bonjour brightside

enter Autumn (ie. March) and the start of freeze-ville! it’s still warm and the threat of bushfires remains imminent but it definitely is getting a little chillier, and i hope it stays that way… after that awful heatwave we had in January, i am officially siding with cool change. anyway i ended my neurosurgery rotation last friday and i was really sad!! i can’t believe how much i came to love it despite not being a ’surgical’ person and i have definitely learned heaps from being part of this awesome team. my new rotation, oncology, sounds a bit mehh after my glorious neurosurg days but i am definitely giving it a chance and hopefully the pace will pick up after a bit.. though i must say i was a little dismayed that the doctors don’t really read CT scans, they tend to click on the report and read it rather than view the scans…. and i was really dying to read the CT brains (because i learnt how to do so in neurosurg) but no one gave me a chance and this morning during grand rounds someone presented a case about brain lesions and i got the diagnosis right (because i actually could read the CT brain…..it is shocking how so few doctors can read a CTB decently) but anyway i was positively beaming!

so i was talking to a fellow fifth year whom i hadnt met before and she asked me what i was up to, and i said ‘Oncology’. to which she said ‘Oh. So you don’t diagnose… but you kind of make dying patients feel more comfortable…. right?’ can you believe how annoyed i felt upon hearing that? seriously. i can’t believe how people misconstrue what oncology is about. sometimes it may involve an element of palliative care but the fact is that most cancers are treatable and that is what oncology is about- curing cancer. i tend to get annoyed when all people think of when they hear the word ‘cancer’, is death. contrary to popular belief, not all cancer patients are dying patients. a sizable proportion of cancer patients make full recovery and actually go on to live to ripe old ages, and fyi more people die of heart attacks and strokes than cancer.

i guess i chose oncology as my specialty rotation because i wanted to gain a different perspective of medicine, and because i have an ambition to dispel the negative connotation of cancer among cancer patients and the general public. of course my other reason is because i owe it to oncologists that my father is still alive after 11 years of surviving cancer. my dad made it through cancer but he continues to suffer from the adverse effects of his radiotherapy…….. so my ever-inspiring aspiration is to help reduce morbidity after treatment and possibly make a positive contribution to every patient i see. another thing i wanted to comment about is that oncology is not ’sad’. for what it’s worth, i can say that a lot of the patients, even those with a bleak prognosis, have come to terms with their illness and don’t feel sad for themselves. i am constantly amazed at how ‘at peace’ they are with their situations and at the calmness at which they decisively refuse further treatment so that it gives them more quality time with family. i am even more amazed at how content they are with life and the fact that they are happy to have lived a full life….. if this is not inspiring… i dunno what is.

one of the best things that happened to me in my neurosurgery rotation was getting to watch an AWAKE CRANIOTOMY, today ie. brain surgery on a conscious patient. she had a tumor in her parietal lobe near Wernicke’s area, a strip of brain cortex that controls speech. if we removed too much of the tumor, she would lose her ability to talk. so Mr D opted to do the surgery while she was awake and we had to keep her talking throughout the surgery while we chipped away at the tumor.

we also used a cortical stimulator to determine the pre-frontal gyrus where the motor strip lay, by stimulating the brain with a small electric current and it was amazing to see her arms twitch whenever the current was applied. ok i will spare you the full details but IT WAS ABSOLUTELY MINDBLOWING. i mean, this is the stuff that i watch on Grey’s Anatomy and never ever thought i would get to see, but voila, my opportunity just came along! i think i hit the surgical jackpot- i am totally in awe and forever grateful. i will probably never see another surgery like this in my life but i’m sure i’ll remember it even if i’m 85 and demented heehee.

on a side note K and i both got ankle oedema from standing two hours at radiology meeting, so we took TED stockings from the ward to wear overnight. hahaha i hope it works

theatre today, for some strange reason, was absolutely hilarious. kr and i were laughing our guts out every 5 minutes, secretly hi-fiving (Mr D+us 1 theatre manger 0), stuffing ourselves with pastries from the drug-reps….. omg it was a riot! i probably haven’t laughed so much in theatre till now. then again, my OT experience before neurosurgery was probably all of 5 hours.

Mr D let me assist for an anterior cervical disc fusion today and it was amazinggg. it really makes me understand how stuff works. i always thought that invertebral discs were jelly-like and translucent (cos of those illustrations in the anatomy books) but now i know they look and feel like crabmeat. haha. i also finally understand how the stealth machine works. understand as in i would probably be able to perform stealth craniotomy right now if i had to. hahaha.

it’s funny how surgery never crossed my mind, because most people including myself think i fit the “physician” stereotype, but whaddya know…. neurosurgery is really pretty interesting. no actually it is intense, hardcore and mindblowingly insane but i kind of enjoy it. i really love hanging out with the team, they are such champs and every day just seems like a ride…. i mean we spend 12 hours on average at the hospital everyday, but it flies by so quickly and surprisingly i’m not counting down to the end of the day like i did in GP. tiring, yes, but boring, no. never a dull moment i would say, we have too much fun laughter and joy. ahhh i dont want this rotation to end!

AHHHHH tomorrow i start my first rotation. i’m more scared than excited really, my clinical skills are rustier than the sunken titanic and i havent been doing any reading that is even remotely related to medicine. i am not a fan of medical journals, truth be told. i would much rather flick through the glossy pages of Vogue than pore over the BMJ. don’t get me wrong, i do love med, for me its not about the reading, it’s about the doing. but of course you have to know before you can do (things correctly)… so it looks like i can’t escape the reading! ooh and speaking of fashion and medicine, i came across this interview in NYmag with Lanvin’s Alber Elbaz. he’s funny.

I wanted to go out of fashion, to study medicine. I thought, you know, who needs fashion? How important is it if you wear a red dress and an orange jacket? It’s not really. But it is important for that woman, she will find a nice fur coat and it will make her happy, she will have a better day. Our job is to give you comfort, to hug you with clothes. I always tell this story a woman told me, that every time she wears Lanvin, men fall in love with her.”

i love how he says “hug you with clothes”. i never thought of it that way, but i want to be hugged with clothes. engulfed in a giant wool scarf in the harshest of winters. i guess fashion has oft been regarded as ’superficial’ but i really do think it’s more than that. and i say that because dressing better inspires my confidence and makes me feel like i am better equipped to take on the challenges of the world…. and one day i would like to wear Lanvin (and Balmain and Valentino too. a girl can dream! teehee)

anyway tomorrow will be interesting! i’m so psyched that i’m in final year!!!! but that comes with the responsibility of doing things well and teaching the 3rd years… i remember this amazing 5th year louise who used to teach me how to examine patients properly, patiently correcting my technique and giving me useful critique that i still remember to this day. i really hope i’ll be useful to patients and to my juniors (and that means i have to start reading talley and kumar all over again.) i’m am going to have to get used to the wards again but i know i will love it- interacting with patients, seeing everyday miracles and just basking in the sheer privilege of being a part of other people’s lives. yes i know i love it.

ok i shall go do work now. i have watched the entire season 1 of samantha who?, and it is so funny. i love samantha! she is so endearingly cute.

annnnd. i leave you all with this SUPER HILARIOUS KARAOKE VIDEO called TUTS MY BARREH (go figure). watch it please?? please?

today i visited a patient in his home as part of a community palliative care visit. he was battling a terminal illness and was in a lot of pain. but he managed to smile at me and even offered me lemons from his lemon tree. he blew me away with his generosity, even in his difficult circumstances- so i accepted. we took a walk in his garden, towards his blooming lemon tree and he said i could pluck as many as i wanted. his wife gave me a plastic bag to put the lemons and so i gingerly tried to pluck 2 or 3 lemons but he stepped in to give me a hand. so we plucked lemons together and he made me take 11 lemons home. later he showed me his prized orchids, his empty aviary (he had to give his birds away), everything in his garden that was meaningful to him. he smiled at all these beautiful things and i genuinely believed that for that moment, he was happy and not in pain.