A Savoury Bradbury.

There are easily four topics I’ve had on and off my mind for the last few weeks and none of them are coming out right.

I wanted to talk about the possible moving in together stuff, but really I’ve only applied for a job and haven’t heard back yet about anything. So it’d be easier to talk about an interview prospect, or a job offer before I can stress about the decision about giving the dogs up or not, and whether it’s too soon for Ben and I to be making such a big step.

Then there was the hen’s party I was at a few weekends ago. Fairly tame as far as hen’s parties are concerned, but still loads of fun. Came away with a memory of the bride-to-be shrugging off the potential of a Murphy’s Law wedding (where everything that can go wrong, will), simply stating “I just want to marry him, that’s all”. Thought a fair bit about how my feelings about weddings have changed over the last few years and that ultimately now, I’d be fairly practical about the whole thing: a wedding is a celebration on one day; it’s essentially a party about getting to spend the rest of your life with this person you’ve chosen – why on Earth would you spend so much money on one day, on a party? I sincerely hope that Ben thinks as practically as me; when I tried to make jokes with Peter about eloping and he would say that he couldn’t do that because he knows me and knows that I would want the big party, with the big dress. (Bee-tee-dubs: I’d never imagined a “big dress”). I’m even at the stage where I’d thoroughly appreciate cheap, but expensive looking, jewellery (i.e. ‘the ring’) as long as it meant the money could go towards the house, or a holiday – something more useful than a rock on my finger that I’d worry about losing.

I’ve noticed how comfortable Ben and I have gotten all of a sudden – even though we’re so far apart and that we haven’t seen each other in weeks. Don’t get me wrong – he’s still on my mind every second, just that things have lost their urgency. This is somewhat of a relief really; it’s nice to go back to thinking about me for a bit and doing the things I want to do. Then again, I’ve been immersed in work and job applications lately and it’s entirely exhausting. Which means my sex drive has plummeted. This almost never happens to me. Thankfully the person I want is in another state, so at least the lack of drive isn’t being noticed. That reminds me I’ve got to book flights for next weekend. I’ve gotten a bit lazy it seems.

The final topic-on-my-mind is a bit of a controversial one. I’ve been trying to find a way to discuss the ‘anti-vaccination movement’ and where the concept spawned from. I’d like to go into more detail when I get the chance because the people who fuel such movements (denialists, naturopaths, homeopaths etc) can really do quite a lot of harm with their ‘theories’ and unfortunately people listen to them because of the persuasive power of anecdotal evidence (‘evidence’ in its weakest form I should say).      …I think you can get the feeling there’s more to talk about there, but for now I’m a bit too tired to be able to research the topic to be able to present the debate for a more invigorating read for you all. Another time.

 

On my way home from work today I was imagining myself waiting to be called forward for the job interview, and striking up a conversation with one of the other candidates (in my mind, likely a mole, since this would be the most logical step for properly analysing candidates: plant a fake interviewee to observe everyone in their natural, nervous state; judgy-mc-judge-pants style.) and when I’m called to the interview I wish the other candidate good luck. Why? Because it’s the right thing to do; because I really am that nice that if I thought they were also worthy of the job then good luck to them; and because if I’m going to have competition for the spot, I want to know that if I get it that it wasn’t just because I was the best of a bad bunch: a savoury Bradbury if you will.

Theory #21: Winning is still winning if it’s Bradbury style, it just wouldn’t be as sweet.

– Dr. Orist.

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Career Direction.

[This started out as a part complaining, part proud-of-my-work-&-achievements-today kind of post, but instead I’ve come back to the what do you want to do? question and on a possible career choice I’m not sure if I’ve talked about before, apologies if I have.]

Wise Words #1:
That the powerful play goes on, and you may contribute a verse.
– Walt Whitman.

It doesn’t look like I did much today, but it was a busy day.
(Part of the reason was that I was in a more senior role today – little bit scary, but we got there okay.)

9hrs in the Emergency Department gave me…

Fractured nasal bones + relocation
Syncope/collapse
Lacerated lip + suturing
Lacerated forehead (+ supervised student suturing)
Constipated (previously, now well) child
Abdominal pain + nausea (?UTI)
Missed miscarriage
+IV cannulation x2
Corneal abraision
Hand abscess/cellulitis

Everybody was discharged home (with adequate advice and follow up of course : P).
I also supervised the medical students + residents.
I was even bold enough to say to a registrar “you can thank me later” since I’d saved them a lot of trouble.

+2 hrs of overtime, mostly to finish writing my notes! (hopefully paid; I’ve requested this time)

My favourite was the abscess – there is something quite satisfying about relieving someone of their pus under pressure. If you enjoy pimple-popping you know exactly what I am talking about (and if you haven’t already youtube has some excellent videos of abscesses or comedomes or pimples being squeezed).
It definitely made my day (and I know that sounds weird).

Otherwise it’s nice to make someone feel better, or fix them, even if there’s not a definitive answer for what made them feel unwell.
I thoroughly appreciate it when a patient thanks me for the work I’ve done (today I got a “thank you, you’ve been amazing, you really made me feel better”) – it makes the hard work worth it.

Yesterday one of the consultants said that I’d be a good ED doctor because he saw me ask a patient’s wife “Are you okay to drive?” because she’d been up all night trying to make her husband feel better. Apparently it’s important to be able to consider the whole picture (because a patient’s social situation and therefore their family members are important too) – I thought this was just common sense!

I don’t know if I feel comfortable enough with the idea of working full time in the ED, or taking on more of a senior role.

At the moment I don’t feel like I know enough or have enough experience to be able to handle everything that gets thrown at me. But maybe with the extra study and the experience I’ll learn.

There’s also the fact that it’s shift work. And the shift work never ends. Though the lifestyle is more flexible and shift changes are much easier.

The only specialty I’ve so far really “enjoyed” (if you can call it that) was a term I was not expecting to like at all: Palliative Care.

______________________________(A little backstory)________________________________

My experience in pal.care as a student was tainted.

Depending on the university, third year med school in Australia is the first of the clinical years. I was part way through my palliative care placement (at the hospital I now work at), when my dad (stepdad) was in another hospital some two hours away, dying of metastatic prostate cancer. It was not easy to try to learn about the process of caring for the dying from a doctor’s perspective when I was already experiencing it from the family’s perspective. I used to say that I couldn’t understand how someone could work in the palliative field, how cold they must have to be to distance themselves from all of that grief and hurting, how could you go to work every day knowing that in the end you know it’s all futile?

My dad passed away on the 17th April 2010. I had left the hospital not two hours before. My mum was with him at the time (and has yet to watch Sweet Home Alabama since as it was playing on the TV at the time). The experience was also made worse by the university’s attitude. I’d already taken two weeks off to spend time with my dad and my mum in the time leading up to his death, but there were only a certain number of seminars that were allowed to be missed per semester – a number I had just maxed. The funeral was held on the same day as another seminar, and aside from the fact that I was giving the eulogy (mum didn’t have the strength, brothers weren’t going to be able to be there), this wasn’t exactly an event I could postpone, ask to rearrange the time for, nor was it one I could just skip — so I contacted the uni and offered solutions to the problem (repeat seminar in second half of the year with other students, go to another hospital for same seminar run at different time, just skip this third one with ‘special consideration’), but  – no. the university reiterated the requirements of my degree and of the components of the clinical placements. essentially making me choose between my dad’s funeral and a seminar. bastards.

For the principle of the thing, I attended the seminar, cried the whole way through, it finished early for my sake (hospital was completely understanding), and I drove the hour and a half to home to make it to the venue only 15 minutes after the ‘starting time’, but of course we had people filing into the room long after I arrived and it didn’t officially start until later so there was plenty of time. Never forgave the uni after that. And certainly left a bad taste in my memory of my pal.care term.

_______________________________________________________________________

I did two weeks as the pal.care resident last year while I was on my relieving term. I found that some of my ‘skills’ (for lack of a better word) in medicine are perfect for palliative work – I am good with patients and their families, I have a lovely bedside manner, I care about my patients (sometimes maybe too much), I take a holistic approach to treatment and consider many of the non-medical factors that might impact on a patient’s treatment.

As doctors we spend our days trying to keep people alive, sometimes fighting hard and doing absolutely everything we can. But in pal.care this idea goes out the window – we’re already at the point of acceptance (even if the patients are still going through their own stages of grief); we recognise the eventuality of everyone’s mortality; we can help, as best as we can, to prepare a person and their family for death; we can try to bring a sense of dignity to the process, and also a sense of control for those who need it; and we can try to make someone’s last moments easier and more comfortable for them and for their families.

This was the side of my pal.care student placement I didn’t get to see because I was too wrapped up in the very personal situation I was going through. Strangely, I can now see working in palliative care as an incredibly rewarding area of medicine.

If this is the path I’m due to take, I would like more experience in oncology and general medicine – there’ll be a lot of work ahead of me.

Theory #24: When you have achieved what you want to in life, or found the path to take you there, contentment will follow. If you are not satisfied, continue your journey.

For now, we’ll see where life takes me.

– Dr Orist.

To the wind the caution.

Be careful. Know what you’re getting yourself in to. Take it slowly. Are you sure this is the right thing to do?

It is wise to learn from your mistakes, and vicariously, through the mistakes of others.

I recently read a post by Of Fries And Men that reminded me of a story my mum had told about someone she was seeing when we lived in Scotland when I was five.

The guy was called Nick, and he was amazing. Mum talked about how fantastic he was, he was perfect for her, he was wonderful with us kids, he was everything she was hoping for and at a time when she really needed the reassurance that there are good guys out there.

Except he turned out to be a liar.

About everything. And he had a wife and kids he was lying to on the side. And his name was actually Matt.

And my mum was devastated. It crushed her. It took her a long time to trust again and be able to move on with life.

This, and countless other cautionary tales, serves as a reminder that even when the world seems perfect, it only holds that precarious position momentarily, as it can all come crashing unexpectedly down.

Now a more pessimistic person than myself might make a logical fallacious jump to assuming that my relationship with Ben is on such a precipice, and therefore to tread the ground carefully and take it slowly when uprooting so much of my life.

But I’m willing to risk it. I want us to succeed far more than I fear the consequences of us potentially failing.

If things fail, then you are allowed to tell me “I told you so” or “We warned you about this”.

I will listen to your advice and experiences, but I will not make a decision because in someone else’s previous similar situation it failed miserably. I cannot live my life cautiously and safely and not get to experience it at all.

Theory #23: Regrets are bigger for non-events.

Now it is just a matter of time until all of the pieces are in place.

– Dr Gigi Orist.

Leaving it for history’s sake.

I’m going to award an extra +10 points to Peter* on the Tally for the life lesson he taught me.

*Don’t fret, he gets another -11 because I remembered one of the worst GTFO moments: his claim “I was raised differently” when I wouldn’t contemplate selling my house to pay his debts. Lucky person they’ll be who gets him next.

 

Theory #12: If it isn’t essential to the plot, leave the mistake for history’s sake.

Peter taught me that, though perhaps not quite so poetically.

He liked the weirdness of things. He wore odd socks deliberately. He went through phases of different brightly coloured hair.

And ruined my bathroom cupboard in the process.

But that’s another story, and perhaps another -11 points come to think of it.

Pete’s thinking was that something is more likely to be special or memorable or meaningful if it has a quirk, a mistake. He loved the two squares I stuffed up in the quilt I made him because it showed that the whole thing was handmade.

It makes me think of the Mona Lisa – is she actually unfinished, or is the intentional unfinished look why her smile lingers just so?

Rarities of collectible items are often worth much more than the original because of a slight error in the manufacturing process. Interesting that the slightly faulty can be more valuable merely because of its mistake.

I have deliberately left the painting in my lounge room as it is – because I know that it is imperfect, and I know where those imperfections lie, and that makes it special because it is mine.

 

Ultimately, I’m just trying to explain future actions for any lack of backtrack editing on this blog.

If correcting an error is not essential to the end goal, I will leave said error – for the sake of The Orist blog history.

– Dr O.

 

p.s. Never fear my little Sheep(pl), I still very much like Ben, and Peter and I are never, ever, ever getting back together. Easy fond memories do not mend feelings easily.

A Resolute Plan.

I am incredibly impatient.

This might be my worst trait.

I will claim that it is solely responsible for all of my unfinished works, unrealistic expectations, and general restlessness.

W.H.Auden believes that laziness acknowledges the relationship of the present to the past, but ignores the future, and that impatience acknowledges the relation of the present to the future, but ignores the present’s relation to the past; and so, if one is lazy and impatient, you cannot accept the ‘present instant in its full reality’.

But I disagree. Impatience does not ignore the past and nor does laziness fail to recognise the future. Impatience is an eagerness to enter the future and see all of its potential, based on experiences of the past; and laziness is perhaps a lack of enthusiasm about the future due to an uninspiring past.

My Theory #5 then: Impatience is a representation of the high expectations one sets for oneself.

Though I do believe W.H.Auden is correct in thinking that you cannot accept the present properly if you are impatient.

I always have plans, but rarely follow through with them all. I always have To-Do lists, and mostly I just want things done already.

This is not to say that I don’t enjoy the journey, I just prefer looking back on the journey from the destination.

Aw shucks, I believe I have stumbled on to my new year’s resolution (NYR). Usually I give up on the whole resolutions thing pretty early, but I guess I really am wanting to change – I think I could be happier, and hopefully it would make things with Ben easier; or at least if I could seem less neurotic – that would be awesome.

NYR: I would like to focus more on the ‘present instant in its full reality’. I cannot hope to curb my plan-making tendencies, but I can try to follow through with the plans.

I will document my progress – wish me luck.

(Note, that was Plan #1: Document attempts to focus on the present, and any plans vs completion rates).

Resolutely yours,

Dr O.