Travel

Finally I can post about travel on this blog as I've just booked the last of my accommodation for my up-coming trip.

The map above shows my favourite destination in blue, where I've been in yellow, and where I'm going in green (spread over the next two trips - Asia this time, Europe/Africa next year I'm already planning - stay tuned for more on that).

I just booked my last night in Taiwan at Novotal Taipei Airport as I have an early flight to Hong Kong the next day.  I booked with Agoda.com as they seem to be so much cheaper than anywhere else I could find (including Asiarooms.com, Lastminute.com.au, and Wotif.com).

Very excited.

Apart from that, I've been organising my folder for med which has those "integrated learning" lessons in it and do my vast amount of journal article reading for my Masters subject.  Luckily, it has been fairly quiet at work this week and I am almost over this rotten cold I have.

Derm and Taiwan

Just started working through the dermatology series (on OUM's Moodle).  It's an 84-page pdf that I'm reading alongside of my Davidson's and others.  I think it's enough to be half a module on it's own.  I'm glad to be doing it on the back of musculoskeletal.  It feels natural.

Fun stuff - I just booked a night at Silks in Taroko Gorge (c), Hualien, Taiwan.  It looks so beautiful (check out the link)!  The night before I'm staying at a home stay in Hualien(b) to break up my journey from Melbourne via Hong Kong and Taipei airport (a).


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Technological wiz

Just figured out how to import my OUM calendar to my Google calendar.  Oh yeh, I feel like a legend!

Integrated Lecture Series

"Integrated Lecture Series" is what they call those supplemental units at OUM.  They are;

Clinical Reasoning & Decision Making
Pharmacology
Molecular Biology & Human Genetics
Embryology
Dermatology
Infectious Diseases & Travel Medicine
Evidence Based Medicine
Medicine, Ethics and Law
Health & Society
Population Health
Communication Skills
Patient Management & Critical Care

They are supposed to be taken horizontally with the rest of the curriculum at the students own pace.  I intend to work through them before my next term starts in October.

Stay tuned....

Masters

I started studying for my Masters yesterday as soon as the exam was over.  I think I'm addicted to studying.  It is much easier except for those pesky assignments.  One is due before I go away and the other while I'm away, so I'll have to do both before I go.  Shouldn't be too difficult.  Will probably take about a week each.

Today I spent the day at work and getting my life back on track.  I organised a new fence for my house, cleaned out my inbox, organised dishwasher and washing machine repairs, documentation for the new mortgage refinancing and holiday visas.  New keys cut, pets registered with council...etc etc.  Some things are quicker in a small country town (no queue at the council office) and some things are trickier (like organising a friend's ute to take my dishwasher to the repairer in the big town).

That is all.  Life is good  Organising other fun things like social events, holidays, and buying beauty products :)  Today I've also started eating better again.

Another exam over

Just did my musculoskeletal exam.  So glad it's over.  Got my best mark yet despite it being difficult and me being so full of mucous that I'm slightly hypoxic. 

There were quite a few questions on bone tumors which I have to thank Kaplan for helping me prepare for. There were also a lot on brachial plexus lesions (no surprise) and a lot on lower limb muscular anatomy (ie which muscle adducts the thigh). 

I think my brain is getting used to studying medicine.  Things are beginning to sound more familiar (despite being different organ systems) and my mind is getting trained to ingest large volumes of information days and days on end (as I've talked about in previous posts).

My favourite books at the moment are (in order of preference);

• First Aid for the USMLE Step 1
• Davidson's Principles and Practice of Medicine
• Kaplan Medical USMLE Step 1 Lecture notes and DVDs
• Lippincott's Biochemistry
• Lippincott's Pharmcology
• Murtagh's General Practice
• Gray's Anatomy for Students
• Robbin's Pathologic Basis of Disease
• Kumar and Clark's Clinical Medicine
• Harrison's Principles of Internal Medicine

Now, off to start my Master's subject and finish my PT assignment finally!

And get ready to go back to work.....

Back (to black)

How sad about Amy Winehouse eh? 

Anyway I'm back!!!  Back in business.  Back to full-on study today, exam tomorrow (kinda stuffed up my revision prep but I'll have to wear it), back to work tomorrow night.  I managed to watch some Kaplan videos over the weekend.  I couldn't even get out of bed before three days ago, so I've been quite crook.  Ripper of a head cold now, but at least I can take some cold and flu tabs for that tomorrow (if I need to).

Not much time to blog now as I am madly cramming.

Wish me luck for tomorrow!

C'est la vie

Apparently I've been working and studying too hard and that's why I got sick.  I dunno.  Maybe. When I got sick in March I was on annual leave, so that theory doesn't really work.  Maybe I should have a good look at my diet and try and boost my immune system with juices again.  Maybe I should stop working with sick people all the time.

Anyway I'm happy because I'm starting to feel better.  I've lost about a week or pre-exam revision, but I'm happy I think I'll have about two good days before the exam to cram.  What can you do?  That is life.

C'est la vie.

Sick as a dog (again)...

Back soon...

MoH duties

Today was occupied by Maid of Honour duties. First, the bride-to-be got sized up for dress alterations, then a hair and makeup trial I also attended (a mere ~150km from my house. Picture.), then it was jewellery shopping for the bridal party, then dress shopping for the hen. Whew!

I came home to find my dog had escaped yet again. I'm now pushing the neighbours for a new fence as it is falling apart.

Just had a nana-nap, now I'm about to get ready and go out dancing!

Study mascot

Hope he doesn't slobber too much on my notes.

Mortgage

I went into Melbourne this morning to see the mortgage broker about my current home loan etc.  It all went very well, things are looking good, and I'm happy with where I'm at financially in that respect.  I'm not over-stretched, it's a sensible sized loan and the capital growth in my town in going good.  The broker couldn't quite believe what I pay in med school tuition fees every month.  He said "Is it what you really want to do?" lol  When I asked about a second investment property, he suggested I probably wait until I finish med school but that I could revisit the idea again next year.  Sensible.

I got my Kindle today too, so that is very exciting. I'm hoping to put my travel guides on it.  I suppose I'll have to get the Lonely Planet's again.  I hope the Kindle doesn't freeze in Tibet or melt in Taiwan.  But it is a lot lighter than five lonely planets in my backpack.

Today I got my first free trial of the French newspaper Le Monde.  The article said:  "On the 16th of June five french soldiers were killed in a suicide attack in Afghanistan.  This month 17 french soldiers have been killed in Afghanistan which is as many as were killed for the whole of 2010."  I had to Google translate about 20% of the words.  I like this method of trying to learn French.  I got the idea from doing a GAMSAT prep course and the lecturer telling English-as-a-Second-Language students to read the newspaper every day.

I'm thinking I might do a francophone trip next year.  Maybe by then I'll be better.  I was thinking world trip next year, so maybe a francophone world-trip.  Here's my proposed itenary (not in order):

• France
• Rwanda
• Seychelles/Madagascar
• Haiti
• New Caledonia/Vanuatu/French Polynesia
• French Canada

I just finally paid for my airfare to Nepal yesterday.  I'm going via Hong Kong now, and seeing as I'm so close to Taiwan, and had 4 days spare, I decided to add in another leg of the journey.  I have wanted to go to Taiwan ever since I saw how much some parts looks like Pandora from Avatar.

I then have one night in HK (on my birthday!) and then 3 in Kathmandu before starting my fortnight in Tibet.  After that it's a week in Bhutan ended with a rest night in Kathmandu (hello hot water!) before a very long trip home.  That is in 7 weeks from now!!  Exciting!  Oh I can't wait....

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Study - just chugging along.  Getting through my Davidson's quite well, but about a day behind on the case study revision.  Not too stressed yet.  Life isn't throwing me any nasty surpises right now.  I have a few days off work.

Life is good.

What I did today

First I slept in as I have had such little sleep in the last few nights.  Well, actually first I logged on for my 5am lecture only to find out it had been cancelled.  Slightly frustrating.  Got over it quickly when I realised I got to go back to bed.

Then I got some much needed groceries, made some lunch, then went 45km to see my tax accountant to do my tax return.  Then, I went to the hospital library to wait for my mentor session.  We went over a few anatomy things that I'll probably need for the exam and the rest of my medical career, including the dermatomes, myotomes, and skin innervation of peripheral nerves of the upper and lower limbs.  We also went over the vertebral anatomy and reading spine xrays.  I feel clueless on tendons so I'm not sure when I'm going to know them by.  Probably not by the exam.  My mentor said not to worry too much as most conventional medical students don't know their anatomy in the same detail as she had to.  It is slightly reassuring, but not entirely.

Then I came home and had dinner and probably took too long of a break.

Now I'm in my study reading my allocated 6 pages per day of Davidson's musculoskeletal chapter and trying not to forget to finish my study of case 1 today but I'm already getting behind on that.  I tried to do ten USMLE World QBank questions but got bored and distracted by the ones that have nothing to do with what we covered in this module (ie paralytic agents)  It also had a question on myasthenia gravis, which we haven't covered and I hope we do in neuro!  The only reason I know about that disease is because in ambulance we use midazolam and MG is contraindicated.

Getting daunted by the task and my mind is wondering.

Realising I study better at work with less distractions and at the desk without a computer.

Think I might turn my laptop off and focus.

Pets

They are their cutest when asleep

Library time

I've just been into the hospital library to borrow Grey's Anatomy for Students and Netter's Atlas of Anatomy to supplement my Moore and Dalley's Clinical Anatomy. I now feel like I need to own all three.

Disheartening

Today I spoke to a fellow classmate who told me he's on the scholarship for getting two HDs (>90%) in a row.  As long as he maintains his grades, he'll get free tuition for a year (or 5 modules).  Wow.  I thought they were almost impossible to get.  He also works full-time.  I emailed him and asked him to let me into his secret, but, while waiting for the reply, I already know the answer.  I'm sure he just studies more than I do.  He said he reads anything and everything he can get his hands on.  I'm not sure I'd retain that much.  I'm impressed by his stamina.

I'm pretty happy with how much I've achieved today.  I've thoroughly reviewed the relevant biochemistry and microbiology for the term.  I'm now working my way back through the case studies.  Things are starting to sink in, and it's nice when you re-read something for the 3rd or 4th time and all of a sudden you brain just goes "oh that's easy" and it opens up room for more complex detail.  This is my theory.

Today it's the first case study - rheumatoid arthritis.  First half of learning issues - anatomy of joints, biochemistry of synovial fluid and connective tissue, autoimmune response, and chronic inflammation.

Well I must get back to it. 

What I'm doing today

More FA

Good day for studying

The weather today is perfect for studying.  It's freezing and all grey and horrible.  I'm off work today sick but I should be feeling better by tomorrow.  I hope this Winter is over soon.

We were supposed to be doing the student presentations today but there was a technical issue and the lecturer couldn't log on.  The students stayed in the virtual classroom a while a had a chat which was nice as we hardly ever get to do that.  Peer-peer bonding is nice.

My closest class mate this term lives 2000km from me!  Sometimes I feel like those 1950's really remote school students in the Australian outback that used to have their lessons by short-wave radio in their homes.

I've now done with my case studies.  I have one quiz to do this week (hard) and the presentation to give (easy).  I have 14 days now until the end of term exam, 6 of those days are without work and 5 if you take out the one I'm doing MoH duties on.

My study plan is to revise First Aid for the USMLE Step 1 musculoskeletal chapter today (plus find, tag, and revise additional sections relevant to this term ie osteomyelitis is under microbiology).  Then revise one case every two days making sure to cover off all learning objectives (as outlines at the front of each case).  Additionally, do at least 10 USMLE World QBank questions per day and at least 3 AMC MCQ questions per day.

For revision I'll combine the case study notes with my Kaplan notes and core textbooks.

I have one day as buffer.

I'll probably only get to revise for 3 hours a day on the days I'm working.

Other resources I will probably use are Wikipedia (I'm big enough to admit it), Doctors In Training Solid Pharmacology lectures, and Almost a Doctor revision notes, flash cards, and mind maps.

So, today, FA.....

(Just remembered other annoying things on my to-do list.... realising 14 days wont translate into much actual revision time...... slight wave of overwhelment coming over me..... trying to stay calm.... might go watch relaxation DVD first.......)

Relaxation and dealing with stress and anxiety

As if it wasn't obvious from the pattern of my recent posts, but I have been suffering from a fair bit of stress lately and that has started to creep over into the realm of anxiety.  I completely blame my job, and more specifically the on-call roster, and also myself for working too much.  I do enjoy the stress.  If I'm not pushing myself I feel bored.  I don't think you need to be a doctor to figure out this might not be entirely healthy.

I like to chill-out too, though.  Preferably on a beach with a cocktail that is served in a coconut with a straw and one of those little umbrellas.  I also like to sleep a lot.  And I love my bubble-baths and TV.  I've often considered putting a TV in my bathroom above the bath.

But my anxiety was starting to affect my composure and ability to study this week.  I was feeling too on-edge to absorb anything and I didn't even want to think about studying.  I had even gotten to that point where nothing seemed to be going right.  I even stubbed my toe and bumped my funny bone. 

It's kind of embarrassing to admit all this and as a med student I don't want anyone to think I can't hack it or I don't have what it takes.  But it would also be portraying a false image to pretend that med students and doctors are perfect, robot-like identities that don't succumb to human emotions.  I hate people who are fake.

Anyway, fortunately for me but not for them, I am not the only one I know going through this so I was put onto this great DVD by Glenn Harrold.



It is a relaxation DVD that uses hypnosis and I have to say it works a treat.  Actually, I went through all this before I went to Samoa last year, and then again when I came back from Samoa.  Before I went to Samoa I emailed the accommodation to make sure they had a DVD player as I got so dependant on this DVD.  I tried my friend's Valium once and it only made me have worse rebound symptoms.  Excercise is great too, and eating Low GI, but this DVD is like my Valium.  I probaby don't have to mention to avoid caffeine and alcohol.  I also read my Dalai Lama book (in the bath) and the first chapter is on stress and also helped.  I feel SOooooo much better today. 

The quiz last night - I did it, felt confident,..... then got 0%!  I nearly died (this was before I did my hypnosis).  I thought "No friggin way.  I know I got these right".  I then realised what might have happened - I had let the timer run out without pressing the "submit" button.  Seems so obvious now, but I was thinking that if I didn't press submit, and let my timer run out, then it would just accept my last answers (which is a MCQ bullet-point format).  I emailed the curriculum coordinator and he sorted it all out.  I got 100%!!!  I also then asked him to look at my 2nd quiz, and, sure enough, I was supposed to get 80%!!!  So for my quizzes so far I have go 95% correct.  One more to go... Hopefully it will end up being an easy 30 marks for the module.

Things are starting to turn around.

Random

Revision fortnight commences with a look at the musculoskeletal chapter of FA.

A day in the life of

I just got home from work.  I'm on-call tonight.  I stayed back about an hour and a half to do a handover as our branch manager is going off on leave and someone else is taking over.  She has just come back off leave so there was lots to go over before I went home, and I'm the Health and Safety Rep, so thereare a few things we have in the works atm.

We were busy again today.  Ever since we moved to this new despatching system our workload has increased by about 50%.  That's about 3-4 hours a day of downtime I've lost now.  We were out late again last night until 4am on a call-out.  My dog is about to disown me.

But that's ok, I don't mind working for my wage, it just calls for an adjustment in my schedule.  I'll probably do less overtime now on my days off so that's where I'll pick up the hours to study.  However, my roster is 5-on/5-off so one week I'll have heaps of time and the next week barely any.

Nevertheless, the show must go on.

I'm now about to login and attempt my terrifying weekly quiz.  I've just opened the books for a quick refresher as it is for the gout case I finished a week ago.  I have my pager and portable radio and luckily these quizzes only go for 5 minutes (timed) so if I get a call-out now I'll be ok to complete it.

My stress and anxiety was good all day until I remembered this quiz.  Now it has gone off the scales again.  As my adrenaline levels don't seem to go back to zero at all, it just takes one minor stressor and I'm off the charts.  It happens every time my pager beeps, or I think about the potential of getting a cardiac arrest as I haven't done one now for over a year (being in a rural area and on-call by the time we get to people they are usually past possible resuscitation).  Anyway, this anxiety thing happened at about this time last year and it finally went away.... when I went on leave. 

Kitty

My cat on my Wii board. I love how oriental she looks. She matches my decor.

Osho and getting over myself

So I've come to the point where I just can't handle my own crappy mood anymore.  I just have to get over myself.  Sure I'm tired, sure I have a lot of stress at work, but that can be neutralised with the right mindset. 
I get Osho.com things sent to my Facebook.  Today's came at just the right time.  I heard a saying once: "When the student is ready the teacher will appear".  Today I was ready.  It's not a new theory or philosophy, its more about remembering to be conscious of one's own mindset, remembering to try and "witness" the mad monkey of the mind rather than getting swept along with it, and remembering that mind and consciousness are separate things.  The consciousness is the real "I" (or soul, if you like) and the mind is something different, as is the body.

Here's an excerpt from today's Osho teaching;

The whole Eastern methodology can be reduced to one word: witnessing. The whole Western methodology can be reduced to one thing: analyzing. Analyzing, you go round and round. Witnessing, you simply get out of the circle. - Osho

(Nb:  Dont't get too wrapped up on East vs West - it's just a generalisation.) 

And here's the Buddhist Four Nobel Truths (which I really need to print out and put on my wall or tattoo on my hand);

1. Life means suffering
2. The origin of suffering is attachment
3. The cessation of suffering is attainable
4. The path to cessation of suffering (the Eightfold path)

It's good to point out here that some people think the translation of "suffering" in English is probably more close to "stress" or "uneasiness" and is meant to describe the difficulty we humans have to just be content.  There is always some attachment or aversion - to want happiness and comfort and avoid sadness and pain.

Thankfully, points 3 and 4 exist.  I think the first 3 points are universal, but the forth is probably left up to interpretation.  Not everyone needs to practice a Bodhisattva's life to rise above suffering, in my opinion.  But generally, the Eightfold path describes the "middle-way" theory which is closely aligned to the Western saying "everything in moderation" and also is studded with acting ethically and with integrity and, of course the most important cornerstone of Buddhism, "mindfulness" which includes the practice of meditation.




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Last night was the tipping point.  Stress at work+++ and I just thought to myself "this can't go on.  I can't change the system.  I just have to deal with it".  When I started in the job I wasn't so focused on how things "should" be.  I just went along with it, did the jobs I got despatched to, did my bit, took them to the nearest ED, and that was that.  Now I've been in the job 3.5 years I see things, faults, all the time. 

Patient such-and-such that waited too long for an ambulance thanks so reasons x, y, and z, who's myocardium died, and now is a cardiac cripple.  Patient so-and-so that was misdiagnosed because facility x is set up like a hospital but really doesn't have the appropriate facilities and the doctor that was on-call didn't bother to see the patient in-person but gave instructions to the nurse over the phone.  And what about the patient that got left at home because the paramedic got too confident with their diagnosing abilities and decided to go on probability diagnosis and not look foolish at the ED than rule out that 1% Red Flag diagnosis which ended up nearly killing the patient.

I can't get stressed out about these things.  But I guess if I'm going to try and live by the Eightfold path I need to try and contribute to bettering the system.  I know I can't fix it completely.

How can I do this?  This may call on all my wisdom and creativity.  Stay tuned.

Med school annoyances

Sometimes my med school really annoys me.  Not because of the learning material or lecturers, but because of stupid administrative errors. 

I get that there are a million different time zones for different students - but get your act together.  Med school is confusing enough without constantly moving the goal posts, giving conflicting information, restricting flexibility in a distance education unit, and then accusing the students of being stupid for raising issues of merit instead of admitting you stuffed up.

Really annoyed right now.

Here is an exact example:

".....final exams will be administered following completion of the module (i.e., "week 9"). The exam will be open from 1 am - 11 pm Pacific Time."

Um, hello.  What day of the week of week 9?  And isn't that part of the USA now in Pacific Daylight Time (I only know that from Googling Pacific Time as stupid me thought it might be the time Samoa is on seeing as Samoa is in the Pacific and where my med school is located)?  And when did I have to start converting time from USA to my time when everything else is in Apia time (where the school is based in Samoa, rather than the curriculum coordinator in the US) or what about UTC on Greenwich meantime?  There is only one US student in my class, one Kiwi, two Aussies, and four Samoans.  But, no, we'll work off YOUR time seeing as you are in the centre of the known universe.

So after a bit of Sherlock Holmes work I believe I've deduced that (I think) my final term exam will be on Monday the 25th July from 6pm to 4pm the next day.  Luckily, I have that day off.  In the past terms we've had two weeks to book a session at the testing centre in the big (capital) city closest to our homes.  Now it's to be online at home.  Can anyone spell "loop-hole"?

When my presentation is is another story..... I thought it was next week (Week 7) but the website where everything is listed says it's Week 8.  I'm going with week 7.  I'm now reduced to relying on gut instinct.

Maybe from their point-of-view it's simple.  But when you're thousands of miles (or should I say kilometres) apart from everyone else, information needs to be accurate, timely, and reliable.

Too much to ask?

Most probably.

Overheard

This is my new section "Overheard" where I hope to put up some funny/interesting things I see and hear in the ambulance, emergency departments, and on the job in general.  This is my vain attempt at finding humour everyday in the job while working the on-call roster, and letting non-paramedics into the world of all the weird things our minds have to deal with on a daily basis. 

I'm trying to write it like a script for dramatisation.  Excuse me if it seems odd but I'm not a writer.  Of course all identifying information has been altered or removed completely and is written in good faith and laughing with the patients, not at them.

OVERHEARD IN THE EMERGENCY DEPARTMENT

NURSE AT TRIAGE

(talking about the football scores to the paramedic)

"They're not doing too well".

ELDERLY PATIENT

(lying on the bed in front of the nurse looking worried)

"Who? Me?"

Back

I'm back at work, back on the wagon, and back in the game.  Killed my massive to-do list yesterday.  Feeling good like I'm accomplishing things and am organised.

Today at work (between patients) my goal is to:

• Go through my emails
• Fill out and return the forms for income protection
• Find and send off the missing patient care record I've been contacted about
• Get everything ready for the accountant next week and the guy that's going to look over my home loan
• Fill out my current timesheet
• Check for my stores order and put it away if necessary

Then, I would like to accomplish today:

• Go through the osteoporosis case study again and read the given notes that come with it
• Cross-check it with First Aid for the USMLE Step 1
• Start tackling the case readings and make a game plan for the weekend to finish it off
• Finish my presentation on Paget's Disease
• Plan my two weeks out before the exam
• Finish those two missing questions on the PT assignment
• Plug into my Google calendar the term dates for the Masters subject and see if the unit materials are available yet
• Try to remain calm as I can feel anxiety brewing.  Maybe try and meditate or watch the hypnosis dvd

That is all.

Diamonds

The rain on my bathrom window backlit with the greyness of the Winter's sky made a nice diamond-studded-like appearance this afternoon.  I love my bathtime.

Second wind?

I am hoping my second-wind kicks in this weekend.  I've effectively had about a week away from the books except meeting my mentor, working through the case study (easy) and doing the online lectures (easy) and a little bit of biochem/pharm reading (hard),which is nothing compared to what I'm supposed to do.

I also went these entire 3.5 days off work without being tempted to do any overtime.

I caught up with friends, slept in a bit, ate and drank and dropped out of Dry July in spectacular fashion.

Feeling good.

But enough rest I must keep going. 

This is the last case study for the term - osteoporosis.  Next week is the presentations (week 7) and then a revision week (week 8) before the end of term exam on the Tuesday of week 9.  So, really, it's like 2 revision weeks.  Which I'm going to need.  So I'm happy that it's worked out that way and my rostered shifts are even favourable.

Well, can't stay and chat.  I have a massive to-do list to tackle this afternoon before I go back on-call in two hours!

Lull in motivation

Well I'm not feeling all motivated and in love with medicine atm. Not at all.  I'm feeling the next 2 weeks of case study plus the final revision week is going to be too long!

I'm hoping it is just a combination of tiredness and hormones (female handicap) and am so happy I now have, after just doing a lecture online now, the rest of today off.  The weather today is puuuuuurfect for watching movies.  This storm better not take out my satellite!  I can't imagine going to the video shop!

Hoping today will be enough as I lost yesterday to MoH duties (and catching up with my friend that moved to London bout 4 years ago!), and the weekend to work/fatigue/sleep deprivation/working with blow-ins.*  Not matter how I feel tomorrow, I will be studying ALL day.

Actually, catching up with my friend was really good because she is a paramedic in London and was telling me all about the UK recession, job cuts, the crap ambulance system over there etc.  It put things in perspective that we've actually got it pretty good here.  Mind you, I see some obvious wasted funds in that in the UK you get a helicopter with a trauma doctor on it for the most minor injuries/accidents.  Plus, you can drive the whole length of the country in about 4 hours.  It kind of seems ridiculous from my point of view especially as chopper are so expensive to run.

Anyway, movies time for me it is.  R+R.  Staying warm with my tea cup.  Might even do my hair later if I can be bothered.  And cook dinner from scratch without worrying about being interrupted.  A whole day of being "insignificant" (as Dr Phil would put it).

Loving today.



*Blow-ins:  Non-permanent staff members, ie people filling sick leave I don't normally work with me, don't normally work at my branch, and don't normally work the on-call roster, which always increases the amount of effort I need to put into my day (despite some blow-ins being lovely people and a breath of fresh air).

Tea

How cool is this little glass teacup and strainer?

House mate

Very exciting news - I've lined up a house mate!  Yay!  A good one too.  She's the girl that normally house sits for me and she's about to finish high school and wants to move out anyway. 

Excellent.

She knows how my house runs and about the idiosyncrasies of my pets (and doesn't mind sharing the couch with them).

Exciting, exciting, exciting.

I've been hanging out for the perfect house mate...


Work - is slowly killing me.  Just an accumulative sleep deprivation.  Had a patient that had some serious chronic fatigue issues after working as a fire fighter for years on shift work.  Now his cortisol levels are all stuffed up and in reverse (high at night and low during the day).  Not only that but he now has insulin resistance and cardiac issues.  Made me think I need to be more strict on my sleep bank again.  Luckily, I worked with some really good people the last few days and my morale has been rejuvenated at least.

Study - I'm taking a break.  I'm so sleep deprived right now I feel drunk.  I have a big day tomorrow full of social activities and MoH duties.  Maybe I'll block out the whole day and try and do some exercise in the morning to get my metabolic processes working efficiently.  Doing nothing medical tomorrow and being social with other human-beings which aren't medical (well, some of them are!) might help me get some quality study done for the rest of the week.  I'm happy with what I achieved with this week's case study.  I have a few days off this week so, again, not so stressed about it.  In fact I'm still really motivated ot study medicine.  I actually love studying medicine.  Still.

Ok, that is all. I was disappointed to read on TripAdvisor last night that paragliding in Pokhara doesn't happen in the monsoon season when I'm there :(  Might have to consider another adventurous activity.  Taking suggestions (from my 4 followers).

Frustrations

Work is actually really starting to frustrate me atm.  Unfortunately I can't really go into why incase someone from work actually reads this thing.  Suffice to say, I am due for some annual leave.

No study today.  Just so so need to stop the world turning for half a day.  Luckily, this week's case study is easy, all bar the ridiculous amount of anatomy I need to download into my cerebrum.  I generally just study until I need a day off and then take a day off.   Today is the day BIG TIME!

Worked with someone yesterday that just got back from Nepal so I have all these exciting ideas for the Nepal portion of my trip.  Excited once again.  Her photos looked so cool!  I'm thinking paragliding in Pokhara.

Time warp

I must be in a time warp