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... stupid exams :-(
28.7.10
23.7.10
selective memory
its been going on for a couple of years now. lots of my friends will attest to this: my memory is full of holes. some will argue that this is related to my gross alcohol intake (which is possible) or suggest that it's simply because my brain needs lots of down time (sleep, daydreaming, playing solitaire on auto-pilot). whatever the pathophysiology, the fact of the matter is, i simply dont remember a lot of things. is it because i dont make an effort to remember them? or is it because im not paying much attention in the first place? or do i really have an inability to form, store and/or retrieve memory? im really not sure.
it is certainly true that my mind wanders a lot. my concentration is often scattered between several tasks, little bits of neuron firing off near-simultaneously, all clamouring for my attention. certain things i recall relatively easily, eg the names of my patients' various relatives, entire monologues from plays and films; but sometimes entire conversations have apparently taken place - but i am convinced that ther other person is simply pulling my leg, much to their amusement and/or frustration!
so is my memory simply selective? do i only remember things that i want to remember? is it just a matter of paying more attention to everything i do? do i need to sleep more and drink less? perhaps...
it is certainly true that my mind wanders a lot. my concentration is often scattered between several tasks, little bits of neuron firing off near-simultaneously, all clamouring for my attention. certain things i recall relatively easily, eg the names of my patients' various relatives, entire monologues from plays and films; but sometimes entire conversations have apparently taken place - but i am convinced that ther other person is simply pulling my leg, much to their amusement and/or frustration!
so is my memory simply selective? do i only remember things that i want to remember? is it just a matter of paying more attention to everything i do? do i need to sleep more and drink less? perhaps...
13.7.10
tyranny of distance, part 3
in the bush, there is just not enough of some things.
what a horrible weekend: the hospital was so full that they had to open up day procedures to put patients in so that more people could come into emergency; our list pushed out to three pages for the first time this rotation; i was still doing my inpatient ward round at 5:30pm in the afternoon. the bed coordinator cajoled and threatened but there is nothing i can do! look at the bloody list:
- a third of the patients are oldies admitted from nursing homes because there are not enough general practitioners in town, such that the ones that are left are either overworked and dont have time to deal with anything more than a six minute consult; or they simply don't know and don't care;
- another third of the patients are oldies waiting for allied health input before they can go home or be placed: physios to improve their mobility, occupational therapists to set them up at home, speech therapists to work on their swallow, dieticians to buff up their nutrition, neuropsychologists to prove that they are incompetent, aged care assessment to tick that box - and even after that, they wait for a bed to be emptied from one of three facilities in town. waiting in hospital to go somewhere else to wait to die. what a lovely thought.
- the final third of the patients seem to comprise entirely of patients bouncing back with a medical problem that cant be fixed (eg end-stage copd), they wont let me fix (eg alcohol abuse) or i cant fix (eg fulminant hepatitis and malaena but no gastroenterologists in town).
so we did the best we could: patched up the oldies so they could go back to their nursing homes; kept the others in hospital so they received adequate nursing care; and provided band-aid solutions or palliative care to those who are simply broken, before they went back into the community or up to heaven.
why would anyone want to live in the bush? and... why do i want to live in the bush?
what a horrible weekend: the hospital was so full that they had to open up day procedures to put patients in so that more people could come into emergency; our list pushed out to three pages for the first time this rotation; i was still doing my inpatient ward round at 5:30pm in the afternoon. the bed coordinator cajoled and threatened but there is nothing i can do! look at the bloody list:
- a third of the patients are oldies admitted from nursing homes because there are not enough general practitioners in town, such that the ones that are left are either overworked and dont have time to deal with anything more than a six minute consult; or they simply don't know and don't care;
- another third of the patients are oldies waiting for allied health input before they can go home or be placed: physios to improve their mobility, occupational therapists to set them up at home, speech therapists to work on their swallow, dieticians to buff up their nutrition, neuropsychologists to prove that they are incompetent, aged care assessment to tick that box - and even after that, they wait for a bed to be emptied from one of three facilities in town. waiting in hospital to go somewhere else to wait to die. what a lovely thought.
- the final third of the patients seem to comprise entirely of patients bouncing back with a medical problem that cant be fixed (eg end-stage copd), they wont let me fix (eg alcohol abuse) or i cant fix (eg fulminant hepatitis and malaena but no gastroenterologists in town).
so we did the best we could: patched up the oldies so they could go back to their nursing homes; kept the others in hospital so they received adequate nursing care; and provided band-aid solutions or palliative care to those who are simply broken, before they went back into the community or up to heaven.
why would anyone want to live in the bush? and... why do i want to live in the bush?
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