The Morning Tour

My mind races to the beat of my radar ears

Thrump thrump thrump
Ambushed within cylindrical inclusion
“Good morning! Please take a seat.”
Tired raspy waaas by the babe since two a.m.
Moans emerge from the huddled hunched-over housecoat
Hack hack cough ptoo muffled behind surgical masks

Beep! The automatic doors slide open
Ding ding ding di-! Heart rate 100 silenced.
“You can’t keep me in here! GOD IS GREAT!”
“ATTENTION MEDICAL STAFF. CODE BLUE-”
“We need to intubate now.”
Shaaaa close the curtains

Beep! The automatic doors slide open
Silence in the corridors; OR suite clamors next door
Whirring drills, thirsty suctions, buzzing cautery
Beware the happy wheezes on the pediatrics floor

Up the stairs to content coos and belches in the NICU
Versus late epidurals aaaaaaaaiiiiiiiieeeeeeeeesssssss

Medicine and surgical wards dominate the other levels
Beds shuffle rehabilitation shuffle visitors shuffle
Nursing station chatter, team meeting mutters, CTU rounds stutter
Deeeeep breath leery pause deeeeep breath
Gasp gasp wheeze shushhhh oxygen needs increase
Demolished deliriums hushed hallucinations

My mind slows to the beat of my mellowed thoughts

Advertisements

Snapshots #4

We were closing the incision, and the surgeon was trying to teach me how to close properly. After he finished, he commented, “Don’t worry, it’s just like sewing. You know how to sew, right?”

“No, I don’t actually.” It was a half lie– I could sew buttons on shirts, that was simple. I could hem my pants in a pinch, albeit creating a new design of slight diagonal one centimeter threads all around the circumference of my pant leg. But no one’s paying attention right?

“Oh well, fine, give it a try and I’ll watch.” I took the needle driver and forceps from him, and began to suture. I kept my focus on each stitch, knowing he was watching intently. “It looks good so far…” He paused. “Can you cook?”

I wasn’t sure what the relevance of this question was. Too focused on the task at hand, I quickly replied, “No.”

“You can’t sew, you can’t cook… What can you do?”

I nearly dropped the surgical equipment. I immediately looked at the nurse with a gaze that read, “You have got to be kidding me right now” which she mirrored. My face grew red behind my surgical mask. I cleared my throat and said, “I don’t know what I can do, but you can check your gender roles.”

There was an uncomfortable silence. Then he brushed it off his own words, saying it was a joke.

I knew that society had engraved this mindset into him without him even realizing. I knew that this was not a rare occurrence in his OR when the nurse gave me a high five after we scrubbed out.

At this point I knew that even in medicine, elements of sexism are still thriving. And that is just a shame.

Snapshots #3

We just finished removing the appendix in a laparoscopic procedure. The patient’s abdomen was still bloated from the gas we used for inflation during the surgery. The surgeon looks at me and instructs, “Push on the abdomen. We need to get rid of this air.”

I comply and reach over to press down when he stops me and says, “Push, but don’t push like a girl.”

“Excuse you?” I exclaimed, catching him and myself by surprise. Me, a medical student, on their first clerkship rotation, who pauses in uncomfortable silence when quizzed on surgery topics, exclaiming in such a manner.

He looked sheepish, and his cheeks flushed pink. “I mean, push hard. That’s what I mean.”

“That’s better,” I said, and I looked up to see the nurse’s eyes upturned. I knew that she was smiling underneath the surgical mask, but sadly I knew from the gaze that this was not the first or last comment that would be said in the operating room.

 

Snapshots #2

We came out of that meeting, my preceptor, the nurse, the patient and myself.

“Well, that went well didn’t it?” my preceptor chirped, as soon as we were out of earshot to the patient.

I found my words, meant to be inner thoughts, slipping into my speech. “You have got to be kidding me. Were we in the same place?”

He was taken aback, and look to the nurse for reassurance. She emulated my exasperated face and said, “She’s right.”

“But she consented!”

Once again, the stark words came out. “She consented? Did she? Did you really think she consented?”

He shot another helpless gaze towards the nurse, who, to my relief said, “No, that was not consent.”

Preamble

It has been one year and I find myself back here, wondering where to begin. It is the feeling we know too well, the one where you have so much to say and do that it is difficult where to begin. And I have been feeling that way for the past year.

It is not writer’s block. My mind is not blocked. Rather, it is overflowing. The thoughts have dribbled and trickled their way into journals, poems, rants, tears, and refocused energy. The thoughts and memories are still engraved and filled up to the brim of my mind. But like a dam if we open the gates there will be a massive flood, and the results will tear apart the beauty of what is being kept inside. Like a slow stream we can appreciate the beauty of the flow, and the sounds of the current.

Now I have twisted the handle and the release of the mementos begin.

I Still Don’t Know

As my first year of clerkship (aka my second year of medical school) comes to a close, I have come to the realisation of a simple fact: “I still don’t know.”

When I wrote my last reflection entitled “I Don’t Know”, I foresaw clerkship as being this roller coaster ride with an unknown ending. This time I’m going to very confidently say, I still don’t know how it’s going to end. But it’s still okay.

When I had imagined myself as a clerk by this stage, I imagined myself as someone who was very put together and knew what they were doing. Maybe to some people I look like I know exactly what I’m doing. Sometimes I do, and when I don’t , I ask for help. But that’s okay. I imagined myself as being able to retain in the best fashion the vast amount of knowledge required for this time of my life. The truth is, I’m still having difficulty, but I’m making progress. And that’s okay.

When I had imagined myself as a clerk by this stage, I imagined myself as being confident in my residency application. I’m not. I’m as scared as those who are applying to extremely competitive specialties. I’m scared that I won’t match. And that’s okay.

Okay?

Being okay is probably the simplest concept that I have adopted in my life, but it’s been one of the best. I suppose some credit goes to “The Fault in Our Stars”, but the majority of the credit goes to an upper year tell me that things are going to be tough, and that’s okay. We live in a time where we are so consumed by not being okay, it’s almost impossible to be okay. When we meet up with an old friend, we often talk about how stressed out we are, how things aren’t going the way we expected it to be, how this is a bit out of line, how our schedules are off track… It almost seems taboo to be okay. The point I’m trying to bring through is that it is possible to find comfort in the midst of discomfort, albeit difficult. The only advice I have in doing so, and how I have done so, is by accepting the possibility of falling.

I am still afraid of failing, and failing is not exactly my top option. However, in accepting the possibility of falling, I have come to terms with the fear associated with it. I am okay.

I still don’t know, but that’s okay.

Snapshots: #1

“This is it,” he said. “He’s fallen asleep, and he’s not going to wake up again.”

“Yes, this is it,” I agreed.

And although neither of us used the D word, we both knew that, given his rapid decline and laboured Cheynes-Stokes breathing, he was dying. So by his bedside we both sat, I, with my hand comforting him on his shoulder, and him, crying in sorrow, watching his father rest in comfort.

Orchestra of Care

When I was little, my parents asked me what kind of instrument I wanted to play. I told them violin or guitar.

They signed me up for piano lessons.

Naturally I resented them for many years as I cried through hours of training because I was absolutely miserable and had to endure Royal Conservatory of Music examinations. Interestingly enough, by some twist of fate, I fell deeply in love with the piano. I think it came with the acceptance and mutual understanding with my parents that I was never going to be incredibly gifted in this talent, but I was good enough to pass. Music became a huge part of my life. When I was in high school, I learned to play the flute and joined the school band. I devoted myself to the endeavor during those awkward years, and had a lot of fun along the way.

When I started university, my parents asked me what kind of extra-curriculars I wanted to join. I told them probably a music ensemble of sorts.

It never happened.

Naturally I resented myself for not pushing myself out of my comfort zone and auditioning for something, if anything at all. Instead, I played occasionally in the comforts of my room and would have sore fingers or be short of breath after a few songs. Each time I played, it was a sad reminder that a piece of me was slowly disappearing, and that it would soon be gone.

When I reflected the other day, I realised I had never really lost the music in my life; it just became so entwined in my life, I almost lost sight of it. Now I see it in the orchestra of care.

Each day is a performance. The preceptor asks me a question, and suddenly I’m in sympathetic overdrive. The spotlight shines on me. My heart races, and my face blushes. In the operating room, my hands tremble as I stitch and everyone is waiting for me to finish so that they can go home. I try to ensure everyone has an everlasting impression.

Each day I’m listening. I’m listening for the right notes, in or out of tune. I’m listening to the heartbeats, listening to each breath, listening to each percussive response, listening for each instruction, and listening to each lesson given. I’m hoping I pick something up. I’m looking for the right quality of sound. I’m keeping track of the rhythm.

Each day I’m asking. I’m asking for stories, for clarification, for feedback, for demonstrations, and for ways to improve.

Each day we are collaborating. Much like the orchestra works together to deliver an amazing performance, we work together to deliver amazing care.

When people ask me if I still play music, I smile and tell them I do, in my own little way.