Now that I have six short (they seem long) months of something resembling clinical experience under my belt, I decided to retake the Medical Specialty Aptitude Test.  The results were far worse than I’ve ever seen them before in terms of where my interest lies!  However as I learned the hard way, there is a big big difference between studying something you find interesting, and working in the same.  Your job is so much more than what you find interesting.  It is a blend of a certain sort of person, the hours, the disruptions, the type of job, and a million other day to day things.  You have to get that mix right or you’ll go nuts.  My step into medicine so far has been successful on the people front - while there are some very very special sorts in medicine, they’re different enough from the special sorts in marketing to make me happy.  So that’s one thing down.  Anyway, here’s the list I got:

	Score
1	radiology	45
2	radiation oncology	44
3	dermatology	43
4	hematology	43
5	med oncology	42
6	psychiatry	42
7	physical med & rehabilitation	42
8	occupational med	42
9	rheumatology	42
10	pediatrics	41

I do not understand why rad onc keeps topping the list every time I take it!  Is there something I don’t know about this specialty that makes it the perfect job for me?  Of that list, I actually like dermatology (no chance, I dont want to be a reg for 10 years), haematology (but only somewhat), and rheumatology (which I actually do enjoy immensely strangely enough).  But no neuro?  Renal?  My two favourites?!  So clearly there’s something, many things really, about the vagaries of these jobs.

Something is happening to me this year.  I’ve really realised I can learn and be successful at pretty much anything I do.  It used to bug me that I had an arts/IT background.  But lately I’ve realised that not so many people can lay claim to be able think and work in two such different modalities.  That’s pretty cool.  Now that I’m actually getting lots right when questioned, that has become blindingly apparent.  Now that I’ve been told by a few doctors that I’m apparently really good with patients (when in my mind I’m just having a conversation), I’m starting to feel like I actually can do this.  Allow me to take this one tiny moment in time to pat myself on the back after so many posts of kicking myself in the knees.  I feel a bit like that guy on Masterchef who was quiet and mediocre the whole time and now at the end is absolutely killing it.  Except that I haven’t been quiet, I’ve whinged a lot.  I hope that when it comes time (and time for me is not med school, it’s specialty exams), I can kill it if I just shut up and keep trying.  If there’s one thing I’m a genius at, it’s perseverance.

Luxury is not the opposite of poverty, but of vulgarity. - Coco Chanel

More and more in life I’ve taken an interest in fashion.  I can see half my readers rolling their eyes.  Fashion?!  That’s not serious or noteworthy surely!  But fashion for me is so much more than what’s in the window at Witchery or what latest piece of so-called avant garde is tottering down the catwalks.  Fashion defines an age.  It is one of the greatest communication tools we have.  Women wore corsets for decades if not centuries then poof! They were gone.  Suddenly we wore pants.  Fashion reflects the political times, world feeling, its creators draw on their childhoods, presidents, trees, you name it.  And while you may claim that fashion isn’t for you, you participate it in every day.  Do you wear pants as a woman?  Do you know a fashion designer decided that for you?  That they gave you that right?  Would you go back to corsets?  Do you wear the colour red because you like it?  Do you know that if a designer hadn’t one day decided they liked red, you’d have very little access to red clothes?

My point is that we are not all fashionistas, but that our lives are pervaded by fashion.  We need clothes to dress ourselves, yet a decision making process is made that goes way beyond warmth and comfort.  We need fashion to project our image.  Humans are inherently shallow.  That’s why you don’t get hired if you show up in a t-shirt and shorts to a job interview.  By going to the effort, you are communicating that you’re trustworthy.  Fashion is so much more than hipsters on King St posing at the lights.  It is a reflection of who we are, where we are, and what we want.

Last night I went with a friend to see the biopic, Coco Avant Chanel (Coco Before Chanel).  It was a look at her early, austere upbringing in an orphanage, and her later exposure to the wealthier ladies of Paris.  These ladies wore as many adornments, jewellery as possible so that people would know they were rich.  When Chanel suggests one is wearing too much, a lady exclaims ‘but wont people think I’m poor?’, much to Chanel’s obvious disgust.  And yet these days, that woman very much exists, that total fashion victim who decks themselves out in the latest and greatest so that people will know they are rich.  Stories of women in rural china who live in dirt floor huts spending their entire savings on a Gucci bag so people will ‘think they are rich’.

Watching Chanel’s obvious distate for this vulgarity and mindless following of dressing conventions was one of the most satisfying elements of the film.  She has one dress and a travelling coat.  At one point she takes the clothes of the man whom she has become mistress to and recuts them for herself.  There’s an excellent scene where she enters a garden party full of ladies in pastels and jewels dressed unashamedly in her new outfit and the contrast is so stark, and again, satisfying.  It was she who gave us the right to wear pants, because she decided to.  She got rid of corsets because she hated them.  And women loved her.

It’s a good watch although it is let down by it’s ending, you get the sense that there’s a whole lot more and it simply skips from when she’s just getting started to her eventual success years on which is wholly unsatisfying.  It is however, worth watching for the realisation that it’s the very people who hate the current fashion that ultimately change it.  I can still remember in my first degree how much I hated what was in the shops at the time which wound up in me buying a sewing machine and never looking back.  Chanels distate for fashion victims, vulgarity, excess and her love of simplicity and dressing for yourself (an unknown concept for women of the time) really resonated.

The film was vindication for me in a way.  I’ve copped grief about being a ‘fashionista’ when nothing could be further from the truth.  I believe in dressing in clothes you love.  In communicating who you are through what you wear.  In changing the dressing habits of an entire world because you don’t agree with social convention.  It is one of the most ultimate forms of subversion in society, and at the same time, of imprisonment.  For Chanel to be anti-fashion (of the times) and to let women in to her own special ethos of dressing which was largely inspired by her own austere childhood and distate for current trends was just wonderful to watch.  In the film a male character calls her an anarchist.

Maybe sometimes you need to be poor.  Maybe sometimes you need to relentlessly be yourself in the face of convention.  Maybe you need to do things your way instead of feeling there’s some other set way you’re supposed to do things.  Because if you didn’t, nothing would ever change.  Chanels utter rejection of the fashion of the times and her own unwillingness to capitulate to social convention was ultimately her biggest success.  I do not have the words to describe how good that is to see.

Since returning from Lismore I have had bad asthma, my eyes resemble a heavy pot-smokers, I have a permanent headache and lots of body aches.  And the air stinks.

Country 1, City 0.

“I’m really impressed by your knowledge-base”.
I’m taken aback.  Encouragement doesn’t come often in medicine, and before I forget myself, I thank my new GP.
“I mean it. “she says, nodding, “I can see you doubting yourself, but you don’t need to.”

You don’t need to.  You don’t need to doubt yourself.  Wait - I don’t need to doubt myself?  I’m not sure that’s something I even know how to stop doing.  My new GP is lovely.  Again, we get along famously, I get along with her patients, and I’m able to answer questions.  I even managed to diagnose costochondritis today without her input at all.  The differentials were the usual, cardiac and gastro-oesophageal reflux disease at the top but the pain history just wasn’t quite right and I told her so and that I didn’t feel convinced, then examined the patient and found it immediately.  The patient, white as a sheet because she thought she’d been having a heart attack for weeks, hadn’t realised there was a tender spot during the times the symptoms abated. She then cried her eyes out because she was so relieved when I told her what I thought it was and the GP confirmed it.

It’s not a big deal in the grand scheme of things.  I’m sure most med students could easily do the same and may even laugh that I got some satisfaction out of it.  I’m sure they’re diagnosing all manner of strange and wonderful things while I’m feeling proud of this pickup.  But that’s not the point.  The point is that GP rotation by far has been the best for me.  For whatever reason, the universe has decided that for six short weeks of my life, I am going to have a positive education.  One filled with encouragement, praise, and patience.  This is the first time I’ve experienced this in medicine.  Abrupt, rude surgeons, snotty smirking physicians, vague geriatricians, and really nice but exhausted and stressed out registrars with no time - it’s all been a bit demoralising.  Enter the GP, enter the lifestyle decision and the ones who are okay with that, and their attitude is just completely different.

This GP is the polar opposite to the last.  This one is a fireball of energy, listing off reams of information, differentials, management faster than  can keep up, grilling me over and over and being genuinely pleased when I get it right and endlessly patient when I don’t.  It’s nice.  It’s really nice.  I said to my sister tonight that I don’t feel that I’ve ever really had much encouragement for anything in my life and she said I’d probably given out more than I ever would have received.

I don’t really judge people.  My background negates that.  But I am so impressed by those who are so okay with themselves, that they can freely praise where it’s due, and so lacking in insecurity and false ego that they are patient instead of demeaning when their student is wrong.  It’s sad but true that most people can’t do that.  They are either too focussed on their own issues to do it, or too selfish because of their own insecurities.  Cynicism, belittling, power tripping, all these things are very animalistic and easy things to  revert to.  I consider this norm.

It makes those who can rise above it really stand out for me, and when around these superhumans, I really do start becoming the best I can be.

I came home from Lismore to be greeted by my stuff.  In piles.  Some neat.  My Ebay box full of stuff that’s been there for months.  After reading Affluenza and living with a fraction of stuff I realised that I’d let all this stuff accumulate.   And they say your personal space reflects your inner space.  I don’t know how true that is, but there is a point in it.

Your Ebay box, that stack of papers, that pile of clutter is all a great big pile of should.  Stuff you should be doing.  Stuff you should have done.  How can we let this kind of thing invade the space where we should feel most at peace?  No wonder we feel stressed in our own homes if we are constantly greeted by all the things we have to do or should be doing.  I don’t need half of this stuff.  I haven’t kept it for any real reason.  And I’ll take my Ebay box to the donation bin I think - it stings a touch when I think that maybe I could sell it and get some money for it - but I don’t have the time.  I’d rather just offload it to someone who will genuinely enjoy it and then enjoy the free space and one less stress that I achieve.

I really hate the word downsizing.  It implies that by getting rid of the stuff you never use and that stresses you out, you lose in some way.  It really should be called upspacing.  You don’t lose anything.  You gain space for new things, you gain calm - and the only thing you lose is the stress that’s been staring you in the face over you having to do something about it.

There was a lady in the GP clinic last week in tears.  Her husband had the fairly newly recognised obsessive compulsive disorder of hoarding.  The backyard was full of ‘junk’ as she put it - but to her husband it was valuable, he told her he was ’saving’ it because it had gone to the tip.  Their backyard, up to their ceilings - she was afraid it was going to fall on him one day.  When did we, as a society, start externalising our self esteem in products?  How is it that we pity ourselves if we can’t afford a new jumper, shoes, or car?  Why does this make us sad?  In Affluenza they talk about the confusion between wants and needs.  When we say “I need new shoes”, what we’re really saying is “these shoes are looking old and outdated and I’d like a new pair to stay up to date”.  And that’s a perfectly okay thing to say.  The minute we start confusing that with a need though, is when our self esteem gets caught up in it, and really distorts who we are.

Do you really need that?  Really?  Would you survive without it?  Would your life dramatically change if you did have it?  I don’t even know what’s in my ebay box anymore.  I’m sure it’s nice stuff that would get some money.  But I’m not selling it because I’m not getting around to it.  And it’s becoming bigger than Ben Hur in terms of challenges and time I don’t want to spend.  One single box.  As humans we don’t need a lot to live.  We need sunlight, food, warmth, our families, love.  We don’t need to hang onto objects from a past we can’t let go because we have our memories, the ultimate storebox.

So I’m being brutal.  I’m upspacing.  My apartment is getting bigger and more spacious by the second and my worries and stresses diminishing even faster.  And instead of that big pile of should is space.  Just space.  It’s worth far more to me than any ebay sale.