The Auricle Vol 2 Edn 2

CONTENTS LETTER FROM THE EDITORS It’s that time of year again. You know the one: where you have absolutely no idea where the last few months have gone.

But never fear: as ever, we’re here to fuel your procrastination and study breaks with our brand new edition.

Read about what it’s like to live with lupus or to work with children whose IQs are below 70. Discover how to tackle the mammoth that is Year 4C (gulp) or the news that you have cancer. Figure out which medical app is best for you. Check out some brilliant comics, illustrations and short fiction. Get the 411 on what’s happening at your medical school.

Keep the submissions coming. We’re growing fast, with thousands of views for our last edition, so grow with us!

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The Human Heart (Anonymous)

CONTRIBUTORS

it’s sometimes lupus 004

Maeve Barlow Victoria Berquist Grace Cowderoy Ming Fan Nathaniel Hiscock Youlin Koh David Mathew Xiuxian Pham Andrew Rabinovich Joanna Wang Chris Wright

guide to surviving 4C 008 notes from osler 011 amsa convention / GC2013 013 amsa council 018

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creative: the silent killer 020

CLINICAL EDITOR / DESIGN Michelle Li

creative: that’s the life 022

PRE-CLINICAL EDITOR Rachel Chen

outside the classroom 024

ENQUIRIES & SUBMISSIONS publications@mumus.org

love week at dandenong 027

WEBSITE monashauricle.wordpress.com

caduceus cup 029 001

Youlin Koh (3B)

FEATURE As told to Maeve Barlow (3B)

My name is Laura, and 2 years ago I was diagnosed with major organ SLE, better known as lupus.

I was 17 years old, ready to celebrate the end of high school and the beginning of university, where I was studying law. This was all before my health took a significant turn, and after a tumultuous 3 months in hospital, multiple incorrect diagnoses and 6 days in Royal Melbourne ICU I was told I had lupus, a chronic multi-system disorder.

Freedom. It’s something we associate with politics, society and the history of oppression. For someone with a chronic illness, freedom is a much more basic concept. Freedom for us comes in that first moment of waking up in the morning and not remembering that you are sick. Freedom is sitting with friends and not feeling pain in every joint while still smiling and laughing. Freedom is the ability to get up each day and not worry about the multitude of symptoms that ravage your body. Freedom is the ability to care for others and not be cared for. Freedom is choice. When you are diagnosed with a chronic illness, you give up a lot of that freedom. Life becomes a series of tough decisions and dealing with daily struggles and sometimes you can feel as if you have no freedom at all and that your illness has become your prison.

Sometimes it’s hard to separate yourself from the disease. You find that every choice you make is impacted by it, that it can dictate your life and who you are. As much as you want people to see you as the person you are beyond the disease, you realize that the disease has become a part of you. You can lose yourself sometimes to the illness; you sometime catch yourself in the mirror and not recognize the person who stares back at you. That can sometimes be the hardest thing, losing that person you once were. Sometimes you grieve for that person you lost and you also grieve the person you could have been.

Self-esteem. This was the hardest aspect. Your mind and body become so separated due to their constant battle over the disease. For a long time I despised my body. The prednisolone, the weight gain, the track marks, the hair loss, the joint pain, the nausea, the pain, the breathlessness—they all served as reminders of my genetic weakness. Mirrors became daily visual post-it notes of my days in hospital and the fear and anxiety that encompassed the world of lupus. I lost not only my self-esteem but my whole sense of self. I was losing a sense of identity and femininity that would be extremely difficult to regain.

However, as time went by, as my body began to recover and as I began to come to better terms with my illness, my mind followed. Now, when I looked in the mirror, I saw a body that had been a pillar of strength for me without my knowledge. While my mind was coming to terms with the new path my life had to undertake, my body tirelessly worked to repair itself, to survive. Acknowledging this, I began to feel the empowerment and thankfulness for my body that I believe most women should try to achieve if only for one day of their lives.

When you become chronically sick, and you’re unable to do so many of the things you could before, you find yourself relying on many others. I’m incredibly blessed with a family that supports and loves me regardless of all the things that they have to do for me, but sometimes the guilt I feel about the worry and sadness they have to feel is overwhelming. I maintain the view that illness is harder on the ones closest to me than it has ever been on myself. You feel helpless and you know that the ones around you feel the same, and that emotion can be very hard to deal with. Fear is also a big part of chronic illness. Mostly you fear your incapacity. You fear the future and what that 005

can bring. Each day you have to wake up and be courageous and keep a strong sense of hope that things will get better.

However, there is a part of me that embraces Lupus.

With all the sadness, the guilt and the fear and the lack of freedom I feel at times, there is overwhelming strength. I don’t think I have ever truly appreciated my family until now with my sickness, or the value of a friend who cares enough to look after me but also a friend who is there to listen.

I also have come to appreciate the simple pleasures in life. A simple shower, a good night’s sleep, a carefree stroll in the park. All of these things, once they are taken from you, hold a new importance in your life.

Victoria Berquist (3B)

Victoria Berquist (3B)

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Youlin Koh (3B)

FEATURE Andrew Rabinovich (4C)

Year 4C of medical training has often been considered to be the greatest obstacle presented in medical school.

With students often brimming with confidence after completion of their first year of placement and general medicine, the shift in expectation, abundance of time-consuming hurdle requirements which serve no purpose for revision, and the ever-looming threat of two days of OSCEs and the dreaded VIA can be enough to warrant a code blue. Experiences range from being asked to break the news of a cancer diagnosis to a patient, to witnessing senior consultants describe a nurse’s attempt at a diagnosis as ‘fishier than a gynecology outpatient clinic on a hot day’ (true story!)

With these challenges in mind, this article attempts to provide some advice to help students maximize revision efficiency, maintain organization and improve their overall experience during fourth year placements.

Base your study and expectations on your unit Matrix.

The faculty now releases a grid of all conditions that are ‘presumed knowledge’, with each disease categorized based on the level of detail required. This grading should be used as a representation for the proportion of your time to dedicate to each pathology. Fourth year is a unique test of time management, making the quality of your study far more important than the quantity.

Always pick activities that will be high yield.

To rephrase, attend the activities whose time requirements are justified by what you are likely to learn. In the ideal world, students would be able to attend every learning opportunity with a hundred percent retention, however this is seldom the case. As such, a half hour tutorial on a ‘core condition’ may be more fruitful than two-hour lecture on a ‘low category disease’: relevant study trumps more study.

Strongly consider joining a MUMUS 4th/3rd year study tutorial group.

One of the central problems throughout the year is knowing when and how much time to devote to the VIA content. This dilemma illustrates the importance of using high yield activities, and maximizing your productivity. Small amounts of regularly scheduled revision will cover the majority of the study required for the VIA, freeing up your SWOTVAC to focus on your written examination and OSCEs (worth 80% of your total grade compared to 20% from VIA). Groups should preferentially be small enough to ensure accountability for everyone’s revision, and should focus on the core areas of medicine, which the majority of examination questions assess. Relate all revision back to EMQs and clinical scenarios—keep it relevant! A recommended practice endorsed by multiple consultants as the single greatest approach to study is to write your own practice EMQs and OSCE stations, then to pool them together with those made by fellow students to create practice exams. This approach often produces questions identical to those found on the final examination, and is highly suitable to the study group setting.

Assign a day of the week as your ‘admin day’.

This strategy provides a routine for completing your multiple weekly hurdle requirements. Each week, you are expected to complete activities for online units of Evidence-based Clinical Practice (EBCP) and ‘Health Services Management’ (HSM) due on Friday and Sunday midnight respectively.

Choose a weeknight you are almost always free. As such, knowing each Thursday requires completion of these tasks prevents you from falling behind, which in the past has had significant consequences: students with ‘unsatisfactory participation’ have had to sit an additional exam to 009

satisfy these hurdles! This is the last problem any of us need whilst preparing for final examinations.

Although obvious, it’s also recommended to choose weeknights away from the due date, as many students forget these requirements without the time allocated to make up for these errors.

Plan your breaks and make your time for yourself.

Medical students are notorious for having poor self-awareness regarding fatigue and burnout.

Whilst medicine has always historically had high demands, the constant struggle of balancing medical studies with employment and personal endeavours is particularly challenging in year 4C. In contrast to year 3B, there is minimal flexibility in placement hours and days off are scarce, equating to approximately twice the overall workload. This makes scheduled recovery time twice as important, as students tend to be particularly vulnerable to burnout in 4C after several years of study and the increased workload. By ensuring fixed time is allocated to social and personal activities along with academic tasks as discussed above, this helps students to maintain perspective about how effectively they’re handling their workload, identify potential time-management problems early before they escalate, and prevent them from neglecting other equally important aspects of their lives.

Ultimately, Year 4C marks the transition away from clinical placement towards simulated employment. Therefore, find a routine that supports the way you learn, remember and complete the requirements presented to you. Hopefully, some of the strategies outlined above prove useful in some capacity. The approaches you implement during your final student years will likely put you in good stead to best overcome the challenges of full-time employment as a responsible junior medical practitioner.

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FEATURE

A/Prof Chris Wright / MBBS Academic Co-ordinator William Osler was a Canadian born physician. Most of you have probably heard the name “Osler” in the context of his nodes (in bacterial endocarditis) or maybe, if you’re into rarities, his disease (Rendu-Osler-Weber disease). However, the reliable source, Wikipedia, gives us a more rounded picture of this man:

He was one of the “Big Four” founding professors at Johns Hopkins Hospital as the first Professor of Medicine and founder of the Medical Service there.

Osler created the first residency program for specialty training of physicians, and he was the first to bring medical students out of the lecture hall for bedside clinical training.

He’s the reason you aren’t just taught in a lecture theatre, and he created the first known journal club. In the early part of the 20th century, he published a collection of addresses entitled “Aequanimitas”.

Towards the back of the book there’s a wonderful page, where he gives this wise advice:

“Well filled though the day be with appointed tasks, to make the best possible use of your one or of your ten talents, rest not satisfied with… professional training, but try to get the education, if not of a scholar, at least of a gentleman. Before going to sleep read for half an hour, and in the morning have a book open on your dressing table.”

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The advice (read!) is sound, but I wonder what this list looks like about 100 years later? Here’s some that have stayed with me, in no particular order, and I’ve expanded the media to include film and the web:

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2.

3.

4.

5.

6.

7.

8.

9.

10.

Hilaire Belloc – The Four Men Franz Kafka – The Trial Herman Hesse – The Glass Bead Game (Magister Ludi) Diva – directed by Jean-Jacques Beineix Salman Khan – www.youtube.com/watch?v=nTFEUsudhfs Randy Pausch – The Last Lecture Evelyn Waugh – Brideshead Revisited Marcus Aurelius – Meditations Martin Gardner – The Whys of a Philosophical Scrivener Richard Feynman – www.youtube.com/watch?v=eLQ2atfqk2c

FEATURE Another year finished and the best week in the lives of 1500 medical students from Australia and New Zealand is over. To describe an Australian Medical Students’ Association (AMSA) Convention (the largest student run convention in the world) to someone who hasn’t experienced one is a difficult endeavour, nigh on impossible, but we shall try out hardest to do this incredible week justice.

Where to begin?

You arrive excited and mentally prepared (or so you thought) at your gorgeous Gold Coast accommodation, ready for your convention experience. You guiltily watch normal guests trying to access the lifts as you began to make your new best friends for the week, helping to carry large, clinking boxes to various rooms where you would return later for your reward. The accommodation is alright – if you like the beach view, five star apartments complete with pools, saunas and steam rooms… you know – if you like that sort of thing.

A short walk down the road brings 1000 rowdy Rangers to the Gold Coast Convention Centre where, within hours, you are fully submersed in the convention experience (your first ever Hawaii 5-0!).

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At the opening ceremony

You return here bright(ish) and early(ish) every day for the four-day academic program. It is an inspirational year, starting on the first day with “Off the Grid” speakers, presenting some of the unusual directions medicine can take you. Professor Michael Kidd (President of the World Organisation of Family Doctors) challenges you to use your medical degree for the greater good, and Dr Lucy Perry opens a door to her Ethiopian Experience working in Addis Ababa Fistula Hospital. Turning to current issues, Dr Michael Bonning presents some deeply troubling research into the mental health of medical students, leading perfectly into the panel on controversial issues in medicine.

On day two, you experience “MedEd” with Dr Simon O’Connor (you may have heard of him – he wrote some book with a guy called Talley?) and media personality Dr Ginni Mansberg testing your education and challenging your mind. The day also includes one of the unexpected highlights of convention – James McCormack and Mike Allan, two Canadian evidence-based medicine enthusiasts who made a dreaded med school topic into a hilarious and enlightening romp through modern medicine (“Best Science Medicine Podcast” – tune in). Day three brings “Future Med”, including some of the peaks and challenges of virtual medicine and digital hospitals, followed by a demonstration of assistive technology that requires only a single active muscle to allow full verbal communication with those who would otherwise be ‘locked-in’.

Our final day, “The Path Less Travelled” brings you some of the biggest names at this year’s convention. Phan Thi Kim Phuc is the girl in the photo that changed the course of the Vietnam War. In a story of personal reconciliation and thanks, she shares how her life was changed by journalists and doctors, transforming her from a near-to-death girl on the side of the road to a loving wife and mother, safe in Canada.

Renowned author Nick Earls talks about his transition from med student to author and of the hilarious times he, and his mother, had in their medical school years. The day is rounded off with Commander Paul Luckin, who regals us with stories of death-defying rescues as part of the national search and rescue service and on military deployment in disaster areas.

The inspirational Phan Thi Kim Phuc All these incredible speakers make up only the morning of each day, with the afternoon packed full of breakout sessions, where you could get hands on experience with suturing or virtual appendicectomies, learn how condoms can reduce global warming (from the CEO of Greenpeace Australia Pacific), or get up close and personal to ask your real questions of allied health staff, legendary doctors and national advocates. Of course, you also take for granted the Monash alumni who lead the academic charge. As veteran convention Rangers Prof John Murtagh and Dr Sally Cockburn make their annual pilgrimage, continuing to cement themselves, their guiding principles, and sound life advice in the hearts of this nations’ future doctors.

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Inspired by academics, the Monash Rangers take to the multiple fields of battle.

O u r g a l l a n t d ebating team pull out some verbal bitch slap… but are unfortunate to come up against the eventual competition runner up, Adelaide, in the opening round. Our tug of war team tear their way to the quarterfinals before coming a cropper and landing in the mud (quite literally – ladies there are photos). Our Emergency Medical Challenge team rise early on Wednesday morning to put their practical Monash education to exceptionally good use, saving some of the more interesting and befuddled patient actors from disaster! Our Pips and Cascade teams row with impressive speed, putting out the challenge for all AMSA Rangers to defeat Adelaide (they’re a little bit good) on their home turf in 2014.

Oh, and did we mention that you’re a world record holders? You’re the world’s greatest (or at least most numerous) spooners, with 1108 Rangers lying down and cuddling for AMSA pride – doubling the previous world record.

Emergency Medical Challenge 016

And last, but definitely not least, you have your social program. Well… wow. A great number of profanities have been used but could not begin to encompass how ridiculous these seven nights are. In no particular order… rollercoasters and fireworks at Movie World, Griffith stole our baby, an ENORMOUS Victorian flag, intergalactic aliens enter a venue where Storm Troopers are crowd control, more than a few deeply disturbing Dark Twisted Fantasies, 60 tight bright and fluoro Monash aerobics instructors, a glorious Gala Ball, after which you have the great honour of meeting many interesting Gold Coast locals in their natural habitat. Topping off an incredible week, Melbourne, Deakin and Monash unite for the first time as VIC PRIDE, an unstoppable force of passion and enthusiasm, culminating in 170 Risky Business clones storming Outback Spectacular and having the best night of your collective lives.

Left: Dark Twisted Fantasies – Right: Risky Business This was our week. As we struggle to adapt to real life again, going through the 5 stages of Post Convention Depression (‘CD), I cannot implore you enough to GO TO THE 2014 AMSA CONVENTION IN ADELAIDE. On top of being a life-changing week in itself, you can use it as your first (or final) chance to prepare for 2015, when this glorious week that all beloved VicPride Rangers call Convention comes to Melbourne for the best, biggest and most exciting week… of all time (yep I’m calling it).

You cannot understand until you get there and experience Convention yourself. But we know.

We have been, and we have experienced. We know why the Rangers chant. We know why they come back year after year, all over the country. We know why you need to join us. It is a week of best friends you would never have met (and will proceed to travel around Australia for because one week is not enough). It is a week of university passion you didn’t even know you had. It is a week of in jokes and laughter. It is a week of inspiration. It is a week where 1500 people can come together with voices raised and celebrate what it is to be a true AMSA Ranger.

It is AMSA Convention.

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But there’s more to AMSA than just convention . . . . . . have you heard about council?

When most people hear about AMSA, they think of convention (partly because convention is amazing) but the Australian Medical Students’ Association has a much more serious side. The weekend before AMSA Convention, MUMUS President Harshan Jeyakumar and I (MUMUS AMSA representative), arrived in Queensland ready for a week of tough debate and hard work. AMSA Council meets three times a year so that representatives from the twenty medical societies in Australia can come together and discuss the issues affecting their constituents.

The internship crisis was a continuing discussion, with Victorian Universities consistently arguing for the right to preference Victorian international students over interstate domestic students in our state. A majority of medical societies believe that all domestic students should be preferenced above international students, but the University of Western Australia agreed with our perspective. It was disclosed after the debate that New South Wales is also moving to the Victorian priority system (NSW international students preferences over interstate domestic students), but that NSW medsocs believed their domestic students still deserved to be preferenced highly in other states, despite not doing so themselves. Although outvoted on the issue, Victorian Universities continue to fight for our international students and welcome any and all feedback on this (and all others… but mostly this) topic. A new working group for the internship crisis has been established to approach the issue on a state-by-state basis, focusing on local movements and MPs, who can make a real difference. We welcome Monash students Kain Xu and Peter Lioufas as our state representatives and encourage all students to aid them in their efforts.

AMSA’s National Leadership Development Seminar was also discussed in depth. The purpose of the seminar was debated – is it a way to get students involved in AMSA and their medsocs or to get people involved in wider leadership goals? We also talked about selection criteria, with representatives asking whether students should be picked based on their CV and leadership history, or raw skill and burgeoning interest (or something in between!). As one of the most prestigious events of the AMSA year, the quality of the delegates and program are paramount.

One of the big jobs of council is policy and a number of Global Health Policies previously reviewed by the AMSA Global Health Review team were adopted by council. Reviewed policies included: the heath effects of climate change, global health curriculum in medical schools, health inequities and their social determinants, health and human rights, millennium development goals, overseas medical placement and refugee and asylum seekers. Special thanks needs to go to all the review teams involved. Other policies adopted at this council included Australian foreign aid, amendments to the internship policy, trial registration and reporting and open access research. The council also approved a policy which confirms what we hope you all hold as true: medical student societies are the key representatives for medical students in Australia. I would personally like to thank the Monash ThinkTank who also reviewed these policies and raised some excellent and interesting points that were debated at council (and who are also my inspiration and joy to work with!).

Victorian Universities had a reason to celebrate at the end of the weekend, as we were very proud to elect a new Victorian AMSA executive to run AMSA in 2014. Headed by Monash student Jessica Dean, we were amazed at their vision and poise as they identified and tackled some of the big issues they would be expected to face in the coming year. We congratulate them on their success and look forward to seeing the fantastic work they will do in the coming year.

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President Jessica Dean

Global Health Officer Timothy Martin

Vice-President (External) Kunal Luthra

Community & Wellbeing Officer Karen Freilich

Engagement & Promotions Officer Sidd Padmanabhan

Publications Jennifer Tang

Events Coordinator Fiona Stenning

Sponsorship Andrew Silagy & Danielle Panaccio

Monash University celebrated another win, with the Monash Revision and Study App (MRSA) receiving AMSA’s national award for best new initiative by a medical society. This student-developed app (Available for download on Apple and Android devices) is being used by meddies all over the country to help them pass their exams and we were delighted that the work of our fantastic development team was recognised.

Finally, we got a sneak peak at Adelaide AMSA Convention 2014. For more information on convention please read the article in this edition of the Auricle - but let me just say that it is going to be a mind-blowingly un-Conventional week. To see the amazing promo video please go to http:// un.convention.al/ and get excited.

For more information on anything at AMSA National Council, current issues or how you can get involved in a ThinkTank or the internship crisis campaign, please email amsa@mumus.org.

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CREATIVE

The Silent Killer David Mathew (5D)

The elderly lady presented to the ED because of her severe vaginal prolapse which was detrimentally impacting her life. She was in pain, and needed surgery to help relieve the discomfort.

Yet whilst examining her, the ED doctors noticed something strange. She was weaker on the left side, albeit slightly. She was ataxic, and strangely Romberg’s positive.

Suddenly, the prolapse shifted to a secondary problem, whilst a CT scan of her brain was done to search for a cause of her weakness. The scan was, expectedly abnormal, and she was referred to the wards.

“Hi Mrs Jones, I’m one of the medical students with the team. Just going to find out more about what brought you here, alright?”

She answered all my questions, but she was nervous. She knew the CT had an abnormality – the doctors had told her she had a tumour in her brain. Yet, she was so sure they could cure her. That’s why she was here.

“You’ll take care of me right? I’m so scared and I want all this to be over. I want to go home and watch my grandchild grow up.” Mrs Jones trembled as she spoke, her lips quivering. She pointed to a picture of her grandchild – he was just a little baby, less than six months old.

“We’ll do our best for you.”

I took the history and examined her. Yes, she definitely had deficits on her left side, together with long tract signs. The diagnosis fit the abnormality on the CT scan.

Investigations were performed, and the pathology was confirmed. It took all but 7 days to get the confirmation of what it was. And yet all throughout the 7 days, Mrs Jones would voice every single medical concern that disquieted her – be it her slight dizziness, or ever so slight headache. She would always be reassured that doctors were doing their best.

And after 7 days, it was time for a family meeting. Time to discuss the diagnosis with the family. To tell them of what to expect. The doctors arrived at her room, with Mrs Jones, her son and daughter present. Ever so anxious, Mrs Jones chirped, “I’m actually starting to feel better, my weakness is better.”

The doctor began.

“So, the scan showed that you had a tumour in your brain. Tumours can be graded from 1-4, with 1 being almost harmless, which can be taken out and patients live for a long time. And then there’s grade 4, where the tumour will not go away. And it continues growing till it takes your life. It’s basically a cancer.”

She paused to allow the family to absorb this. “You have a grade 4 tumour Mrs Jones.”

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CREATIVE

The ensuing moments of silence shattered the room. Looks of shock resonated from the daughter to the son but their mother was surprisingly calm. She sat placidly with a stoic expression on her face.

There was no hesitation for the daughter as she burst into tears and raised her voice.

“So my mother’s going to die? Just like that? How long more does she have?”

“Don’t cry, darling. Come hold my hand.” Mrs Jones extended her arm for her daughter to grasp.

The doctor paused a beat before replying.

“Well, some people deteriorate after weeks, but some take longer, even years. There’s no saying how long.”

“What? You mean my mum may not even have time to enjoy her life? I mean, she came in one week ago with only this prolapse and now you’re telling us she’s going to die?”

The daughter clearly inconsolable; the son fighting to hold back tears. The family shred to bits by the enlarging mass.

Mrs Jones drew a silent cross across her chest as her hands trembled, ever so slightly.

Only religion could provide her with comfort now.

“I’m sorry darlings, for being a burden on you,” she said.

Grief turned to acceptance as the children as they were told about their mother’s condition, and what to expect.

She would live another two years, at most.

That night when her son and daughter left, and the room was all silent, Mrs Jones lay on the bed. Stared into the darkness, letting reality sink in. Her hands trembled unconsciously. All she knew was one thing – the doctors had given up.

She was going to die.

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CREATIVE

That’s the life Xiuxian Pham (4C)

Mansions. Fast cars. First-class plane flights.

Holidays to anywhere in the world. Five-star suites. Riding the waves and sliding down the snow.

The finest aged scotch. Rare wines and the best cigars. Connoisseur of the freshest and handpicked foods.

A life of luxury. Free to be lavished.

Extravagant jewelled gifts for ladies. Designer clothes, tailored to fit. A member of the most exclusive clubs and societies. An upstanding figure, charitable, handsome, a gentleman.

That’s the life.

Isn’t it?

That’s the dream.

Sure, it took many years of hard work. Of slogging through the studies, the long hours, the sacrifices.

Of picking the right routes that lead to the right people that lead to the right positions and the right money.

And finally, success. The highest echelon. The best-paid job in the best-paid sector.

Wake up in the morning. Work. Eat. Work. Go home to comfort. Drink some scotch. Sleep. Then.

Wake up in the morning. Work. Eat. Work. Again, and again, and again.

That’s the life.

Sure, it’s an interesting job. Some of the other colleagues call it a passion. Such zealous, fervent passion that they give up the life for the gritty dirt and discomfort overseas.

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CREATIVE How could you possibly give up the life for that? What do you get out of it?

But. But if this is the life, then where’s the joy? The delight? The contentment?

There’s no satisfaction. Just an emptiness. Even dread. Dreading the waking up.

Dreading the sleep that leads to waking up. A cycle of dread.

Driving down the highway fast. A rush of adrenaline to the head. Press harder on the accelerator.

Keep driving, driving, driving. In search for a reason.

Faster, faster, faster, faster, faster, faster– Stop.

Get out at a small town. It’s night. The stars are shining beautifully. A million of them, usually hidden by the city lights, out to play tonight in the middle of nowhere.

The sounds of jazz dancing in the air. The musician blowing his heart out on the trumpet.

The small crowd cheery, tapping along. Couples dancing, spinning across the floor.

Something in the chest beating. Beating to the beat.

What is this?

Beating hard, pumping something strange to the very fingertips.

Giving up old dreams. Dreams that had no money. No life. It’s a sacrifice you have to take.

Is it?

There’s something. A joyful something. Happy. The music coursing through the veins spreading this joy. Fingers moving, remembering the finger work to play the notes.

A thrilling laughter and a brilliant smile. A girl, shy and happy, asking to dance.

She’s plain and homely, nothing like the high-class women from the high-classed mansion world, but she’s stunning at the same time. And stunned, stumbles after her to spin and dance and whirl through the night. The music fills to the bones until all that can be heard is jazz.

All that can be felt and seen and touched is jazz. The water gasped down tasted of jazz.

The world is jazz.

The music stops and the place is packed up. People leave chattering, exhausted.

Euphoria rushes through the blood. A feeling never felt before. An exultant racing in the chest, an explosion wanting to be released.

Leaning against the car, looking up at the sky. The moon. Over the moon.

Far, far, far beyond the moon.

And then, there was peace.

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FEATURE

OUTSIDE THE CLASSROOM

Community Based Placement (CBP) at Port Phillip Specialist School

Joanna Wang (II)

Photos from 2012 with permission from PPSS.

They say that children are our future. But what do you do, what can you say, when you know that the little guy holding your hand will never grow up to work, to have children of his own, or perhaps even speak?

When I first heard about CBP last year, it seemed like a misplaced concept for an MBBS course.

It was upon entering the program that I realised the treasure of looking beyond the confines of the round lecture theatre and central red building within which we spend the majority of our preclinical days.

This year, along with 7 other fellow meddies (including our very own preclin editor, Rachel Chen), I was lucky enough to be placed at Port Phillip Specialist School, an inner suburban school for children with IQs below 70 .

I had never worked with individuals with disabilities before, let alone intellectual disabilities.

The extent of my experience was being in the same classes twice with an autistic child, once in Year 2, and then again, in Years 7-8. Stepping onto school grounds for the first time, I hurriedly scanned my memories, willing for an enlightening familiarity to surface. But I found nothing. And so, as a blank slate, I went to meet the class I had been placed with, children aged 5-7.

Tuesday, my placement day, is a mixture of variations on playtime, including “choice” (choosing your play activity), bike riding, “circle time” (sitting in a circle for stories, music and bubbles) and meal times. The milestones of reading and writing for “normal” lower primary children are replaced with being able to sit still, to talk to a classmate, and to signal to go to the toilet using Makaton, a simplified adaptation of AUSLAN. Throughout the day, the teachers and classroom assistants are kind and caring, yet simultaneously patient and firm. They are receptive to the subtlest needs and wants of these children who they treat as their own. Surpassing the basic requirements of classroom staff, they change nappies, clean up after mealtimes and connect with parents daily. Undeniably, they are some of the best teachers in the education system.

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Remember that boy I mentioned in the beginning? Let’s call him Timothy. For quite a few weeks, I hardly had the chance to interact with him, as he would always be in his own world. I remember vividly a few weeks into the program when, for the first time, Timothy came up to me and held my hand. We stayed in the same corner of a playground, him reaching his arms out every now and then when he wanted to be carried. He seemed happy, yet there were a couple of times where, for a split second, an inner distress shot out through his gaze. The next week, his sociability had once again decreased. I wondered if he had forgotten who I am. It was back to the Timothy I’d met that very first day.

Another girl, let’s call her Violet, personifies the benevolence and care that brings hope to our world.

She’d get me to watch her play with her favourite toy set and ask me to read books to her. Then she’d swap with me. With the gestures of a true little leader, Violet would direct me to sit where she was sitting (on top of a doll house I couldn’t possibly have sat on without breaking) as she became the teacher reading stories to her pupil. With those tiny palms, she’d guide me to her toy set, which I was instructed to play with while she watched on.

It brings an indescribable blend of heartfelt joy and saddening resignation to see the glint of multifaceted emotions and thoughts behind the eyes of these beautiful children, nay, individuals.

Some may label them simply as “autistic”, or “disabled”, but they are far from a clustered segment of society; they embody the quirks of true individuals, melded with the purity of childhood.

Learning to become a good doctor goes far beyond the pages of anatomy and physiology texts.

It involves rekindling the deep-seated compassion that led us to the MBBS course in the first place.

“Helping others” is a shared dream that is also increasingly becoming a cliché. It is not hard, perhaps even expected, that, as the years pass, our sensitivity to human emotion fades as we use pattern recognition to diagnose and treat. Just as throwing a pebble on a still lake stirs the waters, reminding them to flow to where they should be, vivid experiences of reality are often required to prevent us from becoming desensitised and, eventually, jaded.

Sure, CBP allows us to see health in a community context. For some, we may even apply medical knowledge to patient illnesses or disabilities. But, health promotion is far from a simple matter of extending our biomedical repertoire. It exposes us to health in the real world, reignites sensitivity and compassion, reinforces the value of synergistic, intermingling disciplines (e.g. the teachers, speech pathologists and occupation therapists at Port Phillip Specialist School), and prompts us to the reality of where potential for change truly lies. That is, outside the classroom.

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FEATURE

LOVE WEEK AT DANDENONG Ming Fan (3B)

Once upon a time, 36 timid little ducklings were allocated to Dandenong Hospital. On arrival, they were embraced by doctors and nurses alike, and most of all, their mother duck, site administrator Gina. Over the first semester, they learnt how to talk to real patients, examine real patients and cannulate real patients, with varying degrees of success. They let the vast amount of clinical experience wash over them, erasing the traumatic experiences of second year.

The student common room was their sanctuary. Over the course of the year, many good memories were created here, including cake!birthdays, last minute MCR practice (freak out) sessions, and interesting conversations like the ‘Who-is-your-alternative-race-doppelganger-celebrity?’.

One day, an idea was hatched. There had often been discussion amongst the Dandenong students about what a friendly and fantastic learning environment the hospital was, and how everyone seemed to get along swimmingly. To further this rapport, the students decided to run a “Love Week”, a fun and simple way of letting everyone show anonymous affection to one another.

Love Week was held on the last week of semester to “de-stress from all the studying we would do” (but really to “procrastinate from all the studying we were meant to be doing”). The rules were simple. You are a person’s secret admirer. Don’t do anything that might be offensive, dangerous or overly creepy. Aside from that, do your best to love your designated person for a week in your own special way, and reveal yourself at the end of the week!

There were gestures both grand and simple, and throughout the week many a tear of happiness was shed and many a cheek blushed with graceful gratitude. Some of the more grand gifts included a Zarraar themed gallery hung throughout the common room which walked the line between hilarious and slightly sinister, a diabetes-inducing lolly shrine to Alice, a video montage celebrating the glory of Bec and a basket brimming with goodies for Evie that was almost half her size! Tracey was extremely chuffed to find that her amorous admirer had hidden heart shaped chocolates throughout the common room for her to collect and create a message. Her excited giggling turned to confusion as she tried to decipher the code. Having initially believed her admirer was wishing her ‘HAPPY HAT DAY’, she finally uncovered the message – ‘HAPPY THURSDAY’.

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For one week, Dandenong rained chocolates, tea, cute little notes, cupcakes, macaroons, and other lovely little gifts.

Somewhere between running around the hospital like mad people, helping each other set up shrines, and throwing out red herrings, everyone grew closer together. Friendships were formed between those that weren’t originally close; Gina was spoilt for all the wonderful things she did for the students; the cohort became a more united group of friends rather than colleagues.

And so, the semester finished on a fantastic note and the ducklings lived happily ever after... until next semester.

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