Monthly Archives: May 2010

On being a doctor.

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I worked 12.5 hours yesterday, then 3.5 hours today, starting at 0800. I slept 3 hours afterward; my stamina for long shifts has dwindled!

I should count myself lucky though, I used to have to do 14 hour shifts every 3 weeks, plus the whole week. This is the first I have done all year.

It was actually quite a hard day. I had to deal with 2 fracas (fracases? fricasees?). I was reminded that I really don’t like conflict very much. One of them was an old fella who was doing his best to destroy hospital property, without going into too much detail. It was quite a dangerous situation, because I had to sedate the fella, who was trying to assault all of us.

anywho – can’t go into too much detail but needless to say I had a headache at the end of the shift and I needed quite a large glass of wine.

I do enjoy having residents (junior staff) to work with – they bring out my protective instincts and I make sure they get lunch. Plus I like to teach. Which brought me to thinking about some of the lessons I have learned – “rules”, if you like. I thought I would share them here. Some of them apply to a lot of jobs.

  • Most people are alright. They can be snippy under stress, but underneath they are alright and it usually is obvious with a bit of empathy. Perhaps 98% of them are alright. The other 2% of people are arseholes. There is nothing you can do about it other than pick it up early (early diagnosis being the key) and deal with it.
  • More people, maybe another 15%, are stupid. Sorry, this sounds cruel, but I am probably talking to the converted here. Again, realise this and deal with it.
  • Bearing in mind the above, try to never get angry with the patients or families. If I get angry, I walk away. Most of the time. Very rarely I lose my cool. Which brings me to the next point.
  • We are only human. In fact, you realise just how human you are, sometimes.
  • At the beginning of my career, I used to be very upset when people were angry with me. Now I realise that, whatever I do, I can’t control the way people think of me. They will think what they like, and they will talk. Especially when you get a whole bunch of females together – case in point, Nurses. I have learned, since I am friends with a few, that they like to talk. And bitch. And there is sweet fanny adams I can do about it. Best to keep the head held high, and be super nice, because it will make them feel guilty.
  • On that note, I have learned that, to get people to do what you want, it is much more effective to make them feel guilty than to make them feel angry. This particularly applies when dealing with doctors.
  • Plus, honey attracts more flies than vinegar.
  • Empathy and forebearance are good, and I try to have them, but they run out at the end of a hard day. Best to talk to people between 10 and 2. Or if you can’t see the rule above.
  • Murphy’s law: when you do 100 things a day, you probably get thanked for very few of them. You get one of them wrong (that is a 99% hit rate) and that is the thing you focus on. It just helps to remember this. Important to reflect critically on the work you have done eg. ‘how can I have done this better?’ but important to also pat yourself on the back.
  • Because it is such a thankless job we do, as much as I can, I try to thank people and tell them they did a good job, especially after a difficult situation, of which there are many. Case in point; the cops, security guards and nurses that pinned down the fella going apeshit yesterday.
  • The gut. The vibe. The intuition. Whatever one calls it, always good to follow it. It is usually backed up by skill and experience.
  • I don’t have a magic wand or a crystal ball, nor am I withholding any treatment that would be of benefit out of spite or any other thing. This I tell people sometimes, gently. This is usually quite effective.

Those are the philosophical ones. Now are the medical ones.

  • An elderly person with wheeze has pulmonary oedema until proven otherwise. This I taught to an intern over the phone yesterday, who then went on to fix the patient without me having to go to them. Which was lucky, because I was dealing with the apeshit guy, plus another thing.
  • If a person cultures a bug that I have never heard of, their mortality rate is 100%. This is based on my trial with n=3.
  • For an older person, aim to have haemoglobin greater than the person’s age; this gem was taught to me by a colleague.
  • The line between severe agitation and profound obtundation is much, much smaller than I once thought (this is the rule I was thinking of when sedating the apeshit guy)
  • If in doubt, give the smaller dose, because you can always add but never take away – see rule above.

That is all I can think of for now.

Many thanks to youse all for your comments for the previous entry. I am better now.

I have done some therapeutic cooking – I made a beautiful spaghetti bolognese – the ingredients: organic beef mince, tin crushed tomatoes, little tin tomato paste, oregano, salt, pepper, 1 diced carrot, 1 diced onion, 2 diced stalks of celery, a glug of olive oil and the secret ingredient – a spoon of brown sugar. It is not a quick dinner; it needs at least 1 hour on the stove. Plus the other secret ingredient which is a whole lotta love. Plus I also made a bircher muesli for brekky, with frozen raspberries.

I learned a good rule – try and spend as much time eating the food as you did preparing it. I often get hiccups and heartburn from demolishing rather than savouring food. This is a good one for me.

Bloated silly.

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So I am trying to be all cool about myself, just eat well, exercise, don’t worry about it, but 2kg came on over a week. I dunno whether it is fluid or poo or what but now I just feel….I dunno…dirty….or something and my head is a fricking mess.

It did not help that I baked the baked goodies yesterday, plus put chocolate chips in my porridge. I have only had one bickie and 2 little pieces of cake, but had a few little bits of italian baked goods at work today. I even went for a run this morning but I still feel out of sorts.

I am sure, from the outside, I look exactly the same. But on the inside, in my belly, in my head, I just feel all wrong.

Maybe I should pimp my scales on ebay? Smash them to smithereens? Develop an allergy to wine ( have been partaking in a glass every night).

I bleat into the cold, rainy night: could somebody talk some sense into me? Please?

Runkeeper, how I love thee!

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I went for a run this morning with runkeeper. It is like a garmin, but bigger and bulkier and it plays music and talks to me in a benign american female voice!

I had hoped to do 2 laps of prinny but due to laziness hip issues and blister issues I only got 1 and a bit laps around. The good thing was that my pace picks up as I run – it is good to run a negative split. I am nowhere near the 6min km average I need to be at to get a 60 minute 10km, but maybe for the Melb Mara, or I might pick a Sri C race.

So the plan is this:

  • prepare, plan and premedicate before a run
  • tape up blistery areas (different with the new orthotics).
  • Keep podiatrist appointment.

I have bought a couple of books from bookdepository.co.uk – supercheap books with free delivery. You only have to wait a week or two for them (longer if Icelandic Volcanoes are being naughty). The books I bought are “In defence of food” by Michael Pollan, and “Food Politics” by Marion Nestle. They are part of a global push to eat real food (which is in the peripheries of the supermarket) as opposed to edible foodlike substances (diet soft drink, anything by weight watchers). “In defence of food” also casts doubt upon the lipid hypothesis of causation of cardiovascular disease. I don’t remember anyone telling me at medical school to eat less eggs and meat to prevent CV disease, it is just enshrined in our culture and assumed knowledge. However, I do remember a cardiologist singing the praises of olive oil, dark choc and red wine :). And there is the whole trans fats business…..I was in the supermarket with hubby in the butter section, and he looked at the lard with some interest. I told him that the lard would be better for him than most of the so called healthy margarines….

I am cooking dinner for some friends tomorrow night – the menu is as follows:

I shall let you know how said cake goes…I have bought the choccy chips and I dare not open them tonight for fear of pouring the packet into my gob.

Work this weekend…….ugh….but will pay some bills.

Monday musings.

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I had a good weekend – had planned to catch up with a couple of esteemed running colleagues but it was not to be.

I took the mother in law out for some shopping. She has lost weight recently and needs new clothes. When she came back with stuff like what she usually wears (highly pragmatic but not really flattering or feminine), I told her that I didn’t like them and proceeded to pick her out some things in colours she didn’t normally wear (dusky pink, teal, fuschia – not all on the same garment). Surprisingly, she submitted to trying them on. Not surprisingly, (due to my styling skills), she looked good. Hot damn, she had a waist if she cared to show it in clothes that don’t resemble tents. Not bad for a lady in her late fifties. I even convinced her to buy some makeup from Christian Dior, I have been a fan of Maquillage de Monsieur Dior since a giddy encounter at a Galeries Lafayette in Paris. The mascara is Le Bomb. Love the stuff. I even made her buy a colour of lippy that she maintained was too orangey but I thought bought out the roses in her cheeks (nice Pommy skin well moisturised over the years).  Much better than the yucky pinky plummy brown that she likes which succeeds only to wash every ounce of radiance from a person (alas, the selection of wealthy ladies who lunch).

Had some lovely breakfasts on the weekend – an atypical one cos the MIL was here. On Saturday went to Mitte where I learned about the inspired combination of avocado and dijon mustard on sourdough toast (seriously good, ate it again today). On sunday, we all went along to Cafe Two on Rathdowne st in North Carlton – very friendly waitresses, nice brekky and all manner of interesting baked goods (looked at and admired but not consumed).

Had to stay up late on Saturday to pick up Hubby from the airport; he had his exam on Perth. He needed a bit of phone TLC on thursday after his first exam but felt quite good after the second. It is good to have him back. I took the hubby out shopping on Sunday for new clothes for him – he only has one pair after all his others wore out around sensitive areas (near the butt seam). It is rather like pulling teeth as he hates shopping but I usually deal with it by getting him to try on one or two things and picking out the rest and giving it to the saleslady before he can moan “I don’t need that”. Quick and dirty, that is how it is done.  managed not to buy any footwear or clothing items (Ok – picked up a CD and book but they were cheap!!). I have been inspired by Project Kathryn re: Crap I don’t need and playing with (and wearing) crap I already have.

Last night Hubby, his brother and I went to see a documentary at the Nova called “food inc”, which is about the social, environmental and health impacts of highly industrialised food production in the US. Ok that sounds boring but it was really good, trust me.

The exercise efforts have been fairly piss poor over the last few days (i.e. none) but have been a bit achy in the back and hips. I will rectify it soon – promise 😛

I don’t need any more serotonin, I have my own, thanks very much.

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I went to the headshrinker this morning. It is more like a pleasant chat about myself nowadays than hard hitting and uncomfortable self-analysis.

Don’t get me wrong, I love talking about myself, but I have to pay for the privilege. Still, what price mental health, eh? He got the Sassy show back on the road , and I trust what he says. Being a doctor yourself, you have to sort of “hand yourself over” to the doctor and trust them. A doctor who treats themself has a fool for a patient!

I told him about how I was not going to worry about my weight anymore, he was a little concerned. He said “everyone has to keep an eye on it”. I thought “I know, I have knowledge of many foods to their kilojoule content and fat grams”. This is not healthy. It is certainly not good for mental health. The way I see it, I told him, I should keep an eye on my weight the way a chilled parent supervises a 2 year old at a cafe. Mindful, but not obsessive.

Anywho. I have been feeling really good.

I have discovered an app on my iphone called Runkeeper. It basically acts like a garmin through the iphone (taking advantage of the inbuilt GPS), but a heck of a lot cheaper. It is also available on android phones also. I had a nice little play with it this morning, but found out I was quite a bit slower than I thought on hills. I had a nice little run down Merri Creek, examining the clouds and enjoying the morning. I like the whole GPS thing – an object looking at you from deep space, kind of makes you feel at one with the universe etc etc.

I have enrolled in an art course (drawing, painting etc) at the CAE. I have been drawing in my little doodle diary, rather than watching telly, some nights. It has been good.

Well I had better get myself off to work. Then back home to tidy up for the mother in law.

This weekend – hope to catch up with Sarge Sara and Kath of the new and fabulous blog. I liked her blog on saving money. It puts me back in my place. Which I need sometimes.

Self-Esteem Shopping.

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I heard a good phrase – “Dress for the woman you are, not for the woman you wish you were”.

Also a good one from my brother in law – ” your neuroses are only interesting to yourself, not to other people” (unless or course you have a blog).

Yesterday, I had a day off – was unwell with sinusitis. Head was about to explode in a mucoussy heap (ok, TMI).

Had a good sleep and sorted myself out.

Today, a lovely run with the dog down to merri creek and back. She started out really quickly and was quite good up the hills, but towards the end she tired a bit.

Then off to the podiatrist to get some more orthotics – the old ones caused me some nasty blisters at trailwalker. The best bit was that he was really impressed with my one-legged squat, which I have been working hard on, to improve my balance.

Then some self-esteem shopping – I bought a “diet dress” ie one that makes you look slim no matter what kind of drudgery you are feeling. Then some jeans with a patented pull the tummy in and lift your butt up high tensile stretchy denim. They make my butt look so perky that it could introduce itself at parties (it almost does anyway)

I am over jeans or dresses that are designed by gay men or anorexic women which show the muffin tops rather than skimming over them mercifully.

Am feeling a million bucks now.

Have got the nike plus ipod thingy working, hopefully I can track my runs a bit better.

I have also been practicing my artwork, this helps to smoosh the body obsessions.

I would also like to congratulate wompa and wom-ma on the arrival of their granddaughter.

A catch up – bad jokes.

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Q. How do you make a hanky dance?

A. Put a little boogie in it.

Q. How does a monkey make a toasted sandwich?

A. He puts it under the gorilla.

Ok. That is enough.

Well I have had a good past week. I went to the geriatrics conference, which was held at the Hyatt Regency Coolum. The best bit was the pool and spa. The other good bit was the lovely environment, a lovely run to the beach was had on the last day. The plenary sessions were good but the pool and spa were better. Also I comprehensively broke my 2 standard drinks limit on all 3 nights of the conference. So did everybody.

On Friday, I flew back to Melb, dropped the dog off at my sisters place and then on Saturday morning, hubby and I flew up to Sydney, where I did some teaching. That night we went out to dinner at Cafe Sydney (the Boss’s shout) and again the alcohol limit was breached. But breached in style. We stayed in the four seasons hotel, which was quite flash. The breakfast was quite nice but it was a real battle to get coffee with the breakfast. Post boozy dinner + no coffee = angry. They finally coughed up.

On the Sunday, we went to the Art Gallery of NSW to see the Archibald prize exhibition. I love portraiture and at high school I was quite good at art. The art here, plus an arty co-worker that has just gone on an arty residency in Paris, have inspired me to get back in touch with my creative side. So I bought a few books – a general how-to on painting and drawing, a guide to get in touch with my creative artistic side, and a book on how to make collages. All great books. I did not buy any clothes, which is quite an achievement for me.

I have been trying to distract myself from thinking about food and diets (apart from when it is strictly necessary like at mealtimes). I have actually got quite a bit done. I have gotten home, tidied up, cooked dinner, organised things and done some drawings. I have not sat down properly till after dinner. Today has been a bit of a struggle because it is the time of the month where I want to piddle every 30 seconds and eat my body weight in chocolate, but I have escaped with a tim tam and a freddo, which is quite restrained. Other than that, I have been waiting until meals and having a good filling one rather than snacking. I have also came up with some good ideas for pictures to draw. I have also exercised both days (run on monday, pilates today).

Well, it is NCIS time. Had better strap myself in.