what we may imagine at first glance.

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