Serendipity

My brother is having me watch "Serendipity" with him. The 2001 film starring John Cusack and Kate Beckinsale. Why, oh, why am I watching this? Kate Beckinsale being the exception... (her British accent is so awesome)

Now, this... this is what I call serendipity... Serendipity III...

Home of the "Golden Opulence Sundae," a $1,000USD dessert...

and the "Frrrozen Haute Chocolate," a $25,000USD dessert (a.k.a. most expensive dessert in the world... complete with golden spoon and everything).

Bug

Viral gastroenteritis sucks...

Rain?

I think it's going to starting raining for a week starting Sunday. That's good. I like the rain. It's also been awhile since we've had some serious rain here. That's one thing that I liked about Seattle and Vancouver, too, albeit it didn't rain when I visited there.

Rain?

Rain!

I'm still trying to figure what people really mean when they say certain things here in Australia. A couple phrases...

"Good on you."
"Cheers, mate."

Sounds pleasant enough. But what does it really mean?

The third week...

There are still some things that are hard about practicing medicine in a different place. I've been able to get my admission efficiency down to 50 minutes, which I'm satisfied with. Still, I feel limited. I feel as though I am working with one hand tied behind my back and am not working at what I perceive as my capable efficiency level. Part of it I can still attribute to working in a different system. Part of it may just be that much of the stuff is still paper charts, which makes searching for things rather tedious. I'm doing my best and I'm sure things are just a matter of time.

I think I am tempted to ask for nights next block. That might sound crazy to some, but I don't think it is. At night, there's no one else. You practice the way you practice and let someone else do or change things as they please after handover or signout. Working nights, you accept that people will change things in the morning, and know that they accept that overnight the purpose is to stabilize until the morning when things can be fine tuned. Plus, I think there is something peaceful about the night despite it being busy. People's roles are simplified. I may be romanticizing things here though.

The first week...

So, now that I have a week under my belt, I can't really use the "I have no idea how things work" expression anymore. There's still a lot I don't know, but I just have to keep chugging along.

I think I might be feeling a bit homesick for the first time since I arrived. But I don't think it's necessarily homesick for Los Angeles, etc. Just certain things that I used to have access to that I really enjoyed. Lake Arrowhead for example. I kinda miss Lake Arrowhead. It's a nice place and every time I've gone, I've enjoyed the air, the lake, the Village, etc. It's just such a nice place. I confess I had wanted to purchase a house/cabin there... even thought about working there. Now, I'm so far away...

The third day...

... is starting to settle in. There will be things that I will need to continue to learn, ask, and get used to, but I think the overall admissions process is starting to settle in. My average admission time is now about 55-60 minutes. An improvement, but again, I can do better. Granted, the only things that are available via computer are radiology and laboratory studies. Everything else is by paper, including past medical records. I still need to figure out how to eat lunch. I got by with a mantou I stowed from breakfast and a couple of mini potatoes today. Far from a decent lunch.

Medication brand name crossover of the day:
Duride = Imdur (isosorbide mononitrate)
Piax = Plavix (clopidogrel)
Rani = Zantac (ranitidine)

The second day...

... was better. Not as many patients and better flow to admissions. I can still do better. I was still averaging about an hour and ten minutes a patient. Poor numbers by traditional standards. I still like the people in the ED, which is pretty much where I spend most of my working day. We'll see how tomorrow goes. In medicine, tomorrow is truly another day.

Medication brand name crossover of the day:
Clexane = Lovenox (enoxaparin)

The first day...

... of work was... challenging. The oddest thing that I will say coming out of my first day is that I love the people in the ED? This is a very hard concept to grasp for anyone coming out of UCLA. Sure, I guess some work ups could have progressed farther before being handed over to me. But everyone was really nice and understanding at my inefficiency. If anything, I felt really bad for plugging up and slowing down their bed movements and I felt really bad for the patients who had to stay in the ED longer than they had to. Adjusting to a whole new national medical system was really hard today, and I am just at the tip of the iceberg as far as medications used and not used. Perhaps the most pleasing thing for me is how I remained grateful, humble, and smiling in spite of the day when in a past life I might have given in to disgruntled feelings. But I didn't have a single one. Just grateful, humble, apologetic ones. Tomorrow is another day. I am grateful for each day.

Medication brand name crossover of the day:
Resonium = Kayexalate (sodium polystyrene sulfate)