Wholesale Therapy

Big news today: Costco opened its first Australian warehouse in Melbourne today! That’s right, the American institution of purchasing stuff in packs of 50 right off the shipping pallet, all under an expansive industrial roof, has finally reached across the Pacific to this corner of the world. I know they have locations in Taiwan, Korea and Japan, but as arguably the most Americanized countries in the Asia-Pacific region, it is high time for Australia to finally have a Costco.

For people who are not familiar with Costco, it is a completely different shopping experience than any other place. The biggest difference is that it has done away with the whole pretense of presentation: aisles are flanked not by shelves, but by pallets on which items on offer are shipped. The whole place is a steel-and-concrete warehouse; there’s no pop Muzak playing in the background and no shop assistants helping you trying on the shirt you want to buy. What you see is what you get. Items range from clothes to diapers, from groceries to pet food, from toiletries to cleaning supplies. You won’t find fifty varieties of canned tuna, but what you do find comes in packs of thirty. Want to get some toothpaste? There are packs of five on sale. Toilet paper? How about the packs of fifty? Want some apples? They have 10-lb bags. The big draw is that, per item, the prices are usually quite a bit lower than what one can find in retail shops. Obviously, you don’t go to Costco to pick up some bread and milk, because you will invariably come out with a hundred other things and $300 poorer. It is a boon for budget-conscious and well-disciplined people, heaven on earth for hoarders, but a giant sink hole for the impulsive shopper.

Now, Australians, or rather Melbournians, at least for now, will be able to stock up on a year’s supply of toilet paper and laundry detergent in just one trip. Apparently, there was a two-hour wait for the checkout today. People everywhere just love a bargain.

I wonder when they will open one up in Sydney.

Thirty-roll packs of toilet paper on sale at the Livermore, California, Costco. I had this picture taken to show my friends in Australia because I didn’t think they would ever see such a sight.

Graveyard Shift

For the next four weeks, I will live the vampire lifestyle, or at least keep the same hours. I am assigned to do the graveyard shift: from 10:30 pm to 8:30 am the next morning. The shift started in the middle of the first week and goes for seven nights straight. I then have seven days off, followed by another block of seven nights, then I have five days off before starting back on regular schedule. So, in four weeks, I will actually be working for fourteen days.

So during the fourteen days when I will be working, my sleep cycle will be upside down and turned completely around. Having done night shifts during my emergency term, I now have a bit of experience on how to ensure I have a good day of sleep in between my shifts. I have made my room into a bat cave: windows are shut, blinds are closed, heavy curtains ensure that as little light as possible leaks in, add eye shades from long-haul flights, and my brain will think it’s the middle of the night even during high noon. I set the radio to the ABC (Australian Broadcasting Company, similar to NPR in the States) to serve as background noise. Ear plugs are handy for when the neighbors decide to rev up their cars. For the first couple of shifts, Phenergan just makes the quality of the sleep a little bit better without me feeling groggy when I wake up in the evening.

I actually think doing the graveyard shift allows me to have time for other things. I can wake up in the late afternoon or early evening and still have time to go to the gym, visit friends, and leisurely cook my meals before I start my shift. The downside is that, the weekend, when everyone is out, is the middle of the week for me and I have to follow the same sleep routine. It does not matter how gorgeous the day is or how inviting the beach may be, I have to go straight home for bed after my shift.

To push my sleep schedule back, last night I stayed up until 5:30 am before dragging myself to bed. I had a decent day of sleep today, so tonight I will start pretty fresh. But I know it will be a struggle by 4:00 or 5:00 in the morning. But that’s when my good friend joe will come to my rescue – a couple cups of it, and I can stay awake at least until sunrise. Then it’s pretty much smooth sailing to the end of the shift. Unless, of course, if the arrest pager goes off.

Okay, my shift is about to start; think positive: no arrests tonight, no arrests tonight…

Juicy Juice

The house I am renting this year has a few huge orange trees in the back. And now they are all fully laden with ripe oranges and mandarines. Everyday, a dozen or so of them drop from the trees. As my housemate is not big on citrus fruit, I now find myself with more oranges piling up than I can shake a stick at. I have to get through them in a more efficient way than simply eating them. I can eat until I get sick and still wouldn’t make a dent in the pile. Besides giving them away, juicing them would be the most efficient way of consuming the mountains of oranges before they become part of the compost pile.


Ah, drinking freshly made orange juice is one of the simple pleasures in life (I know, I don’t ask for much). I can’t drink the stuff from the supermarket anymore. Even the “not from concentrate” version tastes “preserved.” One and half liters of the juice wouldn’t even last me two days. I am drinking so much of it that I am sure I pee vitamin C every day. But here’s the good news: no scurvies for me!

Clothes Lines

For most Americans, the image of freshly laundered clothes hanging in the breeze, soaking up the warmth of the sun, evokes the feeling of a quaint bygone era. Today, the crude imitation of “fresh spring breeze” scent that comes from a dryer sheet would be about as close as most people get when it comes to drying their clothes outside. In the US, not only are clothes dryers part of the standard household appliances, in many parts of the country where home owners associations rule with an iron fist, clothes lines in the backyard are actually illegal. They somehow have come to be associated with poverty, are considered eye sores, and thus, have a negative impact on property values. People throughout the country have to fight tooth and nail the get the “right to dry” law passed.

In Australia, that stigma associated with clothes lines in the backyard never seemed to have existed. Clothes lines like this one in the backyard of the house I am renting are not only a standard fixture in almost all single homes in Australia, they often are placed right in the middle of the open yard as the most prominent feature. Neighbors don’t grumble about having to look at your skivvies flapping in the wind; no one hyperventilates over being mistaken for living in a poor house because of the clothes line in the back.


Being the stingy greenie that I am, I absolutely embrace the clothes line for saving me money and being good to the environment. Yes, it takes longer to hang the clothes up on a line than simply throwing them into the dryer and push a button. But I look at it as part of my morning stretches. Yes, the weather dictates when I can do my laundry. If it rains on my day off, I just wait until the next dry day; I have plenty of underwear and socks. Worse comes to worst, if I really need to do laundry when it is raining, I hang them up on a foldable drying rack under the patio cover. On nice sunny weekends, my morning sometimes starts with the ritual of me standing out in the yard under the warm sun, with blades of grass between my toes, pinning the wet laundry up on the spinning rack. I then go out to do whatever for the day, not having to worry about my clothes getting wrinkled for sitting in the dryer all day. In the afternoon before the sun sets, the clothes are ready to be taken down. The wind has done the ironing for most of the clothes. And that smell of fresh air and sun soaked into the clothes just feels so – natural.

I just heard the washing machine buzz. Better go hang them up.

A bee visiting the flowers in the yard

I’m Still Alive!

Yeah, I am still here. It has been over six months after the last entry on my blog; now I am back.

Short summary of what happened in the last six months. I worked. Okay, you are all caught up now. Here is a little more detail if you are interested.

My first term was in vascular surgery – arguably the busiest term in the whole hospital, so it wasn’t exactly a way to ease into this back-to-full-time-work-and-trying-to-be-a-doctor internship thing. Having been thrown into the deep end, I basically spent the whole ten weeks trying to keep my head above water. Fortunately for me, I was in a team of incredibly good registrars and resident. So despite the hectic days, I felt like I was very well supported. The hours were grueling – by non-North American standards – from sixty-five to seventy-five hours per week. I felt like I only came home to sleep. So I spent the time that I had off either cycling along the beach or up the mountain or going to the beach with a book.

During that time a half dozen or so blog entries gathered in my computer and I never got around to finishing them. The perfectionist in me just would not allow myself to put them online without editing. And so in my computer they languished – half done, clumsy, and not fit to see the light of day.

My second term was in emergency. I had a blast! The work was interesting; the team was good to work with, mostly; one of the consultants has the ability to make interns feel like the most inadequate person in the world. I always stuttered when I handed patients over to that consultant. The hours were awesome: each week consisted of four ten-hour shifts and three days off. Having come from vascular surgery, forty hours per week felt like a holiday. So I treated my days off like holidays: biking, going to the beach, reading non-medical books, going to the gym (and sauna), going to Sydney, etc. My blog continued to sit idle. It had already been a couple of months, my unfinished entries were still waiting to be edited, but they were getting lower and lower on my priority list. I figured: who reads it anyway?

I was in the States last month on my annual leave. A couple of friends I saw mentioned that they hadn’t seen anything new on my blog. I even got emailed from some random person asking about it. So apparently people do read it.

All right, now that I have left my blog static long enough to have lost all three of my readers, I am going to give it another go.

New Beginning

It is barely six o'clock, but I am wide awake. Today is the first day of a week of orientation for the batch of new interns. The mix of nervous energy, expectation, and anticipation swirl around my head as I head to the auditorium of the hospital. It is exactly the same feeling as the first day of medical school four years ago. We gather in the foyer, introduce ourselves to one another, and make the obligatory "Hi, where are you from? What uni did you go to? What made you come to Wollongong?..." small talk. There's a buzz of energy in the room; I can feel the excitement in the air. After all these years of putting our noses to the grindstone, it really is exciting that we are finally going to take the first real step toward a lifelong career, and for me, a second career. I am finally going to have a real job and a regular income again. The cynic in me knows that, as time goes by and as we go through the trials and tribulations of post-graduate training, the enthusiasm and idealism we have today will seem naive sometimes. But today, I feel like my whole life is laid out before me and the possibilities endless. Today, I feel like an adult again.

In the Nick of Time

After a somewhat tense and suspense-filled two days, I logged onto my email this morning for the nth time to check my visa status.

It turned out that the only sure way to get things moving was to get on the phone. So, for example, when things like the person assigned to your case got moved to a different section of the Department of Immigration and your file ended up sitting on a desk without anyone looking at it for a month happen, you can get someone to maybe give a sideway glance at the big pile of paper with your name on it. And when they call you back saying that they can't process your paperwork because of some technicality, you can get the hospital sponsor to call them back and tell them to stop being ridiculous. After a bit of back-and-forth like that, I was finally promised that my visa would be finalized yesterday afternoon.

This morning, I logged onto my email, only to find that the notification for my visa's approval in the spam folder. Maybe it was the word "approved" in the subject line or that the text of the email sounded too much like one of those get-rich-quick come-ons, the email filter had decided that it was too good to be true.

That must be the best piece of spam I have ever got.

Sydney Tour

Today I am on a whirlwind tour of Sydney. But it doesn't involve the Harbour Bridge; there's no visit of the Opera House; nor am I getting anywhere near any of the beaches. Today is a day dedicated to satisfying the Australian bureaucracy.

I got back to Brisbane early yesterday morning. I went over to the med school to pick up my diploma, had coffee with a good friend who is heading back to Canada, went back to the place I last lived and re-packed my bag - I needed to dump out my travel gear and pack some work clothes - and headed back to the airport for a night flight to Sydney.

The flight was delayed - first by twenty minutes, then it became half an hour, then it stretched to forty-five minutes. At the end, the flight was one-and-half hours late. I flew on Virgin Blue, another budget airline - well, you got your hits and you got your misses. My housemate picked me up from the airport. By the time I got to Wollongong and settled into the hospital quarters, it was well past midnight.

Which brings us to this morning. My housemate is taking me on a tour of the backstreets of Sydney, but mainly to visit two places: the New South Wales Medical Board and the Department of Immigration. I am supposed to start orientation for work next Monday, but I don't have my work visa sorted yet. Besides the mountain of supporting documents I had submitted, Immigration wanted to see my diploma and registration with the Medical Board. The New South Wales Medical Board requires that all interns coming in from out of state to register with them in person.

With my diploma in hand, I walk into the Medical Board. Registration itself is actually a pretty painless affair, it takes all of ten minutes; the most difficult part is getting to their office. Then next step is to drive to Immigration and convince them that I have in fact graduated from medical school and am now a registered doctor. It is one of those take-a-number-and-wait affairs, not unlike what one would do at the supermarket deli, except in this case, my fate - whether I will be able to work in Australia or be packed off onto the next flight out of the country - is firmly in the hands of the person behind the counter. With my paperwork handed over to them, my day is finished. The only thing I can do now is to wait while my paperwork churns through the mysterious workings of the innards of the Australian bureaucracy. Perhaps the planets will align and the person processing my paperwork will come back from holiday in a good mood and I will get my visa on time to start my orientation next week. At this point, I kind of wish that I can grease some palms and get things sped up a bit.

Or maybe I will occupy myself with the next task - looking for a place to live.

Back to Oz

Vacation is over; I am heading back to Australia. I am flying the no-frills Tiger Airways from Macau to Singapore. After a seven-hour layover, I will be flying the red-eye on Qantas from Singapore to Brisbane.

Macau International Airport is a shiny and modern airport built on reclaimed land. With only a few small airlines operating out of it, the airport feels deserted when I check it. Within ten minutes, I have checked in, cleared customs, and am sitting in the departure hall. With almost two hours to kill before my flight, I occupy myself on the free internet terminal by the boarding gate. The sun beams in through the glass-and-steel eastern facade of the terminal, casting a warm glow on the lounge chairs, the shops, and the waiting passengers in this brisk morning. With a cup of coffee in hand, I stare out onto the single runway that appears to be floating just above the shimmering South China Sea. It is still close to an hour before my flight. My eyes look out toward the horizon; the outlying islands of Hong Kong seem to be faintly visible. My mind wanders here, there, and everywhere. This has got to be the most relaxed I have ever been when waiting for a flight.

A seven-hour layover is just too long to spend inside an airport, even for an excellent one like Singapore's Chang-I Airport. My friend Vignesh, who is a local, has the afternoon free. He meets up with me at the airport. We head into Orchard and the waterfront for a few hours. The tropical afternoon heat hangs heavily over the city; it takes extra effort to just walk along the street, as though we are trying to walk underwater. To revive myself, I have my fill of kaya toast washed down with that most delicious diabetes-in-a-cup: teh tarik. Before long, it's time for me to get back to the airport. I say goodbye to Vignesh, head into the terminal, and get ready for the eight-hour flight ahead.

I'd better get some sleep on the plane tonight. Tomorrow will be a full day of running around Brisbane, capped by a night flight to Sydney.

Day of Reckoning

This is it: the result of four years of formal medical education all hinges on our performance in three hours this afternoon. The sixty or so of us taking the exam this afternoon get to the hospital and wait around the lobby to be called in. We are then herded into another room, wait some more. The room is humming with anxiety; some of us chit chat to distract ourselves while others flip through pages of notes. Psychogenic diuresis kicks in, we drink more water; the toilet is in constant demand. After an eternity, we are lead out of the holding room to our respective stations. At the sound of a buzzer, the exam is officially started.

Three hours later, the last buzzer is accompanied by a collective sigh of relieve from all of us. We stream out of the hospital, some recounting the points they failed to make, some swearing they will be blind drunk tonight. I am just happy the whole thing is over.

In the evening, I join my fellow classmates at the Royal Exchange Hotel, the local watering hole frequented by college students, for a night of celebrating the end of medical school and, for many people, to say good-bye to each other. Soon enough, we will all head our separate ways.

We greet each other by a hearty “Congratulations, Dr. [insert last name]!” and point out the novelty of being called doctors. When used in front of my name, it still sounds so oddly formal. With beers in hand and over the amped up guitars by a cover band, we talk about where we will be next year, what specialties we want to go into, and the possibilities the future might bring. The buzz goes late into the night.

We have done it! I have done it! It feels surreal – to not being a student anymore, to not having to worry about studying tomorrow, to finally have a job again.

One Day More...

Until this is all over! The big, end-of-medical-school-and-must-pass-to-graduate exam is spread out over today and tomorrow. Our class is split into four groups: Saturday morning, Saturday afternoon, Sunday morning, and Sunday afternoon. As always in this kind of situation, I have the misfortune of being allocated to the Sunday afternoon session, just to ensure that the agony of endless waiting is prolonged. The exam is the live, face-to-face type consisting of nine live stations in which we are given scenarios and are instructed to talk to or examine or device a management plan for the real or volunteer “fake” patients.

By now, half of the class has already finished their exams. I am sure they are all appropriately in an altered mental state, but continue to quaff large quantities of alcohol in various disguises which, for many, has been the one constant through the four years of medical school.

While those half of the class are blowing off steam and generally engaging in wanton revelry in ways that may potentially be career-enders should they wish to enter politics later in life, this half – well, me at least – is trying to use our psychic power to predict the questions and topics that will be on our exam tomorrow. They had a cardiovascular system examination station today? I think it might be respiratory or gastrointestinal system tomorrow. They had an O&G station consisting of contraception advice and placenta previa today? It could be pre-conception counseling and pre-term labor tomorrow. Today’s ophthalmology station had patients with glaucoma and retinitis pigmentosa? We’ll probably get a couple of patients with macula degeneration and diabetic retinopathy…

No more studying. I am as ready as I will ever get. It’s time for some sleep.

Turkey of a Day

Happy thanksgiving! Hope your turkey is delicious.

Because I’m not having any.

I’m getting used to doing nothing for Thanksgiving now. For one thing, in Australia, today is just the fourth Thursday of November and nothing more. Secondly, we have our big, end-of-medical-school-and-must-pass-to-graduate exam this coming weekend. Any holiday would have to take a back seat to studying. For the last few days, I have set up shop in the library with my study group, pounding the past exams. And today was no exception.

So I came back in the evening, cooked up some quick pasta, and called it a day.

Maybe I can do some kind of Thanksgiving dinner next year.

Ten for Ten

In the early afternoon, I walk out of the children’s hospital with the other student in the rotation, feeling tired but relieved. Now that the exam for pediatrics is behind us, what are we going to do?

First, a beer is essential. Then, I am just going to enjoy the sunny afternoon.

Next week is study week for the big exam: everything we have learned over the last four years will be fair game. The diploma is going to be hinged on whether we pass this exam. So, the pressure is on.

But for this afternoon, I’m not going to think about it. Maybe I’ll even go see that new Bond movie tonight.

All Studies and No Exercise

Ugh, I feel like my body is atrophying. This is the last week of the rotation, which means serious study time, which is encroaching on my exercise time. For a whole week now, the only exercise I have been getting is my bicycle commute to and from the hospital. At a measly seven kilometers roundtrip, the commute is long enough to make me break a sweat, but not long enough to make me feel like I got a workout from it. Well, it’s better that than nothing.

Halelujah

I guess I can say "Halelujah!" that it's almost the end of medical school. But this halelujah actually refers to one of my extracurricular activities - the Queensland Choir. We are singing Handel's Messiah this year and this is the final week of rehearsals. Last week, with my unlucky viral infection, my voice dropped an octave and I could only sing about two notes. Singing then would probably get me kicked out of the choir. So, with my voice recovering over the weekend, I feel like I should join the last two rehearsals before our concert at City Hall this coming Saturday.

This will be my final performance with the Queensland Choir. The Messiah is always fun to perform. It was one of the first concerts I had performed in during my undergraduate years with University Singers. In the following ten years or so, I had performed it with other groups a few times. The complexity and intricacy of the masterpiece makes it a challenge but also a joy to perform each time. And each time I gain a new appreciation for Handel's genius.

After this concert, the choir will break for the summer and next year, I will be far away from Brisbane. During the three years that I had been able to sing with the Choir, I had a lot of fun learning new music and making new friends. With no formal music education and not able to play any instrument, I can count on singing as the artistic complement to the scientific side of my life. Being able to sing with a dedicated group of enthusiastic singers and lose myself in the music is incredibly stress-relieving, even during rehearsals when we get yelled at by the conductor.

Halelujah!

Downed by Germy Kids

Everyone else on the pediatric rotation has been getting sick. It seems that whatever virus the sick kids have been coming into hospital with, it is now being passed around our group of med students. A few of my compatriots have already been feeling miserable as of late. Amidst the constant sniffling, I have luckily avoided getting hit - until last weekend. A hint of a sore throat on Friday brewed over the weekend and, by today, has become a full-blown case of viral upper respiratory tract infection. This has got to be the worst time to be sick. There are only two weeks until the end-of-rotation exam and then another week until the final exam. I really can't afford to be sick this close to two important exams. I know it's probably viral and I just have to let it run its course. If it's caused by what the kids have been spreading around, I should be feeling pretty sick these couple of days but I will be fine come exam time. Let's hope it's that and nothing worse.

A Historic Day

After lunch, I am on my way to the ward to find more information from a patient's chart for my case presentation when I decide to stop by the staff tea room for a cup of coffee. As I enter the room, I hear the TV on with sound at full volume. A couple of nurses are organizing charts while looking up occasionally at the TV. The local TV channel is carrying live coverage of the US election. I make my cup of coffee and see Barack Obama on the screen getting ready for a speech. At the bottom of the screen flashes the designation: "President-Elect." As he starts to speak, I sit down with apt attention and sip my coffee absentmindedly.

Earlier in the day, I looked up the election returns online whenever I could. As I watched one swing state after another going to Obama, first Pennsylvania, then Ohio, then Virginia and Florida were starting to look more and more blue, I became increasingly hopeful even though the results were only based on exit polls. It almost sounded too good to be true - what, no "too close to call", no outcries for recount? I wasn't going to get my hopes too high; I was almost anticipating that some of the swing states would turn yellow, and then we'd get bogged down in yet another round of law suits for recounts and countersuits to stop recounts. I was telling myself that I wouldn't be convinced until the official counts were confirmed. Now that McCain has made his congratulatory phone call to Obama, I am relieved that the drama that had followed the last two elections won't be repeated this time.

I watch as President-Elect Obama speaks in his trademark soaring oratorical style. I notice that my eyes grow moist as his infectiously hopeful speech goes on, his eloquence a stark contrast to what we have had to suffer through in the last eight years. Images of his elated supporters crying, singing, and celebrating flash on the screen. Obama's election has brought hope to me and to many people who feel the country is heading in the wrong direction. But this is only the beginning; we can't expect Obama to fix everything. The things that are going wrong in the US are beyond what any one person can do to fix. He is inheriting a country with its economy in the dumps, a health care system already running over the cliff, and the only thing constantly going up is the national debt. These problems won't be solved overnight, but I know the one thing Obama can do as soon as he takes office is to repair the United States' image internationally. To paraphrase a popular credit card commercial - one economic bailout package: $700 billion; fix the health care system: $50 gajillion, to have the United States regarded around the world as the beacon of freedom and democracy once again: priceless.

With Obama's speech over and the local station switching back to its regularly programming, I dab my eyes dry and start my way to the ward again. I walk out of the staff tea room with a slight spring to my steps; I, as an American, am standing taller today.

Burning Out

There is a recent article on the New York Times about medical students in the US feeling burned out and depressed that contains some alarming statistics: 11% of those surveyed have had suicidal thoughts from depression, almost half of medical students surveyed suffered from emotional exhaustion, depersonalization, and a low sense of personal accomplishment. Among the factors cited are the constant lack of sleep, the pressure to excel, the hazing from senior students and residents, and having the firehose of information aimed at them non-stop. In the article, the author, an accomplished specialist herself, recounts her years in medical school when she felt miserable but unwilling to admit it because she did not want to admit to failure amidst the fierce competition among her fellow students. The article paints a picture of cut-throat competition and every-man-for-himself mentality in the US medical community.

After reading that article, I feel especially fortunate that I had decided to go to medical school in Australia. Now in the final month of medical school, I can say that I have not had any reason to feel burned out in the four years of medical school. Perhaps being a few years older than the average medical student has given me the emotional maturity to better deal with life's ups and downs, but if this article is an accurate reflection of the system in place in the US, I think my coping skills might have been pushed much closer to the limit there. Sure, the firehose of information has always been there, as was the pressure to excel, but to a much lesser degree because internship placements in Australia has nothing to do with one's rank in medical school. Any lack of sleep I have had was due to things unrelated to medical school; I don't remember any incidents of hazing by senior students and residents. In general, I never felt that I was alone in the course. Everyone I know has helped one another the whole time, whether it was to discuss the finer points of some intricate metabolic pathway or to lean on another's shoulder for emotional support. I would say camaraderie and cooperation are the better words to characterize the last four years.

I am not saying the medical school system in Australia is better than that in the US. The competitiveness of US medical schools is the impetus behind the constant innovation, for example. But for my own sanity and mental health, I am glad that I have been able to enjoy the relative tranquil four years in Australia.

Playing House

During a teaching session with one of the pediatricians today, I felt like we were the characters on House.

We saw a thirteen-month-old baby girl who was admitted to the ward yesterday. Through her mother, we learned that the baby had a previous history of Hand, Foot and Mouth Disease, which is a viral infection that happens commonly in children. It ran its course and she got better. Then her mother noticed a rash and diffuse redness in the area covered by the diaper. The mother treated it like a diaper rash. After a couple of days, the baby had not passed any bowel motion and was crying incessantly. The mother thought she had constipation and gave her some enema. The baby opened her bowel but was still unwell. At this point, the mother noticed that one of the baby’s legs was swollen from the hip to ankle and that she was spiking fevers intermittently. The mother finally brought the baby in to the children’s hospital Emergency Department. After having five different doctors taking a history from her, the mother clued in to the fact that the doctors were suspecting a non-accidental injury – i.e., child abuse. After a skeletal survey of the baby turned out normal, more investigations revealed the final diagnosis: the baby had septic arthritis of the hip. Ok, so the diagnosis was not House-worthy, but the process just made me think of the show.

There we were, three med students taking turn asking the mother the history yet again. Each time we were lead down the garden path, only to find that each piece of new information made us do a complete U-turn and think about a different process. Sure, all we did was take the history, we didn’t do any of the crazy things on House like going to the patient’s home and digging up the sandbox (as if doctors really do that in real life). Unlike House, our clinical coach, the pediatrician, was actually very nice to us and to his patients. So maybe it wasn’t like House after all, but I really enjoyed the exercise.

Going into the rotation, I didn’t think I would like pediatrics that much. But I think it’s growing on me.

Baby Check

I enjoy going to the neonatal ward. With all those chubby newborns and happy parents around, you can’t help but smile and share their joy. Yesterday I followed a resident on the ward and did a few well baby checks, which is one of the skills we have to learn during this rotation. Before each newborn is discharged, they are given a once-over by a doctor to make sure they are normal beyond having ten fingers, ten toes, and no obvious deformities.

Like everything else in medicine, there is a system to doing a baby check. You literally go from head to toe and front to back to examine the baby. I especially enjoy doing the primitive reflexes like the grasp reflex in the hands and feet, a telltale sign of our arboreal ancestry, and the Moro reflex, which is believed to be the only unlearned fear in the newborn. Today we had our baby check skills assessed by the neonatal consultant. The way I interacted with the baby I checked must have looked really natural, the consultant asked me afterward if I have kids of my own. Well, besides the four babies I delivered during the O&G rotation, yesterday would have been the first time I handled newborns. So maybe I do have a knack for handling little babies.