its not easy being a patient. all your symptoms are so subjective, and you tend to place more significance on some symptoms over others. a doctor will ask you a few "simple" questions which aren't really that simple e.g:where's the pain?

i've taken a sick day. i'm off work. i think i'm recovering from food poisoning. -stay away from KFC at all costs - It started with severe central abdominal cramps that must have been directly linked to the toxins causing my intestines to spasm violently. then the vomiting, - the lead up to a good vomit is always the worse part compared to the relief afterwards. still feeling a little bit whoozy though. maybe its just a sign of over exhaustion?

i wish it was simple

me and my good friend will drove down together to hamilton this afternoon to re-unite with our mutual friend dan. the triumphant trio as we were! its been a little while since our last reunion. we enjoyed a meal together in this uber-cool hamiltonian cafe whilst espousing on the shortcomings of our health system. we then began to talk about our time in niger together. good times and "my how far we have come" -a mantra which we would often recite on the dank smelly wards of galmi hospital- its soo incredibly weird that even after 10 months of occidental taint the experience of galmi is still fresh in our minds and is yet to be lost in memory. and so we plan to return to that place in the next couple of years.

its strange to relate such experiences within the frame and context of our current working environment. it almost seems ridiculous. how complicated it is over here. the duty to care for our patients is surmounted by our duty to generate screeds and screeds of notes in order to protect ourselves in case of litigation.

as i reflect on the current junior doctors strike and what it actually means to achieve i cannot help but feel a little bit cheated. i wonder if all this is just an intellectual power struggle between heads of equally grotesque beasts of inflated self-importance, and us poor doctors are merely pawns in this battle. we all entered into this contract believing -perhaps too idealistic for our own sanity- that we were going to help people/to help heal our nation, one sick person at a time. we were once human vehicles driven by the cherubs of good will, now we seem to have turned into animals led by demons of ambition and pleasure seeking. although it would be nice if we worked less than eighty - ninety hours a week...

thursday grey

its saturday.
i can now reflect objectively on the events of thursday night. probably the worst night on call ever! the earlier part of my 7 night stretch was pretty sedate, i.e.: from day 1 to day 6 - you got an appendix here, a gallstone there and everywhere an abdominal pain...i was anticipating and almost half expecting that the last night would either be tremendously busy or deafly silent. the gods of the surgical wards wanted a little more excitement that night, they wanted more than a little "low urine output"...

so there i was starting the shift. the 'day' surgical intern bellowed "welcome! welcome" as soon as i stepped in. an ominous feeling stirring inside me now. and there began the night...i was handed over two sick sick sick patients which was enought to make me a little bit nervous. nevermind the consultant that night wanted me to do hourly checks on mrs.x incase she choked and died. which she did later in the morning-after my shift of course!...whew... There were 5 patients to be admitted in emergency and about 15 needing reviews on the ward. the task was a little daunting...but by grace and support from my aloof seniour we managed to survive the night. by the end of the shift i was physically shaking-i had missed mr. b's vein (a good one too! a big fat juicy one) twice.

i had a couple of fresh moments too. we malaysians have this thing we call a "fresh moment". we don't talk about it much as its a little embarrassing. anyways, you are more susceptible to experiencing a fresho when you are sleep deprived, nervous and caffeine free in my case. remember that lady i was asked to keep checks on, yes...anyways she was crapping out, so i called the intensive care resident...and as soon as she answered the phone...it happened. i was speechless. i could not speak a word of intelligible england. "you know ahhh dat laydeee uh...yah huh she uh dat one you know got crackles one hoh?!....".....silence....awkward silence ensues...."i'll call you back"....

i will stop here...
thanks for listening.

nights

mr. X was sleeping soundly before i frightened him into wakefulness. i can only imagine the fear as his eyes tried to adjust to the dimly lit room, me a dark figure standing over him ready to attack him with my stethoscope. in hindsight (hence lack of foresight) i probably shoulda been more gentle with the guy in my approach. a "hey Mr. X! i'm just gonna push on your tummy over here!" is not the best way. ... Mr. X survived the night.

i am now 2 hours into the shift. and i am feeling terrific. my brain is adjusting to the day-night time reversal thing. i must say, i do prefer working night shifts. its a lot quieter and if you do need to deal with a sick patient - you have time to think which is a very good thing to do when you have a sick patient.

i spent most of today sleeping. i watched the first hour of that last prequel installment of George Lucas's Star Wars movies...episode III it is called. couldn't watch anymore. that guy that plays darth vadar seemed kinda whiny and just plain ol'stoopid. rather than getting all worked up about losing padme he shoulda invested more time and energy into cloning her. i know i would have.

strike actions

we're caught in the middle, between two parties with conflicting interests. both clearly misunderstanding each other. if we strike, then the people suffer but only for a few days. if we don't strike the people will suffer in the long run. so i guess its time to strike. for the common good and all that...

hard? nuts...

got some pictures for ya mike!
the one of the top is of the little big building housing fremantle markets...crazy smells and colours inside. you should take a peek. and then have a wiff...



here's a question. how many doctors does it take to start an oven?



the green sack is called a swag. every bushman in oz has one. you stick your sleeping bag inside this canvas sack, then you slip yourself into the sleeping bag and now you are warm and dry. like moist toast. mmm...

perth action

i'm back.
this morning @ 4:30am - anneke and jason were roused by all the commotion of my frantic shuffling in the kitchen as i was getting ready to leave for the airport, they sleepily said their farewells.

5:30am - i left armadale airport at around 5 in the morning, my awesome friend hester dropped me off. hester is awesome! and she's got this cool group of kids that she teaches at the local school. she invited me to help out on an excursion to fremantle - where she allocated 6 precocious kids to me - i think i was supposed to teach them something about australian history, unphased at the prospect of such a task - i managed to spout rubbish quite eloquently in full confidence that whatever i told them would be forgotten by the time they turned eleven. ... perhaps i shoulda used that cheat sheet eh hes? :)

-stopped over in adelaide for a couple of hours
-there was this really crap in flight movie which i watched half-way through -"casanova"- don't watch it. its crap. i was hoping for something more savoury as this was the last leg of my return journey. and was in need of some entertainment...sitting by yourself for prolonged periods-strapped into a window seat can be boring.
-back to good ol' aucks! @7:30pm, i anticipated the landing on good old new zealand tarmac, it was incredible.

i declared my sandy tramping shoes (which i wore on our little camping trip up north/?west of perth) @ customs-they're a sad bunch. why did i tell you that? i don't know...anyway, i walked out of the arrival lounge hoping to see someone familiar, and there she was. mum. mum collected me from the airport, i love my mum.

meanwhile my good friend doc phil is having a huge flat warming. i swear i could see his roof on fire from 30000feet in the air. party on phil!

dan and katie. what can i say. i like yas. a lot. you stinkin' bullers!

kangaroo rats and cats

gidday mates! i like you all very muchly, and i think i'm missing you crazy dongers.
i am sitting in this asian tourist information centre place, using the internet facilities. and there's this funny british chick, acting all asian like...cool.
anyways, i was walking down the street-listening to the mars- and picking off cat hair off my jacket.
everything in perth is within walking distance-if you work/live/play in the city. its quaint, and its quiet. i think its growing on me. not that i'm thinking of moving or anything.
i'll be home on saturday. look forward to seeing you all.
p.s.: got some camping done out in the oz bush-cold cold cold
p.s.s.: mike! your autograph is worth millions over here in Armadale, Perth!

love ya'll!

16:19

i've come to the end of my 3 month run. i can't help but feel as though there is still some business left unfinished. i wonder if its possible to not feel this way. i find myself mentally visualising each of the patients on a kind of split screen with specific allocated jobs to be executed for each of them. so, i'll be heading off to perth tomorrow morning. 6:50am. which means i gotta be at the airport to check in by 4:50am. dang. i knew i shoulda booked a later flight. oh well...see you soon

was hansel and gretel sad too?

its tuesday.
as thursday looms closer i feel a foreboding sense of discomfort. i have become somewhat comfortable and accustomed to the ways of psychiatric medicine. i may be a little sad to leave these parts of the woods. the disgruntled and sometimes fuzzy animals have brought me much joy. lo'perhaps it is time for me to venture into the other parts of the forest to search out and smell alien roses. i'll just make sure i leave a trail of valium tablets to guide me back home.

$petrol

ouch

taking life.....too seriously

after returning from west africa, i thought 'man i must have picked up a real load of cynicism or something' but maybe its not cynicism, maybe its realism?



this girl is 2 years old. was.



playing 'afro-jungle' music @ a wedding. we were just playing whatever the hell we wanted. there was more noise than harmony really, no one cared none.



village kids. everyday, they walk up this large hill to fetch water from a well. its filthy dirty, but hey what do they care...they're poor, right?

cool. now lets get back to bickering about stale cookies and gossiping about who's going to go out with who!

knee jerk

i asked myself something(s) today.

what does God think of me? am i doing what i am supposed to be doing?

is it enough to just read my bible? go to church on a sunday? open the door for someone? raise my hands and close my eyes after that magnificent key change? to not stray from convention (because convention keeps us safe...doesn't it?)

the fact that he chose (emphasis on chose) to save us from an inevitable and most unpleasant end i.e: the death after death, overwhelms me with a sort of confused relief. such a gift, if not the ultimate of gifts should move us to live a life of worship. not in the way of raising hands and straining face. but spirit and in truth!

let us be conscious of our social responsibilities….
lets get real…

…. let us glorify him by standing for justice. not charity. charity is superficial.

look at the child with no home, no food, no parents. what will we do about it? read our bibles more? go to church more? open more doors for more people? raise my hands and strain my face more after an even more magnificent key change? although these things are both good and biblical, it is the acknowledgment of God and all his power and glory in the things we do which puts a smile on his face.

worship is not limited to one act (as we have been so conditioned), but is done properly when the heart and attitude is in the right place. true worship is felt inwardly, and manifests through actions. "going through the motions" out of obligation is vain. check out Amos 5:21-24.

a fellow doctor i work with had a chat with a scared and stigmatised-by-the-public manic patient today, and he worshipped.

mum does some funny things sometimes. here's mum cleaning out the gutter in a poncho.

life is better with nintendo

mike sent me this t-shirt.
now my life is one kick ass video game!

psych?

Other fields of medicine tend to be algorithmic, mechanical, leaving little freedom for creativity or variation in the way we treat our patients. Psychiatry allows for this creativity as every patient is different and there are certainly many ways to approach the problems encountered. Being a relatively new field we know, dare I say it, little about how the brain and behaviour work. The brain mind discontinuity is one of the biggest mysteries that has yet to be solved. And this is exciting. There are discoveries being made at a level far more fundamental to human medicine than anything other specialty fields have to offer. For example, finding chromosomes that may harbour a gene for autism, new drug treatments for kids predisposed to bipolar disorder, statins and cholesterol lowering drugs slowing progression of alzheimer's etc, the implication of specific regions of the brain in anorexia nervosa. The main reason why I am opting for psychiatry is that it is the only medical field, I believe, to be “speculative” in the way that the humanities are. It does not rely exclusively on a disease-biology model. I want to study something intrinsically enriching, something that will make me see Man and his environment in a different light. To study psychiatry is to gain understanding of humanity and its frailty.

Psychiatry is challenging, the people we often see are the “sickest of the sick” (some with both mental and ‘medical’ problems). Was it not the desire to help people that drew us to medicine in the first place? In my opinion people with mental illness need our help the most. We have the opportunity to help them achieve a level of functioning that will allow them to live fulfilling and independent lives. How is someone with type 1 diabetes going to survive if their mental state is in such a way that they cannot understand the importance of compliance? We can read about appendicitis or myocardial infarction and learn how to cure these by following specific steps in a mechanical fashion. But when you read about depression or psychosis and see it in our patients, something inherent in our own being is triggered. We begin to feel, and we are allowed to.

photo-oil on canvas-the scream-edvard munch

sans-arcade pronounced sawnh-

just damn sexy, damn it.

...so punk rock

So we were chillin’ at the local BK joint when a murder of fine young cannibals entered the place in linear fashion. Colour co-ordinated black shirts with eponymous band names, matching tapered Levi’s – worn almost too low and too tight (an attempt at producing an image just shy of cool). There was a striking contrast between their porcelain skin underneath their black cottons and eye liner. You know the kind, those “emo” kids, displaying a carefully manufactured aloofness. Wallflowers, more self assured than they actually are. Here it seemed that they wanted to say that they felt confident in their indifference to convention, that they are ‘different’. Oh…are they now? I’m not saying that you shouldn’t wear tight black jeans and black t-shirts, - if worn in good taste I think you’d look pretty cool. But it seems ridiculously delinquent when they claim creative individuality while dressing to look just like their mates. They’re really no different from anyone else. Insecurity I suppose is an intrinsic part of our humanness, I guess we all struggle with/for acceptance-whether we choose to admit it or not. I certainly do.

ego surfing

check these pages out...

www.davin.co.nz
www.davintan.com

love

i love!...that i don't have any real attachments to anything. i think i've realised the old adage that you should work to live and not live to work. although sometimes it feels like all i do is work, but nevermind that. i mean, i could pack up and leave for some obscure town offset from age old bratislava or maybe kirsk? anytime i want! no fixed abode, no fixed anything really. no real commitments. (you could argue against that). i've got itchy feet, no ring on my finger and no one latching onto my wallet. nice. selfish? ... probably. but i'm happy. i guess im a delayed gratifier.

was over at vince's and kylie's place the other night. some might say it was pretty much a non event, but i like to call it quality time. no need for flashing lights/loud music/or dashes of adrenaline, just time spent with good mates. oh by the way...now that i'm not moving out do you guys want your stuff back?

watched the new tarantino movie last night with shaun. the hairs on the back of my neck still feel pretty stiff.

hey check out these monkeys. see the big swollen thing? yup. that means the female is ready for mating! check it out, her poo is stuck mid-evacuation. yux!