Leaving my comfort zone

You could argue that this whole trip has been an exercise in leaving my comfort zone, which is true. My slightly neurotic need to plan has been tempered by elements of the trip that have been totally beyond my control, such as the weather.

From a medical point of view, this week has been fabulous for procedures, but also an exercise in leaving my comfort zone and trying not to show how very nervous I was! I have put in an arterial line, which is a bit like putting a venous drip in a patient but is in the artery instead to allow regular blood gases to be taken and a beat-by-beat blood pressure recording to be made. I have also intubated a five year old and a three year old (with a lot of help). I can definitely see myself doing this sort of practical thing in the future. I have also done another viva practice this week, on lung compliance, which had been good for improving, at least in theory, my ability to communicate physiological principals.

I have been joined in ICU by two medical students from UNSW, which is good, although they are both cramming for finals, while I have at least 10 months to go so can’t really motivate myself in a similar way. We are, however, going out for tapas and sangria tomorrow, which should be fabulous

Abstraction and Aroma

Saturday was a lovely day, which began with a gym session at 8 followed by brunch with coffee. I then took the bus into the city. I first went for a wander through Hyde Park to the Archibald Fountain before arriving at St Mary’s Catholic Cathedral. The cathedral was oddly reminiscent of Durham, although very modern by comparison. It was really strange to be in a religious building where the history only began in the 1800s. I did not stay for Mass, but would like to on another occasion when time permits.

I made my way through the Botanical Gardens to the Art Gallery of New South Wales. The building itself is stunning. The current building was built in stages, and has a beautiful aspect out over the Botanical Gardens and the waterfront. It has free entry and lots of seating areas, so it is a good place to sit and read. I enjoyed the Aboriginal art gallery and the Degas statues. I even managed to find a painting of Diogenes in his barrel just for Sarah! The real reason I went, however, was to relive my year nine art days with the Abstraction exhibition, which involved quite a bit of Cubism. It was a collection of 150 paintings from around the world by Monet, Cezanne, Matisse, Picasso etc. It was a good exhibition, although very busy, so it was a bit difficult to really appreciate the art. After the exhibition, I had afternoon tea in tea museum café, with many pitying looks from the waitresses who didn’t seem to understand why I was so content to eat my scones and drink my tea alone.

After the gallery, I went on a shopping trip. The primary reason for this was that I need a scrapbook to put all my tickets and programs into, as I have a rather spectacular collection of tickets growing in my bedroom. Sydney, however seems bereft of such an item. I therefore gave up and instead searched for the second item on my list- mascara. This item proved far easier to find than the first, although prices in Australia are much higher. After an incredibly busy bus journey home, I taught my flatmate Matt how to make Delia’s Minestrone soup and had an early night.

On Sunday, Matt and I went to the Aroma coffee festival at The Rocks. I have never tasted such an amazing cappuccino, nor seen so many people queuing for coffees. There was a really lovely atmosphere, with live street entertainment and a bit of a party feel. The weather could have been slightly more festival like, but it was still a brilliant day.

This week in ICU should be very practical. I am looking forward to some hands-on work. I can’t believe how quickly the time has gone- I’m really going to miss it when I leave. I am looking forward to G being here and showing him why I think Sydney is amazing!

Thank God they didn't find the BeeGees...

This week I have learnt a very important lesson. It is not sensible to increase both the speed and incline on a treadmill and then become so distracted by your success that your ipod goes flying across the room never to be seen again. My initial hunt was unsuccessful and I was reluctant to ask for help from the gym guys on the grounds that the track that was playing when I dropped my ipod was ‘Staying Alive’ by the BeeGees. However, a full week later it has still not turned up which means I have been bereft of music for an entire week!

Life on ICU has been less depressing this week. It has been good for learning procedures. On Friday, I did a lumbar puncture, which was scary but really exciting. The patients have been an interesting lot this week. A couple have been readmitted either post-op or have bounced back from the ward. I am becoming more aware of the differences between the Australian health system and the British health system. For a start, there are far more ICU beds in Oz, so the admission guidelines are less stringent. In a way it is nice when the patients stay for a while because you get to know them and their families.

I also have been to see Inception, which is a brilliant film, but is one of those films that you need to see twice to full appreciate just how clever it is. I saw it with Matt, my flatmate, at Bondi Junction, where we also had dinner in the food court. Duck Laksa is gorgeous!

Lost: Blonde girl in search of a tower...

Flying to Melbourne was relatively straightforward. Apparently for domestic flights no-one cares about seeing your passport or how much fluid you take on board. The flight was 1 hour 15 mins, and they gave me drinks and a quiche on the aeroplane. Exciting!!

The commute from Melbourne airport to the city centre was not at all difficult- I went on the Skybus and they transferred me to the hostel. I then discovered that I was staying at a building site. After accidentally trespassing on the building site whilst trying to enter the building, I finally made it to the front desk. The hostel itself is not bad-when they have finished the building work it will be fabulous. I met one of my roommates, Tom, and went for a walk around the river with him. The Melbourne run was happening on the Sunday, so we had to avoid the various 10km signs. Melbourne is a beautiful city, very cosmopolitan and almost European. There are lots of little side streets with cafes spilling out into the street, which were great for coffees and breakfast.

I met Kat in Federation Square and we wandered into China Town for dinner. Our plan had been to follow the locals to find a good eatery, but the place they went to was packed so we chose a slightly less busy eatery for goyza and curry. We then met up with the people Kat had been on tour with and went to the cinema to see Toy Story 3 in 3D, which was great although did make me feel a little travel sick.

Saturday started with coffee and croissant in Federation Square while watching the sunrise, before a walk through the Royal Botannical Gardens. It was a lovely way to have a proper girly catch up before walking to the Victoria Markets. Here you could buy virtually anything you could want and quite a lot that you didn’t want. As with all Aussie shopping centres, there was a fabulous food court where we had souvlaki and Turkish bread. Turning back on ourselves, we went to the Tim Burton Exhibition in the Museum for Moving Arts. It was well worth a visit- I had no idea just how many films he had been involved with. In the afternoon, Kat went to a rugby match. As I still don’t really understand the rules of rugby league, I offered to be the scout and to find out how much a trip up the Eureka Tower would cost. This turned out to be slightly more difficult than anticipated, as the tower I had been shown was not the tower I needed to be at. Thus I spent a considerable amount of time standing in front of glass doors hoping they would let me in, before giving up and having a coffee and a cupcake.

Melbourne is famous for its shopping, and I did enjoy mooching around and looking at things that were well beyond my budget. I did balk at the idea of going into the Gucci shop in my hostel kit of jeans and a t-shirt…I thought it would be a bit too obvious that I had no intention of buying anything.

After the rugby, Kat and I met for dinner in a tapas bar that was recommended in the Rough Guide. Even at the relatively early time of 5:30pm, it was heaving, so we were lucky to get a table. The food was excellent- scallops, sea trout, croquettes, zucchini fries, oysters… The one down side was the cost of the alcohol, but we decided it was well worth the expense. We had managed to find cheap tickets to see Calendar Girls at the theatre, so enjoyed a great giggly night eating ice cream and watching slightly senior women take their clothes off.

Sunday began with breakfast in a gorgeous café tucked into one of the side streets. I had French toast with strawberries, while Kat had the Eggs Benedict. Even at 8:30am, the place was busy, so we knew we had found somewhere good. We then went up the Eureka Tower (88 floors in 30s) to get a true panorama of Melbourne. This view was particularly good because we could see people starting the Marathon down by the river. No, we weren’t tempted to join them!

My weekend in Melbourne went too quickly. I think I needed a couple of days extra to really relax into the city. It is well worth a visit for anyone who is fairly close by. Particular thanks to Kat who arranged her tour around me- it was lovely to see her.

The week of dinners

This week has been fairly depressing on ICU. People are sick and getting sicker, and I think I must have been shielded from this in my previous weeks because there was always someone on the ward who was getting better. However, in the words of Frank Sinatra, ‘That’s life’, so I had better get over it. I have put in quite a few NG tubes and cannulae and assisted in putting in a PICC line, so my practical skills are improving.

I have been out for dinner with the medical staff for a Fellow’s leaving do. This was my first thai meal, and while I don’t have a clue what I was eating, it did taste good! They also had amazing cocktails- the Naked Native was particularly good.

On Wednesday night I was taken out to Aria, a restaurant with amazing view of the Harbour Bridge and the Opera House. We had the degustation menu- seven courses of absolutely amazing food with equally great company. I think my favourite course was the goose; cured goose breast with chicken liver parfait, poached rhubarb, black pepper and gingerbread. Amazing.

This weekend, I am meeting Kat in Melbourne for the weekend. I fly out on Friday and come back Sunday lunch time.

I am now Dutch

Friday night was epic. It began with duck pansang in China town, which was amazing and not quite as hot as the thai green curry I had last time with my Dutch friends. Then we bought Roosters scarves and went to the rugby. Apart from the fact that I don’t really understand the rules of rubgy league, I really enjoyed the game. And we won!! After the game, I went back to the city with my friends for a night at the youth hostel bar. We got some odd looks in our Roosters garb and Dutch dancing is a revelation!

Saturday was a fairly quiet day. In the afternoon, I met Veronique and Michele in Bondi Junction shopping centre. I managed to find a few of the odds and ends I needed and then we went to the food court. Unable to make our minds up as to which of the many cuisines to go for, we decided upon seven courses between us all! Very full, we went to the cinema to watch ‘Grown Ups’, before heading home for an early night.

On Sunday, the Dutch trio (Michele, Veronique and myself) took the ferry to Manly. The views should have been stunning, but the weather didn’t quite want to play ball! Manly is a lovely little town with an amazing beach, where I will be taking a surfing lesson at some point. We then walked through the national park to Spit. It is a 10km walk, with quite a few stairs, although not as many as the Blue Mountains. It was another fabulous day.

A week of many parts

This week was my week on paediatric intensive care, and I was determined to make a good impression. This lasted all of forty minutes into the ward round, when I collapsed and a code blue was called. I spent a sizable chunk of time on a paediatric trolley in the ED before going home for the day. For the rest of my time on paeds, I was greeted with ‘Oh, you’re THAT medical student’. Fabulous!

Fainting spells aside, I have really enjoyed paeds. I have seen a lot of the conditions that we read about in textbooks- congenital heart defects, inborn errors of metabolism etc. There are a good mix of patients, those who are fairly fit and well who just come in for one night after major surgery and those who are born with suck complex medical problems that they have been in ICU their entire lives. It has certainly raised some interesting ethical issues, and I reminded me why I love this specialty.

And now we shall take the scenic route

Sunday morning involved a leisurely bus journey into the City to meet up with some friends and to go to the fish market. We started in Darling Harbour, which has been used as FIFA central, with big TV screens projecting the live matches. It was gloriously sunny, so we wandered around the harbour and crossed the footbridge, before popping into a café for coffee.

Our walk to the fish market was supposed to take 10 minutes, however we opted for the scenic route, which took considerably longer as it involved walking along the headland. It was well worth it! Even though it was nearing the close of play, the market was full of fresh fish, and restaurants where you could watch it being cooked for you. We tried oysters and then shared seafood platters, which were supposed to serve two but easily served four. We had grilled octopus, scallops, oysters with chorizo, battered cod… it was amazing! We then ordered salmon and tuna sashimi, which was a little strange, particularly when combined with a wasabi-eating contest.

We ended our day by buying a bottle of wine and sitting by the harbour watching the sunset. It gets dark fairly early here, but Australia is not limited by Sunday trading hours, so Veronique and I went shopping so I could buy a coat- my English stoicism has eventually given in to the 3 degree mornings! We also had pedicures, which are really popular over here and available in every shopping centre I have been in.

We agreed to go and watch a Rugby League game on Friday, which should be fun after my week of paediatric ICU. I don't think certain people (Vikki) will forgive me if I come back a League fan!

And then I ate a 1000-year-old egg

Week three in ICU has been a real mixture. Some of the really sick patients are getting better, which is fabulous. However, there are a couple of really sad cases where metastatic cancer and massive cerebral bleeds have put up a better fight than the combined forces of the patients and medics. I’m learning loads… the teaching sessions of the week have been: management of severe brain injury, non-invasive ventilation, airway management, renal physiology and a journal review about the use of certain antipsychotics for delirium in ICU. I’ve also felt surgical emphysema and stuck my finger through someone’s chest cavity to feel his lung (we were putting a chest drain in, I hadn’t just stabbed them!). I’ve also sat in on a family conference, where the consultant had to break bad news. This was interesting to see as it was done with great sensitivity and care. We also did a couple of simulated senarios. My role in each was ‘medical student’, which was great as I just did as I was told and did CPR and put fake cannulae in. In both cases the ‘patient’ survived, although this may have been due more to luck than anything else in the first senario, as none of us had realized that the oxygen was not turned on!


In addition, one of the Residents is Chinese and brought in a 1000 year old egg for us to try. I will now quote Wikipedia to give you an idea of what this entails:

Century egg, also known as preserved egg, hundred-year egg, thousand-year egg, thousand-year-old egg, and millennium egg (or Pidan in Mandarin), is a Chinese cuisine ingredient made by preserving duck, chicken or quail eggs in a mixture of clay, ash, salt, lime, and rice hulls for several weeks to several months, depending on the method of processing. Through the process, the yolk becomes a dark green, cream-like substance with a strong odor of sulphur and ammonia, while the white becomes a dark brown, transparent jelly with little flavor. The transforming agent in the century egg is its alkaline material, which gradually raises the pH of the egg to around 9, 12, or more.[1] This chemical process breaks down some of the complex, flavorless proteins and fats, which produces a variety of smaller flavorful compounds. Some eggs have patterns near the surface of the egg white that are likened to pine branches.


I definitely will not be trying one again- the aftertaste of mouldy egg will stay with me for a long time!


Thursday night was out with the girls for amazing tapas and Twilight. The tapas restaurant was fabulous- we has scallops and octopus and meatballs and several other things I can’t remember anymore! And sangria, which was another first for me. The cinema was lovely, a bit like Zefferelis in Ambleside. You can take a glass of wine in with you, which is very civilised.


Friday night was dinner in China town before the Dutch game. We ate in the food court, where there must have been at least a thousand different meals from various different outlets. Not good for someone as indecisive as me!! My seafood Thai curry was amazing, if hot enough to make me weep.


I shall write again soon, and will eventually get round to writing some postcards.