David Graff – davidgraff.com Today with Dave, Downunder it's Thursday, December 14th, 2017 @ 12:41 PM

Entries Tagged as 'Medicine'

The End of an Era

This post is back dated about 4 months. It’s one I’ve been thinking of but for a number of reasons has just been delayed. My life changed a lot around this time in a lot of areas. One of which is work. I’m no longer a resident doctor. I have moved on in the stages of training to be a full time emergency trainee. I won’t rotate out into different fields or teams, except for a few elective rotations. From this point on, I’ve got about another 5 or 6 years until I’m fully trained. It seems like a long haul, but I suppose the start of med school is further back in history than that is ahead. So here we go… headlong into the future. I’ve got a lot to figure out, and a lot to do, but that’s what makes things great in the end.

Everything has changed

There is lots different around here, on the website and in my life, but from what is written down it is hard to tell. I haven’t been writing here for a few reasons, some described below, some not. For the first time since having this site, I completed an update of the underlying software. It was something I was basically scared to do because everything was working and I didn’t want to lose it all and then be in a big mess. But, developments are underfoot that have finally necessitated an upgrade. The previous version had been released October 26, 2007… that’s even before I was accepted at UQ! It seems as though the database came up alright and everything went off without a problem… there was nothing to be afraid of I guess. I had read some nightmares of everything disappearing, which they maybe fixed the problems since then.

But that’s not all that is different. I now have a job to look forward to at the end of my second post secondary degree. The last time I graduated I had no idea what I would be doing. This time, I know the time, date and place that I will begin work. Contract signed. It is a very good feeling to have some future security. My application to Alberta went well, but I needed to make a decision about which way to go. After a massive amount of consideration I have decided to undertake internship in Australia. It is a one year commitment that essentially completes my degree with a year of paid hospital work. After which I will achieve ‘general registration’ which will allow me to work as a doctor in Australia in a broader sense.

I do have my second thoughts about Alberta, especially as the process is about to go into the next phase on Saturday, but I couldn’t keep straddling the fence forever, and to continue to straddle would mean thousands of dollars spent flying back and forth across the world and missing time from my program here, in the final run.  Let’s hope I have done the right thing!

 

A Great Day

Some days are better than others.  Sometimes everything feels like it goes your way.  This was one of them for me. To be continued…

For the record

This week I am in the ICU.  There have been a lot of interesting things to see, and it’s a pretty special environment.  There is physiology, pharmacology, infectious disease, and end of life.  There is lots to think about from an experience in the ICU, but I suppose I would say here for the record, if I’m ever in the unfortunate position of being brain dead, go ahead and take whatever is still good.  But!  IF I’m simply locked-in, prop me up and let me watch the Discovery channel all day.  I want to learn and see what happens in the future! 🙂

2011: Some things are different, some are the same

So it is well into February and so much has happened this year that I suppose it’s time to make a post to acknowledge it.  My holiday was filled with family and friends, my new nieces, my nephews, and my siblings and their partners.  It was so great to be home.  Busy, which is funny to think, because everyone else was working, raising kids, generally accomplishing things, while all I had to do was hang out with them.  But still, it was a lot of it, and I’m so thankful for the people back home.

After the longest break of my degree, I have returned to Australia.  Upon arrival I spent a quick weekend recovering from the travel and time change, and then headed to Brisbane for Ophthalmology at The Royal.  I don’t really know why, but despite being stationed in Nambour, I have the first half of this rotation in Brisbane (a 1.5-3 hour drive, depending on traffic).  So, I am living at King’s College again.  I lived here when I was looking for an apartment in 2009, that’s why some things feel different, and some things feel the same.  Same sweaty nights, same mosquitoes waking me up at 4 am.  All part of the process I suppose.  And when you think about all the things I have sacrificed for this crazy journey, this is just another small piece.

Right now I am on Cardiac surgery at the Princess Alexandra Hospital, which is pretty neat.  Yesterday I watched an 11 hour procedure, which involved a double bypass, an ascending aorta graft and an aortic valve replacement. The patient did not breathe, had no pulse, no circulation, no bypass pump, no brain activity…  for 80 minutes.  To accomplish this, the patient was cooled to 18 degrees C!  Then when we were done, they simply reversed everything, and the heart started to beat again and they closed up, and we went home!  Crazy.

Anyways, I am going to get to sleep, since I’ve had long days, early starts and short nights lately.

1000 Days

Some have been good, some have been bad, each one takes me closer.

It’s a Mad World

So much time has passed without me really writing it down here.  It’s a shame, since so much has happened, and I didn’t really take the opportunity to record it along the way.  I have a renewed my motivations and we’ll see how it goes here.  There has been a lot of exciting news in my family in the last little bit, which each of my three sisters welcoming into the world a brand new daughter each!  I am so excited for these little ones!  I can’t wait to meet them.  I know my sisters have had their hands full with getting these girls into the world safely, and I am so happy they are here.  There have definitely been some trials along the way, that’s for sure.  My thoughts and prayers are with them, always!

School-wise, these last weeks have been crazy.  Literally.  I am on my psychiatry rotation and it is challenging in a lot of ways.  Here is some mood music for this post:

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There are a lot of things I have seen this last month and a bit that are very sad.  Many people struggling with realities and perceptions of realities so different than mine.  People crying out, needing, wanting, hoping, angry, sad, confused.  There are so many situations that seem un-fixable.  Things cannot be un-done, fathers can’t come back and love instead of abuse, stimulate instead of neglect, mothers can’t undo the drugs done while pregnant, and the people here are just left to pay the price.   It’s been a lot for me to think about, and I really internalize what I see.  It challenges me deeply on what I think it is to be a person, to be self-aware, and what to do about it.  This is a field where you really do see people that cannot function properly in a real life situation.  Concepts of consequence, cause-effect, future planning, insight vary from patient to patient.  They can of course be completely absent.  It breaks my heart, to be honest.

I can’t really recount all the crazy things I see, ’cause that’s probably a breach of student-doctor-patient confidence, and because it’s too crazy to remember.  Sometimes it’s just strings of words… sometimes they make sense, sometimes they don’t.  Sometimes I am a member of the people from outer space, sent to spy on the patients to see how much they have been telling the doctors.   It has definitely grown on me in the time I have spent, but I am starting to feel confirmation that it’s not for me full time.  I think I look forward much more to helping people in a GP setting, even if it’s a psych issue, than in the full lockdown of the secure ward.  Starting to feel something about what I want to do for a future practice is exciting too.

A few good days in a row

The last few days have been pretty good, getting into doing things a little more.  I have admitted a few patients, done a few canulas and even written a referral letter to Rockhampton for a Royal Flying Doctors extraction of a patient.  It feels pretty good to know what goes on enough to do something that is a little bit useful.  Nothing is really difficult, and it’s definitely not anything someone else couldn’t do, but whatever.  This will probably be one of those things that you look back and think, strange that I was excited about such small repetitive items of routine.  Future me will think it’s dumb, but current me thinks it’s cool that things are actually starting.

I cut someone today

For the first time, I put a scalpel to someone’s skin today, and cut them.  It was actually really cool, I did the local, excision and dressing… did everything.  Some people might not think this is a big deal, but there was a time when I thought I shouldn’t do medicine because I couldn’t handle the blood and cutting someone.  After wound care, a surgical observership in first year and seeing quite a few excisions out here, I am happy to charge forward into it.  I think I did a good job too, which is really good.  I don’t think I will have to think back to “that first time”.  I might mess things up in the future for sure, but at least that first cut was straight and smooth.

Because we’re doctors

Today something happened that is hard to get used to.  Someone used the phrase “because we’re doctors” to me.  Directly to me.  Now, usually when this happens I feel a real obligation to say, “Well, I’m still just a student.”  But there was literally nobody else around, and the speaker knew fully that I am a student.  It felt a bit odd, but I suppose it will be true eventually.


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