Study life - day one

a) Looking at FB
b) Searching the fridge
c) Thinking about useless things
d) Feeling sad, and a bit annoyed
e) Room is getting progressively messier
f) The house is so quiet
g) It's strange not to meet people
h) No class, I thought I would love it
i) Bored, disconnected from the world
j) At least there's a cat on my lap
k) A 10 minute walk, or run
l) Feel like eating, a lot
m) Three lamb chops, yum should be full
n) Another look at the fridge
o) Two oranges, a nectarine, an apricot
p) Mmm, passionfruit yoghurt
q) Maybe I'll have some of that raspberry yoghurt too
r) A packet of Shapes
s) And some raisin toast
t) Still hungry
u) Where do I eat out tomorrow
v) Check deals, and Urbanspoon
w) Elective forms, insurance forms
x) S & S - who wants to meet up?
y) Bored, tired, the songlist is getting old, screechy
z) Sleep


In no particular order:

Section A

I've thought alot about it this week. The time, and resources I would happily give, if it was before. But it's not the same. Of course I've known that for a long time but still don't understand your unwillingness to be open and clear, when we knew each other so well and talked so easily. Not hating you for being loyal, but for your mixed messages. What can you possibly mean by saying you care, and never initiate conversation. How do I interpret you wanting distance, then wanting "occasional" good chats. That time, we talked about having to celebrate our twenty firsts. Then you promised to catch up, saying of course it matters. But it doesn't.

Being in the same city can be far away, when you want it to be that way. You, and that other bro, are the same. Pretending to be old friends, but only there when it's convenient. "I'm quite busy" - I genuinely believed it. I'm good at believing excuses and lies. But now that it's been months, a year or more, it just means to me sorry I can't be bothered to make time, that I prefer to be surfing FB than to see you. Hate to realise it, but we always have time for friends that matter.

Section B

The learning is great. But it's a matter of perspective, on the social interactions. Some weeks are good, and some aren't so. The opportunity is that without a cosy nest, it frees you to mingle with those who are older, younger, alone, different, or just don't really belong - the people who I used to ignore when I had my nest. And leaves plenty of lunches to spend one on one with people outside. But other times, like this time, I feel that it's really going nowhere all semester and that doesn't look like it's going to change. I can't help but hear a mental snigger every time we talk about this place being welcoming. Sorry, about being judgmental. To me it seems that they will politely converse with you, if you look for them to, but save the real conversations, laughs, with the insiders. If you speak the same lingo, have the right connections, then your social calendar will be filled with gatherings and dinners, but if you're not, you will never be invited. It's petty but we all have feelings. If you're inside, you will be given roles as time goes by, and if you're not, I suppose you don't meet the criteria of popularity, which is strangely associated with your commitment. Good thing is you learn to do, quietly, the way it should be done. Maybe if you were pretty, cute, or handsome, and available, they would converse with more interest? Yes I suppose there's no point getting to know someone with whom you have no romantic potential, and anyone who is paired clearly has more than enough in terms of their social needs.

Mmm, that's terribly cynical. Some weeks I am thankful, optimistic even, that this is the place to be. But this time, when I'm meant to be thankful I just feel discontent. And it's sad, knowing that this is supposed to be a hospitable family and be a great symbol of love. If only for the social aspect, the dance class group, or any random club, can be better family than this. I long to be elsewhere, but I do remember that I have a task here, and I will know when it's time to fly away again.


Five things I realised:

1. It seems that I can wake up and be motivated to attend things without much problems if I know that there will be morning tea, coffee, lunch, afternoon tea and ice cream breaks. Yum.

2. Not that I needed to do this but - the opportunities for networking with others in the field when people meet face to face. Sure you can contact people via whatever means, but the human touch of real life interactions is irreplacable.

3. Global health, vaccines, and WHO work is interesting.

4. Talks are more about sharing ideas, ways to explore an issue, discussions, debates, inspiring better approaches, rather than purely delivering a lecture on a topic people don't know about.

5. You can have great quality data, do a good research study, or have a great idea about solving a problem. But presenting it is just as important - it just doesn't look very professional if you have your "poster" presentation as a few loose black and white, A4 sheets in the regular size 12 font.

Closing a chapter

Whenever I think back, I feel thankful, and amazed. I've been wanting to write this, but unfortunately thankfulness tends to be easily swept away by dissatisfaction.

First impressions - odd, self promoting, and abrupt. I was offended that first day when you asked me what percentile I was, and quickly came to the conclusion that I was playful, wanting to do the minimal amount of work, and clearly anxious because of my legitimate questions. I thought uh-oh. Actually, I was irritated even before we met, with the months long lags between the email correspondence. My fears were confirmed in the following weeks and months with your unorthodox ways, and how you refused to engage in my questions in a straight forward way.

I was plucking ideas out of thin air, attempting to implement them with the active discouragement of those who were supposed to help. And just when the plans were to be executed, the internal strife, the gossip and knowing looks, and your boss pulling me aside and asking me to pick sides. You went away temporarily and the person replacing your role almost didn't want to do what she agreed to do, when she became angry after seeing that you had taken her material. Then, you left unexpectedly in the last few months, and they said I should be okay to sort things out, myself. Not once did I have any direct feedback about the final product from anyone there, or anyone else, until the process was complete and buried. Indeed, perhaps as you've intended, I've learnt much through the process. But to this day I can't decide whether your method was intentional and effective, or whether the free reign (or negligence, depending how you see it) went just a bit too far. You were right, I was anxious. The uncertainty, and how out of my hands the whole process was, disturbed my sleep more than any exam.

I disliked you intensely, but I read God's word and prayed constantly too - avoid gossip, be respectful, reflect God's character, and work as if we're working for God and and not for man. Over time, the interactions changed, rather - God transformed them. Far from perfect, but workable. In the end, you had surprisingly positive comments and well wishes. And I wrote to myself, "I never thought I’d cry at the end of this whole thing. Cry because of his sickness, because I don’t like to see suffering or hear of suffering to that degree even in the person I once loathed. I have to thank God, thank God and only God for helping me have a neutral and eventually positive attitude towards his strange ways. And thank God for him being receptive to me too."

During the time, when all that felt dark and hopeless, I was also hurt and shattered by the intentional lies of someone I trusted, and weaving through the complications that followed. Like Job, I felt God was sabotaging various areas of my life. I wanted to trust God, that he had good plans for us, that he promised to be with us and never forsake us. Much of the time, I probably didn't believe that, but other times, I did. Since there was no consistent guidance, and I didn't know what to do, I always made the comment that God was the one who was guiding me in this work. So when it came to penning acknowledgments, I thanked all the usual suspects, and (after contemplating whether it would be weird and deciding I had to include it) thanked God for giving me the people whom I thanked, and "for being the source of my purpose, strength and guidance each day." I worked, but it was through (or together with?) what God had given me.

I thought that was it, but there was one last thing. And finally when that was complete, we could close that chapter. There's nothing extraordinary in any of this, but walking with God makes ordinary paths (with its ups and downs) special, and when I look back, I'm amazed at the journey and where he's brought me. Although it's tempting to think I did it all myself - see the passage below.

When you have eaten and are satisfied, praise the Lord your God for the good land he has given you. Be careful that you do not forget the Lord your God, failing to observe his commands, his laws and his decrees that I am giving you this day. Otherwise, when you eat and are satisfied, when you build fine houses and settle down, and when your herds and flocks grow large and your silver and gold increases and all you have is multiplied, then your heart will become proud and you will forget the Lord your God, who brought you out of Egypt, out of the land of slavery. He led you through the vast and dreadful desert, that thirsty and waterless land, with its venomous snakes and scorpions... You may say to yourself, "My power and the strength of my hands have produced this wealth for me." But remember the Lord your God, for it is he who gives you the ability to produce wealth, and so confirms his covenant, which he swore to your forefathers, as it is today. - Deuteronomy 8:10-18

I stop to remember and record, because it's easy to quickly forget. God wants his people to remember, make a monument, mark the milestone. The Passover feast was to be a yearly reminder to the Israelites of how God spared the Israelites who had the blood of the lamb on their doors, whilst striking the Egyptians (when Pharaoh refused to let the Israelites go). Similarly, after the second crossing, God instructed Joshua to command the people to make a stone monument to remind future generations of what had happened.

Furry friend

Why does your breathe smell so bad everytime you open your mouth. It is lovely though, to have your warm body on my lap, and that constant, rumbling purr. Then silence, and lots of ear twitching, as you fall asleep. You're the only cat I've ever really liked. But I'm keeping an eye out on those unpredictable, evil claws that always manages to prod into my skin through my clothes.

Lost in translation

Ha. What a stereotypical, overused title. Oh well.

Our previous hospital was predominantly of Anglo-Saxon background, and throughout the whole year we saw less than a handful of patients who couldn't speak fluent English. This hospital, similar to other metropolitan public hospitals, has migrants from everywhere, Italian, Serbian, Vietnamese, Chinese, Greek, you name it. This time there was an elderly Asian gentleman in the wards.

"He speaks Chinese, anyone speaks Chinese here?" the consultant looked around.

I hesitated, remembering the disapproving tones we had from our tutors at the mention of students being used as interpreters. Plus the last time I spoke in Chinese was an awkward international call to organise my elective. I had said "hello", instead of "喂", and the lady handed phone to someone else saying, "她在说外国话".

But since the Asian intern didn't volunteer herself, I said, I can speak it, to some extent. They wanted to know if he knew where he was, and the day and month. Okay.


Ask him if he's coping at home. That's tricky, I had to think hard, and came up with a half formed phrase (can't remember the exact wording) which he understood and replied that for small things he could handle it, but some of the more strenuous activities were difficult. He seemed happy to be able to converse and be understood properly. And we moved on to the next patient, and I reflected on the experience.

We've had many HP/EP/PD tutorials about using interpreters, and speaking to people from different backgrounds. We're always told, you should always use a trained, professional interpreter. Really? Yes I'm totally far from fluent but if you're asking about which day and month on ward round, how essential is it to find an interpreter. Or, the man in ED with his chest pain who was brought in by his daughter, are you going to wait for who knows how many hours for the only Serbian interpreter in the region, or are you going to ask the daughter who is also able to give good collateral history?

Our teaching has always focused on what can go wrong. The classic dilemma is the scenario where children are used as the interpreter, then they tell you that in their culture, it's better not to tell their terminally ill parent what is going on. See, they say, the children should never have been used to interpret in the first place. Or the example of awkward interviews, and misunderstandings with a doctor who speaks the patient's language as a second language. So the blanket rule is, always use an interpreter. Oh of course, how could people not understand that, I thought.

But now I disagree. Why do the tutors shake their heads when our classmates say they themselves, or the patient's family, were interpreting for a patient? True, there's lots of things that can go wrong in using non professionals, but there's also lots of things that can work better. It's impractical to call an interpreter for everyone who has some difficulty with English and clinician know it. If you work on those principals, how about calling an interpreter for every doctor who finds it difficult to communicate fluently in English?

In our society, it seems that having a certificate is a tick of excellence (and not having one, equals being inadequate). After working in hospitality, I realised that in some places, it's compulsory to have a food handling certificate. Before my hospital placement last holidays, I had to have a "hand hygiene certificate". Our hospital never provided one, so I searched online, answered a few MCQ's and printed myself one from the website. Do you really think there was any difference between my hand hygiene practices before and after the certificate? The point I'm making is that having a professional with a certificate every time doesn't mean you've optimised communication. Look at the interpreter who was called in, only to discover he spoke the same language but in a different dialect to that of our patient. Hmm, (nice man he was but) very useful? Or my friend's experience where the professional interpreter was interrupting the flow of the interview by cutting in, when the patient began to express herself in English. On the other hand, professionals can be great - I saw an age care assessment, and mini mental performed by an experienced interpreter, and it flowed seamlessly.

Consent for surgery, yes you wouldn't want to use someone who fumbled with the language, or emotionally involved, as an interpreter. On the other hand, ward rounds every day with basic questions, the family member can probably do a better job of helping you out with history (since they are often involved in the care too) than the professional.

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