first emergency

Today was exciting! Charlie let me scrub in on a shunt surgery and I got to do the abdomal part under his supervision! That was awesome! I got to do the skin incision, incise further down to the muscle through the fat.... then put the end of the catheter in the abdominal cavity and then help him withe closure - some facscia suturing and the skin! I also got to intubate patients and I had to say goodbye to a wounderful team in the theater!!!! I have really enjoyed working with them and spending time outside theater as well. I don't know if it has made a good impression that I have not spend that much time in the public hospital even though I was assigned to a surgeon who is mainly operating there, but I have had so much more fun in the other theater and watching a great surgeon operate is just so much more exciting than watching someone who is just learning themselves without much explanation. Maybe I would have had a few more oportunities to scrub in on cases in the public theater, but the social part of the experience and the teaching would not have been quite as good... In the private I have certainly seen a lot more brian sugeries that I would have in the public and it is all just so much more organized. Today I went to the public, because I needed to get a signature from my supervisor, who I have been trying to get a hold of for the past days of this week and it was just so much different...nurses weren't as nice, surgeon didn't talk as much, no teaching from the anethesiologist..... But if my supervisors did have a problem with me being in the private so much, they could have told me, but they never did.... Anyway I have had a great time there!

After I left today I went to get some dinner and when I was waiting for my food to get ready someone had an epileptic attack! Not good for the guy, but great for me! I was the only person in the room with medical background.... I went to the guy made sure he didn't hurt himself, made sure he was breathing all the time, tried to talk to him.... I may not have done things in the right order, but I was amazed at how little the whole situation freaked me out. There are definetely worse emergencies, but I was a little proud of myself that I felt confident enough that I could handle it. I was glad that someone was there as well to help me figure out which leg to put where when turning him on the side, cause I always get that mixed up.... But it was great to have experienced my first Emergency on the street, because I have always wondered if I could stay calm and what I would do and what it would be. Now I know it was a young guy who had a seizure at KFC and it didn't freak me out. 

last Sunday...

The last Sunday in Sydney (at least for this time) is over.... We started out having breakfast at Coogee-Beach! With some people from the hospital and the other Germans we went to a restaurant overlooking the water. I had blueberry pancakes. The view was stunning and the pancakes were ok, not like Deb's Sonday Morning pancakes - but it at least made me think of them. After breakfast I went to La Perouse which is at the nothern End of Botany Bay. There isn't much to see and I just walked around Henry Head and enjoyed some more of the typical countryside. I saw tons of little lizzards. There were three different kinds that I could actually see and two that I also got a picture of. They were so quick... and most of the time I could hear them, but not see them. The same was true for most of the birds. I really enjoyed walking a tour that wasn't crowded, because that way I got to see some animals! Mammoth had tried to get close to the lizzards, but that never really worked.... ;)
Later in the afternoon some clouds came up and I decided I head back towards the city and not stay on the beach. I only went back to Maroubra, got off and did some shopping at a German supermarket, to be able to bake a cake on my last day... Now I just have to find an oven! Appearently ovens don't necessarily belong to an Australian kitchen! We got a stove, but no oven and I asked Morgan and he's only got a stove as well... So I need to find someone living close by with an oven.... I never thought that would be a problem! ;)
Then I walked down to Maroubra beach and back along the coast to Coogee. As you may recall on the first Friday I was here I did go down to Maroubra as well (without a camera back then) and sort of lost the costal walk at some point. This time I found it! And I am glad that I went back there again. It didn't look that much different from the other costal walks that I have done - cliffs, touquois water, amazing waves... But it is always so nice to look at and walk along! And the sea was really rough in the later afternoon today. So the waves were really really great!
Now the last weekend is over, my legs are tired from walking around so much and they might actually enjoy a weekend of just sitting around... ;) So I have prepared them well for next weekends journy (or at least I have tried to do so...) Now I have to start thinking about packing and getting things organized, because so far I have been putting that off... I wanted to enjoy the last weekend and then start thinking about organizing everything.... I will do that with very mixed feelings. I am looking forward to many things, but I am also a little bit sad, that I will leave quite a few nice things behind and mostly of all that the adventure that I have been planning for so long and that I have been hoping for to happen even longer will be over soon...
Tonight when we were out for a glas of wine someone asked me what I get out of this: It is really hard to say while you're still enjoying the experience....

the Blue Mountains' Grand Canyon Tour

At first I have to give a short update on what has happened during the second half of the week... Since I have been too busy (and then to tired) to write up to now, even though some really exciting things did happen....

On Wednesday surgeries were over by 9pm, so that could be considered a short day...;) I once again was allowed to intubate most of the patients (not the first one, because I was still rounding with the other team, while that happened) and it is getting easier each time... I am so glad Sudeep is letting me do that! During the day an appearently very important Australian celebrety showed up to watch Charlie operate, because she is one of the public spokespeople of his foundation and wanted to have a closer look at what happenes in theater....
During rounds in the morning it came in handy that I am German! We have a patient with a very German name and someone noticed that and since she was not responding when they spoke to her in English, my registrar asked me to examen her in German... And it worked, she opened her eyes when spoken to in German!!!! She had suffered from a head bleed and was just waking up... For the next two days they had me examen her in German every morning even though she already responded to English, just to watch me I guess....

On Thursday I scrubbed in on a spine case. That was really cool. My registrar had a great day and let me do the skin incission and open the surgical wound all the way down to the muscle.... Really amazing. Since there was no other doctor scrubbed I was his assistant for the entire surgery and really got involved! Very cool!!!! Once the sugeries of the day were over I went back up on the ward and was allowed to take an extra ventricular drainage out (it is basically a tube stuck into the ventricles - the fluid filled spaces in the brain - to drain fluid that would otherwise build up and cause severe damage). I felt like I had really done something by the end of the day. In the afternoon Jörg, Katja and I then went to the AMP Tower to have enjoy the stunning view across Sydney. And it was stunning. I just can't get enough of that, I could have stayed there much longer than the other two and just keep walking around and soaking it all in..... For dinner we had initially planned to go out to the oldes Pub in Sydney, but Aneela (the American Fellow) had suggested to go to a brasilian Barbecue instead. That was amazing. I don't think I have ever eaten that much meat in my entire life during one meal! It was all you can eat and they kept comming up to the table with all kinds of different meats that had been grilled... There was so much to try and I wasn't hungry again until lunchtime on Friday!

Friday was again a little bit frustrating. The clinic I was supposed to go to didn't happen, but when I went up to the ward none of the doctors was there yet to start rounds - I had once again showed up way too early... (for Australian standards at least!) I took the oportunity to take care of my paper works and get all that organized... Later I wanted to go into surgery, but that one got canceled because the child had had some really strange EKG.... so they decided to wake him back up, instead of risking rescucitation with the skull open.
Back on the ward, rounds were finished, but there was nothing for me to do and in clinic they already had two other students, so I decided after having spend so many nights in the hospital over the past weeks, that I would just take the rest of the day off and enjoy some sunshine and the beach... I had a great afternoon on the beach. It wasn't too hot, the water was great.... and I finally got to just be lazy and enjoy doing nothing, but reading a book.....

And then today. I got up early and went on my last daytour...:*( It was wounderful. It was a group of only 11people and a guide. We went to the Mountains in a minivan and our first stop was in an area where one can usually see the grey kangaroos, but unfortunately not today.... It was still a nice tea break. The guide was a real nature person, he told us all kinds of really interesting things about plant and animals all throughout the day! If I had done the tour on my own, I would have missed so much! It was awesome! The next stop was a non touristy look out to see the three sisters. The guide wanted to make sure that we don't end up in the areas where all the tourist go, but actually get to enjoy the scenerie far away from the crowds. We had lunch on the bus - not a 1hour lunch break in a place with nothing to do but eat, like most of the day tours offer... I loved it! That was exactly what I wanted - get off the bus to do thing and see stuff and not eat. After lunch we got to the start of the grand canyon tour. There is just no way I can describe all of it satisfyingly. The track was narrow with lots of stone steps, steep parts, sand, wooden steps, some flat parts and extremely interesting. It was so much fun. We walked about 250m down into the canyon through bushland and rainforest land. It was amazing how the plants changed from one meter to the next. The guide described it as stepping through doors and that's what it was like. Absolutely great. He also took us to a termite hill, pointed out spide webs, showed us a special lizzard, a flesh eating plant and explained so much that it would take a few more hours to write it all down... As already said, I would not have been able to enjoy the stone formations, the different colors of the stones, the burned and newly growing trees and the animals and plants as much as I did without our guide. It was a wounderful tour, even though I did slip once and landed on my budd. It was kind of funny, because I was not the only one that slipped when we were walking along the river down in the Canyon. Falling wasn't funny (I admit that), but the other girl and me, we were the only ones to wear real hiking boots, everybody else just had normal sneakers and the two of us ended up falling.... (maybe the shoes are only made for European hiking.... - she was from the neatherland!) At the end we had to climb up again, it was a lot steeper than going down and there were hardly any flat parts along that part of the way, but the view up top across the seemingly never ending green bushland was stunning! It almost didn't feel real.... At the end of the day our guide took us to a tourist spot, just to be able to take a quick look at the three sisters from the post card point of view.... Then we headed back to Sydney with tons of great memories and things to tell. It was just like the kind of tour I had hoped it to be, except that I did not see any Koala (exstinct in that area) and not Kangaroos....
The group of people was also really nice. Mostly people my age and most of them were in Australia for work and travel. So they all enjoyed life and were a pretty easy going bunch of people. Just one girl from Germany was different... She had been in Brisbane for 6 month with EF for a language study year abroad (don't recall what that is really called), but it is similar to the three week summer courses except that the students stay for 10month just like au pairs and exchange students. She was really unhappy with how things had been going and was on her way back to Germany. And talking to her made me realize how much I really enjoy being here and having the opotrunity to see and do all the things that I have been doing and seeing.... Even though some things have not been running smoothly in the past and I have had quite a few frustrating moments as well, I still got so annoyed by her negative attitude after a while that I just couldn't talk to her any longer, because it felt as if it took away some of the excitement I felt about this whole trip.... And on the way back into Sydney I got a little bit sad.... It was the last big adventure, now I will still try to spend as much time as I can in the city to soak up some more of the Sydney feeling before going back, but coming back today made me realize that my adventure is almost over....

Monday, monday - and tuesday

Monday morning.... after an exciting long weekend work just did not seem extremely appealing, but there was one surgery to look forward to, one that I could hopefully assist with and do some cutting and closing, some real surgeon's work.... and there is also a need for all kinds of tubes before starting surgery.... The meeting in the morning was very boring, there are just some people in this world, who like to hear themselfes talk.... Very, very annoying! Once I was headed to the theater with 6 surgeries coming up Monday didn't seem to be all that bad anymore... I got to practice intubating patients again and was excited every single time I managed to do it and especially, becuase it has become a lot easier over the past weeks - it's all a matter of practice! Unfortunately the surgery that I had been looking forward to for almost a week (before I had let other students assist, who did only spend a few weeks here knowing that I would stay longer and hopefully get my turn....) didn't turn out to be quite as exciting for me as I was hoping. The shunt equipment hadn't been set up properly, which aggrivated the surgeon a little and teaching was then not the main priority anymore.... I was quite upset afterwards, because I had been hoping for a similar experience to what the other students had had in the past.... Oh well. The last surgery of the day (for me at least) was a very interesting surgery, the anatomy was that I got to see was amazing, and it just once again proved to me why I am loving this so much... I could have watched them forever find their way between nerves, vessels, important brain structures.... The skull base is just so very fascinating! But shortly after 12 I decided to leave and not stay for the last surgery. I knew I was going to be tired the next day if I stayed too long and I was still a little bit uphappy about the shunt surgery and the fact that I don't actually get to do quite as much as some other students in the past....
On the ward we don't have very many patients and there isn't much work I can help with (and appearently they don't really expect students to be there quite as much as I am...), so I sometimes get a feeling of being kind of useless up there and then going to theater is sometimes a little bit frustrating as well, because even though most of the surgeries are very fascinating and interesting and the teaching is usually really good, I sometimes wish I could get to do a little more.... but that's just what students have to deal with (unless you are in switzerland, you are usually only no 3 at the table with nothing much to do....

Today I went to clinic again and we saw patients pre- and postoperatively. Some are really impressive... and it is great to once in a while see a few patients, who are actually talking to you and are not asleep most of the time.... So today I felt a lot better than yesterday and not quite as frustrated.... Tomorrow will probably be another long day in theater again, but I love the team Charlie is working with, so it will be as lot of fun as well!

Trip to Jervis Bay

Today was amazing! Even though I had to be ready for pick up at 6.45 I really enjoyed every minute I was out today. They day started with a tour around Sydney to pick up other people and I could watch the city slowly waking up and the sun rise.... It was a nice extra city tour!Today's bus driver was much more pleasant und the group of people traveling was much smaller (only 15people), but we still had a big coach! The sky was bright blue all day long and sun was shining all the way down to Jervis Bay and back to Sydney and the scenerie was amazing. Since traffic was pretty good the bus driver altered the tour and took us down to the coast and drove along cliff rather than up on top. We drove across a C-shaped bride, that was going along the cliffs (it was actually featured in a Ferrari commercial once...) We stopped in Kiama, where there is a rock formation right on the water and if the tide and wind is right water comes out of one hole just like out of a wale's blowhole.... We had a baby wale today... All the way down the coast I just could not believe how incredebly beautiful the weather was. I had checked the forecast and it had talked about thunder storms by mid day, but the sky stayed bright blue. In Illawhara (that's the part of the country we drove through) they do get a lot of rain though and everything was still very green, not like in other parts of the country and driving a long the coast it reminded me a little of pictures I had seen of Ireland. The next stop was Jervis Bay where we got on a Boat to cruise the bay for about 2,5hours and look out for Dolfins! And we got lucky, again not quite as many as they sometimes get to see, but still quite a few. But they were really hard to capture on a picture..... But it was fun to watch them and cruise around the bay. The group of people I was traveling with was really nice. One woman was from Zurich (we spent quite some time talking) and during lunch time we chatted with a couple from Texas and a Lady from L.A. It was really a nice group of people. The wharf in Jervis Bay looked like right out of paradis - white sand, clear turquois water and bright blue sky. I could barely believe that I saw all of that!!!! It was amazing (had I mentioned that yet...;))
Then we headed to Kangaroo Valley in Kangaroo Valley (the town got the same name as the valley - not confusing at all;)) On the way I did see one Kangaroo hopping through the bushes! Pretty cool, but again too quick for a picture, so you just got to believe me! Kangaroo Valley was another really green area.... we had to drive up a very windy road, but the view from the top into the valley was (guess what) really, really great..... Kangaroo Valley (the town now) was a cute little country side town with little wooden houses on the either side of the one main road... And that had really good ice cream! Driving through Kangaroo Valley (the actually valley now) we passed a lot of other very similar towns. We appearently also drove by an intersection where one could get to the town where "Babe" was made.... The last stop of the day was Fitzroy falls. A very impressive and high waterfall (61m). Fortunately it had rained a little bit over the past days so that we did get so see some water going down.... Most of the stops today where quick stops, but they all were great and the countryside we drove through was wounderful. I am afraid the pictures will only represent little of what is actually there.....
I had a wounderful even day, even though I was dressed a little inappropriate since I had expected rain to come in at some point during the day.....

where it all began

Today I slept in.... What a pleasure!!! No noise, no cars, no work..... It was great. Then I took the train for the first time today and went to Cronulla, which is a small peninsula south of Sydney (still sort of part of Sydney). I walked along the coast around the pensinsula and went swimming for the first time. At first I just wanted to walk along the beach at one of the bays, but then the water was so nice and warm that I just couldn't stop myself. I had wanted to wait till I had someone to go to the beach with, because leaving my stuff unattended is not really great, but since that hasn't worked out so far, I decided to just take the chance. It was wounderful. The water was warm and really soft.... I didn't stay in too long, because there was noone to watch my bag....
Once I had finished my trip around Cronulla (which wasn't much different from the rest of the coast, still very beautiful, but again cliffs and the bluest water I have seen so far - which I still can't get enough of....) I took a bus to Kurnell. Kurnell is where the Botany Bay National park is and that is where Captain Cook first landed in 1770. They got all kinds of memorials set up alongside the water to remember people that came with him and the first European to die on Australien ground is also burried there. I did not walk around too much, because I was worried I might miss the last bus going back to Cronulla.... So I sat down and read a book right behind Captain Cook's memorial. From there I could overlook Botany Bay and watch planes coming in and landing on the other side of the bay (very busy!). I also got to wittnes how a thunderstorm slowly formed. The clouds were amazing, but the rain in the end wasn't.... ;) It was still a really nice relaxed day (even with the rain at the end). I got to see free flying parrots for the first time. Their colors are amazingly bright, but unfortunately they were too quick for the camera.

Canberra - Trip to the Capital

All of a sudden week Number 6 is over..... That happened really fast! Wednesday and Thursday I was in surgery, but it wasn't all that spectacular and a little bit frustrating on Thrusday, because I had to stand next to two scrubbed surgeons for almost 7hours to suture the skin.... Even though I was promised before that I would get to do a little more than just be Number three at the table..... But I took the time to make it look pretty and I am proud of it! I think it looks very even, I was even tempted to take a picture, but didn't have a camera.....
On Wednesday the surgeries were finished early and Charlie took the team out for lunch. That was a lot of fun, even though things were revealed that should have just stayed in the dark.... After lunch I went downtown and used my bridgeclimb certificate to visit the Pylon lookout. One of the four stone pylons of the bridge hosts a museum about the bridge and you can go up there and enjoy the really great view. It is exciting every single time, I have spent so much time now overlooking the city, just looking at the bridge, the opera house, the skyline.... and I still love it. I just can't get enough of it!

Today was another hospital off day and I had booked a day tour to go and visit Canberra. Canberra is about 280km south of Sydney, so I got to see a lot of country side today! That was pretty cool. I even saw a kangaroo, but since we passed by so quickly I couldn't tell if it was relaxing or dead.... We stopped a in a small town on the way down, which was supposed to become a tourist town when the railway was built, but then they took a different route and all the inns that had been opened there gradually closed again, but it still claims to have the oldest continuously running Inn! There was also a court and a jail and lots of really pretty small houses. It was meant to be a morning tea stop and many of the older folks walked right into the suggested restaurant, but I decided to look around the town.... Much better!
Around noon we got to Canberra. The town just doesn't feel right (even though that might sound weird). I think one can feel that it was designed on a map and didn't just develop like other big towns in the world or Sydney.... There is a hight restriction on Buildings and they also wanted to preserve a lot of the plant and therefore the town is extremely green, but I could barely see any houses.... It seemed to be empty and not filled with life.... The line from the War Memorial to the parliament house is a little bit like the Mall in DC, but there are hardly any people..... It was just really, really strange. We went to the National Museum, which was really interesting and very well equipped. I wish I'd had more time to look around.... Then we went to the Parliament House. That is a fun building. It was build on a hill - sort of. The actually took down the hill, then build the house and then put the soil on top of the house, so that the building is now part of the hill - very funny idea and very unique. The architects gave a lot of thought to the building. It is a very bright building, lot of light everywhere and many meaningful details that one would not recognize without a tourguide - really interesting. Today I found out that in Australia everybody has to vote once they turn 18 and if you don't show up without a good reason you have to pay a fine! I haver never heard of another country making their people show up for election (except for communist states maybe...). The next stop of the tour was the War Memorial. On our way there we drove through the embassy quater. I was impressed by the fact that some had hardly any fences and seemed to be on property that was very little secured. Especially the asian Embassys looked really great. The America Embassy was the largest one and bigger than the parliament building.... I was sitting on the wrong side of the bus, so I could not take a picture of it and for the same reason I couldn't take a picture of the German Embassy.... It wasn't all that spectacular anyway, but it would have been nice. The War Memorial was build to honor all the soldiers that had fought for their country. It is a big museum, but since I am not a history freak it didn't excit me all that much, even though the exhibits were really neat. There was also a remberence hall and thought it was quite impressive that they did not just have pictures of a navy, an army and an airforce soldier, but also of a woman!
The last stop in Canberra was on top of the highest Mountain. From there we had a pretty nice view over the city and there again I couldn't see much city.... Some of the buildings were really impressive, but very well thought through, but it just seems to be too perfect, too well planned, not spontanous - I just did not have the same feeling that I get when I am wandering around Sydney, especially downtown, Circular Quai, the rocks.....
On the way back to Sydney we stopped in another small town for dinner. It was another country town and because sheep are very important, this town has a huge and I mean HUGE sheep standing at the town entrance...... Very impressive.
The sunset was pretty spectacular, because there were some thunder storms, so some of the sky was really dark and other parts looked like they had cought on fire.... and we got to see a big, bright, full rainbow!

nothing exciting

I got my internet access back! So that is sort of exciting, but other than that, nothing much happened.
I was in the hospital till 8.30 (pm!!!!), because today was Morbidity and Mortality conference... Interesting, but made the day a little longer! But the difference to the German M&Ms was - apart from it being late at night - that there was foodf! Thai food! I think Thai food can definetely compete with Mexican! Some of that stuff is extremely tasty..... (and makes my pants smaller ;)) There are so many Thai Restaurants around the lodge, I think one could eat at a different one each night and still not have been to everyone after a week....

blog trouble

I have been trying toupload pictures last weekend... but for some reason the site would not open. So I am sorry, that you can't enjoy more pictures....

Yesterday I also had to get a new password for my internet at the lodge, but I did not get back in time to activate the account.... So I have to do that again today and hopefully will have internet access by tonight.

Yesterday was mostly spent in theater. The spine meeting in the morning was as interesting as usual. Being with Charlie most of the time doesn't get me much spine experience (not that I am extremely interested in that....), so those meetings once in a while are really good. Spine cases are harder to watch, because very often the surgeons don't use a microscope attached to the camera which they do for brain surgery and therefore even when being scrubbed in it is hard to see things..... Since there were only two surgeries on yesterday we got to leave theater shortly after 6!!!!! and because "Grand Tourino" has been talked about quite a lot during surgery, Aneela and I decided to go and watch it... Who knows when we get out that early again!!! It was a great movie! I can certainly recommend it, great dialogues, great acting, not too many words, but just enough and great facial expressions (that often said more than words) and very, very good music to underline the story..... Really great! On the way back to the Lodge I met Joerg and Katja and we had a glass of wine in a bar. So the night turned out very different from what I had planned (reading mostly - surgery and for fun.....) it was another fun night out....

Neuroendoscopy

On Friday and Saturday Charlie gave a Course on Neuroendoscopy and he had invited me to come and watch as well. I was really lucky to get that chance, because the participants had to pay AUS 2700 for that course, well they also got to work on cadaver heads, but just having the chance to listen to talks given by very well trained and great neursurgeons was really interesting and even though I did not get to do things on my own, I still got to watch and appreciate the anatomy. It was definetely a worthwhile experience. I also had the chance to talk to some of the Neurosurgeons about what it is like to be Neurosurgeon in different countries, because many of them have trained and work in different countries all over the world - very interesting.
Friday night all the participants and instructors were invited to have dinner at a restaurant overlooking the harbour and the operahouse... It was amazing! The food was great, the company was so much fun and I really enjoyed a great night. For some reason there were also some fireworks going off over the Botanic Garden and since I love fireworks that just made the evening more special.

Saturday night was Mardi Gras in Sydney. It's a big Gay/Lesbian festival with a parade throughout downtown. Me and the sister of the German Neurosurgeon tried to go and see some of the parade, but it was too crowded downtown. People were standing on chairs and there were up to 6 rows of people standing at the side of the street, so no way for us to see anything... We just got a glimps when we walked past the emergency area, where they wouldn't let people stand/stop.... It was really colorful. Many people were dressed up - appearently the goal was to use as little fabric as possible to just barely cover the most essential parts of the body..... and some preople just shouldn't have done that.... ;) We did not stay very long, because we did not see much anyway and so we ended up spending more time waiting for a bus than actually being downtown. Since some of the main roads downtown were closed for the parade the busses had to detour, but it was nowhere visible how that worked.... First we had to let a few busses pass on the downtown, because they were already too crowded and then on the way back we waited at a bus stop where got dropped off, but appearently the busses took a different route back than they did downtown.... After about 20minutes of barely any busses passing by we figured that out and walked towards a different street where the busses did show up, but once again we had to let about three pass until we finally got onto one that would actually take us back - it was an adventure!!!!!! And it seemed as if the entire town was partying. I just wish I'd seen a little more of the parade, because I think that would have been fun, but prior to the event people kept telling me about Mardi Gras and whenever I asked where a good spot would be to watch the parade and not just the people around, because I did not care about the crowd and the partying on the sidewalks, nobody would give me a satisfying answer. So that was a little dissatisfying....

Today I slept in! And I got to sleep in, I did not wake up from earplugs or noise. This new room is wounderful! The scrub nurse from Charlie's theather wanted to take us to a Korean barbecue for Brunch.... well it turned into a lunch.... We wanted to meet at 11 in front of the hospital, but one of the nurses did not show up till about 11.40!!!!! She kept calling and telling us that she will be there "shortly", "in 10minutes", "soon", "almost".... Time is just a very different thing in Australia.... 10minutes past the meeting time is still on time and that might even been 10australian minutes...
The food was amazing. It was spicy, but I did not get the hickups, even though later during the day I felt as if it was going to burn a whole into my bowel.... It was really spicy, but really, really great. I love the variety of asian food that you can get here and most of it tastes really great! I wish we'd have that variety in Germany as well. That is one thing that I will definetely miss - all the little asian restaurants...
After we had finished lunch, which was not just tasty, but also a very interesting social experience - because people are just so very different when they are not at work and I did get to know them a whole lot better - it started to rain, not just a little bit, but really bad rain. I still went to Bondi, because I had only been to the beach there and it was supposed to be a nice shopping area and I felt like wandering around for a little while, but rain was really bad, so I ended up in a big mall and the book store.... That was still very nice, even though I did not get to see a whole lot of Sydney this weekend and didn't do quite as much walking around. It was a quiet weekend and now I will start to read my new book "Life in his Hands" (A story about Charlie)....

a little bit of Frankenstein

After rounds I tortured a patient again trying to get blood from very old veins that have already spend a few weeks in the hospital and some time of that in the ICU.... many bruises and barely any vein left.... Together Andrew and I managed to get all the blood and afterwards we went out to have some coffee and a tasty berry muffin. It was nice to get out without the other doctors, so we could talk more freely and talk about stuff we normally can't with registrars around....
Then I headed off to the theater for surgeries. I got there just in time for the case to start, because by now I have learned even though a case is scheduled for 8.30 it is very likely to not get started until close to 10....
I got to scrub in on 3 cases today. That was a new record and really cool. The scrub nurse was also really great today, extremely student friendly. She actually told me to get scrubbe in on the second case so that I could get a better view of things... It was just going to be a short case and I didn't want to waste a gown and gloves and then not do anything, but of course I love to scrub in and when I get a chance a take it.... In between cases in one of the theaters I wanted to go and see what was going on in the other theater, but of course that was not as easy at it sounds (the green sticker didn't give me permission to go there.... so I had to beg for that, but it worked!) And it would have been really bad if it hadn't. It was like going into Frankensteins lab.... The patient had a sarkoma in all around his eye growing into the skull base. So the ENT surgeon (HNO-Arzt) was working on the front and taking the tumor out and the Neurosurgeon was working form the other side. It was really strange watching them work on either side of the skull base with.... Just like Frankenstein, they had little hammers and a chisel and slowly worked their way through the bone around the tumor tissue... Really great to watch. I then went back when the were getting ready to close the head again. That was really interesting to watch as well, because they did not replace the bone they had taken out, but still had to protect the brain before the Plastics people came in to fill the facial defect with a musle flap. It is an extensive surgery and supposed to last till 4 or 5 tomorrow morning..... And even though I was getting ready to leave to enjoy the sun outside I was glad when I got offered to scrub in and help closing up. I got to practice some more sutures and I also got to put all the stapels in and the plastics people were impressed how evenly those were placed.... :) On the first case I also got to do the closing, on that case I even got to do all of the sutures. My registrar was really patient and slowly but steadily let me do all of it. That was really great. So overall that was a really great day in the public theater. I never thought I'd experience that.... After all the bad days I have had in there, it was so nice to experience that!
I still got to enjoy some sun and a walkt to the beach after I left and for dinner Katja (the sister of the German Neurosurgeon, who is midwife trying to get do an observership at the hospital) and I went out to the Rocks to have some Pizza! Very tasty, very good! A nice glass of wine, sitting outside, walking along circular quai..... having some ice cream for desert.... ;)

a new home

On Monday I moved. The new place is so much better. I got my own little bathroom. I can really close the window and I don't hear any cars anymore!!!! Once I close the door to my room I can actually stay inside and if I don't want to I don't have to meet others anymore. I even got a little kitchen Area and a TV to watch - so I actually get some news now. But the best: I got internet access and don't have to stress about how to get online access to check email and chat anymore. I am feeling so much more comfortable here!

On Monday I also got to assist Charlie during his last surgery. That was pretty cool. The anesthesiologist also let me practice how to intubate patients and I got to practice putting lines in! Being in the private hospital with this team is so much better, because I actually get to do something beside must neurosurgery. That day one of German Neurosurgeons had his first day with Charlie as well. That made watching surgeries a lot better as well, because he did explain quite a lot in addition to all the things Charlie always explains and he also pointed out difference to how they do it at our hospital in Greifswald. So that was really great! That night we also met for drinks. I really enjoyed the company and I was really glad to go out and actually know the people and know that we got things in common. Meeting new people is always exciting and interesting, but it is very different and less relaxed.

Tuesday was a regular day at clinic, but I was allowed to take history on some patients. I really enjoyed that - Patient interaction! I hope I can get to do some more next week. Charlie then took all of us out for dinner to a really really great chinese Restaurant. Since there is a conference for endoscopic neurosurgery this weekend Charlie has invited Neurosurgeons from all over the world and we had dinner with a Neurosurgeon from Italy and one from America. It was a very nice group of people. And the dinner was amazing! We went to that restaurant that served very fresh seafood. They caught the crab, the fish and the muscles freshly from their tanks and then showed them to us before preparing them.... really cool! The dinner had about 5 different courses. Amazing and really tasty.

After rounds I went to the theater and once again was allowed to intubate and catheterize the patients. It is really nice that I get to do things. The anesthesiologist also questioned me on some anesthesiology topics. So I don't just get asked about surgery and brain anatomy, but also about anesthesiology and that makes it a really great experience, because it's not just one subject I focus on.
Now we just got back from dinner at a Thai restaurant. The German Neurosurgeon took me and his sister out to Coogee. That was really nice. We ate at this little restaurant where the big front window was opened all the way and the window seal was turned into a sitting bench. I really love those little restaurant. It's like sitting outside, but still being protected from wind and rain....really great.

Overall it has not been a praticularly exciting week, but still a good one with lots of nice little experiences.....

toured out

My tourguide ran out of tours to walk..... I have done them all! Now I can start looking around Sydney a little more and maybe explore some of the "hip" suburbs.... We'll see....

On Saturday I finally found the Sydney downtown shopping area. It wasn't all that impressive, considering Sydney is such a big City. But I was once again amazed that there are really, really old european looking buildings right next to extremely modern skyscrapers as well as really badly looking, not well taken care of buildings. I saw the town hall and I was a little shocked that the surounding area was not better taken care of. It is such a pretty building, but it was very dirty around it. I found an amazingly huge food court. I was glad that I had had my homemade sandwich before I walked in there. The variety of food one can get all over Sydney is amazing anyway, but it all seemed to have come together in one spot there. I was impressed. I also visited the Queen Victoria Buidling and the Strands. Those are two really old malls, and they look very european. They got really nice little shops, wooden walls, nice decoration, very, very cool! I have never seen such pretty malls! I have also found the Apple store. That was a different kind of impressive. It is about three or four stories high and got a glass front with the big apple on it. Looks really neat.

Later I walked all around the Rocks and found some really nice little narrow streets, that I have not see before when having been down there. So far I think that is my favorite part of the town. It is also the oldest part of the town...I saw the oldest hotel and Pub of Sydney (my tour guide once again was quite misleading, but I found it anyway - no it was not me misreading the map, it was the map giving wrong information!!!! I swear!)

I finished the day walking across the bridge to the the northern side of the harbour to watch the sunset. It was an amazingly beautiful sunset.... overlooking the habour, looking at the opera house and seeing the sun set behind the bridge....very, very nice!

On Sunday I visited Chinatown, which was surprisingly small! I would have expected something much bigger! It was not very impressive, but the chinese Garden of Friendship is one of the most peaceful places I have visited this trip. It was given to Sydney on the Bicentennial of Australia and designed by chinese landscapers keeping all kinds of chinese philosophies in mind. I really enjoyed walking around there. It was very peaceful and quiet, even though there were a lot of other people. Lateron I walked towards Darling Habour and that was so completely different. It reminded me of Diseny Wold in LA. It was very strange coming from the chinese garden and walking up to this playground like Place. I walked all the way to the fish marked. On my way I passed Star City - the Sydney Casino. Of course I had to get my ID checked.... Appearently I don't look like I am over 18 yet ;) Because I got stopped by security whereas others could just walk through.... It is a pretty big Casino.
At the fishmarked I had some fresh lobster. It was really good. I don't think I have ever seen so much fresh fish in one place. The variety of things one can get there is impressive. Oysters, Sushi, all kind of muscles, crabs, fish, octopus.....

week #4

Tuesday

It was not particularly exciting. Just a normal clinic day. It was just kind of interesting to watch how important the personal secretaries seem to be to appearently all great neurosurgeons.... I have now wittnessed the third one to really have some trouble keeping up with his schedule when his secretary is on vacation..... It was kind of funny.

Wednesday

Another day in the private hospital theater. I got to intubate a patient and practiced catheterizing.... but the more exciting part of the day was the evening! It was the 25th and I was hoping to get a student rush ticket to see Madame Butterfly at the Opera House. I was really worried that it might not work out and that I got all dressed up for nothing.... but it all worked out. I managed to get a ticket worth AUS 250 for only AUS 55! So waiting till the last minute definetely payed off! Even though my heart rate and blood pressure may have slightly been out of normal limits.... ;) I got to sit in Row 13 almost in the center! It was amazing. Unfortunataly the translation was a little bit too high, so that I had to move my head a little much every time I wanted to see what they were talking about, because then I could not see the stage anymore..... The Voices were incredible and it was over way too soon!
While waiting in line I met three other students and we had a quick dinner before going to the show. Two of them were from Germany going to a Language school and the third one was from Japan. The girl from Germany was a lawyer and her name was Anja... (I thought that was kind of funny....) It was a wounderful evening and I am glad I took the chance to wait and not get a for sure ticket....

Thursday

It was a short day in the hospital. We only had one surgery. It was a little bit frustrating to be in the public theater again.... And I was also hoping to finally get to do a little bit more during surgery, since I had been so patient and always let other students who weren't here quite as long as I am go first.... and then this time the intern got to do the exciting things..... It just didn't seem fair, but then life is not fair. (With everybody else I probably would not have minded, since interns are higher in hierachy than students, but it was the fact that is was her that really bothered me.... because she just knows when to say the right things to impress people and when to do overtime.... and she is not very nice to her fellow intern, bossy.... long story!) Anyway. I am hoping to have a go next week. (Never give up hope!)
After the surgery was over I left for the day and decided to go to the harbour and get the most out of my weekly ferry/bus/train ticket. I took two different ferries. I got to go all the way to the west end of the habour (Paramatta): that was a one hour ferry trip! On the way back it was getting dark and I could enjoy the sunset... Really pretty. I sat down next to an older gentlemen, who really loves his town and he was an wounderful tour guide. He told me about places we passed, how things have changed over time... Very cool. On the way back a biochemist from Canada, who is in Australia to do "work and travel" joined us. She is really nice and as it turned out her parents were both from Germany. Once we got off the boat we wandered around circular quai and the rocks for a little while. It was great to have some company and it is amazing how easily one can meet nice people that are willing to share some of their time. The past two days reminded me a little of Hape Kerkelings story (meeting people on the journey, spending some time, nothing serious, just some time not alone....)

Friday

This is probably the most exciting day of the week! My registrar had allowed me to take the day off, so that I could really use up my weekly pass.... I spend most of the day at Taronga Zoo. It is not a big zoo, but a really pretty one and the scenery is awesame. I got to see Koala, Kangaroos, Penguins, Meercats, Wombats, those animals, whose name I can't remember, but that sounds like Enchiladas... Unfortuantaly no Platapus... I would have loved to see them as well. I had a great time. I payed some extra money to be able to go into the Koala Area and see them close up and get a picture with them... Really cool. They are looking so soft! I also saw the bird show with an amazing view acros the harbour and the sealion show. There would have been so much more to do and see, but I was glad that I got to see all the animals....
After the visit to the zoo the day wasn't over. I DID THE BRIDGE CLIMB! It is insanely expensive,but an incredible experience. 700steps, and then the sunset 134m above sea level.... It was amazing! We were on the bridge for almost three hours. I had shaky knees at first and my stomach was little bit unhappy at first, but all that was over once we stepped on the arch. The view is incredible! And reaching the summit is an incredible feeling......
Later that night I used the last chance to take a ferry before my pass expired and took a ferry to neutral Bay to see the harbour at night.... Amazing!!!! I think it will take me a while to digest all those amazing impressions...

Unfortunately at this moment I can't share any pictures with you, because I am only at a public internet cafe to at least give you an update..... Amazing pictures will follow soon....

no internet

hi everybody. I am still on the face of this earth. I have been very busy over the past week and just wanted to start telling you all about the exciting things.... But I just got told by security, that I can not be in the building anymore and that means not internet access for me until I move... Not even on weekends anymore... I hope you all are doing fine. Tim I hope you had a terrif Birthday and enjoyed the slightride.... I am thinking of you all.

I have had a chance to see Madame Butterfly yesterday and on tomorrow I will do the bridge climb... I wish I could tell you all more about it!

9-5?!?!?!?!

There is no nine to five in surgery..... and I honestly don't mind.... ;)
I started the day with a spine meeting at 7am this morning. The cases are incredebly interesting, so it is definetely worse getting up and seeing things! Later I got to attend pediatric neurosurgical rounds, it was quick, but still great to see some pediatric cases! And then I went to the private hospital. As long as no one cares I will always choose their theater over the public ones. The atmosphere is so much nicer and the teaching is a lot better as well.... I left around noon though to see patients in the preadmission clinic and show my face in the public hosptial again, but since there were only three patients to be seen this afternoon and the surgeries ahd started late this morning so that the case I really wanted to see was just about to start, I managed to get out of clinic and went back to the Theater.... That was at 1.30pm and now it is 8pm and that case is just finished and there are still two more to go.... I want to see the next case as well, but I believe I will probably not stay for the last one, but we'll see how things go. Dr. Teo constantly surprises me how quickly he can finish cases that seem to be major and incredebly long for any other surgeon.... and after all what's waiting outside the hospital - my room and an evening with me, myself and I... So I might as well stay here, see some cool things and enjoy the company..... And we get dinner for free, which is always a plus for a poor medical student.... ;)

Part II
Dinner was delicious.... And afterwards I managed to make the entire theater laugh at me... I got to catheterize my first real male patient (before it had only been dolls...)..... A real penis is way slippier and a lot harder to hold onto with all the glibbery stuff that has to go into the urethra to make the catherter slight in more smoothly.... And of course it being a first it took me a lot longer and everybody watching definetely got a kick out of it. The anesthesists comment in the end was: "Hey we all enjoyed it, even the patient.... ;)".....

brunch and the walk around South Head

This morning I got picked up by Morgan (Neurosurgeon from Milan, Italy) and his girlfriend (Radiologist from Milan). We all were invited to have Brunch with Charlie (Australien Neurosurgeon) and his family. Morgan was perfectly on time considering that he is Italian.... ;) It was really nice to get to know everybody outside the hospital and the food was really good!!!!!
In the early afternoon I left and walked with Aneela to Bondi Junction to take the bus to circular quai. She was late for an appointment and after having done the Manly scenic walk yesterday I could barely keep up with her. That was quite embarrasing..... I had never taken the Bus from Bondi Junction before, so I got to see some new neighbourhoods... Really pretty! Sydney got some really really nice streets - small, neat houses, little yards in front of them, lot of trees, little cafés and shops..... Then I took the ferry to Watson bay. And guess what - it was sunny all afternoon, a little hazy, but sunny!!!!! I woke up to a blue sky in the morning, but that changed sometime between 8.30 and 10... and I did expect some rain in the afternoon again, but fortunately I was wrong about that. Once I got to Watson Bay I did another one of the tours from my book. I walked to the light house on South Head. South Head is the southern border of the entrance to the Sydney Harbor. It's like a little peninsula and it has been used to protect the harbour from invasions, which is still very visible all along the coastal line there..... I also tried to see the Navy Chapel which was marked as one of the things to be seen in my tour guide, but there were guards that wouldn't let me go through..... I thought that was kind of strange since the tour guide didn't make it look like some really well protected piece of land, but appearantly they aren't right all the time! Walking along the coast was once again pretty spectacular. I can't get enough the turquoise color of the water, the cliffs, the breath.... and the Sydney skyline almost always visible. The plants are also really incredible. Today I realized why some of the pine trees kept looking sort of weird to me and I could not quite figure out why... It looks as if their needles are pointing the wrong way.... After I had finished the walk I layed down in the grass in a park with a book and enjoyed an hour of evening sun, before I took the ferry back - into the sunset..... Circular Quai is really lively and since I wasn't quite ready to go back to my small room, I walked around there for a while and enjoyed being surounded by people. It makes me calm just sitting there, enjoying the warmth and watching people..... They all seem to be so very relaxed and that somehow transfers..... It is a really cool city with a great way of life!

Manly Scenic Walk

Friday was a regular hospital day... It was Michelle's last day and the neurosurgical team from the public hospital went out to have coffee together after we had finished rounds. Later wasn't much to do. I helped them "stick needles into patients" and afterwards joined Charlie in his clinic again, since there was nothing left to do on the ward. Clinic was once again really interesting. And I did see him tell a patient that the tumor was inoperable for the first time. I also saw how he deals with patients that aren't sure about whether or not they want surgery.... he tells them not to have it! Which is really good, because usually those are the patients who will end up having complications. And after having seen a patient where everybody in the room agreed that the he did not want surgery, Charlie once more explained to us the importance of never trying to convince a patient that surgery would be best for him....
Today I was hoping for the 10-25% chance of rain, which had been on the forecast for the past week..... But it did not happen: we had showers all morning, but those weren't bad and I did not let them stop me! I took the ferry to Manly. That is a beach at the nothern side of the habour. It is really long and nice beach. Manly too is a pretty litte tourist suburb..... I really enjoyed the colorfull houses along the main tourist streets even though it was raining and thunder storming a little.... When the little baby thunderstorm started I was hoping it would pass through just like all the other little showers and started the Manly scenic walk even though it was raining quite a bit. And I was lucky, after about 30minutes the rain stopped and never started like that again. I had to deal with some spaying and the second rain of the forest, but other than that it stayed dry!!!!! I did not regret having taken the chance and doing the 10km walk along the coast. I had some incredible views across the harbour and parts of the town. The way through the Sydney national Coast park was very adventurous as well - natural stone stairs, small walk ways, lots of trees and very very green plants, ups and downs, wooden walkways overcrossing little waterfalls.... It was really, really great, even though once I got to the part where one had to walk along the beach I whished I had had some more solid ground, because after at least 8-9km of walking up and down, climbing stones .... my feet did not enjoy walking on the slippery sand.... But anyway it was as great trip along the coast again, even though I did not get to see quite as much water this time, because most of the time I was walking surrounded by trees/plants.... Unfortunataly most of the animals were always way to quick for me to be observed closely or even have their picture taken...... And they (birds, lizzards....) do blend in perfectly as well, so they are really really hard to see.
When I finally got to the bus stop where I was supposed to catch a bus going back into town I could not find the numbers from my Sydney guide on the list of busses stopping at that particular stop.... Taking busses is quite convenient, but also really hard if you don't know where you're going.... I don't know how other tourists do it, because on the bus you can't really tell where you are and you never know when the next stop comes up and what it is going to be. The bus ride was quite adventurous as well. I have mentioned before that the bus drivers seem to be pretty ruthless drivers.... Today one bus drive came so close to our bus that it tore off the mirror.... We all had to get off the damaged bus and onto the next one.... And I only knew where to get off, because I knew once we had crossed the Sydney harbour bridge that I was close to circular cay where the bus to Randwick leaves..... So I took the next stop after we had crossed the bridge, then got my map out and figured out where I was....

the excitment of Surgeries....

Yesterday was another Charlie day.... We got to the operating room (Theater, as they call it here) around 8.30 and did not finish surgeries until close to Midnight. Which was still amazing, because considering that he did 3 tumor surgeries und two small cases and got done by midnight is just incredible. I thought the first surgy would take at least 6-7hours and he was done after 4!!!!! It is just incredible. He is quick, efficient and knows exactly what he is doing. It is amazing to watch him and it is even better to be able to assist him.... At 10pm he finally asked me if I wanted to scrub in - what a question! He could have asked me at midnight and I still would have said yes! During the day I got a little upset, because I am not blond and not skinny... and those girls seems to get more attention and chances quicker.... But at some point it was my turn, and I loved it!
After the last surgery was over he invited everbody out to dinner, but I wasn't hungry and wanted to be able to assist with surgeries today and therefore decided to not go at 1am.... it was probably the more reasonable thing to do, but going out would maybe have made things a little bit easier, since those social events always help getting to know people better and have more in common. Maybe next time, even though I don't think that there will be a single day when his surgeries will be over before midnight!
Today I had to jump a few more hops before I was allowed to scrub in, and I believe I may have made the nurses a little bit mad at me, but I just didn't want to accept being told by the scrub nurse to not scrub after I had done all the required things and the surgeons wanted me to assist. Today it was just too much and I did not want to quietly accept it. So fortunately my registrar backed me up and we worked it out together. But it was once again ridicolous!!!!! Apperantly my supervisor had sent out an Email that no student was allowed to scrub on neurosurgical cases (by the way this is a teaching hospital!!!) That message was passed on to the scrub nurses and appearently the note about us being allowed to scrub after we have had the training wasn't.... So we called my supervisor and even though he said over the phone that I am allowed to scrub (since I am on his service and had the session) the scrub nurse still insisted on not letting me do it. Which just really upset me (but I kept that to myself, since getting made wouldn't have made her change her mind and I just let my registrar handle all the frustration....)It is just insane if someone who has made a rule can't make changes to that rule! Anyway we had to go to the next important nurse and she too was not impressed by the phone call and the message from my supervisor who specifically said that I could assist and get scrubbed, because he had sent out an Email a few weeks ago.... We finally found another person, who was able to clearify (not a doctor, not even a nurse!!!!) the whole situation and said since my supervisor said it was ok and since I had had the sessio I was allowed to scrub. And then all of a sudden everybody else wouldn't opose anymore, but I think it is just so frustrating since this is a teaching hospital and the nurses and the Theater stuff (not even the doctors) make it so hard for us to learn.... I don't even want to do much, I just want to scrub in, because I can see better and I don't have to worry about contaminating anything when trying to see better! Once we took care of all that I had two awesome surgical experiences. One of the patients I had seen on Monday in preadmission clinic. I was allowed to assist a little bit and help with the closure. I still haven't quite figured out how to not hurt the needle.... My needles always look like someone tried to kill them once I am done with sutures. The skin on the head is really thick, but the experiences surgeons don't bend their needles... So I still need to work on how to apply the right amount of pressure and how to move it through the tissue smoothely..... But it is still great and I feel more comfortable with the instruments every single time. Even tying a knot doesn't seem awkward anymore - not even with my left hand, because before I came here I had always practiced and done it with my right hand and now I had to learn how to do it with my left hand, which makes holding on to the instruments a lot easier, but was really hard at first. With the second case of the day I even got to assist more, because it was just me and the surgeon! Really, really cool! But I really got to experience the difference between the public and the private hospital today.... The nurses and anesthesia in the private hospital are so much quicker! Yesterday the turnover time was so much quicker and when the surgeon asked for something he/she didn't have to wait several minutes to get it. They were all interested in getting things done quickly, whereas today some things were done soooooooooooo slowly.... For Example with the first case: the patient was taken to the operating room around 8 and we did not start the case until close to 10!!!!!!
But anyway. I had a great time with the surgeries today and I might get some more experience next week on Thursday, when todays surgeon will operate again (she is a female neurosurgeon and so nice!!!!!)

Brain Tumor Clinic

Some Days are definetely better than others. Today I decided to join one of the famous Australian Neurosurgeons in his clinic again. Since he is so well known, many patients that aren't offered any treatment elsewhere do come here to see him. So he has got some really neat cases! And he takes time to explain things to students as well. Time goes by really fastwhen being with him. He had actually offered to supervise me before I came here, but since he is not a University professor that did not work and I would not have gotten credit for it back home...
Some of the patients we have seen today he will operate on tomorrow. That is pretty amazing! Come and see him today and have surgery tomorrow....The surgical schedule will be pretty busy though tomorrow and we will probably be in the operating room till after midnight.... I am still looking forward to that though, because there will be some really really interesting cases and some really exciting procedures. (two very malignant brain tumors, a probaly non malignant brain stem tumor - but a high risk procedure because of the location (probably 5-6hours), and two minor procedures) And as already said, he likes to teach....
I just worry a little about not being in the public hospital, where my supervisor mostly operates, but he is not around most of the time anyway, has not once invited me to join his clinic and as far as I know there aren't any surgeries on tomorrow.
I still don't really know 100% what is expected of me and where I have to be and what conferences I have to attend and when they all are. America may have been very stressfull and there were a lot of things to do, but at least after a few days I sort of knew what was expected and where we had to be and when we had to be there....
I tried to find the other doctors today after clinic was over and nobody was on the ward anymore. I left a note on the message board and I hope that is ok. They all communicate over the cell phones..... I don't have one and I am not quite used to the more relaxed way of doing things around here (and I am not sure if I like it - I hate incertainty!). For Example this morning we had a meeting at 7.30 and I was the only one there at 7.30, everybody else showed up after that..... But that's how things seem to work around here....

a day on the ward and in clinic

Last night I wanted to go to bed early, get some good night sleep and start the week well restest.... well I did not quite make it.... I looked myself out of the room and had to wait for security to let me back in - so I spend almost 20minutes in the hallway already dressed in my pyjamas with only my tooth brush and my tooth paste and a towel.... The doors to the rooms are really tricky, once they fall shut behind one, they can only be opened with the key, so I have to take my key with me whenever I leave the room. I was scared since day one that I will forget at some point and it happened last night.... Fortunataly the security people got a general key and I am not the first to forgett the key - I at least got to wear some real clothes and not just a towel.... ;)
This morning I then almost overslept, because for some reason I must have turned my alarm off during the night.... I am still not able to sleep all night without waking up. I don't know if it is because of the noise (wind, cars) or the cold.... (because the windows don't close properly it feels as if I am outside.... Alex the American neurosurgical fellow actually said "it is like camping outside" and he is sort of right about that.... ) So anyway I am trying to get used to it and thanks to the "survive the cold training" at Tim and Deb's house I am used to wearing sweaters at night and wrapping up in more than just one blanket.... ;)
The day started with a neurooncology meeting. We reviewed scans with the radiologist, radiothearpist and chemotherapists. That was pretty interesting. Afterwards the whole team went for coffee at a nearby restaurant. So that was a great start to a Monday..... It is nice to get to know them outside the hospital as well, because that reveals sides otherwise completely hidden....
Later during the day Michelle and I helped on the ward. We examined a patient and I learned how to make proper notes in the chart and write a consult. I am still having difficulties finding the right words to describe what I have found on examination. Fortunataly they are all really helpfull and when I describe what I found they give me the correct English medical term for that! I also tried to put a peripheral venous catheter in, but the patient just did not have any veins... Not even the intern managed to get on in....
During lunch time we went outside, because guess what: we're back in the hospital and the sun is back outside, but only long enough till our work day is over - seems like it got the same working hours as we do.... !
In the afternoon we had preadmission clinic. That's when we see patients who will have surgery during the week. That is really great, because we get to draw blood (don't have to, but can if we wish), then take the history, examen the patient and afterwards present our findings to the registrar - some real patient interaction! Knowing the history of a patient makes their surgery more exciting as well.... So I am already looking forward to tomorrows sugery... The patient had had a fracture of his first vertebra 10month ago and has been wearing a stiff colar since!!!! I just couldn't believe that noone has offered him surgery yet....
The neurological exams are still giving me a hard time... Not the exam itself, but writting down my findings using correct medical terms. It is a little bit frustrating some times, but at least having had the American training of how to organise a note in the chart and presenting patients propperly makes that part easier - now I just need to learn all the neurological terms and I am finding new ones I don't know every day..... I hadn't thought it was going to be that hard after already having had exposure to Neurosurgery in English....