Painful sports talk.

When the following column was published in Australian Doctor, I received considerable backlash from readers.  I was accused of being catty, socially inept and un-Australian amongst other things.  One reader said I should be ashamed of myself and another called for Australian Doctor to “do the right thing and let this column fade into obscurity.”

While this certainly was not the first time my light-hearted tongue-in-cheek columns have been misinterpreted, I was a little surprised at the vitriol generated over what was intended as a self-deprecatory fluff piece.

As for being un-Australian, I would have thought that my “taking the piss” was very Australian!

So what was the fuss about?  Read on and make up your own mind, and I’ll get back to watching the Winter Olympics….

………………………………………..

I’m not a big fan of inane chit-chat. I’ve absolutely no objection it if fulfils a purpose such as putting a nervous patient at ease, but there are times when talking about the weather, the price of petrol, Paris Hilton’s latest furry handbag accessory or Auntie Mildred’s stamp collection drives me up the wall. Sitting around the patio on a Sunday afternoon “shooting the breeze” with my in-laws used to be a regular torture. Thank goodness for divorce. 😉

image rubgy unionThere is only one type of conversation I find more painful than small talk, and that is sports talk. Rugby in particular.  I’ve never understood the fervour of armchair sports fans.  If watching testosterone-laden men thump each other in their attempts to grab an egg-shaped piece of air-filled leather toots your horn, I’m not going to criticise. Just don’t feel offended if my eyes glaze over and I start looking for an escape route if the conversation turns to ladders that aren’t the type you use when painting a house.

I still have nightmares about the time I was trapped in the operating theatre listening to an orthopaedic surgeon blabber on about rugby union matches. Oblivious to my distress, he drilled and hammered away as he plated the radius (forearm bone), pushing and pulling the fractured limb with the confident and carefree brusqueness at which orthopods excel.

It was painful, terribly painful, but I couldn’t object. Paralysed and powerless, I lay there, a terrified nine-year-old, insufficiently anaesthetised.  After what seemed like an hour, but was probably only a few minutes (all football-related conversations seem to drag on interminably to me), the anaesthetist woke up to the fact that I was awake, presumably by lifting his eyes from the sports pages for a moment to notice that my pulse had skyrocketed. The last thing I recall was his saying, “Hold that thought. She’s a bit light – time for a top-up.”

It was traumatic at the time.  The first night post-op I slept only fitfully, alone in a strange hospital room. The frightening shadows and noises of the orthopaedic ward mingled with my nightmares, nausea and pain. I vividly recall the particular dream I had that night; variations of it have haunted my dream-life for years.  It involved finding myself hanging from goalposts during a massive televised football match, attached to the metal cylinders by big screws through my forearms, crucifix style. The crowd were jeering and laughing at my attire – a hospital gown with only air on my derrière.

In my lucid moments, I begged for my parents, only to be told to be quiet and go back to sleep. None of the nurses believed my story of being aware during the procedure.

The following day the orthopaedic surgeon was likewise sceptical – until I relayed snippets of his conversation.  I do not recall if his face betrayed even a hint of embarrassment or concern, but I was probably too young and traumatised to have noticed. All I remember was that he made some off-hand rugby-related jovial comment and moved onto the next patient as quickly as possible.

Perhaps that particular childhood experience could be used to justify a dislike of rugby, having bones broken, night duty nurses and orthopaedic surgeons, but the truth is that none of these are on my list of favourite things for far less significant reasons.

It could be said that for someone who claims to abhor meaningless chat, I sure do a lot of it, in both verbal and written forms – this column being a case-in-point. A fair comment, I admit.

We should have a pointless conversation about it. Maybe after next week’s game.

……………………

First published in Australian Doctor on 5th July, 2013  On Sports Talk

http://www.australiandoctor.com.au/opinions/the-last-word/the-last-word-on-sports-talk

“So you are practising at being a doctor, generally?”

I had such fun on the phone tonight… with a cold calling scammer of all things… just had to write it down…

8:30pm, Friday 17th January. Phone rings

Me: Hello, Genevieve speaking

There is a 3 second delay, a slight crackle and then a heavily accented voice greets me.

Him: Hello madam, I am calling from Microsoft Customer Care.

I laugh loudly.

Him: Madam?  I said I was from Microsoft Customer Care

Me: (cheery) I know, I heard you.  So what are going to tell me is wrong with my computer this time?

Him:  Not your computer, madam, my computer. I have a problem and I was hoping that you could help me.

This is a new one to me, I thought.  Let’s see where this goes.  I’m intrigued.

Me: Your computer?  I thought you said you were from Microsoft Customer Care.

Him: That’s right madam.

Me: And you’re ringing about a problem with your computer?

Him: Yes madam. My computer won’t let me log on. It keeps asking me for a password and then says my password is wrong.  Can you help me with this?

Me: Why?

Him: I don’t know why, that’s why I need your help.

Me: No.  Why are you asking me to fix it?

Him: I’ve heard you’re very good at fixing computers.

Me: From whom?

Him: Pardon?

Me: Who told you I was good at fixing computers?

Him: My colleague did.  He said you were the one to go to.

Me: Your colleague from Microsoft Customer Care?

Him: Yes madam.

Me: And where are you calling from?

Him: Umm…  from nearby to your home.

Me:  Nearby where exactly?

Him: Just one moment madam  (sound of frantic typing) … I’m in Ball-Leena

I presume he was mispronouncing “Ballina”, the town in which I live, in northern NSW

Me:  Oh, from the big Microsoft headquarters in Tamar St?

Which of course does not exist.

Him: (relief in voice)  Yes madam, that’s right

Me: And you’re calling from there now?

Him: Yes, madam.

Me: (as if making pleasant conversation) So how are you finding this weather we’re having?

Him: The weather is… umm…  very… nice?

Me: Nice?  You call sub –zero temperatures and blizzards nice?

It has been hot and sunny – we are in the middle of an Australian summer.  It has never snowed in Ballina – at least since the last Ice Age.

Him: (uncertain) Umm… yes.

Me: You must like the snow, then. You a skier?

Him: (with relief) Yes, yes, I like the snow on the ground because I like to ski, but I would like you to help me with my computer now.  I heard you were very clever to fix computers.

Me: So you said… from your colleague at Microsoft Customer Care.

Him: That’s right, madam.  My computer won’t accept my password and I…

Me: Sorry to interrupt you but I’m a little confused.  You work for Microsoft, right?

Him: Yes, madam.

Me: And the colleague you mentioned works for Microsoft?

Him: Yes madam

Me: And yet he recommended me to fix your Microsoft Windows problem. How interesting.

Him: (getting desperate) Please will you help me?  I really need to use my computer. It is very important for my work.

Me: Have you spoken with the IT support person at your workplace?

I idly wonder whether Microsoft have IT support staff for their own office computers.

Him: Umm… I’m working from home today and I need to get onto my computer to do work right away. That is why I’m calling you.  I’ve heard you are the best at computer problems.

Me: So you said. What are you typing on?

Him: Pardon?

Me: I can hear you typing.  If you can’t log on to your computer, what are you typing on?

Him: Umm… my laptop, madam. It is working very well.  My desktop is my problem.

This is just too much fun.

Me: OK, I’ll see what I can do to help.

Him: (with huge relief) Really?  Oh thank you madam.  If you would just go to your computer and…

Me: We don’t need my computer.  We can use yours.

Him: My computer is not working.  If you just…

Me: Not your desktop, your laptop.

Him: My laptop is fine. I need…

Me: Great.  Bring up Internet Explorer or Google Chrome

Him: (frustrated) But they are search engines for websites. I can get to any website I want. That’s not…

Me: Type in “Microsoft password problem” into your search engine of choice.

Him: (becoming increasingly frustrated but trying not to show it) They can’t help me. I’ve heard that you are the best computer expert, madam.

I thought it was time to cut him a break.

Me: I think you have the wrong “madam”. I’m only a doctor.

Him: (voice brightens) A doctor?  A person doctor?

Me: Yes, a person doctor. Not a computer doctor. We deal with different viruses.

Him: What kind of person doctor? A bone doctor? A nerve doctor?

Me: I’m in general practice.

Him: (in all seriousness) So you are practising at being a doctor, generally?

Me: No, I’m… never mind.  Sorry I can’t help you with your computer.  Good bye.

Him: Wait! Do you know about knees?

Me: Only those belonging to bees.

Him: I don’t understand madam.

Me: Forget it.  Have a nice…

Him: Wait!  I have a problem with my knee.

Me: I thought you had a problem with your computer.

Him: I do. And my knee.  It clicks when I bend it and hurts a lot when I…

Me: And you would like my advice?  As a doctor?

Him:  (eagerly) Yes please madam doctor. That would be very kind of you.

Me: No worries.   Go to your laptop.

Him: My laptop?

Me: Uh huh.  Bring up Internet Explorer or Google Chrome.  Type in “knee clicks when I bend” into your search engine of choice and then…. Hello?  Hello?  Anyone there?

……

Most fun I’ve had in ages… which probably suggests I should get out more. 

Ignorance is bliss but not necessarily a good OSCE (exam) strategy

My recollections of sitting my RACGP OSCE (Fellowship clinical exam) are rather hazy, and not just because it was over a decade ago. I do have one bit of advice though – a do-as-I-say-not-do-as-I-did tip – try to avoid traumatic brain injuries in the month leading up to your clinical exam.

Here’s the story of how I came to be doing my RACGP OSCE exams with 6 facial fractures and left temporal lobe contusions….

Saturday, 4th October, 2003.

Photos from old computer 115

I couldn’t close my mouth. That wasn’t a good sign. Many a time I’ve been admonished for having my mouth open more than it’s shut, but on this occasion it had nothing to do with being garrulous. My upper and lower jaw no longer occluded. I sat up – gingerly, to discover that I was completely alone in unfamiliar bushland, with no recollection of how I got there. I lay back down and closed my eyes, inappropriately unperturbed.

Like a slowly developing Polaroid picture, the details appeared in my mind’s eye. The colours were increasingly vibrant yet the focus remained blurry. I remembered studying for my OSCE exams that morning before deciding to take one of horses for a ride in the State forest to clear my head. The rest was a blank; my head had been cleared too well.

Living at Pomona0013It was time to play CSI. The skid marks and saddle imprint in the mud clearly showed where Rondo had shied and fallen (probably on seeing a kangaroo – he was terrified of them), and my face had left a lovely impression at its point of impact. Thankfully, Rondo appeared on cue when called – mud-splattered and jittery but unharmed. It took us several hours to find our way out through the maze of interconnected forest trails, what with my disorientation and his being one of those rare horses with no inclination to make a beeline for home. Unlike many males I’ve known, he was excellent at taking direction but hopeless at finding it.

I remember only one thing clearly about that long ride home: laughter. My laughter – laughter which bubbled up from deep inside, slipping between my maloccluded teeth and spilling out of my bruised mouth. In my concussive haze my situation somehow seemed side-splittingly humorous. The funny side was the only side I could see.

I laughed more in that next month than I’d done in the preceding three years. Although my personal predicament lost its comedic edge fairly quickly (temporal lobe contusions and six facial fractures requiring two maxillofacial surgeries and a six-week liquid diet do tend to be dampeners), the world around me tickled my funny bone in completely new and outrageous ways. I laughed at the news. I laughed when I got stuck in traffic. I laughed over spilt milk. And most surprising of all, I laughed at corny American sitcoms. You know the ones: weak, predictable story lines, groan-worthy one-liners and canned audience laughter. I found them not only funny, but hilarious. I’d laugh so hard that I’d double up on the floor in stitches with tears streaming down my cheeks. I kid you not.

Despite my looming exams, my neurologist prescribed “brain rest” and instructed me not to study. Nothing I read seemed to be retained anyway, so I put my books aside and indulged in my new-found penchant for mindless entertainment. I laughed the days away without a care in the world.

Living at Pomona0020Three weeks after my accident, less than a fortnight after two reconstructive surgeries, and against medical advice, I sat my OSCE exam. In my brain damaged state, I was not at all worried about whether I’d pass or fail, happy to turn up and just “have a go”. I don’t remember much of it, other than wondering why my fellow candidates all looked so worried, receiving stern glances from an exam supervisor as I giggled to myself in a rest station, and having to ask one of the role players about her presenting complaint at least three times (my brain simply refused to retain the information).

I miraculously passed (although it was far from an outstanding performance!). Somewhat unfortunately, over the following weeks my ability to laugh outrageously at the banal also passed, and my sense of humour crept back to the dry and satirical side of the fence. The news of the world was again depressing, traffic congestion got my goat and split milk, although not inducing tears, no longer triggered a giggle.

I’m not sure if my laughter was the illness or the medicine, but it was definitely an integral part of the healing process. Having a traumatic brain injury was for me a far from unpleasant experience. In fact, it seemed to suggest that life is not only more painless for the brainless, but it is also much funnier.

While sitting a major exam in such a state was entirely without stress at the time, I do not recommend it as a technique to reduce performance anxiety. In all seriousness, I was very lucky to have passed, and believe that the only reason I did was that I had spent the previous 18 months preparing. Not by going home and studying every night, but by engaging in deliberate practice each and every day when seeing patients. Good communication skills and examination techniques were so ingrained that they did not require the concentration and higher level thinking that the knock on my head had temporarily disabled. These semi-automated skills alone are not enough to be a safe and competent doctor in the real world of course, but, together with a big helping of luck, were enough to carry me through the OSCE exam on the day, as I smiled and laughed my way through the stations, completely unfazed.

“I want you to be my friend, not my patient” – social dilemmas for rural GPs.

I’ve just read a brilliant column by Dr Mel Clothier in this month’s Rural Doctor

Making friends is hard to do | Rural Doctor
http://www.ruraldr.com.au/opinion/last-yarn/making-friends-is-hard-to-do

She talks about how hard it is for rural doctors to separate their professional and social lives. This is such an important, difficult and often under-appreciated problem for rural doctors, especially when they’re starting out and trying to get established in a rural area. Although such dual relationships are challenging for everyone, I get the impression that the friendship/ patient dilemma is often hardest for young single females (would be happy to hear any opinions to the contrary!).

I know that I found it really hard as a registrar. This aspect of rural practice contributed significantly to my being almost burned out by the end of my training. Overworked and socially isolated, I thought that I may have made a big mistake in becoming a rural GP.

Trying to make social connections for the purposes of friendship are problematic enough, but add the desire for an intimate relationship into the mix, and you have a whole other layer of messy. For very good reasons, the separation has to be absolute, which cuts down one’s dating options in a small country town drastically.

When I’d first moved to a rural area, two years out of med school, romance was the last thing on my mind. My boyfriend had died during my intern year – of testicular cancer – and it took me a long time to be ready to move on. When I finally was ready to consider a new relationship and hopefully, in time, a family of my own, I was working 60hrs a week in a small country town. A good breeding ground for horses and cattle, perhaps, but not ideal for a young, single female GP.

And so, I chose the obvious solution – did what any overworked, lonely, newly Fellowed country GP would have done – I took four months off work – to do a reality TV show. It was the ABC’s Outback House, not A Farmer wants a wife, although in retrospect, the latter may have been more useful.

It was a life changing and meaningful experience – one that I would never ever do again, even if paid large sums of money– and certainly not a solution I would suggest to you. 😉

There are no easy answers, I’m afraid, but putting the effort into maintaining relationships and supports outside your local community (including online ones) is really important. As hard as it can be to do, I try to decide (together with the other person involved) whether they are going to be a (close) friend or a patient. I spend a good deal of time explaining why it isn’t beneficial to either of us to be both.

It does get easier!

20130927-222931.jpg

Coming Out of the Personality Closet

It is a year today since I saw a TED talk which changed my life. OK, “changed my life” may be a bit strong but it certainly changed my sense of self-identity and self-worth.

Having spent my life thinking that I fell squarely into the extrovert camp, twelve months ago I discovered, that I am in fact, an introvert. 

It started with Susan Cain’s TED talk…

which I followed up with her excellent book, “Quiet: The Power of Introverts”  http://www.thepowerofintroverts.com/

I have since read more widely on the topic, realising that I was embarrassingly ignorant. The more I read and reflected, the more I realised that I had forced myself to “act out of preference” for most of my life, and beat myself up quite unfairly when my square peg didn’t fit into society’s round hole.

At the risk of sounding melodramatic, it was a perhaps a little like someone with same-sex attraction discovering that there are many others just like them in the big, wide world, and that their feelings are not shameful or wrong.

In case you are not au fait with what an introvert actually is, let’s start with a definition / description:

(From http://giftedkids.about.com/od/glossary/g/introvert.htm )

Contrary to what most people think, an introvert is not simply a person who is shy. In fact, being shy has little to do with being an introvert! Shyness has an element of apprehension, nervousness and anxiety, and while an introvert may also be shy, introversion itself is not shyness. Basically, an introvert is a person who is energized by being alone and whose energy is drained by being around other people.

Introverts are more concerned with the inner world of the mind. They enjoy thinking, exploring their thoughts and feelings. They often avoid social situations because being around people drains their energy. This is true even if they have good social skills. After being with people for any length of time, such as at a party, they need time alone to “recharge” When introverts want to be alone, it is not, by itself, a sign of depression. It means that they either need to regain their energy from being around people or that they simply want the time to be with their own thoughts. Being with people, even people they like and are comfortable with, can prevent them from their desire to be quietly introspective. Being introspective, though, does not mean that an introvert never has conversations. However, those conversations are generally about ideas and concepts, not about what they consider the trivial matters of social small talk.

…………………..

Like so many people, I associated introversion with less developed social/ communication skills and an element of shyness / discomfort / not fitting in certain social situations (large groups, new people etc.).  People with Asperger’s tendencies for example. So when I kept coming up as an introvert on any psychological test I took, I totally dismissed it.

A particularly memorably instance springs to mind. The owner of a medical practice I worked for as a registrar paid for a psychologist to come and test everyone’s personality as part of a staff development program. The psychologist then made suggestions as to how the workplace could be improved based on the results. The rationale was that we would be able to better work together if we understood how each of us ticked. Not unreasonable, but I came out as strongly introverted and had a big argument with the psychologist about it. I then totally bagged the whole process. I’m embarrassed about it now, in retrospect. Mind you, the psychologist obviously didn’t understand what introversion really meant, as he just doggedly stuck to the line about how valid the tests were without trying to explore or explain I got the result I did.

I’m not in the least bit shy, but the truth is, the deep truth that I’ve been hiding for as long as I can remember, is that I find being around people for long periods draining, and if I don’t regularly recharge by having time alone, I get very edgy.  I never feel lonely. Ever. In fact, I’m at my happiest when I’m by myself.  If I think of my 10 most satisfying and enjoyable days of the past 5 years, they’d all be ones I spent alone.  

I learned social skills and got very good at wearing a mask – fitting in, being a good communicator, friendly and generally well liked.  I spent my life trying to convince myself that I wanted to do “normal” social things, like going out for drinks or to a party with friends. I’ve tried to tell myself that engaging in evenings of social chit chat should be relaxing and enjoyable, rather than frustrating and draining. I’d feel relieved when I had a legitimate excuse to avoid social functions, but then feel guilty about my relief.

There have always been social things I enjoy, don’t get me wrong, like rehearsing for a theatre show/ orchestra/ choir, and interactions when the conversation is deep/ meaningful and engaging. I get a real buzz from performing in front of a crowd, whether that be through teaching/ presenting, acting or performing musically. I adore working with small groups as a medical educator.  However, I need to have my down time beforehand and afterwards to be able to do these things successfully and pleasurably.  I also prefer to do most of my day to day activities alone, if I’m given the option. I always thought there was something wrong with me because of this.  But not anymore. Not for the past year. I have been given the entitlement, in my own mind, to be who I am.

Since my lightbulb moment, I have become far more accepting of myself. I no longer pressure myself into socialising when I’m not feeling so inclined, and don’t feel guilty when choosing my own company over others.  I’m honest with my friends and family about needing “me” time, no longer feeling the need to give rationalisations or excuses.  They have all been tremendously supportive, and not taken my “rejections” at all personally, understanding that the “It’s not you, it’s me” cliché actually rings true in these instances.

Interestingly, I’m enjoying socialising more and feeling less drained by it in general. While the overall numbers of hours I spend socialising has decreased a little, the number of hours I’ve spent enjoying social interactions has increased significantly. Understanding and self-acceptance has banished the pressure and guilt, making for a much happier camper all round. I’m not at risk of becoming a crazy hermit cat lady anytime soon.  Not that there is anything wrong with being a crazy hermit cat lady if one is being true to oneself.

I’ll finish with two quotes. Firstly, from Susan Cain, to whom I owe a great deal,

“When psychologists look at the lives of the most creative people, what they find are people who are very good at exchanging ideas and advancing ideas but who also have a serious streak of introversion in them. This is because solitude is often an essential ingredient in creativity/”

And lastly from Ralph Waldo Emerson,

“To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment”

Ralph Emerson