The curtains and bed sheets are a plaid red and green. It reminds me of my uniform in primary school. So Liam, David and I have just finished 10 hours worth of clinic work in Molong hospital and their GP HealthOne.
I was super excited prior to this trip cos, to me, it basically meant a road trip out west and I love kangaroos, i love the country and I love road trips! I didn't really account for the long study sessions in the car or the very real possibilities of our accommodations being sub par as it has been in the last two towns. But we always arrive at night, to a ghost town, basically, and I let my imagination run and I start to believe that we've stumbled into a town of cannibals. lol.
That was the case for Molong, anyway. We were the only ones staying in the hotel besides the staff and had the upper floor to ourselves. When I came back from my shower, someone had left the door open and a cat just lay in the door way. A demon cat. I kid, it seemed nice. Anyway, we went into the local pub to grab some dinner, and we sat down before we looked at the menu. Everything was so very dearly priced and we weren't prepared to dish out that kind of money for a basic steak. So we grabbed a few beers and left. Just as we did, though, we saw the specials sign outside that said "Chicken Schnitzel $12.50". And we were fucking burning at the fact that we missed it. And it was just too awks to go back in and order food. Cos we actively denied someones offer to take our order. So we trudged back to our hotel, bummed that we missed out of the 12-fiddy Schnitty :( and had mi goreng for dinner.
We woke up the next morning and met Dr Christie at Molong Hospital and followed him on his morning rounds. It was a lot like the rounds I went on in Thailand, except the entire hospital was half the size of one ward at Nakornping and it was essentially an aged care facility more so than it was a hospital. There was lots of talk about the future renovations, too, where they'll rebuild the entire hospital and introduce a palliative care centre along with better and more rooms. The rounds took all but 40 minutes. Some patients were there post op and were just waiting around for 6 weeks to pass before they can start weight bearing again on their surgically renewed hips. With those, the doctor just asked if they were feeling okay and moved on. He spent more time with the more difficult patients, I guess. The ones that were in a lot more pain and the ones they were just making comfortable until the inevitable.
After this, we met Dr C again at the practice in town called HealthOne. It was very nice, very modern. We were each assigned a doctor to follow until lunch time. It was a lot like my week in Pediatrics in NKP, but this time I could actually understand everything the doctor was telling me because of the lack of a language barrier. I was with a Dr Zambo, who is quite a character. Kind of makes up his own rules, but he really connects with each patient. He kept up selling the benefits of being a country/rural GP and I was so drawn in. He was a lot like Dr Surachai? I think was his name, the head of Peds in NKP cos he asked me all these questions and we went through brief differentials and diagnostic plans and what not. I was super happy when I knew the answer, but a lot of the time I came up short, lol. But that's okay because what I lacked in intelligence, I made up for in questions!
He short of zips through all his patients like they did in OPD at NKP, but in such an efficient way where he actually manages to take all these measurements, ask them how they're feeling, talk about their families and have them explain to me what was wrong with them and give me a detailed history of their troubles. That's what I really appreciated. He got them to tell me what they did for a living and where they're from and what was wrong with them. He also graduated from my uni too so we bonded a little over that, haha. Super nice, super inspiring guy.
After lunch, omg. Liam and I went to get properly cooked, warm food cos we were living off instant noodles and muesli bars up until this point. I had never missed warm food so much in my life, haha. Anyway, we bought toasted sammies and met David back at the GP. We spent the rest of the day with Dr Christie in his room and really observed him as he worked through a palliative care patient. It was pretty intense. There was this one youngish bloke, he was diagnosed with stage 4 terminal cancer and had a botched surgery and had all these things wrong with him. Before he came into the room we were warned, I guess, that the guy was terminal and he'd pretend as though he was okay with it, but he really wasn't. It was probably one of the hardest 40 minutes of my life. After getting past the superficial jokes and when they finally spoke about a plan, I found it so hard to breathe in that room. There were so many times where I actually wanted to excuse myself because of the tightness in my chest. He was a trooper though, whenever it got too heavy, he'd crack a joke for us, but the entire time I just felt like I shouldn't have been there and it was getting harder and harder to listen to his story and to them talk about his future. It wasn't until his wife broke down that I felt a bit of a catharsis, to know that I wasn't the only one who felt that way about the situation, idk but I could start breathing again.
I guess what made it so uncomfortable for me was the fact that the doctor was so clam about it, and the nurse sitting in would try real hard to avoid eye contact, and whenever she needed to raise a concern, she'd do it with such formality. I don't know, it was just so detached and I guess it made it worse. But I can understand that it is their job. He isn't their only palliative care patient and to come right out and say it without any underlying pretext or judgement or pity is obviously the best way. I asked Dr C afterward how he could get through that and he said "what do you mean?" in an almost callous way, like it wasn't as tough as it seemed to be and all, but I guess it's an occupational thing. He was telling us about the connections we have when we understand that we're dying. We all have an intellectual understanding that we're gonna die one day, but we don't know when and for all of us, it's in the very distant future, so we don't worry about it too much. But for patients that he looks after, they need to emotionally understand that their time is going to end soon. That the belief that death being in the distant, hazy future is no longer the case for them, but rather they have a clean line in the sand which marks it.
He was telling us about the connections. He related it back to what the patient said, about small things like wanting to have an appetite to enjoy a steak and wanting the mobility to play golf again. Those connections to things are what stops them from reaching that emotional state of acceptance. And that when they do, they say, it's okay, and they mean it, because they've let go of all those connections and that's when its okay for them to go.
So that afternoon was really a big eye opener. Not just about the situation for doctors and other medical professionals in a rural setting, but for medicine in general. I learnt so much from observing those two and I'm expanding my horizons even further, because it's not what we all think it is.
Anyway, there is an uncanny resemblance with Molong and Bluebell in Hart of Dixie, but that'll be something I can talk about later.