Man up, bitch.

I think I have PTSD.

Every night, as I lie in bed trying to fall asleep, I get flashes of rended flesh, bone saws, needles, wires and blood. I had dreams about suturing last night. Cardiothoracics is quite confronting, and since I don't have time to process it at work (12-16 hour days this week) my brain has decided to process it at night.

My interactions with the team may also be having an effect. All week I've been stoic, laconic and taken everything on board without whimper or complaint. I've been the perfect dude.

Sure, I can laugh at your jokes about mistresses vs wives.

Yeah, it's weak to admit uncertainty or fear.

Totally, you should dismiss nurses/clerks/women if you don't find them physically attractive.

It's wearing. I feel depleted.

I had my afternoon off yesterday and ended up sniffling in Myer's shoe department. I was looking at all the pretty girls in pretty dresses and realising that they don't feel the need to justify or hide their femininity. They don't over-compensate for their perceived female weakness with an ice-queen demeanour. They're allowed to enjoy being girly without fear of mockery.

I'm going to overcompensate for my current asexual, repressed, verbally-abused state by choosing a slutty Halloween costume. Because that's empowerment?

I can't win.

1 week down, 11 to go.

wrong again

Cardiothoracics is amazing.

I sewed up a half meter of leg. (Then I had to take the stitches out and sew it up again, but my bosses were really nice about it.) I helped twist sternotomy wires into place. I poked a lung out of the way to get at the aorta. I touched a beating human heart.

My life has never been more like Grey's Anatomy.

Despite my pessimistic predictions, the day was somewhat balanced. Sure, I started at 6:45 this morning, but I was home by 6:30 tonight. AND I got lunch. Yes, it was my half day. I essentially worked 5 hours of unpaid overtime, but Dude! I touched a heart!

The team is definitely not used to having a girl around. The conversation centered on the Registrar's lack of sexual prowess as correlated to his manual dexterity. Due the gown/glove/mask combo, I'm pretty sure the Boss thought I was dude. "Sam, pull like a man, not like a little girl..." But they were patient, they taught me ridiculously cool things, and they were very charitable about my fear of surgery.

Actually, maybe they were so nice BECAUSE I'm a girl?

Boss: "You want to do Emergency? It's not as good as cardiothoracics. But it's a good choice for women, cos you can take time off to have babies."

More notables:

- getting told off for being gentle while putting catheters in. "They can't feel it, so if you take more than 2 minutes, you're being soft." Ouch.

- the heart "restart"; not a gentle lub dub, but taking a metal rod and jabbing the exposed myocardium violently, like killing a bug.

- watching litres and litres of blood pour out into tubs, then get sucked back into the body, clean and oxygenated

- getting 6/10 on my (repeat) suture line. Triumph!

- realising I hadn't peed, drunk water or breathed clean air for 5 hours, and still feeling pysched to take on the afternoon operation.

1 day down, 89 to go.

Lifestyle

I'm fresh off the Inter-Hospital soccer tournament, beet red and happy.

Hilariousness ensues when a bunch of deconditioned, unathletic people push themselves as hard as they physically can. As Adge says, "When doctors are off work, they just want to prove how good they are at other things". We are not that good at other things.

Highlight: Adam in goal. Alone. Opposition breakaway. He started screaming, "Seriously? Seriously??? Seriously??" Opponent freaked out, tripped and gave up the ball.

Also, seeing our mild-mannered Endo registrar do a full sliding save. He's my boss, but I was screaming "Pick it up! You're the wall, dude, you're the wall!"

In contrast to this awesomeness, my last shift in Rehab was Saturday morning. I'd been to the End of Rotation drinks the night before, where I had abstained from food & common sense. As a result, I found myself telling a family, "I'm so sorry for your loss" and certifying a still-warm body while hungover. I can't recommend it.

I guess it's the Aussie commitment to leisure. The work hard/play hard thing gets taken to extremes in medicine, but dammit, we're having fun.

But now I need a nap.

reflection

Regular readers (hello VPL! Edmonton! Dan!) will remember the debacle of last week; the patient who bled from his gut, code blued, was intubated and topped up with blood. And my egregious error of not PR-ing (bum-poking) him for a suspected bleed. And the ensuing thanks to various religious figures for his continued survival.

Anyways, he's back.

This poor gentleman has returned to Rehab for some more physio, some more therapy and a little more medical negligence.

He actually looks much better. His colour has improved (the result of keeping blood INSIDE his body) and his breathing has slowed (ditto). I am afraid to go near him.

Why do I bring this up? Cos I had a small mental breakdown this afternoon when reading his medical notes. My entry goes "Pt's breathing resolved, BP improved. Impression: panic attack, for review in am". The next entry goes "MET call".

Every single panic attack I see from now on will get a PR.

Every last one.

(I talked to my consultant about it and she said, "Sam, everyone has near misses. And everyone makes mistakes. And people get lost. You've got to push on, and don't worry too much about it.")

Now I'm drinking a beer on my sunny deck.

My job is messed up.

Moving on up...

I haven't moved in almost 4 years.

For the last 4 years, I've been sleeping on the same side of the bed, in the same room, with the same windows, doors and night sounds.

Tonight, I am going to sleep on the right.

Packing 4 years worth of debris was both dusty and illuminating. I found all the "bad" (career-girl-rescued-from-miserable-existence-by-dashing-artist) books I'd stashed under my yoga mat. I found the ear plugs I thought I'd lost two years ago. I found the love letters from a guy I haven't spoken to in years. I found the source of that smell. There was a lot of sorting. A lot. Some laughter, some tears, some screaming. The hardest part was sorting my books. Every "give-away" feels like losing a friend.

It's true, I haven't moved far; just up a flight of stairs. But it feels like a major transition. I have my own bathroom, a walk-in closet and a balcony. My own balcony! (I can almost see greenery from my window!) I am starting to feel like, maybe, I'm a grown up. Successful even.

So, while my next three months may be a living hell (see previous post), I will have my own grown-up room to come home to.

I will have the memory of this first night of feeling like a success.

Especially with the Top Gun theme song on the stereo.

"No, Iceman. You can be MY wingman..."

Uh Oh

Adge and I had a rough day. Post-work, we needed a drink. We went to our hospital bar ("Where's the bar?" "Mom, it's a hospital, there's no bar." "No wonder people hate hospitals!") and ran into the Cardiothoracics team.

The 6 dudes I'm going to be working with for the next 12 weeks. Luckily, I was drinking, or else i'd be panicking right now.

"Ha, we make fun of Ken cos he's Asian..."

"I just don't get Jewish humor"

"O no! Two women interns? What will we do? TWO WOMEN?"

On and on, until one of them got a text message and said, "Dudes, we have to go. The hot nurses will be leaving soon and I want to hit that..."

This is the team I will be spending (roughly) 60 hours a week with, for the next 3 months.

They were friendly at the pub, but one of them already told me "I don't have a good side, so don't bother."

The other one looked sheepish at that, then told me, "I'm the moderate". And the third (married, devout Muslim, father of 5) told me, "I'm the nice one..."

But then they all laughed.

There is no nice one.

It's not that I think I can't handle myself; I worked at SSG for 6 years.

They duct-taped my head to a phone WHILE I WAS TALKING TO A CUSTOMER. They verbally and physically abused me. They were the most sexist, racist, homophobic pack of bitches on the planet. They were (in short) private school boys.

So why am I worried? Cos that was 9 to 5.

This is 6:15 to 7:15.

Am to Pm.

Expect either:

1) Total mental breakdown

or

2) Sam integrates. Adopts the behaviour. Starts hitting on nurses. Threatening to show you her balls. Etc etc.

And all I wanted was a quiet drink before moving day.

Comeuppance

I thanked Jesus at work today.

The old "no atheists in foxholes" thingo turns out to be right.

Last night I left work after seeing a patient who, though sick, I declared stable.

This morning, he wasn't on the ward.

He had crashed around midnight, bleeding from an unknown source. His blood pressure dropped. His heart rate skyrocketed. He had to be taken to emergency, intubated and topped up with 4 units of blood. Then they did an emergency gastroscopy. He had perforated an ulcer.

Seriously, at 6pm, I had pronounced him well.

My registrar (the aforementioned SpiderReg) said, "Look..." (and you know nothing good ever starts with "Look"). "You were probably right. But, if this sort of thing comes up again, do the following..." and listed the appropriate management of a suspected bleed.

Which I've learned before. Which I KNOW. Which I have employed hundreds of times on hundreds of patients before this, but decided not to do this time...

My complacency has been flayed off me.

I'm going to start paying more attention at work.

PS: He lived. He is not dead. And it is for that, and my soul, that I offered fervent thanks to Jesus. Christopher Hitchens can suck it.

O Canada. Thank you for your stunning vistas, your majestic trees, your placid seas and most of all, your endless bureaucracy.

I just paid 235 US dollars to write a TOEFL exam. An exam testing, through writing, speech and multiple choice questions, my ability to speak English. Despite having English as a first (and only; Klingon doesn't count) language. Despite attending high school, university and medical school in countries that have English as their primary spoken language. Despite flying colours in the MCCEE which is administered in, natch, English.

This Canadian application process can't be good for me. I alternate between white-hot bubbling rage, utter despair and cheerful denial. My skin is peeling, my hair is falling out and I'm eating everything that's not nailed down. (And no, we can't attribute that to the sunburn, hair-dye or last-night's-baking frenzy).

To add insult to injury, I have to do my TOEFL in time for results to be sent to Canada. Which means this Saturday. At 9am. In Werribee, a pox on the land between Melbourne and Geelong. I will have to get up at 6:30 to train to bogan-central in order to speak into a microphone and have my English skills criticized by a panel of faceless robots.

I am supposed to be moving, picking up a Turkey and basking in the new spring sunshine.

Instead, I will be using hand sanitizer to remove the waxy germs from the communal test headphones.

Do you see where the rage comes from?

Falling in love...

On Thursday night, I was all set to write a dour description of "The Talk", the conversation you have with your patients when they are going to die.

I was going to compare it to "The Talk", the conversation you have with your partner after they tell you proudly that they don't read books. And "The Talk" you have with your family when you realize your life choices are going to disappoint them, yet again.

Luckily, Thursday night I was too full of Xiao Long Bao to breathe, let alone type.

Friday brought new thoughts. We have a new Registrar, a smart, sarcastic funny woman who is 19 weeks pregnant and loves medicine.

We saw every patient, and she actually solved problems. Not "patient has itchy foot, apply calamine lotion" problems. More "patient has been confused and disoriented for weeks, let's check his growth hormone level, realise he has pan-hypopituitarism and replace his pituitary hormones" problems! Giving families of brain-injured patients new hope! Getting chemo for our cancer patients!

We call her "SpiderReg" and Adge and I hum as we whip through the work. "SpiderReg, SpiderReg, does whatever a SpiderReg can..." That's right. She has super-powers.

She sat us down in the afternoon and taught us things.

I can now name the 5 components of a haemolysis screen. The 5 DIC markers. The effects of hypoadrenalism on the body (Conn's Syndrome to you). This is the first time I've formally learned anything THIS YEAR. I could feel my brain yawning and stretching, saying "Ooh, this feels good, why haven't we done this more?"

So, Friday I'm in love. With my job, with medicine, with my Registrar. I'm on the ball with my Canadian applications (reference letters are such a great confidence booster). My team is set up to win the Grand Final this weekend. I no longer have to listen to Lawyer Talk at home. There are home-made sausage rolls cooling on the counter.

Life is sweet.