Elsevier Ambassador Blog

  • The Mental Health Epidemic

    These are the dates I found out close friends and fellow medical students had committed suicide.

     

     

    3 years ago
  • Carry Pens! And other things I learnt from my first placement.

    1. What on earth a call bell sounds like.

    Now it sounds ridiculous, but it’s those tiny details that get taken for granted and subsequently missed. Which is precisely what led me to standing in the middle of a hallway like a deer in headlights thinking what on earth is that beeping?! It can take a little bit of adjusting to get used to the hospital environment: there are so many new sights, sounds, smells. So heads up, try to be a bit less daft than I was and find out what the call bell sounds like early on.

    2. Carry scissors. And tape.

    I can guarantee you that there will be a point where you, or somebody around you, will need them, and they’ll be lost in that giant black hole that contains all the lost bobby pins and pens too. Speaking of which…

    3. Carry a pen! Carry 600 pens!!

    I am a firm believer in the idea that you can never have too many pens. Of course, they will absolutely all run out at once, but there are only so many safeguards you can apply. At least everything’s going electronic now though, right?

    4. Your patients really will be patient.

    For many years now, nurses have been Australia’s most trusted profession. This is actually reflected in the way the patients treat you. Sometimes you’ll have trouble getting the oxygen saturation because your patient’s hands are too cold, and sometimes you just won’t be able to find a pulse.

    Don’t be scared of your patients - they want the same thing as you do; for them to recover. They won’t mind if you fumble a little bit, or take a bit longer than the RNs. They know that if you don’t practice, you won’t learn.

    5. Bringing food for everyone to the break room is always a good idea.

    Seriously! Healthcare is such hard work! A little something to fuel everyone will not only get you in everyone’s good books, but more importantly, will show them how appreciative you are for everything they’re teaching you. If you are a star in the kitchen then bake up a storm! When you find yourself being far too tired to cook, a Friday afternoon store bought cake is guaranteed to be welcomed with open arms. Bonus points if you can bring something healthy that still tastes good.

    6. That I wasn’t going to kill anyone!

    I was so anxious doing my first set of obs! Of course, I wanted to get everything perfect, but I think it helps to step back and think about what you’re doing. Stay calm, and remember that if you’re too nervous, you’re probably going to be a bit less accurate in what you’re doing. Try to relax, because by the end of the week (maybe even the shift) you’ll be so much more confident in your skills!

    7. A little kindness goes a long way.

    Getting on the ward for the first time is the perfect time to consolidate all the skills that you’ve learned. Blood pressures, ECGs, handovers, there’s so much to do! But it can be all too easy to forget about some of the soft skills that we learn too. So, if you have a free moment, have a chat with some of your patients and check if they need anything. Sometimes, all someone wants is someone who’ll listen, or even just a cup of tea.

    8. It will be so difficult.

    You’ll see some really tough things. You might even see some people die. You might cry. You might need to have forty minute showers each day when you get home so that you can make sense of everything you saw, like I did. But, in saying that…

    9. It will be so much fun.

    You will feel so empowered knowing that you are using the skills you’ve learnt, and knowing that even so early on, you’re already helping people and making a difference.

    10. That this is what I’m meant to do.

    It sounds corny, I know, but as soon as I actually got into the hospital and interacted with patients, other nurses, families, doctors, pharmacists, social workers and everyone else, I really knew that nursing was my calling. I cherished the patient interactions, I adored learning from the RNs and I was exhilarated by the problem solving I had to employ to navigate each of my days there.

    And I hope you’ll feel this to.

    3 years ago
  • Adventure Awaits: A Guide To Planning Your Electives


    It is that time of the year again when final exams are just around the corner. If you’re looking for some guilt-free procrastination, why not start planning your elective?

    Overseas electives are arguably the most exciting part of med school. It’s the perfect excuse to travel (not that you should ever need an excuse) and you’ll also get to see patients presenting in weird and wonderful ways that you could only ever imagine back home. Having said this, we’ve all heard stories about the nightmare elective and the endless stress that takes over when things don’t go to plan. As they say, failing to plan is planning to fail and when it comes to your elective, it’s absolutely spot on.

    Location:

    The first and most important decision to make is where to go. Do you opt for a first world country where you might see cutting-edge procedures or should you instead go to a third world country where patients present with fascinating illnesses that have long been relegated to the realm of textbooks in countries like Australia?

    FIRST WORLD

    Pros:

    • Research opportunities
    • Networking with important contacts
    • Skills more applicable to Australian healthcare

    Cons:

    • ‘More of the same’ – most first world clinical settings are very similar
    • Lost opportunity to be pushed outside your comfort zone
    • Cost – expect non-refundable application fees in the hundreds

    THIRD WORLD

    Pros:

    • A completely new and foreign experience
    • Learning to adapt in low resourced settings
    • More affordable
    • Cultural appreciation

    Cons:

    • Comfort
    • Safety – although if you do your research you will be safe

    Ultimately, both sides have their merits. It is worth keeping in mind that many reputable centres in first world countries have a long waiting list and will only consider applications supported by university letters of recommendation. With that in mind, this is a rare opportunity to get into some of the leading healthcare centres in the world. Remember to also consider language barriers!


    Self-directed vs. Company Electives

    There are several companies that offer ‘pre-packaged’ electives to students. It is definitely worth considering these options, particularly if you are not a seasoned traveller or if you are travelling to a country where safety may be an issue. You will of course be paying a lot more money for it so it’s worth trying to plan your own if you can – even if there are hiccups along the way, you’ll definitely learn invaluable life skills!


    Logistics

    If you’ve decided to do it yourself there are two main things to consider; transport and accommodation. There are comparison sites available for both so be sure to take advantage of them to avoid paying more than you need to.

    FLIGHTS

    Skyscanner is my go to site to compare flights. Some people say booking on Tuesday gets you the cheapest flights, so far that’s been the case in my experience. If you don’t want to be checking prices everyday sign up to email newsletters from sites like Iknowthepilot.

    ACCOMODATION

    Some hospitals will have accommodation but the costs may be prohibitive, especially in first world countries. If you are travelling alone, staying at a hostel will save you a lot of money and it’s also a great way to meet new people. You’ll want to avoid dodgy hostels (accommodation is certainly one of those things that can make or break your trip) so be sure to check comparison websites like Hostelworld. I will admit I wasn’t the biggest fan of hostels (think small beds, shared bathrooms etc.) but after a few good experiences, I’ve been converted. Having said that, they’re not for everyone. If this is the case you, try Airbnb. Hotels should be last on your list as staying for a couple of weeks will almost certainly break the bank.


    Plan Early

    This is THE most important tip of them all. Electives left to the last minute almost invariably go wrong and at best you’ll be paying way more than you need to. Book your flights at least 3 months in advance to avoid ticket price scalping or worse still, sold out flights.


    Before you leave

    • Bookings – have a calendar to make sure all the dates align correctly (triple check everything!)
    • Travel insurance
    • DFAT registration
    • Have a backup elective – there are often last minute cancellations

    Remember to travel onwards after your elective. With super busy lives ahead of us as future interns and JMOs, you cannot afford to turn down a chance to see the world.

    Safe travels!

    3 years ago
  • The Socratic Method

    During my first year of medical school, I noticed these odd terms reappearing in my lectures and assignments. These were along the lines of “critical thinking” or “analytical evaluation,” and at first I overlooked them as I busied myself with learning anatomy, physiology and the likes. But by second year and their continual mentioning here and there, I thought to myself, “these terms must have some sort of importance and if they do, how am I to learn how to change the way I think?” It was finally during a tutorial at hospital where these wishy-washy terms started to develop meaning. The teaching doctor began his lesson by saying “You medical students are too used to being spoon-fed, I’m going to teach you this lesson through the Socratic method,” and off he started. His first question to our slightly confused faces was “Who was Socrates?”.

    Ancient Greek was never my forte, so I soon found myself learning that Socrates was in fact a famous classical Greek philosopher credited one of the great founders of$post Western philosophy. His “method” was to engage his students in a line of questioning in or$postder to solve a problem. As simple as that sounds, he noted that specific questions directe$postd in a specific order would reveal the extent of his students’ knowledge and their underlying $postbeliefs. This teaching style is often practiced in law school, however can also be used in a medi$postcal setting.

    Once young, fresh, slightly scared but excited medical students find the$postmselves thrown into hospital and begin roaming carelessly around the wards or into an operating$post theatre, they will develop their own taste of the “Socratic method”.

    Translated into a medical education setting, a modern version entails: A senior doctor proposes a series of questions to lead the medical student to arrive at the same answer to their question via their own critical thinking. This often generates a rational discussion where a student can memorably extend their knowledge due to the slightly traumatic experience of being questioned/targeted by a doctor but also shows the student that they are able to work out the question using their own foundations and some well-directed guidance. An overall positive and educational experience!

    However, sometimes something peculiar will happen. This situation is referred to in medical terminology as “pimping,” and often masquerades itself as the Socratic method. It is as follows: similar to our previous scenario, a senior doctor will direct their line of questioning towards their junior colleagues starting at the bottom of the food chain, beginning however, with a rather inconspicuous topic, with which they are guaranteed to hear “sorry I don’t know…”. They will then move their way upwards from intern to resident and so forth until someone answers correctly or everyone is shown to be “incompetent”.

    This type of questioning does not line up with the intentions of the Socratic method. In fact, the purpose behind “pimping” is not based in education at all, but as a way to re-establish the medial hierarchy. By using an incredibly difficult question, or one that requires a list e.g describe the descending pathway of the vestibulospinal tract, the attending doctor can make themselves look and feel very knowledgeable with an after effect of both attempting to teach the medical student something useful mixed with a tinge of humiliation. Obviously this is not the best way of teaching, however it is an age-old tradition that has been practiced for over three centuries with earliest references found in 1628 by a London doctor named Harvey.

    Following in the footsteps of every medical student, we must remain vigilant and prepare ourselves to be posed difficult questions in rapid succession anywhere in hospital may it be ward rounds, operating rooms or even after getting your whole team coffee.

    3 years ago
  • Physio Abroad - A Student in Vietnam

    In January 2017, I ventured to Da Nang, a coastal city in central Vietnam with La Trobe University to volunteer as a physiotherapy student with GGC Volunteers. GGC Volunteers Ltd is an Australian registered charity that supports organisations and facilities in Vietnam, through sending volunteers and student groups to assist in improving the health, education and social welfare of children in the Da Nang region.

    On my first day of volunteering, I was faced with the austerity of care provided in Vietnam. It was confronting to walk into a facility where some of the teenagers with disabilities were chained to their beds. The children with cerebral palsy would be lying flat on their backs on a play mat, lacking the strength to move around or sit up. Although it seemed foreign to me, a westerner, to see these children left lying on the floor, I came to learn that it is the norm for Vietnamese children to be laid and fed lying down when they are unwell.

    “You cannot change what you refuse to confront” – John Spence

    GGC provides a charity physiotherapy clinic for children with disabilities. One of the regular patients attending the clinic was an 18-year-old girl with diplegia. Throughout her passive stretching and exercises, she persisted through pain, even telling us to “push harder” indicating her diligence to see advancements. It was gratifying that she did not let her condition define her capabilities and came to each session with a willingness to improve. It compelled me to believe that a diagnosis or condition, acute or chronic, does not define a patient or bind them. The improvements that I witnessed in some of the children over 2 short weeks, verified that there is no limit to one’s ability to improve. As a physiotherapist, I will have the potential to make patients and their families believe it is possible to break boundaries.

    “The limits of the possible can only be defined by going beyond them into the impossible” – Arthur C. Clarke

    Correspondingly, the family members of attending children shared this commitment to improving health. The mother of a girl with Down Syndrome was always punctual, encouraging and an active participant in her daughter’s treatment, rather than watching from the sidelines. This mother would carry her daughter on the back of a motorbike, their only means of transport, to and from the clinic. This unwavering dedication struck me and reinforced that not only patients, but their families, can play a crucial role in optimising the health care experience.

    During the experience, I become aware that poverty and the economy forces many Vietnamese families to orphan their healthy children, let alone children with disabilities, who increase their economic burden. I witnessed the mother of a severely disabled child abandoned at a support centre, return to take her child back into her care. The mother of the child with Down Syndrome, among others, reassured me that unwavering love and selflessness for children exists and goes beyond one’s poverty and/or disability status.

    “Love conquers all” – Virgil

    This experience enabled me to confront and conquer barriers, broaden my horizons, gain new perspectives, strengthen my cultural competency and most importantly, make a difference; albeit a small one. For these reasons among many more, I would recommend volunteering abroad (or even locally) to all of you.

    To learn more, visit http://www.ggcvolunteers.org/


    3 years ago
  • Your Patient, The Person - An Elsevier Series by Natalie S

    Compared to the nurses and doctors running around the Hospital, as a medical student I have ample time to attend ward rounds, watch procedures, and talk to patients. I usually choose the last option because I either have a timetable clash, or haven't been fast enough to catch a procedure. Interns have been happy to point me to patients who don’t see many visitors, have been stuck in the hospital for weeks, and are keen to chat for hours. Over the past month I’ve spoken to many patients who were generous enough to donate their time to a lost medical student on her first rotation who needed a sense of purpose, a sense that she accomplished something on the ward today. And that is how I met Beth.

    I’ll call her Beth for the sake of anonymity. Her real name is Arabic because she emigrated from Lebanon in 1963. Beth had nine siblings. Had. Two of them died as soldiers in the war, and that is when her parents had enough. She told me, with a tremor in her voice, about how they gathered up all the money they could to send her to Australia. She was the eldest, at 19 years of age, and had the best chance. They sent her to live with a fellow Lebanese family. Beth informed me that she used to be beautiful – waving me away when I tried to interrupt with ‘but you still are!’ – and that she would turn heads everywhere. The wife of the family she lived with became suspicious. She’d listen to the fights between the husband and wife in the other room, reaching a higher and higher crescendo every night. Soon Beth was shoved out the door in a foreign country where she couldn’t even read the street signs. Beth’s eyes watered, but her gaze was fixed straight into mine when she said, “I didn’t know where to go. I wandered for a day, and ended up in a park. There was bread scattered on the grass that people had left for pigeons. I leapt on it and ate and ate and ate. I felt like less than an animal.”

    Beth slept in the park for 3 days, until one night she heard something familiar under the street lights. Arabic, her native language. Her pale hands gesticulated wildly, like frightened birds, as she told me. “I jumped up! I couldn’t believe there were people here who spoke Arabic! I could not help myself; I started screaming help me, help me, help me! At the top of my lungs. I grabbed onto the man’s jacket and wouldn’t let go.”

    The men were from Lebanon, like Beth, and took her to their church. Beth lived there, with warm showers and fresh food, until she secured a job as a fruit picker on a local farm. She practiced her English in the orchards. She says she doesn’t know what would have happened to her if she hadn’t found them that night.

    Beth taught me many things. I listened to her pan-systolic murmur and I learnt about glaucoma medication from reading her chart. But meeting Beth, and many other patients in similar situations, made me appreciate the challenges many people face when they arrive in Australia. I have learnt about signs and symptoms, but I have also learnt much more. Learning about the complex and unsurmountable barriers our patients have had to overcome has helped me develop compassion not only as a future medical practitioner, but also as a human being.

    4 years ago
  • A Physio Student Takes on Stadium Stomp

    As most know, starting university can be an absolute whirlwind, as terrifying as it is exciting. For me, choosing La Trobe meant leaving much of my support network behind and venturing out alone, into unchartered waters. It wasn’t until my first orientation that I began to feel confident that I had indeed made the right choice and that Physiotherapy was the right fit for me. Up until then, I had never been entirely sure which career path I would pursue. One thing I was sure of was that I had a passion for health and helping people as well as a keen interest in sport and fitness. Taking all that into account, a future as a physiotherapist seemed like a good idea.

    Those first few classes opened my eyes to a whole new world of neuro physiotherapy and cardiorespiratory physiotherapy. As someone who’d come into the course expecting it to be all about muscles, it was refreshing to be introduced to an array of other components, each vital to the way the human body operates.

    Having said this, my first real taste of physiotherapy exposure came from volunteering at an event called Stadium Stomp with the Australian Physiotherapy Association (APA). Despite having such limited experience and no exposure to actual massage techniques, I decided to dive in head first and get involved.

    Stadium Stomp is an event that encourages participants to challenge themselves by attempting to tackle every step in the MCG within the space of a few hours. For some, this is a relatively simple task. For others, it can take a huge toll on their bodies. As a volunteer, my role on the day was to massage the calves of people who came in, spending about 5 mins on each person. Being so new to the world of Physio, this task was a little daunting at first. However, as I finished working on my first stomp client I was delighted to hear that, in spite of my lack of experience, my thumbs were ‘magic’.

    That simple compliment boosted my confidence and before I knew it, I’d been working for 2 hours. It wasn’t until I finally took a break that I realised how exhausted I was. I knew that when I went back in, I would have to come up with some new methods of massage to spare my thumbs from disfigurement. This was an important learning curve as it allowed me the chance to experiment and work out which methods were best for me. It was also at this point that I got to talking with one of the professional physiotherapists who gave me other tips on the types of movements I could be doing to avoid fatigue.

    Overall, it was a really great day and one I feel lucky to have been a part of. It was so exciting to observe trained physiotherapists up close and pick their brains about what they do on a daily basis

    It was the first chance I have had to do something hands on and use the few skills I had acquired. I learnt so much from observing and talking to everyone and it is definitely something I would love to repeat in the coming years.

    I would certainly advise anyone who gets the opportunity to volunteer in something like this to jump in, regardless of how ill-equipped you might feel. The skills you’ll gain from the experience will definitely be worth it!

    4 years ago
  • Ahmed

    I wiped away the condensation on the window next to his hospital bed. Ahmed had wanted to look outside, but had trouble getting out of bed nowadays and couldn’t do it himself. There was little to see. It had poured with rain over the last few days. Commuters bustled past in long black coats, white plumes of air escaping between their lips. A thick fog had enveloped the street, and people vanished into outlines. Naked trees trembled against the bite of winter. I turned away from the window, but Ahmed continued to look outside. The television was broken, and he could not read the English in the hospital magazines.

    His chest rattled as he breathed in and out. Ahmed’s pyjamas were four sizes too big for his frail frame. Different puffers in all shapes and sizes were lined up neatly like soldiers on the bedside table. Next to them were photos of his family. A beautiful woman standing next to a younger Ahmed, children playing at the beach, a family smiling at the photographer. There were many photos. Ahmed must have been in hospital for a long time.

    “Three weeks.” He informed me. It had been one thing after another. Ahmed was diagnosed with emphysema over a decade ago. He had been a construction worker, and everybody on the site smoked. He helped build skyscrapers that were sixty levels tall. He and the boys would light up a cigarette as they dared each other to look down, while standing on makeshift balconies that shuddered with the wind. He felt as though he were close enough to touch the clouds, back then. Everybody smoked, and nobody talked about the side effects. Nowadays he ran out of breath just walking to the bathroom.

    “But really, it did not bother me until last month.” He said dryly. “My grandchildren visited, and one of them had a cold. A few days later, the Devil was knocking on my door, telling me to let him in. Barely had the energy to call an ambulance.”

    Ahmed was diagnosed with pneumonia, which had worsened his emphysema symptoms. The emergency doctor had taken chest x-rays to confirm his pneumonia, and discovered something else. Squamous cell lung cancer, a cancer that was common among smokers. It had already spread to his liver.

    But Ahmed preferred to discuss his family. His son Uncaught Error: Call to undefined method Magento\Framework\App\ResourceConnection\Interceptor::insertMultiple() in /var/www/html/apacmagento/app/code/Infopro/CheckoutManager/mp_blog_posts.php:922 Stack trace: was a mechanic, and had been taking apart and fixing cars all his life. In primary school, his son had dismantled the radio out of curiosity, and successfully put it back together when Ahmed threatened to ground him. His grandchildren were also talented, Ahmed declared proudly. His grandson was a top soccer player, and his granddaughter had all straight As.

    “What were your parents like?”

    A dark cloud passed over his face. “They always worked hard.”

    “Sounds like you take after them.” I replied tentatively.

    Ahmed shook his head. “My father worked in a textiles factory. I never saw him except on the weekends. My mother took care of the family; cleaned up after him all the time.”

    He took a gasp of air. Failing to find his words, Ahmed felt along the bedside table until he found his puffer. “It was the asbestos. She did all his laundry, and they didn’t know about the asbestos in the factory until it was too late. Did you know you can die from asbestos just by handling clothes exposed to it?” He laughed bitterly, and his laughter turned into a hacking cough. “My father couldn’t handle the guilt. He followed her six months later.”

    Ahmed fondled his puffer absent-mindedly. “Smoking isn’t that different. The first cigarette my son started smoking was mine. Cheeky bugger stole them out of my dresser. He smokes around my grandkids. I can smell it in their hair and on their clothes. And he learnt it all from me. “

    He stared through the window, which had fogged up again. His eyes misted over. “He’s visiting this afternoon, and I’m going to tell him what I told you. We’re both quitting today.”

    4 years ago

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