What I learned in Clearwater psych ward - part the first

Been thinking about pain, and wealth, and trees that fall in the canopy, oddly enough, amongst a lot of other things.

Anyway. Me and the Clearwater psych reg.

I was in final year Med School at the time, and almost constantly frightened. Dimly aware that in a few short months I would be sent out as a real doctor, and understanding that my knowledge was deeply inadequate to the monstrous task ahead of me, I had constructed for myself the most demanding final year I could.

While other people lounged away their time in ear nose and throat clinic (three days a week), or hepatology outpatients (four out of every five people you saw had either hepatitis C or cirrhosis and the fifth had both, so that you only had to read ten pages of Harrison's, and you had two months to do it), or colorectal (watching endless footage on a tv screen with innards onnit while the specialist shoved tubing up some sedated person's bum), I did four terms of General Med, one General Surg and one psych.

I did this because I wanted my inadequacies exposed during the few short months left of being a medical student, not after January when I was an actual doctor who could kill people.

General Med means a bit of everything. General Med means the guy in this bed has renal failure, the next one had end stage diabetes, the third has some thyroid problem, the fourth is NYHF class IV heart failure, and so on. It means you have to know stuff. It means you get ritually humiliated in front of your peers and your patients until you can, at the very least, make a half-arsed attempt to keep most people alive until someone competent comes along. General Surg is the same, but with innards.

And that's what saved me in first year doctoring.

Although, to be honest, it didn't save Mrs Butterwoman, the woman who died on the first night Benedict and I were on duty, and actually expired beneath our hands. Dead set, I'd been a doctor less than twelve hours, and my record stood at one night, one death. Apparently Benedict told the tale of Mrs Butterwoman to a group of interns a few years later, and her blundering, futile, gruesome and ultimately unsuccessful resuscitation, and everyone in the room paled and grew still.

Anyway. In first year the only time I wasn't frightened (and more on that fear later, too) - the only time I wasn't frightened was doing psych. I remember strolling across Clearwater's open lawns, chatting to the snub-nosed registrar and listening to the magpies carolling in the trees*, and daydreaming about the time, a year and a bit in the future, when I would be a trainee psychiatrist, and would never have to see another broken bone or heart attack in my life.

Mmmm.

She (the psych reg) was freckled, and blonde, and blue eyed, and more than a little bit stressed, and I was determined that this rotation was going to be painless. So I did everything I could to make her life easier. I answered phone calls, I checked medication charts, I wrote up clinical notes for her to sign and I got a review article for her on the phenothazide antipsychotics so she could scan it the morning before clinical rounds and impress Dr Melleril.

And all the time I tried to gently extract from her any survival tips for life beyond graduation, some whisper of what it was like, some hint on how to survive.

At that time I looked on becoming a doctor as one of those "Schwarzchild radius" things, one of those event horizons that information cannot cross. Like having a child, or being in love, you can hypothesise but you can't understand what it's like until you've crossed over - and once you've crossed over, you can't cross back. I knew that by the end of summer someone would sign some bit of paper and offer me a job and I would become something that killed or cured.

So - I tried to extract handy hints. Survival tactics. Social mores and exotic customs for our destination.

Gods, I've rambled on, and that entry was meant to be about something else. Right - next entry is pain, freckled blondes, and trees and stuff.

Thanks for listening,
John

*You know how Doctor Doolittle and Solomon and various other people could understand the speech of animals? I've often wondered about that. To you and I, birdsong is melodic chirping. But were Solomon or Doolittle to stroll beneath the eucalypts, they would hear bird after bird shrieking "You mate, fuck off - this tree's mine", or "Hey, girls, get a load of this!"