anecdote

More proof that I will never be admitted to the exclusive boys club that is surgery:

We wear masks in theatre. These masks are made of special filtration paper, and often slide around one's face during an operation. This can obscure one's vision.

Bossman, being an experienced surgeon, uses a strip of medical tape to attach the mask under his eyes, thus ensuring a good fit (and preventing his visor from steaming up). After weeks of a steamy visor and working semi blind, I copied him.

The operation went well. I had the best view I've ever had while stitching. After I scrubbed out, I went to peel my mask off. It hurt. A lot. Tears sprang to my eyes, but it all came off in one piece and I thought, "Great! I'll be able to use this in the future."

Then I went to the mirror. The skin under my eyes was still stinging, and when I looked up close I saw tiny pin-pricks of blood across my face. The damn tape had peeled off a layer of my skin. For the last two days, I've walked around with two scabby raccoony bruises under my eyes. And my face hurts every time I put the mask on, even without tape.

My skin is too soft for surgery.

Bossman bursts out laughing every time he sees me.

triumph!

I GOT TO CLOSE THE CHEST!!!!

On my first day in theatre, Bossman said "Sam, patients judge a surgeon by how good the chest wound looks. They don't care about anything else. So you will never get to close the chest, because your stitches look like shit."

Tonight, around 8:45 pm, I finished my row of deep (non-skin) sutures and stepped away from the body to allow Bossman room to work. He gave me a look and I quickly stepped back, thinking I had made a mistake. He slammed the needle-holder into my hand and walked away without saying anything. So I closed.

The endorphins got me home, elated and singing out loud (JEW Praise Chorus, FYI), despite lack of sleep/food/personal life. Now i know why the surgeons do it. It feels so good when you get it right...

Uh oh. Have I drunk the kool aid?

hot

There is something magical about walking home on a hot late night. The streets reek of garbage and bats skitter overhead, but my veins are still fizzing with the last MET call and it feels good to be moving. The greasy yellow moon lights my way past the Smith Street bums and Monday night alcoholics and I nod at them. I just put a drip into one of their friends.

This city has its moments.

I'm pretty sure 98% of my current goodwill is being generated by my air conditioning.

2% love, 98% air-con.

Life Skills

While I rant, rave and moan about it, my surgical rotation is giving me useful life skills that I have employed this weekend. Before this rotation, I was soft. Weak even; I ate regular meals, got regular sleep, rarely experienced physical pain and spent so much time doing things I enjoyed that I became spoiled; I didn't appreciate what I had.

No longer. My time out of the hospital feels like a release from prison. Everything I do is tinged with a sensation of rose-tinted wonder; "O my god. I'm not unhappy right now!" And while I'm sure it gives me an air of thinly veiled desperation (Must.Have.Fun.) it is also paying off in pleasure.

Examples:

1. Hot Date Friday met me at a rooftop bar in Melbourne, which was packed. We stood and talked, sipping beer in the sun. Later, as we sat at a tiny table in a filthy Chinatown dumpling house, he exhaled; "It's good to sit down; we were standing for 2 hours!" I hadn't noticed.

Surgical skill: standing motionless for hours, ignoring physical pain.

2. Harry Potter movie, Saturday. We'd been out for lunch at Glen Waverly's premiere Japanese restaurant where I had consumed litres of diuretic liquids to accompany perfectly seared beef tataki & thinly sliced tuna. Harry Potter is a long (amazing!) movie; almost 3 hours with the previews. I didn't leave the movie once.

Surgical skill: See above. You can't leave theatre to pee, so ignore the pain.

3. Back from HP; due to meet friends at Spanish Fest in 20 minutes. The weather is hot, we're going to be dancing. I change from comfy summer dress to sultry Latin swishiness in ten minutes, out the door and arrive on time.

Surgical skill: Quick change. "Sam, we need you in theatre to close the chest! Stat!"

Other things come up daily; not taking criticism personally, learning to compartmentalise (she died, we need to focus on him), diplomacy, selective hearing (Sam, you're eating again? Aren't you worried about getting fat?) and physical and mental endurance.

Mostly, I feel this INTENSE appreciation for everything I do that is not surgery (And I seem to pack a lot more into every weekend). It makes life seem just a little bit sweeter, so maybe this job is good for something.

kidnapped!

I think I have Stockholm Syndrome.

I'm starting to stay later than is required of me. I actually came back to work this evening, after leaving, to make sure that all my jobs were done perfectly. And I voluntarily stayed until 8pm yesterday to cover for another intern who was sick.

Why? I want my Registrar(s) to like me.

Yep, the same guys who delight in tormenting me.

There's also a little voice in my head that says, "Screw them. I'm tough. I can totally keep up with them and work just as hard and laugh off the deaths and handle the blood and..."

In a way, it means work is going well. When you push yourself to do more, and realise that more is getting done, you've achieved success. Right? Right.

Now off to sleep, I'm going in early to prepare for 6:45am rounds.

Seriously, Stockholm Syndrome.

Addendum

I just skimmed the blog and realised that I've mentioned crying in my last four posts. There are good things happening in my life, I swear.

Like Nurse Bear bringing over home-made spinach cannelloni in meal-sized portions so I can have something real for dinner this week.

And having brunch with my favourite girls at my favourite spot where the Saturday special was "Canadian breakfast - pancakes with maple syrup & bacon".

And having my friends tell me again and again that they hope I don't get a job in Canada.

So, yes, work is hard. But life, overall, is good.

lengthy, emotional rant ahoy!

The roller coaster continues.

I handed in my fortnightly timesheet yesterday. I worked 168 hours. I will be paid for roughly 100 of these. The other hours are apparently my donation to the hospital; the gift of my sanity, health and life.

My bosses laugh about it. "Cardiac surgeons work the worst hours," they say with a note of pride. They equate their work hours with masculinity and identity as surgeons. These are men who don't see their kids and don't mind.

The women (nurses, of course) of cardiac surgery are not much better.

The snapshot is a woman in her mid-thirties, wearing excessive mascara (when you wear a scrub-mask, you've only got your eyes to work with) and tanned within an inch of her life. She talks loudly about her gym sessions, flatters the surgeons and ruthlessly undermines any new female on her turf. Say, the new intern.

I get a continual barrage of snide remarks ("God, you look tired", "Your sniffing sounds disgusting", "We got you the extra large gown", "Don't think you can do what the guys do in here") and daily subtle gestures to let me know that I'm not wanted.

The worst was Tuesday night. An emergency case; a woman with a dissecting aortic aneurysm. I scrubbed at 2:30 and was still standing at 8:45pm. We were all exhausted and hadn't eaten since breakfast. One of the nurses brought some lollies in and, being careful to keep sterile, tucked a snake or jelly-baby behind each surgeon's mask. First the boss, then the registrar. Then the anaesthetists. Then the other nurses. She looked at me pointedly, smiled and took the rest outside.

Alas, I can't just hate women. My boss, Matt, is equally kind. "Sam, your stitches yesterday looked like shit", "Sam, you're embarrassing me with those hand-ties", "Sam, don't be so weak". And maybe I am weak.

But yesterday, our patient arrested on the table and blood fountained across my head and mask as we re-opened the chest. Matt turned to me and said, "It's the intern's fault" and laughed like a drain. I had been scrubbed for 8 hours at that point, had not spoken a word, eaten, drunk or peed for those 8 hours and now there was blood all over me.

I stood there and took it. And I didn't cry till I got home.

So I'm not as weak as they think.

Fuck this job. 9 weeks to go.

choke

Well, it's happened. I've cried in front of the nursing staff.

Today was the first of two back-to-back 15 hour shifts, otherwise known as "weekend cover", a euphemism implying that I flit about the hospital smiling at the nurses, casting an eye on patients and generally, not treating anything too serious.

In reality, my patient's airway obstructed.

He's a guy waiting for an emergency stent of his bronchi (breathing tubes) cos a cancer is compressing them. His surgery was supposed to be this morning. It was bumped. It was supposed to happen at noon. It was bumped. Each time it got bumped, I reassured his wife and him that they shouldn't worry, he would be fine until the theatre became available.

Then he started making gagging noises. "Stridor" is the medical term for the sucking, wet snore that comes from obstructed airways. He was so loud I could hear him from the hallway. I called my boss who said, "Look, he's sounded bad before, don't worry too much." I took another look at the patient. Sweat was pouring from him, his rib cage taut with strain and he looked terrified. I called a MET.

In a way, its a good thing. You get lots of help, senior doctors come and tell you it's ok, the patient is whisked away to theatre.

The downside is that you're left on the ward with 110% adrenaline in your veins, and get a little bit teary. And then a nurse sees you and her face crumples with sympathy and she says, "Oh, don't worry sweetie..."

Suddenly you've lost the respect of the entire nursing staff. For the rest of day they give you pats on the shoulder, ask you how you're doing with "poor poppet" faces and try to feed you everywhere you go. (Ok, it's not all bad.)

Sheesh.

2.5 hours to go tonight. 15 tomorrow. Then back to the 12 hour days Monday.

I don't want to do this anymore, thank you.

Everyone loves a good medical drama. During medical school we watched House, Grey's Anatomy, ER and All Saints obsessively, thinking that we were looking into the future.

Sadly, it turns out that Scrubs is the most realistic show on TV.

Unfortunately I'm not the "Turk" in my show; that's my Buddy. She's got the love life, sporty balance and career pathway all mapped out. She makes it look easy.

I'm JD. I spend my days trying desperately to win the approval of an emotionally shut-down megalomaniac, skiving off with my friends/co-interns and failing to have a personal life. Overly invested in getting people to like me, good at the family/empathy/heart to heart stuff, not so good at the medicine.

Adge is the cool talented one. I'm definitely nerd.

I told K, the cool pharmacist, about my halloween look (for the record, Sexy Grapes was a sweet outfit) and she laughed. "Oh Sam, that's such a Doctor's costume." Not a compliment.

Anyways, see if you can match the action to the episode:

- hiding in the changing rooms/storage closets/doctor's office

- being condescended to for being female, then mocked for not wearing makeup

- stealing patient's food off the trolley, getting caught by the boss

- wondering if I've lost my earring IN someone

- getting hit on in clinic by patient's nephew (there to translate, uncle was not impressed)

- singing out loud on the wards (seriously, I'm that tired)

That said, I'm ok with being JD. I know who I am (Nerdcore!) and I'm making it work for me. Plus, wouldn't you rather live in a comedy? House is waaay to intense. I need the comic relief.

PS: It's all the more surreal cos my co-intern sounds a lot like Uter from the Simpsons. Recently arrived from Germany, she laughs like she's wearing lederhosen. And she's always eating chocolate.