The day three phenomenon

Well I’ve been back at work for three days after our holiday to the Red Centre (more about that later, hopefully with pictures, if I get organised) and I’ve been reminded of how my brain deals with this.

On day 1 the thought process is “Oh no, I am back at work”.

On day 2 it more like “Actually, it’s quite nice to be back at work”

And on day 3 it’s “I wonder how I can arrage it so that I can get paid all the time, but only go to work if I feel like it…”

(Unfortunately flexible work hours don’t work too well with health care…).

The David Hospital

I have started work at a hospital where there are five ortho registrars, and four of us are called Dave. The fifth is a Margot, and she is being honourarily (or perhaps insultingly) called Dave or Davina by a number of people.

The Med super and his locum are also called Dave.

They’re bloody everywhere I tell you…


Today Simone got official confirmation that next year she would be at the Princess Alexandra hospital for the first six months and at Greenslopes hospital for the second six months.

As for me, I will be at the QE2 Hospital.

Overall this means we will be back on the south side, and looking to blow some of Charlotte’s inheritence on reacquainting ourselves with our favorite restaurants and hang outs around town, should any of you out there wish to join us.

Also, there will be the possibility of an Australia day BBQ, work schedules permitting. More plans closer to the time.

Like ghosts in the half light

Well I am currently on what I hope will be my last ever stint of ward call nights.

It’s been a while since I’ve done nights, and somewhere al0ng the way I appear to have gotten much better at not caring, and delegating all manner of things to the day team. A great many things can wait 2 or 3 hours when it comes down to it.

Still it’s strangely pleasant for the first couple of hours wandering around the hospital all by myself, master of all that I survey (so to speak), although about 4am I start to feel less like master, and more like zombie, and lurch from job to job and try to find comfy spots to lie down for a few minutes between calls.

Two more nights…


One of the odd little traditions at the Cairns Base hospital is an annual event called “Boys Lunch”, which essentially involves the male doctors taking an afternoon off and having a few drinks (which if you know anything about medical types usually equals “getting totally rotten”) and watching a few strippers (although I have heard less flattering descriptions of them bandied about by those who have attended previous lunches).

Now luckily this year’s boys lunch coincides with  me being working a week of nights, so I didn’t have to make up some other excuse as to why I didn’t want to go (because I don’t think the organisers would understand that I find the idea of getting trashed with the boys on a weekday generally unappealing, and the idea of watching strippers in the company of my work mates just plain disturbing). The fact that I’m on nights also means however that I won’t been able to organise an alternative event entitled something like “The lunch for people who would like to sip Gin and Tonics at the Marina Bar” for those other like minded boys and girls who’d like a few nice drinks, some good food, without strippers and in a classy establishment.

The bit that’s funny is that a few weeks later there is a reciprocal “Girls’ Lunch” which also involves drinking and strippers (or “Man whores” as I’ve heard them described in conversations), but which is made out to to be somehow classier then the Boys lunch.

The funny observation that Simone made last night was that it was an amusing feature of modern equality of the sexes that the women tried to attain equality by lowering themselves to the men’s level. Needless to say she won’t be rushing out to oogle strippers in two weeks, although I may not have to twist her arm too far to come out for a chocolate martini instead…

Oh thank heavenly merciful crap

I passed the exam. Don’t know exact details yet as to how much I passed by but for the time being I’m happy enough. Now I just need to get rid of all the excess adrenalin that’s currently running around my body (It was a little anxious waiting for the results, and there were some hiccups with the college website this morning which meant that for about a quarter of an hour I thought I’d failed and had resigned myself to the fact that I’d have to continue studying and re-sit). In hind sight the coffee I had this morning may not have been the best idea…

Dave should not be allowed near students

Today we had two third year med students floating around ICU and I found it next to impossible to not start yabbering on at great length to pass on my “wisdom” (you can all stop sniggering now). I explained ventilators to them (qualifying it with the fact that I only have a pretty rudimentary understanding myself). I discussed ionotropes. I went through acid base status, membrane electro-chemical gradients, and potassium regulation and management.

In the end it was probably a good thing that they popped off for an extended lunch break, or I would have just kept on talking and talking, and never gotten any work done at all.

Ignorant until proven guilty

(This post was alternatively going to be titled “Public Hospitals: You get the care you pay for”)

Well after listening to Jeremy talk about the stress of being responsible for ICU patients in the last few weeks, I got to experience it first hand last week.

My registrar got cellulitis from a scratch on his leg from kayaking, and was away for 3 days, and so I got something of a field promotion to pseudo-registrar.

Now the problem with ICU patients is two fold. Firstly they are (as their location suggests) genuinely quite sick (as opposed to the apparent level of health you see in some of the other people you see around the hospital, some of whom appear to see it almost as a nice little holiday). They need intensive care, and so require more technical support and more detailed knowledge to be able to manage them successfully.

The second problem is that while, in the first 2 years of being a doctor, I have generally become rather blase about what I can get away with on the care front (the old adage that Medicine mostly involves amusing the patient while nature cures the disease actually turns out to be remarkably accurate – most people tend to get better in spite of what you do (or the relative ineptitude of your methods of doing it), rather than because of what you do)) ICU patients are still surrounded by that aura of mystique, and I haven’t quite shaken off my tendency to be generally scared to do anything to them in case they should suddenly and catastrophically collapse in a heap as a result.

So the first day of being responsible was rather petrifying really. The nurses would ask me to rewrite some fluids, and I’d spend 5 minutes deliberating about the type of fluid, the rate, additives, other meds that may be needed as well, possibly implications for the ventilator settings, and a million other (in the end probably unnecessary) things before I eventually just wrote them up for more of what they were having before.

By the end of the 3rd day however I had settled on 3 general guiding principles, which had made my life considerably less stressful. Firstly, run almost everything past the bosses. They seemed happier when I asked than when I didn’t, so I just asked a lot. I’m sure that in a few weeks they would have gotten sick of it, but for a few days they were quite happy.

Second was to listen to what the more senior nurses said, and when they said “Can you change this for me” or “you should do this” I willingly went along with them, because they know far more about ICU than I do (at this stage).

Finally I learned that the first question in any unfamiliar situation should be either “what do they usually do here” or, more importantly, “Is there a protocol for that?”. More often than not there was already a protocol, and so you just followed it and almost never needed to worry about having to figure stuff (slowly) out for yourself, or being wrong.

Anyway, I managed to bumble my way through 3 days of it before my reg came back and I got shunted back into my largely superfluous most-junior-doctor-on-the-ward position, and no-one even died.

Terrorism and kidnapping

The other night while I was cooking dinner Ellen (who I’m sharing a flat with while we are in Dunedin both studying for the exam, and who I worked with at logan last year) looked up from her study and said something to the effect of “You know what, I’m really starting to like Last’s” (which is our (rather wordy) anatomy text book).

I found this rather amusing because I found myself wondering if this was some perverse form of Stockholm Syndrome, the situation where captives come to empathise with and form emotional attachments with their captors.