Body of Proof is a cool TV show!

It translates to: "This is the place where death delights to help the living."

Every person has something to teach us, and we never stop learning- even in death. I love it when I learn something new from watching TV shows.

Happy Anzac Day!

Townsville's Anzac Day Parade

Perfect weather at the Strand + gelato right after watching the parade = awesome way to spend the morning. I love Australia. Alright, now that I'm back in my room and changed into my favourite yoga pants/plaid pjs thingamajig, I'm delving back into Hematology and Renal Medicine. HAPPY ANZAC DAY!

Best quote ever!

So I was sitting at lunch today chatting with Delara,

Me: "I've learned to accept that I probably won't be having real fun until the end of November..."

Del: "Yeah...when I think about how much fun I'm not having, I think of my parents. They NEVER have fun"

SO TRUE. LOLLL I love my friends.

I can't believe I forgot how awesome medicine is!

Today was possibly the longest day of classes I've ever had in a long while. I had

8am-11am Respiratory medicine GLS

11-12pm Hematology and Renal medicine lecture

12-1pm Respiratory medicine lecture

2-430pm Rural, Remote, Tropical & Indigenous Health GLS

5pm-815pm GPSN Suturing & Plastering Workshop (not a mandatory session but I decided to go because I wanted to

do be able to do some suturing and plastering in my mid year placement in Emerald)

Holy shit right? I admit I have been feeling a little stressed over the this year compared to last year. It just felt like the work was neverending that I've lost my enthusiasm for learning new things. Funny enough though, after today's epically long and tiring day, I think I've finally got my groove back on. It definitely had to do with the suturing and plastering workshop. We got to practice suturing on a pig's trotters and did plastering on each other. For the suturing workshop there were 5th & 6th year med students, a registrar and some doctors who helped out. The pig's skin was a bit tough to penetrate but I think I've finally gotten the hang of it. For the plastering bit, there were 2 orthopedic technicians who worked at Townsville hospital who helped out. It was really cool and got me all excited for medicine in general.

The sutures that I did:

The plaster my friend did on me: (I got plaster all over my bb trying to get it out to get a picture of us)

So yeah, I can't believe I forgot how awesome medicine is!

Learning the proper rowing technique

This is a great site detailing the proper rowing technique:

http://www.concept2.com/us/training/technique.asp

This is definitely one of my future wedding songs

http://www.youtube.com/watch?v=OayhO9K7LDs

He sings with so much emotion this live version gives me the shivers.

You Make It Real- James Morrison

There's so much craziness surrounding me,
There's so much going on it gets hard to breath
When all my faith has gone you bring it back to me,
You make it real for me

Well I'm not sure of my priorities,
I've lost sight of where im meant to be
And like holy water washing over me,
You make it real for me

And I am running to you baby,
You are the only one who saves me
That's why I've been missing you lately,
'Cause you make it real for me

When my head is strong, but my heart is weak,
I'm full of arrogance and uncertainty
When I can't find the words, you teach my heart to speak,
You make it real for me

And I am running to you baby,
You are the only one who saves me
That's why I've been missing you lately,
'Cause you make it real for me

Everybody's talking in words I don't understand,
You got to be the only one, who knows just who I am
And you're shining in the distance,
I hope I can make it through
Cause the only place that I want to be is right back home with you

Reflections on my 2 week Queensland Ambulance placement

I did my 2 week end of year placement with Townsville’s Hugh Street Queensland Ambulance. I rode along with 2 advanced care paramedics. I did 2 lines (lol doing lines make me sound like I’m doing coke) with them – basically 4 back to back 10 hour shifts with a 2 or 3 day break (can’t remember if it was 2 or 3) followed with a 4 back to back 12 hour shifts. The 2 paramedics I worked with worked very well together, were laidback and were very approachable individuals which greatly helped my learning as I never hesitated to ask any questions.

One thing that really resonated with me was their excellent bedside manners no matter what hour of the shift it was (boy oh boy, the 12 hour shifts were pretty brutal especially during the wee hours of the morning- I did fall asleep at one of the chairs while waiting for the patient to be admitted to ED and one of the paramedics got a snapshot of me doing this...very professional, of me I know). Be it infants, middle aged or older aged individuals of the same/ different race or gender, they were able to connect on a level with them for them to give them the sort of trust such the patients felt comforted. At the same time, the paramedics could also get a good medical history.

During these 2 weeks, I mainly observed though I got to auscultate a patient. That’s the extent of “clinical skills” I got to do. Taking blood pressure manually was out of the question since they carried automatic bp cuffs and I was completely fine with that. I was told to cannulate but I wasn’t trained to do so, so I graciously refused. Despite just observing though, I learned a wealth of knowledge with regards to ECGs, types of drugs administered and the methods by which they are administered that affected the drug efficacy. Some cool things I learned that I can’t wait to practice (who wants to be my pretend patient?!?!)

- For cannulating patients, you have to start in the distal arm before trying it in the cubital fossa

- I learned how to find a good vein to cannulate properly and how to cannulate patients in a bumpy vehicle (it requires some skills for sure!)

- For psychiatric patients, you can directly ask them bluntly if they wanted to commit suicide and expect them to give you an honest answer (how about that for not beating around the bush?)

- They can administer oral glucose (glucagon), glucose via IV or via intramuscular injection (which I thought was pretty cool because when I was volunteering on SERT we only carried oral glucose)

- Patients with angina are usually prescribed with beta blocker drugs that help lower their heart rate, so when these patients are administered GTN (glycerol trinitrate) without having their blood pressures checked (uh-oh! Bad news bears), their heart cannot compensate the loss in blood pressure

- They administer various pain relief medications:

o Methoxyflurane (inhaled analgesic)

o Morphine sulphate (injected analgesic)- this one has stronger side effects like vomiting and nausea

§ It also lowers blood pressure so you’ve got to be careful if you wanted to use them in patients who just used GTN aka nitroglycerin

- Other than learn cool things, I got to visit quite interesting places. I got to see the inside of a holding cell at a police station, went and treated a prisoner (to be honest I was a little scared haha), got to visit Palleranda Beach. I definitely got to see more of the things I don’t see on a daily basis (i.e domestic violence/ assault). The one thing I wished I got to treat and didn’t get to treat was a drunken disorderly. I thought it would be fun since it would remind me of SERT and responding to all those drunk students saying gibberish and remembering, at one point in my life, I was like that.

In 1^st year of med we learned about interprofessional relations multiple times between healthcare professionals and it was during this placement that I saw it in play firsthand (between the triage nurse, the ED nurses, paramedics and the ED doctors and you could say the cops as well). The handover of patients to the triage nurse at the emergency department had to be concise. The paramedics had to paint an accurate picture and how significantly it affected patient care outcomes.

The most memorable activity that I undertook was transferring a patient to the Royal Flying Doctor Service. This patient was being sent home for pallialitive care. His partner was very emotional and I was also getting very emotional as well as she started talking about her children and how hard it was to lose the father of her children. I decided to steer the conversation away from her dying husband and got her to talk about her children and her future aspirations of them. This particular case was so memorable to me because I was moved to tears by a stranger (though I tried very hard to hide it) and felt her pain and felt honoured in a strange way that I got to spend the last few days of his life with him. What was also heartbreaking was the fact that the paramedics had told me that her husband might not even make it through the night due to his deteriorating condition and her not knowing it, but at the same time, me feeling like it wasn’t my place to be telling her that for fear of making her feel more devastated. In a way, I felt helpless. The bright side of things were that he had one of the most aggressive type of brain tumour and had 2/1/2 years of healthy life despite being only given 8 months to live. (I’ve changed the number of years and months to preserve confidentiality)

That’s the beauty of the healthcare profession. You see people on their worst days and at their most vulnerable and you hope that somehow you’ve helped in some way or another and though sometimes you’ll know, other times you’ll never know. I think what’s most important is that you did your best with the knowledge that you have.