How to HSM: The Meteorologist

By Anonymous 

What is the most important way in which care of a patient is coordinated between the health care professionals working in this clinical unit?

The sudden crack of thunder rolled over the hills in the distance. Out of the window the storm raged on, the violent swinging of the tree branches and pelting down of rain was punctuated by the odd flash of lightning. The psychiatrist sat back in his chair, leather loafers rested on his desk, staring out the window, mesmerized by the vigour of the storm. It was not uncommon to catch him in moments of deep contemplation like this.

I lurked at the threshold of his office, unsure of whether I should interrupt. I started to raise my hand to knock against the open door, but he spoke before I had the chance to do so. “Take a seat,” he said, not turning away from the window. I took a seat at his desk and sat for a moment waiting for him to prompt further conversation. He slid his feet off the desk and swivelled his chair towards me. “You see that out there,” he said motioning to the spectacle outside. I nodded, unsure where this was headed. “That,” he continued, “is the human psyche. Majestic, unrelenting, but in part, destructive.”

“Uh huh,” I responded. After a final glance out the window, his attention returned to me and he asked:

“So, what can I do for you?”

“Well, I just had another question,” I replied, “about how patient care is coordinated amongst the team at this clinic.”

“Right,” he nodded, a hint of a smile playing on the edges of his mouth, “I’ve always been quite fascinated by how mundane the questions medical students ask me are.”

“Well its not really my question, it’s for-”

“Well the short answer is that its not coordinated,” he cut me off, “its all really very haphazard.”

“Okay. But surely an attempt at organizing is made-”

“Well we try to organize,” he said, cutting me off again, “but this is a community clinic for psychosis. Psychosis, by nature, is a deeply disorganized condition. I mean being disorganized of thought and speech are in the DSM criteria. Its very challenging for a psychotic patient to adhere to appointments, scheduling, treatment and medical advice. It really undermines most of our attempts to organize.”

“Well then,” I fought on, “so what initiatives are made, however ineffective they may be?”

“Well our case workers and psych nurses to a stellar job,” he explained. “They stay in touch with patients and their families, track their treatment and progress, and organize appointments accordingly. They do house visits, provide counselling when needed, and can seek out community initiatives, job seeking services and housing for patients when the timing is right.”

“So how does that relate to what you do?” I pushed.

“They collaborate with me.”

“In what capacity?”

“In a collaborative capacity.”

“Okay…” my voice trailed off. This was proving to be quite difficult. I was beginning to think he was deriving a sadistic pleasure from this intellectual hazing. I shifted uncomfortably in my seat. Maybe I ought to quit while I was ahead. But of his own accord he continued:

“Think of it like this,” he gestured at the window again, “psychosis is the storm. The patients are the residents of the affected area, they need to be evacuated. The case workers and psych nurses are the SES, they know how to escape in a logistical sense, but me, I am the meteorologist. I can foresee and identify the illness just as it begins to roll in. I can direct their efforts.”

“That’s quite poetic,” I nodded in agreement.

“I have to write that down,” he began to search his desk for a pen, “that has to make an appearance in my memoirs.”

“Thanks for answering my question,” I said as I began to move towards the door.

“Anytime”

“And good luck with the memoir”

“I’ll send you a signed copy,” he responded with a sly smile. I ducked out of his office and hurried away with a sigh of relief.

A Virtual Rally

By AMSA Crossing Borders 

On Sunday, April 5, AMSA Crossing Borders called for refugees and people seeking asylum to be released from immigration detention centres into community detention, in an effort to protect this vulnerable population from COVID-19. Hundreds of Australian Medical students engaged in the virtual Palm Sunday Rally. Supporters shared photos of themselves holding up posters with the hashtag “#detentionharmshealth” on social media platforms in lieu of marching in person. The rally also went global, with Medical Students from many countries including Bangladesh, Qatar, Rwanda, India, Tajikistan and Indonesia joining through the International Federation of Medical Students Associations.

This year’s rally focussed attention on the impact of COVID-19 on refugees and people seeking asylum in Australia – particularly the risk of spread in detention centres and income support for those in the community. [1]

AMSA believes that all communities have the right to the best attainable health. In the current pandemic, the health of refugees and people seeking asylum in Australian detention facilities must not be neglected. AMSA therefore joins the Australasian Society for Infectious Diseases (ASID), the Australian College of Infection Prevention and Control (ACIPC) and Doctors for Refugees in calling for all detainees to be released from detention urgently to prevent rapid Covid-19 transmission. [2]

This is in line with AMSA’s policy on Refugee and Asylum Seeker Health, which takes the position that “it is unacceptable for Australia to sacrifice the physical or mental health of any refugee or asylum seeker in order to achieve other political or policy goals,” and

“The Australian Government must cease its practice of mandatory, prolonged, indefinite detention, in order to minimise the detrimental effects on refugee and asylum seeker health.” [3]

People in detention facilities are one of the groups most at risk of contracting the virus. The close proximity of living spaces and shared facilities is not conducive to adequate social distancing between detainees. As of 29 February 2020, there were 1440 people in Australian immigration detention facilities. [4]  Furthermore, the employees of the centres risk transmitting the virus between the detention centres and the wider community.  As Professor David Isaacs wrote in a recent petition to the Department of Home Affairs, “Failure to take action to release people seeking asylum and refugees from detention will not only put them at greater risk of infection and possibly death, it also risks placing a greater burden on wider Australian society and the health care system.” [5]

Current measures including “increased cleaning of communal, high-traffic areas and common touchpoints” [6] are, in our view, insufficient to prevent the devastating impact of an outbreak in any of the centres. The “absolute minimum necessary step” according to Australian Infectious Disease experts is that “detainees should be held in single rooms with their own bathroom facilities.” [7] Doctors for Refugees have an open letter with 980 signatories at the time of writing, calling the Government to start “immediately using alternatives to detention to provide those who are currently in immigration detention with appropriate alternative accommodation in the community.”[8] AMSA endorses the expert opinion that release is the most effective way to mitigate the health impacts on detainees and the public health of all Australians.

The Australian Medical Students’ Association (AMSA) is the peak representative body of Australia’s 17,000 medical students. AMSA’s Crossing Borders for Health is a transnational medical student initiative which aims to remove barriers to health care for refugees and asylum seekers.

Find out more about us and the Palm Sunday Rally through our social media outlets:

FB: AMSA Crossing borders

Instagram: @amsacrossingborders

[1] Palm Sunday Justice For Refugees – Virtual Event – 5th April 2020 – Social Media campaign and Online Actions. Refugee Action Network, 2020, April 4. Available from: http://www.refugeeadvocacynetwork.org.au/?p=1820

[2] Holt, R, Vasefi, S. ‘We are sitting ducks for Covid 19’: asylum seekers write to PM after detainee tested in immigration detention. 2020, March 24. Available from:  https://www.theguardian.com/australia-news/2020/mar/24/we-are-sitting-ducks-for-covid-19-asylum-seekers-write-to-pm-after-detainee-tested-in-immigration-detention

[3] Policy Document Refugee and Asylum Seeker Health Position Statement. Canberra: Australian Medical Students Association: 2019. Available from : https://www.amsa.org.au/sites/amsa.org.au/files/Refugee%20and%20Asylum%20Seeker%20Health%20%282019%29.pdf

[4] Immigration Detention and Community Statistics Summary, 29 February 2020. Department of Home Affairs: 2020, February 29. Available from:

https://www.homeaffairs.gov.au/research-and-stats/files/immigration-detention-statistics-29-february-2020.pdf

[5] Australian doctors call for refugees to be released amid coronavirus fears. SBS: 2020, April 2. Available from: https://www.sbs.com.au/news/australian-doctors-call-for-refugees-to-be-released-amid-coronavirus-fears

[6] Moore, S, Ton, W. Palm Sunday refugee rally goes online. AAP: 2020, April 5. Available from https://www.news.com.au/national/breaking-news/advocates-rally-online-for-refugee-release/news-story/cb1badfa60f92ae268761502865cdfbb

[7] Davis, J, Russo, P. ASID ACPIC Joint Statement COVID-19 and detainees. Australasian Society for Infectious Diseases: 2020, March 19. Available from: https://www.asid.net.au/documents/item/1868

[8] Open Letter to the Australian Government: Controlling COVID-19 in Immigration Detention and the Community. Doctors for Refugees: 2020, April 7. Available from:

https://docs.google.com/document/d/16M02AA9KvM1G45JM3iiP4xpP9JuAOzIEac8mneL03ms/edit?pli=1&fbclid=IwAR2rHeKMvISDkwape3QiSkTS3ae5UDD8SpY6946Sohw8KRSYquzdy6JcvcM

 

‘What Did You Have For Dinner?’

By Tracy Nguyen 

“What did you have for dinner?”

If this question seems strangely familiar to you, it’s probably because, like me, it’s what your mum asks you every day at the start of your calls. And of course, on days where we call several times, there would be the variant of ‘what did you have for breakfast?’ or ‘what did you have for lunch?’.

Being an international student means I am living very far away from home for the first time in my life and can only go back once or twice a year. Even after four years spent in Melbourne, I can never really say for certain that I no longer feel homesick. Fortunately, with how busy med life is and thanks to all the support I have from my beloved friends, the homesickness is only temporary, and  doesn’t prevent me from enjoying my life in Australia. It is more like a reminder of the fact that I now have two places to call home, with even more people who care about me.

In the early days of arriving in Melbourne, I would cry at the moment I heard my mum’s voice over the phone asking me ‘what did you have for dinner?’. Instead, I now excitedly share photos of my simple meals with her, and just reassure her that I am not starving due to COVID-19. Although things have changed significantly since the day I left home, something that hasn’t changed is how much my mum still worries about me.

I know that there is nothing exciting about the repetitive recipes that I make throughout the week, but that is just the way our conversations always start. There will always also be a series of other classic questions about the weather, whether I wear warm enough clothes, and reminders to get enough sleep and to drive safely.  Strangely enough, I never grow sick of all these familiar questions – it’s just her way of showing her love and care, and hearing her concern after having a long, busy day warms my heart. It somehow makes me feel like she is always there by my side no matter how far apart we are physically.

 I’m sharing this story about my homesickness as a reminder that it is normal to feel upset, lonely, homesick, and stressed. Whether you’re a first year or final year, an international or local student, living far away from home or spending time with your beloved family, this is a difficult time with uncertainty and disruption for everyone, and we all need to time to adapt to this new situation.

The most important thing to remember is that no matter where you are, you should always have access to some form of support. Family, as always, will be an amazing source of comfort and will always be there for you whether or not you can meet them in person. With the help of modern technology, social distancing is much more of a physical effort rather than a social one; it does not sever the ties between us but rather brings people together and further emphasises the significance of the social connectedness that we may sometimes take for granted.

So take this opportunity to spend more quality time with your family, call some good friends you may not have had the chance to chat with in a while due to your busy schedule, and make sure they all know you are thinking of them. And of course, be ready to start the conversation with the question “what did you have for dinner?” 🙂