An unorthodox festivity

The Silent Night was broken by the dawn on a cold and rainy morning. I dragged myself out of my warm bed and staggered to the bathroom to shower. Welcome to Christmas 2006.

A long distance phone call was made to the family to wish them festivities and say goodbye to my sister departing overseas yet again. The sound of the family enjoying themselves only made the distance seem further than it really was. I kinda wished that somehow they would show up on my doorstep to suprise me, but knew this would not happen.

The streets were devoid of the usual morning ebb and flow, as people spent treasured moments insdie with their families. I walked in eerily silence to the bustop and caught a ride into the city. Against the grey city outline I sought out the sandstone cathedral dwarfed by the surrounding skyscrapers.

With each song, the choir turned well loved meoldies into muscial poetry. The small gathering were reminded both in song and word of the hope that Christmas brings to all of us in Jesus. It was nice to just be alone for once and be anonymous. To sit and drink it all in. To thank my Lord for this day.

When I got home, I started to get ready to cook my traditional roast dinner when my phone rang. It was my intern buddies from other hospitals, fellow Christmas orphans in need of company on this Christmas day. And so my well planned out dinner was shelved and I found myself in the city eating Yum Cha and celebrating with good friends. It was a far cry from my desired turkey... but far more enjoyable than eating alone.

Finally the clock ticked over to 2pm and I found myself in the ED on Christmas. It was not too busy, the nurses were decked out in tacky $2 Santa hats and there was so much junk food we could have had an infarct ourselves. Some bored nurses started playing Christmas CDs over the ED intercom just to annoy everyone and one fo the specialists donated 2 bottles of champagne for us to crack open in celebration.

The atmosphere was jovial, the registrars were casual and it was great. We even had our own Rudolph the Red Nosed Drunk*

One lady came in with a head injury from a flying shoe (that her adult daughter had thrown at her) One girl came in with a black eye (that her drunk grandfather had inflicted on her) One guy came in vomitting blood (after he'd binged on alcohol for a month).

Amidst the celebrations, the awfulness of life sat side by side with the joys of life. Whilst some partied, others suffered. It was a far cry from my family based traditional Christmas. But it was a Christmas to remember.

* A rounded German man who was a Nazi sniper (apparently) and now spends his life getting drunk and wanting to commit suicide and frequently fronting up to ED.

The Importance of Christmas

I must admit I'm a Christmas addict.

Being raised by a British mother, I was indoctrinated early into all things traditional about the festive season.

Our family would never dream of anything less than a roasted turkey for lunch on Christmas Day with all the trimmings and church in the morning.

Christmas Carols MUST be watched the evening before Christmas and lame jokes about leaving grass out for reindeer must be laughed at every time wihtout fail.

And I luv every bit of it!

But it's not the trimmings that make Christmas special.

I couldn't care much for the presents (although they are quite nice and I'm happy to have them)

And although I luv them dearly it's not about family either.

It's all about the 'reason for the season' (so they say)

Each Christmas I am so amazed and excited to think about how God limited himself and humbled himself enough to become a human.

To eat and breath with us. To share our pain and toil. To share our joys and passions. To wrench us from the power of death.

I cannot help but well up with pride and emotion as I hear the Christmas message sound forth each year in carols.

Their words so articulately enshrine the exciting news that happened 2000 years ago. That in a backwater town, out the back of a pub, was born the chosen one who woudl die in my place to break death itself and bring us into freedom.
"Born to raise the sons of earth,
Born to give them second birth.

Adam's likeness now efface,

Stamp thine image in it's place,

Second Adam from above,
Reinstate us in thy love"

This day is so important because it breaks the passage of time in two. The entire history of the world hinges on it. The dawn of a 'new and glorious morn' arrives. As I remember the plan of the ages fulfilled that lonely night, I look forward to the final chapter in which:
"Once again the scene was chang'd New earth there seem'd to be, I saw the Holy City Beside the tideless sea. The light of God was on its streets The gates were open wide And all who would might enter And no one was denied. No need of moon or stars by night, Or sun to shine by day, It was the new Jerusalem That would not pass away "Jerusalem! Jerusalem Sing for the night is o'er Hosanna in the highest Hosanna for evermore!"

Amen.

Christmas

Last weekend I had an early Christmas.

Due to the fact I'm stuck in ED on Christmas Day, I decided to string together some days off and go home to spend Christmas with my family a week early.

As I flew home I gazed out into the distance over the dry dusty countryside. It amazed me just how barren and lifeless the land had become. Perhaps symbolic of what was to await me?

As the plane touched down I saw a familiar shape waving intently at the plane.

It was Dad.

As I got off the plane, I tilted my head down; half embaressed by the display he was putting on and half trying to avoid facing the reality of a man I once knew.

Finally I looked up... and as I looked up I saw a man that shocked me. A man devoid of the warm beard he once sported, the beard that had defined his care and yet his authority. The beard that had not been removed since before his marriage. It was now gone and the face I saw beneath looked too familar. Too much like mine.

The next few days showed just how much his degeneration had come. Familiar names meant nothing to him anymore. Phrases were less constructed and more bizarre. Days were spent picking up the leaves and sticks in the yard (purpose? we do not know but dare not ask).

The man who once controlled hundreds of millions of dollars of roadworks could no longer control his bladder. Days once spent in government meetings were now spent in front of a television waiting for the afternoon gameshows.

His new friends were now the strangers he met on the street. His old friends were now the ones he didn't know.

And yet as we exchanged gifts, it was as though time had forgotten the last year and he was the man I once knew. The familiar Christmas carols and rituals brought back memories of past festivities shared with this man. The out of tune singing, the warm summer nights, the home cooked roast.

Last Christmas I called this man "Dad", one year later he mistakenly called me his "Dad".

As I flew back to Sydney, I was confused. Was I leaving home? Or was I coming home?

As I hugged my mother and felt her tears, I knew that the dream I once remembered of home had gone. The warm past was gone and the cold future awaits.

Merry Christmas to all you blog readers... please treasure each Christmas day you have with your loved ones. You don't know how many you'll have.

The good, the bad and the ugly...

The Good:
Getting a free Christmas lunch at work with hot chicken and salad followed by yummy mud cake. The bosses decided to splash out and suprise us all which was very nice of them and meant I actually got fed for once in ED.

The Bad:
Finding out I had a patient call up over the weekend and complain that I sent her home when she couldn't walk. To be honest, she was treated very quickly because we had a lot of other people waiting. And I DID make sure she had crutchs and asked the nurses to make sure she was ok befroe she left. Anyway, yeah in an ideal world I shoudl have done better but honestly, we had no registrar to cover us so we were pretty snowed under... just cranky that after trying to help these people they still complain... as my Mum would say... "If you're gonna die... go die quietly in the corner and don't make a mess on my nice clean floor"

The Ugly:

My face. Mum and Dad got me an electric razor for Christmas and so after years of using the cream and razor it's time to go electric. However according to some random site I Googled about tips for achieving a smooth shave it takes 1 month for the epithelial scar tissue to change (when you blade it you scar the underlying skin each time whereas with electric you dont) and during this time apparently one's face is supposed to undergo some weird skin remodelling. And so it's kinda uncomfortable and rough, but hopefull in a few weeks time my face will have evolved into a more electric-friendly protoplasm to deal with.

The future...

Well the next 12 months of my life have now been set in stone and my social life will now have to accomodate the ordinances of the Zoo.

So what lies in store for Dr J next year? Fun filled medicine in the wards he once trod and loved?

Not really.

Term 1 - ED

That's right kids Dr J your favourite fun loving doc is back for round 2 in the ER. Usually people like to take a break from the banality of chest pain and PV bleeders but not J. He's overdosing on the excitement in the ED just becasue he can (well, actually is forced to). So whilst he graduates into being a 'resident', a flood of eager but paralysingly slow interns will be forging their way through the waiting room list and begging him for advice on stuff he himself has no idea about.

Term 2 - Relief

Contrary to the sound of the name, this term is NOT a relief...it is usually an excuse for JMO management to banish you back to ED under the excuse of "to help out the new overseas doctors" People generally take time off on terms they dont like.. and so you end up filling in for jobs that no one wants and do a whole lot of scut work.

Term 3 - Paediatrics

Time to do something I enjoy for once! Yes, that's right about 10 years ago (man I'm old) I decided I wanted to be a paediatrician and help sick kiddies. 10 years later it's still quite an appealing job. No grumpy old people and their non-English speaking families; just a whole lot of litigous over anxious parents with snotty kids. Thankfully the cafe in paediatric section makes up for the bad food elsewhere in the hospital.

Term 4 - Geriatric Rehab

They're incontinent of urine and faeces, they can't tell you what's wrong and no they're not babies.
Most people become suicidal when receiving a geriatric term. 10 weeks of crumbly old people who never get better. I was advised strongly by my GP trainers to do a geri's term to help me in the future. I despised working the geri overtimes though this year and so very cleverly (gold star to me) snuck into a geris rehab term where most of their acute medical problems are sorted out and they are just getting some 'body-building" (read: physiotherapy) prior to going home so they can have another fall and die within 12 months*

Term 5 - ICU

The one thing I have never done in med school (thanks to some clever wagging) was Intensive care. Thsoe people with bazillions of tubes stuck into every orifice just didn't appeal to me. No patient's awake to talk to, no happy discharges home and no happy relatives. And yet somehow I got lumped with a whole term of this with 12 hour/day 7 day/week work (on a rotating basis). I just dread the thought of advanced physiology/pharmacology. Thankfully I've got 2 weeks of annual leave then to break the suicidality I might be experiencing.

And so this is what 2007 will look like for me. Not much fun by the sounds of it.

But along with this comes a sad realisation. I have no more surgical terms. Due to intern requirements and SRMO's BST needs, I will never again don the scrubs. I will never scrub in to assist again. My last operation was my total colectomy at 3am in the morning. I'm kinda sad about that. I, who was once a hater of all things surgical am now lamenting the oppurtunity to wear those blues.

Soon it'll be time to end the "Intern Experiment" and start the "Resident Experiment"...

* statistically once you break that femoral neck you generally have less than 12 months to live.

Restless J syndrome

Causes: Seeing off too many good friends at the airport, disruptive shift-work, lack of friends around during days off, family illness, lack of girlfriend, surmounting end of year bills, stupid hospital admin, propsect of 'another' term in ED.

History: Patient usually spends time at work wishing they were not and when not at work bored out of their brain and wishing they were anywhere else. Gets frustrated with life for no particular reason. Intolerance for minor issues and excessive somnolence. Poor dietary intake of take away.

Tests: Seretonin level, intolerance severity index, TFTs, EEG.

Treatment: Gold standard therapy is with multidrug therapy of holidayavir combined with peoplepril. Delays in initiating treatment can lead to the morbid complication of 'burnout' which can only be rectified by goinghomestatin.

Each week I hear of yet another friend taking off overseas/interstate on holidays and I just watch out the window of my house and watch the planes fly overhead wishing I was going too. Everyone else is getting exctied about the holiday season and I am stuck in ED on Christmas Day with no family or friends.

It's just hard to get excited about life when all it consists of is work and sleep. Work itself is actually not that bad at the moment. But somehow it's just not satisfying.