When I was an intern in my last year of med school, I did my voluntary assignment, naturally, in psychiatry. I was placed on an open unit dealing with patients with affective disorders.

There was a resident there, a woman called A – maybe in her mid-thirties or early fourties. She was specialising in Childrens’ psychiatry, and as such had to work a year in adult psychiatry.

I disliked her from the start. She was distanced and gave me the feeling I was stupid when I asked questions. At that point I was still seeing a therapist (who is also a psychiatrist) weekly while recovering from a severe depression I got about a year before.

I had two patients of my own. I still remember them, even though I can’t remember their names. (I’m bad with names. It’s annoying.) One was a depressive patient who was scared of being at home and later on of riding the bus. The other woman had what we thought might be bipolar disease and came in with a depressive episode.

Since she was bipolar and I always had the feeling I had to know things instead of asking on rounds with the chief attending, I I thought I’d try to find out what to do when someone had a manic eopisode, in case one of the other doctors would ask. Doc A was sitting in the conference room, and I asked her.

Lil Doc Fae: I was wondering, how would you treat a manic patient?

Doc A: Why do you want to know?

Lil Doc Fae: I have this patient with bipolar disease and thought they might ask during rounds. I know what to do about depression, but I’ve never seen a manic patient before.

Doc A *points*: There’s a bookshelf over there. Read it up.

I was mortally embarrassed. I read it up.

I told my therapist the week after and she chuckled and said, “Honestly – she’s a childrens’ psychiatrist and won’t have seen much of bipolar disease or mania. Have you not had the thought yet that maybe she doesn’t know either?”

And I boggled. Honestly. The idea that someone could know as little or less than me had never crossed my mind. That’s how confident I was at that point, haha! And somehow, instinctively, I knew she had to be right.

I never talked to Doc A about it. I didn’t even think about it myself, at that point I just thought, oh! and that was about it.

What I will never forget though is how things changed from that point on. Because suddenly it was easy to work with her. We got along very well. We played to each other’s strengths, and at the end she was my favourite doc there.

And all of this because I thought differently. Because that was the only thing that had changed, the way I perceived her. My behaviour to her must have changed, and that made her change hers. I have no idea that I did anything differently, but I believe knowledge of any kind makes you behave differently automatically.

It taught me to a degree to question others’ motives, especially when I assign them negative ones. I think it also meant that I was born to love cognitive therapy

But, anyway. Another thing. I’ve always seen my mother as an incredibly disciplined and tidy person. She used to have everything tidied, and cleaned and whatnot. And I could never do it. Cue tons of teenager-mother-conflicts. I’ve always had problems keeping order, I’ve always had waaaay too much stuff, never been able to keep sensible routines. At the same time it’s always been a big thing for me. While I’ll never be a neatfreak, I don’t like it when it’s too cluttered. I somehow always cross the line between comfortable and cluttered without noticing. Honestly, it just happens!

I remember very well the only day I’ve been truly suicidal, about nine years ago now. I woke with the thought, “I will clean now. At least they won’t be able to say that the apartment was a mess.”

And I wondered what the hell was wrong with me when obviously my mother had it all down, and how could I not have learnt this from her?

When I was visiting last week I got my answer – she isn’t too good at it, either. She really hates it as much as I do. She could force herself when she was home with me and my brother, but now that she’s working part time again, stuff doesn’t get done the way it did before. She told me how she didn’t clean the bathroom because my brother was staying and would shower that day, so it wouldn’t pay off to clean the shower just before that – sheesh, I so recognise that line of reasoning.

It was good, to see that she isn’t perfect, so I’m not too imperfect either.

Nurses here study for four years. They’re generally very well educated and do an amazing job. They’re also mainly female, and have two employers to choose from – in other words, they’re screwed. I’m all for them getting more money.

The only “but” there is that I wish they wouldn’t have to strike for it. It should just be bloody obvious to people that you should pay them according to the quality of their work, which they’re not right now. So they’re striking.

The thing is of course, that without them, nothing works. So even though the doctors, secretaries, assistant nurses and so on are working, the units in which the nurses are striking are still closing down.

In our hospitals it’s basically surgery, medicine and the ER. Of course they’re always taking real emergencies (meaning, if you have a heart attack, no one will send you home, but if you come in with a sore throat you’re out of luck) and the hospitals here and in Slightly-Bigger-Town are working together, so that the ER is open in one of the two.

Since I’m working in GP right now, for me this means that lots of the patients who would have gone to the ER during the night or weekend (the sore throat variety) will now be calling us in the morning instead.

The nurses’ union has asked for neutrality from the doctors’ union which has been granted. Meaning, we are not supposed to do any additional work that would normally done by nurses, so as not to dilute the effects of the strike.

Our nurses in GP won’t strike, and we have received a note that while we are to be neutral, our employer has the right to revoke free days and to prolong working hours. Which they promptly did, and I don’t especially like having ten minute appointments – mostly because I think my patients don’t really like having those, there’s not too much time to get any kind of talk, trust or relationship going. And of course they’re saying, this is neutrality because you’re not doing the nurses’ work, you’re doing the work the doctors in the ER would normally do! Which to me doesn’t really fly, and I feel like a strike breaker.

It makes me feel uneasy. There’s nothing I can do about it, really, and I can see on the other hand how it’s better the patient get a short appointment than not getting any, but – well, it’s making me uneasy. I remember when I was five, six years old and my grandfather was the president of Germany’s textile union, and how I would walk with him on the May 1st demonstrations, being proud of my red carnation broche. I have been thinking a lot about him these last days. He was an interesting man, managing to combine his work with being a conservative Christian (and voting as one). It has always fascinated me, even though I see myself neither as socialistic or conservative.

All that’s just to say, hey, work’s been a bit strange.

Friday our Diabetes nurse (who is awesome by the way, and one of the prime examples why they should really get 15% more pay – she knows more about diabetes than any doctor I know) took my bloodpressure. And, yikes. My mom has high bloodpressure, and I know that she found out when she was my age. I have been taking it just to see because of that in the past, but then I remembered I hadn’t checked in a long time.

Anyway, she was alarmed enough to give me the 24 hours – erm, thingo? You know, you fix the cuff on your arm and have a cable around your shoulder, and a little box on a belt that you’re carrying for 24 hours. It checks every 30 minutes, and every hour at night.

Yes, that does mean I didn’t sleep tonight, because every hour the damn thing made BZZZZZZZZZZZZ and blew up until I thought my arm would fall off. ARGH.

And just in case I will deny it later, if I’m lying over 140/90 average, I shall do the exercise thing till the end of the year to see if it makes a difference. Because I would so love to not have meds for the rest of my life. At least not yet

On the light side, I’ve been stitching and I’ve finished the Hinzeit Doctor block today, YAY! I’m so very proud of it. While I was working at it I had to keep thinking about how I’m so glad I made it through med school, and thankful that my parents put me through it. I’m happy that I have a job that lets me feel that I sometimes make a difference. It’s the best feeling I know. And while I know that there should be other things in my life that make me happier than my job – well, maybe sometime there will be, but right now I’m just glad I’ve got that. It’s a great thing to have. I feel like I’m doing a good thing, and like I’m doing something I’m good at.

Sentimental blah-blah aside, here you go:

This is it without all the charms attached, because they will be hiding a big part of the caducei:

And this is it with the charms:

And two close ups that show the charms better. They’re adorable, I will definitely do more Hinzeit designs in the future.

This design does mean a lot to me, and I definitely want to buy a frame for it. I don’t know if I should get the frame that’s meant for it and shown in the picture (see in the last post or on Webshots) because I used such different colours, and I would love to have something in another colour. Right now I don’t have the money anyway, but it’s definitely something I want to save for.