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I didn’t like what i had become, I was grumpy, stressed, my health was shot. I was inpatient. Snappy. My head which had used to be full of stories, and images was now concerned only with getting enough sleep to make it through the next on call cycle.

But unlike my friend Halaina over at the D word, change came quick, I guess the signs were there but I was fixated on the idea of becoming a plastic surgeon and ignored it until I was forced to confront them
The consultants had not made time to see me to discuss my future, but assured me that they would have me in my current job and not to worry.
I didn’t (rookie mistake. Don’t trust them as far as you can throw them.) and a few weeks later got a generic health department telling me I was unsuccessful in my application for my current job.
This was a bit of a kick in the balls, as I had no negative feedback, and no heads up this was on the cards.
But this was the big kick I needed. Looking back over this blog, I was always torn between my need to do my art and my love of medicine. The last few years was an experiment in subsuming my art for medicine and I didn’t like it. I wasn’t me. I missed being creative, I missed collaborating, I missed moving and dancing.
I had forgotten these things and this kick was what I needed to reassess.
I took the time to step back and get in touch with what I wanted out of life, I looked forward to what I could expect if I wanted to pursue plastics and I found no joy in that.
I took wise counsel from trusted friends and decided to step back in 2015. reconnect with my art practice and take a different path.
So in 2015, I’m dancing again, teaching, doing a Masters in Sports Medicine, a Dip in child health, making films, riding my bike badly. Its going to be good.

Follow your bliss’ (Joseph Conrad)

a lecturer once told me this and it stuck in the back of my mind until recently and it seems apt.

I did manage to make a small film at the end of last year which re-enforced how much I missed being creative.

Us Right Now (120mb. NSFW)

LakeWanakaTree

Lake Wanaka 2013

Holy carp, Its march 2015. A lot has changed. I lost the last few years as a plastic surgery registrar (resident for you yanks), I haven’t created barely anything during that time so 2015, I’m stepping back, reassessing, reconnecting with my arts practice.
Its a bit odd, stepping back from a promising, exciting (lets face it glamourous sounding)¬†career and something I didnt’ think I would do, but I feel I should write it down, its something young medical students and doctors should think about before embarking on study/specialisation.

This is largely inspired by my friend over at the D word someone I knew as a young ballet student who became a gorgeous dancer with the Australian Ballet and has moved over to Germany and tackling new and greater challenges. Check it.

1602_GH1_0001

‘He missed his bus, but he knew he had to get to the game, so he kept calm, didnt’ panic and got a cab – cause he knew he needed to get the game. See thats the sort of clear thinking that we want of our leaders’ -Footy show thingy on sunday morning

Really? I’d be proud of a 6 yr old who could do that…if thats the standard of intelligence we benchmark our footballers against I think we’re in a bit of trouble.

I reflect back on how he came here. Here, where he lies being breathed for into barely developed lungs, a tube fed delicately through his nose into his tiny distended belly, covered with skin so fragile I worry a breath will take it off. A yellow beanie, lovingly made by a nurse covers his peach sized head and malformed face. His miniscule hands and feet periodically twitch bathed in eerie UV light. A cheery sign proclaims his ownership of this incubator but just around the corner his scans show the extent of his injuries we can’t see; part of his brain never developed.

Mum never wanted him. She asked for a termination but for some reason, was talked out of it. She had kids already, more than she could handle and certainly he was unwanted. She came back some weeks later, having tried to kill herself. We patched her up, and sent her on her way. And now, she came back, having been beaten and in premature labour.
And so he was born and promptly discarded. Mum returned home, back to her other kids and his future is unclear. For now he lives with us in the special care nursery, being breathed for.

Lillies

I have overheard some students saying that they were disappointed that there wasn’t enough death in hospital. Maybe I’m too soft and squishy right now, but I’m in no hurry whatsover to see more than what comes.

Random Violence
I observed a craniotomy .

The man’s brain was, in a word, buggered. There was a haematoma covering probably a 1/3 of his left hemisphere, obliterating his 3rd ventricle. It had lost its nice colour, the normal texture and architecture, and to top it off, there was an uncontrollable cerebral bleed. He never regained conciousness and passed away. We never found out what exactly led to these horrific injuries – other than some sort of altercation. I know it happens all the time, but its sad that someone can be beaten this badly and be left there – he was only brought in as a chance finding.

On suicide and not knowing
I had interviewed him recently. I was chastised for not delving into his deep melancholy having been distracted by his more florid pathologies though my risk assessment and management plan had been satisfactory.
I had been the last one interview him, in fact. We had gotten on well, talking about music and ultimate fighting. He was picking up, becoming happier, more reactive, interested in getting better.
But somewhere along the day, and I’ll never know why, something changed and he tried to take his own life by leaping off a building. He didn’t suceed totally, but will be severely paralysed at the very best.

I wonder what was going through his head, I feel awful for his family, for the team that has been looking after him and inevitably we all think back to when we last saw him, was there a clue there? could we have forseen this? could we have done something about it?
But mostly I just feel sad.

on dying
He’s dying. He knows this but not quite know how soon yet and the question has come whether we treat him aggressively, for little gain, or we go palliative and he can return to his country(land) and family. He thinks that aggressive treatment will get him 5-6 years. It won’t, 12 months or so at best. If the renal failure doesn’t get him, the cancer will.
So we talk, about life, his family and about dying. He’s not afraid of dying and is remarkably cheerful and graceful, and for that I’m grateful – it makes a difficult topic easier to discuss.
We’ll meet again soon after he talks with his family and he invited me cheekily to his country some 6 hours away.
I hope I can get there, I hope that I did the right thing, I hope that he chooses well, and I hope that he has a good death.


I had grand plans of frequent updates, of tales of mirth and woe as I entered my clinical years of training. Unfortunately studying is like being mauled by a bear while being simultaneously sodomised by an irate porcupine. So I haven’ t had the time to poop, let alone formulate a semi quality post. However I thought it was about time to chuck a few things up else I would be falling behind my esteemed colleagues Here, here and here.

I dont know shit. That much is obvious on a daily basis – I spend most of the time with palpatations, (the caffeine doesn’t help) trying desperately not to be revealed to be an awful fraud.
But I am grateful to be able to be present and particpate in powerful moments like births. I may be entirely superfluous to the patients medical requirements, but their generosity never cease to amaze me.

She was a grand-multi (well expecienced mum), with an uncomplicated preganancy and as I had seen her the week before in antenatal clinic, generously invited me to be present. It was all going smoothly, and baby’s head appeared on schedule. But then it turtled (Looked like it was trying to go back in) and its colour started going bad and from there I stopped breathing – the obstetrician came in and tore off the end of the bed, the paediatricians rushed in, the midwives jumped in and pushed her legs back (McRoberts). As the ostetrician pulled almightily on the baby, a midwife did some magic internal manouvers and bub was delivered – floppy, pale blueish to the waiting paediatricians. The whole thing probalby only took 4 minutes but it stretched into eternity until we heard the baby cry. Big boofhead (4.3kg) was fine, and mum was fine, and i needed a bex and a good sit down.

One of the things that stick with me is this women who I followed through a 20 hr labour, ending in a C section. The poor thing was exhausted, and there was no father present, so I got to hold her baby and take him up to nursery. For the most part, they were happy endings in obstetrics – some tense moments with more shoulder dystocias and a few emergency caesars, but mum and bub ended up well.

ANd though it’s a cliche, really childbirth is crazy, gross, beautiful, wonderful, joyous all at once – and the sight of a healthy baby and the look that the parents have for their child makes me forget that I haven’t eaten anything more substantial than a muesli bar or slept for more than 3 hrs in the last 48.

However there are some awful stories, from relatively simple and common (from our point of view, but terrible for them) miscarriages, and ones of abuse and neglect resulting in severe disability or death for the neonates.

It had been the transplant waiting game for sometime, always waiting for the call which would see him fly away to get his new heart. In the meantime he dealt as best he could with the cocktail of drugs – the frusemide dance and his constant companion the dobutamine pump which prevented him mucking for bait. Though it certainly didn’t stop him going for a fish whenever possible at preposterous hours of the morning.

I remember his enthusiasm for his subject and his pet interest, the endothelial glycocalyx, which became my pet interest and together we devoured reams of papers and planned our research. He patiently taught me the basic science, and encouraged my fumbling attempts to come to grips with the material. It was a fragmented process, arranged around his health, his work, and my freaking out about this and that exam. Every now and then there’d be a message about some potentially catastrophic problem, but a few days later he’d emerge, looking battered, but determined to keep working and never flagged in his love for teaching nor his eagerness to do get started on the project. But it was always fun getting together, having a yarn and a scheme.

He gave me confidence, encouraged my interest and provided guidance. It was in his course that I first thought that maybe I can do this medicine thing.

It was something we had discussed, and he faced death with calmness and acceptance. He was a teacher through and through and gave me insight into his thoughts, an understanding of where he was and why.

It was a privilege to have been his student, and I will be forever grateful for the things he taught me about science, medicine and most of all life.
Farewell.

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