Sunday, August 31, 2014

Speak

Double post, because it was Malaya's Independance Day and I did not give it a mention.

No really, I'm just here to speak. I don't like exposing my thoughts on Facebook anymore. Bloggie is still my little sanctuary.

I've reached that stage where my Facebook feed is full of friends getting engaged or married. Actually most of them are acquaintances of the past, from the stages of my life that I've moved on from - the IMU junior, the KL church people, the Green Road band mate etc. People I have on Facebook but actually haven't spoken to in years.

I'm happy for them.

I turn 25 next week and am newly single. Sometimes I get the torn feeling of both despair and calm, but most times it's just clear blue calm. I'm enjoying to solitude, getting back into music and art, cooking, advancing in yoga, working on the nitty gritty of the Australia thing, anime, Japan. Just me. Time - all 24 hours of it - all mine.

Delayed gratification has always something I could do well. I would wait and debate and agonize before doing or buying something I wanted. This time, I feel that waiting is the right thing to do.

Now that I'm actually starting to put my pieces in place for applying to Australia, it's actually really exciting. I am trying my darnest hardest to put up my usual defence mechanism - expecting the worse, expecting the minimum, expecting nothing at all. I may not get a job, or be presented with less than ideal circumstances. It's not working very well, the defence mechanism.

I'm letting myself have fantasies over a job offer by end of the year and having all my pieces sorted, hopping on a plane, and enjoying the life of sun, better pay, free ulu accommodation and salary packaging, and no carrying 5 bleeps (including the registrar's) at a time. I envision myself getting into my hobbies properly like crafting cosplay outfits or taking Japanese lessons - something I've been too stingy to do. I see myself actually going out and having a social circle that's more than superficial, I may start wearing shorts again and stop wearing socks 24/7. I see twice yearly trips back to Kuching. I may even meet someone.

I allow myself these dreams and delusions far more than I should. Then I figuratively slap myself and start focus on the bad stuff, like how expensive everything will be (tbh after Aberdeen I shouldn't be fazed...Nottingham totally spoiled me for rent prices forever), the complexities of superannuation, Aboriginal and bogan problems, drought and flood, deadly animals, The Problems People There Face That I Just Haven't Figured Out Yet.

It's pretty exhausting mentally, really.

After my ALS, I'm finalizing my CV and sending it to every hospital with a HR email plug on the website. Then it's certifying documents, which may be an issue for the next 3 months as there's no notary in Wick. A short trip to Aberdeen or Edinburgh should sort it, but that's just more logistics to settle. Then there's a million other applications and IELTs on top of that.

One step at a time, don't count your chickens. After all the disappointments I've had you'd think I'd know better than to fantasize about the end point before I get there. It's just so....UGH. I've waited so long.

Scenes and thoughts


Have been spending my last few days of annual leave studying for ALS (Advanced Life Support....not that herd mentality ice bucket fad) in the hospital 'library', which is sort of like a large office with some computers and books. At least it's warm. The house gets so cold I've taken out the portable heating.

Sunday was a nice balmy sunny day so I took a stroll down town...although I generally do not care much for 'happening' places and large malls and abundance of weekend leisure activities, Wick is really quite sad la. There's barely a 'high street' and half the shops are closing down. The other half that actually sells things somehow look cheap - sun-faded cards tackily arranged etc. Sort of reminded me of all the 100%-discount-store style shops in Kuching.

One half of the high street....

And then I do a 180 degree turn and snap. That's all folks!



Yep that's two closed down Chinese takeaways...at least the Indian restaurant down the road was still thriving.

For a moment I thought my favourite band were playing somewhere near....then got horribly let down


The Wetherspoon's pub that we're been to like 10 times since coming here.
Took a walk down the mixed stony/sandy shore.


At least it looks pretty from this angle. It was actually quite dirty.

Just reflecting on how ok I am with being alone. Sometimes it's lonely, but often I relish being able to do what I want at my own pace. Besides there's no one who really shares my interests here.


Disturbing amount of animal carcasses...but with all the rubbish I suppose it isn't really surprising



Went to see the Trinkie on Friday - an outdoor pool filled with seawater when the tide comes in. Friend was scouting places for his ice bucket thing but I'd never do it outdoors in the freezing wind. Crazy angmos arr.






Yeah. Mossy. He didn't do it there and then.

So where was I again?

Ah yes, studying for ALS. I'd done all the pre-course required and was going to read up the final bits....but NHS Highland's computers allow Youtube and blogs and all manner of distractifying things Grampian blocked!!!!   oAo''' (I'd say that's a definite plus for this place)

I ended up Youtube-ing anime piano covers and looking at cosplay sites.

I miss being able to talk anime, or fandom things, or obsess about Japan, or jamming, or talking about cooking and baking. The weekend alone was actualy bliss, catching up on anime and listening to OP/EDs in between ALS revision.

Side note - I know I really shouldn't - but every time someone goes to Japan and does not speak the language or understand its pop culture - I feel this stab of envy and you-don't-deserve-it!! feeling. It's completely irrational, seeing I'm no fluent Japanese speaker and am not into idols, but at least I'd be able to decipher a menu. I've dreamt of going to Japan since my mid teens. What I really want is a month WWOOFing on a farm (on preferably southern Honshu) - there rest of the world can have that bland Europe.

I also want to cosplay. In a con. Now I'm actually earning I can afford all the wigs and contraptions, but I ain't going anywhere near a con where I am. Sigh.

I doodled.
Someone on dA remarked in response to 'how do you draw so well' - to practice lots (no surprises here) and fill up 14 sketchbooks. Then you will be good. No idea where the figure came from, but I'm on sketchbook no.2. I tend to prefer traditional but that's only because the tablet can lag sometimes.

There's a keyboard in the oft vacant hospital chapel. Been practicing the Arabesque and random anime tunes over the weekend. It's really one of the pleasures I've got up here. Plus the broadband isn't bad, so I'm quite happy.

And then it's back to work tomorrow...oh dread.

Wednesday, August 27, 2014

Edinbraaaahh


 Had a wee bitty time off, dinnae want ter stay in Wick fer too long, hoped on a train and made it to Edinburgh. Crashed at old buddy Jade's awesome crib. I seriously cannot wait to get my own little abode and start filling it with Le Creuset pots and John Lewis chopping boards.

Photo dump ahead.



Caught the tail end of the Fringe- watched a show called the Bunker Trilogy. About 20 people in a small room within arms length of the actors, who were fabulous and proper professional actors.


Getting ready to tuck into tea....sandwich and a scone.


The girls ordered takeaway sushi... all that amounted to 20 quid each for 4 people...sorry but that was the most painful 20 pounds I've spent in a long while...food wasn't bad but 20pounds is a lot for takeaway!!


This alone was 20pounds...sigh.


Dimsum fix at a Malaysian restaurant - they played the ambiency 'atas' type Malaysian restaurant. 10 pound rendang/nasi lemak...dim sum was pretty good though. I had a century egg porridge, cuz I just miss the stuff more than curry mee. Better enjoy it while it lasts I guess. No Malaysian restaurants north of the central belt...


Short trek up the Pentland Hills, which was a 30min drive out of Edinburgh and was a fantastic park for walks and hikes.















Also happens to be near a military training facility....







Middle Meadow Walk plastered with Fringe posters...the old hospital is to the right, which is being converted into apartments. I hope they don't turn the morgue into a suite....


Royal Mile. Gotta love those cobblestones - not sure I'd enjoy the steep slopes in the long term though...


Walked down the Royal Mile down to Holyrood place and the Scottish Parliament...to conquer Aurthur's Seat.



Halfway up and the view already wasn't half bad.





You know you've reached the top when you see people milling around with that look of bored satisfaction...


....and when there's a compass thing.


Attempt at selfie of compass + view, because vanity.


See the trailsss


Phone camera does little justice to the actual view as interpreted by my retinas... but it'll do.


Descent - though on the joints.


Jade has a lovely, well equipped kitchen so half my time was spent tinkering around her kitchen with all the utensils, pots and gadgets I just coveted so much.....


Made Mary Berry's carrot cake which  I found to be far superior to my usual carrot cake recipe...shall be using this from now on. Problem is it also calls for ripe bananas which would make it a carrot-banana cake. It adds to the moisture and flavour of the cake but I don't always have spotty banana on hand.


All hail Mary Berry Queen of Cakes!! (Also, GBBO pwns.)


The National Museum again. Last visited in 2008.



Made okonomiyaki. Can never get tired of this.



Chicken rice by friend.


And more cake!! This is Mary Berry's cappucino cake, which is described by Jade as 'eating coffee'. And love the stencils - see what I mean by coveting her kitchen?

Rest of the time was on her keyboard playing anime songs, pop songs, classical songs - bliss. This is my idea of a holiday really. A bit of scenery, good company, a well stocked and well equipped kitchen, lots of cooking and baking for my hosts (who are usually at work during the day), and the music was just the icing on the cake. Beats a stressful solo trip to say Europe, which I'm finding to be increasingly overrated.

And then it's the 06,30 train back to Wick in the morning.

Tuesday, August 12, 2014

The difference

Two cardiac arrests in my entire year in Aberdeen.

Two cardiac arrests in my first week in Wick.

*************************

So many patients have the same last name. It makes things extremely confusing. My friend came up with the conclusion that they're all inbred.



Sometimes I feel like I'm in the Great Scottish Redneck Central.

************************

I need a good soul wrenching heart vaccuuming anime or fandom with tons of my favourite themes and humour and darkside and bromance and fanfiction fodder.

If all fails, I rewatch those scathing Youtube reviews of The Last Airbender. Cracks me up every time.

(But noooo I'm here reading up on ischaemic penumbra and haemorrhagic transformation. People sitting for professional exams and who have to study consistently after work have no soul.)

Sunday, August 10, 2014

It doesn't rhyme


Started off in GI
Knocked out livers, bleeding varices
It's all the cheap alcohol I tell ya
Bilirubin Haemoglobin (don't forget the urea)
Hepatic flap, ascitic tap
IBD and steroids
Gastroscope colonoscope (I'm going down to Short Stay)
Patients yellow as the Simpsons
?functional I kept at bay
I stuck a drain in someone's belly
Then they went back to watching telly
Yay me!

Moving on to general surgery
Everyone was in a hurry
Receiving week, answer the bleep
Appendicities diverticulitis sometimes peritonitis
CRP, CT (we may need an MRCP)
You've got gallstones fatty!
KY jelly essential without a doubt
Triple therapy - gent monitoring is a pain!
No dalteparin post op please.
Although I didn't get to have a stab at an abscess
I slid a tube down someone's nose
They stopped vomiting so yay me!


Neurosurgery oh what the heck
EtOH XS knocking heads
Warfarinized oldies with SDH
Young ladies with GBM - I'm so sorry
(but I'll also need to examine your breasts)
CT head, MRI, are they obeying commands
GCS, pupils, always have a pen torch handy
ACDF, stealth CD, stereotactic biopsy
I stuck a needle in someone's back
But it wasn't a champagne tap
Anyway, yay me!

Oh how the year has flown
Being first point of call for scoring sewsing Mr Jones in bed 8
Who's tachycardic hypoxic pyrexial and likely septic
ABCDEs but don't forget the septic six
Speed typing IDLs
The family want to speak with a doctor now
Chasing bloods requesting imaging
Speak to dermatology he's got a rash
Speak to ENT she's got a nosebleed
Speak to the med reg it's not surgical
Sorry to bother you but I have to make a shitty referral
I'm at the bottom of the food chain you see
Please be kind to me.
Despite it all I survived the year
Yay me!


Brain surgeons

Despite the occasional (ok maybe half the time) chaos that was neurosurgery I strangely enjoyed it. Neurosurgeons have always had an unfortunately negative reputation of being aloof and pompous and 'never see that patient', and I must confess I initially had the same misgivings about the specialty (not entirely my fault - at the tender age of 15 on a hospital attachment I was rather emotionally scarred when the resident notorious neurosurgeon yelled at two other young un's and I for the grievous crime of being female and wanting to do medicine.)

It was chaotic, mainly due to understaffing and just plain lack of space. ARI Neurosurgery covered the whole of north east Scotland and we would see SDHs from Shetland and cauda equinas from Inverness all the time. I even have a NPH from Wick, and did the LP (twice because I botched it up). There were 5 consultants - 4 regulars and one locum. During my time there'd been two of these locums. There were 3 registrars for these 5 consultants and the whole of NE Scotland - and you can see where the problem is. We juniors would support the wards and oil the logistics of getting a patient in and out of theatre as best as we could, but that could only do so much.

Most ward review patients needed a reg opinion and there was nothing us juniors could do. The regs had haphazard ward work, theatre and oncall schedules and no one really knew where they were but were never around when you needed them (much to the chagrin or the receptionist who bore the brunt of many an unhappy patient in the waiting area). The consultants also had recently developed a habit of adding last minute elective patients on the list, which was a headache for juniors and secretaries. Honestly, the number of times I walk in in the morning and a reg asks has this patient been consented and the anaesthetist is looking for the big notes and I know nothing about this patient - because he was added on the list at 6pm last night after I left.

rageeeee

And the doctor's office, by gosh. It was the smallest space in all my three jobs, had 4 computers, two of which were constantly having issues. These were the jr dr computers of course, regs got the better ones. I must have spent hours on the phone trying to get to IT because it wouldn't open PDFs, or had a sticky mouse, or just wouldn't start. The office was in a state of constant mess with letters and bits of paper with referrals just existing no matter how hard we tried to keep it clean.

The two FY2s were constantly bogged down with extra work for MDTs which I honestly felt sorry for them for. It was a mind boggling, soul destroying amount of pure admin work that had been dumped on them...just because. Not the mention FY2s were on the reg rota meaning they carried the oncall bleep meaning they took registrar level referrals for heads and spines....which is probably a first. I mean cardiology FY2s don't take referrals that ask cath lab Y/N do they? But it was overall quite well supported by the regs and I'm sure my FY2s learnt a great deal. A band 3 (100%) pay grade didn't hurt either.

After the whirlwind of the first few weeks I settled in comfortably enough. I quickly learnt some tricks to increase efficiency - stuff like keeping a pen torch and measuring tape in your pocket, pre empting CDs for Stealth, and seeing pre op/post op patients the minute they arrive. Heads went to ITU mostly and spines went home comparatively quicker. I saw an EVD for the first time and more CT and MRI scans of brain tumours, subdurals, subarachs, and spinal stenoses than I'd ever seen. The consultants were generally approachable and very good at well, fiddling with peoples brains. They liked to do a separate ward round in the middle or close to the end of the day though, so we'd be on the phone at 6.15pm trying to discuss a relatively minor ailment to a usually equally disgruntled registrar.

We would share the spine oncall rota with orthopaedics although this arrangement was very arbitrary - what we were told would be 'one week us one week them' turned out to be 'three weeks us one week them' according to the whim of whoever did RotaWatch (who is probably sleeping with someone in ortho). Spine was the bane of the department, as it would easily double or triple the work load. I didn't mind the broken spines so much (usually fit young men falling off stunt motorbikes), but what grinded my gears were the query cauda equina compressions, who were more often then not, functional middle aged women with chronic pain issues. But of course, if they had some spinchter dysfunction we couldn't not accept them. Getting the needed MRI for these patients was a constant battle with our radiologists, and 9 times out of 10 there was no CES.

Chronic pain patients. Don't even get me started. They would have a PMH of IBS, depression, fibromyalgia, migraines etc with more than 5 documented drug allergies. Some are fine, and some are downright classical OSCE template 'difficult patients'. Malas nak layan.

Despite that it was all good fun in retrospect. We had great ward staff and allied health pros (the best pharmacist I'd ever had the good fortune of working with), I got to know all the regs and consultants and knew what each of them liked, and was actually starting to get really good at my job, until, like every one else, I had to move and start completely green in a new ward where I didn't even know where the cannulas were kept.

I'll miss you neurosurgery.

Friday, August 8, 2014

3

Day 3 in Wick.

Saw a  20 year old OD in A&E with a BAL of >500. Stayed back 2 hours to watch the show but that was on my own accord. Battled with an unconvinced radiologist in Inverness about a CT head but that's nothing new. What's different is probably the pissed of radiographer who may have come all the way for nothing.

At the moment the medical ward is full house with 3 FY2s and one CT who'd worked as an SHO before. That is definitely the reason I'm still able to feel light hearted about work.

I cycled to work today. Half  town probably knows me as the new doctor who cycles, but I don't mind that. What made me >.<'' somewhat was the bunch of kids who yelled 'hey chinese lady! ni hao!' and continued to ni hao until I was 400m down the road. The adult with them obviously felt there was nothing slightly awkward about this. I've been ni hao'ed by angmos since Nottingham and I'm sure they don't mean it in a rude way, but it's very >.<'' ok.

Oh and I got a gold star.