Sunday 11 August 2013

Plodding along the increasingly tortuous road

Hey everyone


So I haven't posted much recently, and that's mainly been because of both things at home and things here (ie, the course). The title of this post probably seems a bit negative, but it absolutely captures the present completely. I'm currently having a bit of burn out with regards to lecture and home study style learning, and literally can't wait until we move into the hospitals next year. So in that respect, it's just one foot in front of the other until then (hence the 'plodding'). And the road continues to get more and more tortuous as we continue -- it might be smooth-ish right now, but as we get up to those dreaded end of year exams the shit is going to hit the fan in a major way. The end of year exams are on not only this semester, but the first semester as well. By then it's likely I'll have about 200000 words of notes in my onenote document. How are we meant to study all of that and retain any appreciable amount...it's just going to be very interesting. So at the moment, it's one foot in front of the other as the world around us and the path under our feet gets more and more treacherous.


Anyway! let's revive this post before it just becomes a general rant.

Probably a week ago now my laptop out of nowhere died. It would boot, but it would go to something called the 'aptio setup utility' or something like that, and wouldn't continue on to windows no matter what I did. I took all sorts of advice but to no avail, so the next day I went out with a friend and bought a new laptop. That may seem rash, but I simply don't have the time to spare to get the other one fixed. I have like 4 lectures a day on average! There's no way I want to catch up on that many lectures if the laptop would take like a month to come back. So I bought a laptop. And...an ipad mini. Why did I buy that?? It was a bit of an impulse purchase, but I've been thinking of getting a tablet for a while and there was just a better app store with the ipad. At the end of the day I want my phone to have excellent pre-installed applications because they're what I'm going to be using most of the time (eg, the keyboard), but on a tablet that's not as important. I'm going to be spending probably 95% of my tablet time in third party applications, and the argument is there that apple has better third party applications for some reason.

The ipad turned out to be one of my best impulse purchases ever! It's nice to have a big screen to enjoy everything on, but the main use for me has been facetime. Now, I know that's really lame. I scoffed at the facetime ads when they came out, and said to myself 'why didn't these people just use video calling'. But there's just something about it that makes it super easy to use...anyway, so my use of facetime has basically been exactly as apple portrayed in the ads -- facetiming my girlfriend (long distance relationships suck), and facetiming my family. I shudder to think that I've been so...predictable to an international corporation. But facetime is indeed cool, and I've greatly enjoyed using it.

The laptop I bought is a sony vaio pro 13, which it turns out is actually a very new laptop indeed. It's a pleasure to use, and is perfect (aside from the absence of an ethernet port. But, ethernet really needs to update the standard because the heads of the cables are now much too large for this day and age of measuring thickness of laptops in mm's).


Well this didn't end up being much of an interesting post, so I'm sorry about that. Just an update, I guess.

Catchas!
Circle

Wednesday 17 July 2013

What We Can Learn From Hannibal

I feel like it's about time I did a bigger post! Plus I'm bored tonight, and I don't feel like studying.

I read the Hannibal books a long time ago (in the distant times when I had the time to read normal books), and one of the things that struck me about the man was the mansion in his mind. The details of this mansion are but degenerating memories in my mind, but some parts are supported by links with other things I have since learned. Hannibal used his mansion as two things if I recall correctly -- as both a storage place of memories and knowledge, but also as a place that he could retreat to at any time, a place all of his own and removed completely from the reality that his body remained surrounded by. In year 5 our teacher taught us some relaxation techniques and my classmates and I went with it because really it just gave us an hour to sleep in class. But one thing did stick with me. She told us to create a place in our minds that was the most relaxing place to us that is possible, and keep it in the back of our thoughts and always return to it and imagine ourselves to be walking through it when we needed to remove ourselves from life for a moment. She told us that, and when she gave us a chance to try it my mind immediately went to task and in my mind's eye blossomed the most beautiful scene. And in all these years that place has remained completely unchanged. I won't give details of my place because that isn't the point -- despite irrationally not wanting someone else in my space, it should be up to you to know what you would find the most relaxing, and have a place of your own.

But my place is not as real as Hannibal's mansion is to him. He experiences his mansion as though his feet were actually on its carpets, his lungs breathing its air, his eyes seeing its displays (for that was the nature of his storage of ideas - putting them on display). Not only does my place function as nothing more than a place to relax and separate myself from the world, I experience it as though I am forcing it upon my mind. I think that is why Hannibal's construct struck me so strongly, because it represents something that I desire very much. This 'method of loci' technique may also help me to learn the immense and unending lists of things that I need to learn for medicine (possibly the start of Hannibal's use, too!). Method of loci is used by almost all memory champions, and if it can work for them then I would be willing to try.

Also, apologies for my last blog post. I wasn't having a good night!

The other night I was sitting with some high school students who are at the college as part of a program showing them what university is like, and to inspire them to attend I guess. I would have liked to have sat with my medicine friends but their entire table was filled with people from the college not wanting to sit with high schoolers, so I just sat with the younglings. At first I didn't say much, as is probably normal with me, but then I broached conversation with them by asking normal things like what were they doing at the college. These boys were probably the kind of kids that I wouldn't have been friends with in high school -- a bit too loud, very competitive, etc. However a couple of them became interested when I said that I was in medicine, that we got into a proper conversation. Much of it consisted of them asking me about my course, and about my future, but we eventually turned to talking about their futures. One of them said that he wanted to be an astronaut but the others laughed at him, and the others didn't say that they knew what they wanted to do (I presume some of them simply didn't want to be laughed at too). But I started to talk to them about what I had to do to get to where I am, and the amount of work that I had to put in. And by now about half or more of the table of boys were listening to me, and the tone of the conversation had turned greatly -- it was much less them and I talking, it was now more me talking to each of them individually, and as such they were much more open in their responses. I talked to them about the regrets that I have had in the past, and the things that I would have done differently if I could go back to their age. At this point the entire table was listening to me. I told the boy who had said that he wanted to be an astronaut that if he but started now doing a small amount of study per night, and kept it up, by the time he was in year 12 (a few years away for them) he would have the whole world at his feet, and he would only be a few small steps away from living his dream. No one was laughing at him now, none of them were talking at all! It's as if I had removed some long standing obstacle, and the gears of their brains were turning at full speed, imagining the possibilities. We talked for a bit longer, before their teachers brought them away, but quite a number of them thanked me for talking to them and one even said thanks for the inspiring words. I really enjoyed that conversation, and I sincerely do hope that some of them were inspired to put in the small effort now, so that their future is disproportionately easier.

We went ice skating last night with some of my friends, and it was absolutely brilliant to get away from the tedium of study. A number of the people who went are my friends already, from college or just from medicine, but a few I didn't know but proved to be very nice people indeed. One of my better friends from college and I both decided to try out proper hockey skates, and wow did they make no small amount of difference! By the end of the night I was properly running on the ice in that manner that hockey players do to get up speed, and taking corners in that way that looks so smooth. I did a small amount of damage to my feet though, with several blisters appearing because I hadn't worn socks that were thick enough to pad them. To be fair I don't actually have thick enough socks because I left them in Perth, but I should have bought some or something.

Anyway, in medicine we're in neuroscience block and even though people all year have told us that it's the worst block I'm actually loving it! Well, I've never liked learning the cranial nerve nuclei and I have to learn them now, but aside from that it's all fantastic. Even the physical exams and the patient interviews have effortlessly imprinted themselves on my mind. 

Yesterday too I bought a new phone -- the galaxy s4 -- but today the company that I bought it from said that I needed to provide proof of who I am by sending them, including other things, a utility bill with my name on it. Well, I live at college...we don't get utility bills. So I've had to email them back and ask them to cancel the order. It's sort of easy for me to go directly to their store, so I'll maybe do that tomorrow. The news has come out tonight though that Verizon is set to reveal their new line of motorola droids on july 23rd which isn't too far away, so on the off chance that the motorola X is revealed at the same time, and on the off chance that it's a more attractive option than the galaxy s4, favour may pay the one who waits a few more days with refunded cash in hand... In other but related news I finally got around to getting my forms to the college and now they can pay me for the tutoring I did last semester. I think it's actually going to come to quite a handsome amount, which should hopefully pay for me a tablet computer! I'm thinking of getting the galaxy note 8.0.

Well this post did end up being one of a reasonable size, but I have run out of things to blog about which is a sure sign that probably you have already passed the point of being boring! Haha. So here I shall sign off.

Till next time!
Circle

Monday 15 July 2013

Like the lion with no teeth, or the jester with no jokes, or the banker with no coin, behold the hollow man.

Saturday 13 July 2013

Dr Universe?

So, I think either today or yesterday the Australian contestant for Miss Universe was decided -- and whaddaya know, it was a medical student from Melbourne! As far as I know she isn't from the University of Melbourne so she's probably from Monash but she's 19 so that's young to be in graduate medicine...either way, I'm pretty sure I'm getting a transfer to wherever she's from!

Just goes to show, med students are the most beautiful people ever. That's my unbiased take from the news. Also, good luck Olivia Wells!


Catchas,
Circle

Wednesday 10 July 2013

Neuro, and the study timetable

So we started neuroscience this week, and by all accounts of students from previous years it is by far the hardest block in first year. So we have all been looking at this block coming up with a large degree of apprehension...but for me it hasn't so far turned out to be so bad! I've done quite a bit of neuroscience and neuroanatomy in the past however so that's probably the only reason I'm going along ok. I actually am loving it so far -- I think what I like so much about neuroscience is that any deficit in it you can see in immediate ways in the patient. You have damage to your spinal cord? Ok, let me touch you at specific levels...oh, you can't feel below this line on your chest? Ok, the damage in your spinal cord is here. In other areas to investigate function you have to do all sorts of complex things like run lab tests, attach all sorts of weird wires to the patient, or look for the consequences of poor function in places that the patient is quite surprised you're looking at (like looking at the fingernails to get information about actually several different organs, a couple of which are in the gastrointestinal system!). In neuroscience the cause and effect relationship is immediate and plainly obvious, and that's one of the things that I find extremely interesting about it.

Also, I made a study timetable over the holidays (it actually took me the whole two weeks, that's how good I am at avoiding work) and it planned out my every 15 minutes between 6:45am and midnight every day of the week, monday to sunday. Call that ambitious? It was. The issue was always going to be how well I stuck to it, and I'm finding that with missing my girlfriend it's all the more difficult. Still I am finding that I'm doing more study, which is good I guess...I'm just being more liberal with my free time periods than I should teehee. I should get a handle on it soon -- I'm already finding my focus improving though.


Until next time! Sorry for the boring post!
Circle

Saturday 29 June 2013

Going back

My 2 week mid-year break is over, and Melbourne is the last place I want to be. I feel like this must be how dumbledore felt as Harry forced the potion down his throat. This must be done, but just at what cost.

Sunday 16 June 2013

Mid Air Emergency

(now, I don't know why but I'm going to try to build up the situation as though you don't know what this post is going to be about from looking at the title)

So, the other day I was on a plane back home because I finally finished exams and I was free (FREE!). I'm pretty used to being on planes so nothing was out of the ordinary. They'd served our dinner, and everything was peachy. I was watching Avatar, and I think they were only just past the part where Aywa (or whatever her name is) just decided to take a side in the battle in the skies, when, all of a sudden...the screen cut and a message was displayed saying there was a cabin announcement. In short order, my worst nightmare came true...

"If there are any medically trained passengers, please immediately make yourself known to staff by pressing your call bell".

The blood I felt immediately drain from my face, and my heart stopped. I wasn't ready for this! In a split second my mind had a furious battle where numerous arguments fought: first and foremost, I was afraid that I would be the only medically trained person on the plane, and that if I made myself known I would suddenly have a life on my hands. Within that though, I knew that despite being just a first year medical student I still perhaps knew more than the average joe blog and so I knew I should take the call. Still, I was afraid of having the life on my hands. Secondly, to be honest I wanted to be a part of it. Not because I was nosy, but because it was exciting and perhaps a chance to use some of the knowledge I've gained so far.  Thirdly, as I saw another person press their call bell I had to think about whether my limited knowledge would be of any assistance at all, and whether I would just be in the way. Fourthly, I did consciously put my stethoscope in my carry on luggage just in the remote chance that something happened in the air because I've heard horror stories of airline medical kits not even having stethoscopes and I want to be prepared. So, all of this went through my mind in about a split second. I wasn't ready, but my mind went blank and I just knew what I should do: I pressed the call bell.

Within less than a second a hostess came to me but I was already getting out of my seat -- I didn't know what the issue was and if it was serious then time may have been against any attempt to save the person. Once I decided to help, I was committed. I felt sheepish being escorted to the rear of the plane, feeling way out of my depth and wondering just what the hell I'd just gotten myself into. If I couldn't help this passenger, what would I do? The people around might be looking to me as the person to save the passenger, and if I didn't know what was happening to them or if I didn't know what to do, what would I do?? I was freaking out, but trying to stay calm at least to assess the situation.

Making my way to the rear of the plane, I noticed that there were barely any passengers around and I wasn't sure if they'd cleared the area but it was really good. When I arrived there was already a guy in a tshirt talking to the man who had an oxygen mask on, and there were probably 5 or 6 air hosts/esses around. The guy in the tshirt I quickly realised was an experienced medical person, which made me instantly relieved -- I felt like he had saved me, as much as he was saving the passenger. I soon learnt he was a trainee surgeon from a victorian hospital. He was doing a history of the guy, while the air hostesses got out what seemed like every piece of medical equipment and materials the plane had. The guy was diaphoretic, tachypnoeic, had rigors, tremors, fever, headache, had vomited profusely and had a large quantity of diarrhoea over the whole duration of the flight, had chest pain, numbness around the mouth (we decided probably from hypocapnia secondary to the tachypnoea), and he felt very nauseous. He had lost consciousness while trying to tell a hostess that he was feeling ill, and he convulsed while unconscious. While the nausea, diaphoresis and chest pain initially had me wanting to rule out MI, the surgeon said quite rightly that at the patient's age it was highly unlikely, and so with the fever he was more inclined to go straight to a bacterial cause -- sepsis, secondary to a gastroenteritis.

Basically, we found that almost everything the aeroplane had was for acute life threatening non infectious conditions like an MI. In the absence of IV antibiotics (or even oral antibiotics), our options were severely limited. Basically, we could only give symptomatic treatment and hope that the diarrhoea and vomiting had reduced the infectious load enough that he would make it to our destination. We gave him an aspirin for the chest pain, and we were going to give him some fluids that they had (hartmann's solution) but the cannula didn't connect with the tube from the IV bag for some reason, so we just had to be content that we had secured a peripheral line for the ambulances who were going to meet us when we touched down.

The man's condition was pretty serious. His temperature was very high, but he perceived his temperature to be varying wildly -- one minute he would be sweating profusely, the next he would be shaking with extreme shivers. The sepsis appeared to be quite bad. We had him on 4L O2 and he said that was the only thing stopping him from vomiting. His condition become the worst we saw just before we landed, but he still didn't vomit again after we saw to him.

As for what I did myself, it wasn't all that much. I of course offered my stethoscope and it was gratefully received so the surgeon could listen to the breath sounds. I also liaised a lot with the aeroplane staff, telling them what we needed and what was happening now. I also talked a lot with the surgeon, giving him equipment and talking to him about what he was doing and thinking, what I was thinking, etc. I really wanted to get in there and have a listen to his chest as well, but there wasn't enough space and I didn't want to speak up because I was just a medical student after all...

Anyway, when it was apparent to us that he was perhaps at least stable, I talked more casually with the surgeon. We got friendly, and he said that he'd give me his number and when I'm back in melbourne I should give him a call and maybe he could give me some experience in his hospital -- including theatre! I'm sure he didn't mean that though so I'm staying realistic, but I'd still love to even just get to be friends with him.

The staff of the plane thanked us so much after the paramedics came on board and we started packing up. They were thrilled with us, even the captain came down and shook our hands. One of the main staff people gave us each a bottle of wine, and they took our details and the captain said he'd see what he could do...he meant about getting free tickets I think!! Incredible.

All in all, that was an incredible experience and I am very glad that I decided to stand up and offer what little I could. I couldn't believe that it was actually happening and I still can't in a way, but it taught me several things but most importantly, it gave me my first taste of a situation where not only are tensions running high, but I am also required to be able to think critically and draw upon my knowledge. So exciting.


Until the next time,
Circle

Saturday 8 June 2013

Stories

I want to maybe start posting tiny stories on this blog, as a way of staying sane and as a way of widening the variety of things I post about. You always hear people say that practice makes perfect, and so my stories would be crap to start with but hey maybe by the end of the year they'd get better.

Catchas!
Circle

Friday 7 June 2013

Exam prep

Heading up to exams next week -- WOOHOO! Wait a minute, I'm not excited about that...take that woohoo back!

I have two exams next week, and one of them I'm either going to ace or miserably fail utterly and wholeheartedly. That is, of course, the main FBS (foundations of biomedical science) test. Basically, it's all of gastro and renal block, plus all the labs from the whole semester. That's all the immunology labs, all the cardio labs, all the resp labs, all the gastro labs, all the renal labs, all the anatomy labs, all the microbiology labs, and there's one other set of labs that I've forgotten too. Oh, histology. Oh and the pathology labs for all those organ systems too. Sooo...since I'm really only just starting revising the lectures for gastro and renal, what do you think my chances are?

Well, that's actually an interesting question. See, everyone right now is stressing out about anatomy. BUT, I've already done heaps of anatomy! So if anatomy forms a large amount of the test, then I'll almost be able to wing the rest of it...don't you just hate it when you get to the point where you're thinking about how to minimise the amount of work you have to do simply because you're in a position where you can't possibly hope to do it all. Ahhh well.

After next week I'm heading back home for our two week mid-semester break (yeah we only get a 2 week break), and after that we have neuroscience which is universally stated as being the absolute hardest block of the whole year. It's six weeks long!! So I'm hoping to bring some of my pathology books home and study up some neuroscience over my break so that it doesn't hit me too hard .Knowing me though, I'll be posting here probably at the end of the first week of neuro that I wish I'd actually done that study over the break.

We talked to a vascular surgeon trainee yesterday, and he said that while he's training now to be a surgeon he actually knows that there aren't any jobs available for him. And that kicked off a massive discussion about our job prospects in medicine...basically, they suck. And the prevailing opinion is that some day technology will basically replace doctors. If not doctors, then certainly surgeons. For example, cardiothoracic surgeons -- drugs to treat heart conditions are getting pretty darn good now, and lots of people are saying that they're heading the way of the dodo. Hopefully neurosurg doesn't become obsolete for, hmm, at least 60 years :P

Anyway so that's me for the moment. This weekend's going to be a mad struggle to get enough sleep and cram a whole pile of stuff into my memory circuits (yes robotic overlords of the future, I am a robot and you should keep me alive). And when I say a whole pile I mean it: I exported my onenote notebook to word so I could see the wordcount. Here it is:


Like...what. Halfway through the year, people, and I'm almost up to 100000 words. Imagine being told to write 100000 words. I would laugh in your face and then do a little poo in my pants when I realised you're serious. Thank god I moved to dvorak, or I bet I would have been veeery familiar with the effects of carpal tunnel syndrome. Actually come to think of it...damn, knowing those effects would have been handy for this test (get it, handy. My mum thinks I'm funny ok).


Wish me luck!
Circle

Thursday 30 May 2013

Hospital Allocation

Today we received our allocations to the hospital that we'll be learning at for the rest of our courses after this year. I wanted to be at a major metropolitan hospital but before even entering the course I didn't get that luxury. I was down to a choice between two hospitals, and I preferenced one over the other because I really only liked one of them, the other one seemed like a bit of a dump...anyway, so of course I've been allocated to the hospital that I didn't really want. Hooray, right? Ah, me. I just can't shake the idea that not being at a major hospital is going to affect my internship chances somehow, and by extension my ability to get into whatever training course I want later (I say that rather than 'my ability to get into neurosurgery', as a hat tip to the fact that I will probably change my mind in the future -- everyone does, multiple times). If I'm going back to Perth after my MD course then I guess it doesn't matter as much...but what if I don't go back to Perth? There's actually a lot of unknown in my future at the moment.

They only let you change clinical schools in very specific circumstances, and I don't meet any of those circumstances, but just in case I sent them an email tonight saying that if anyone happens to want to move out of the school that I wanted, and has to move to the one I'm to go to at the moment, then I really wouldn't mind being someone they think of to swap with that person. I guess that's the best I can do!

Having said all of this, I know that I am still going to get a good education. I'm still going to go to my hospital and get as involved as I can without annoying everyone. I guess I was just hoping to get involved in that 'big hospital' feel, with all the important consultants and surgeons (I'm thinking neurosurgeons of course) around. Not that they'd have any time for me, but still. Also, the facilities at the metro hospitals are a bit nicer.


Adios,
Circle

Monday 13 May 2013

GP Visit!

I've got my first ever visit to a GP tomorrow, and it's 1am and I should really get to sleep because it's at 9am tomorrow (today?). I'm super excited! A lot of my friends have already been on their GP visit and they report various amounts of involvement -- some have just been sat in the corner, but some have been able to even take blood! I hope my GP is really willing to let me get involved, because I will absolutely do anything he's comfortable with me doing. I'd be a bit stressed out about doing an interview, but like last time I'm sure that once I'm doing the interview I'd be ok. I mean I've practiced on people before, so it shouldn't be too bad to take that and do it with a real patient.

Next year I'm going to actually go to a GP every friday I think, which I wasn't so sure about initially but now that I think about it I think it's going to be really good. It will not only let me get integrated with a community, and see patients come back time and time again, but it'll give me really practical skills and great patient contact. In some way though...I have a small voice at the back of my head that's saying that I hope it doesn't convince me to be a GP. I will keep an open mind though, because if seeing a GP work really gets me excited, then why not be a GP.

Exciting times in my world! Wish me luck!

-Circle

Sunday 12 May 2013

Contracts For Difference

Hola!


A long time ago I used to not be into medicine at all, and was in fact well and truly obsessed with contracts for difference (CFDs). Why were you so obsessed with them, I hear you ask? Well, it's pretty simple. Basically, trading a CFD is the same as trading a share, except for the same change in price in the underlying security you make either a much greater loss or a much higher profit. For example, the other day I was trading USD/AUD with a leverage of about 99.75%. Normal share trading you can think of, for the purposes of comparison, as a CFD with a leverage of 0%. What you get is what you can pay for. With the CFD I was trading the other day, I was only having to come up with 0.25% of the total value of the goods I was trading. Now when something increases in price by $2, if you buy at the bottom price and sell at the top price you only get $2 for every share you were able to buy. If I was to buy that without using CFDs, I might only be able to buy a few hundred of those shares because my money isn't being leveraged. However, if I was to buy with a CFD I could leverage my money and have the buying power of say $10000, without actually having anywhere near that amount. Now I can buy many more than a few hundred of those shares, and so even though the price difference is still just $2 I am now making a much grander profit. 

The downside to this of course is that if it had gone down $2, I could have just put my family into bankruptcy (quite literally -- leverage can be extremely powerful in CFDs, such as my 99.75% example above). At the moment I use extremely tight stop losses (automatic levels that you set where, if the share trades at that value, it automatically sells them for you, to 'stop' your 'loss' hence the name) and I only trade in small amounts. However, it's still easy to see how powerful these things are: I think I traded 2 units of gold, which I needed to put I think $6 on the line for (that's instead of having to put out about $3000 to have 2 ounces of gold...). The share price went the way I thought it would, and I took a profit pretty quickly, and the profit ended up being $10. That's $10 above my $6, so by the end I had $16 on top of my reserve cash. Now, you're probably thinking 'so what, that's $10, who cares!' but think about this: that ends up being a 167% profit. Now, change my $6 into $6000, and all of a sudden out of that small price movement I've made a clear $10000. $6000 usually would only have bought me about 4 ounces of gold if I had no leverage, so my profit would have only been about $20 ($5 per ounce, because before I owned 2 ounces and made $10). You can clearly see that a $20 profit after putting $6000 on the line is not quite as good as a $10000 profit for putting the same amount of money on the line.

So, if there's so much profit to be made out there by the calm and logical investor, why didn't I go into it! Well, I read a very wise share trader once say that to be a day trader you can't do it on the side -- it has to replace a job. It takes a lot of time to watch the markets, and be in a position of knowledge about the share price, rather than guessing where you think it's going to go. At the time when I was thinking about going into CFDs in a big way, I just couldn't see myself sitting at a computer all day as being much fun. And if it really did happen in a big way for me, if I retired in a couple of years with a billion dollars in my pocket (my dreams were big, ok) then what? There's only so much you can sit on a beach sipping cocktails! At that time as well I was getting veeeery interested in medicine, so I decided that I would give medicine a go and see where it takes me. Of course my attitude to medicine is now very different -- even if I could be guaranteed of billions in CFDs I wouldn't stop pursuing medicine -- and I'm very glad that I decided to not go into CFDs.

As mentioned though, I have been doing the odd trade here and there recently, and as long as I don't put much money into it it could be just a nice distraction. I intend to set up a trade in the morning, and not touching it again until the evening, seeing what happened with it and learning about what went wrong for about 5 minutes. If it could be a nice little earner on the side as I go through these next years then that would be pretty nice!


Regards,
Circle

Friday 10 May 2013

Update-yness!

Hello!


Long time no speaketh! I've been extremely busy just recently, not that that really surprised me. Ahh we have done so much, and in such a short period of time.

The lectures continue to come thick and fast. My OneNote system is working fantastically for me, allowing me to organise all of my notes and include helpful diagrams as well. OneNote doesn't do much tracking of the notes you write but you can export it as a PDF, then import that PDF into Word...anyway, so right now I have about 65000 words of notes, over more than 300 pages! We look at each other and wonder how on Earth we're going to study all of that for the final end of year exams, where everything that we've learnt in the year will be assessed. It's going to be intense I'm sure.

Speaking of assessment, I had one of those recently! It was our first one. Below is the very nice bell curve of results:


Guess where I was! Right smack bang on top of that curve. I got basically the average mark, which is far, far from where I want to be unfortunately. So it's time to knuckle down and get my groove on! The test was on only lecture content that we did between the start of the year and the day of that test, but we have a test coming up in I think about 4 weeks that will assess the lectures we've had since, PLUS the content of the labs from the whole year thus far! I have a few friends that are second year med students here, and they say that everyone sort of does ok in the first test, and then gets demolished in the second test. I intend to not be one of those people that gets demolished :P Things will be better for the next test!

Some exciting news! The QS World University Rankings just released their 2012/13 lists, and Medicine at the University of Melbourne is number 9 in the world! We're basically only behind big names like John Hopkins, Oxford, Harvard etc! That blew my mind, and I think I have told everyone I can about it. I am so proud to be here, and hope my cohort can be the one to take us higher!

We have been doing some pretty interesting things here recently. In our Principles of Clinical Practice subjects we sometimes get patients to come in so that we can practice interviewing them, in a fishbowl format so that the other people in the class sit there and watch you, so that you can get feedback on your interviewing afterwards. I did mine last week, and I stressed about it a lot beforehand. When he introduced himself he said he had shortness of breath, and that's fine, but then he said he also had a smoker's cough...well, basically I had to interview him not just about his shortness of breath, but his cough too, AND his smoking habits haha. It actually went extremely well though! The patient, when the interview was finished, basically as soon as our tutor asked him to give feedback he pretty much exploded with praise, he was so animated and it seemed like he was extremely impressed! He said that he felt extremely comfortable with my interview style, that there was a great flow and he felt like I had really given him a lot of sympathy and listened to what he had to say. I was stoked with that!! Then other people in the group were able to give me feedback, and it was all much the same. I was pretty happy with that!

I think the last time I posted I was still doing cardiovascular medicine? Well, we're actually up to gastrointestinal medicine now, having completed respiratory already. Basically, everything we do seems to revolve around diarrhoea. We have seen some not so pretty pictures, let me tell you that...the worst have been pictures of parasitic worms. My god. And someone had the idea of eating parasites so that they would eat all the extra food that we eat that we don't need, to stave off obesity...no thanks.

College is going great too. I probably aren't leaving my room as much as I should though, because it's so easy to stay in my room! The meals here seem to have become stuck in a rut of not being all that great...having said that, there was a curry tonight that was pretty good! They have a fondness for soggy brown rice, which is disgusting.

That's probably a big enough post now, I'll post again soon when I think of something interesting.


Regards,
Circle

Saturday 2 March 2013

A Taste for Clothes

When I moved to college, I was told that we'd have several black tie events. Coming to college I'd only owned one business shirt, let alone a suit, and let alone a tuxedo, so be told that in 2 short weeks I'd need to be able to deck myself out in finery was quite a shock to the system. So, having just recently worked out how to use EFTPOS (I was afraid I'd swipe the card the wrong way and look like an idiot...or something), I went to the city in search of a tux.

I found a menswear shop that had a large banner saying some big discount sale happening plastered over the front of the store, so I hopped right in. The first thing that I said to the salesman was that I needed a tuxedo, and so he proceeded, like any salesman would given the opportunity, to sell me something that was anything but a tuxedo. At the time I was thrilled to bits with it -- my first suit! -- but after consulting my most informed friend on these matters I was told that it was in fact a business suit. A good business suit, but a business suit nonetheless. Back to the drawing board.

Like any good scientist, I researched the topic. I quickly entered a world of shawl vs peaked vs notched, winged vs turn down, and satin faced vs self faced. I found that the tuxedo looks deceptively similar to the business suit -- but in fact there are several critical factors that separate the two, even down to whether the trousers have hems or not. I searched for and wide on the subject: on current styles, on styles that I liked, on styles that are definitely out of fashion. I researched etiquettes, standards and optionals. I profess now to be a slight expert on the black tie event in general, and especially on the correct components of a man's tuxedo. I thoroughly enjoyed learning all that I could on the matter, because it's a part of life that I haven't ever been a part of before. Woe betide any salesman that tried to sell me a self-faced jacket lapel now.

Armed with this fresh knowledge, and a topped up bank account, I skipped the cheap discount suit shops and went to David Jones (ok, so it's no Armani store -- it's the best thing my budget can do though). I didn't even bother looking at the suits before finding a salesperson. I asked for a tuxedo and credit to them they did show me an actual tuxedo, but the lapels were highly peaked and while I know that that may be in fashion now, and perhaps more formal, I think a more timeless look is the shawl. Over the next few hours I went from David Jones to Myer and back and forth (luckily in melbourne they are just across the street from each other), and gradually constructed my suit. There was a very limited selection of pleated wing-collared shirts, but they did have one in my exact size. The shoes were particularly hard to get -- I knew exactly what I wanted, but neither of the stores seemed to have something similar. In the end Myer had an almost exact match in their storeroom, but they were damn expensive. I do love them though.

I've worn my tux twice already and the third occasion is just next week. Wearing it, and knowing that you've spared no expense to put together such a correct set of pieces that you could wear it to a dinner with the Queen, makes me feel like a million dollars. For someone who is still really not out of his tshirt and shorts phase buying such a formal piece was a true eye-opener. One of my friends (that same classy friend that informed me about my suit) recently showed me this particular site, the website of Brooks Brothers. I've use to never be able to understand how women could spend so much on clothing, but I'm ashamed to say that I do now. If I could buy everything that Brooks Brothers sells for men, I would in a heartbeat. I would blow every paycheck I get on their clothing. I realise the value of good clothing now. So much in female fashion may be about buying a label, but I don't believe the same can be said about the clothing that Brooks Brothers sells, and perhaps most mens clothing in general. They're not cheap, but the quality of the clothes reflects that. To wear nice clothes is a luxury that I haven't pursued before. I wouldn't say that I'm intoxicated by it, because I still wear my tshirt, shorts and thongs to uni every day. But when you go to Myer and feel the difference between a $20 polo shirt and a $50 polo shirt for instance, I will almost always now go for the latter.

Why am I writing about this? I'm not sure, I guess I find it an interesting story. It's probably a bit of a personal journey for me, going from slightly ignorant, to a point of self-awareness and probably materialism. Is it materialist though? I would care if someone burnt my tux to a crisp, but I think that that's more because I don't have a job at the moment so all my money doesn't come back. If I had a good paying job, and someone to look after other than myself, I think that my priorities would be vastly different. Hmm, perhaps this isn't the end of this personal journey.


Stay classy,
Circle

Wednesday 13 February 2013

Taking the steps

We had a practical lab today, and we learnt how to take blood pressure in a number of ways, both manually and with machines of various size and ability. It sounds mundane, and plenty of people in all walks of life can do it, but it sure was exciting for me at least to get out my stethoscope and use it on someone else for the first time! It was fairly hard to find the brachial pulse on most people, but I'm sure that with practice that'll become second nature. As part of the lab we are able to take part in a research project organised by the medicine faculty, investigating blood pressure. It's the largest study of it's kind in the world, so it's no small thing. Part of it is to do with changes in how long it takes for our heart to readjust itself after we go from laying down to standing. My blood pressure went below 25mmHg when I stood up...that's really not good. Then I took an anti angina drug and repeated the experiment, and the blood pressure stayed lower for longer, which was what we expected. It gave me a thumping good headache too, because it worked by vasodilation.

On another note, the pharmacology lecturer made us watch this video, because...here's the scary part...it summarises most of the drugs we're going to have to be very familiar with by the end of the year. Fantastic.


Regards,
Circle

Tuesday 12 February 2013

Microsoft OneNote

So, I figure it's a good time for an update! Lots has been going on and it's all very exciting.

Yesterday was my first day of actual proper medicine, as in learning things. It was an extremely full on day as well, starting at 9am and ending at 6pm. That was an ordeal, but thankfully we had an hour break in the middle of it all. So during the day we had 5 lectures and 1 case supported learning (CSL) tutorial. The lectures were pretty interesting, but were mostly introductory in nature. For example, we had general introductions to pathology, physiology and histology. It was a great chance for me to trial a new note taking system -- using Microsoft OneNote.

To put it briefly, it promises to change everything. No more do I look at a densely packed lecture screen and despair, because now I can just bang out everything on the keyboard. You can either organise all your subjects with separate notebooks, or, as I do, have a single notebook for the course and have tabs for each subject. Each tab in each notebook can then have pages...and its on each page that I write the lecture content. I don't use any of the fancy templates to structure a page -- they have too much frill for me. I even organised a few sub-pages in one of my pages -- blood, bone and cartilage are sub-pages to the page 'connective tissue'.

So already there is a vast amount of granular organisation available, but it gets better with a couple of tricks. Firstly, it has an almost instantaneous search function, so if I want to find out where I have previously been taught about something I can just quickly type the string into the search and have listed the page it's in, and when you then press enter on one it takes you straight to the instance it's mentioned. Secondly, having found an interconnection between two separate pages...you can then actually produce a link that will take you straight there to be placed in your other, current, note. So in the example I've just searched for something and it's come up in this other page before, clicking on that result takes me straight to where I've mentioned it, and right clicking on that mention and pressing 'copy link to paragraph' will give me a text link to place in my current page that will take me straight to the previous mention of the thing. It boggles my mind, and is probably going to be the biggest thing that keeps me now doing electronic notes. Thirdly though, I keep a wonderful little program open called 'snipping tool'. If you're unfamiliar with it, get familiar with it quick -- it basically lets you copy exactly what you want from the screen to your clipboard to be pasted anywhere. So for example, I'll have my lecture notes open as a PDF while I'm at the lecture, and if the lecturer has used a particularly good picture or table to illustrate an example then I can quickly pop into the snipping tool, crop around the picture or table, and paste it straight into my notes. WOW.

Aside from lectures -- which are a breeze now with my new system -- we've had a few tutorials as well. The CSL this week is about a patient with headache, photophobia, general malaise (what a favourite term), lethargy, cerebral disturbance and a bad temperature. It only took him 3 hours to get much worse, so his friends took him to hospital. We decided it was probably an infection, and more specifically probably a meningitis. We discussed things like what sort of history we would take, what tests we would order, etc. For the record, we'd start him on prophylactic antibiotics (types that cross the blood brain barrier, too) order a lumbar puncture and test the CSF for a number of things -- protein and glucose levels (will rise and fall respectively in the case of bacterial meningitis), cell count (PMN's will be high in bacterial infection, whereas lymphocytes will be high in viral infection), and you can do tests to detect bacteria in the CSF as well. It was a much better CSL session than last week's ones, because we'd all prepared a bit for this topic so we all had something to contribute.

We also learnt a bit about how to show patients that we're listening to them in our principles of clinical practice (PCP) tutorial. Things like when to use open questions, when to use closed questions, non-verbal techniques to use, etc. It was fun! This morning I had a lab where we tested the patient's CSF for the presence of bacteria, except the test was inconclusive...which sounds lame but it's still a result, and could point to the bacteria being Neisseria group B because apparently they don't get picked up by the test we did very often.

It seriously feels like a whole week has gone by already. This year is going to be crazy...crazy, but fantastic.


Regards,
Circle

Sunday 3 February 2013

The Beginning

Everything starts tomorrow. I haven't done any pre-reading. I'm feeling pretty unprepared, academically and psychologically. Ah well; into the deep-end we dive with naught but our wits.

Circle

Sunday 27 January 2013

Settling in?

So I've been here more than a week now, and not a single page of medical textbook has been read. Thought I'd get that sad admission out of the way right at the beginning of this post!

So most of last week was me going to and from the city getting clothes and supplies. I bought two suits -- the first is a business suit for the first week of semester (we're visiting a hospital, and they told us to wear stuff we'd wear to an interview), and the second is a tuxedo for the black tie event at college that's happening on the 29th of January. Suffice to say the bank account is losing weight! I also caved to popular culture and bought two pairs of vans (a type of hipster footwear). They're surprisingly comfortable, and I think I can justify them as long as I don't go full hipster and get funky coloured ones (not that I'll be getting many more at all -- they're damn expensive)(my current ones are black and white, and just white).

From friday onwards it has all been 'orientation weekend' here at college. It's all about going from just knowing people's names and what they study, to actually knowing the person I guess. I have to admire the social abilities of people -- no matter who they're speaking to and no matter how conversant the other person is, they can just whip something up to talk about out of nowhere, and they perform this trick countless times and for hours on end. I'm not incapable socially, but I can't keep it up this long. Anyway. I've come to just saying that I'm an MD student, because it sounds somehow less pretentious. Some people luckily don't know what an MD is as well, and sometimes they don't ask which avoids the whole issue. Like other people I've spoken to, I'm sure that at some point I'll just start saying I study architecture or politics or something.

So, what else is there to say? I did my first ever load of washing (can you believe it). It was a front loader machine as well, so all my prior training on top loaders came to naught. I put a white sock in with the blacks and it came out still white, so the colour didn't run on the warm wash. This is very good news because it means that I can put everything into the one load and not feel like I'm overly risking the whites, while at the same time saving $2 by not having separate washes for the colours. #washingmachinetactics I'm also going to need to purchase some pegs because I had so much to wash that I basically took up all the free pegs that were on the lines.

Hmm...

I bought a stethoscope, and worked out how it worked. You're meant to be able to put it on different places on your chest and hear different aspects of the heart as it beats, and to my highly trained ear...everything sounds exactly the same all over the chest. So there you go.

I'll leave it there, it was my bed time 2 hours ago.


Night!
Circle

Saturday 19 January 2013

The Move


So today I finally made the move that was set in motion all those months ago when I put down that I would do medicine here at Melbourne. I write this on my familiar laptop at a desk that I don't know, in a room that I don't know, in an environment that I have no experience in (college), in a city that I barely know. The room is in that familiar state of 'unpacking', with things strewn across the floor and desk as they await my brain arbitrarily deciding where they should live for the next indeterminate time. My time here has been a whirlwind of meeting new people, trying to impress them despite them talking as if they speak essay. The tour was great but it's filled my head with names and locations that I can't quite reconnect. I have two keys, none of which look anything like keys -- one opens most doors but not all, the other opens some doors but not most, one will replace the other soon, but I can't remember which is which for any of that. On the topic of keys, my wallet will soon explode from them -- not only do I have the two keys from college, I also have a medicare card, HBF card, my red cross card, soon it will have my student card as well, and sometime soon I will get myself a concession card for the public transport here (a myki card, I think it's called). All of those cards are additional to ones that I already carried in perth (eftpos, mastercard, driver's license, etc)! Phew.

The good news I guess is that for the moment there's no undergrads here, which means I can settle myself in quite nicely. Being a graduate student I'm part of something called the Middle Common Room (MCR) here at the college (undergrads are in the junior common room, JCR; admin staff and others like the master and chaplain are in the senior common room, SCR). The orientation for MCR is in a week and a bit, so we're all going to arrive fairly soon. People apparently are arriving in a trickle though, which is great because it'll give me that chance to get to know people over time instead of in one great whack. Also, being no undergrads around there's no big parties happening and overall college isn't intimidating at all. Just a warm and welcoming place so far!

I've put the 5 medicine textbooks that I could bring with me on the bookcase, and they stare down at me even as I type. I fear for my safety when I sleep. Tomorrow is a day for shopping and handing in forms for medicine, but then I must study or I'll be left behind in the very first week of the course -- I promise you, books!

Meanwhile, quite a few tears are shed back home unfortunately =( it's so hard to leave behind your whole family, the missus, and all your friends, just to pursue your own dream. It feels selfish in some way! It's all part of the bigger picture though.

Step one into the future complete. A billion to come, all increasingly difficult. This blog will cover it all, so it's time to buckle in and tighten the suspenders!


Yours, from Melbourne,
Circle