Get over it

It's been a long time since I have posted. Tests came and went and I was forced into a routine of training and studying before I left to France. It was also only today that I had reason for another post.

There are situations where people come to despise each other. Whether it be a couple breaking up, or something said in the spur of the moment. Life teaches us one thing, we need to move on or else that seemingly little moment will rule our lives. There are some moments in our lives that are truly life changing. There are moments where we change who we are and how we deal with people. But then there are moments that we let rule our lives when it would be easier to just let everything go. By turning a mole hill into a mountain what are we really proving?

On a completely different note...why do people see the need to put messages on their boyfriend's or girlfriend's Facebook wall? Who is it really for? Their partner, or their friends? Would it not serve them better to merely send a message to them (a private message that is). It's just something that I am battling to understand.

Blackberrys ruin friendships and I can prove it

I've never really approved of society's new addiction to the Blackberry. Instant messaging has its place, but I think that it shouldn't really have a place in relationships with people that you see every day. The truth is that these conversations usually cause problems, either due to a complete misunderstanding or merely due to the cowardly ability to simply end a conversation when you disagree with someone.

If you choose to fight with someone, it makes no sense to do it over instant messaging. I've always found it far easier to type things out and push the "enter" button, almost without a thought to what I have written. It's almost my way of showing a lack of inhibition. And should I say something really offensive to someone I don't really have a way to take it back or explain my point of view. Hell, there isn't even a "sarcasm" sign that I can use.

Instant messaging should be used when there are people that you don't see every day that you wish to talk to and when you need to urgently sort something out. It has no place in every day relationships. (in my humble opinion)


Sorry for not posting in quite a long time. Training has been occupying a lot of my time and I have been trying (unsuccessfully) to start work on this new block.

Kill the messenger

My ankle is starting to heal so I can finally start to get back into the swing of things, training wise. The sprint final is next weekend so I am hoping to be fully fit by then (at the moment I am pretty much there, just slap some tape on my ankle and I am good to go).

University this week was rather draining. Hospital day was a bit of a fiasco again, though I did learn a lot. I'm just starting to finalise the arrangements for my elective at the end of the year. I want to do it in internal medicine, the excitement of trauma and surgery just isn't for me.

The patients at the hospitals are really awesome. It's really amazing that you get to meet new people every day. Everyone has a story to tell, they just need someone to listen. If you don't hear at least 1000 stories in your life, are you really living? It's one of the reasons that I really like to get out and meet people (not at clubs though). It's in the most remote parts of the world that the greatest stories are hiding.

I suppose that my quote for today kind of follows on from last week. There are times when you simply cannot control the future, it is not in your hands.

"I am lucky. I did not choose this life. It chose me. It's strange like that; not picking my path, but rather easing into the water and letting it carry me where it will. Yes, there will be nights where I feel like my destiny is at my fingertips and there will be nights I wish the lights were off and I could just make these sounds in the dark. Still, I will always be there, wherever there might be, staring into blackness hoping the blackness stares back at me."

It turns out that sometimes the future actually belongs to someone else

This past week has been rather interesting. I had a really awesome time in Belfast training. Perhaps my ankle and my chest don't really agree (but I wasn't asking them!). Haven't been able to run because of my ankle, but I will hopefully be able to get back into it this week. Sprint Final is coming up soon and I would like to do well there.

Wednesday turned out to be a rather interesting day when a second year physio managed to lock their keys in their car. It probably looked a bit suspect when a group of people were trying to shove a coat hanger into the door of the car to try and get it open. The Toyota Corolla held up to several attempts to "break in". Its downfall in the end was another car key, that happened to open the car door... (the same key wasn't able to start the car, much to my disappointment).

Thursday started off rather shakily, when we happened to find a woman's underwear on one of the seats of the taxi set to take us to our community site.

Our driver tried to make a joke out of it... needless to say, I will not be going on one of his trips again (voluntarily).

Today ended up being the Wits open day. I was volunteered to go and help out speak to potential students. I must say, I feel a little bad "lying" to them. I just couldn't bring myself to say, "You are going to hate it." I have also recently come to the conclusion that lectures are an utter waste of time. I just need to convince myself to not go this week (or maybe next) so that I can try and prove my point (to myself, mainly).

I ended up finally having the conversation that I needed to have. It came about in a rather odd way and, needless to say, didn't end up going anywhere near in my favour. So another girl that I like ended up liking someone else. A little soul searching later and I have decided that I want to be an intensivist, will perhaps move overseas to take my sport further. This all mainly due to the fact that I don't really know what "here" holds for me at the moment. At times it doesn't feel like much...

The Cure for Depression?

Hello, there should be more blogs about dealing with depression when you're stupid and worthless, so here is a self help blog entry. 

Today's assignment is simple. Just go out and get on the bus. 

It doesn't matter which bus. Whichever bus comes next. Get on, and just go. You could ride that bus to the very end, thank the driver, and then walk into the woods and just die. Just lay down right there and wait and wait until you were dead. Who is going to miss you?

Really, think about it. If you went out to the middle of nowhere and just sat down in a ditch and cried by yourself until you were dead, who would be the first person to wonder where you'd gone?

Call them up! Maybe they want to get ice cream?

Medicine's Golden Touch

Portfolio entry for the LOTS block...


Hospital day provides an opportunity for medical students to be exposed to the challenges posed by the healthcare system in South Africa. It creates a sense of social responsibility to the millions of people that rely on the public health care system in this country. To be honest, it can be a bit of an emotional rollercoaster at times. There are times when it is difficult to see the challenges that everyone keeps telling us about. However, in the renal ward at Charlotte Maxeke Johannesburg Academic Hospital it is often difficult to come to terms with the reality that many doctors face.

There are just 120 places for haemodialysis and 80 places for peritoneal dialysis for the whole of Johannesburg. Many patients are excluded based on a long list of qualifying factors. It’s something that is very difficult to accept, because renal failure is not a disease that can be treated with medication. Those that are not part of the lucky few are sent home to die, while private hospitals house dialysis machines that are not always used. To me it seems an unethical practice to let machines go unused. There needs to be a point where human life is valued above money.

When visiting Chris Hani Baragwanath hospital the same issues seemed to be staring me in the face. Orthapaedic patients were being forced to wait more than a year and a half to receive life-altering surgeries. Often people coming to the orthapaedic out patients department have restricted abilities that prevent them from going to work. Not being able to help them timeously adversely affects both them and their families. It creates this cycle of poverty where the poor are unable to work and the rich continuously complain that the country cannot function adequately when only around 10% of the population is paying tax. [1] It creates the perception that the NHI would not work in this country; that it will augment the exodus of the educated few to “greener pastures”.

Medicine is not a profession that should be undertaken in the pursuit of money. By nature, helping people should be done with the intent of helping them, with a complete disregard for cost. In fact, helping people often incurs a personal cost. And there are people that show their true faces in public healthcare, unscarred by the make-up of private healthcare. There are organisations, such as the smile foundation, which help correct cleft lips and palates, free of charge. Perhaps it seems a little unrealistic to wish for a state where health care is free and of a high standard, but is it not something that we should be striving toward?

Recently, while a lecturer was explaining the intricacies of the South African healthcare system, a few students brought up the topic of the NHI. It seemed that their main concern was about how it would affect their income, a clear sign that most were already planning to go into private practice. I have no problem in making them feel guilty. I don’t think that they should be able to live with the fact that they are essentially deserting the millions of people in this country that rely on public healthcare. Perhaps I am different to most of my current GEMP I class, but to be honest, I shouldn’t be.

The issue of private and public is one that is very close to my heart. The discrepancies in resource allocation mean that many people are left without any healthcare, while doctors and hospital administrators of private institutions live lavish lives. I think that it is time that the university began to push the social responsibility aspect of medicine in general. Hopefully those in my class will begin to see that there is more to medicine than money because, if they don’t, the future of healthcare in this country is in the wrong hands.

The illusion of easter and other holidays

I suppose that I should start off with the fact that I am rather against religion in general. Religion has never done anything beneficial throughout human history. The only thing that it has done is given people a reason to kill each other over differences in belief.

I am not quite sure why good friday and easter monday are holidays in this country. Jewish and Muslim people do not get public holidays for their religious occasions. I am not sure why there should be "preferential treatment" in a sense. Rather don't have any religious public holidays, it helps to promote unity and non-discrimination.

SA team selections are in and I am going to France in August :). I can't wait, although the nerves are already starting to set in.

I am almost finished my latest portfolio entry. Will post it once I am finished.

Some of my new favourite quotes:
Unrequited love is a waste of time. Just walk it off. There. I said it.
Sorry, I think you mean "who," not, "whom". People WHO correct grammar in casual conversation are obnoxious. Now run along. Men are talking.
I can be happy alone, sure. I can be happy without ice cream, too. If we're being hypothetical.
I think you are beautiful and I would like to kiss you. I can think up some clever lines, if you'd prefer. But I wanted to say that first.
I have super powers and a costume. Every night I panic just outside my door, but every night I try again.

The Important Things in Life

There are three important things in life:
(1) University
(2) Orienteering (or sport in general)
(3) Relationships

These three things form the basis of every person's everyday life. It's very difficult to have a conversation where you do not talk about at least one (or in my case, all three). My memory is often so bad that I think that sometimes I say the same things over and over again in a conversation (they must have been important, right?).

For me, university is almost taking a back seat at the moment. I always wonder what it would be like to study something different, even though I am enjoying what I am doing. In high school I used to love creative writing, getting the opportunity to just make up a story (and perhaps wish that you were living it). There is more to life than university (which is what many people fail to understand). In three and a half years time, when I finish, things are not going to get any easier. I will not suddenly have time to do the things that I have always wanted to. It's time to do them now. Which brings me to:

Sport has become something that I live for. I go through stages where training is a bit dreary, but then after a weekend like this past weekend I have this sudden surge in enthusiasm, like I can train for 4 hours every day. I spend the whole day looking at old maps and looking at route choices. It's something that I wish that I could do every day. Sport opens so many opportunities. For example, this year I get to go to some obscure part of France. I would have never been able to see the things that I will see. My coach is under the impression that orienteers and adventure racers often see things that even the local farmers have not. It's also provides the opportunity to meet people, and fantastic people at that.

Which brings me to my next point. Relationships are the axis around which most of us live our lives. Always trying to impress someone so that you will be noticed, giving a casual glance after an action to check for approval. Perhaps it is not the best way to live life, but it does keep you in line in a certain respect. I have met some of the most amazing people through my sport (both orienteering here and overseas). You meet people that are always there to give good advice, people that are there to give a word of encouragement when you feel terrible and then there are the people that you just wish that you could spend more time with. Perhaps it would be regarded as girlfriend potential, but I am going to avoid that completely and say that I mean someone that I can talk to. And really talk to, not the usual small talk that we are all used to. I am not necessarily asking not to be judged on what I have to say, that is often too much to ask :). But I suppose this brings up the topic of who you should and shouldn't be "friends" with ("friends" is my new definition). It's difficult to be close to someone when everyone around you is looking for the latest gossip or even encouraging you to see something that perhaps isn't there (I often don't need other people, I tend to make odd conclusions all on my own). I just want someone to talk to damnit! Don't read into it (as I am always told as well). [worse could be someone reading this and thinking that I am talking about them, I am talking about someone, but is it you?)


I had an awesome weekend in Cape Town. Was great to be able to run in the forest again! Managed to win the SA sprint champs (my goal race of the season) and picked up a second place in the long. The middle was a bit of a nightmare, but oh well. The Hi Tec Infinity challenge takes place tomorrow and then there is the UJ sprint event on Sunday. Looking forward to it and hopefully I can do well this weekend.

SA Sprint Champs (V and A Waterfront)

WC Middle (Grabouw)

WC Long (Grabouw)

When you're through thinking say yes

I am just back from an awesome weekend in Cape Town. I went down for the SA sprint championships as well as middle and classic courses in the Grabouw State forest. Was a really awesome change to the monotony of third year. I am not sure how some people can live with just spending every day studying. I could not spend the rest of my life just doing medicine. It's not because I don't enjoy it, it is more that it is at times emotionally draining and sometimes difficult to see past the bad things that happen.

Another interesting topic came up last week. Would you ask your girlfriend to have an HIV test before you dated them? (Assuming that you would also have one yourself, I am not trying to be sexist) I would almost take it further and say that would you test yourself every few months while in a relationship? (I suppose that this point is more applicable to medical professionals that are exposed to the risk of infection every day, but could be extended to some other people...) I would, but perhaps it is more to do with the fact that I would never want to put my significant other at risk. I would also get the HPV vaccine...

Life can be difficult and complicated sometimes. Often it is quite easy to figure out what you want out life, but your decisions affect other people. It's easy to make split second decisions and take actions that you regret, not because they were not the right thing to do, but because you changed something. You changed a friendship or changed someone's view of you. It's difficult to imagine that one action could change everything, I am more concerned about it changing for the worse though...

I am listening to the new album by Yellowcard. Perhaps it is related to the above, but seriously... When you're through thinking, say yes!


"We are responsible with our patients. The problem is we blow it all out at work. In our own lives, we can't think things through. We don't make the sound choice. We did that all day at the hospital. When it comes to ourselves, we've got nothing left. And is it worth it—being responsible? Because if you take your vitamins and pay your taxes and never cut the line, the universe still gives you people to love and then lets them slip through your fingers like water, and then what have you got? Vitamins and nothing."


‎"If I could fly I would never land. I would be free. One day I'll realise that's a metaphor, not a fantasy."

Academic Doping And Public Practice

This week was rather exciting, conversation wise. The topic of using Ritalin came up (one of my classmates is using it to study). Its use is generally widespread in the Health Sciences faculty because many people turn to "self" medicating because they did not get the results that they wanted.

I think that it is not really something that people should mess around with. Firstly, I really do think that it is equivalent to doping in sport. If you really did need the drug, a doctor would prescribe it to you. If it hasn't been prescribed to you, then sit down and work...

Here is a copy of my recent portfolio piece, I'm already tired of them...

They say that it is difficult to appreciate life until you are put in life or death situation. For many people in the renal ward at Charlotte Maxeke Johannesburg Academic Hospital it is very difficult to not appreciate life. With only two hundred dialysis places for the whole of Johannesburg, many people are forced to go home without life-saving treatment. It was after one of the patients had been discharged that I spoke to them about their stay in hospital. Thembi is a middle-aged woman that happily stood at her bedside, all your belongings packed and ready to go home. She had just been told that she didn’t qualify for dialysis because she was HIV positive and had not been on ARVs for at least 6 months. The smile was inexplicable, unless my assumptions were correct in that she didn’t understand what not getting dialysis actually meant.

It came to me then that perhaps this was an example of doctor-centred bias. With so little time to talk to all of the patients in the ward they were unable to address any concerns or questions that they patients may have. Another patient in the ward had recently demised because they had refused dialysis citing that they believed that they could “fight it [renal failure] themselves”. It is beliefs such as this that make me ask questions about the health profession, and not just in South Africa. The dynamic of health care is such that the doctor’s knowledge is usually superior to that of the patient. I think that that is especially a problem in the public health care sector in this country because understaffing often prevents doctors spending more time with their patients.

It is a problem that seems to plague hospitals and clinics around Johannesburg in general. At my community site there are two nurses and one doctor that treat over six thousand patients every month. It was at this clinic that they linked non-adherence to the lack of staff. The nurse in charge said that often she could treat forty patients in less than half an hour. With very little time to spend counselling and providing information, it is understandable that often patients are not given information about side effects and procedures.



When asking my patient how their stay had been in hospital and how they had been treated they didn’t seem to want to say more than that they had been treated well. I am not sure if it was to do with the person trying to come to terms with the fact that they would be going home to die or if the person was afraid that we would tell the staff working at the hospital about their response. I didn’t think that it was appropriate to delve any deeper in this case and I left it at that. I didn’t really feel that it was my place to try and explain the situation. She may have understood it all along.

The renal ward has been a very difficult ward to work and learn in. At times it is not easy to see past the good that the doctors and nurses in the ward are doing. The nature of renal medicine makes it such that life and death decisions are commonplace. Although this is the nature of medicine in general, it is very difficult to work in an environment where the very limited resources often determine, directly or indirectly, whether someone will live or die. It would be a lot easier to accept in an area of medicine where resource use can be maximized, but with something as complex as dialysis, it is usually the patient’s only hope.

I am really bothered by the fact that most doctors go into private practice without even being bothered by the problems currently plaguing the public service. For me it would be unethical and inhuman to practice medicine in the private setting. This case was merely the first of many that could have been solved by there being more doctors in the wards. Even if the person could still not have been given dialysis, the doctor may have been able to come up with another treatment that would have given them a longer life. Medicine by nature is a career about people; perhaps we need more “people” to study medicine.

Although patient-centered care is something that all doctors should be striving for, I do not believe that it is something that will be achieved, at least in the public setting. I think that what doctors should strive for is not a complete hybrid between patient and doctor-centered care, but rather doctor-centered care with only a slight emphasis on the patient side. If one question is answered it is better than none and in an environment where doctors are working 36-hour shifts it seems a little optimistic to assume a completely turn around in patient care. The emphasis on some of the patient-doctor themes in fact seem to be channeling individuals into the private sector which seems a little counter-productive. In all honestly, I believe that the medical school should be showing individuals the current problems with the health care system in South Africa and engaging with the students to solve the problem. One trip to a local clinic should leave most prospective doctors with a social obligation to go into the public sector. Too many medical students are focused on making money. The Wits Medical School currently has three hundred GEMP I businessmen and women; it’s about time that they had three hundred GEMP I doctors.

Passion and Nobel Laureates

Today a rather interesting conversation was started regarding passion in medicine. It is very interesting to hear the different points of view. At this stage most people swear that they are studying medicine in the hopes of being able to help people. There are some people that are, however, still interested in the money. It was interesting to meet the doctor at our community site this week. He was the only doctor in a clinic that serves 6000 patients every month. He has probably had every opportunity to move overseas or change to private practice, but the amazing thing is that he didn't. Clearing something else is at work. It was on the verge of tears that he told us that we still had the opportunity to change career.

In this country the health care system faces many challenges. In many cases only a fraction of the qualified doctors stay in the public sector. To not give back to the community and to not make a real difference (since you can touch more lives in public practice) almost seems a little unethical to me. If you go into a career thinking about the money you may make what is the point, if it is not something that you enjoy, or rather if you are not helping as many people as possible then surely you are in the wrong profession? Granted, working in private practice and then working one day a month in a public clinic is noble, but it does not compare to doing it every day. In many cases it is not even a question of money or working conditions. Consultants are paid more than a million rand a year, I don't need to buy my own boat, I don't even want an expensive car, it's enough for me. It's not even a question of whether you should work in private practice so that you can have a family.

Hospitals in the Gauteng area are not even underresourced. On a visit to our community site today we found well stocked consulting rooms and medicine cabinets. The problem was understaffing. It's actually shocking to see because often I think that the medical schools are not pushing the issue enough. Although we are required to do community service it still doesn't quite measure up to making a long term commitment to making a difference. One of my friends brought up an interesting example. People are always so willing to work for MSF when in fact they could make more of a difference in their own country.

For me, job satisfaction is much more than a paycheck. I would be happy just being challenged everyday, challenged to perform at the best of my ability because people depend on it. It's the thrill that I seek, something that I don't see myself ever getting in the private sector. There is also the issue of research that comes into it. If I were to ever move overseas I would move to a socialised country, it's something that I hold close to my heart.

Today a Nobel Laureate came to speak to us at university. It seems to me that not all of the discoveries are that impressive, though I do suppose that many of them occurred almost 30 years ago. Even those things discovered just 30 years ago have become common knowledge (in some cases knowledge from 10 years ago is now being taught in lectures). It was an interesting lecture about viruses and carcinogenesis. It's a rather interesting topic considering that some of the content affects us everyday in hospitals (with Kaposi's Sarcoma in HIV). It would have been a lot better if he had answered my question :) (although we did work it out afterwards).

After a day of revelations...
"How come being easy keeps getting harder?"
"If I’ve learned anything over the past 5 years, it’s that you do not know where you’re going to be tomorrow. You have to make decisions based on that; it’s almost pointless. So, you know, whether I learned, I think I’m pretty aware, pretty conscious of that point to live in the moment. It’s a hard lesson, but it’s like, I’m trying to learn to quiet my mind down, know what I mean?"


I have never been much of a fan of the whole carpe diem crap. It's one thing to say it and a completely different thing to actually put it into practice... So perhaps I have a few decisions to make, it may take a while...


The thought of the world cup still seems to send shivers down my spine, but perhaps it has to do with something my friend said: "Put away your books, your notes, your doubts, your fears and insecurities. Put away your laptops and your pens and pencils, put out of your mind that sneaky freaking suspicion that you just might have left something out. Put away the negativity and anger, put away that feeling of knowing nothing. Just remember how you got here and where you're going. Ke Nako, it's time."

Steak and kidney pie and the class fashion show

There is something about some of the people in my class, they just tend to irritate me. There are the people that cannot be wrong and then there are the people that (without trying) are able to annoy you to the bone. Thank goodness for thursdays and friends, not sure how I would survive otherwise.

So Wezley was told today that he doesn't have the personality to be a surgeon. Needless to say, Wezley took it upon himself to, in 2 hours, irrevocably prove that he was arrogant enough. Would be interesting to see if there is some sort of correlation between personality and specialty choice (at least at our stage).

Hmmm...being assigned to the renal ward makes me think about steak and kidney pie for some reason (or at the suggestion of my brother). Looking forward to it though. Nursing begins on thursday :).

Judge Cameron is coming tomorrow to speak to us. My brother felt that we would be better served to have a class fashion show and let him judge it. Not sure how well that would go down.

‎"In this world there are two kinds of people. People like me, with knives and people like you, with eyeballs."

Difficult patients, crazy people and hospital day

The first portfolio task was a good way to reflect on the HPD. Turns out that Joburg Gen was the worst option because of how bad the organisation was. We were kept waiting for 2 of the scheduled 3 hours in the morning. Below is my portfolio task:

Stalking the halls of the concrete jungle that is the Charlotte Maxeke Johannesburg Academic Hospital I find it hard to imagine that quiet ever haunts its wards. Excited medical students followed nurses that daily walk the long corridors blindly. It was on a part of our guided expedition that we met a patient named Mark. Mark was a middle aged, handsome man happily listening to music while staring out of the window of his ward. He had left his family in the Cape to come to Johannesburg looking for work. His voice laced with disappointment, he spoke about how the person that had offered him a job had let him down and he was left out on the street. After six weeks of fighting to find food, Mark decided that he wanted to end his life. He jumped off the roof of a relative’s house, head first onto the concrete below. Partially paralyzed, he now lay before us on his bed.

A now remorseful Mark spoke of how selfish it had been for him to so rashly attempt suicide. There was no hesitation in his voice as he recounted the story, almost as if it had been rehearsed. He spoke of battles to get his life changing surgery that would allow him to sit up (and not remain merely lying on his bed). He seemed to have a new outlook on life, a positive one reflected in his efforts on mastering his archenemy, the wheelchair. He spoke with disappointment as he recounted his attempts to mount his “steed” that morning, with no avail. It was easy to understand his disappointment, but it was difficult to comprehend how a man had changed his outlook on life in merely three weeks.

Lost in the haze of the usual Grey’s Anatomy or House episode, it was difficult to see the reality of the picture in front of me. It seemed like the happy ending to the fairy tale, but I was reminded of the usual twist that usually accompanies stories in real life. Although the man retained eye contact throughout the conversation, many parts of the man’s story did not add up and it was difficult not to wonder about what he had not told us. He had seemed to be extremely open about his ordeal. A colleague’s question (about who had found him) rattled me more than it did the patient. But then it dawned on me that we had perhaps not earned the right to deserve such honesty. “It’s a basic truth of the human condition that everybody lies. The only variable is about what.” – Dr Gregory House. His story seemed too rehearsed, or perhaps I was being too harsh.

The counseling that he had received could have brought about the sudden change in his point of view, but it seemed that perhaps the somewhat “luxury” life inside of the hospital had left him blind to the realities that would await him when he left. After coming from an environment where food, a warm bed and a shower were hard to come by, he moved to an environment where all of his daily needs were provided. Although Mark spoke about having the support of his wife and a job to go to when he left the hospital, I am not sure that he was able to grasp the magnitude of the change that he would have to undergo. He would probably never be able to walk again and, in my eyes, this could almost be viewed as a regression of his previous circumstances rather than an improvement. It will be a true test of his “newfound” character when he is forced to face the world.

This only being my first patient I was left with many questions that I was not able to answer. Many of the questions that I wished to ask seemed to be too invasive and difficult to phrase correctly without seeming judgmental: “Why were you not staying with your relatives here?” “Why did your outlook on life change so quickly?” Although I had become immersed in this man’s story it was still difficult to believe. In my mind I could only think, if I were his doctor then I would be here to treat him and not judge him on his previous actions. The countless prisoners stumbling through the halls echoed this line of thought. Although this is easy in theory, it is very difficult to implement in practice, especially when the hospital’s resources could be better used to save those that in fact wish to live.

Today I learnt that it is not my place to always judge those that find their place advertently or inadvertently in the wards of Charlotte Maxeke. I also learnt that sometimes the difficult questions are the questions that perhaps need to be asked in fulfilling the biopsychosocial analysis. By asking the those questions it allows the patient to think their answers through and allows for the possibility for counseling that I am not currently equipped to perform. Some of these questions could be the tools that prevent the patient from again attempting to commit suicide. I also learnt tolerance, that although perhaps I disagreed with Mark’s methods, I should still be able to try to understand his world view.

In a hospital environment it is very difficult to gauge sincerity. My patients have a story to tell, but I will never know exactly what they are leaving out. I will never find out whether Mark was telling the truth or not. I do believe, however, that the hard questions that I was unable to ask do have a place in the medical field. Mark was a fantastic first patient. In my heart I hope that he was sincere and that he is able to one day support and experience life as it should be experienced, with family and friends always close by. It has finally begun to dawn on me that today was not as surreal as it seemed. Mark was real…

*points finger into the air* [Still the best thing that has happened this week!]
It was great to talk to some of my very good friends this week, a great release after the week that we had.

A quote from A softer world:



"Children are the future which, let's be honest, is way worse than not having hoverboards."
‎"I get a crazy impulse when you smile at me like I want to step in front of buses, in a good way."




"It's a basic truth of the human condition that everybody lies. The only variable is about what." - Dr Gregory House

Playgrounds, nurseries and lonely children

Today turned out to be a rather interesting day. We started off with the usual microbiology and laboratory techniques and continued into another lecture by our rather eloquent microbiology lecturer on bites. Who knew that human bites were the worst bites to get? The story of the panty hamster will begin to haunt me as well, who knew that hamsters were so comfortable living in playgrounds.

The patient doctor theme seems to be another one of the "fluffy" themes. It's still rather interesting and I have been told that it is important by one of the older students. I'm not sure that methods of consultation are best taught in the lecture environment, but it is a start at least. We will be learning, however, to remove nurseries while keeping playgrounds in place. Not sure how much use a playground is without children though. We will have to see. :)

I was assigned to Charlotte Maxeke for the LOTS block. I see this almost as winning the lottery (due to the fact that I can wake up slightly later).

Often people consider small talk to be the order of the day. I don't. I have something to tell you, are you listening?

http://xkcd.com/222/

The pathology of dancing

[Courtesy of one of my friends]
It is amazing how there seem to be microvesicular and macrovesicular groups of people on the dance floor. Depending on the song and the group of people, the groups seem to change with little or no predictability. It really would be cool to work of the maths of it.

Had a great 21st last night and a great start to the orienteering season today. It's awesome to be racing again and it was great to run on a new map. Hopefully this week will yield a few more interesting conversations to comment about...

For now I will leave you with this... Why do toilet doors always seem to open inwards. Doesn't it make sense that it should open outwards so that you don't have you use your [hopefully] clean hands?

And this...

Every time I almost die I feel so alive. Why would I ever want to be more careful?

A moment of silence for PCMS

And thus ends the first 7 weeks of third year. I must say, there was very little that could actually pass as exciting. The test wasn't too bad either. I do, however, feel cheated when they make me study so much pharmacology and end up asking almost nothing on all of it.

The second block starts on monday and the timetable looks rather interesting, beginning with the "new" Medical Zulu. Yay! *insert sarcasm here* I don't really think that it is a bad thing, I just think that it is a little condescending to assume that because someone is black they speak Zulu. Perhaps that is just me. I suppose that falls under my issue with being condescending to the population at large and the specific instruction in our student manuals to not use medical terminology around patients. Not sure whether to mention it though, don't want to come across as "that person". Several lectures by Duse should spice things up though.

Ultimate frisbee this evening was awesome. A nice break from university and lectures, pretty much a highlight of the week :).

The power of self denial

I find it extremely interesting that people are able to convince themselves of things, even though the truth is blatantly staring them in the face. Although most of you think that this may be a creationism jibe, it isn't. Society has certain points of view when it comes to certain issues, for example, when you date two people at the same time it is usually considered cheating, but not to some people. Perhaps it is a need for a person to lie to themselves just so that they can make it through the day. I suppose that I can live with that as long as I don't have to lie as much as you do.

Another thing, I'm not sure where it says that you need to be friends with your ex-girlfriend. Yes, in some cases it is accepted, especially when the breakup isn't on bad terms. But when your ex-girlfriend proceeds to date your friends (notice the plural) I don't think that it is condoned, let alone accepted. Please stop bothering me about being your friend, you had your chance before you screwed me around for almost 3 years. And please stop using the excuse that you were just trying to make everyone happy, you didn't. Just because you felt that you weren't making anyone unhappy doesn't mean that you weren't.

But you didn't have to delete me.... But ok. Like i know you don't want to really have much to do with me, but still. [To some people it is their lifelong dream to remain as one of my contacts on mxit]

It isn't really. I just don't like bad feelings ever. [You considered that before you screwed me around for 3 years?]

That's ok. Things can work how you want them. I just never expected that from you of all ppl. But it's ok. Whatever makes you happy :) [Apparently the smiley changes the tone of the sentence]

I did speak to you, well tried. And well it's ok. It just seems really low that's all. But i respect you decision. [You spoke to me and told me that you wanted to date another one of my friends, telling me doesn't make it alright.]

And i do hope one day you might want to look past everything, cause it would be nice. [I decided when I came to university that I only had time for friends that I enjoyed being around. I am still civil around you, I just don't ever want to be your friend.]

Powerbalance bands and the logic of pathology

I always laugh when I see someone with a Powerbalance band and I think that is mainly something to do with the fact that society seems to believe in the power of the placebo effect. It's the belief that things "happen for a reason" or the ever popular correlation = causation. I don't believe in miracles or coincidence. It is difficult to put your belief into something that you have no power over. People often wait for things to happen and say that it was fate. I tend to believe that it was someone else who was sick and tired of waiting. Perhaps it is time for people to start breathing (stop using oxygen infused water and oxygen tablets) and actually do something about whatever it is they are waiting for.

I have begun to realise something when it comes to medicine as a whole. We are finally finished with anatomy and suddenly things have begun to make sense. It's not about parrot learning anymore, the learning has a bit more meaning. Things begin to fit together and have a logical progression. Finally! I am kind of looking forward to the test :).

I'm feeling a little lonely again. I'm still searching for someone to talk to. Hopefully I will find them in the darkness...

"I am lucky. I did not choose this life. It chose me. It's strange like that; not picking my path, but rather easing into the water and letting it carry me where it will. Yes, there will be nights where I feel like my destiny is at my fingertips and there will be nights I wish the lights were off and I could just make these sounds in the dark. Still, I will always be there, wherever there might be, staring into blackness hoping the blackness stares back at me."

First things first and just walking

Monday turned out to be quite an awesome day, although I didn't get much sleep before lectures today (probably 4 hours). It started off with being stood up by the health minister. I thought that it was rather remarkable that he was in fact willing to talk to us, but I think that the press kept him occupied which left us having to leave to go to lectures. The campaign that he was launching is a great initiative to try and curb HIV infection rates in the country. By proactively offering testing all around the country it promotes social responsibility to in fact be tested for HIV.

After university I had to help out at the street party. It was a lot of work and I really hope that we will make some money out of it. Saw Wezley and Bernard playing rugby which was awesome (even more awesome was the fact that they beat a lot of the people that I know from high school). We only finished at around 1 am and I still had to drive home (an interesting task when you are really tired). The rugby club really needs to work on the basics to make things work, because a lot of things were just illogical.

Someone brought up something yesterday that was interesting. She asked whether I chose to be single. I do think that it can be a choice...but not so much in my case. I suppose that we often put it down to waiting for the right person. That's what I am doing, just waiting for someone that I can talk to.

I just saw the Johnny Walker advertisement on TV and to say the very least it is motivational... Although having a marathon runner promoting alcohol is a bit of a cop out. When things get hard, just keep walking, or if you would rather, Swim (Jack's Mannequin).

Valentine's Day

Valentine's started rather early this year. First there was the MSC selling roses for charity. I was really astonished to see girls and guys from my class buying roses for each other, even if they weren't in a relationship. It taught me something important about the people in my class, for them Valentine's isn't some commercialized holiday. It is a special day for them to show someone that they are loved. Perhaps I took part in this year's Valentine's Day rose buying, perhaps I didn't. You'll have to wait and see.

Yesterday brought another interruption to the usually monotony of life. It was the Valentine's Day night race (10 km race). Feeling rather underdressed (I didn't wear any pink or have any fairy wings), I had a really great race, breaking 40 minutes for the first time. I hope that that is merely a dry run (no pun intended) set up for the actual Valentine's Day on Monday. Hopefully better things are to come.

Aaron Motsoaledi is coming to medical school on monday and I dare say that I am in fact looking forward to it, even if he is just there to launch an HIV awareness campaign. He has really turned around health care in this country and, although that wasn't really hard, I really respect him. I'm looking forward to the expected Valentine's Day joke (surely there has to be one with these politicians).

Finally there is street party. Sport's admin is convinced that people have nothing better to do other than help them sell alcohol. I don't really care that it would make my club money, my problem is that they expect five people to be there from 3pm until 1am. Absolutely ridiculous! What a farce! Oh well...

May everyone find love this Valentine's Day and to the person destined to be my next Valentine (in the non-commercialised version of the word [girlfriend]) I will always say that I wrote this for you. Do not argue that I wrote this year, just accept that I realised that bigger things were still to come :).

The concrete walls hold fragile values,

the library the power to kill,

the cafeteria the delights of many,

the second floor only deadly still.

Yet within the minds of students taught,

there lie the words from textbooks bought,

to uphold the values for which they fought,

and find the peace of mind they sought.

But the halls of tables and the chairs,

hold both hope and despair,

to free the minds of those who dare,

to challenge people, not compare.

Values, minds and free thoughts,

that fight for place in parking lots.

To change the perception of them all.

Just you and me against the world.

The fear and those things that you don't quite enjoy

There's something about medicine, there are times that it is really hard to enjoy. You are taught new things, but it never seems like you are going to remember anything. If anatomy is anything to go by, then I will remember very little. Which leads me to the odd conclusion that perhaps they are teaching us how to learn, and the material is merely a tool in the process. I remember the things that I love, which in third year seem to be few and far between. I suppose that it is all with the ends in mind, completely disregarding my lack of enthusiasm for the means.

There is something that comes attached to medicine. It's a fear in many shapes and forms. Firstly, there is mind-numbing hypochondria. Suddenly things that you completely disregarded (or simply didn't know about) become far more real. But there is another type of fear that I thought about today, it's not the fear of what may happen to me, it's the fear of what might happen to my friends or my family. It's the fear that when an ambulance is opened at a hospital it won't be just another person, it will be someone that I have spoken to, someone that I know. We are taught to distance ourselves from all of that, but I suppose we are never taught how to deal with it when it does occur.

Here's to hoping that that day may never come. Here's to hoping that my nightmares never come to fruition. Here's to hoping that I can sleep tonight.

Interventions

Considering that things are getting a little out of hand, I think that it is time for an intervention.

Now interventions are appropriate in the following situations:

1. When graduates find it necessary to wear their sunglasses on their heads, indoors.
2. When people make a mockery of the english language.
3. When people begin to quote Grey's Anatomy, way too often.
4. When people park in our parking spaces.

Now in order for an appropriate intervention to take place you need the following:

• One large intervention sign
• Equipment appropriate for each situation
• Keen crowd of groupies
• Camera (To record the moment)

This will need to be perfected in light of all the potential interventions in the near future. The intervention to be staged tomorrow will serve as the prototype for all future interventions.

On a slightly unrelated note, I have added a few more medically related fields to my list of morally acceptable career paths. I think that one of the reasons why we are put in positions of "power" is so that you can influence people for the better. I have met so many amazing people that I wouldn't have met had I decided to become an engineer. It's not just meeting people though, it is the opportunity to actually make a mark, impart some knowledge.

I would like to be remembered one day, perhaps for some research, or some other project. But I think that the thing that will have the most bearing on my life will be what my patients and my friends think of me. And that need not necessary be that I am the kindest person alive, I would rather be known as being a good doctor (In the helping others sense of the word). I say this because I am already not on the best terms with some of my friends.

List:

Medicine

Physio

OT

Pharmacy

Microbiologists and Geneticists

Perhaps I should explain my reasoning behind this list. There are certain careers where you in fact aid your fellow man directly and those are the ones listed above. Other careers like engineering and architecture allow you to aid your fellow man indirectly, but you are always distanced from those that need to be helped most. Lawyers often just help the wrong people.

I know that I have mentioned the mockery of the english language in this post. I have not spent the time to check my spelling and grammar, it is late. If you feel really strongly about my poor grammar then please feel free to stage an intervention.

I have become really fond of two web comics: A Softer World and xkcd. One of them provided me with my new favourite quote:

‎"I know that you don't love me, but there must be something I can do to make you a better person."

Sometimes all that you need is a little conversation

It's odd how I sometimes find myself drawn to people. It's really not a sense of attraction, at least as far as I know, but rather a hunger for conversation. Some people just have really interesting points of view. And yet mundane conversation seems to be the rule of the day. Most people are kept occupied with small talk and never tread into the realms of deeper conversation. It's also often hard to start a conversation where you are asking about more than how the person's weekend went.

There are only a few people in my class that I really enjoy talking to. It's the people that I can have an honest conversation with and not be bogged down in small talk. But I do honestly feel lonely sometimes, because I need that kind of conversation every day. I haven't yet found someone who is willing to speak to me on that level and let me share on that same level.

So I suppose at the moment I will have to settle for the small talk and keep an open ear for the conversations that I crave.

Tomorrow we receive our BP cuffs and stethoscopes. I suppose it almost marks a coming of age, though some people did have to wait a lot longer. It does feel like an adventure, with so much to learn, and new people to meet every day.

It's so much like an adventure that it's easy to get lost sometimes.

Baby talk and religion

My cousin has just had a baby so I am constantly exposed to the subsequent baby talk. I have never been a fan of speaking to babies in that way, for me it almost seems unjustifiable. If babies do not understand, then why are you speaking to them like that? Surely they are human beings like the rest of us? It is the same as when children ask the "hard" questions, is it really necessary to dumb down the answers in the effort to get the child to understand or would it be better just to tell the truth and let your child make the conclusions for themselves?

It is extremely interesting to see how children turn out in the end. I have been friends with countless individuals who were just like me 15 years ago but are now, as many would consider "off the rails". In my opinion it often has much to do with the parents and not the children. Perhaps leaving children the opportunity to think is not a bad thing. Children are far smarter than they appear.

Another topic came up yesterday that left me feeling a little bleak about the world. Often individuals are judged on their primary beliefs because that is seen to be an indicaton of the person as a whole. I would rather that people did not assume that I was a bad person because I am not religious. I would rather leave that up to them to determine through getting to actually know me. I am willing to give you a fair chance if you are willing to give me one.

I should say that I distinguish between religion and belief in evolution. I find that they are mutually exclusive. I suppose at least that is how I justify it :), otherwise I would seem like a bit of a hypocrite.

Orienteering starts tomorrow, I am really looking forward to it!

Running again and the ethics of clinical trials

It was great to be running again after being sick for a week. Didn't seem to set me back too far and I will hopefully be back in form by monday for the first School's League orienteering race of the season. I decided to do them just for fun and for the experience.

Watching Grey's Anatomy brought to light an interesting ethical topic. Is it ethical to give someone a placebo in a clinical trial?

"The placebo has to be the doctor's greatest deception. Half of our patients we tell the truth, the other half we pray the placebo effect's real. And we tell ourselves that they will feel better anyhow, believing help's on the way, when in fact, we're leaving them to die."

Grand Design

I always find it interesting when the age-old creationism versus evolution comes up. We are taught in class every day the basic principles of evolution, we apply it when trying to solve problems and yet people still are not able to accept it.

We were required to do a study for our biostatistics class, so my friend and I decided to try to compare an individuals "perceived" education and their belief. The hypothesis was that, since the graduates had been exposed to the idea of evolution for a longer period of time they might be more likely to believe in evolution. This didn't prove to be true, in fact it was equally split 50-50. It was interesting, however, that there were more people in my limited sample group that believed in evolution. Progress, at least as far as I am concerned, considering that in first year 80% of the class believed in creationism.

I am sick of the people that cringe at the word. It's a part of life, deal with it.

Graduates and the clinic that we love so much

My medical school takes great pride in admitting graduate entrants into the medical program. (It is the only medical school in the country that does) It is true that it  adds a sense of excitement and flavour to the mix with all of the new points of view, but hell, some of them are just weird. It is fun to playfully mock them though. Today we had the ever popular "Wife beater wednesday". It might be a hit at main campus, but not so much here.

Then there are the graduate trends:

1. Wearing sunglasses on top of your head, indoors.
2. Blocking staircases ["How many people with a degree does it take to block a staircase?"]
3. Pointing out mistakes that are obvious (like mistakes with dates) to the lecturer (though this is only one person in particular)

This week has been really hard on me, especially when I finally realised that the clinic is not all that it is made out to be. Every week the students run a clinic for anyone that wants to come (though it is mainly for the homeless that have a soup kitchen there). On monday evening I did intake and met a well-dressed individual. Although it is part of the social history that I am meant to take, I made a point to ask where the person was working. He said that he was actually studying a masters and working part time at the university. Once I had completed the intake we were taught clinical skills and I proceeded to run into him downstairs. We practiced clinical skills on the patients waiting, in the hope that it would perhaps speed up the line. When we were finished, the man asked why lymph nodes became swollen. A fifth year student proceeded to explain that it was the body fighting against "goggas" in the body.

This really made me angry because I felt that it was extremely condescending toward the patient in question. He was educated, and yet he was still being treated like a child. I concede that many patients do not know much about medicine, but, in my eyes, there are different levels of medical knowledge. There are levels which I don't even understand. Many medical students seem to think that there are just two, that level that medical students learn, and the dumbed down, public level. I honestly don't care if some of the patients there are homeless, many of them are immigrants that have degrees, in engineering and the like, that have not been able to find jobs here. In my opinion, if you can teach someone the mechanism of how something works, they are more likely to understand it in the future. We are not trying to create a stupid society that doesn't know what is going on, we are trying to educate society as a whole. I have even explained to someone how the reading of blood pressure works.

It is perhaps because I did intake on this person that I took the initiative to explain to him exactly how lymphadenopathy occurs. I might not have found out more about him if I had not done intake. It just distresses me that it is not the first time that this has happened, other patients are also sometimes left out of the loop. Perhaps many of the other medical students there have been around a lot of patients and have distanced themselves from all of them. Perhaps that is something that I still have to learn.

But for now I will take pleasure in giving them knowledge that they can take away with them. It's not much, but it's something.