Life

Kate.

Dr Kate Granger MBE

Dear Kate,

I’ve never met you but my heart is broken.  I was a resident when I first discovered #hellomynameis and I remember reading your story and thinking how amazing you were, how suffering the blow of such a terrible diagnosis and at the same time, using your experience made something positive out of it.  I loved how much you loved medicine.  Your knowledge, the passion you had equally for the science and humanity of it; I remember thinking at the time, will I ever love this job that much?  I was burnt out and overworked by a giant, thousand bed hospital that had gobbled me up and chewed me into millions of tiny pieces.  I loved how you loved life, music, food, how you enjoyed all of it, in spite of it.  I followed you through time, all these years, to today.

When I became a registrar I had no idea what I wanted to do.  I figured a year of it wouldn’t hurt for experience sake and back then, I was so lost and confused by the brutality of the job.  And my first year of registrarship was a further baptism of fire that I wouldn’t wish on anyone.  Multiple personal tragedies, workplace bullying, and discovering what ‘clinical governance’ really means, more being gobbled up by the system, and int that year, being so lost I couldn’t speak anymore.  I kept following you, reading your tweets, feeling the dread that came with each infection, cheering for you when you got home.  Your love of life, of your marriage, your work, helped anchor me, helped me remember what was important in life.

Right at the end of that hard time, I did my first geriatric medicine term and like you, fell in love.  Suddenly I understood it.  It was all the best bits of medicine (for me), wound up messily with the culmination of human experience.  It was medicine, it was families, it was psychology, logistics, pain and suffering, healing, quality over quantity.  And finally, with a new purpose, that horrible year faded into memory, I got my exams and sailed happily into that world where I am now without one single regret.  And throughout that whole, torrid, journey, you were there on your own incandescent, heartbreaking, amazing, world-changing path.

I’m so sorry.  I’m sorry about Christmas.  I’m sorry Chris and God, so sorry about Charlie.  I’m sorry about the baking and the music and the little ones.  I’m so so goddamned sorry that your patients don’t get you as their doctor because you are who they need.  I’m sorry that thousands of people are championing your cause because I damned well know that if the cancer never happened there wouldn’t need to be the cause.  I want to wind back time for you, make the diagnosis never happen because you deserved your family and your career and all the cakes and Pimm’s and other nice, bright things in life. And you took all of that sorrow and turned it into magnificence, the highest form of functioning.

At the beginning of the year at my hospital in Sydney, the nurses had set up a table at the entrance and took photos of us in a picture frame adorned with the words ‘Hello My Name Is’.  We had name badges and wristbands and I wore them until they fell apart.  I’d been introducing myself properly ever since learning of you, not always perfect with it, but so much better than the at-times patriarchal way I’d been trained.  And these days it’s ingrained and it’s perfect because Kate, for you, I’ve practiced and practiced and practiced.  And early on I’ve been that scared resident that couldn’t look their cancer patient in the eye and since you, not any more, and since having my own interns and residents, I’ve trained them too and I know they’ll train all the others.

I love my job now Kate.  I appreciate the little things so much more.  I’ve learned so much from you and Chris, more than just introducing myself properly (and how sad we needed a campaign to teach us this), and forever more, for you, I will introduce myself, I will love my job, I will always try to look on the bright side of life and work with the hand I’ve been dealt.

The last thing I wanted to say, because I’m not sure you ever did, not publicly anyway because you’re a lady, was this.

Dear cancer,

Fuck you.

All of my love,
Another Kate.

Dr Kate Granger MBE and consultant geriatrician, passed away last night at the age of 34 from a rare type of cancer.  She was given less than two years to live at diagnosis, and in the five years that followed, sparked a worldwide campaign to have healthcare workers introduce themselves to patients, and treat them with the respect and kindness that they all deserve.  The #hellomynameis campaign has been adopted by hospitals and health facilities all over the world, and Kate and her wonderful husband Chris have raised over 250,000 pounds for the Yorkshire Cancer centre in Leeds.  Kate wrote two books in this time because she was clearly a spectacular overachiever, you can find them here.  She will be sorely missed by healthcare workers all over the world.

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Perfect motion.

9 years ago my husband and I got in an old Magna and moved our entire lives to this state so I could go to medical school.  That day, driving away from my childhood home is forever etched in my memory.  It was burning hot, and as we drove away I cried and told him to turn the car around.  I couldn’t imagine a world without my whole life in it.

How do I put 9 years of my life into a blog?  How do you even begin?  All I know is that the pace of my life increased a thousand percent and didn’t stop until now, 9 years later.  Years and years of the most amazing journey that’s shaped the person I am today, so profoundly different from the one that arrived.  9 years of the most solid friendships I’ve ever made.  Transitioning from terrified arts grad through the incredibly rigorous physician training program to the mostly self-assured doctor that I am today.  I have my moments.  I have a million photos of the things I’ve done.  I have the scars from the tragedies that have fallen in the duration, and the strengthening of those friendships as a result.  The beliefs I entered with are not the same as the ones I exited with.  That breathtaking naivety that you enter medical school and internship with, that you have to enter with otherwise you would never survive, replaced with a gravitas that comes from the things you have seen and a gentle patience for that breathtaking naivety in your juniors that you cultivate for as long as humanly possible.

How do I describe that life in which I had a baby, the one that came at the end of a rainbow, who irrevocably took my heart and put it outside of me in the form of fat little arms and legs?  Who slept while I studied and cried while I slept?  Who broke my heart with every 15 hour shift, endless weekend and evening teaching, and those single days off where I was torn between wanting to sleep so hard and being with her?

How do you put a decade into a single post?  I don’t think you can.

And here I am, in my final 15 hour shift as a basic physician trainee, in my last ever shift at this hospital that I’ve been at for 3 years, the hospital that broke me and reshaped me over and over.  The residents are buzzing about the wards, I’ve got some downtime after seeing some very sick patients.  That panic that used to consume me at arrest calls replaced with that sense of calm that comes with experience.  That knowledge that there’s always someone you can call, and the sense of achievement you get when you lose the fear of calling anyone!  I feel no fear about starting advanced training.  I should.  But after everything, god, after everything that has happened, I have no fear left.  I’m here to learn my craft.  I’m here because I want to be.

Right now I’m wrapping up my last ever med reg job.  I’m moving interstate.  I’m sorting out daycare.  Reading my orientation timetable.  And I’m saying goodbye to this wonderful state that has given me so very very much.  There are no better friends than the friends I have.  No better job.  No better husband and no better child.  I’m exhausted from a sick daycare petri dish baby, I’m not sure when I last washed my hair, and my husband and I haven’t had a moment alone since before she was born and my house would almost qualify as squalor but, here I am, okay with it all.

Through it all, like golden threads woven through my time, shine my incandescent friends with whom we have laughed and cried every step of the way.  Thankyou so very very much.

Delayed gratification.

After you pass your specialty exams and that initial “I’m so elated I can literally not feel pain or heat or cold or anything other than epic joy” feeling wears off, you inevitably go through the stages of post-examhood.  There’s the part where you promise yourself you’re always going to have this amazing level of knowledge and spout facts to anyone who’ll listen – your boss, your intern, the ward clerk, the nice coffee lady and sometimes the endlessly giving patient fridge.  Then there’s the part where you make up for all the time lost not-exercising, so you sign up to a gym and start working out maniacally as if there’s some way you can cram all that lost time into a week.  Then you overhaul your hair, your makeup, start wearing nice dresses and heels to work to prove to everyone you were only just a thrown-together massive slob while you were going through exams.  You stuff your fridge full of healthy stuff and start banging on about how much energy you have now that you exercise and eat well and brush your hair…

And then you crash.  You crash so hard you can barely drag yourself to work, your clothes look like you’ve been travelling for weeks, and your hair, it just can’t be spoken about.  That awesome amazing flawless human that you became for oh, about a week evaporates and you start lurking in the corners, hoping no one will notice how terrible you look and feel only you don’t know why because you should be feeling great right?  You’re through!  Through all the exams forever!  So you keep schlepping to work hoping that whatever this is, hormones?, not enough food? wears off only it doesn’t.  It doesn’t because for two years you haven’t stopped.  Exams are over but the job where you don’t sit down and walk all day and people fight over getting to sit in a chair (actually it’s a polite “no you sit in the chair!” type of argument) and some days it’s sad story after sad story, or worse, death after death, and those 15 hour weekend shifts are still there.  They are still there and you haven’t stopped.  And suddenly you’ve called in sick, feeling horribly guilty at the scared tone in your interns voice despite all your reassurances that the bosses wont eat them if they call them, with horrible bronchitis.

And then you do what any sane rational person feeling completely out of control does.  You spend way too much money online. “Bras? I haven’t bought any how long? CLICK! Ooh Philosophy does a peppermint body wash? I need body wash!  CLICK! ” and suddenly you’re stacking coupon codes and having a big box of Benefit products with more free samples than there is product coming your way.  Then you go and do all these pop psychology quizzes about what makes you feel out of control and then you think that if you just ate better then you wouldn’t get sick so much, so back onto overhauling your diet it is and suddenly your grocery cart is full of raw cacao, which as far as I can tell is a higher calorie version of cocoa, chia seeds, and Medjool dates because in some way, these must be superior since all the raw/Paleo/wholefoods people use them in everything.

No matter how many times you sit an exam in medicine, this happens every single time.  You cannot prepare for it, and you forget about it every single time.  The worst or best part, I can’t tell, is that it feels great.  And then you crash from that and get your credit card bill.  Mainly it’s that the whole wide world, that you’ve been denying yourself for two years is suddenly wide open and you want it all.  Now.  And at once.  This is probably why doctors wind up in the media doing stupid stuff sometimes.  That juggernaut of delayed gratification gets us in the end.

The delightful first birthday

In a way The Baby’s first birthday was the first day of the rest of our lives for both Mr G and I.  Playing around with icing, planning food, overcatering – my career hasn’t left any room for entertaining ever and I’m completely new at it.  I bought the Australian Women’s Weekly Vintage Birthday Cakes books from my childhood and went all out on the number 1 cake.

Here it is, freshly iced with buttercream icing that I watched a million YouTube videos on how to do because I had no goddamn idea.

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And here it is after I bombed it with a million decorations and spelled out her name (blurred) in silver balls that Mr G found in Woollies for me.

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I also made Nigella’s Nutella Cake from Domestic Goddess.  The ganache split but the hazelnuts hid it well.

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I’d never had honey jumbles as a kid (nor heard of them) but found this attractive looking recipe on Taste.com so thought I’d have a crack.  They were delicious and I’m told they were true to people’s childhood memories.  They are basically iced gingerbread renamed for some reason.  At some point when I’m less tired, I’ll start photoshopping my food photos to perfection like other blogs.

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Here’s one heavily filtered with the Instagram filters.  Those are peanut butter squares also from Domestic Goddess up the front.  They taste exactly like Peanut Butter Cups – it’s frightening.  And delicious.  Note the copious amounts of cheese and glass of champagne,  because as I quickly learned, the first birthday party is really for the grownups.

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And here’s the baby taking off because the grass is full of far more interesting things than a grownup has to offer!


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I can happily report that much champagne was drunk, the baby cried and fell asleep in her pram while the rest of us stuffed ourselves full of party food and reminisced about childhood and discussed handbags.  The little things are so brilliant so sometimes.

Dust, the regular kind.

I sat down tonight, hair wet from the shower I had time to have, after playing with my baby all evening.  I realised that it’s been a month exactly since I posted, and it’s probably taken that long to start feeling like me again.  The person I was before medicine deconstructed me.  The dust is finally settling, and here I am, nearly 8 years on from starting medical schools, with all exams finally, finally behind me.  I can be who I want and learn what I want when I want.  In the past few weeks I baked a birthday cake for my one year old, I sewed a ton of quilt blocks for a quilt for her, I hung out with friends, drunk champagne, read books, did a yoga course – all things normal people do.  I still go to work and see terrible things from time to time, but it’s different now.  I get to have hobbies again.

And at work I’m clearheaded than I’ve ever been.  I see the problems, I investigate the problems, and I have plans for the problems.  I’m not perfect but that loud voice of self-doubt has evaporated and been replaced with a ‘you passed the Royal Australian College of Physicians exams!” voice whenever self doubt appears.  I will say this about education – once you’ve got it, no one can take it from you.  No matter what happens in life, it will always be yours, no matter what you choose to learn.

My blog is probably going to get less personal and more fun from hereon, but I’m so looking forward to the little things.

Stardust.

3 months.  3 months I saw patients with varying degrees of attention and quality.  3 months I walked those corridors, struggled through them, cried in them.  I cried every. single. day.  In cupboards, to my friends, and into my lunch.  I left evening teaching early because my breasts were like rocks and leaking but I couldn’t stop breastfeeding because it’s all I felt like I had for her as a mother.  I had nothing else to give her.

3 months I froze and practiced and froze and practiced and froze and froze until I didn’t anymore.  The words started to come, not perfectly, but there they were.  A semblage of structure, something approaching sense coming out of my mouth.  I was struggling and behind right up until the last two days, two days before, it suddenly started to click.  I have lived my life to varying degrees of raw and burnt out and never before have I been so raw and burnt out.

3 months I sat in teaching, feeling like an outsider, feeling like I shouldn’t be there.  Mother’s don’t do this.  My colleagues were already in study groups, they didn’t know me nor I them and I was alone.  Mother’s on TV were doing washing and not letting their babies watch television and steaming sweet potatoes.  Mother’s don’t do this.  They don’t become mothers and sit both specialty training exams in the same year. I cried.  I can’t repeat how much I cried.

And for 3 months my husband, not without his own challenges, got the baby up and fed the baby and changed the baby and played with the baby, rinse and repeat for 12 hours a day.  That precious hour I got with her was a shadow.  I could barely look at his drawn and haggard face, the guilt nearly killed me.  3 months of the most crushing guilt and escalating burnout.

I showed up on the day, exhausted, in something resembling a suit that I’d cobbled together to fit my new odd-shaped body.  My hair has all fallen out from breastfeeding and stress and it was barely passable.  My tights felt uncomfortable.  I walked in there and did my thing.  I forgot to do so many things.  I said stupid stuff.  I ran away in the lunch break and cried some more, somehow there were still tears left.  I listened to the other candidates bang on at each other with nervous excitement.  I sat on hard plastic chairs in a 1970s hospital lunch cafeteria and ate a bad sandwich.  After lunch I did embarrassingly badly, I can hardly think about it.

Afterwards I went and sat in my hotel bar and bought myself a glass of champagne because everyone who’d sat it sent lots of messages to our group about how happy they felt that it was done.  I drank that glass and cried some more.  I didn’t feel happy.  I felt broken and defeated.  And stupid.  Really really stupid.  Only a stupid person would attempt this with a baby and no extra family support.  For the next two weeks I was so sure I’d failed.

And there it was, like stardust.

In my inbox, there it was.  For whatever reason, uncomfortable stockings, imperfect skills and hair and motherhood, I passed.  In spite of it all, I passed.

No one I worked with could ever really understand the self-doubt I felt.  From the outside I seem to have it more-or-less together except for the corridor-tears with my inner circle.  So much has happened since I started this journey in 2013.  More than I want to recount or even think about.  I’m a different person than the one who started.

The further down the rabbit-hole I go the less I feel like I know.  But I know that for what it’s worth, I did this.  I really really did this.  I got into medical school, survived it, and did the physician exams and passed them.   Whatever happened long ago, who I might have been and the things that might have happened just don’t matter anymore, because I did this.  And I can’t wait to get on with my life.

The perfect set of circumstances.

It’s December.  The sun is shining but I can’t feel it.  I live over the road from the sea but the water feels like it’s a million miles away.  My body feels a thousand years old and the baby has been asleep for no longer than an hour at a time over the last few days.  My exam notes are on the floor in a corner and I’m staring at the wall, asking my mother, through a veil of coffee-tinged fog, what craziness had entered my head that thought I could sit a five hour written examination with a newborn?  My mother shrugs and says “you can spend your whole life waiting for the perfect set of circumstances”.

And there it is, like lightning.

And here I am again, 3 weeks out from exam number 2, horribly horribly behind, with a small baby, the loving and long suffering husband, and us, just us, in our tiny place, with all our family interstate.  My colleagues put in hours and hours and I come home to see my little girl who gets a new superpower every day without me being there.  She is always happy to see me and my heart lives in various stages of broken.

I cry at work almost daily, mainly out of frustration.  Too many patients, not enough time, I don’t really know my colleagues, I have no little group.  They walk around the hospital in their study groups, diligently seeing cases.  I have no courage.  I present cases, I’m told things like “you need to work on your knowledge, your confidence, your face, your eyes, your words”.  I cry some more, and keep going.  The circumstances are far beyond ideal.  I’m incredibly close to failing.

And then I come home, to my loving and long suffering husband, to my smiling baby and my tiny apartment near the sea.  I talk to my friends via text because phonecalls in the evening are pointless with a baby and they cheer me on.  I think how lucky I am to have everything I have, exam or no exam.

have the perfect set of circumstances.  Maybe not for a huge exam, but I’ll do my best.