Miss Potter and the Northern Hemisphere Winter

I got to ward rounds about one minute late, but nobody seemed to notice me anyway. Until Dr R was like, "how are you?" and I turned around thinking he was addressing someone behind me, and there was nobody there :P

Instead of tailing the resident around though, I followed one of the consultants up to the gen med ward. Oxford is different to Sydney in that many people with simple heart conditions are managed entirely by the general medicine team, don't have much contact with actual cardiologists, and never get moved to the cardiology ward. So I saw 4 patients with heart failure with Dr D, who quizzed me throughout the morning. Luckily I was able to answer his questions about Barret's, Multiple Myeloma and Thyroid diseases because they show up in 5th year case protocols!

I then made a mug of instant ramen. Shortly after coming out of the staffroom though, the emergency alarm went off. It turned out one of the patients (a 50-year-old lady with dilated cardiomyopathy who'd just had an ICD inserted) on the cardiology ward collapsed, having gone into VT. A minute later I heard her talking though, so I assumed she recovered. But then she went into VT for a second time, and lost consciousness.

In years 4 and 5, whenever there was an emergency, all the students would be told to get the hell out of the way. I was about to do the same here, before one of the junior doctors asked if I knew how to give CPR. When I replied in the affirmative, he told me to get a pair of gloves on and get into the room ready to take over from someone doing chest compressions. I did a couple of times, though I fear I wasn't terribly useful because I'm a bit of a weakling and I tire quickly. Actually, once more fit young male doctors came along, my job was to hold the arms of the patient because in her semi-conscious state she kept flinging them around, dislodging her cannulas. The patient's pulse came and went, she flipped between sinus/VT/VF, they had to put a magnet over her ICD because it kept randomly going off, many shocks were given, PE/rupture/etc were all ruled out eg by echo, a heck of a lot of adrenaline got infused, they had to suction the intubation tube because it filled up with sinister red fluid, and the team even tried some amiodarone. The resuscitation efforts continued for about one and a half hours but unfortunately, with the patient becoming less responsive and the pH dropping severely and the lactate rising, and since the patient had requested to not end up in the ICU, they decided to stop. 

My paternal grandfather passed away when I was 11, my great-grandfather when I was 12, my maternal grandfather when I was 16, and my great-grandmother when I was 21, so this wasn't the first time I'd seen someone who'd recently passed away. But I don't think any of that fully prepared me for how sad and scary it is when someone slips away rapidly before your eyes. Like as I saw the patient's extremities turning blue, watched as successive blood gas readings came back more and more acidotic, felt her grip weaken in response to "squeeze my hands if you can hear me", and then got asked to help clean up some of the blood before the patient's husband came in, I still didn't quite believe what was happening. I just kept imagining she was going to get her pulse back properly, and then slowly but surely wake up. And also, when we were leaving the room, I couldn't help but think how horrible her final moments must have been...she was evidently aware that she had a tube down her throat and a needle in her neck and two more in her arms, plus we were squashing her sternum, and taking arterial blood samples from the femoral artery (that's basically in the groin, folks). One of her cannulas failed so a new one had to be put in, and she tried to fend off the needle. And even when we weren't checking her response, I noticed she sometimes just held my hand anyway. 

But yeah. Just nothing completely prepares you. I sort of sleep-walked out of the ward and to the registrars' room to message someone online, because I remember just desperately wanting a hug but being too scared to ask any of the doctors. So I got a virtual hug from Mr Ravenclaw. Then I decided to call it a day and calm my nerves with some piano and fudge. It was kind of good timing, as I realised I could properly bid farewell to the Steinway that has served me so well during my term at Oxford. Whenever I've felt like a wreck, I've usually gone to the piano and just played all the bad feelings away. I did a post office run to send off some goodies to Northern Ireland (only 2.70 pounds including packaging for a small parcel going across a body of water!? And the lady felt apologetic that I couldn't quite fit it into a "large letter" and had to pay more. I'm pretty sure I've paid more than $5 to send a hat from one Sydney suburb to another). 

The weather was dismal. Seriously, not only was it bucketing down, the wind was howling away so that even if you had both an umbrella and a raincoat, you still got wet. And since nobody was keen on joining me for an Atomic Burger (apparently there's a burger place that's decorated to look like a cartoon), so I just went back to my flat, did a quick ab workout, showered, and then ate up the last of my udon. I just need to figure out what on earth I'm going to do with my rice, because I have a large packet and nothing to cook it with. I think I may just end up eating it plain one morning. 

I was going to write an entry the other day about how the snow had all melted, and just like the winter wonderland, and my English adventures (along with all my petty woes), nothing can last forever. But I can't think of a clearer example than today of how fragile life is. And it is so humbling when you think that even though it was my first time, for everyone else in that room it was just part of their daily job. They have the courage to deal with such trials as these many times a month. I have been reminded once again that even though I'm near the end of my med school journey, I'm barely at the beginning of becoming a doctor. 

What did I do with my Thursday...well, I went into hospital as usual, but I didn't do my usual things. Because...it was the day of the final year med students' final exams, and I had volunteered to help out from 8am-5:30pm. There were a few reasons why I'd signed up:

1. The promise of a free lunch and free snacks.
2. To meet other med students (and it turned out also, junior doctors who were currently doing research).
3. To support the 6th years, because our job was to provide them with a stress-free run through their stations.
4. To earn brownie points with consultants from my department, who were being examiners.
5. To see the students (and examiners!) dressed up in "sub-fusc". This usually consists of black pants/white shirt/white bowtie for boys and black stockings/black skirt/white blouse/black ribbon for girls, all worn under academic robes. However due to the infection risk, during the practical exams, robes aren't worn and the white shirt sleeves are all rolled up to the forearms. Still, it was quite a novelty! I wonder what would happen if we turned up to our exams in sub-fusc for lulz. I mean, I had a conversation with a 4th year med student who explained she quite appreciated the exam uniform, since it helped her get her head into the zone.

I was also hoping to get to observe some of the actual exam stations, and see what kinds of questions were asked in Oxford finals, but since I was assigned to be a chaperone, I only managed to see/hear some of the questions and marking schemes. Nevertheless, I could tell that the standard of the candidature was extremely high and once again I felt slightly underqualified to be in Oxford!

There was an amazing walnut cake for afternoon tea, but I missed out on the apparently even more amazing "lemon drizzle" cake. Coincidentally though, I found a recipe for it in one of the free newspapers we were given to read during the breaks, so I will  be attempting it when I get back to my kitchen and my utensils and my ingredient supply. I had been planning to go out on Thursday night to a bop, but I was too tired to go (and besides, I wasn't terribly keen to get hit on) and ended up curling up with a bowl of noodles and a new book recommended by the boyfriend.

Friday was one of my insane days! I followed my favourite resident and registrar all day until Journal Club, where we were shouted lunch by the people marketing "Edarbi" (azilsartan medoxomil). I then went back to the ward for a bit, although it was quite sad as we had to tell the husband of a lady with carcinoid that she was reaching the final stages of her illness. I stalked one of the consultants back to his office and gave him my elective forms, so that he would have a few days to fill them out. It's actually been quite difficult as I have been floating around the three cardiology teams: electrophysiology, intervention, and imaging/structural/failure for the last month without a lot of emphasis on a particular one (well, except maybe EP, I don't understand it well enough...) So hopefully Dr D has seen me enough to say that I've been present and involved in my elective. I guess if I haven't, then perhaps I could stay another 4 weeks here...but I'm not sure if my visa, wallet or family would like that.

So I came home at about 3pm and attempted to do a load of laundry. Unfortunately, the machine swallowed a few of my coins and appeared jammed, so I trekked up to the accommodation office to ask what could be done. Apparently I may get refunded my 1 pound 20 pence...if the machine gets serviced in between now and Thursday. The chances are slim, but hey, I tried. And I put a sign on the machine with Don't use this machine! It will eat your coins! so hopefully nobody else will suffer the same fate. I got my laundry done eventually in another machine (though it looks like I'll have to do yet another round of washing tomorrow...aargh!)

I then had a shower and got ready for the two parties I had to attend this night. Firstly, there was a black tie dinner to celebrate Robert Burns' birthday. Burns is a Scottish poet, the author of Auld Lang Syne and a couple of other famous bits and pieces, so Scotland like to celebrate him with "Burns Night". It admittedly felt a bit weird to be celebrating a Scottish poet on Australia Day (well, it was the 26th in Australia by 1pm 25th Jan GMT) but it was SO much fun. We began with drinks upstairs, before we were serenaded with a guitar/violin duo as we descended the stairs to the dining room in our tower. And then the bagpipes suddenly began! We filed into the hall as Scotland the Brave played. None of the other elective students managed to snag tickets, so I ended up surrounded by strangers, but everyone was amazingly nice and put me at ease immediately. The first course was soup, after which the bagpipes came out again, as the Haggis was brought in (="Piping-In of the Haggis"). As I'd specified "no red meat" I was classified with the vegetarians, so my haggis/neeps/tatties was once again a safe, spicy veggo version. In between our mains and dessert we were once again serenaded by our guitarist, who sang a few of Burns' songs. One of the fellows of the college also stood on a stool (not a table, or a chair, because that was not OHS-friendly) to recite the tale of Tam O'Shanter (yeah, same name as the ridiculous hats my school made us wear in winter). Even though it was in Scottish, he acted it out so well that I understood most of it (plus he gave us a synopsis, so that helped!). After this awesome entertainment, we had Cranachan. Holy crap it was strong!

After this there was coffee/chocolate and Scottish dancing. Unfortunately I couldn't hang around for long as I had to be at a "sexy sub-fusc bop"! I love doing the sexy schoolgirl thing so this was really fun! Plus, 2-pound vodka/cranberries? Who wouldn't be enthralled?! I came home at around 2am though, aiming to be fresh and bright for Quidditch the next day.

This didn't quite work though, because I left my Skype running on my phone and got woken up a few times during the night. I also found out that my body clock does not like me sleeping in. Hurrah for my regular 7am wakeup, even on a freaking Saturday! I went back to bed, of course, but barely slept and ended up wide awake before 9am. So I stumbled out of bed, made some ramen, decided to give Justin a call, tried to eat gracefully in front of him, and perved on his amazing house.

I made it to Quidditch, got my weekly dose of crazy cardio, and got horrendously muddy (to the point that I am considering not bringing my boots back, because no matter how much I rinsed and scrubbed, the mud would not budge), then excused myself a bit early so I could tidy up before BD's afternoon tea (she's a med student coming to do her elective in Sydney!) Unfortunately I left my scarf behind, so I may need to put all my knitting projects on hold while I make myself a new piece of Ravenclaw paraphenalia. Furthermore, the public toilets had no sink, only an "auto soap/wash/dry" machine. So I was basically sticking my head into the machine, wiping my face with the inside of my hoodie, and...yeah, it wasn't a pretty sight and no matter what I did, I couldn't get most of the gunk out of my hair.

BD's place, which is a little bit north of Oxford, is a beautiful old house with multiple cuckoo clocks and numerous photos of family all over the walls. We were treated to some amazing food, including a very authentic pavlova, and some malteaser concoction that looked like brownies but was actually solid chocolate. BD's mum was so sweet and thanked me already for helping out BD with her Sydney visit. Her sisters were also really great, helping to cook and clean up! And BD's friends were awesome. Even though I do funny things like call "yohg-urt" "yoe-gurt", they still put up with me :)

Eventually it was time to go, and I decided to head straight back to my flat. I was fairly glad, as shortly after I arrived back, it started pissing down...

Time for an update, I think. The last few days of my second week in hospital got kind of hectic, because the guy who was meant to be my supervisor finally showed up. So I had to be on my best behaviour and stay in hospital til at least after 4pm. But I learnt lots of stuff! I have played with an ICE catheter! I have heard a lot of ESMs and felt "slow rising" pulses! I have gotten horribly confused by the different units used to report blood test results! I have met lots of patients/doctors/students who think I'm American! I have spent a lot of time in the med student clubhouse known as Osler House (WHICH HAS A PIANO OH MY GOD MY WITHDRAWAL SYMPTOMS ARE CURED)! My team have made a LOT of orthopod jokes! Also for some reason I’ve had to chaperone 2xPRs. And this is the cardio ward! I shudder to think what gastro/neuro wards are like here!

Also I saw a blood glucose monitor that claimed it was "fast, compact and stylish". Excuse me, "stylish"? How on earth can a piece of medical equipment be "stylish"?

The other elective students (C, H, J and R) have all started now, which has made my life a bit more interesting (though K has gone home, sadface)! Although nobody is staying at the hospital with me (maybe I should've paid the extra $$ to stay in college...but then I'd have to catch the bus into hospital every morning, and I hate mornings), we've had dinner together (<3 Wagamama!) and gone to a party (or rather, a "bob") together, and I'm hoping we can do a pubcrawl together too (C's idea).

Ah yes, the "bob". Where the action only starts after 10:30pm, 6-shot cocktails cost a mere 4 pounds (my readers will probably be dismayed to learn that I asked for a half-sized "Willy-O", the Osler House specialty), candy brains/eggs/teeth etc are served, people proudly wear cardboard boxes/paper plates/newspaper/garbage bags/next to nothing, "Gangnam Style" is the only song that brings everybody together, and the vodka lemon/lime consists mostly of a really disgusting green cordial. It was held in the main room of Osler House, with the canteen being converted to a bar and the couches being cleared away to create a dancefloor. However, I noticed people spilling into other rooms, especially the pool room (but alas, the piano room was locked for the night). And despite the bitter cold, a number of people were loitering outside...smoking >_<

I've also been adopted by the Quidditch Society and the Harry Potter Society (which overlap a bit). Thanks to them, I've gotten some serious exercise, I've had someone to see Pitch Perfect and Les Miserables with, I've gained the courage to just stroll casually into colleges (thanks soooo much B and M for taking me to Trinity and Oriel!), and I've consumed a significant amount of chocolate biscuits while knitting my next sock. They are also teaching me to speak Oxford English (yeah, apparently it's not all about the Oxford Comma). It's not a library card, it's a "bod card", for example. And we have to be quiet because of "collections".

Actually, their knitting club, a subset of the HP Society, deserves a whole paragraph. Not only is everyone making Hogwarts scarves and eating chocolate biscuits, they are the coolest (read: geekiest) Oxford students I've met yet. And for this I love them all. Today, they sang excerpts from Les Miserables, spent >15 minutes discussing the number of minutes in a year, and discussed past and upcoming D&D campaigns (admittedly, I don't play RPGs because I lack the time, but for all my dating I have {happily} been a D&D widow, which I prefer to being a football widow or something because at least D&D/Shadowrun/Pathfinder/Dark Heresy are compelling intellectual pursuits).
But generally, I love Oxford students in general (except the smokers, they’re just gross)! Even though they say things like, “awwww, who thinks it’s cute that the Aussies are cold!” I’ve still had really fun conversations with them. Especially about our wildlife. And our beaches. I’m so excited that some Oxford med students are coming over in the next few months! I hope I’ll be able to drive them up to the northern beaches and stuff.

This week I also managed to fit in lots of touristy things! I did the free Footprints walking tour on Saturday morning when J, my med school colleague/neighbour/revue friend came to visit. The guide was genuinely funny, eager to tell us all the tales of Oxford (e.g. the Mallard Duck story, the college “where fun goes to die”, and the antics of several Rhodes scholars including Bob Hawke and Bill Clinton). We also wandered down many cobblestone roads, got inspired by the same sights/sounds that CS Lewis (omg the Narnian lamp post!) and Lewis Carroll did, discovered what a “kissing gate” is, and took a jumping photo near the Bridge of Sighs. Today I visited the Bodleian Library, the Radcliffe Camera, the Divinity School, Harris Manchester College, New College, and the Museum of Science (so I’ve now done most of the Harry Potter sites, apart from Christ Church, which is a work in progress as I’m trying to get myself invited to dinner there).

And don’t get me started about my retail therapy…remember that red dress I mentioned a few entries ago? Well, it got marked down from 18 to 10 pounds, so I caved in and bought it. Since I’m going to start going to parties more, investing in a decent dress is not a bad idea. I guess the problem is that I also caved in and bought a 20 pound wool trench coat and a 5 pound pair of cute pink shorts (I’m planning to wear them to skype the bf). Oh, and today I did my varsity shopping…bought a Green Templeton hoodie (whose logo DS will approve of), an Oxford t-shirt to match it, and some track pants. WHAT?!? I got a student discount! Oh, and I bought some tea towels for my mum and grandma and another female relative that I have forgotten to buy presents for. Oh well, I plan to chuck all my toiletries before I leave home, so that’ll free up significant weight/space in my bag…

And now speaking of toiletries and things, I can’t help making a few comments on my accommodation. ( Read more... )

In summary, it’s been a really hectic week, but I love this place and it’s going to be so hard to leave after one month (except when I think of the warm weather back in Australia, then I can’t wait to go home and defrost)!

Oxford, Days 2-4
I'm now settling in, learning the nuances of my flat. For example, one of our showers doesn't get hot enough to have a comfortable shower, the lights in the bathroom take 5 seconds to turn on, I can get moderately dodgy wifi from one corner of my room, and the washing machine on the far right gets stuck mid-cycle.

I'm also slowly getting acquanted with Oxford itself. You can't seem to walk anywhere without bumping into a beautiful old church or something, and I love that. I even intentionally got lost a few times. Sometimes I was following squirrels. Yeah, feel free to judge me. 

Today I went to the Asmodean Museum...wait, Ashmolean (dammit, DS, for putting Wheel of Time into my head, but it's your birthday so I'll forgive you) which turned out to be quite amazing - I spent about 2 hours wandering around there without even paying to get into the "special exhibitions"! I especially liked the collection of Egyptian mummies, the musical instruments (omg, I saw the Messiah!), everything Roman (I managed to read a few of the Latin sentences without having to look up the translations!), the Greek pottery, the Chinese porcelain, and the Japanese paintings. Actually, I was really proud of myself today because apart from buying some tofu (hurrah! I can stop being malnourished!) I didn't spend any money today (Ashmolean museum is free, and I have a frequent-rider bus ticket).

Unfortunately, the same cannot be said for my other days in Oxford. Okay, granted, I had to do several rounds of groceries because I prefer to cook most nights, even if all I cook is pasta, noodles and fried rice. I also ran out of hotel soap...but fortunately Boots chemist was having a 50% off sale, so I got this fantastic vanilla/raspberry body wash for a little more than one pound. This stuff usually retails at Coles for over $4 a bottle. And oh my gosh, I love it! It smells like those strawberry-and-cream hard candies that I haven't seen since the 1990s. And even though I have been using it for less than a week, I already feel all nice and moisturised. When I get home, and it comes on special at Coles, I will buy a shelf full of it.

But yeah, I still need to get a dress for my formal college dinners. I saw a nice red-and-black dress today, but it was a little bit big and not quite formal enough, so I put it back. I kind of want an excuse to get something from this quirky place, which I see every time I ride the bus, but it's probably so expensive I may as well be shopping in Australia. And as hard as I try, I will probably gain weight in between now and my gradball in November. 

Anyway, you're all going to think I've been all play and no work. I actually disagree...I think I've been fairly well-balanced so far! I've been getting to hospital at 8am for ward rounds, then going to the ward, or the cath lab, or outpatients. I've also spent some time in echo. The bosses and registrars have been really nice so far, even when I've asked horribly dumb questions like, "What's a firm? Is it just like a team?" Some of them even seem to like Australia (one registrar thought that Australians have cool place names, eg Wagga Wagga).

I feel like I need to work on my mannerisms because the way I phrase things sometimes sounds odd to English people. In my next entry I'll make sure I describe in detail a situation where someone looked at me a bit funny. I mean, usually they can smell my accent a mile away so they roll their eyes and think, "stupid Aussie" but like...oh, I dunno. Actually, to be honest, it works both ways, because sometimes I take awhile to process what people with heavy northern accents are saying :( some of the doctors must just think I'm really dumb.

I've also had the pleasure of meeting one of the other elective students. K is from Poland, and apart from being ridiculously smart, beautiful and gracious, is a really fun and adventurous person! I actually feel quite bland next to her (in fact, with everyone telling me Oxford is extremely competitive, how the hell did I get in?!?)  I imagine all the other elective and native med students are similarly super-hyper-overachievers...eeeeeek!

But yeah, there you go! Not only have I survived week one, I'm having a ball! And the other Oxford students haven't even officially started term yet...next week, the parties start!!