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Has it ever occurred to you what a contradiction bikers are?
Their bikes are all clean and sparkley, while they themselves tend to be unshaven, unwashed, and generally rough.
Perhaps they spend so much time cleaning their bikes they don’t have time to clean themselves as well…
There is a quite interesting article in the current Time magazine about Doctors’ experiences of the American health system from the recieving end, either as patients, or a patient’s relative.
It’s quite interesting, as many of the issues raised are the same that I suspect you would experience in Australian or New Zealand hospitals.
It is also interesting though, the startling differences in the way the American health system operates, and most of the differences cast a very very negative light on how the Americans do things. They think that limiting junior doctors to “only” working 80 hour weeks is reasonable and healthy for their professional development, and that junior doctors working with minimal supervision doesn’t adversely affect patient safety (one senior doctor comments in the article “The only thing wrong with 1 in 2 on call is that you miss 50% of the good cases”). It’s frankly terrifying, not to mention blindingly stupid when you consider not only the patient safety issues but also the social and psychological fallout of those practices on doctors lives and health.
There is however a good little sub section entitled “What makes a good patient?” which I think everyone should read. It uses the case of a patient with multiple chronic diseases and conditions, who is medically really difficult, but who listens, ask questions, looks things up, and has reasonable expectations.
A quote I love from the TV show House goes “There you are. The mystery of medicine. Everyone wants your opinion, but nobody wants to listen to what you have to say”. It unfortunately rather nicely sums up most of our interactions with patients, and so when you see on the ward a medically difficult patient who actually listens you know you’re going to have to work really hard, but that it’s going to be a satisfying effort, and one that will ultimately be beneficial for both parties. The doctor will feel satisfied because their efforts are appreciated, and subsequently they will go the extra mile for that patient. The patient will also feel greater satisfaction with the relationship because of the more personal interactions, and will probably ultimately get better medical care.
I found it interesting the other day driving through brisbane and seeing several billboards advertising winter fashion collections for various places.
Whoever the advertising companies were that did those campaigns, their staff obviously never venture outside (or are never allowed outside, or are all gimps, or something), because the billboards sported pictures of beautiful women wrapped up in heavy coats and fake furs, all happily frolicking in snow under wintery gray skies.
Now I don’t recall when we last had genuinely winterish gray skies for more than an hour here, let alone when the last time it snowed in Brisbane (if it ever has…), and as for wrapping up in jackets and furs, well, it’s fine if you’re trying to loose weight in one of those bizarre “You can sweat yourself thin!!!” infomercial schemes, but otherwise generally a little superfluous.
Just another example of consumerism gone mad, when the concept of what winter should be takes precident over what winter actually is.
There is a courtyard between the orthopedic and surgical wards which is a designated smoking area, and there are always people out there during the day, but I’m always amused and astonished to see how many people you find out there at night.
Walk past it at 10pm and even though it’s pitch black out there you can still see vague shapes moving in the gloom, and the occasional orange glow as they suck on their cigarettes and cause the ends to light up.
It’s 10pm! I don’t approve of smoking at the best of times, but if you’re outside and smoking at 10pm, it seems as though you can’t really be that sick can you?
On friday night I did ward call, and saw the two ends of life.
I had to declare an old lady dead, after she had passed away as a result of her cancer, in the palliative care ward.
Then as I was leaving the palliative care ward I saw a literally newborn baby being wheeled down the corridor in a crib obviously off to the maternity ward.
It says something about life, but I’m not sure what it is right now.
One of the features of internship which I’m a little uncertain about is the wisdom of changing departments every 10 weeks.
I have just changed from Orthopedics to general surgery, which is not that big a change, but others have gone from medicine to surgery, or mental health to obstetrics. or visa versa.
I was at a point in orthopedics where I knew the team, I knew the nurses and allied health staff, I knew how things worked in theatre and on the ward and in outpatients. Basically I had gotten to the point where I was good at my job and felt I was being a genuinely useful member of the unit… and then they shifted me.
Now admittedly the learning curve is not as steep this time around, but I’ve still gone back to the situation of not knowing the skills and temparements of my team members or of the nursing and other staff. I also don’t know all the differences in the way the surgery department’s systems and processes work yet either, so basically they have taken a bunch of interns had been trained up to usefulness, and made them inefficient again.
Now as I understand it many countries in the northern hemisphere run their medical internships on a system where you do a 6 month medical term and a 6 month surgical term, and I have to say that I wonder if that isn’t a better arrangement. That way you spend a month or so upskilling, and then 5 months just being good and efficient.
On the other hand however I suppose that people who got stuck for 6 months on a discipline you didn’t like, with a team you didn’t get along with would probably discagree with me on this.
Have you noticed recently how pervasive the whole mobile phone marketing apparatus has become?
It’s everywhere.
There are phone shops by the dozen in any shopping mall you walk into. Almost every sporting team or event has some sort of mobile phone sponsorship. Ads for plans and handsets are everywhere and seem to be constituting larger and larger segments of TV ad breaks.
In my mind I can’t help think that the other industries that have been able to employ these kinds of mega budget advertising campaigns have been the likes of alcohol and tobacco, and as a result I keep on wondering what skeleton is going to eventually come out of mobile phones’ cupboard…
After all, anything that lucrative cannot be entirely healthy or wholesome, can it?
One of the things about getting married as a staid white guy is getting used to wearing a ring, and one of the things I’ve been noticing recently is how I’ve become used to having my ring on.
Now, when I have to take it off to go into theatre of whatever I find it quite weird that when I squeeze my third, fourth and fifth fingers together my ring finger is soft and squishy, rather than being firm and metallic and incompressible, as I have become used to it being.
All the TV coverage of Israeli Prime Minister Ariel Sharon’s hospitalisation after his stroke has been something of a depressing reminder of the general ignorance within the average population of health matters.
Journalists, politicians, and well-wishers alike have been commenting on his condition and recovery progress as though they expect him to be back leading the country in a few weeks or months.
What they seem blissfully clueless about is that people who have major bleeds into their brains (and Sharon has had at least two from what I can tell from the new reports) are generally lucky if they return to being able to tie their own shoelaces, let alone leading a country.
The statistics on stroke alone are depressing enough: 1/3 die in at the time of the stroke, 1/3 die within 1 month, and overall only 10% return to living at home.
Today I saw, I think for the first time ever (or the first time I can recall at least) geese flying in a “Vâ€. I’ve always known that they do it, but I haven’t ever seen it except on TV. Now I’ve actually seen it, and it’s pretty cool.