Ad Nauseum

I suppose there’s no point in pretending – I’m never going to be updating this blog very often. But hey, it’s my blog, thus my prerogative, right?

The same goes for picking which wordpress theme I’ll use. I really liked Desk Mess, but the header/navbar had the tendency to break if I added too much stuff. So I decided that with the new year coming soon, I might as well start looking around for a new theme that, maybe, doesn’t break that same way. Maybe it’ll break in an entirely new, shiny way. That remains to be seen as I’ve just switched out to Brainstorming for the moment, and see how I like this. You may possible pick up on the ongoing theme here, though – the mess is still my thing, so to speak. I’m afraid I’ll never get the hang of having a well organised desk, so I may as well have my blog reflect that, right?

Anyway, that’s not what I came here to write about.

So it’s Tuesday December 22nd, and 6 days earlier on Wednesday night, Ross and I were staying over at a friend’s place in Groningen – where we’re both commuting to daily now, as I’ve begun working on my research project at UMCG – so we could hang out with some games and pizzas, before catching the pre-premiere of James Cameron’s “Avatar” in that new shiny 3D they’ve got set up, downtown at Pathé. That morning, while I was sitting on the 4th floor of the hospital typing away at a library computer, I could see the sky filling itself with snow flakes drifting gently down, covering the streets with white – and I could also watch the world of Twitter rejoice at the first snow of the year. As we cycled to my friend’s house later that day to meet up for dinner, the snow had progressed from gently-drifting-down to putting-down-a-good-inch-or-two. More rejoicing, because snow is awesome! It’s white and pretty and ohmigosh-we-haven’t-had-this-much-snow-in-so-long!

Seeing how I’m a total wuss when it comes to cycling in a good layer of snow, we decided to take the bus to the movie, which was to start at 20:30 (or 8:30pm for the non-24-hour-clock-initiated among us). The movie got done around 23:30, and as we waited for our bus back home to arrive, we were challenged to our first snowball fight of the year by the people across the street. The bus came to pick us up, saving us from shameful defeat since the other team had gotten backup twice our size. We headed home, played around in the snow-covered street a little more – more snowball fights, snow man and angel making, drawing pictures in the snow – and then turned in for the night.

Then, Thursday morning, we woke up to find everything, everything, completely covered in white. A tent had been put up further down the street to cover up roadwork, but we could see from the window that it had collapsed entirely – our bikes were barely discernable from the hedges they stood against. My friend grabbed a ruler and stuck it in the untouched layer of snow on their balcony, and came up with a good 16cm (about 6.5 inches) of snow. Ross had to walk his bicycle down to the office to work, and I eventually did the same to work at the library, before deciding that I didn’t want to get stuck in Groningen for another night (also considering we were expecting people to come by and replace our heater Friday morning at 7:45) as the snow was causing a heap of trouble for public transport, with many delays or trains not running mostly due to frozen track changes, and left early around 13:30 to walk to the station. I made it to the station on time to see a train coming back from Leeuwarden, settled into it and waited for it to leave again in the opposite direction at its scheduled time of 14:34.

I, and a whole bunch of other folks – the train was packed up to the middle aisle being full of people standing – were in that train, which just sat still on the tracks at the station, as the wind kept picking up and tossing the snow at an increasingly horizontal angle, with no announcements being made about what the hell we could expect. At one point, they’d shut down the train for a good half hour, leaving us locked inside with no windows and doors that would only open when the power was running. Ross, who’d had meetings through the afternoon, finally called me around 15:30 asking if the train had left yet and if maybe he could still make it. By now, the next train coming back from Leeuwarden had returned on the same track as ours in front of us, and our train had just been restarted and connected to it, but otherwise not budging, so I figured we wouldn’t be leaving until 16:04. Ross decided to try for the same train and headed out to the station.

In short, Ross and I did manage to make it home, on the same train, while I had left work two hours ahead of him. Coming home, we picked up take-out from a new place around the corner and settled inside, I got a call from the heater replacement guys that they were not going to make it tomorrow as they were still working then (at 19:30) on heating emergencies all over the city, expecting not to be done until 22:00 that night and more to come the next day. So, yeah, considering we still had some warmth left in ours, our replacement was understandably the one to be put off for now.

We both took a snow day that Friday, when the layer of snow had grown to twice the size of Thursday’s, working only a few hours before heading outside around 16:00 to get some more snowball fights and snowman making on – at least, the plan was to make a snow man, but it eventually became a somewhat recognisable Mickey Mouse head. Saturday was spent sleeping in and writing (late) Christmas cards, before walking our way to the grocery store, since even more snow had fallen by now – double what we’d measured before – and it was rather impossible to cycle or drive or anything else that involved rotating motion. I baked brownies, we got milk for special hot chocolate we’d been saving for a good winter night like this, and had a really nice, cozy weekend cuddling under fleece blankets on the couch.

Then came that inevitable Monday. Trains and traffic had not improved any over the weekend – in fact, they were now advising anybody who didn’t have to leave the house, not to. Especially not to make use of any trains, and the buses weren’t going anyway, so options for transport were rather sparse. Lucky that Christmas break had begun for most people sticking to school vacations (including me; I’d taken this week off), but everyone else still had to find their way to work. Ross had a meeting so had to go to the office, luckily making it relatively on time there and back – but all the news sites and channels were going on about people getting stuck at train stations, Schiphol airport, in the middle of nowhere ’cause their car couldn’t make it through the snow, etc.

Today was thus deemed another snow day to work from home. At Ross’ work, though, they’re now dealing with something else fun – the snow began to melt, but their roof is leaking a bit, meaning a couple of their offices have been getting a little soaked overnight. And as I’m typing up this post, the snow melting has just changed radically to another enormous snowstorm, with flakes the size of feathers, like some deity is shaking out a big fluffy pillow of goose down. Meaning their drain pipes are getting clogged up, meaning more leaks and getting-soaked-inside. That’s just an awesome combination with an IT company!

I find it mostly funny how all this snow makes all of NL kind of fall over *thunk* helplessly. There’s absolutely no system for this kind of thing here, because weather like this rarely strikes our little low country. Sure, we’ve got the trucks to salt the roads, but only for the bigger roads, and the snow had already come down hard enough for this to do any good. We couldn’t even find a shovel in our apartment building to try and clear out the pathway leading up to our front door. All those huge snow snoveling trucks we’re seeing used across the pond for the snowstorm around DC? Yeah, man, we wish. Even the German train organisation is now offering to give out advice about how to deal with the snow to our local train orgs, since they’re like, “You only have 15% of trains running? Why didn’t you prepare better like us?”

For this year’s holidays we were going to head off to my parents in Purmerend tomorrow evening from Groningen, after Ross gets done working, be home around 21:30 – but it looks like our plans may need to change if this keeps up…

Yeah, I haven’t been very faithful in updating this blog, as I meant to – it’s been a busy few months. The summer was awesome, followed by internships at surgery, pulmonary medicine and pediatrics – and now I’ve finally got myself a month off to enjoy, before I dive into the next phase: my research project, which I’m doing in the OB/GYN field that I’m thinking of choosing as my particular specialisation later. You know, when I grow up.

For now, though, I’ll happily remain at intern level, which sets me at a very peculiar state between layman and fully licensed doctor. Though I’m still a year away from getting my official MD, under supervision I can and am allowed to give shots (the syringe kind), draw blood, put in intravenous lines, examine a patient, assist in surgeries, suture a wound, come up with a diagnosis and plan (for some problems, hardly everything) – and, fall under a professional high risk group of people who are urgently advised to participate in vaccination programs, free of charge by the hospitals we work at.

There’s been a lot of media attention around H1N1 (or as it’s also called here, New Influenza A, although that name’s already gone out of fashion much faster than Mexican Flu ever will) and its upcoming vaccination – mostly, why the hell it’s taking so long and why the hell we should get vaccinated, anyway. There’s people who have been so riled up with the whole flu dramarama that they stormed their doctors’ offices for a regular flu shot, just in case until the H1N1 is ready in which case they’ll be the first to stick their arm out – then there’s people who always got the regular flu shot for a medical or professional reason and are now awaiting the call to come pick up the H1N1 vaccine – and naturally, there’s the people who insist they’ve never needed a regular flu shot before, and this new H1N1 vaccine’s barely been tested to be safe, it’s getting rushed onto the market, they’re sure as hell not going to let anyone stick one into their bodies.

Vaccinations in general have been getting a lot of criticism the last few years – this whole campaign (mostly in the US, as far as I could tell) insisting that autism, of all things, was caused by vaccines was one of the most ridiculous things I’d ever seen. No medical research has ever turned out an actual causal relationship between the two, and besides, have we forgotten about the role vaccinations have played in ridding the (western) world of many, if not most, potentially lethal infectious diseases?

Then there was the HPV vaccination program, which was another one where people felt things were rushed and nobody knew enough about long term side effects for it to be instated nation-wide, and oh my god we couldn’t let such dangerous materials touch our precious little girls, could we? Forget the fact that HPV is responsible for nearly all of the cervical cancers found, which is the second most common cancer found in women after breast cancer, which has a much higher chance of having all sorts of consequences for said precious little girls, albeit at a later age.

And now there’s H1N1, which has turned out to be an official pandemic by now, but still has people doubting whether to take it seriously.

We as medical students and doctors and nurses have been talking about it, naturally. Most doctors (to be) that I know of support the vaccinations and plan to get one themselves, keeping in mind that we as medical professionals work with patients whose health is already failing – getting a bad flu on top of it could be fatal, to them. It’s not so much that we doctors are so scared of catching H1N1, but we can’t risk spreading that virus amongst those who already lack reserves to fight something new on top of whatever’s ailing them. The regular flu that comes up every winter season can be lethal enough – that’s why we get our regular flu shots each year, too. This is no different, to us.

But that’s us medical professionals, aside from those who obviously have a medical risk themselves. That doesn’t count for the average Joe, who has no day-to-day interaction with people who could die from a simple influenza. Should everyone get vaccinated, then?

And here, I think we leave the medical reasoning, and it turns into something economical, besides something of personal choice. The question becomes whether a nation-wide vaccination program would be cost-effective, considering that H1N1 will – for most perfectly healthy people – turn out to be a bad flu, but nothing much worse than the regular seasonal one we’ve all dealt with in the past. It just so happens that nobody’s dealt with this particular kind before, so it’s going to hit you extra hard without the pre-existing immunity. It becomes a question of whether we can deal with the possibility of half the workers being down with this flu at the same time, creating a sparsity in work force – which some people, who are presumed to be immune thanks to the Spanish fever some decades ago, are happily taking advantage of by advertising that they won’t get sick when all those others will. It becomes an issue at society level, rather than personal – what would be most benificial to the larger group, rather than the individual?

That last line, in itself, is the core of preventive medicine. You burden a large number of individuals with a screening or treatment procedure, to try and help out the smaller number of individuals inside that larger whole, not to get sick or at least less sick. That’s what mammography screening is for, that’s what cervical smears are for, that’s what all those vaccinations when you’re a little kid are for, that’s what ultrasounds before and the heelstick after you’re born are for. Hell, that’s why some other forms of screening is not performed – it costs too much to perform on so many people, when only so few benefit from it. There’s all kinds of calculating and stuff involved there that I’ve never really gotten into myself.

My view? No, not everyone requires a H1N1 vaccination. If you’ve got a medical condition that makes you vulnerable, yes, I suggest getting vaccinated so the flu will have less of a heavy impact on you. If you’re healthy, the only real reason I see to get one is to avoid spreading the virus to others who are less able to guard themselves from major complications – meaning, if you’re a medical professional or you’re not, but you are taking care of someone who falls under a medical risk for prolonged periods of time, then I’d say you’re duty-bound to get vaccinated. Otherwise – it’s just another flu, and you’re free to do with that what you want, but I do think you can count on getting hit by it at some point. Whether you want to do so with a little pre-emptive protection from a vaccination, which actually has been tested pretty thoroughly (as much as any new product can) and really is not that much different from the regular flu shots we’ve been using for years, or with only your own immune system at the front lines, that’s your own choice.

Why I decided to post about this, when it’s been discussed to death by so many other people who are far more expertitious (is that a word?) on the subject than I’ll ever be? I don’t know – to give this blog some sort of relevant content, I guess. But also because I’m surprised by some fellow interns or nurses who refuse to get a H1N1 vaccination because they don’t feel it’s necessary or because they’ve let themselves get scared out of it by all the media frantics. Mostly the latter, really. The longer I’m in this, the more I get frustrated at all the misinformation spread around, so the more I feel the need to comment on these things sometimes. Next time I’ll pull up some reliable sources to support whatever I’m spouting off on then, too, but I’m feeling a little off-beat today – I might look up references when I’m feeling less fuzzy later. (Edit: If nothing else, here’s a few articles on Wired that go over the arguments pretty well.)

Got an opinion of your own? I’d love to hear it.

Some things will never change – even as an intern, sitting between the world of student life and the “real” working world, I get to bring high hopes for the summer vacation. Though I consider my upcoming 4 weeks off in July/August a luxury, as many regular working people probably would, many of my student friends are getting their usual full two months break. It’s all relative, and hey, this is my blog. I get to complain if I want!

As of today, I have one day and a week left to go at my current internship until I get to say goodbye to the medical world for a month that will prove to be all too short. I’m expecting this to be kind of a strange experience, actually – not being surrounded by doctors steeped in medical knowledge and experience, or patients dealing with their various physical or mental problems, or fellow interns just trying to pick up as many medical skills as we can, might even be a little disorienting. Not a day goes by, weekends aside, that I’m not talking about something medical with someone. Even during weekends at my parents, I’ll end up talking to my dad (internist for about 30 years) about something medical. It drives my mother and boyfriend nuts, I’m sure.

Hell, put a group of us interns together for something as simple as a dinner out together, and we’ll still be stuck talking about our experiences at the hospital, our future plans for next internships, our crazy ideas for possible careers.

It’s a coping mechanism of a kind. So many new impressions come by every day, so many proving grounds to stumble your way across, so many tragic stories and frustrating patients that pass by our eyes, you have to sit down and share these things, or you’ll probably end up going mental yourself. And it’s such a big part of your life, no matter where you go – already as an intern, you have to plan ahead, study, work your way towards that future. And once we have our actual degrees and are done being interns – we don’t get to stop being doctors at the doors of the hospital. You can go out there among the regular people again, but you always leave one foot stuck in the door back to that insulated medical world where you always find yourself coming back to.

So in a little over two weeks, I’m boarding a plane to Florida, so I can spend almost three weeks hanging out with my boyfriend and his family, and do absolutely nothing to do with medicine, or hospitals, or patients, or being sick (unless one of us catches the so-called New Influenza H1N1 – oh the fanciness), or being a clever little intern. Though all of that is always hanging around and undoubtedly I will come across a medical question or two from other people I meet there – you’d be surprised at the things people end up asking once they learn you have some semblance of medical knowledge – it’s going to be far, far away from all my interning here, and after running internships almost nonstop since January, it’s a break I find myself much yearning for.

So I’m counting down. I’d write more about my current internship, but for one thing, it’s not the most interesting (at least not to others) and two, I’m kind of sick of talking or writing about it to anyone. Which is why it took me so long to get back to this blog, as I’d started it with the intention to document my experiences as a medical intern in the Netherlands, specifically within the new educational system that Groningen has put up in the last few years, but… when you spend most of your time inside that world where all anyone ever does is talk and talk about these things already, you just end up not wanting to outside of it anymore.

Thus, instead of restricting myself to posting all exciting and interesting updates about my internships, I’m going to allow myself to ramble here about random and personal stuff as well. I’ll probably end up posting some photos and stuff from recent trips Ross and I have been making too, in order to show them off to my non-Dutchie friends mostly, as I keep promising to do. And, as you can tell, I’m switching to English for my posts here, too, since not everyone who might want to keep up can understand Dutch.

Here’s to a new, more active start of this site, then!

So after about a year of complete inactivity at this blog, I’ve decided that maybe it’s time to upgrade to the latest version of WordPress (considering I was still on version 1.x and they’re up to 2.8 now), ditch all my old Dutch posts, and switch to English so that more of my friends all around the world (aww) can read along. No, I’m not attention-whoring at all!

Naturally, I’m too lazy to come up with an exciting new layout on my own, and so I’ve done a little poking around to see what awesome new themes people have put out there lately… and, well, this one seemed more than appropriate. Anyone who’s been to my house will likely know exactly why. It’s a Gemini thing, I swear.

Anyway, I’m going to be poking at this new setup for a little while, so don’t get too confused if things change here and there.