tag:blogger.com,1999:blog-30640363562060381702023-11-16T02:41:21.778+11:00The Littlest DoctorLittle Dochttp://www.blogger.com/profile/11517595600274206869noreply@blogger.comBlogger17125tag:blogger.com,1999:blog-3064036356206038170.post-6364048646724822902011-12-25T00:53:00.002+11:002011-12-25T01:11:09.525+11:00It's hardIt's been 6 months since she died, and I still get teary thinking about it. I still see her face. Pale when she arrived, at the end it was bluish-white and stained with the flecks of pulmonary oedema that developed during the course of the resuscitation. Every time they compressed her chest more fluid would fly out, covering me, the airway nurse, and the guys doing the CPR. I think they kept forgetting she was just a child, with how hard they were doing the CPR. But it's easy to get carried away in the high stress of it all.<br />And then she went from VT to a bradycardia, and that's when I realised we weren't going to win. Even after we'd been doing CPR for 45 minutes, I didn't think we'd lose her until then. Next cycle she was in asystole. And then she was gone.<br />And I still cry when I think about her. She was someone's. And she was so little. I wish her parents could know that we care. On their first Christmas without her, I can't even imagine what they're going through.<br />This is a hard job I've chosen.Little Dochttp://www.blogger.com/profile/11517595600274206869noreply@blogger.com0tag:blogger.com,1999:blog-3064036356206038170.post-84369207249081784302011-11-11T23:35:00.000+11:002011-11-11T23:36:11.728+11:00Training continues...“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet” (Remen, 1996)Little Dochttp://www.blogger.com/profile/11517595600274206869noreply@blogger.com0tag:blogger.com,1999:blog-3064036356206038170.post-47532276844728439382011-01-24T05:23:00.000+11:002011-01-24T05:24:42.532+11:00New beginnings...I’ve realised that I only ever think about blogging when I’m feeling a bit sorry for myself. I still have occasional moments of melancholy but overall things are better. Exams are over, and it feels like I have a future. Well, obviously barring some sort of unfortunate turn of events I have a future, but I mean one in medicine. It probably will be in emergency. Without the added stress of study life’s not so bad. Although I am in desperate need of a holiday! <br /><br />I’d like to blog more, but I don’t know what to write about. Even with exams out of the way I spend nearly all my time at work, and my days off recovering from endless night shifts and running around trying to catch up with friends.<br /><br />I’m hoping that 2011 is the year of more fun!! Now I just have to figure out how.<br /><br />Actually, I think I know the first step. When I was a kid I was diagnosed with social phobia, and although I’ve made leaps and bounds since then, social situations still provoke a lot of anxiety for me. I feel awkward, nervous and I always feel as though I look awful and that no one will want to talk with me. But I still keep getting invited to things, so I guess I can’t be too bad. This year, I’m going to challenge myself by making myself commit to social events and not back out of them at the last minute. Even if I have to turn up to places alone. And I feel fat.<br /><br />I also need to take better care of myself. Eat less crap, exercise more.<br /><br />The last few years there’s always been one step more to take before I can get on with things. I’m in my late 20s. No more holding patterns and waiting. It’s time to get on with it.Little Dochttp://www.blogger.com/profile/11517595600274206869noreply@blogger.com0tag:blogger.com,1999:blog-3064036356206038170.post-22591447201693820882010-10-18T00:42:00.001+11:002010-10-18T00:44:11.593+11:00Well, crap...I hate what I'm doing now.<br />And although I've been out of emergency for 3 months, I don't miss it yet.<br />What the hell is going to happen??Little Dochttp://www.blogger.com/profile/11517595600274206869noreply@blogger.com0tag:blogger.com,1999:blog-3064036356206038170.post-3918038645571016832010-07-08T23:40:00.002+10:002010-07-08T23:42:08.294+10:00Everything's going to be okayI know I’ve disappeared for, well, forever. This year’s been stressful, more stressful than I’d thought. I thought once I was only working in emergency (no more gen med or ortho, thank God!!), everything would be okay. But it didn't work out quite how I'd planned.<br /><br />At the beginning of this year I think I was pushing myself too hard, trying to achieve so much so quickly. It’s been rough, not meeting my own expectations, and then having to reassess.<br /><br />But I've realised something big today - everything's going to be okay.<br /><br />I’ve been so stressed about all aspects of my life at one point or another, but I just need to fricking let go and just let things happen when they happen.<br /><br />I only have one subject to go, and hopefully that means I’ll have finished my primary exams by the end of this year, but if I don’t it’s okay (although certainly not ideal!). After exams is a research project, and the department I work in likes us to get on with it. But if I need to take some time out that’s okay too.<br /><br />I feel like I'm always planning for the future instead of living in the present, and have been since medical school. But I can do a bit of both! And maybe start enjoying both my personal and work life a bit more! Hell, I’m even enjoying studying more!!<br /><br />Um, but only just :PLittle Dochttp://www.blogger.com/profile/11517595600274206869noreply@blogger.com0tag:blogger.com,1999:blog-3064036356206038170.post-8732726192191032542010-03-08T17:36:00.002+11:002010-03-08T17:44:15.299+11:00StressI'm sick of being so stressed. About work, about study, about what little life I have outside of work and study.<br />Exams are in 2 weeks. I'm trying to study today, and it's not going well. I'm tired, and I've fit in going to the gym, running some errands at the shops and having lunch with my mother - all of which was great, but was ambitious. So now it's nearly 5pm, I haven't done anything yet. And I'm finding it hard to get started.<br />I'm sick of this life. Hrm, just realised that could sound a little dodgy :P Not sick of life, sick of *this* life. I would like one with more time to relax, more time to become more clinically competent at work, and more time to have FUN! While I'm still young :PLittle Dochttp://www.blogger.com/profile/11517595600274206869noreply@blogger.com0tag:blogger.com,1999:blog-3064036356206038170.post-88336040996444266992010-02-07T02:08:00.003+11:002010-02-07T02:16:08.329+11:00ProudI was sitting at the bus stop beside the hospital, waiting for the bus which was already 5 minutes late.<br /><br />An older man sat beside me. Just then, the blades of the chopper on the nearby helipad began to beat faster, and faster. The chopper rose in the air. The noise was deafening.<br /><br />We looked at each other, sharing the moment of excitement (I felt a silly urge to wave at the chopper! :P)<br /><br />As it flew off, we made small talk about how loud it was.<br /><br />And then the man said "It's wonderful though. Every time you see that you can think to yourself that there's another life hopefully saved. It's amazing, isn't it?"<br /><br />And for a moment, I felt proud. Proud that when I'm work those patients are brought to me, to my department, and my colleagues.<br /><br />I know this probably sounds conceited, but in the day to day running of things we don't get time to stop and reflect on the work we do. We focus on the difficult (and usually very well!) patients who challenged us, or worry about things we could have done differently.<br /><br />But today, a stranger at a bus stop reminded me of the good that we do. And I'm so proud of us!Little Dochttp://www.blogger.com/profile/11517595600274206869noreply@blogger.com0tag:blogger.com,1999:blog-3064036356206038170.post-44651235352237134732010-02-01T00:42:00.003+11:002010-02-01T00:46:13.251+11:00Decisions, decisions...If you have a paroxysmal tachyarrhythmia don't take caffeine pills.<br /><br />Hypothetically speaking, you could decide to start taking them so you can have more energy for the holiday you've saved up for a long time to afford. And 3 days into your holiday, you might end up in hospital for 3 days before being discharged to go back home, your long awaited holiday ruined.<br /><br />That'd suck. Hypothetically.Little Dochttp://www.blogger.com/profile/11517595600274206869noreply@blogger.com0tag:blogger.com,1999:blog-3064036356206038170.post-73314076443891543082010-01-19T11:35:00.003+11:002010-01-19T11:44:53.315+11:00I hate (and pity) drug seekers...Telling me that you're not drug seeking does not, in fact, reassure me that you're not drug seeking. Following that up by asking for IV morphine pretty much guarantees you paracetamol and the door. Hope it doesn't hit you in the butt on your way out.<br /><br />Also, if you present telling me you've lost your authority meds (the same day you got the script filled, such a shame!), I will do whatever I have to do to make sure you don't get more than 2 days supply. Even if it means running from ED to pharmacy to dispense the tablets myself.<br /><br />Enough already people! Detox and start contributing to society, please! Your mum will appreciate it.Little Dochttp://www.blogger.com/profile/11517595600274206869noreply@blogger.com0tag:blogger.com,1999:blog-3064036356206038170.post-77607012734529137612010-01-16T00:23:00.000+11:002010-01-16T00:25:23.039+11:002010Hrm, my posting has been quite sporadic… Probably not entirely surprising considering my work schedule and the fact that I’m supposed to be studying for exams.<br /><br />I don’t have a very reflective nature. Part of starting this blog was to get me thinking about things, and to maybe come up with a way to express or work through some of the things I encounter. For the most part I just roll with things, but there are still a lot of joys and frustrations that I experience. I find myself in some very odd situations, or listening to some very odd stories from people with lives so wholly removed from my own experiences.<br /><br />I’ve seen a few people reflecting on the end of the decade. It made me think (briefly!) about how far I’ve come in that period of time. 10 years ago I’d just hung up my high school uniform and was excited to be heading off to start uni. I had a few friends from high school heading to the same course and I was looking forward to freedom, fun and figuring out what I wanted to do with my life. Medicine was a background thought but I figured I’d see where life took me.<br /><br />Now, I’ve progressed in my career. I’m no longer a resident (no more ward call, thank goodness!!), and I’m working towards being an emergency doc. My relationship with emergency medicine has its ups and downs. Sometimes the crap patients get me down. The entitled ones who present with a chronic problem and expect miracles. The aggressive patients who make me feel as though my safety is threatened while I try to help them. The people who present asking for help then tell me to get stuffed when I suggest treatment.<br /><br />But then there are the people who I begin counselling through their miscarriage. There are people who lay in the trauma bay scared and crying, who I can comfort and help. There are people who I can reassure and send home. There are people in unfortunate circumstances with fascinating physiology.<br /><br />Last night as I was examining a very polite ex-con it occurred to me that I would never have imagined things would quite have ended up like this. I’m tougher than I thought. Life has its ups and downs but I’m happy with where I am. And where I think I’m headed. But I’ll continue to see where life takes me.<br /><br />Hopefully to Paris somewhere along the line though! :)Little Dochttp://www.blogger.com/profile/11517595600274206869noreply@blogger.com0tag:blogger.com,1999:blog-3064036356206038170.post-17090865862966143002009-08-15T21:10:00.001+10:002009-08-15T21:11:38.719+10:00Accept Natural DeathI heard of this terminology for the first time today. I like it. I think one of the best things we are able to do as a doctor is to help someone die with measures for comfort and dignity when we can’t cure them. But somehow, we can get into situations where what we as medical professionals believe is best for the patient is different from the beliefs of the family.<br /><br />I think a lot of people don’t realise how violent CPR is. I had the lovely family of a frail, older patient ask if we could do ‘gentle’ CPR. It’s a nice idea, but doesn’t exist unfortunately…<br /><br />It makes me sad that when a person comes into hospital they risk losing the right for a peaceful death. We have to obtain consent to allow a person to die. For most, the idea of dying peacefully in one’s sleep is how they want to go, and how they want their loved ones to pass away. But when people are actually confronted with giving medical staff permission to stand back if their loved one is found near death is a very difficult decision to make. And caring family members unwittingly expose their loved one to a violent and prolonged death.<br /><br />When this is the likelihood, I tell people this. I tell them honestly, CPR won’t work and we might hurt more than we help. But sometimes they won’t or can’t listen. They can’t understand. Or some doctors (understandably) don’t want to give families graphic details. But I think they need to understand what they may be insisting we do to their family member.<br /><br />All I can do is hope she keeps breathing and her heart keeps beating. Because I don’t want to break all her ribs, and watch her suffer and end up bloodied and bruised instead of quietly passing away. If it comes to it, that’s not the dignified ending she deserves.Little Dochttp://www.blogger.com/profile/11517595600274206869noreply@blogger.com0tag:blogger.com,1999:blog-3064036356206038170.post-49544396445815097592009-07-11T20:47:00.001+10:002009-07-11T20:49:10.121+10:00CompassionWhen I was a medical student I completed an elective in emergency medicine. I met an amazing doctor. I was actually supposed to be supervised by another doctor while I was on elective, but that doctor was on annual leave, so the head of the department took me under his wing. This doctor had been practicing emergency medicine for a very long time… But now, he was older, and not well, and couldn’t work clinically anymore but he lead the department at this large, tertiary hospital. He was so loved by his staff.<br /><br />He taught me about compassion. He taught me to pity people who self harm, to treat aggressive dementia patients with respect, to have sympathy for people who are addicted to drugs, and not to blame people with mental illness for their disease. It can be frustrating, but whenever I find myself starting to get annoyed with patients I remember him.<br /><br />But he loved his staff, and said that if someone chooses to be abusive they can pick up their leg and leave of his department!<br /><br />He stopped working not long after my elective, and sadly passed away earlier this year. I am so grateful I had the chance to meet him. It’s so easy to be influenced by the many bitter, angry and cynical doctors you meet, but his compassion made me a better doctor, and I’ll be forever grateful.Little Dochttp://www.blogger.com/profile/11517595600274206869noreply@blogger.com0tag:blogger.com,1999:blog-3064036356206038170.post-51653135545578949942009-07-04T22:55:00.000+10:002009-07-04T22:56:25.151+10:00AmbitionI’m ambitious. I want to do well, in everything, work and personal life. Right now I don’t have a personal life, but I’m hoping that will come in good time. Hoping…<br /><br />At work, I’m ambitious. Everyone knows I want to do emergency medicine. I’m on a rotation there at the moment, and I want to do well. I think maybe I put myself under too much pressure. I want to do well at work. I want to be on the ball, doing the things that need to be done and generally impressing the bosses, but I feel like I so often fail at that.<br /><br />I don’t know what to do.<br /><br />I probably need to stop thinking so much!Little Dochttp://www.blogger.com/profile/11517595600274206869noreply@blogger.com0tag:blogger.com,1999:blog-3064036356206038170.post-54222055314651484162009-07-02T22:30:00.001+10:002009-07-02T22:32:01.058+10:00TVNo wonder I’m sick of work! I’m having a quiet, fabulous and delightful evening, sitting on my comfy couch wearing a fluffy robe and watching Private Practice, one of my favourite shows. I need a favourite non-medical show… :PLittle Dochttp://www.blogger.com/profile/11517595600274206869noreply@blogger.com0tag:blogger.com,1999:blog-3064036356206038170.post-60734151452156670802009-06-10T22:55:00.001+10:002009-06-10T23:03:31.193+10:00What to do, what to do?The study isn't going well. After much reflection, I think I know why I'm having so much trouble focussing. I don't know if emergency's for me.<br /><br />In so many ways I love the work, the acuity, the random patients that come in to the department and figuring out who's actually sick and why... But I'm unhappy at work at the moment. And I don't know if it's me or the job.<br /><br />There's a lot of bullshit that comes with working in a large emergency department - in any large workplace. It's getting me down. I don't know how I'm doing relative to the other junior doctors, and I'm getting mixed messages from various bosses and I don't know where I stand or what I should be doing.<br /><br />I feel like I should be better than the other junior docs, because this is what I want. I probably put too much pressure on myself, because I am still so junior after all.<br /><br />But for the first time ever I don't know if I want emergency. And I don't know if emergency wants me.<br /><br />So it's difficult to focus on study at the moment.Little Dochttp://www.blogger.com/profile/11517595600274206869noreply@blogger.com0tag:blogger.com,1999:blog-3064036356206038170.post-16420665906963725102009-06-09T20:18:00.000+10:002009-06-09T20:19:29.046+10:00PikerI piked on dinner tonight so I could stay home and study.<br /><br /><sigh> I am so lame.<br /><br />But quite pleased to have some extra time to study! :PLittle Dochttp://www.blogger.com/profile/11517595600274206869noreply@blogger.com0tag:blogger.com,1999:blog-3064036356206038170.post-52417185986461297342009-06-09T01:06:00.000+10:002009-06-09T01:10:16.210+10:00MeI'm a doctor. I'm little, both in size and doctoring-status.<br />And I'm sick of it!<br />Um, the status, the size I came to accept a long time ago... :/<br /><br />I'm second year out of medical school, and hoping to specialise in emergency medicine. I work, I study for exams, and I eat out far too much.Little Dochttp://www.blogger.com/profile/11517595600274206869noreply@blogger.com0