Old Shakey

Doogie Howser2

People write passionately about discrimination in Medicine: sexism, racism and even fattism (yes, there is such a word, I checked). Today, I want to talk about Ageism.

Ageism = Prejudice or discrimination on the grounds of a person’s age. (Oxford Dictionary)

Like all forms of discrimination, it goes both ways. There is ageism from the doctors to the patient, and then there is ageism from the patient to the doctors. The latter is the cause of my ongoing angst.

When am I going to see the real doctor?

This is actually something I get on a regular basis, usually after spending 45 minutes with them, taking a history, examining, diagnosing and explaining their treatment options. I suppose I should really consider it as a compliment. I do know I look young for my age. I know I don’t look like I am about to turn 40 (*sigh*). This can be attributed to both my ethnic background, but also to the fact that I don’t smoker nor spend much time in the sun (I do, however, sport a very unattractive sallow chronic ‘fluorescent tan’.) Yes, I do look after myself, but despite being a plastic surgeon, I have yet found a colleague trusty-worthy enough to stick needles or scalpels in me, and I am definitely too chicken to do it to myself in front of the mirror (unlike some of my colleagues – *winkwink nudgenudge*). So, no, my youthful appearance is not chemically or surgically enhanced, all I can blame it on is my genes.

So, why, you ask, am I complaining about looking young? Well, here’s a list of reasons why my age-inappropriate appearance doesn’t exactly make my job easier.

I don’t mind having someone young for the cough and colds, but can I please have someone older for the serious stuff?

I am not having someone fresh out of medical school operating on me.

You are too young to understand my problems

I need someone who are older and know what they are doing.

You look younger than my granddaughter, how old are you?

I am not being judgemental, but you are too young, I want someone who’s competent.

I have a very complex problem, I need someone with a little bit more experience.

The standards for the young graduates nowadays are not like the good old days, I want an older doctor who has been through the real training.

I want a doctor who is at least my age.

Now, what in the world makes you think you have the right to ask for my age? You are saying it isn’t being judgemental. But it is. You are judging my capabilities as a doctor by my age.

These patients feel that because of my age, I lack experience and should only treat the ‘easy’ stuff. There are two incorrect assumptions here. Firstly, the inferred ‘lack of experience’ by my age. Most people don’t realise that to become surgeon, one has to finish medical school, gain basic medical experience working as a junior doctor before being selected via a rigorous process to become a trainee in surgery. The surgical training program can range from 3 to 7 years, depending on the actual specialty, any sub-specialisation training within that specialty, and any additional overseas training to gain a wider perspective. At the end of which, one has to go through a series of very stringent assessments before a specialist qualification can be granted. I was at least 10 years out of medical school before I became a fully-qualified specialist surgeon. All I can say is, if 10 years of working and training (and not forgetting the 6 years of medical school before that) doesn’t constitute ‘enough experience’, and my qualification ain’t worth shit to you, then go ahead and set your own definition of ‘experience’.

Secondly, the patient’s assumption what ailments are ‘easy’ to treat and what aren’t, may not exactly correlate to true clinical relevance. A cough and cold may be easy to treat, but it may also be a manifestation of something more sinister. I would never presume a cough and cold as exactly that – I am a plastic surgeon after all – I always refer the patient back to their Family Doctor, as that is something those doctors would have more knowledge of. Patients who infer that they know what is ‘easy’ and what is not, show not only a total lack of awareness for the complexity of medicine, but also their disrespect for their doctor’s judgement. What may appear to be ‘easy’ may just be a harbinger for an underlying problem which is very difficult to treat, or it may just be the tip of the iceberg where surgical complexity is concerned. One of the most critical aspect during our training is to be able to recognise when we are out of our depth. If your doctor admits to needing a second opinion or assistance of another specialist, you should be grateful that you have found someone who will not take risks with your health.

People think that lack of ‘life-experience’ due to age is a deterrent to being a good doctor who could understand the issues of the ‘older’ population. This myth is easily busted when I look around at my colleagues. Which one of us isn’t jaded by what we have seen during our careers? We have seen it all. Birth, Life, Death, Disability, Misfortune, Pain, Suffering, Drug Use, Crimes, Abuse, Deviants, Perverts, the Insane, Murderers, Liars, Malingerers, Sadness, Grief, Anger, the list goes on. Some of the things we see and the frequency in which we see them, gives us multiple life-times of the so-called ‘life-experiences’. Sure, we may not have experienced any of these ourselves personally, but sometimes watching somebody we care for going through it and feeling utterly helpless can be just as real to us as the person who is experiencing it. Many of us view some of our patient’s misfortune as personal failures, and they take their toll on our own mentality.

Each specialty also has their demographic of patients; to assume that we have no inkling to a patient’s particular age-related issues is really quite ignorant. Most of my patients with skin cancers are elderly; I understand they may have issues getting to and from hospitals, care at home and simple matters such as attending appointments for dressings. We organise nursing home-visits for their dressings, and sometimes, arrange suitable surgery dates so that their family can take time off work to care for them. Most of my breast cancer patients have young children. We fit their appointments around school pick-ups and their surgeries out of school holidays so they can spend as much with their children as possible. Doctors are not unaware of our patient’s personal situations; we are not blind to possible social issues surrounding health problems. We, ourselves, have elderly parents, young nieces and nephews, friends outside of medicine and older/younger siblings. Often when we meet new patients, if they are not of similar age or demographics as ourselves, we can still relate them as one of our own relatives or friends.

So you think we don’t have enough ‘life-experiences’? Well, tell me, have you ever had to listen to a mother’s heart-breaking sobs in the middle of the night while she is sitting next to her dying 3-year-old baby? Have you ever had to spend two hours stitching up a battered wife’s mangled face and then watch her leave with her husband because she refused to report him despite your best efforts in counselling her? Have you ever stood in a room, watching a whole family saying goodbye to a man dying, while you are busily pumping him full of morphine because you know there’s nothing else you could do for him? Have you carefully removed a brain tumour from a patient who only hours before, had a psychotic episode and scratched, punched and spat at you? I could go on, but did you just say you were abused as a child? I have lost count of the number of child-abuse victims I have seen, but I understand everyone’s story is different. A different variation of the same……

Education has changed dramatically over the years, and this has definitely influenced Medical Schools. Standards are different, and they are different for a reason. The emphasis in medical training has changed, from purely scientific rote-learning to a more holistic clinical approach. Yes, I may have bitched and moaned about some of these changes as a teacher, but I can see why these changes needed to happen. To be honest, I don’t envy the students and trainees nowadays, an explosion in medical knowledge and technology over the last two decades has added a phenomenal amount into their core curriculum. Some of which I have yet to catch up with because it bears no relevance to my current sub-specialty. When I attended medical school, notes were written on paper, lab results were given over dial phones (yep, I am that ancient), X-rays were on films and put up on light-boxes, blood pressures were taken manually, pulses were counted with a pocket watch, surgical drills and saws were hand driven (not powered by electricity or gas). Back then, the list of diseases I needed to exclude for any presentation could be written on half a page, the number of tests I needed to do could be counted one hand and the number of ways I could treat it could barely fill a chapter in a textbook. Things are so different now, possibilities in Medicine are endless. Medical education nowadays place importance on basic core knowledge so that a graduate is not expected to know everything, but rather, to be able to pick out and apply relevant components of their knowledge to clinical situations. Most importantly, they need to know how to approach the problems and where to source the information they require. The point of today’s schooling is to generate a doctor that thinks, rather than one that relies on a checklist. So give your young doctor a chance, you might be surprised, he/she may think of another approach to your chronic problem. Something that is different to the same old thing which hasn’t been working for you.

We all know that we are getting old when we think everyone else is looking younger, especially when we see our pilots boarding the same plane we are travelling on. Commercial pilots start their careers in their late 20’s and to a lot of us think they are just kids, really. They are responsible for hundreds of lives for hours, but their age does not reflect their capabilities in getting all of us to the correct destination, safely. Why? Because of their qualifications. No airline would put a pilot at the helm of a plane unless he/she has passed all the requirements and assessments, whether they are young or old. In fact, once the pilots have reached a certain age, they have to be re-assessed for their ‘fitness’ to fly.

Some patients actually admitted to coming to me because their previous surgeon was getting old and I looked young (if only they knew!). Some do so in the hope that I have more up-to-date knowledge on new techniques, new technology or new approaches to their chronic problem. Some change surgeons because they have become concerned as their previous surgeons are deemed to be ‘too old’ to still be operating (ageism in the opposite spectrum), whilst some disliked the more paternalistic approach and ‘old-school’ attitude of their previous older surgeons.

Some older surgeons nearing their retirement have insight into their decreasing capabilities. Their eyes aren’t as sharp anymore, their hands have started to tremor, or they are now on several heart medications and struggle to cope with long cases. They cut down on the number of cases they take on as well as limit the type of operations they do. Many become surgical assistants to their younger counterparts. When I first started, I had one of the retiring Professors of Surgery as my regular assistant. It took a long time for me to adjust to giving him orders and correcting him when he is not doing something right. The nursing staff used to giggle when I would say, ‘Would you mind sewing that drain in for me, Sir?’ But it was a very happy arrangement. Prof could still get his hands dirty without the stresses and responsibilities of a surgeon, at the same time, I had instant access to any advice I needed. Not to mention the stories he used to tell as we were operating, those were gems to learn from. He would always tell me that he was not there to judge my competence, but to be my assistant for procedures I was more than capable of doing on my own.

So next time you meet a young doctor, don’t ask them how old they are, ask them what their qualifications are. And if they are just learning, give them the benefit of the doubt, because you could contribute so much to their education and experience by sharing yours with them. You never know, when your doctor retires, and when you are much older, they will be the ones in their prime, in charge of your health.

So you still want a doctor who is at least your age? Ok then, why don’t you go down the corridor and see Old Shakey next door?
Doogie Howser

* Disclaimer: Please do not take this blog as a disrespectful post to generations of surgeons before myself; I fully acknowledge the fact that their expertise could not be surpassed by myself. I am deeply appreciative of their willingness to share with me all that they know, as well as their unfailing support to me as a fellow surgeon, despite my age.

 

 

Hospital Fashion

 

*The latest fashion on the hospital corridor catwalk*

The latest fashion on the hospital corridor catwalk

Am I getting old? Am I becoming a prude? Am I behind in the fashion trends? Or am I just jealous? I am totally appalled at the attire of the female interns and medical students these days because I have had enough of skimpy dresses, mini-skirts and porn-star platform stilettos in my clinic and ward rounds. I think it is time for me to be a bitchy old female surgeon and write a fashion rule book for my young novices.

Rule # 1 Cover up

There are many reasons why short skirts and low cut tops are just not very practical when you are a doctor. Basically, there is a lot of bending over to do. In clinics, when you have to examine patients, you are constantly bending over. Now, there’s nothing more humiliating than having your undies on display or having your boobs pop out when you are crouched down to look into a patient’s throat. On the ward, when you are taking blood or putting IV cannulae in, again, you are flexing those hips and putting your bum into the air. Don’t forget, usually there’s somebody right behind you, either it be the person accompanying the patient, another doctor, a nurse or even one of your colleagues to enjoy the view of your derrière hanging out under the hems. As for those puppies in front, it is awfully distracting for everyone concerned not to stare at the deep canyons of your v-neck, or the shadows behind an unbuttoned blouse. Imagination of lies beyond those valleys has an uncanny ability to lure one’s attention. Similarly if you are sitting at the desk, short skirts ride up, and a crotch on view is particularly attention-seeking. If you cross your legs to avoid that scenario, the skirt will move up more, displaying the milky-white flesh of your naked thighs, which have a visually enticing power of their own. You want your patient to actually listen to what you are saying? It would be best if you redirect their captivated interest away from your exposed flesh.

So girls, button up, cover up and let those hems down. You don’t want to give your elderly patients a heart attack or the disinhibited psychiatric client a stiffy. Don’t be surprised if one of the 90-year-old’s in the Dementia ward sneaks his hand up your backside, or a 30-year-old in the trauma unit talk to your boobs. The only place where you are safe to prance around half-naked is in the intensive care unit, where the majority of your patients are unconscious.

Oh, and see-through clothing does not equate to covering up, especially when you wear hot pink lacy bras and thongs under a thin white dress. That’s called beach-wear.

Rule #2 Lycra is not attractive

What is the story these days with squeezing your body into clothes two sizes too small a-la-Kardashian style? Trust me, you can look amazing in fitted, tailored clothing that allows you room to move without having to suck it all in with a rigid sheath that makes you look like the Michelin man when you bend over (see? there’s the bending over again).

Tight clothing doesn’t let you move. You would be surprised at some of the positions you may have to be in when you are a doctor. Contortionists only have to hold a position, but doctors not only have to coil into positions that require expertise in a game of twister, but also perform medical feats at the same time. I had to dress a patient’s foot wound once, squatting on the floor with my head upside down. If you are ever involved in chest compressions on a patient who has collapsed on the floor, those tube skirts may not hold when you kneel over the patient with your legs apart, and the bum-hugging pants may split if you have to hunker down to secure an airway.

Also – trust me on this one – tight clothing does not constitute covering up. It can be rather revealing in faithfully outlining certain parts of your anatomy; visible thong lines, beaming headlights and camel toes are just a few things that come to mind; all of which are seriously distracting in life-and-death conversations.

And if you really think that tight clothing flatters your figure, the names whispered behind your back are usually not as complimentary. Health workers love to give each other nicknames, and I really don’t think you would want to be stuck with Dr Bootylicious in a place where you may want to advance your career in the future.

"You will not be going to clinic in that outfit, young lady!"

“You are NOT going to clinic in that outfit, young lady!”

Rule #3 Wear shoes that will save your feet and your patient’s lives

Tottering on 10 inch heels on a surgical ward round is not attractive, especially when you are trying to balance files, clipboards, gloves and your phone. Unlike physician rounds, surgeons don’t round with file-trolleys that you can lean on, and we also walk really fast, as most of us have to get to the operating theatre or clinic by 8am. So if you can’t keep up in those ridiculous shoes, no one will be slowing down for you.

A survey was done to show that 15-20km was the average distance an intern or resident has to walk during a working day. You will soon learn that one of your jobs is being able to be at 3 places at the same time. When they build hospitals, they usually try to put all the surgical clinics, preadmission clinics, surgical wards, and the operating theatres as far away from each other as possible. They also put in ultra-slow lifts that fits no more than 10 people, so you will find yourself racing up and down the stairs out of necessity. The moral of the story, wear shoes that will save your feet, because you still have a long long long way to walk for the rest of your medical career.

Wear something covered. I know some men have feet fetish and find pedicures irresistible, but having glamorous open sandals will not protect your pretty toes. Imagine walking around with vomit between your toes all day or even slipping on pee as you walk. As doctor, you will also be handling a lot of sharps, and having one of your tootsies stabbed with a fallen needle or nail ripped off by a drug trolley may just make it a rather bad day at work that you could do without.

Most of all, if there is a Code Blue (cardiac arrest), you need to run. Murphy’s Law dictates that the area where your patient has collapsed would be the furthermost place from where you are when it goes off and none of the lifts will be working. So, if you are teetering on your heels, you might as well start making your way straight to the morgue. Because by the time you have staggered down there in your stilettos, the patient would have been declared dead and bundled up into a trolley on his way for a coroner’s review.

*This is what happens when you run on stilettos*

This is what happens when you run on stilettos

Rule #4 Hospital lighting is not kind to heavy makeup

Unlike the romantic, flattering illumination of disco and restaurants, the hospital is brightly lit night and day. Hospital fluorescent bulbs do not give a warm soft glow; instead, they paint your skin in a starkly pale blue shade. It is exceptional for clear vision when one is perusing pages and pages of patient charts and examining every abnormality on a patient’s body. It is also particularly revealing for showing up every imperfection of your skin and each granule of make-up. The thicker you lay it on, the harsher it looks, until those dark eye-shadows and red lipsticks become a portrait of Alice Cooper.

alice cooper

The other thing you will learn is that lengthy days are detrimental to your facial palette. What may begin as seductive thick mascara on eyelashes and carefully layered blue shadows on eyelids will become the makings of a vacant racoon stare after 48 hours on-call. The blush would make its way down from the cheekbones to your nose, so you’ll look like you have a runny nose. While the lipstick will either be completely chewed off or will have migrated onto your teeth. Half of your powder and foundation would have rubbed off, so your forehead will be particularly shiny in the brilliant lighting. Overall, the picture becomes rather unappealing even in a horror movie.

Rule #5 There is a reason why we got rid of white coats

White is a colour reserved for dinners without Spaghetti Bolognese and Chilli Crab. White is suitable if you don’t plan to land on the ground while playing tennis, and it is definitely suitable for your wedding unless you have very clumsy relatives.

If you wear white to the hospital, be prepared for it to be used as a virginal canvas for body-fluid-art. Most colours of organic liquids go very well with white. Poo-brown is an earthy contrast to a pale background, although there can be unpredictability to the exact shade and texture depending on the source. While blood-red is always visually stunning when splashed generously, although the colour does turn coppery if left for long periods. Sputum-Green has just enough shade to make a warm pastel base whereas bile from projectile vomiting tends to veer towards turquoise; Pus-yellow can be used to enhance the warm tone of the overall canvas. The sanguine stain of Urine-gold can be a bit tricky to see on white, but sometimes when there is bleeding in the bladder, hues of Haematuria-rosé are a little bit more noticeable. These are often complimented by regular ink-blots made by the leaking pen that never leaves your hand. The beauty of this art-work is that it is eternal; no amount of scrubbing, baking soda, washing powder or dry cleaning will completely removed these physical mementos of how you acquired them.

"I told you not to wear white if you wanted to shoot people."

“I told you not to wear white if you wanted to go out and shoot people.”

Rule #6 More bling, more bugs

I do understand that these days, fashion is all about accessories. Style is almost entirely judged on how people decorate their outfits, rather than the actual garbs. Well, all I can say that you will just have to accept that doctors cannot be part of the current ‘trend’.

Some hospitals have banned ties for men – as it was found to be the main source of cross-contamination between patients. It was not uncommon to see these ties taking a swipe at patient’s groins, or a dip into a pus-filled wound. Nurses can’t wear bangles, bracelets, and rings, because no amount of hand washing will disinfect these as potential bacterial-carrying vehicles.

So, young female doctors and students, I would advise that you leave your blings, danglies, chains and scarves at home – unless you like being a free taxi for bacteria, or keen to bring your work home, literally.

Rule #7 You are not auditioning for a Shampoo commercial

Meredith Grey drives me nuts. I just don’t understand how anyone could see what they are doing with that mousy hair floating around her face constantly. You might think flicking those luxurious locks on ward rounds is eye-catching, until you accidentally smack it into your senior registrar’s face. Long hair has a lot of perils in hospitals. Like the tie, it can take a dunk into cavities where you may not want it to go. You could inadvertently tickle your patient when you are bending over the patient (there it is again!). It could get caught on bed rails, IV poles, monitoring lines and plaster saws (yep, seen that happen). When you are doing a procedure, hours of preparing a sterile field can be instantly swept away with your hair. Bangs and hair in the eyes can also be detrimental to your vision, which may not be so helpful when you are placing fine stitches or handling fragile body parts.

Tie those loose alluring locks away from your face, ladies – you may find it disadvantageous to your modelling career, but at least it will save your day job.

"Maybe if I cut my hair, people will think I am a real doctor."

“Maybe if I cut my hair, people will think I am a real doctor.”

Now I know these rules are harsh, and I am not aversed keeping up with what’s in vogue. I am as much into the latest trends as the next fashion-conscious female. I am not advocating dressing-down either, as crack-showing skater jeans and ripped off-shoulder T shirts are not exactly confidence-inducing attire for the sick and injured. There are ways to look beautiful without being inappropriate, it is about retaining your individuality in the role you have picked to play in society. You have chosen to become a doctor, not a model, not a tart, and definitely not a hooker.

Just remember, the hospital is not a night-club. You are not going on a date (and if you are, it is rather sad you are having it in a hospital, so get a life!), neither are you selling your ‘wares’, and advertising your ‘goods’. If you are dressing up to snare a rich doctor husband, you would be setting your trap for the wrong kind of men. There are plenty of playboys in the medical faculty, as there is definitely no shortage of male doctors who think they are God’s gift to women. These ‘hot’ charismatic egomaniacs are more interested in the junk in your trunk and the boobies in your bra than your personality. They are more concerned in accumulating notches on their belts, and having available booty-calls on speed-dial, than learning about your aspirations. You would be mistaken if you think by attracting their attention, they will be willing to marry you/help you get the job you want/get you out of trouble/recommend you for a promotion.

I am not suggesting that we should masculinise our appearance, but there are ways of being feminine without flaunting ‘sexuality’, and being gorgeous without over-embellishment. Dressing elegantly in appropriate attire will go a long way to instil confidence in your patients. Your seniors will take you seriously and be more than willing to share their knowledge with you. It will not upset the nurses (who are stuck in unflattering uniforms with colours that make them look like tampon packages), and draw attention away from those higher up the ladder than yourself. And believe it or not, professional dressing will actually make you sound smarter than you really are. You want the men to stop ogling at you; you want them to look at you in awe.

So, Ladies, save your reputation, your career, your feet and your patient’s lives. Next time you pick your apparel for work, channel classics such as Jackie Onassis, Audrey Hepburn and Grace Kelly.

JackieOnassisAudrey HepburnGraceKelly

 

Music in the Theatre

Another One Bites the Dust

Most days when I am operating, I choose a playlist on my iPhone and plug it into the speaker. I don’t have it on particularly loud, but I do have it playing, as to create background noise. Silence can often convey tension, and I find people work better together when everyone is relaxed. Often, patients will comment on the background music as they are being wheeled into the operating theatre, and some appreciates it as it takes their minds off on what’s to come. Sometimes I use it as a topic for conversation, to distract the patient as he or she is going to sleep.

My playlists consist of a wide range of music. I remember trying to load up my husband’s iPhone with music a few years ago, so he too can play music in the operating theatre. I asked him what he wanted on it. He told me whatever I want. The next question that came out of my mouth was, ‘Do you want something you like, or something that’s cool?’ It took me a while afterwards to realise why he was sulking.

I have lots of playlists. One for early in the day, all calm smooth jazzy stuff, then one full of pop and lively tunes for the afternoon. I even have a playlist called ‘closing music’, just something to put on when I am finishing up a long case – the first song being ‘We gotta get out of this place’ by The Animals.

Lately, the shuffling on my playlists seems to have a life of its own, with very bad timing. Just a week ago, I noticed my patient’s eyes look at me in horror as he was going to sleep. I couldn’t work out what was causing his distress until I realised that the sound system was softly playing Led Zeppelin’s ‘Stairway to Heaven’. It was not the first time in the last month that my playlists have shown impeccable timing and bad taste. Because the week before, Queen was blaring ‘Another One Bites the Dust’ as my patient was being wheeled into the operating room.

So here I have compiled a list of songs that should not be played when patients are about to have surgery. I have erased them from my work playlists.

Knockin On Heavens Door – Guns N Roses and Bob Dylan

Tears in Heaven – Eric Clapton

Dancing with Mr D – The Rolling Stones

Kill you – Eminem

Ready to Die – The Notorious B.I.G.

Great Gig in The Sky – Pink Floyd

If Tomorrow Never Comes – Ronan Keating

Killing Me Softly – The Fugees

Now if anyone else can think of any other inappropriate songs that they may not want to hear as they are being put to sleep, please feel free to add to the list.

 

 

 

 

10 Things I Hate About You – Part II

10things5

Well, when I wrote the original ’10 Things I Hate About You’, I actually had no intentions in writing a Part II. However, as hubby pointed out, it was totally unfair that I got to vent all his less-than-appealing traits to the public without any input on his part. He felt that since he didn’t get to defend himself, everyone should know about the things he hated about me; our’s being an equal relationship and all.

Hang on a minute. As far as I was concerned, he loves everything about me. Absolutely everything. I am flawless, perfection itself, and can do no wrong.

Well, wasn’t it a reality check when he unceremoniously handed me this list.

1. You are permanently attached to your phone.

Ok, I need to be contactable at all times for my patients. You should understand that, you are a surgeon yourself. So what if I occasionally use it to check my Facebook, Instagram, WordPress, email and maybe crush some candies. I can’t NOT have it on me! What if a patient desperately needed my advice after surgery? And what if I missed out on my best friend posting her latest hot date on Instagram? I may need to give a life urgently on Candy Crush. It’s life-saving stuff, this little phone and all that it conveys.

2. You don’t know how to say ‘No’ except to me.

That’s a bit harsh. I can’t always say yes to you, otherwise we would permanently be stuck in bed. You know you might actually have an issue, the number of times you ask for it, maybe you should seek counselling or something like Mr X-files in Californication. Oh, what? Oh, you didn’t mean that? *Blush* Oh, ok. Yeah, you are right, I just can’t say no to people. It’s just one more patient to add to the list, one more favour to do for a colleague, one more committee to join or one more meeting to organise. I know it takes up too much of my ‘spare-time’ *insert sarcastic laughter here*, but I am just trying to help out. I don’t always say ‘no’ to you. I mean, you don’t really need me to cook dinner for you, do you? There’s Lite’n Lazy in the freezer that you can pop in the microwave if you are hungry. You do know how to operate the microwave on your own, right? How about some take-away? Just look it up on google and dial it on your iPhone. I am sure you will be able to find a present for your mother’s birthday – you don’t really need me, it’s not as if she’s liked anything I’ve given her in the past. It’s just that other people really need me, and you are so capable, darling.

3. You are always rushing me

Well, if you don’t always drag your feet whenever we are heading out, or take so damn long getting ready, I wouldn’t be rushing you at all, would I? If you would just spend one minute less admiring yourself in the mirror, and stop practising your Blue Steel, I wouldn’t have to scream at you to hurry up.

4. You don’t like my friends

You don’t like my friends. So we are even. You think my friends are opinionated, loud, and coo-coo. Well, let me tell you, your friends are narcissistic, chauvinistic and appreciate the wrong things about women. Yes, I know all about the tits and bum scoring system that you and the boys whip out on your nights out. And I don’t even want to know where they take you during those escapades.

5. You don’t find my jokes funny

I know, I am sorry I may have misled you. I used to laugh at your jokes when we were dating. I was being polite, and I wanted you to like me. Then, when we were past the dating stage, I just didn’t want to hurt your feelings. Now, I really just don’t find male stupidity funny. And you have to admit, the quality of your jokes have deteriorated from our dating days. You weren’t exactly telling me the types of jokes you are relaying to me now. No, I definitely don’t remember the words ‘boob’ or any references to the male genitalia in any of the jokes you told me all those years ago.

6. You don’t listen to me when I am talking to you

Sweetheart, let me know tell you something about women. We multi-task. Yes, it may seem as if I am not listening to you when I am texting on my phone, reading a post on Facebook, watching TV or ‘working’ on my computer, but in actual fact, I have been listening to you. I may not respond – usually because I don’t really like what you are telling me, but trust me, I heard you. I may make sympathetic noises, which I know annoys the crap out of you, but that just means you are ranting and raving about something totally inconsequential again. You do realise that you talk at me and not to me sometimes, especially when you start a tirade about some political issues in the paper. You would raise your voice, get all hot and bothered, and then you look at me as if I was the culprit causing all the trouble. What do you want me to say? I am sorry for everything that the Australian Labour Party has done?! Trust me, Hon, I am listening. I heard you the first time, as well as the second, third, fourth and fifth time.

7. You can’t sleep in and that means I am not allowed to sleep in either

You always complain that we don’t spend enough quality time together. Well, having breakfast together is quality time, right? I mean, if you want to spend as much of my waking moments with me, then you need to get up when I do. There is no point me eating on my own at 5am on a Sunday morning, if you ate with me, you could talk and I promise to listen.

8. You fall asleep at the dinner table

Trust me, this takes talent. It’s not easy to snatch speed naps in between courses. You should know better than to book an 8-course degustation menu at the 8.30pm sitting. By the time the dessert arrived, it was midnight. I am getting old, if you haven’t noticed; I am usually passed out with my glasses around my nostrils by 9pm. So if you want me to stay awake for dinner, you better feed me at nanna time by 6pm. Or clear my schedule for a nanna nap in the afternoon so that I can be prepared for a big night out.

9. You count my drinks

Ok, this is easy. There are a multitude of reasons I don’t like you drinking. You have a strong family history of alcoholism. You use it as an excuse to get out of driving (and you know I hate driving in the dark). You have very posh taste in alcohol – you would have nothing but Moet, Grange and 18 year plus single malt whiskey. You can tolerate such a huge amount of alcohol (thanks to your Eastern European genes), it gets rather expensive when we go out. You are a terrible drunk. You go straight from sober to the funny drunk with no warning. And you know exactly how I feel about your jokes when you are trying to be ‘funny’. The funny drunk stage only lasts for 10 minutes before you become the sleepy drunk, or rather, the unconscious loud-snoring drunk who obviously has issues with his own airway, because the snores are regularly punctuated by convulsive thunderous snorting when your addled brain reminds you to breathe. And you wonder why you find yourself sleeping on the couch the morning after.

10. You break the Fart Trust

Just give me a minute to explain the Fart Trust. The Fart Trust is the ultimate form of trust in a marriage. The problem lies in the fact that you and I have very different definition of the Fart Trust. To me, it means that you own up to your fart. To you, it means that you warn your spouse before you fart. Now, I understand you have issues with my ‘silent killers’, but I am a lady after all, and I don’t go around letting it rip loud and clear like you blokes do. If you asked me, I would gladly own up to my own farts but I don’t see why I have to verbally announce them.

 

So there, I do hope you feel better now that you have exposed my unappealing side to the public. Maybe it’s not fair that I get to defend myself with your list, but Hon, this is my blog. Get your own if you think your views have been poorly represented.

Oh, and of course,I love you too.

My Other Half

Anaesthetic

A surgeon is incomplete without an anaesthetist. I cannot perform surgery without one, I cannot concentrate on what I do without knowing that there is someone looking after my patient. A surgeon and anaesthetist are like husband and wife, yin and yang, each half of a twin, right and left hand……

The success between a surgeon and an anaesthetist is based on complete trust. The anaesthetists trust us not to harm our patients during an operation and we have implicit trust in them to keep our patients alive and stable while we perform the necessary tasks. As much as we love to be-little each other in jest, we are completely cognizant of the fact that we couldn’t do without each other; as I said, like an old married couple.

Often, conversations flow during a procedure, particularly long operations. This could range from clinical discussions, to personal relationships. These conversations are like those when one is lying in the dark with one’s best friend, where deep personal thoughts are said out loud, and honest responses are given. These earnest dialogues take place over the top drapes separating the anaesthetic corner from the surgical field. – so-called ‘blood-brain barrier’ – because the anaesthetists are the ‘brains’ or the smarter doctor (so they think) and we are often jokingly known as the bloody butchers. It is not uncommon to have my anaesthetist’s head peering over this drape, reassuring me when I become hesitant in an operation, comforting me when I lament on difficult patients, encouraging me when I am struggling with a particularly challenging procedure, and humouring me when I rant and rave about injustices in my personal life. But not all of our verbal exchanges are serious, often well-aimed insults are fired regularly across the patient, in an attempt to evoke witty repartees.

Last week, I lost my anaesthetist. She wasn’t just my other half, but she was my friend, my confidant, my rock, and part of my life. We started our careers in private practice together, we supported each other through some difficult times in our profession, and we shared many stories, experiences and challenges in our personal lives together.

It is difficult for me to accept that she is gone from my life. She was like a pair of comfortable old shoes, someone who knew me, someone I didn’t have to pretend with, an old friend whom I could just pick up an old conversation where we left off a week ago. Her sense of humour and directness fitted my moments of moodiness, her logic and reasoning soothed my indignant outbursts. She gave me sympathy when I needed it and empathy when I got frustrated.

She put my patients to sleep safely and efficiently, many times anticipating what I required in the anaesthetic without asking me. She never doubted my judgement or questioned my requests; she knew when to speak up and when to pipe down. She knew that in times of emergency, the last thing I needed was to have to spell out specific instructions to her, whilst trying to deal with my own stresses.

She had traits that frustrated me, and yet made me laugh at times. She had no sense of direction. Sometimes I would walk past her on my way back from the recovery unit, and see her wandering towards the change rooms. When I asked her if she was going off on a toilet break, she would say she was heading out to see the next patient in the holding bay (which was in the opposite direction). It didn’t matter that she had been working with me in that theatre complex for the last 5 years, from time to time, I still had to physically steer her towards the correct corridor, and the right direction.

She had a thing about firearms, which was amazing considering the fact that she was from South Africa and was given her first pistol at the age of 18 as a birthday present. When I took her to the local gun club to trial clay pigeon shooting, she was nervous and afraid, she pulled the trigger even before the clay pigeons were being flung! There were a few holes in the walls of the trap house where her gun was pointing at. At the time, even though we both laughed so hard at her inept attempts, I was particularly proud of the fact that she overcame her fear to give it a go.

One of the things I admired most about her was her ability to do as she pleased without worrying what others thought of her. She didn’t care about unflattering photos on Facebook. She didn’t mind dressing up as the dorkiest bride at a friend’s party celebrating Prince William and Princess Kate wedding. She tried everything and anything without judgement and reservation. She did her best for the patient even if it meant hassling or inconveniencing other colleagues. She did what was right even if it meant she had to take the long way round or spend extra money. She talked about her life and her opinions openly, without fear of being judged for what she believed in.

She was generous. And she was considerate. She bought me a pair of expensive padded theatre shoes because I was complaining of shin splints and calcaneal spurs after being on my feet 18 hours a day. She ordered coffee for everyone in the operating theatre whenever we were having a particularly long day. She would tell me to un-scrub and take a break if I was doing a long case.

She treated everyone the same. She knew all the anaesthetic nurses’ family members by name. She never failed to ask about their pets. She would treat the orderlies with respect, and she would tell me off if I had inadvertently offended her. She spent the time and energy teaching new nurses and technicians, and she would patiently explain her particular preferences even though she had been working at the same place for the last five years. She gave her best clinical skills to the thief who came into the emergency theatre after crashing a stolen vehicle, and to Nelson Mandela when he had eye surgery in 1994.

She was passionate. She loved the wild, and her homeland. She travelled to South Africa regularly to visit her family, and to spend time at her beloved chimpanzees and gorillas reserves. She was forever posting links about wildlife conservation and the cruelty of game hunting. She was constantly reminding us not to become complacent in protecting species that were less fortunate than us in protecting themselves.

Most of all, she was prepared. One could never pull the wool over her eyes. She saw reality as it was, life and death as it happened throughout her career. She saw cancer patients younger than her daughter, and accidents that changed young men’s lives forever. She and I often lament about how life is too short to bear grudges, to hold back and to be afraid. She wanted to protect those she loved, as we all found out when she passed. She had prepared an envelope for her most trusted closest friend, just for an unexpected time such as this. Her affairs were organised down to the last detail, and her will was legality iron-clad with no contestability. The fact that she took such pains to stipulate everything as the way she wanted, not the way she was expected, showed that she was a realist, with the foresight and consideration for those around her.

She was 59. One year short of the big 6-0. She didn’t look her age, because she lived her life with the enjoyment of someone who was experiencing everything for the first time. She was taken away from us too soon. Too unexpectedly. We are all still in shock, as to how it could happen to someone who was so full of life.

I am finding it difficult to grasp, that she is now gone.

When I walked into my operating theatre today, you weren’t there. Even though I went through the motions and completed my list without a hitch, I felt lost.

I felt lost because you weren’t there.

So I cry, because I know you will never be there with me again.

 

Stalker #1

stalker 5

When I was a young resident working in the Emergency Department, a young Japanese sushi chef was brought in by his friend because he had sliced his fingertip off. Ok, everyone please refrain from making jokes about fingertip sashimi….. ‘Hmm hmm, but I would imagine it would be quite tough, especially with the nail’. Stop. It. Right. There.

I digress. I was assigned by my senior registrar to ‘patch’ him up, during which, I tried to make polite conversation to take his mind off the pain I was inflicting. He told me about himself and how he had only arrived in Australia 12 months ago. He told me about his restaurant, which I realised was the new one that I drove past everyday on the way to work. He asked me whether I cooked or if I preferred to have someone cooking for me. It didn’t take long for me to realise that Mr Sushi Chef was trying to chat me up. He asked me if I liked Japanese food, and I said I did. His friend (or ‘wingman’) beside him then said that my patient was ‘a very good sushi chef’. I nearly rolled my eyes, and refrained from commenting the obvious: he was so good at it that he sliced his fingertip off. I caught evil smirks on my nurse’s face as she turned away to get some equipment, which left me no doubt of the fact that this story would be doing the rounds as soon as we have finished in the procedure room.

After I have dressed his finger, given him instructions and antibiotics, I said my goodbyes (whilst trying to push him out the door) amidst his effusive gratitude. He then invited me to his restaurant for free sushi. I politely declined, but he insisted, so I just made some very non-committal noises to get him off my back. Mistake Number One.

The whole incident was forgotten a few days later, after everyone have had their turn at making a joke on my behalf about being hit on by a Sushi Chef who sliced his fingertip off with bits of raw fish. Yes, yes, I have heard it all, in all variations.

Until a week later, when a platter of sushi was delivered to our emergency department with a thank-you card, one that not only had my name on it, but the name and address of his restaurant, with his personal mobile number. Despite another round of jokes at the expense of Mr Sushi Chef’s sharp knife skills, (‘hey, Tiff, is that some finger pulp I see in your sushi.’), the platter was devoured within 20 minutes by everyone in the department. I had to admit that the sushi wasn’t bad at all.

When I left my shift that day at 10pm, I headed out the staff exit next to the ambulance bay. As I closed the door behind me, I saw a shadow from the corner of my eye.

‘Dr Tiffany, I have been waiting for you.’

I spun around and nearly got the fright of my life. It was Mr Sushi Chef. I frowned at him; the exit was a restricted staff area. Unease flooded me. I took out my badge, in case I needed to make a quick entry back into the department. He asked me if I enjoyed the Sushi he sent in the afternoon and that whether I had his number. I politely thanked him for the platter and told him that it was unnecessary. I decided against telling him that I wasn’t interested considering I was alone in a dark alley with him. I wasn’t too sure what he would do if I turned him down. I tried to make polite conversation with him, during which I found out that one of the receptionists had given him my finish time and my usual routine. He asked me if I wanted to go out for a drink, but I told him that I was tired and had to do an early shift the next day. He asked me to come into his restaurant tomorrow after my shift, and refused to leave until I agreed. So I did, and breathed a sigh of relief when he left. I quickly headed towards my car in the public car park and drove home. Mistake Number Two.

The next day at work, I rang the restaurant and breathed a sigh of relief when one of the waitresses picked up. I left a quick message to say I would be caught up at work and cancelled the dinner. I then went to see my supervisor and told him about the incident. It wasn’t my intention to get the receptionist into trouble, but I was concerned that next time, it wouldn’t be something as harmless as a persistent admirer.

Or so I thought. Flowers started to arrive. By now, the department was in an uproar of jokes. It did not matter that I was known to be in a long term relationship with a fellow colleague already (my current husband), everyone thought it was very sweet. By the end of the week, I had to write a note to him, thanking him for his gestures, explaining that it was unethical for me date a patient (I didn’t point out the fact that it was ok if the doctor-patient relationship was already finished), and that I was already in a relationship. I told him that he was very sweet, and some girl would be very lucky one day. Blah, blah, blah. I tried to make it as gentle as possible (if any rejection letter can be considered as such), and then I sent it to his restaurant. Mistake Number Three.

The flowers stopped.

One early evening, two weeks later, I found him waiting for me by my car in the car park. The first thought that hit me was how long he must have spent walking around the eight –storey car park to find my car. Secondly, how the hell did he know which car was mine?! In between those inane thoughts, I considered turning around and running back to the hospital, but at the same time, I realised he had already seen me. He was much taller than me, and It would have been no contest for him to outrun me in my kitten heels (I was on my way to meeting some friends for dinner). I slowly approached my car, but stood a few metres away from him.

He told me that he just wanted to speak to me, because I had broken his heart. I said that I was already in a relationship. He then said that I couldn’t possibly be happy in my relationship, otherwise I would have turned him down the first time and that he wanted me to be the lucky girl I mentioned in my ‘love letter’. He said that he waited for weeks by his phone for me to call after he had received the letter. The letter was a sign that we were star-crossed lovers like Romeo and Juliet. He was approaching me slowly as he spoke. It was at this point, I realised that I was dealing with a slightly deranged individual.

I had slowly manoeuvred myself to the car door, so I told him that I really wasn’t interested. He stayed still, but smiled at me knowingly as he watched me getting in the car. He said loudly just before I closed the car door that he already knew where I lived because he followed me home that first night. I told him that his persistence will not change my mind and he could follow me all he liked, because I was heading out for dinner with friends. When I arrived at the local pub, I was shaking so hard, I had to sit in the car for 20 minutes before I could join my friends.

The next day, some dead roses arrived for me, and a card declaring that I broke his heart again last night. This time, there were no jokes being bantered around. I had another meeting with my supervisor. I was to car-pool with a male colleague to and from work. There was no shortage of volunteers, as everyone knew my partner was seconded to the Emergency Department at Port Hedland Hospital over 1600 km away and I was living alone for 3 months. Many nurses offered for me to stay with them for a few weeks. Our emergency department trained the medics for SAS (Australian Special forces), so often, one of them would either offer me a lift home or to walk me and a colleague to the car.

One night, one of the SAS medics, Theo, drove me home. He had been assigned to me for 8 weeks and I had just spent the week making him efficient in stitching up wounds and putting in IV lines.  In return, he had driven me home for the last three evenings in a row. He lived at the barracks one suburb away from mine. When we arrived at my place, he pointed out that there was a brown Holden Gemini across the road which had been there the night before. I knew it wasn’t any of the neighbour’s and told him so. To my surprise, he got out of the car and walked to the brown Gemini. I called him back, but he just waved me off and told me to stay put. Yep, ‘stay put’ like I was one of his little soldiers.

He tapped on the window. While I watched him, bending over and speaking to someone through the window, all sorts of horrible images went through my mind. I could hardly hear anything as neither voice was raised. I clutched my phone and thought, what if he got stabbed, or worse, shot? I started to get out of the car, hoping to physically pull that 220-pound pure muscle mass away from danger. However, as I shut the car door, I saw that he had already turned away the Gemini and was walking back towards me.

‘Was it him?’ I asked. Theo nodded and signalled for me to stay quiet. He took the house keys from my restless hands and pushed me towards my unit. I imagined Mr Sushi Chef’s beady eyes looking at us, and almost felt my back glow with heat.

Theo shepherded me into the house, and quickly went around the lounge to switch all the lights on. He then opened the blinds at the front window and stood in full view of the street. I imagined he would have made an impressive shadow in my window frame. Whilst looking out at the car across the road, he took out his mobile phone, dialled a number and put it to his ear. A second later, I heard the brown Gemini splutter as its engine ignited. It headed off with a squeal down the road.

When the car disappeared from sight, he put his phone back into his pocket and lowered the blinds. ‘He won’t bother you anymore,’ he said, ‘but you can come over and have dinner with us. Stay the night if you are worried.’ At the word dinner, his eyes took on a glassy appearance, ‘I think Mandy is making curry tonight.’ Thoughtful silence followed. ‘The baby will probably keep you awake all night though.’ He winced at his own words.

I politely turned down his offer. Despite knowing his wife was an excellent cook (as evidenced by the incredible lunch boxes he brought to work everyday), crying babies was definitely not an additional enticement to his offer.

‘What did you say to him?’ I asked curiously.

He shrugged. ‘I told him I was a security guard and that if I saw either him or his car anywhere near you again, I will call the cops. I told him I knew his number plate, his phone number and his restaurant, which I will give to the cops. After which, he might get fined, or go to jail and he would lose his restaurant.’ He helped himself to a glass of water from the tap and sat down on my lounge.

I followed suit, glad he wasn’t leaving yet, and laughed at him, ‘That’s not true and you know it. The cops would have just ignored us.’

‘He doesn’t know that, he has only been in Australia for 12 months,‘ Theo winked. ‘Anyway, all the chefs are the same,’ he would know because his brother-in-law was a chef. ‘The restaurant means more to them than anything else in the world, they wouldn’t do anything to put it in jeopardy. And my guess is that he’s not even a permanent resident, so he can’t afford to get in trouble with the police.’

Theo was right. Despite the fact that we car-pooled together for another month, Mr Sushi Chef was never to be seen or heard from again.