life

How I Cured My Bald Patch.

In my previous post I mentioned all my hair fell out from stress.  It was thin and breaking and terrible and when I finally fronted up to my horrified hairdresser, she loaded me up with such good advice, none of which involved buying overpriced products from her salon.  I originally thought about titling this ‘How to cure a bald patch’ but seeing as this only worked for me, and to prove that something works you have to prove it in well over a hundred people, get it peer-reviewed and then published, I thought I’d give you my anecdote instead.

First – exercise, food, vitamins.  Everyone needs these.

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My hairdresser told me to take silica and fish oil, or alternatively, eat fish.  So I did.

Then she told me to put organic coconut oil through my hair before washing it and leave it in for a while.  I don’t think there’s a hard and fast rule about how long.

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It smells amazing!  I use it as a moisturiser, instead of butter in cooking (if you don’t mind the coconut flavour) and for frying.

She also told me to keep putting treatments in my hair.  She didn’t care which ones, and didn’t try to sell me any.  I got a sample of Terax Crema from Adore Beauty and haven’t looked back.

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I think they’ve changed the packaging now, I hope the product itself hasn’t changed.  I only wash my hair twice a week because all of that is such an ordeal but it’s looking a million trillion times better and I love my hairdresser all the more for giving me a half hour long lecture on looking after myself and eating right.  I wish healthcare was more focused on wellbeing.  I’ve always said that if I don’t make it through my physician exams, then I’m becoming a GP that incentivises good health.

The most important thing to get my hair back though, was relieving stress.  Some stressors I couldn’t change (like my job or location) but some exercise here, some good food there, and the knowledge that ‘this too shall pass’ got me there.

As did my Yoga Studio App!  If you’re like me and would like to fall out of poses in private, then this one’s for you.

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It is hands down the best Yoga app out there – I even took it to the park and fell out of poses in public I love it so much.  Great to do right after a run.

I’m happy to report that with all that on board, my hair started growing back, and my bald patch is now covered in hair.  Short and cowlicked hair, but I don’t mind at all.

Phew, enough posting for one day I think, time for some more study >__<.

And while I’m procrastinating…

Did I really not post since last September? Let me catch you up on the last year:

  • I started physician training.  (For those not familiar with the system, when you finish your internship and residency, you often then thinking about the pathway you want to do: surgery/physician training/obstetrics/general practice/anaesthetics and so on.  Physician training is what you do to become a medical specialist something, don’t ask me what yet!)
  • I spent six months at The Regional Hospital From Hell.  It wasn’t all that bad, but it was really really hard.  Like, you pick up the phone 24 hours a day for 7 days a week, every three weeks, for four hospitals spanning a large country region.  And you deal with questions like, chopper or ambulance?  And you keep your cool when people call you at 3am for a medical issue not even remotely related to your specialty because they don’t want to wake up the right person who is known to not keep their cool and figure since you’re so junior, you’ll just say yes.  You come into work for all seven of those days too.  The sleep deprivation was a bitch.  As was seeing my husband once a week (when I wasn’t on call).
  • Lots of my hair fell out from the stress and I discovered a bald patch! I have the best hairdresser ever though, and it all grew back.
  • I made some new friends in my new network, and started working at my new home hospital which is great! I found a lovely study group…now to just err, study (more).
  • I stopped being vegan because it was too hard, I realised that the population examined in Forks Over Knives (i.e. I’m not an overweight type 2 diabetic who required bypass surgery) and there’s some great evidence for The Mediterranean Diet.  So rather than treat myself for something I don’t have, I switched over to preventing something that I may easily develop.

In short, life has been boring for a blog, but exciting for me.  Interesting election huh?  I wasn’t surprised by Tony Abbott winning it, and I got a sausage AND a cake at my local voting station.  What have you been up to?

Tears in Rain

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It’s after hours. I’m doing one of those famed fifteen hour shifts where you don’t sit down. The cardiology fellow is on the phone telling me he’s sending someone up from the cath lab, they’ve just had emergency intervention for their massive heart attack. ‘We couldn’t get access,” he’s telling me, with that calm sense of urgency, “and that femoral sheath can’t stay in – can you have a go when he hits the ward? Otherwise call anaesthetics to do it”.

I tell him I’ll have a go, and wander up. Something about the impossible lights my fire, it doesn’t matter if I can’t do it. I wander into the patients room, his family are all there, I ask them if they wouldn’t mind stepping out. I happily go about setting up, cheerfully miss my first attempt, tell him I’ll have one more go then I’ll get the anaesthetist…and then I notice the tears streaming down his cheeks.

“I don’t know what happened”, he’s saying, “one minute I was mowing the lawn…”

He stops and looks at me. “I nearly died didn’t I?”

I nod, pull up a chair, and hand him a tissue.

“You’re here now” I tell him, “that’s all that matters really”.

“Life is so short”, more tears stream down his cheek “so short”

We talk. I could almost see his whole world changing before his eyes. Everything he held true evaporating. I repeat that all that matters is that he is here, and that he gets to keep going. I tell his family to come back in. More tears. The cardiology nurse comes in and tells him that his kind of heart attack is known as the widowmaker (yes, we really do refer to it like that!) His family looked stunned, they don’t know what to say. After all, it was like any other day – Dad was just mowing the lawn.

The guy has lots of risk factors. A little bit overweight, drinks on the weekends, smokes a bit, all seemingly benign enough, all completely insidious. I don’t need to point this out. He’s already talking about never smoking again. Watching people come to realise that how their body works is so much more important than how it looks is one of the best parts of my job. No one ever really listens to their doctor. I can tell people how to live and they’ll smoke, drink, and eat too much fat. You have to realise what’s bad for you for yourself.

I get the line into his foot. Less than ideal but it’s a big one and I know the cardiology fellow will be happy. And I know this guy will live. Watching people get to live is the best.

Conversations in strange places

It’s 7pm. I’ve hung around at work well past finishing because I have a dinner date nearby and I’ve just finished up in critical care. My friend whose on until 11pm and I are sitting at the nurses station talking about life and science fiction, future plans. In the background monitors are alarming, sounds I hear as I fall asleep at night now, ringing in my ears, reminding me that medicine never sleeps.

My friend is brilliant. So keen is he to become an ICU specialist, that he has taken responsibilities far beyond the rest of us, and been rewarded with skills and knowledge that far outstrip my own. He’s waxing lyrical about laterally thinking your way through a nosebleed in a bleeder (a sick patient prone to bleeding too much), I’m having one my regular crises of confidence, the uncomfortable result of being part of a specific minority in med school that all too slowly is disappearing Right in the middle of my crisis of future failures he lands it on me.

‘Make your worst performance the best on the day’. My fugue is broken – and he explains that as the result of being forced to do high-level music for his entire life (that he says is specific to his cultural heritage), he had to take nerve racking performance exams yearly. For his whole life. That he met with prospective failure, and sometimes the reality, so often that he learned this valuable lesson. His father explained that the more you practice, the more our bring up your own worst performance, that if on the day you choke, you drown in anxiety, that even if you give your worst performance, it will be the best performance for the day.

It was one of those moments in life where you feel your mind undergo a massive correction, that ‘aha! I understand what I need to do now!’ moment. Where self doubt evaporates and is replaced with motivation and interest. Your baggage can cloud a lot for you.

In the background, a new patient is wheeled in, intubated, an unfortunate survivor of a horrific accident. More alarms. One of the nurses asks another if they want Chinese takeaway for dinner. One of the seniors wanders past and reminds my friend that a new patient has arrived, does he want to put in some lines?

We say our goodbyes, I thank him, and as he walks away he says, ‘us good people have to stick together you know’.

I swell up with pride to be counted among his own.

Fortune teller

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Every now and again we come to a time where we make Big Choices. A career, get married or don’t get married, have kids or don’t get kids, dedicate your life to becoming an astronaut. For a lot of people this happens in a nice linear fashion, go to high school, university, get a job, progress through job, maybe get married, maybe have kids.

It’s come time for me to choose a career path within medicine, except that it’s medicine which at times feels pretty much synonymous with ‘cult’ in terms of how much it takes over your life. Less helpful is the platitudes of ‘you should choose x, it’s good for women’, where x is something like general practice, or psychiatry. Such a loaded statement! ‘Good for women’ automatically implies that you are the primary carer, that it is your responsibility to choose a career, not in something that you’re in interested in, but that is appropriate for your station. Meanwhile it feels like all the guys are becoming surgeons because they feel no such pressure. Never mind the rest of us who really loved their surgical rotations and could really do that job for life, and be good at it.

It’s not the ‘good for women’ part that puts you off in the end though.

Imagine getting up at 5.30am for a 7am start every day. Now imagine that while you’re at work, you’re not allowed to sit down. You have to stand or walk every minute, all day. You might get a sit down for ten minutes at lunch before getting back up again. Now imagine your boss expects you to manage all your clients externally, and attend all the meetings and keep them happy without their input, that your performance is based on this. When you do see your boss for your internal client meetings, he stands over you and questions your detailed knowledge on everything, and consistently points out what you’re doing wrong for the hours that you are together, still standing by the way. Praise is rarely, if ever, delivered.

This picking and testing happens every day, for at least 12 hours a day, along with the standing. After your meeting with your boss, you go and check on your other clients, your patients, where you learn that one tiny mistake in theatre, one moment of exhausted distraction has resulted in someone suffering a surgical complication. Maybe you had an off moment, maybe you didn’t want to be at work that day, that you wished you could chuck a sickie – except that if you did that, everyone else’s day would then blow out to 24 hours and people who’d been waiting months for surgery would get delayed again. Whatever your moment, you’re painfully reminded that there is no margin for error, no room for an off day. And by the way, you’re on call this weekend, for it’s entire forty eight hours, where yes, you will be required to stand, and yes, you will get called in 5pm Friday and not get home until midnight Sunday where your regular working week will start anew. And you have a lazy intern who hasn’t done anyone’s paperwork so as well as checking forty inpatients (think forty client meetings in one day) you have to write a bunch of discharge letters, and get into theatre with your boss where he will lean over you, test your knowledge relentlessly and tell you everything you’re doing wrong. Until 2am.

So maybe you love surgery, would be a great surgeon, but would you put yourself through that for the next 6 years of your life? Forget your future kids, would you want that for yourself? In medicine, things like prestige and money fall away for most of us in the face of what we want from our lives. What we want from our day. We are always told ‘look at the life your boss has’ when choosing, and decide if you want that. Then you have to fit relationships, kids, and friends and anything else that’s important into that.

I read an article a while ago written by a pediatric heart surgeon who said that while it was nice they were so well celebrated and had achieved so much, that in the end it wasn’t worth it. They’d missed out on friendships, relationships, and woken up with all a whole lot of prestige and not a lot of anything else.

These lessons can be applied to any career, not just medicine. I’m still in the process of choosing, of working it out. I have an idea of the direction, but it’s the details, it’s the cult of medicine that gets me. Who knows if it will work it out?

Sometimes you just have to pick something, give it a red hot go, cross your fingers and hope the rest of your life fits in. The universe will always conspire to help the dreamer.

My Ecology

You died. You bloody died! You weren’t supposed to die. You were supposed to be the part of the story where I learn the true magic of modern medicine, the Saving Lives dream come true. But you died.

My history of you begins with the bat phone. It’s really called that. Loud important noises go off, the two way radio gets picked up, the story begins. An electronically transmitted ECG appears on the screen. It’s bad. It’s real bad. My registrar tells me to go to the resus bay and I busy myself setting up stuff to put a line in and get blood. Needles, tubes, alcohol wipes. And then you’re there on a stretcher, eyes wide open, scared. You’re barely moving. You’re talking two words at a time. People are everywhere, fussing with breathing gear, setting up for an ECG, attaching you to monitors. The boss is shouting orders. I shout back that I’ll get a line in. My reg leans in and says “are you sure can do it fast?”. I nod yes. It’s automatic. Immediately I doubt myself, I’ve only tried one line this large before and it was such a horrible painful failure that I never tried again. But this time it’s different. The line goes in immediately.

We push in fluids, the cardiology team arrives, time for you to go upstairs. Upstairs. The magic life saving place that is the cath lab, where truly broken hearts get fixed and where you’re supposed to live. You’re only young. Your wife and daughter appear as you’re being wheeled away. The boss stops the bed moving for a minute so they can have a moment. An eternal moment. I watch from a distance as your wife sinks into a chair and your teenage daughter stands there blankly. And then you’re wheeled away. Wow, I think. Wow. To be a cardiologist must be so amazing, because they’re going to fix that.

We go back to our other patients. Five minutes later the sound of emergency pagers ring out, reaching a collective crescendo. The team leader nurse is already halfway out the door with the portable defibrillator. She shouts at the medical student, the only one free to push the cart. He’s only just started on clinical rotations None of us doctors can help, we’re too busy with the other patients. I watch him obediently follow her up stairs.

We go back to work. Later the team leader appears. “He arrested. He’s tubed now. They’re pushing on with the angio”. Everyone agrees to find out what happened in the morning, it’s time to go home, now past midnight.

I’m at work today. I have a few patients I’m sorting out, mainly elderly people with elderly person problems. I see the cardiology registrar. I ask him. The registrar shrugs and says “oh that guy died”, and walks off.

You weren’t supposed to die.

I go back to work. The wind is out of my sails. For a minute a small voice tells me I want to cry. Another tells me it’s not my journey. Another tells me to get back to work which sounds sensible so I do. Another says nothing and just observes.

“You’ve got to learn to be more lazy”. I look up, and an intern is standing there, handing me a coffee. It’s late. It’s nearly time to go home. “you’ve seen so many patients” she says, “way too many!”

She’s right in a way. I’m not getting out on time. There’s a lot of paperwork left to do but I don’t really mind. I used to mind. I stay back and finish it. I lament my lack of thoroughness for seeing so many. I call consultants to get the patients admitted and give half baked stories but it’s late and they just want to sleep so they accept them.

I get my handbag and walk back to my car. Driving home I notice the other cars on the highway, some big, some small. Lights passing through the night.

You weren’t supposed to die.

The Scream


Years ago I went to an Edvard Munch exhibition, the contents of which spanned his life. I will never forget the room dedicated to the development of The Scream, it’s a picture which repeated itself throughout his life, but it was one of the first sketches of it, made when he was young that really haunted me.

The original drawing showed a child standing in front of a bed, hands to face, mouth opened in horror and terror in its eyes. On the bed behind the child laid their mother who had just died. Edvard was only five years old when he watched his mother die of tuberculosis in 1868 That drawing haunts me to this day, he drew it over and over again.

The famous 1898 picture has taken the fear and the horror from that child, and transferred it to another place – blood red sky, a bridge, but the emotion is the same. The saddest part, when you think about it, is that terrifying childhood thing, to, as a five year old watch your mother die, and quite horribly, was carried with him, was transplanted to wherever he was. It’s a painting that has so many layers if meaning to it but this one speaks to me the most. That monsters-under-the-bed fear of something terrible happening to your parents, and that fear coming through.

Now why you’d want that hanging on the wall is beyond me!

To end on a happy note, some of Munch’s last works were of green grass and blue skies with white fluffy clouds. His style completely changed in terms of content, suggesting that he found some peace. I so hope he did. That worst-fears-realised painting might have gone for over 100 million dollars but I like to think that Munch would have given all of his talent, fame, and money that he made, to have never had to paint that painting.