Friday, March 30, 2007

I'm All Thumbs

After drifting for a couple of months, I'm finally settling down - well, for eight months anyway. From now until the end of November, I'll be doing four rotations in Hervey Bay: surgery, mental health, GP, and internal medicine.

Surgery rotation, consisting of two weeks of orthopedics and six weeks of general surgery, started on Monday.

Having done a bit of orthopedic research in my former life, I am all over it. So when the first time I am asked to scrub in and assist in a hip replacement surgery, I run to the sink and scrub away: scrub scrub, under the nails, palms, back of hands, scrub scrub, fingers, between fingers, wrists, arms; ten layers of skin later, everything below my elbows are squeaky clean. Remembering the proper sterile technique I learned at the beginning of rural rotation nine weeks ago, I back myself into the operating theater, dry my hands on the sterile hand towel, put on the sterile gown - so far so good, I haven't accidentally contaminated anything yet by touching unsterile objects.

Then I proceed to put on the sterile gloves. Picking up the left glove with my right hand behind the right sleeve, I gingerly put it over my left fist, which is still inside the left sleeve. Tucking on the left sleeve with my right hand, my left hand slip through the sleeve and into the glove - but into the wrong fingers. As I try to get my hand out of the glove without contaminating it, a nurse says from across the room, "Dr. Young, you look like you're struggling a little bit," with just a dash of schadenfreude. Oh, she must enjoy tormenting new doctors and med students. I say sheepishly, "Yeah, my fingers are stuck." "Just take it off and start a new pair." I rip off the glove and put on another one, but as I pull on the glove, my right hand slips and touches the glove. She says to another nurse but sounds more like announcing it to everyone, "Can you get another pair of 7 1/2 please." She walks over, pulls the glove wide open, I put my hand in, she lets go, and my hand goes down and touches the edge of the drape. "Another pair!" she's thoroughly enjoying it now. After five pairs of sterile gloves, I am finally gowned and gloved. Way to go for that killer first impression! Feeling like a giant boob, I walk over to the operating table, being conscious not to bump into anyone or anything while keeping my hands in front and just below my chest.

Assisting in surgery sounds a lot cooler than what it actually involves: holding a retractor with one finger and another one with an elbow while suctioning the wound with the other hand and holding the patient's leg between your legs. The only perk is that you get to see the surgery up close, but you also have a pretty good chance of getting splattered while the power saw cuts its way through bones. But at the end of the day, after inhaling the acrid smoke from the diathermy burning through flesh, trying not to pass out from the fumes coming off bone cement being mixed, and wading through the puddles around the table, you know that underneath the acres of sterile drapes, someone will have a pain-free hip, it feels damn good. And I didn't even do the surgery.

I just hope the joint doesn't get infected. And I need a pair of comfortable clogs.

Saturday, March 24, 2007

Road Trip!

Throw three med students on break, some camping gear, a car, and a week of free time into a blender, push swirl, and what do you get? That's right - road trip! Notice anything conspicuously absent in the above mix? Like, a plan? That's because we don't have one.

This is the highly-anticipated first one-week break of the year. On Monday, Richard, Pam, both Year 3 med students, and I decide to go on a road trip. So we throw some clothes and camping gear in the back of Pam's car and start driving south. The initial plan: Sydney, 1000 kilometers to the south in New South Wales.

On the way, we start reading the Lonely Planet Australia guidebook and discover that a whole world of possibilities exist between Brisbane and Sydney: Coffs Harbour, Port Macquarie, national parks. There's plenty to do without having to waste two days driving to and back from Sydney. So we revise our plan to: Coffs Harbour and Port Macquarie, and maybe something else in between.

View of Coffs Harbour from Muttonbird Island

First stop: Coffs Harbour, four hours south of Brisbane. It's a laid-back small town by the ocean. Green, with a nice sandy beach, calm waters, and the tacky Big Banana tourist trap, what more could a group of road-trippers ask for? We visit the Big Banana, camp at a caravan park by the beach, and have the freshest seafood for lunch, but only after Pam goes nuts and jumps out of a plane (I would do it too if I could afford it). We look at our options again: go south to Port Macquarie or inland to the national parks. Going farther south means more pleasant towns and camping at caravan parks. Going inland to visit national parks means seeing some of Australia's pristine forests along the Great Dividing Range and doing some real camping. Without much deliberation, we revise our plan again: after Coffs Harbour, inland to the national parks.

Dangar Falls near Dorrigo

The area inland from Coffs Harbour is home to a dozen or so national parks and forests, some of which are World Heritage-listed. After climbing over the escarpment to an elevation of about 1200 meters above sea level, the road levels out and winds around the gentle hills of the New England Tableland. The green rolling hills stretch to the distance and are often dotted with houses and grazing cows. The lush green is quite a contrast from the parched brown I saw in Outback Queensland a few weeks ago. The main road that connects the few hamlets is called The Waterfall Way because it passes by a number of quite nice gorges and waterfalls, something not normally associated with this part of Australia. We stop by a couple of them and end up at Cathedral Rock National Park for camp.
View from top of Cathedral Rock

Cathedral Rock National Park is one of the smaller national parks in this area. Its name comes from the giant boulders haphazardly piled at the top of a hill. After pitching our tents at the empty camp site, we walk the three kilometers along the trail and scramble to the top of the rocks. What a view: 360 degrees of panoramic view of the surrounding forests and mountains. We enjoy the scenery as the sun slides closer and closer to the horizon. We wisely make our way back just as the last ray of dusk disappears and the whole camp site plunges into darkness. Then something amazing happens: the sky lights up, not by the moon, but by a billion stars. The Milky Way is drawn across the sky like a swath of silk, even the faintest stars between the bright ones are visible. The last time I saw a night sky like this was in the Kimberley in Western Australia and in Tibet.

Light streaming into the woods at the camp site

The next morning, we wake up to a group of kangaroos and wallabies having breakfast near our tents. I engage the kangaroos in a bit of a staring contest with my camera before their curiosity wears off and hop away. After breakfast, it's time to drive back to Brisbane. The vacation has been short - only four days - and without any prior planning, but it has been great. I found a part of Australia I didn't know existed. It's definitely a place I will come back to in the future.

Cows have the right of way on country roads

Thursday, March 15, 2007

One Down, Nine To Go

My time in Chinchilla flew by so fast, I barely had a chance to check out the town. But believe me, not much happens in a town of 3500 people. The only things I have to remember Chinchilla by are a few photos I snapped during one of my evening jog/bike rides.

This week, all of us on rural rotation converged from all over Queensland to Toowoomba, the base for UQ med school's rural division. We shared what we learned and presented to everyone cases we saw during our rotation. After a short exam this afternoon, it's the official start of a one-week break. A whole week - actually ten days, including this weekend - of sleeping in, relaxing, catching up with friends, and generally not thinking about medicine. That is really something to look forward to. I'd better enjoy this break, because the next rotation, surgery, is going to be full-on.

One rotation done, nine more to do before the end of med school! Hmm, maybe I shouldn't be counting down so early.

Sunday, March 4, 2007

Ambo Chasing

I heard the news from a nurse at the GP's office: there's going to be a motor cross competition in town this weekend.

"Sweet!" I think to myself. I'm not a big fan of motor cross. But a bunch of people on motorbikes jumping up and down mounds of dirt - that's got to produce a few injuries. Okay, I think it's sweet not out of a sense of malice, but because I know it's going to create good opportunities to see some sports injuries. Unfortunately, that's the way it is for us lowly med students - if you want to see some cool stuff, you'll have to hope that people get sick or hurt. This is the plan: I go down to the field and watch the competition. When the first injuries happen, I'll just follow the ambulance back to the hospital. I'll be an "ambulance chaser" for the day.

friends to cheer them on. I pick a spot uI drive the twenty kilometers out of town to the field. It's a hot day with not a cloud in the sky; the air is bone dry. The dirt hills created for the race are constantly hosed down by water trucks to minimize dust. I walk past the huge collection of tents and motorbikes to the spectators section next to the field. The competition has already started. Motorbikes weave through the course, powering up the ramps and flying over the little hills. Round and round they go. The small and subdued crowds gathered at the sideline look on, occasionally someone yells out the names of theirnder a tree and watch for a while. Before long, I'm bored. I mean, after watching the 500th motorbike going past, my attention span is about finished. I walk around and take photos from different angles. Two hours and zero crash later, I give up. I've had enough of the race. I'll head back to the hospital and, if someone crashes, the ambulance will take them there.

Well, they must have heard about the med student in town and are trying to avoid me, because at the end of the day, not one person has crashed or even landed funny. So much for my plan to get some practice on handling a sports injury. Good for them. And for me, all I got are these lousy pictures!