Keeping it simple

Having a simple-life, a relaxed home-life, down-shifting, living frugally, living green, and living ethically can sometimes all share a similar thread.  One of the most important things to do, in my opinion, is to de-clutter.

When you de-clutter your home you begin to know exactly what you have and where everything is.  The things you already have you can take more time to look after and repair rather than replace.  You can enjoy and actually read the five novels you have instead of the five-hundred, for example.

I find the food in my pantry is much more likely to get eaten before it expires if I know exactly what I have in there, can see it all, and it is kept nicely in their packets or those plastic containers.  The same goes for the fridge, the wardrobe, the sewing cupboard, etc.  For some reason I buy less new stuff when I am more aware of the stuff I already have.

I'm not a de-cluttering expert, but this is how I do it;

Rubbish - junk that is no good to anybody

• Finally get to use those plastic shopping bags in the kitchen draw.  Take one (or two - for some reasons all mine have holes in the bottom, so I double-line) into each room in your house and don't leave that room until it is full.  I'm forever filling mine with paper and mostly empty tubes and containers of stuff which is well-and-truely past it's use-by date and I'm continually asking myself "Where did all this crap come from?"  The normal answer is that is accumulates over time somehow.
• Take bags straight to your bins and sort into recycling and rubbish, thereby full-filling the minimum green obligations.  If you don't have a recycling service for some reason, dispose of the rubbish in the best way you can.
• Repeat the top two steps as frequently as necessary.

Junk - junk that may be useful to somebody

• Boxes would be handy here. I collect and save cardboard boxes that stuff gets delivered in at work.  The other option is the local supermarket.
• Get those old books you are seriously never going to read because you've had them for 10 years and haven't even read the blurb and put them into boxes and take them to the local op-shop.  
• I tend to keep reference books, like "Vegetarian Nutrition for Athletes" and "What Flower is That?".  These have their own small bookcase.
• Other junk, like crappy old crockery when you already have 20 dinner plates.  Exceptions - keep old cutlery for picnics, keep jars for homemade chutney.  These will be coming posts!  Old bottles can also be handy too. If you do decide to hang onto bottles and jars, it's best to put them in their own box out of the way yet where they can be found when the time comes.  The garage or laundry are good places.
• Childrens' toys - as much as I love my Hello Kitty manicure set, it might be time to give that to the op-shop.  If the toys are too dirty and embarrassing to give to friends/relatives, don't under-estimate the op-shop.  I forever see children leaving there with a new toy.
• Things in this category also might go well at the local trash 'n' treasure market.  I've done a few, but the goal is to get rid of everything, even if someone offers 20c for it.  It's junk to you, remember!

eBayable - junk that probably has some value to somebody on eBay

• Have a look at what stuff you have and never use and ask yourself if you'd rather have it cluttering up your home or $5.
• Things I have found that eBay really well are textbooks (medical and scientific go well for me), Nintendo games (Wii and DS) and some DVDs especially TV series.  I'm guessing other textbooks or well-known books might do well, as would other video games and some DVDs.  I had the Grey's Anatomy series and they sold very well.
• Anything with a brand-name that is normally expensive to buy new seems to do well. I got rid of all my genuine Pandora charms in a flash!
• Things that I find don't sell well are old clothes (unless they have a designer label) and other things that should really be in the above category and taken to the op-shop.
• Remember that eBay charges a small fee (unless you list it without a gallery photo for 99c reserve price) and there is time involved in putting up an item for auction and then organising posting it.  Also, some buyers can be really annoying.  Overall, I've had a good experience on eBay.

Valuable items - things that definitely have an intrinsic value

• Valuable items don't normally fall into the clutter group, but if you find yourself with something that definitely has value, such as gold jewellery or a very nice antique, either display them, store them appropriately, or sell them at the right place such as a jeweller or antique store.  eBay may be appropriate in some instances.
• Taking the time to display something nicely shouldn't clutter your home.
• If you decide to store something should only be for certain special circumstances such as heirlooms.  If you do decide to stare a few things then pack the item appropriately and label the box clearly.  Don't forget you have it!

By now you should be feeling much better.  You might be surprised at how often you have to repeat this process!

Things I like to keep in mind while I'm de-cluttering;

• When did I last use this?
• If this got stolen from my home, would I even notice it was gone?
• If I had to move overseas, would I bother paying to ship this with me or to put it in storage?
• Does this thing enhance my life, or make it more cluttered?

There are some exceptions to the rule, but try not to get trapped here.  For example, I like to reuse sewing fabrics, buttons, and bits and bobs.  I have a sewing/crafting section of my cupboard.  I keep it fairly organised.  I also like to re-use envelopes (I keep the ones banks forever send me junk in and re-use them for my mail - just takes a bit of sticky-tape and white-out) and scrap paper.  I also keep these very organised in their own draws in my study.  I have a friend that is a farmer and keeps old motor parts in his shed, just in case, because he generally uses them eventually.  If you do some of these practices then you need to keep this sort of junk organised or risk getting cluttered. It might be best to set yourself limits such as one draw, one cupboard, or one shed!

You might want to de-clutter a room a week, or I like to do a plastic bag in each room and a box on one of my days off before I start the housework.  The important thing is to start.

Once everything is de-cluttered you can start to organise your remaining stuff!

Good luck!

Glycosylated

This was the word in my brain when I woke up this morning.

Grounded

I'm grounding myself for the next two weeks.  Well, at least for this week.  I am waaaay off track with my study.  Apart from my normal 80-hour fortnight, I did 43 hours of call-outs over night and 12 hours of an overtime night shift.  I also went away on my days off twice.  Yeh, I'm so behind.

I'm only at Code Yellow though, because I think I will be ok if I pretty much just study and do nothing else.  This time of year gets increasingly difficult, though, as I have two work Christmas parties to attend, another social function which I promised my friends I'd go to months ago (they get a little cranky that I can never make anything and booked me in advance) and I've put myself down to work an extra shift at a music festival coming up in my area.

My final exam (for this module) is on the 15th of December, so, yeh, I've got 18 days, 6 of which I'm free of work or social commitments.

Standby to find out how this all ends!  I'm off to finish my presentation....

I've got a long way, Baby...

Here is my list of what I need to complete before I graduate (minus a few USMLE exams!).  I still have so much more to do :(

I've highlighted the pre-clinical modules I've already completed (and endo which I'm nearly finished).  It's a little bit disheartening.  So much work for so little gain!

Good grief.

Back to it.

Plan

I can't log into my quiz yet again and I've run out of ideas.  The help desk number is in the USA and I don't want to make an international phone call.  Frustrated.

It's Thursday afternoon, I have a double case-study I've barely started, and I'm feeling so behind.

It's times like these I like to make a plan.

Here's mine;

Today 
1. Give up on attempting quiz.  There is nothing I can do so I need to let it go  What ever will be will be.
2. Whatever happens - read half of my case study by end of working day.  Get to page 52 (in 3 hours).
3. Do the dishes and hang out laundry.
4. Wash hair as soon as I can tonight between call-outs.


Tomorrow
1. Whatever happen finish case study by end of working day. 104 pages.
2. Vacuum as soon as I get home between call-outs.
3. Watch Kaplan at home on-call between call-outs.

Saturday
1. At least scan all readings for this case study by end of working day.
2. Prepare for tomorrow's lecture.
3. Put away clothes in wardrobe.

Sunday
1.  Do lecture and academic advisor meeting
2.  Write down possible exam questions from lecture.
3.  Do tidy-up of house before friends come over Monday.
4.  Night off - watch some tv or mow lawns.

Next week (Week 7)
1.  Do a bit on presentation each day (break into daily chunks - TBA).  Submit by Friday.
2.  Prepare revision study plan during breaks from putting together the presentation.
3.  Start throwing out junk from cupboards during study breaks and keep on top of house work.

Week 8
1.  Make revision study plan
2.  Revise for end of term exam as per plan
3.  Use study breaks for house work and continue throwing out junk from cupboards.

I feel a little bit better now.  Now to go read that case study....

Down-shifting

I've just started reading a new blog - Notes from the Frugal Trenches, amoungst others from Simple, Green, Frugal Co-op blog.  I was reading about "downshifting", as the thought of it pretty much dominates my mind atm.  I thought I'd just reflect on my own downshifting journey over the past few years.

(YA = years ago, MA = months ago, ie in the past from where I am now).  I've tried for chronological order;

10YA - Lived on a 33ft yacht for about a year.  Realised how many more stars there are in the night sky away from cities, pollution, lights etc.  Got nostalgic for the days when I used to be able to see the Milky Way from my suburban home as a child.  Realised I hadn't seen many stars at all in the city for years.  Quite a shock.

9YA - Did my Army preventive medicine (environmental health) training living on-base for a few months out in the sticks.  Really enjoyed my lifestyle there and how good I felt, particularly my afternoon 5km run around the base through the trees on a dirt track and some grass, the fresh air, and the lack of traffic.  Decided at this time I wanted to move out of the city but would still want a good career, which I didn't have on the yacht.  Looked at the Army full-time, decided on becoming a paramedic.

7YA - Began becoming a paramedic.  This included some clinical placements in rural locations which I really enjoyed.  Started narrowing down where I would want to move to. 

4YA - Got my first full-time ALS paramedic job in a rural city.  Had quite a culture shock as my normal forms of entertainment were either not available at all, not readily available, or not of the same standard.  At that time these were fancy dinners at restaurants, cocktail bars, Gold Class cinemas, and live shows/gigs, as well as a membership at a nice fancy gym with a eucalyptus steam room and aromatherapy room to name just a few.

3YA - Transferred my job and my life to a small rural town.  Another culture shock again. No shops except the op-shop and a small supermarket which didn't contain any fancy products. Searched the supermarket shelves and couldn't find rice milk or tofu (they are now available). No free-range chicken, no fresh organic food.  No takeaway food and the one and only restaurant at the pub was terrible.  No gym at all.  And my roster involved being on-call a lot.  Had to begin shopping on-line which helped me decide what I really wanted and less impulse (still some impulse buying).  Had to learn how to cook and how to use more staple ingredients. Bought a Nintendo Wii and set-up home gym and bought Tracy Anderson workout DVDs.  Go for an occasional run in the fresh air around the paddocks - reminds me of the good ol' times on the Army base.

1.5YA - Bought my house so I could finally do things like install solar panels, put in a vege patch, plant some fruit trees, and get my non-existent gardens in existence.  Already had some nifty devices like those standby power switches.  Water tank already insitu.  Grey-water hose from washing machine to vege patch in place since renting as we were ina serious drought then.

8MA - Decided I was going to go frugal. Rearranged my budget as much as possible (with more help from My Budget with who I have been with for a few years now). Reduced as much as possible.  Shopped around for cheapest insurance, internet, phone etc.  Simplified.  Convinced myself to only travel overseas once per year instead of up to 4 times at one stage!

6MA - Found myself the perfect house-mate to take up some of the ridiculously large amount of space I have in my house and to contribute rent.

4MA - Started reducing the amount of overtime I work.  Enjoy my days off.

2MA - Finally getting my feed-in sorted for my solar (so the electricity company buys-back any excess I generate thoughout the day).

1MA - Started seriously looking at rural acreage for my (hopefully) final transition to as rural as I want to go.  Planning to rent my rural township house out (I wont sell it as I need a city or town house as an asset as my acreage house will firstly be my forever-home so I can freely design and do with it what I wish without worrying about resale, and secondly it will not increase in capital as dramatically as my township house, and thirdly my plan is to have a number of small-mortgage houses with people renting them off me and to never have a large mortgage to which I am chained to as per the advice from a few of the older people I'm friends with).  Am still currently in the planning phase or the acreage house.  Projected period of planning is 12 months, projected period of construction/moving is another 12-24 months after that. V. excited.

Recently - Bought my first few shares! They were in a co-operative wind farm!  V. cool.  Hoping to receive my first few small dividends in the next year.  Joining some local sustainability groups.

So now I've started a new post category - the "simple life" which I hope share the more time I intend to spend on my down-shifted, frugal, green, simple life. 

---------------
I'm hoping to still keep up with modernity, though.  I love technology and I have no intention on rejecting modern life and living like the colonials.  I'm just trying to cultivate that part in my bio that says "find the time to stop and smell the roses....."

Update

I haven't blogged for a few days because I was away from home enjoying myself for a bit of a long-weekend away.  Very nice indeed.  I went away visiting friends in another part of the state in the country-side.  It turned out to be like a mini-holiday and I found it very refreshing for the soul, despite there being a horse-biting incident!  Ouch!  Apart from the minor dramas, it makes me want to work part-time for the rest of my life and just chill on my property somewhere.....  I'm a long way from that being a reality.

When I got home my dog had been home alone for a number of hours as my baby-sitter (and soon to be roomie) had gone to work.  My dog was fine.  I then had to go drop into work and pick up the pager to start call.  I was gone for about 15 minutes and when I got home my dog had emptied the rubish bin all over the floor!  He really told me how impressed he was that I had left again so quickly after returning!

Being away from the weekend, I unfortunately missed another lecture, which is now a total of 1% minimum down the drain from my module grade.  I didn't intend to - I was all ready to use a foreign computer again, but it was all a bit too hard at 8am on a Sunday morning.  Now I'm not sure I'm going to be able to beat my PB of 87%.  Pituitary diseases and Cushings syndrome were basically a blur to me....

But, there is hope for now we start something that all paramedics know at least a thing or two about - diabetes!  Diabetes mellitus to be precise.  It's a double case-study this week, so I better get to it.  It's already Wednesday and I haven't began my study week yet!  Eek!

Glucocorticoids

Well I'm studying the glucocorticoid axis right now and it's starting to sink in. I think I've gotten used to being able to read something only once or twice and understanding it, but with the last two case studies it's taken a lot more work. Well, at least it has seemed to.

I read a few of first paragraphs on cell biology and molecular biology of my Kumar and Clark's Clinical Medicine text before starting back in the adrenals this morning. I'm not sure how much will sink in.

I have my Cushings lecture on my iPod all ready for my long drive this afternoon. I hope it doesn't send me to sleep at the wheel.

Now I'm going to go try and watch some adrenal/molecular bio videos online to spice things up a bit.

Tonight I have a social event to attend which will be a nice change, shut to be honest I'm kind of back in the study groove now. Typical.

Dawwww

A cute photo of my neighbour's kitten who is very adventurous.

Survival stroke

Survival stroke was a swimming style we got taught in school as kids - ie how to not drown.  That is what I feel like I'm doing this week in med school.

We were busy at work, and because I feel like I totally stuffed up last week and I have a few extra pressures coming up this week, I sit down, look at what I have to do, have a mini-meltdown, and the completely freeze-up.....

Ah, that reminds me of a story.....

I have been mentally collecting stories of the best (ie worst) excuses for calling an ambulance and getting despatched to.  Out in my rural area, these types of incidents are few and far between.  The best one I have personally got despatched to was a cut finger while cooking.  A few nights ago I topped my previous personal best of "hungry" and "scared of thunder" when I heard a city crew got despatched to a "brain freeze" - yep, the kind you get after drinking a slurpee too quickly.  Seriously.  How does that even make its way past the call-taker to the despatcher.  I'd love to know what the paramedics had to say to the caller.

But I digress....

I'm in brain-freeze myself, but the other kind.  The kind that makes you go completely mentally blank.  If I was trying to write a novel it might be called writers block perhaps?  Or is it pure procrastination?  Overwhelment (yet again)?

I'm in damage control. Again.

In good news, my fitness regime has been going surprisingly well!  I hope I can keep it up.  I've decided to workout every day on my days off, and to not worry on my days I'm working.  That's still 7 days a fortnight which is pretty good and includes cardio and muscle workouts - TAM of course.  I caught a quick glimpse of some surprising muscle definition this morning and I am again a converted follower of Ms Anderson.

My diet has been going well.  My sugar cravings have diminished quite a lot which is good.  My brain is getting used to functioning on slow-release carbs and fruit instead of lollies and Coke.  This has to be a good thing.  I'm still into my tofu and veges.  I craved a cheeseburger last night, got one, ate about two bites and  seriously couldn't stomach it.  My dog was happy about that.  I'm not sure what has happened to me - this doesn't usually happen.  I can still usually have my cheat food day, but this week I struggled to eat a Cheery Ripe.  I had to eat half, take a break, and eat the other half later on.  Well, I think I know what's happened - I started drinking this meal replacement called Rapid Loss.  I got sucked into the infomercials and I'm kind of glad I did.  It's working well for me.

So this morning I had a meeting online with my academic advisor and we started going through molecular biology and the basics of pathology, you know, just to add more study on top of my endocrine case studies, the intergrated learning series, etc.  Ugh.  So I looked at the MIT free online courses (Open Courseware) and I've ordered the molecular biol text to do their course.  WTF?  When will  Ido this?  Ugh. 

Overwhelment.

Damage control.

Survival stroke.

Proctor troubles

Im having trouble with my remote proctor once again. And the proctor troubles not only stops me from doing my quiz, it slows down my whole Mac. And.... I couldn't connect at all until I unplugged the darn thing. Ugh. Technology, eh?

So I'll do my quiz tomorrow some time.

I finally have a night off tonight. I studied for a while this afternoon, then I watched a movie - Something Borrowed - a total chick-flick. I needed a real night off from everything. Feeling better.

I feel like I haven't absorbed much from last week, which was on the pituitary gland. I guess it's lucky the diseases are fairly rare, but I think the endocrine system is highly testable on the USMLE. I will have to look at it in revision week.

So this week is adrenal, which I'm finding difficult as well. It's just all so new to me and there is a fair bit of biochemistry in it. The case study was dense and I had to just basically skim it and delve straight into the readings to make any sense of it all. So, that is what I'll be spending tomorrow doing for sure. More adrenal.

I ordered a Doctors in Training lecture on Endocrine from their new Internal Medicince course, but the streaming stuffed up. I think my Internet connection is a little slow ATM and I don't know why. I hope to get to watch it tomorrow some time and maybe the adrenal one too, and the associated pharm lectures. I'm missing the appropriate Kaplan lectures for these two weeks, so DIT it is.... I'm so glad I can purchase some of the lectures individually.

That's about it. Worked a lot at night this week which is good for money but bad for study time.

Such is life.

Big yard

Lots of mowing.


One of my main goals is to get one of those beautiful lawns you can walk on bare foot and not experience pain.  From where I've had it, to where it is now is quite a dramatic improvement, but I still have a fair way to go.

I finally have a mower with a motor in it, but I still like my push-mower and it gives me a good workout.  I like to get out in the garden for about 30mins to an hour after work each day, get some vitamin D and a large dose of allergy-inducing pollen to go with it at this time of year.

We worked past 4am this morning (actually it was quite funny because I attended the same patient at 11am and then 14-hours later at 1am and she was confused as to what sort of shift I was on - I just love explaining that I work 24 hours for 5 days straight.  It gets a great reaction). I got up at 12noon, had a relaxed break, vacuumed a little, and went back into work at 2.30pm.  There I started studying the physiology of the adrenal hormones while simultaneously sorting out my solar power feed-in contract and cancelling my pay TV (seeing as I'm trying to be green and frugal into my future life).  I also got to order a cheap international edition of Guyton and Hall physiology so I finally have pretty much every textbook I need.

At 4.30pm we got paged and I just got back now.

I got home and my neighbour brought me over a plate of dinner - how lovely a surprise!  Very nice indeed.

Now I just want to read more of this physiol chapter before going to bed/getting paged again.

Stress level is about a Code Orange.  Only because I think I can make up ground in revision week as I have a few days off and no other commitments, and apart from last week, I've been keeping up ok.

I read on Gwenyth's GOOP an article by her holistic osteopath about spine pain and it's life "meaning".  Neck pain can be either physical (osteoporosis) or emotional (life overload).  I have neck pain now.  I always attributed it to studying too much, but some times I can study for days on send and get no pain, and other times just an hour will make the pain incredible.  Food for thought, me thinks.  I don;t know how I got onto Goop - it never tends to hold my attention much, but I think a blog directed me back there again.  I don;t mind Gwenny, and she discovered Tracey Anderson which I thank her for greatly, but the Goop articles I normally find a bit dull.

Ok, back to the books.

Sugar

Trying to keep up my schedule, utilise maximal brain power, and keep my good humour are all very difficult to do on a calorie-restricted diet.  But seeing as my weight ballooned to an all new high last week, and new research is strongly suggesting what most intuitively know that it is much  better to never gain the weight in the first place, I decided I needed to take action asap.

I'm happy to report I'm back down under the previous personal record of top weight to my "comfortable" weight, but I'm going to try and get down a bit more towards my "happy" weight.

Studying is much easier for me under the fuel of lollies, but as I've said time and time before, my medical studies are not going to come at the cost of everything else which is important in my life.

Speaking of studies - we've been really busy at work.  This is good in one respect because the call-outs over night are earning me enough money so as I don't need to do any over time atm, which is doubley as good because I have stuff to do on my days off  including study and more study.

Today I was sleeping util noon (we were working until past 2am) and I started studying the adrenal glands in Robbins for an hour before having to work again.  It's now nearly 5pm.

So, again, I must go back to it.  I'm hoping to get an hour and a half done before going on-call and then I'm hoping to do a TAM workout as I just got my latest Metamorphosis dvds in the mail this morning.

Code Red

I'm at Code Red, or at least reddish-orange.  I'm having internet issues, time management issues, and life-getting-in-the-way-of-study issues.

It's Monday and I just want to start my next case all fresh and leave Pituitary behind.  I'll have to catch up on that in revision week.  I just don't have time to back pedal now.  Pituitary is a blackhole of my term in which I cannot afford to get sucked into right now!

This week is Adrenal, which is quite fitting as my adrenals are continuously working overtime.  I guess it's not too much of a surprise as I am a paramedic.  I'm also doing Adrenal Tumours as my presentation so I hope to cross-study for both.

Gotta go look at my new case...... No time to waste when you're at Code Reddish-Orange.....

Waiting

Well I stayed up late last night trying to figure out this foreign computer I'm using for today's lecture (i did bring my old laptop but then I had trouble with the wifi password, which I now have, but I already set this computer up....agh) and my new headset - which I realise I just spent $45 on the wrong kind (it has a usb and i need the audio/mic jacks), annnddddd the lecture starts an hour later this week.  Noone told me that.

The only other student I can see logged into the uni site is from NZ, and all the other students are Yanks including the lecturer - so I'm right now presuming that the US had a timezone change over the week.  Would have been nice to know.

I've had an absolutely lovely weekend away - it is so beautiful here and very refreshing for the soul and adrenal glands.  Unfortunately my study has suffered and next weekend will be the same deal.

Those podcasts I downloaded from iTunes didn't sync onto my iPod. I was so annoyed when I got in my car and found out.  However I found some old OUM lectures from before they took them off  iTunes so i listened to last year's version of my lecture today - I hope it helps me prepare as I am so under-prepared.

Must go now and make use of this extra hour before class.

Podcasts

So, where are we at? I got to review for my quiz quite comprehensively yesterday but I almost went into a cardiac arrhythmia when I realised how I stupidly messed up two questions.  Geez.  Insert palm of hand to forehead move here. Oh well. I won't miss them on the final exam.  At least I still got 80%.

These quizzes account for 30% of the total unit mark, and a quick predictive calculation of what I'm expecting for the other 70% puts me on target for another ~85% module.  That is ok, but I was hoping to get up closer to that 90%+ mark.  Frustrating.

I have a few days off and I'm going visiting - I have a 3-4 hours drive ahead of me today so I'm quickly downloading some medical podcasts onto my iPod. OUM used to have podcasts of their lectures but I can't seem to locate them - there is something right down deep in the back of my memory that makes me think they sent an email saying they were ceasing that. Hmmm...

Normally, I have no need for podcasts on my iPod as my place of work is, oh, about 500m from my house.  I don't travel much.  And I wouldn't subject my co-workers to an audio book about the USMLE in the ambulance.  I have so far gone through TWO of those thingies that put your iPod through your car's radio - but the sound quality is terrible.  I could get an iPod jack for my car, but that's an expense I'm trying to avoid seeing as I really could do with a couple of new tyres sometime soon.

Ah that's about it.  Stress at about a Code Orange today as I'm going away for the weekend and I doubt I'll get any study done before my Sunday morning lecture.

PS  I also have to take my old laptop with me as my friggin iPad doesn't do Java and therefore doesn't do my lecture. Sheesh.  Maybe I should have got myself another laptop instead of my desktop.  But I do love my desktop.

Ah, back to a quick clean of the house before I head off.

Unpredictable

Just about as soon as I finished my post yesterday we got paged and were out of the branch working until about 5pm, ie I got nothing done on my study or anything else.

I went to beD at 7pm. Another early night. A mega-storm which we had been warned about all day on the radio started at about that time and I couldn't tell you what the intensity was because I slept like I was dead all night. I woke at 6am feeling almost normal and here we are today back at work for my last shift of the week.

Today I've just been reviewing last week's material for my quiz today. I used to find it annoying to have to go back to the previous week in the middle of a new week, but now I'm starting to think it's good because it really does help solidify that long-term memory. I also, as you may recall, didn't have much time to study last week so I'm catching up on those readings now. I'll go back to this weeks pituitary adenoma later today. Juggle, juggle, juggle.

That's about all. Although I disappointingly haven't been able to exercise as much as I wanted to this week, I have got my diet going really well - lots and lots of healthy food. I've now begun the process of reducing portion sizes and eating more frequently. I've caught up on sleep so I'm hoping to introduce exercise back tonight when I'm off work! Hoorah!

Links and yikes

Yesterday I got to almost finish my case study - that wont take long this morning to complete.  I also got to read a little in the Anatomy and Physiology book which we have here at work in our mini-library which the staff have just formed over time with book donations. They are all very old and probably a little out-dated, but never-the-less.  The readings this case aren't too massive so I'm staying optimistic that i might get them done this week.

I also did another section for my PT course and have seen I really need to do more on that to get it done in the allocated 12 months, seeing as I'm half-way through! Yikes!

I've added a few links to interesting articles.  I will try and do this regularly.  The first one is about a fellow OUM student. 

Student on a mission
Intern squeeze could hurt reputation
Rural doctors say scholarships are key

Off to go read/learn.

The current international med students and IMGs in Australia issue

I've been watching the whole med student tsunami, lack of internship places for full-fee and international med students (students from overseas that study med in Australian universities) and IMG situation in Australia since before I started at OUM, and more intensely now as the debate grows.

Here are a few links to some interesting articles today;

Medical students to take expertise offshore

Lack of internships may send Australian trained doctors elsewhere

These articles are focused on international students, but the incentive for universities to not lose those precious dollars from the international students will help open internship positions, and hopefully PGY-2+, making more room for....ME!!!

Time, wellness, and balance

Today is the first day of my new fitness routine. Right now I weigh more than ever before in my life. I have no multiple pregnancies or chronic hormonal imbalances to blame, well unless you count my chronic stress.

I think it went off the rails about in Tibet. Going on a big adventure like that was probably not such a good idea given the amount of stress I endure at home with work and study. Bali is looking good for next time (although I have been pricing up Mongolia).

I went to bed at 7.30pm last night. I was just exhausted from my normal life of work, call-outs, and med. I constantly crave junk food and sleep, but unless the Earth's gravity has increased by 10% in the past month I need to put the brakes on these bad habits ASAP.

I was talking to my dear friend about how we as girls can take care of our looks (figures/hair/makeup etc) without being superficial. In the same way I used to think only greedy people had money, I'm finding it difficult to psychologically make sense of how I can take care of my looks without being shallow. It's difficult, because to find the time to exercise and eat right requires prioritisation. Only shallow people would put how they look above study, right? I think this where a lot of women get caught when they have families - by always putting their families first. But I can tell you as a single female, I have the same guilt trips just in different forms.

Today we were so flat-out at work I did less than an hour's study. I finally got home at night and I did my TAM workout. I'm so glad I did. I watched a little Kaplan before deciding to eat dinner and post this before going to bed early again. I am also glad I found a way today to make tofu tasty (slice thinly, marinate the hell out of it, and stir-fry/grill until a little charcoal) and I have started the process of sugar detox.

Day One down and I feel fine.....

Now for an early night's bed. Let's hope tomorrow I can fit in more study too.


- Posted using BlogPress from my iPad

Money (and other things I like)

I'm getting quite used to the idea of going to Samoa for a year to do my internship, although I will definitely do the USMLE.  One thing, though, well two things that are kind of the same thing - finances.  The money I need to finish my clinical rotation, and the financial set-up I need at home to go and earn <not enough to pay my mortgage back home>. 

So anyway, it always feels awkward talking about money but it's a really important subject.  I think the whole GFC drew a spotlight onto our spending habits.  It's now becoming cool to be frugal.  I'm not cool.

For me saving money has always fallen in the same heap as dieting - good intentions, great plans, but doesn't last very long and only serves to make me feel (more) like a failure. 

I'm setting myself some goals - and I think they are more "real" if I put them here on my blog so here goes;

• Pay off my mortgage and any other remaining debts by the time I'm 40

Ok, so it was really only one goal.

I'd also like a sustainable house.  I'm kinda in the process of making it happen right now.  My current house is in my township and I want to go more rural onto acreage.  That's where I want to live sustainable and off-the-grid.  I can't buy the land yet until I get my first doctor job in Australia.  But I can plan/save/research for ideas.

• geothermal heating/cooling

My dearest friend Dr Donald Payne PhD is a director Direct Energy where they are really leading the way with this technology in Australia.  In a basic nutshell, you drill into the ground where the temperature remains relatively constant all year round, then the air you use to heat/cool your home is cycled through the underground pipes where they adjust to the underground temperature (for example 22oC in Summer) and then you use this air which you only have to cool by 2oC to cool your home for thus using much less energy.

• wind turbines

Harnessing wind for residential power is one of the best ways to generate energy in areas that don't have great sun all year round but are not in built-up areas; like where I live/want to live.  This things go nuts on what might seem like a still day down at ground level, but up there (20m) it's windy!

• solar power and hot water heating

I think this category almost speaks for itself.  I like the almost "passive" use of coiled black pipes on your roof to get some initial warmth, and then using a solar hot water system.  I have solar power on my current home but I do not store the excess power in batteries at the moment because I cannot afford them. 

Some others are;

• self-composting toilet
• vegetable garden
• rainwater tanks
• bore water
• grey-water/black-water systems
• other energy saving devices (I have some already) including the remote switches to turn off standby mode on appliances
• top-opening fridge

Well, that is all I have off the top of my head for now.

Times

Yep I'm struggling to be able to keep up with daily posts.  Things are a little hectic with work and study.

I feel strangly calm this week.  I feel like I haven't done much study but I think I've covered all the important stuff so I'm sure I'll get a nice shock in the lecture tomorrow when I realise I actually know nothing at all.  I don't know what I don't know yet.

We (Australian OUM students) just got sent an email today explaining how the Australian Medical Council and Australian Medical Board (I still haven't figured out the difference) have stated that IMGs must do their intern year in the coutry of their medical school, ie it looks like I'll have to do my intership in Samoa.  This is not a bad thing - I like Samoa and I want to do international health.  I also may be able to do it in the US or NZ and then transfer across.  Interesting times. 

The email also outlined some good things - the AMC exam part 1 can be done online.  This is great if I'm going to be in Samoa/US/NZ.  And I can be employed on just Part 1, and then do Part 2 to get full registration.  If it's online it might be more flexible with the dates etc.

The Samoan government has agreed to allow Australian OUM students to do their internship in Samoa.  This is a very good thing as I was a little concerned there might not be enough intership positions in the small island nation of Samoa when they have 25 of their own locals graduating as well.  Let's hope this is still the case when my time comes.

So that is all.  For me nothing much has changed - I'm still preparing myself for the USMLEs, to move to Samoa for a period of time, and to have a hard time trying to break back into Australia.

OMG Code Yellow

Today i had my meeting with my mentor which took me until lunch time.  Then it was a quick bit of "OMG-how-on-Earth-did-my-house-get-so-messy" emergency clean.

Now, I'm at Code Yellow panic because I have my quiz tonight/tomorrow and I haven't read about the female reproductive hormones.  So I'm doing that now (from last week) before I can go back to parathyroid hormone and calcium/phosphate regulation.

I didn't watch any Kaplan last night - I watched Star Trek Enterprise instead.  Anyway no time to dwell, I've got a chapter from last week to read.

Today

I didn't get to blog all weekend due to work trying to kill me, once again.  We got called-out during the night Friday and Saturday night which meant I was asleep most of Saturday - but I managed to do some study, and then on Sunday I got home at 6.30am so I slept for one hour before my online lecture at 8am-11am.  My brain wasn't working quite as well as it should have been and I answered a few questions incorrectly which in fact I knew the correct answer to.  No harm done though as we were being graded only on participation and not on correct answers.  Well, actually, I think for correct answers you can gain marks on your participation but you don't lose any marks for incorrect answers (but you lose heaps for not attending at all).

So after 11am I decided to just stay up (I got to go to the Farmer's market which was nice) as I only had to go back to work for two hours so I figured I'd try and get my body-clock back on-track by waiting until 9.30pm (after dinner) to sleep.  I slept-in Monday and required a mental day-off, so I didn't study at all.  I had a lovely day and did a little bit of gardening to plant my new lavender, roses, and daisies from the market, although I felt like a total zombie for most of the day.  I went out for dinner too, but my Japanese Slipper virtually knocked me out.  I only got 8 hours sleep last night and I so I still feel a bit tired but I didn't want to waste to much of today as I wanted to get some decent study done.

To make up for yesterday I have achieved quite a lot today.  I got through my case study number 3 in only three hours.  That's a new record for me.  I was feeling really proud - until I wrote down all the readings I need to do - holey-moley, there are 27, plus 3 for Sunday's lecture, plus 3 for the quiz (whew- just found out the lecture 3 and quiz 3 are the same this week and it looks like there will be a lot more cross-over from the case readings this week too). Well, at least 27.  Some are really quick (histology) and some take forever (physiology and pharmacology).

So, to recap, the first 3 hours this morning I read the case, now I have three hours before dinner and I have so far figured out what I am supposed to do this week and answered as best I can the case tasks before my mentor meeting tomorrow and I will now commence the readings and see how far I get.  Tonight I am planning on watching about 2-3 hours of Kaplan videos which I am really getting in to.

Still highly motivated this term.  Feeling pretty good most of the time except when I think of all the work I'm doing just to gain such a basic understanding of medicine.

Quote of the day

 Reading about parathyroid glands "....fat individuals will have fat glands, and vice-versa."

No time

I think it's fair to say if you're working full-time and studying med, you have no free time.

I got called out for work until 3am this morning.  I got up early at 11am to do a bit of urgent house work (dishes) before returning to work at 1pm.  After an hour for shift change-over, lunch, doing some work-related admin, management dropping in etc I got so little actual study I'm starting to feel stressed. In 4 hours I read four pages from my textbook.  Where on Earth did the time go?

It's now Friday night. I just got home from work and I've done the rest of my urgent house work which included vacuuming.  I'm on-call again tonight so who knows what the night will bring.

So I have to end this post cause I need to get a few more pages done now before watching some Kaplan videos tonight.

One of the worst things is, I've just realised the readings I was supposed to do last week, and the references I have been given for both weeks are for a different edition textbook, that I figured I'd better read the whole endocrine chapter of Robbins Pathologic Basic of Disease but I'm making the mistake of back-pedalling.    Feeling overwhelmed.  I've gone against my won rule.

And I so need to wash my hair tonight.

First endo quiz down

I did my first "weekly quiz" for endocrine just before - I think I fluked it.

I had obviously spend too much time focusing on the case study and things surrounding hypothyroidism that I didn't cover-off on some of the additional readings of other endocrine hormones.  I figured we'd cover them as we went along in the module.  Not so.  Not so at all!

Well I got some very good advice from a fellow classmate and which readings to focus on for the exam.  Ok.  I think I might know what I'm doing now.  I swear half of the difficulty of studying med is trying to figure out what you're supposed to do and when.

So, in a nutshell, it seems the case studies are all well-and-good but I need to make sure I'm doing the additional readings.  For example, there was a questions about the hormones of the anterior pituitary gland. Well, silly me thought we'd cover that in more detail later in the module as there is a case on pituitary disease.  Yah I'll have to remedy this and thankfully I've got away with an ok grade this time.

As I've had four days off work this week I was feeling pretty good about my progress, but that quiz has shaken me up a little.

No time to dwell.

Back to the books!

Masters grades are in

I got my grades for that Masters subject I did and they are good.  I'm so relieved.  I wasn't sure how I'd go because I wasn't happy with my work, but then again I'm never happy with my essays.  Whew - one less stress.

I also looked through my transcript and that subject I "failed", well I think I should have been given a "withdrawal - late" grade instead so I've emailed about that.  They gave me "fail - insufficient" instead.  Cause that grade is a real bummer.

I have one more "easy" subject of Masters, Ethics, so I'm now considering doing it - hahahaha.  Now that I'm on the other side of the pain of juggling Masters and med school and basking in the glow of achievement.  After that easy subject comes two research subjects and two research projects.  Yuk.

Well back to studying med.  I have this new routine where I reward myself for completing a reading by doing housework!  I think I need a doctor.....

My dog

I love my darling dog, and he loves going for car rides. We don't go far without his proper safety-harness seatbelt thingy, but to tell the truth, he really only likes short trips around the town centre where we can drive slow and smell all the wonderful smells.

I got told once that talking your dog for a walk is like them getting to read the newspaper.  I guess my dog just got a quick scan of the headlines today.

It seems to make people happy to see a giant dog in a small car as well.  His head sits up higher than mine. Sometimes when I come out of the supermarket I see him sitting in the drivers seat behind the wheel, which looks really hilarious. It's well-worth the hairs he leaves all over my car seats.

Another one of the most amusing yet simple things in life, I think, is how much dogs love car rides and how much cats hate them!

Remote proctor

I got lazy and distracted yesterday arvo.  I just couldn't do it.  I needed to chill and rest my brain.  At least I got in a few hours in my mentor session and about an hour at home on the new case study, but that was it.

This morning I'm happy to report I've got my mojo back and I'm nearly done with the case before lunchtime, which is great.

I've also installed my Remote Proctor, which is a weird camera thing and finger print scanner as now our end of term exams are done from home, rather than in the testing centre in the city.  This is great for a lot of people who have to travel great distances to testing centres.  I kind of liked having the day off and going into the city.  I think I was less likely to be distracted by my pets, phones, whatever.  I suppose I can turn my phones off but try telling my dog and cat to amuse themselves for 2 hours when I'm just sitting here in my study ignoring them!  Believe me I've tried reasoning with them: "I'm doing it for us so we can have more plants to sniff, more toys to chew, and the expensive pet food". LOL

Back to finish this case study now....

MD vs MBBS

I just read an interesting article in the Medical Observer, and it's the not the first on this issue.

University of Melbourne began their graduate entry MD course this year, and the full-fee places cost over $219,852!  The debate is whether this MD has been designed purely to circumvent the Federal restriction on Bachelor degree fees.  Melbourne argues it is to reflect the postgraduate-level of the degree in-line with US med schools, versus undergraduate entry MBBS which has been the traditional stream for Commonwealth countries until recently.  Masters degrees apparently don't have these restrictions.  The MD is seemingly being marketed as a Masters.

You can read the full article via the link below.

What do I think?  MBBS and MD as medical degrees have always been considered equivalent (not to be confused with the Commonwealth "Doctorate" much like a PhD).  Whether you do a 5-6 year undergrad MBBS or a 4 year grad-entry MBBS, you still end up graduating at the same level.  As will the new Melbourne MDs, and US MDs, and even me as an MD from OUM.  We all start out as interns, PGY-1.

I personally recently decided to change to the MD stream at OUM because now MD students sit a separate assessment in basic sciences which is supposed to make sure they (we) are prepared for the USMLEs.  I wanted to make sure I was also prepared for the USMLEs as I intend on sitting them.  My friend doing the MBBS stream, for example, is not intending on sitting the USMLEs.  Why?  Because they cost over $2000 to sit, and the similar exam OUM provides is for free, and she is intending of working in Australia (or Samoa or NZ).  She will sit the USMLEs if and when she decides to apply for residency in the US.

Also, if the University of Melbourne thinks "MD" is more appropriate and better than "MBBS", then they must be right? Right?

What does all this mean?

I don't have a clue, but I do have a sneaky suspicion Melbourne's trail-blazing may indeed create a sort of two-tiered graduate system (as was mentioned in the article).  I hope not because I don't like tiers.  There are tiers in ambulance and I don't think they provide better outcomes for the patient at all, but that is a whole other post.  If the MD course wants to be a Masters, then be a Masters, or a dual MBBS/Masters.  If it wants to have a semester of research, that's great, but that's what OUM is wanting to do too based on recommendations from PAASCU.  And I'm sure there's other med courses which also have a strong research focus.  (But how dare I compare the University of Melbourne to OUM, right?)  Will "MD" be a more desirable set of letter to have after your name than MBBS in a few years...?

What does this all really mean to me?  I'm not really sure and I don't think I really care.  I just want to learn how to be a good doc, to graduate, and to find myself a job.

I just thought it was interesting, that's all.

Enjoy.


Fear MDs will lure students into specialties

University of Melbourne MD degree

Mentoring

As part of my course, I have to see a mentor for two hours every week during my pre-clinical modules.  Today was my first mentor meeting for this term.

I am so lucky to have the mentor that I do. She is a top emergency consultant and works at the local major regional hospital.  So, basically, she is doing the job that I want one day. (Emergency medicine is still my first preference, with paediatrics and general practice as my other top preferences). She is very optimistic about my prospects of finding a job once I graduate, despite me being an IMG (International Medical Graduate) and the surging medical student tsunami in Australia.  Geez I hope she is right.

So today we had a double session and we went through the first two cases - hypo- and hyper- thyroidism.   It went well.  It even went better over a pot of jasmine green tea and eggs florentine.

That was my morning.  Now I'm home and my afternoon will be going through the second case study.  I believe I can finish it today as I don't have work to interrupt me.  I like to get the case study read and out of the way before moving on, although after each Learning Issue there is the associated readings, but I prefer to do those all at the end.  I liked my method last week of reading the case study (and looking up any unfamiliar terms along the way), watching the associated Kaplan videos, and then doing the readings.  The readings were easier to digest with a quick overview first from the case and the videos.

Yesterday, FYI, I had my first online lecture for the term.  It went for three hours and covered the first case study.  I was so glad I had done the pre-readings as you need to have done them before class to be able to answer the questions the lecturer asks.  There are about 10 students in my class so we all get asked questions in turn. I felt pretty confident about most things, but once again I feel inferior to the nurse practitioners and osteopaths - they are already seeing primary presentation of hypothyroidism, for example, and ordering and interpreting tests.

My mentor told me every time I have a patient from now on, after I've finished all my paperwork and other duties for work, I should sit down and go through all the possible differential diagnoses for that patient, write them all down, and then write down how I would work that patient up as a doctor and what tests I should order.  I will definitely do that from now on.

To be honest, I didn't realise until this week that thyroid problems could cause arrhythmias.  I will look at that more closely now, although my mentor did say it's not exactly the most common cause (of bradycardia and AF).

Ok off to get cracking on this hyperthyroidism case study.  My dog is already crying at my because I'm at the computer and ignoring him.

PS  My iMac is going really well.  I think it is one purchase I can definitely say has made my life better.  Loving the iPad too.

Today's routine

Today I was so tired.  By the end of my working week the sleep debt has accumulated so much I feel like I've done an all-nighter... I tried to fix it by going to bed at 6.30pm last night as soon as I got home from work - but I could only sleep for an hour before my body said "Hey, I'm normally woken by a loud beeping noise at this time so I'm just going to go ahead a wake-up now anyway".

I got up and watched Paramedics: Recruits from the night before which was 20 minutes with fast-forwarding the ads.  I was happy to see this week they showed a patient that vomitted all over himself and the ambulance as that is what the job is really like.  I have become good at pre-empting emesis with my four years on-road experience (plus 3 years ambulance training and 7 years army medic experience).  I was watching the tv thinking "He's gonna spew!  Get an em-bag!", but, no, they were insistently trying to put a Hudson's (oxygen) mask on him.  They nearly wore it too.

All I wanted to do was watch tv last night. Instead I got to finish the physiology Kaplan videos for all of endocrine, which is excellent.

Today at work I watched the whole pathology section for endocrine as well.  I have now completed the videos for endocrine in the first week of the term (except for pharm because its thyroid section is so small - I will watch it at the end of the term for revision of the other endocrine drugs)!  Excellent!  The videos took me about 1.5 hours today.

Retention of videos - probably about 75%, which isn't bad considering they are designed for revision.  For me, I found them handy as an introduction to the topic.  I think watching them again as revision would be better.  The biochemistry I watched the other day is probably my weakest area (as usual) but I think I could do well there if I spent more time on it.  I think being in the MD program now this is something I'll certainly have to look at.

We went out on jobs for most of the day, and I managed to scrape in the endocrine section of FA over about 20 minutes.  I took my Guyton and Hall in the ambulance with me, but my partner finished his paperwork too quick and was done before I had refurbished the ambulance.

At work I'm always looking up anything I don't know, especially patients medications, and revising things like diagnosing left and right bundle-branch blocks, and when I return to the ED cubicle with my finished paperwork, often the doctor has ordered his initial tests and management and I can check what they are.  At triage I'm on my phone Googling everything while I wait that 5 minutes.

Tonight I have to prepare for tomorrow's lecture.  I have to make sure I've done those compulsory readings, which is a massive task.  It will take me all night, and that's if I don't get any call-outs.  It's also my baby-sitter's 18th tonight so I promised I'd drop in if I could.

That is where I'm up to.

In other news, my dog hates thunder and I felt so sorry for him today as we were stuck at the hospital and it was a big storm. He got into the rubbish bin yesterday, but it was my fault as I left chicken bones in there andI guess the smell was just too irresistible. He once did that when I first got him last year but he got the bin lid stuck on his head.  Enough time has passed now and he has regained his courage towards the bin.  I must remember to put such smelly-delights straight out into the big bin in the garage where he can't get to it.

Study pattern

For those who are interested in the day-to-day study pattern of an OUM med student, I will try to continue to give a daily description this term of what I'm doing.

So, yesterday....was almost too long ago to remember.  We were quite busy at work and I was feeling really tired.  I think I probably managed about 4 hours study (it's a 12-hour shift, but we had a break for the first 2 hours, so 10-hours at work yesterday on-duty) and I first revised the second half of my case study notes (from the day before) which took about half and hour.

Then I started back on one of the readings - Kumar and Clark's Clinical Medicine.  I had done a few pages on Intro to Endocrine so I revised them, then finished the intro section and went to the section on Thyroid Axis, which is about 3 pages, and then I started on Hypothyroidism.

I managed to borrow the Guyton and Hall Physiology text from the hospital while I was up there with a patient.

That is all I got to do in four hours (!) because it was so interrupted.  Maybe it was more like three hours.

When I got home I watched the last 15 minutes of Send in the Dogs which is about the Police Dog Squad in Australia.  I had started watching it the other night (for about 15 minutes) when I decided to record it and study.  I then recorded Paramedic: Recruits so I wonder if I'll get a chance to watch that any time this week.

I also had dinner.  About an hour had lapsed since I got home and I started watching the Kaplan videos again.  I think this will be my new nightly routine.  I revised the notes from the night before, and got about 30  minutes into the video when my pages went off at about 8.30pm.  I was out until 2am working.

Due to being out so late, and working basically from 9am to 2am, we got a break until 12pm today.  So now my day is cut short.

Today I started studying back at work with the Guyton and Hall Physiology assigned reading.  So, I thought it said to read pages 74-76, but it is in fact chapter 74-76!  It's about 40 pages!  Also I need to accomplish about another 15-20 pages of Kumar and Clark and a few pages of anatomy (but I'm not going to stress too much about anat).  These are the three that are listed as this week's syllabus, but in the case study there's manyt other readings, such as embryology, histology, and pharmacology, which makes me think the syllabus are the most important.  But obviously I'd like to achieve all of the required readings.  There's even more recommended readings and links to websites, but I can't see it happeneding.  Maybe if I have spare time after Sunday's lecture I'll scan the weblinks.

Normally, I highlight my textbooks and try to mentally retain the knowledge as I go.  Obviously, I can't highlight the library book, so I started to make notes instead.  I'm not sure which will be more effective for me.  I'm starting to think note-taking, which goes against my normal way.

Probably a combination of reading, highlighting, note-taking, and watching the Kaplan videos is ideal.

Ok, there goes my 15 minute blog break.  Back to it!

Study-buddie

I got my confirmation email today that I am indeed in the endocrine class this term.  Yay.  And even better, my friend from first term in Samoa is in this class with me too.  Double yay!  It will be great to have a study partner this term.  We have decided to have weekly Skype sessions before our lectures to compare notes and what we believe are the key points for the week.

I am making good progress through my first week's case study, although it's now the end of Wednesday and it took me two days to read the case study.  I now have three days to read all the assigned readings from the core textbooks which is far-and-away much more than 50% more reading, if you get my drift. 

I started my morning by doing housework before work, then revising yesterday's stuff before moving on, which was extremely effective for retention (I believe).  I also Googled and Wikipediaed any words or terms I didn't know or fully understand as I came across them before moving on, which I think worked well.  I underline the word and then label it with its definition.

I make notes in the margins of the case study and go back and edit and adjust anything as necessary.  Being critical of the case notes and my own notes works well for me.

If things are listed within a paragraph, I relist them in a bullet-point list as my mind digests this form of list easier.  Anatomical things I generally draw pictures, and especially for microscopic anatomy such as, for example in this case, the structure of a thyroid follicle.

Thyroid follicle

I also draw chemical, molecular structures.  I have now chem background except my own self-study for the GAMSAT, but I still can visually appreciate the difference in structure between thyroxine (T4) and triiodothyronine (T3) (see below):

This helps my brain remember information about T4 and T3 as I picture them in my mind when describing their actions and interactions with iodine and thyroxine binding globulin (for example).

I also did the end of case quiz (which is different to the new graded weekly quizzes) and was satisfied with my progress and retention thus far.  I think they were perhaps a little easy, and I think I need to look at some USMLE-style questions from somewhere at some stage.  I normally don't get my USMLEWorld Qbank 30-day subscription until the last 4 weeks of term, but this term I might start early, even though you can't choose just "hypothyroidism" questions for example.  Hmm... I'll decide when I get paid next week if I can spare the $100.

I could probably do with two or three new textbooks too.  The library at the hospital was shut today when we took our first patient there, so I'll try again during the week.  I need this week just Guyton and Hall's Textbook of Medical Physiology.  I have the others already which is great.

So that is all.  Yes, I'm super-dooper motivated this term for some reason.

I hope it lasts.

Endocrine

I'm back at med school finally and it looks like I'm doing the endocrine system this term (I haven't had a confirmation email yet but it's the only one I can access and in my profile it is listed as one of my courses).

Endocrine is not exactly an area of expertise for paramedics (compared to my previous modules of cardiovascular, respiratory, and musculoskeletal) except for perhaps diabetes.  So this should be interesting.  At least I know where the thyroid gland is.....

So this week's case is hypothyroidism.

It also looks like I have my lectures at a humane time, albeit on a Sunday at 8am, and the three one-hour lectures are back-to-back which is really great.  I mean, it's difficult trying to sit still for three hours, but it's easier when trying to plan the other parts of my life around the lecture times and I'm less likely to forget them.  Morning is also the best time because at work most of our jobs seems to come in in the afternoon and evening.  Saturday nights can be a killer too, but I am happy with 8am after last term was 5am!

The weekly online quizzes are open for 22-hours on Thursdays, so that works out well for me too.  They are fine because I can find 10 minutes in a 22-hour window on any day of the week (usually).

So, yeh, I'm happy to be back studying again.  I'm a year and a half into the course now and I want to ramp up my performance a bit more.  Well, actually my grades have been good so far, but I want them to be excellent.

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Sunday was my sister's wedding.  I am officially free of MoH duties now.  It all went really well and it was a total credit to my sister who organised such a wonderful event.  She hand-made a number of decorations such a pin-wheels and mini-noodle boxes for the lolly-bar which put such a lovely personal touch to the whole thing.  It was simple and classy yet elegant.  Bravo to her.  My Mum knitted a wedding cake (just for show, not for eating!) that was super-cute and sat on the gift table.

The day before the wedding we picked up the flowers from the florist.  The flowers were my contribution to the wedding, a gift from me, and OMG I can't believe how far a fairly decent amount of money wont go when buying wedding flowers. Yikes!

It was probably the best wedding or event I've ever been to!


And now all it right in the universe once again......

Back into the routine

I'm back into the "study at work" routine.  I watched the first of 14 hour-long lectures on immunology by Albert Einstein School of Medicine on You Tube and started the immunol chapter of First Aid for the USMLE Step 1 (which I often call "FA").  I did so much study today that I rewarded myself with housework when I got home. lol

That is all.

I wish I could motivate myself to revise last term but I cannot.

I want to start preparing for the Step 1 but it's so hard when you're struggling to keep up with the term's curriculum.

No more Masters

Today I finally submitted my final assignment for this term in Masters of International Health. Woo-hoo. I hope I pass because it was pretty average work.

I've decided to take a leave of absence from my Masters and to concentrate on med school. Of course this all makes obvious sense to anyone sitting on the outside.

Well, again it happened today. As soon as I decide to take a break from masters, I see something about the health crisis in poor countries. Today I was checking out Dr Najeeb's video lectures on YouTube, and he had these "other" favorite videos so I watched one and it had the most horrible pictures of really skinny little children in Africa. It was quite alarming and moving. It was all photos I've seen before, and I have experience first-hand with this sort of thing, but it's so easy to forget "those" people way over "there".

I haven't decided to give up my goal which is to work for MSF, but I have decided I really need to put more focus, time, effort, etc into med if I'm going to get the USMLE scores and therefore hopefully residency that I want.

In other news - I'm settling back into work ok. I'm loving my new twin-Apple purchases of the iMac and iPad and they have indeed made my life better (it's not often a purchase can fulfill that promise).

And I start my new term of med school on Monday.

So I'm feeling particularly motivated right ow, which is probably due to the modest break I have had away from med, but I put in one of my Kaplan videos tonight, read a page of my Davidson's, flicked through my Murtagh's, scanned a bit Standford Mini Med School, and now I'm feeling a little lost and without direction. I suppose the best thing to do would be to revise or look at those "additional" modules from OUM once again but I wasn't expecting to have completed my masters assignment by tonight.

I did watch about five minutes of the Kardashians wedding special before I started having delusional thoughts of sticking chopsticks through my eye-balls. I'm just not that integrated back into the western world yet.

The Wheel of Life and how I got into buddhist philosophy

I'm really stuck on this Wheel of Life.  I find it absolutely fascinating and amazing that it almost so perfectly describes the human experience.

I keep thinking about it because I've already learnt so much from it and situations continually arise in which I can self-reflect and use the Wheel to help me kind of self-analyse what is going on.

Wikipedia actually (as usual) has a nice summary (search Wheel of Life and it will take you to "Bhavacakra which is the real name for it).

So someone asked me the other day how I got into buddhism.  I'm not sure.  I think I really started thinking about it in first year uni when we got taught about mind-body connectedness and we were given an example of a mouse entering a room full of people and how all the different people might react differently to the mouse.  The mouse is the same mouse, but our perception creates our reality.  From understanding this concept I was able to understand the Four Noble Truths (which I have blogged about in a previous post). But basically it's about finding happiness by dealing with your own inner perceptions, not the outside world.

Then, I had a question about karma.  I kind of intuitively knew karma was real.  I mean, whenever I've done something good to someone or been nice to them I've always felt better and then seemed to have people be nice to me too.  Then I thought a lot about Newtons Third Law, which to summarise, that all actions have equal and opposite reactions.  Therefore, if I'm putting positive actions and words out into the universe, I therefore must get positive actions and words back to me.  But that's a little difficult to prove outside of physics.  And some people have karma from past lives they have to deal with first.  This is why you might feel you have to work a lot harder to begin with in life.  All I know is the more I show kindness and generosity to people, the more I seem to get it back in return.

Then, I had a big question mark about reincarnation.  Seriously?  I used to be a cat?  Or Joan of Arc?  Then I read somewhere that reincarnation can occur in your current life.  I explain it like this to my girlfriends: "You know how you seem to date the same guy over and over again?"  That's reincarnation. You haven't learnt how to deal with your attachment to assholes, and that the nice guy is the one you should go for.  This is the reincarnation of the lesson in life you need to learn before you can move on.  It's obviously not just limited to dating.  It's also in your career progression, dealing with personalities, dealing with money, etc etc.

And somehow, over time, I've come to accept that life reincarnation is possible.  If I think back I think that started to happen as I started to practice meditation.  And by "practice" I mean "put into practice" rather than "try hard to learn how to do it".  Like enlightenment, meditation happens when you stop trying and start simply being.  But that's another lesson.  When I first started meditating I felt a connectedness to the universe.  When all my thoughts, fears, and worries settled back down into the background, the "mad monkey" (which is what they call the constant and continual chatter in your mind) hushes for a second or two, you honestly can't help but feel connected to the universe.  Like the soul feels strong again, and the soul feels connected without time or space barriers.  This is how I really knew the soul existed.

Incidentally, I've been reading Stephen Hawkins The Universe in a Nutshell recently and he talks about time perhaps having no dimensions.  Being infinite.  Like space.  But, again, I think that is for another conversation or this post will become it's own book.

Then, I asked on this recent trip, "What about the problem that 90% of all the humans that have ever lived are living now"?  Where do all the souls come from?  Well, I got explained by my Bhutanese guide that we might have been a tree or just a seed.  We don't know.  But we were and always have been part of this universe and we will be yet again reborn into samsara (this is the sanskrit word for the cycle of rebirth, which, is not ideal!)

So, samsara.  Samsara is what is depicted in The Wheel of Life in a symbol form.  Which I like, because I believe I am introverted and I therefore find pictures really helpful as my mind thinks in pictures.  I was interested to read that historically they think Buddha himself drew the first Wheel to help explain ordinary people understand his teachings.  I'm ordinary I guess.  And further on in Wikipedia it says it was put on temple walls to help teach "more simple-minded farmers and cowherds"!  Well, I wont be too insulted. I happen to like farmers.

Anyway, where was I ......?  Here's what Wikipedia says:

The meanings of the main parts of the diagram are:

1. The images in the hub of the wheel represents the three poisons of ignorance, attachment and aversion.
2. The second layer represents karma.
3. The third layer represents the six realms of samsara.
4. The fourth layer represents the twelve links of dependent origination.
5. The fierce figure holding the wheel represents impermanence.
6. The moon above the wheel (top left in the image at right) represents liberation from samsara or cyclic existence.
7. The Buddha pointing to the moon (top right in the image at right) indicates that liberation is possible.

So, in my own journey of understanding things, I get the "hub" of ignorance, attachment and aversions.  In fact, I think its a lovely neat summary, rather than all the other twelve deadly sins and the like.  Everything comes from ignorance, attachment, and aversion.  And, in fact, attachment and aversion are due to ignorance and vice-versa.

Karma - ok I think we accept that now.

The six realms of samsara (or segments as I described in my last Wheel of Life post) are interesting.  Very interesting indeed.  Especially the jealous, lucky, and greedy realms.  They call these realms the demon, god, and hungry ghost realms, but I think my translation is a bit more accurate for everyday English.  So it's interesting that the lucky realm is the most "comfortable" life but it's not the way to enlightenment.  The "human" realm is, which I thought previously (as I wrote in my last Wheel post) that is was the enlightened segment, but actually it's the human realm where one can work towards enlightenment.  This is better than the :lucky" realm because people in "lucky" are so preoccupied with their comfortable life and defending themselves from the jealous realm, that they forget to practice the path to enlightenment.  And according to The Buddhist Society, these people are in serious risk of being reborn not as a human, but as a lesser being such as an animal where it will take a very long time to work up enough karma to get back up.

So, yes, the realms are transient, day-to-day, minute-to-minute depending where in your life you currently are.  And the Wheel, held in the mouth of death or "impermanence" is a mirror to remind us humans what it's all about, the bigger picture, and not to get distracted for too long.

I have thinking about this Wheel a lot.  About my jealousy towards the privileged people that got to go to a top school, got into med school straight away, and haven't had to work as hard as I have to get to the same place.  And then I have been thinking today a lot about the current Occupy Wall Street movement as there is an Occupy Melbourne movement gearing up.  Are we in the jealous realm?  We did, afterall, help plant those seeds in which those big Fat Cats now eat the fruit.  And, are we also in the lucky realm in Australia, the top 0.5% of the wealthiest people on the planet?  Have we forgotten?  Are we preoccupied?  Or are we the "hungry ghosts" that just want more and more?  Is one flat-screen tv per household no longer satisfying?

Many questions.  But the main thing is, when I feel jealousy or hatred towards the lucky people, I know where I'm coming from.  I'm coming from jealousy realm.  And that is born out of either ignorance, attachment or aversion.

And finally, the outer circle.  The twelve links of dependant origination.  The "human activities" I think I described it as, as that's what it kind of looks like.  Well, I have just learnt today that they are actually:

1. Lack of knowledge
2. Construction volitional activity (I think this is work or crafting stuff)
3. Consciousness
4. Name and form (I think this means physical being)
5. Contact (ie with other humans)
6. The six senses (the mind gets its own sense)
7. Pain
8. Thirst
9. Grasping
10. Coming to be (this is the coupe having sex, ie conception)
11. Being born
12. Old age and death

These twelve sections are part of what makes the wheel go round, but I have to study this outer layer a bit more in depth before I can fully understand its pertinence.  I believe that the six realms are internal causes of suffering, but the outer twelve are external causes.  This is why I thought they were simple activities of daily living.  Mmmm so much more to learn.

Ok I think this concludes today's lesson.  I'm teaching myself, rather than trying to preach so I hop ethis doesn't annoy anyone too much.

Just part of my "about stuff' in which this blog is supposed to be about.  My life and stuff.

Now to cease avoiding this friggin essay.....

Mac time

Well, I did it.  I finally bought myself an iMac.

I've had my Lenovo mini-laptop for about two and a half years now, so I think I got my $500s worth.

I was looking and umming and ahhhing over an iMac before my trip, looking at refurbished models, secondhand ones, the student discount, the finance options, etc etc.  In the end I was trying to write this friggin annoying assignment yesterday and thought "I've had it".  Coincidentally it was the same day Steve Jobs had also had it.  RIP Jobs.

So I generally pride myself on not getting too swept up in the hype.  I've managed to resist an iPhone all this time, and an iPad.  I finally succumbed to an iPod a while ago when my cheapie MP3 just wasn't making the grade.

I have also found my recent computer habits are quite confined to the desk therefore a desktop makes sense, that and also I spend a LOT of time at my desk at home thanks to that little medical degree and masters degree I'm trying to work my way through.

My smart phone is doing very well for internet browsing the odd thing here and there.  The ebooks I have on it serves me well for a bit of study squeezed in where I can at work or the traffic lights.  Perhaps the only gap I could find is those times I want to sit on the couch and do a bit of uni work, or at work when the work computer is occupied..... And then they invented the iPad.

The iPad was initially only interesting to me because it is yet another in a long line of technologies which seem to have been developed straight from Star Trek's vision of the future  And they called it a "pad" which is what the Star Trek one is called ("PADD").  So that's cool.

But now with my whole going back to the desk top thing I though there was room in my life for an iPad, so, well I was already in the Apple store anyway, so that's how my credit card got a nice workout today.

And what about my Kindle?  I still think it;s superior for reading comfort and probably suits us older people who don't like reading from backlit screens.  But I haven't really used it.  I have friends that use their's all the time.  Hmmm.  Not sure what I will do with it now I have the iPad.  I can't imagine carrying both around.  Stay tuned for more on this.

So that's about it.  I have the weekend to do these assignments and I really can't wait to get back into med school.

Back home

I'm back home now.  I arrived late Sunday night and was pretty much a zombie for two days, which seems to make sense as I hadn't slept for two days thanks to my flight schedule.  I go back to work Sunday night.  Have have two assignments due on Monday for my Masters which I haven't even looked at yet.  OMG.

My house-sitters left my house in very good order so I don't have to stress about housework at all, which is so wonderful.  But I have a lot of mail to go through, bills etcetera, but that's fine.  There's nothing scary in there.

I start my new term at med school in two weeks and I'm anxiously looking forward to it.  I just want to progress through this degree already.  I'm a bit nervous about the MD program I've switched too as I am already expecting it to be more difficult for me as my basic sciences are my weak point.  I have also heard from other students that the new exam system is not user-friendly and there has been a lot of complaint that it adds more stress and is not a fair system.  Great.

So I am still to transcribe the posts I wrote in Tibet and was not allowed to upload due to the censorship by the Chinese government.  I also have some cool pictures of my trip, but that too will have to wait until I do these assignments.

Looks like I'm back.

Last day

I can't believe this is my last day on this holiday. I fly out tonight and should reach home by tomorrow night.

I can't believe what I've done in only 4 weeks. Its crazy! It feels much longer than 4 weeks, more like 4 months!

This morning I used the hotel spa facilities and had a nice go in the steam room. Yesterday I had a lovely pedicure. I ALMOST feel human again.

Yesterday I went to buy some thangkas. I got the Wheel of Life for myself. It matches the Buddhas Life one I already have. Two of my friends had a requests; Medicine Buddha, and one where a monkey and elephant slowly change white (representing the path to enlightenment). Now I have three pictures to get framed when I get back (the other is a panoramic photograph on canvas of Potala Palace taken in 1916).

Today I have to fun task of packing! I searched online to find out my airline allows 20kg of check-in luggage total, and there is no "piece" system, ie I can check-in two bags for no additional charge as long as the total weight is less than 20kg. Sweet. I have an extra bag now but they are both small(ish).

I love it here but I also can't wait to get home.