(one two three)
if you close the door
the night could last forever
leave the sunshine out
and say hello to never
all the people are dancing
and theyre having such fun
i wish it could happen to me -
- but if you close the door
id never have to see the day again
if you close the door
the night could last forever
leave the wineglass out
and drink a toast to never
oh someday i know
someone will look into my eyes
and say hello
youre my very special one -
- but if you close the door
id never have to see the day again
dark party bars
shiny cadillac cars
and the people on subways and trains
looking grey in the rain
as they stand disarrayed
all the people look well in the dark
and if you close the door
the night could last forever
leave the sunshine out
and say hello to never
all the people are dancing
and theyre having such fun
i wish it could happen to me -
- cause if you close the door
id never have to see the day again
id never have to see the day again (once more)
id never have to see the day again
- "after hours", the velvet underground
(well, minnie: it looks like you opened the door, emerged from the darkness, looked that someone in the eye, and said hello to forever. i wont go as far as saying that youre dancing around embracing the sun, but perhaps we can retire your song to never...)
21.3.10
expectations
there is a world of difference between expectations and dreams. one dictates what one should do while the other merely describes what one would like to do. should is such an evil word. if one believes in free will, that individuals are capable of making independent choices and are therefore responsible for these choices, then one should (haha) be able to lead a life free from "should". for example:
- my child should do (insert medical specialty) versus i would like my child to do (insert medical specialty);
- my child should marry an asian guy versus i would like my child to marry an asian guy;
- i should pass this exam versus i would like to pass this exam;
- i should study more versus i would like to study more (who am i kidding here?);
- i/my partner should behave a certain way in our relationship versus i would like (my partner) to behave a certain way in our relationship;
- i should know what to do versus i would like to know what to do
... etc. let's all try to lead a life free from "should"!
- my child should do (insert medical specialty) versus i would like my child to do (insert medical specialty);
- my child should marry an asian guy versus i would like my child to marry an asian guy;
- i should pass this exam versus i would like to pass this exam;
- i should study more versus i would like to study more (who am i kidding here?);
- i/my partner should behave a certain way in our relationship versus i would like (my partner) to behave a certain way in our relationship;
- i should know what to do versus i would like to know what to do
... etc. let's all try to lead a life free from "should"!
12.3.10
just do it
what is it about being a medical registrar that still fills me with unease? im into my fifth year out of med school; spent a couple years as a relatively competent resident (at least i think so); managed patients on my own pretty much since day one; admitted hundreds more; ran codes by myself; done a stint in icu and even worked as a locum "registrar" for a few weeks. lots of my colleages are doing it / have done it / are over it. and yet i dread that first day in mildura and a part of me wants to put it off forever.
i think it's mostly the responsibility of the job, or my idea of it anyway. the sense that the buck stops with me. im supposed to be making the calls, running the show, supervising my interns and only occasionally "consulting" with my bosses. if something goes wrong, then im the one whos stuffed up, not done enough, let the patient down. i know it's not exactly like that, but thats how it feels.
i love being a resident when i have an easy-going registrar. i get to do whatever i want, but if things aren't working out, i handball the problem into his/her court, and demand a solution. it's that simple. now i will be on the receiving end. serves me right.
the last run of nights was insane. six transfers and two code blues. it's difficult when all ive got on my side are one div one nurse, whose probably been working in subacute for twenty years either side of her pregnancies, and a non-medication-endorsed div two nurse, and me all on my lonesome. it feels like the day teams dont know and dont care about their patients medical issues (but the stump looks alright: what are they, surgeons?) and when the person on the other end of the phone is half asleep, or questioning your judgement, or telling you they're on bypass, well... that doesn't help either.
im starting to understand why xiu keeps moaning about not knowing enough. its this... panic. it freezes me. and then the endless replays in my mind (the "i could have done this... i should have done this... maybe it would have made a difference..."). the guilt. the gaps in my knowledge seem enormous. didn't i learn anything in medical school? it spurs me on for a moment, until im lost in the overwhelming amount of information in harrison's or uptodate. then i despair.
not that im into acute medicine or anything. but sometimes its great just being lost in the heat of the moment, doing thing, thinking that you know what is going on and what to do, and not having to worry about the consequences.
i think it's mostly the responsibility of the job, or my idea of it anyway. the sense that the buck stops with me. im supposed to be making the calls, running the show, supervising my interns and only occasionally "consulting" with my bosses. if something goes wrong, then im the one whos stuffed up, not done enough, let the patient down. i know it's not exactly like that, but thats how it feels.
i love being a resident when i have an easy-going registrar. i get to do whatever i want, but if things aren't working out, i handball the problem into his/her court, and demand a solution. it's that simple. now i will be on the receiving end. serves me right.
the last run of nights was insane. six transfers and two code blues. it's difficult when all ive got on my side are one div one nurse, whose probably been working in subacute for twenty years either side of her pregnancies, and a non-medication-endorsed div two nurse, and me all on my lonesome. it feels like the day teams dont know and dont care about their patients medical issues (but the stump looks alright: what are they, surgeons?) and when the person on the other end of the phone is half asleep, or questioning your judgement, or telling you they're on bypass, well... that doesn't help either.
im starting to understand why xiu keeps moaning about not knowing enough. its this... panic. it freezes me. and then the endless replays in my mind (the "i could have done this... i should have done this... maybe it would have made a difference..."). the guilt. the gaps in my knowledge seem enormous. didn't i learn anything in medical school? it spurs me on for a moment, until im lost in the overwhelming amount of information in harrison's or uptodate. then i despair.
not that im into acute medicine or anything. but sometimes its great just being lost in the heat of the moment, doing thing, thinking that you know what is going on and what to do, and not having to worry about the consequences.
25.2.10
e
she was the first ward patient i'd looked after in a long time. a young thing, barely out of her teens, she was preoccupied with life, frustrated by an illness that seemed to thwart all her attempts at normality. for a while, as her lung function fluctuated, we wondered if she was really compliant with her treatment. our doubts made her angry: didn't we believe (in) her?
it was as if her entire existence hinged upon others believing in her. adolescence is tough enough to negotiate without having to deal with what is essentially a terminal illness. for her, walking that fine line between striving for independence and relying on others was particularly difficult. for someone who was yet to develop a strong sense of self-identity, who still needed other people to validate her choices, the loss of autonomy that came hand-in-hand with each hospital admission threatened to overwhelm her hesitant steps towards adulthood.
the final blow came months later, when i'd left the service. a colleague informed me that she was in icu with full blown respiratory sepsis. the bosses had decided to go down an unusual and bold path. she was on ecmo, and awake. the thought of it terrified me. i couldn't bring myself to go in and visit her. on each day that i went into work, doing another job at another hospital, one of the first things i'd do was to check on her latest bloods and chest x-ray. the little patch of aerated lung grew smaller and smaller; the oxygen level in her blood became lower and lower. sepsis gave way to ards. transplant wasn't an option. and then, finally...
icu is a frightening place to die. it's so completely alien. there is no day or night. there is no privacy. nurses and doctors, orderlies and clerks, family and friends, all come and go in shifts. the only constant is the throbbing fluorescent light reflecting off the shiny surfaces of medical hardware and the sterile white linen. endless miles of tubing sprout from banks of beeping machines and invade the helpless bodies on trolleys. the only view outside looks onto the enormous grey helipad, where broken bodies from traumas are brought in from all across the state. all we can offer are words, and when that fails, sedation.
she had dreams. simple, worthwhile ones. to finish uni. to move out of home. to travel. others waste their entire lives looking for reasons to live. she only wanted to live.
dream on, e. you're free at last.
it was as if her entire existence hinged upon others believing in her. adolescence is tough enough to negotiate without having to deal with what is essentially a terminal illness. for her, walking that fine line between striving for independence and relying on others was particularly difficult. for someone who was yet to develop a strong sense of self-identity, who still needed other people to validate her choices, the loss of autonomy that came hand-in-hand with each hospital admission threatened to overwhelm her hesitant steps towards adulthood.
the final blow came months later, when i'd left the service. a colleague informed me that she was in icu with full blown respiratory sepsis. the bosses had decided to go down an unusual and bold path. she was on ecmo, and awake. the thought of it terrified me. i couldn't bring myself to go in and visit her. on each day that i went into work, doing another job at another hospital, one of the first things i'd do was to check on her latest bloods and chest x-ray. the little patch of aerated lung grew smaller and smaller; the oxygen level in her blood became lower and lower. sepsis gave way to ards. transplant wasn't an option. and then, finally...
icu is a frightening place to die. it's so completely alien. there is no day or night. there is no privacy. nurses and doctors, orderlies and clerks, family and friends, all come and go in shifts. the only constant is the throbbing fluorescent light reflecting off the shiny surfaces of medical hardware and the sterile white linen. endless miles of tubing sprout from banks of beeping machines and invade the helpless bodies on trolleys. the only view outside looks onto the enormous grey helipad, where broken bodies from traumas are brought in from all across the state. all we can offer are words, and when that fails, sedation.
she had dreams. simple, worthwhile ones. to finish uni. to move out of home. to travel. others waste their entire lives looking for reasons to live. she only wanted to live.
dream on, e. you're free at last.
9.2.10
nights
freezing to death in the tiny on-call room, struggling to stay awake despite twenty-seven cups of coffee. the words on the computer screen swimming around, and after trying to put them together for the third time, i still have no idea what they mean. im supposed to be studying but its not working. only four hours to go before i can go home and have a beer at nine oclock in the morning.
the loudspeakers outside my door seems to be mumbling something. then my pager goes off. code blue in rehab c. great. out of all the wards in the hospital, of course it had to be the one furtherest away from me. i put on my shoes and run. but ive forgotten my stethoscope. turn back. whats the stupid door code again? run run huff puff chest pain. going through the als algorithm in my head, getting the hs but always forgetting the ts. oh its the same guy i reviewed yesterday: why is he still here? didnt the day team do anything? the subacute nurses fluff around. ivc, ecg, do my own obs, make some whimsical comment to lighten the atmosphere, a set of bloods, call a taxi to take them to the alfred, write some notes, inform the ao. only three hours to go before beer oclock.
sigh. at least im awake now.
the loudspeakers outside my door seems to be mumbling something. then my pager goes off. code blue in rehab c. great. out of all the wards in the hospital, of course it had to be the one furtherest away from me. i put on my shoes and run. but ive forgotten my stethoscope. turn back. whats the stupid door code again? run run huff puff chest pain. going through the als algorithm in my head, getting the hs but always forgetting the ts. oh its the same guy i reviewed yesterday: why is he still here? didnt the day team do anything? the subacute nurses fluff around. ivc, ecg, do my own obs, make some whimsical comment to lighten the atmosphere, a set of bloods, call a taxi to take them to the alfred, write some notes, inform the ao. only three hours to go before beer oclock.
sigh. at least im awake now.
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