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man. how long has it been since my last entry? carmi...this is for you...but not just you.

im here in my office. i have no patients scheduled today. i spent the morning thumbing through various psychiatric journals and i read excerpts from the new zealand medical journal. i then had a chicken pie and an avocado sandwich for lunch. after my stomach was full, i trudged lazily upstairs to sit with a couple of colleagues who happen to be old friends (they were both on their lunch breaks). i think my stomach is actually expanding - the volume of food im consuming has increased in recent months and i think this is directly correlated with the size of my waist. im sitting up straight - hoping that i'll burn some calories doing so.

i've managed to finally get through this book that i've been reading for the last month! its called the 'interpreter of maladies' - a collection of short stories written by pulizter prize winner Jhumpa Lahiri. at first i wasn't sure whether i liked it or not. i've decided that i do like it, but i don't think i'll read it again. the stories are basically about outsiders - people who don't quite fit in and the reader is shown only a cross sectional view of their lives, we are forced to come up with our own conclusions to these stories i.e.: what happens next? - seems to be the question i was asking myself each time! Its as if Ms. Lahiri, through this book, wishes to convey that life goes on.

i'll be driving down to tauranga straight after work to see charity.

i've made a mixed cd of eclectic up beat tunes to keep my mind busy for the journey. i need to shave. i hate stubble. i look so dirty. im feeling a little bloated too - dang chicken pie!

i think i'll go make myself a cup of coffee. i might look up the latest clinical guidelines for the management of various mental disorders...maybe.

Upcomin GIG

my band [sansarcade] will be playing @ Schooner Tavern on 15th March - 8pm start.

tickets are $5 at the door - a steal!

its gonna be way way way fun.

just let the poor die

"just let the poor die"

you'd never hear me say or think that in a demi-century. but my actions. the selfish things i strive for, and the meaningless accruement of more material wealth. even the title of "Missionary" -even for a short term- which only serves to boost my already inflated ego. all that...disables me from doing the things that really matter.

what inspired such impassioned introspection - i hear someone ask? here we go...
it is not enough to have an "open heart/ and an open mind". BOLLOCKS. i heard someone say this-in regard to the plight of innocent people whose blood is being shed all over the world. what good is an open heart/open mind if nothing of 'time-worthiness' is collected in that filter we call brains. we are saturated with crap everyday. in the news - we hear about new zealand winning that sevens rugby game.yay. yawn! in the media - we hear tom and katie are squabbling over baby suri? people talk about how their workmate is a biatch for getting that promotion instead of them. and even church. yes. church - lets store up treasures in heaven guys - c'mon. Jesus wants YOU TO PROSPER ! oh. by the way your hair looks great , oh dude...that is a sweet outfit.you have soooo much style. oh u play the guitar? you should totally play at some christian concert/festival thinig! yeah!

sorry. maybe that was a little harsh. can't delete that now though. on a roll.
the church stands at the junction of power and powerlessness. i cannot help but feel we are standing with our feet pointed towards the latter. now let me first disclaim that i am in no way implicating any particular body of worship here. i speak generally. having said that however - it does have personal implications. at least i hope it does. i too am guilty of the same crimes - including the one of blissful ignorance. ah. free will. when was the last time you sung a song at church about Amadou dying on the street because he got no malaria pills - [you can buy them here for less than a dollar from the pharmacy in new zealand]? probably never. no no no. that would be too "in your face" ... too "confrontational". oh yes yes yes. you are quite right, we wouldn't want to tell people what its really like out there in the world, let alone think about that stuff. people just gotta get closer to God. we just gotta pray more. fast more. read our bibles more. lets get spiritual. coz that's what the world needs now isn't it.

c'mon man. lets do something with our lives. i feel like cussing right now. f'in lets do something!

finish that university degree so you can use that knowledge to free martyrs in jail.

go write that poem so you can inspire the oppressed.

go paint that painting - make people feel.

go finish that engineering degree so at least Amadou doesn't have to breathe dust while he's dying.

the fact that i had to be reminded that it was my birthday is probably commensurate with its insignificance. well perhaps that is a little hard - i suppose i feel a little indifferent or maybe its ambivalence?

what significance does "25" have? a quarter of a century young. what does it mean for me?

im not really sure to be honest. i still feel like a kid - as if i haven't quite grown up enough- indolent. maybe i never will and lets hope so.

its a little irksome that we should even be talking about 'n' life crises'...why 25? why not 26? or 16? etc etc. i guess its just an arbitrary figure, but i reckon its a kind of rest station to take stock and think about stuff e.g.: are we happy? and so on. its a little selfish - but that's okay, sometimes you gotta be in order to evaluate yourself and see where you fit in the grand schema. there are a few things i'd like to see happen in my lifetime before i go though. [i've had this inkling notion that mine will be short. about a decade left to go]. i'd like to see equal opportunity available to my bros/sists in Niger - and to achieve this would require a wholistic approach to mental/spiritual/physical well being - which would include improving the social milieu and all that good social justice stuff those hippies rave about :)

here's to another 25 + years. weeeeee!

klink*

good news?

i read in the paper today -
a young pakistani girl was raped by 11 men and then forced to parade herself naked downtown - the men felt their actions were justified after her brother had eloped with a local villager (obviously their family did not approve!).

how do we let such atrocities happen? though i understand it in the context of our propensity for evil...i still don't get it. this should not discourage us, rather it should challenge us to do something.

amid all this tragic news.
there are uplifting stories.
i had the pleasure of helping a young 30 year old schizophrenic lady. disowned by her family, and cast out of their home - they had had enough. they had even uttered the heart shredding words "my daughter is dead. this is not my child". it all seemed hopeless for her. but not so. she's now living in a supported flat and pretty much fully functional again - normal. she's happy. i cannot stop smiling.

duty

psychiatrists* come closer to human suffering than any other branch of medicine. so we should be aware of the fact that poverty and political, social and economic inequalities between groups predispose to conflict. they directly contribute to psychiatric morbidity by increasing the disparity between the 'haves' and the 'have nots'. the greater global psychiatric community has a moral duty help such. conflict is greater in semi democracies or governments in transition like east Africa and democratic institutions must be inclusive at all levels

*A physician (an M.D.) who specializes in the prevention, diagnosis, and treatment of mental illness. Psychiatrists must receive additional training and serve a supervised residency in their specialty. They may also have additional training in a psychiatric specialty, such as child psychiatry or neuropsychiatry. They can prescribe medication, which psychologists cannot do

*A*

its been almost a year a half since we left niger. traces of africa still occupy my mind. i cannot forget. perusing the hundreds of photographs daniel and i , took caused memories i had thought forgotten to resurface. and its now never been more alive in my mind. i suppose i've become almost obsessed with the idea (see previous post). i stumbled across this photo of *A*.

now i recognise his suffering. i was never really convinced of it until now. im sure he had the so called 'supreme affliction' - a disorder of the mind. left undiagnosed. misunderstood and stigmatised - this young man lived a life that was ridiculed. i feel sorry. i feel angry at myself for not seeing it-if i had would i have been able to help him? to our credit we offered him our friendship - but certainly this was not enough. i yearn to see good health return to people like *A*.
is hope a mystical thing?

i've long had an inkling that i might die young. all i ask is that i live long enough to see some sliver of resolve.

hope rising now.

...

forgive the title. its a little broad. but i think its apt. don't worry this entry will not take long to read...not that im really worried about what you think.

plenty has happened in this whalefarmers' life since his last post in october. i won't go into detail as the sensitive nature of the material could invalidate the reputations of certain persons. but, i'll just mention a few things here and there.

so, i have a new job. and i love it. for the first time in a long time, i find myself happy -actually happy- to go to work. the thrill of being able to help a person both physically and mentally is exciting. the outcome rewarding. i smile all day. once again i am inspired and at the same time encumbered also by a burden. i read articles of the atrocities taking place in darfur - get itchy. i must go there. but i reckon finishing my specialist examinations first would be a good idea - i'll be in better stead then. my dream of starting up a mental health service in central and west africa remains. the mentally afflicted are treated like animals, thrown out onto the streets - beaten , scolded, scalded, humiliated, killed. i hurt. you should too. i fear this goal given me tunnel vision. i have no time for wasting time. consequently people get hurt. i sometimes wonder if im being narcissistic or economical.

night#2
29/10/6
00:11
i obviously have nothing to do.
i've managed to find a nice quite spot in the doctor's office , and i've strategically kept the door ajar-my little statement that conveys that i really don't want to be disturbed with non-urgent problems, but i am available if the need arises.

its a rare thing - when a house surgeon goes looking for work. i've just recharted two medication charts, made them nice and pretty to look at. maybe its because i'm in such a good mood? ["dig a pony" currently plaing on my Mp3 player...i no longer dispute that the beatles are perhaps one of the greatest band that ever existed. ]

8 more hours till shift ends
guess i'll go find some unsuspecting geriatric patient to play pranks on.

talking cures

good lord. has it been that long since my last post?
thanks baz for rekindling my enthusiasm for journaling.
your comments inspired me to browse through my previous entries...and i am glad.
it seems i have grown a little, just a little.
i read my little post after i had finished my first 3 months of full time work and i can remember those feelings that i had distinctly. weird. now i am finishing up my last 3 months of full time work as a house surgeon - man it feels good - and stepping up to a registrar position in december. its all happened pretty darn quick. i'm just glad this year is over...
right. i'm starting to fade now. i've just had a bottle of beer, and i think i'm ready for some sleep...

justice, justice you shall pursue

its been more than a month since my last entry. forgive me if this sounds damaged.

how should i start? i suppose i'll start with my present disposition. a series of events accompanied with each own set of emotions and traumas - and wherein most of these circumstances did not allow catharsis - has led me here. where's that? exhausted and tired, angry.

its been a pretty rough 3 months for all of us. surely the lord didn't want it this way. at the end of some days we find ourselves unable to shake off our bitter temperament. some of us take our bleepers home - what's the point? hospital is home! with each passing minute we become more and more demoralised, acutely aware of our own feelings. we become nasty, impatient, short tempered, angry jerks.

i read something in deuteronomy last night. summed up it goes something like this. "justice, justice you shall pursue - [include mercy somewhere]. i remember God, and the task he set before me and my colleagues - i ask for forgiveness and feel empowered by a renewed sense of responsibility and mission.

i gotta get me this tattoo.

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!