Heathcote

I have been spending close to one week at my rural placement, Heathcote. This place is 30 minutes away from Bendigo, which is a big regional town and 50 km from Kilmore which is a small town like Heathcote.

The population of Heathcote is around 2800 people and most of the people here are Anglo-Saxon. I hardly see any Asian people here . There are 2 doctors (GP) in the town and one small hospital. The hospital is run by one GP and that GP has resigned from the hospital last week. Now, the hospital is facing the dilemma of recruiting another GP.

This problem is a common scenario in any small town around Australia. There are not many doctors who like to work far away from major cities such as Melbourne and most of the doctors who work in rural, are being forced to work by the government.

Having said that, there are still doctors who love to work in a small community. There is one doctor, not far from Heathcote, who is still working to provide the necessary health care to the community, despite he is already 80 years old . It is something that amazes me.

Anyway, back to my rural rotation. I lived in a nice house next to my supervisor and it has wireless broadband internet connection. This place has a nice environment and I always saw kangaroos jumping around the neighbourhood. In fact, this morning, I already saw around 20 kangaroos alone .

Every medical student in University of Melbourne is required to spend 3 weeks in rural setting as part of their medical course. Rural rotations means that you are send to a small town, far away from your home and you have to learn what are the differences between rural and city health system. Some people were send to a place that is about 400km from Melbourne and close to the border of New South Wales. It is almost impossible for them to go back to Melbourne every weekend. Hence, they have to stay at that place for the next three weeks.

Not all accommodation has internet connection and I'm fortunate to be blessed with internet facility. Without internet, I would be stuck in rural doing nothing and getting bored.

This is my second week of rural rotation and I'm already looking forward for this rotation to end. There are not much that you can do here and I miss having superfast broadband connection at home .

Cultural Safety

On the third day at Dookie Campus, all of us have to travel to Rumbalara Football Club, Shepparton, which is about 40 minutes away from Dookie Campus. The main reason we have to travel to the football club is to learn about the cultural differences among many races and in this case, it was the Aborigines.

Aborigines in Australia have been abused for hundreds of years. They were isolated from their families and integrated into the white society to such an extent, they lose their own language. Australia has its own dark history.

Read more

There was an interactive session where the medical students were split up into two group and each group have to become a predefined culture group and follow all the rules. It was an interesting experience as each group culture is significantly different and each group has to find out what are the rules of the other cultures.

I find the session was useful to highlight the differences of cultures among human being. We are not that easy to accept any people who are different from us. Sometimes, deciding which one are good or bad rules in a community can be difficult since it is subject to various factors such as culture, faith and the global environment.

Dookie and cows

We spend three days at Dookie campus and most of the time there were lectures that we need to attend. Bear in mind that attendance sheet were distributed at each lecture and 100% attendance is required from all medical students.

At the end of the first day, we were given a tour on how to milk the cows. It was an interesting adventure for most of us since many of us were brought up in urban environment and hardly see any cows at a close range.

Seeing how the workers milk the cow was an exciting experience for all of us. Most of us took several pictures of the cow but at the same time, we have to beware of any unexpected things that could happen during milking.

The cows are milked from behind and the milking machine is attached to the udder. The machine will automatically stopped when it reaches a certain amount of milk. I'm not sure how much though.

Since we milked the cow from behind, the butt is facing our face and the cows can unexpectedly urinate or defecate at whim. There are two rows of cows during milking process and we stand in the middle. So, we have to be cautious on both sides .

On that day, several unfortunate people had the accident. It was not a nice experience to have that on your first day of your rural rotation.

Rural rotation

For the next three weeks, I will be doing my rural rotation. For the first three days, I will be at Dookie Campus, which is about 204 km from my home and it took me roughly 2 hours to get here. Right now, I am blogging from Dookie Campus using wireless network .

After this, I will spend the rest of my rural rotation at Heathcote, which is about 155 km from Dookie and the journey will take another 2 hours from Dookie. The journey from Heathcote to my home will be another 107km (1hr 27 minute travelling time).

The map below will show the locations that I have written in the above paragraphs.

Melboure to Dookie


Dookie to Heathcote


Heathcote to Melbourne

p/s: I might not be able to blog once I'm at Heathcote since I'm not sure whether the internet will be available at my accomodation.

Fascinating photo.

Can you think how this picture is taken? [Note: this is not achieved via any photo-editing software such as Photoshop or GIMP]

The answer.

p/s: It took me few minutes to understand the technique. Incredible shot .

Favourite Firefox extensions

These are my favourite Firefox extensions in Firefox 3.0.

1. Adblock Plus. I certainly recommend my reader to install this popular Firefox add-on. It blocks 95% of website advertisement and this also includes flash ads. It certainly helps me on having faster loading of any websites and have better internet surfing experience.
2. DownThemAll. A useful download manager. It contains download accelerator and help me to organize all my downloads.
3. IE Tab. I used this for any websites that stubbornly have to be displayed using Internet Explorer. This add-on is also useful if you are a web designer.
4. Web Developer. It helps me whenever I'm designing this blog layout. It also help me to gain further understanding on how each website works.
5. Greasemonkey. This allows me to customize the way a webpage displays using small bits of JavaScript.There are various JavaScript available to be used with Greasemonkey. It certainly useful if you would like to try various JavaScript available on Greasemonkey
   

Related: My favourite Firefox extensions [2007]

Perak piyor

Inspired from Sarah who took a quiz on loghat Pahang on Facebook

Hafiz took the istilah loghat perak yg anda faham quiz and the result is anda mmg perak piyor!

anda mempunyai pengetahuan luas dengan istilah2 yang digunakan diperak, anda mmg berasal dr perak kerana anda familiar dgn istilah2 yg sukar ini...dengan ini anda layak utk berkahwin dgn og paris, lambore dan kwsn2 yg sewaktu dgnnya!

Take the quiz on Facebook: Istilah loghat Perak yang anda faham

Time Lapse Videos

These were interesting videos showing changes over time. How clouds move according to the wind, how the sun bring brightness to the nature and how moon shone light upon darkness.

Definition of time lapse video:

Time-lapse photography is a cinematography technique whereby each film frame is captured at a rate much slower than it will be played back. When replayed at normal speed, time appears to be moving faster and thus lapsing. Time-lapse photography can be considered to be the opposite of high speed photography.

Shlino lake sunset time lapse from Timelapser on Vimeo.



Spitzmeilen - Swiss winter mountains in time lapse from Michael Rissi on Vimeo.


My way from Per Erik Sviland on Vimeo.



Pixel's Revenge timelapse showreel from David Coiffier on Vimeo.

More time lapse video: 1, 2

Emergency Medicine review

I have finished my three-week rotation of Emergency Medicine. This was one of the most interesting rotations that I've been so far. It is a rotation that I've been looking forward since pre-clinical years.

I have managed to refreshed my knowledge on various acute life-threatening medical problems and able to perform few simple procedures such as putting a cannula into a vein, making plaster or back slab, practising Advanced Cardiac Life Support and observing how to manage various fractures.

Three weeks seems a long period for many but it seems to me that I prefer longer time in ED. Perhaps another week in ED will be good for me .

Overall, in this rotation, it is up to you whether you would like to be busy or just enjoying lots of free time available. You have to be very proactive in approaching doctors and nurses to get an opportunity to do lots of stuff. Most of the staffs here in the hospital I attached to, have been very nice and helpful.

My advice to my colleagues who will be doing ED after this:

• The best time to see lots of patients will be after 5 or 6 pm. If you are in the morning shift, there will be few new admissions except if there is any major trauma happening in the local vicinity.
  
• Fast Track, a section of ED which handles Category 3 t0 5 will be a good place to get your procedural skills done.
• Make sure you get to see lots of common presentation to ED [Chest pain, SOB, headache and fractures]
  

Mnemonic for Delirium

Delirium is an important medical symptom and may pointing to an immediate medical emergency if not recognised early. Here is mnemonic to remember the causes of delirium

• Drugs
• Endocrine (diabetes, thyroid, parathyroid or adrenal dysfunction)
• Epilepsy
• Lung Disease (pneumonia, COPD, sleep apnoea)
• Infection (Encephalitis, meningitis, syphilis, HIV, septicaemia)
• Injury (Concussion, subdural, extradural haemorrhage, burns, general and cardiac surgery, #NOF)
• Intracranial (Tumour, raised ICP)
• Renal (acute and chronic end stage failure)
• Intestinal (Carcinoma, obstruction, ileus)
• Unstable circulation (Arrythmias, CCF, Myocardial infarction, Hypertensive encephalopathy, hypoperfusion, blood loss, shock)
• Metabolic (Hyponatremia, Hypokalaemia, Acidosis/alkalosis, hepatic failure, dehydration)

Adapted from Bloch and Singh, Foundation of Clinical Pyschiatry

acopia

It means inability to cope and it usually refers to coping with life .

In medicine, we learned many Latin and Greek words and this represent the fundamental vocabulary among health professionals.

a+verb(in Latin or Greek)+a = inability or loss of description of the verb

Example

1. apraxia - loss of the ability to execute or carry out learned purposeful movements
2. agnosia - inability to smell
3. agraphia - inability to write
4. ataxia - inability to coordinate voluntary muscle movements; unsteady movements and staggering gait
5. agnosia - inability to recognize and identify objects or persons despite having knowledge of the characteristics of those objects or persons
6. alopecia - loss of scalp hair
7. anaesthesia - Loss of feeling or awareness
8. aphasia - loss of the ability to produce and/or comprehend language

When I first read the diagnosis of acopia, I was perplexed and unable to understand the meaning of the word. Theoretically, it is not a medical disorder. It is a description of what is happening to the patient. In fact, the word of acopia can be used to various medical disorders and thus it lacks sensitivity or specificity.

More on acopia.