Thursday, June 28, 2007

Racism in Australia

I went to a dinner meeting with a group of local GPs last week. One of them brought up the topic of the isolation and frustrations foreign-trained doctors feel while working in Hervey Bay.

Just some background information. The public hospitals in the area are staffed by doctors from all over the world: England, South Africa, Croatia, Germany, the US, Burma, Nigeria, Fiji, India, Sri Lanka, and Pakistan, with the South Asian contingent being the largest. Walking around the hospital is like touring the United Nations. The English everyone speaks is tinged with different accents. The hospital seems to function well enough. But if you were to walk into the emergency department, you can feel the numerous posters that proclaim "Racism is not tolerated here!" silently performing their pre-emptive role, putting a lid on something almost palpable roiling beneath the surface.

Backtrack a little more. Australia is having a huge shortage of doctors at the moment, some places worse than others. The Fraser Coast area, which includes Hervey Bay, is among the hardest hit. To bridge the gap, Queensland Health has recruited large numbers of what's called international medical graduates (IMGs) from around the world.

Besides the expected culture shock, what a lot of these doctors didn't expect was the overt racism from some patients hurling racial slurs. I personally haven't seen it happen, but I've heard nurses and some doctors describe what had been said by some irate patients.

"This is one of the most racist places I've seen in Austrtalia," said an administrator of the hospital at the meeting. "Maryborough and Bundaberg [two towns within an hour's drive from Hervey Bay] are One Nation territory," he continued. For those unfamiliar with Australian politics, the One Nation Party was a short-lived but influential party in the last ten years in Austrlia. Its xenophobic nationalist and protectionist platform ran counter to the Australian federal government's policy of multiculturalism. Being in the middle of a place where the party's base, it partially explains the sometimes intolerant attitudes displayed by some patients.

Today's local paper reports that Pauline Hanson, one of the founders of the One Nation Party, has stopped by Hervey Bay on her campaign trip for a Queensland Senate seat. Hanson achieved notoriety when she said, in her first speech to the House of Representatives in Parliament in 1996, that Australia was "in danger of being swamped by Asians" while denouncing the "privileges Aboriginals enjoy over other Australians." The paper's editorial, noting her sizable group of supporters in the Fraser Coast area, attributes her popularity to her honesty in saying things people now are only able to think, but not dare to say. That instantly reminds me of a certain media personality in the US. Looks like it's the same reason for the popularity of Ann Coulter, of the US Fox Network screaming match fame. Have we really progressed all that much when intolerant remarks can find so much support? In the four decades since the Civil Rights Movement in the US and the end of the White Australia policy, have we achieved nothing more than shoving ball gags into people's mouths and draping thin veils in front of their faces?

Thursday, June 14, 2007

Got Their Priorities Straight!

Heard a story on the radio today that gave a glimpse of the quintessential qualities of Australians.

It rained more or less for about two weeks straight along the eastern seaboard in Australia. In many places dealing with the worst drought on record, this was a good relieve. But in some places, it rained just a bit too much. The Hunter Valley in New South Wales, famous for its wines, is flooded. A little town called Hinton, with a population of 400, has become an island. As happens in a lot of natural disasters, many people of Hinton have lost their homes and are now relying on supplies brought to them by the State Emergency Service (SES). The quick response of the SES has helped the locals take the isolation in stride. Now they are just waiting for the water to recede.

So far so good with the story - pretty normal stuff, really. Then a twist in the story just makes it so uniquely Australian. An important event was happening last night and the town needed extra supplies from the SES. That event was none other than the State of Origin - the Queensland Maroons was playing the New South Wales Blues in the annual rugby league series. Ever since the flood water made the town into an island, its beer supply has been steadily dwindling. Beer supply at the local pub, which has become the meeting point for the stranded residents since the flood had started, was now at a dangerously low level! What would the people drink while watching the game?! No worries, just send an SOS to the SES. And what do you know? A dozen kegs were delivered by boat to the pub by the afternoon. a crisis was averted.

Good thing they got the kegs there, because the Maroons beat the Blues at the end of the night. So the good people of Hinton, New South Wales, had enough juice to drown their sorrows. Don't talk to them about their lost possessions, their team just lost the State of Origin, again! Just give them some time...

Tuesday, June 5, 2007

Eating Disorder?

I may have an eating disorder I didn't even know existed. I came across this article today, ironically, at dinner time. After reading it, I thought, "Hmmm, maybe I have orthorexia."

Simply put, orthorexia is an unhealthy obsession with what the sufferer considers to be healthy eating.

A lot of people consider me a health nut. It's true, I don't eat most fast food anymore; I avoid red meat, shellfish, and really spicy food; I do eat more fruits and vegetables than I used to; I shop for organic food when I can; and I cook the vast majority of my meals. Does that make me orthorexic? I don't judge what other people eat. If you want to chow down on a Big Mac for lunch, I'd say I wouldn't eat it, but if you like it, knock yourself out, I'd just eat a Subway sandwich with you. I have no problem spreading butter on my toast; I don't feel self-righteous or evangelize about the supposed "virtues" of my eating habit; I don't get anxiety attacks about how "pure" is the food I eat. I don't eat out much, but it's more for financial reasons than for not wanting to eat "bad" food. Does that still make me orthorexic? OK, like one of the orthorexic subjects in that story, I post pictures of my meals on my blog. Is that so weird?

Coming from the world's fattest country and currently living in the world's second fattest one, I can't help but ask, is it so bad to want to eat more healthfully? As the every-expanding waist line of the population makes being overweight the norm, our fast-food culture makes thoughtlessly shoving junk food down our throats the norm, is it so bad to be outside the norm in these regards? Must we pathologize everything "abnormal?"

Plus, maybe all I have is just the boring MSH - med student hypochondriasis.

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This was what I was eating while reading that article on orthorexia: baked pork sausages with quinoa and assorted vegetables.

Sunday, June 3, 2007

Going Mental

Last week was the first week of mental health rotation. The mental health inpatient unit has fourteen beds and they've been full most of the time. Mental health service has come a long way since the days of Bedlam. The big institutions are all gone; no one gets committed anymore. What's left now are acute services and patients are discharged to the community. And then there are the rules. All the rules and regulations that ensure the proper treatment of patients while they are at their most vulnerable directly translates into mounds of paperwork. I know paperwork is an unavoidable part of medicine, but mental health definitely takes the cake in this aspect. The doctors are constantly writing in patients' charts and filling out forms.

I sat in on patient interviews all week. Listening to their stories and hallucinations, hearing them describe the way they perceived the world around them, I felt like a voyeur peering through a keyhole into their psyche. This catatonic patient who worried about every minute details of daily living, that floridly psychotic one having a complete breakdown, this one with delusions of grandeur who absolutely believed in his story, that schizophrenic one who was constantly arguing with the voices in her head - it was like watching a drama, a comedy, a tragedy, and a film noir all rolled into one. From day one, the med school has been teaching us to empathize with patients, to understand where they are coming from. But it looks like psychiatry wound have to take exception to that rule. The hardest part of psychiatry is probably learning to not empathize so much that we start to identify with the patient - in order to maintain insight into the patient's problems, but more importantly, for our own sanity.

It's going to be an interesting rotation.

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Tonight's dinner: chicken cacciatore on cous cous with silverbeet.