Last month, our CEO  resigned to go to Red Cross. Now our legal adviser is going to Northern. Why does it feel like they both left like rats jumping from a sinking ship? Or maybe it's because Monash is too stingy to pay them a proper salary.

Working at Frankston has a few downsides. Or upsides depending on your perspective. I'm now taking an extended lunch break because the consultant can't leave me alone in theatre (technically not a reg yet!) But this varies from consultant to consultant. Some are more than happy to leave me alone whilst they take a break. Some let me run the anaesthetic as I have been doing at Moorabbin. Just takes a bit of adjustment to the hand holding at Frankston I guess. Not complaining!

Conversation between the anaesthetic consultant in charge and myself.

Me: "How are the patients in HDU? "
C: "They're fine. You didn't break them"
Me:  "But I didn't even see them"
C:  "That's why you didn't break them" *grins*

I've found something else that I hate today. I received a call from the Australian Red Cross asking for monthly donations today; they managed to get my details from a one off donation I made to the Nepalese Earthquake appeal. This isn't the only charity organisation that makes "cold calls" to their donors to try and get more money. I have been donating to make-a-wish for two years now and they regularly call me to ask for more. "Sir, all we are asking is for another 5 dollars a month, an easily manageable amount" And after I increase? Another call several months later with the same request. Before you know it, the donation amount is OUT OF CONTROL! The worst bit is how difficult it is to say no on the phone. They try to guilt-trip you into donating by playing down the monthly amount and saying how significant it can mean to the people the help. If you don't increase your donation amount, you're a bad person. And if you say no? They still don't let you hang up the phone and try to convince you another way. It has come to the point where I have had to change my phone number with make-a-wish so that they can't actually call me with these harassment calls. Seriously, if this is how charity organisations work, I'm surprised anyone still donates in this day and age.

Primary Anaesthetics Exams next year in August. And this is how I feel right now! Now, unlike Linus, I am studying but the more I read, the more I realise how little I know...

For those of you who know me, I'm not the slimmest chap on the block. I'm in the process of sorting that out... Poorly, but I'm aware it's a problem. However, there seems to be a subset of fat people who have no insight into their problem of being horizontally challenged.

I just came out of the staff carpark and this fat woman was parked on level 2 as well. Whilst I chose to take the stairs, she chose to take the lift. Now, she might be taking the lift so that her knees that are sore from carrying all that extra weight can be saved from tackling the one flight of stairs to the ground floor. More likely this was a sign of the laziness that led to her obesity in the first place.

To all the fatsos out there. If you're going to take a lift, park up at the top level so physically active people can get a spot that's closer.

A topic of discussion has hit the SRMOs this week in view of the job offers for training next year. Predominantly, the talk has been about who should have missed out and who we wished didn't miss out. Let's be honest...not every doctor is created equal and in the end, we are all humans so everyone has their own idiosyncrasies. The SRMOs as a group this year is a really good bunch and if possible, I would prefer everyone to get on the training program but four of us didn't; a whopping 30% mostly due to interview issues as far as we can tell.

I have reservations about  certain SRMO who did get a job next year. He's a bit of a loose cannon and has some issues with being power hungry, so to me, he is the ugly duckling. In my opinion, I don't think he is suited for a career in anaesthetics and I can imagine that the only thing that will take his arrogance down a notch would be a catastrophic patient event. And two other SRMOs I have talked to have agreed about this. Of course, we all smile when working with him but a recent conflict at work between him and another SRMO has highlighted to me exactly how difficult it may be to keep a cordial relationship. Despite objections from the medical registrar and the other SRMO, he gave a patient in active CCF and having a NSTEMI 5mg of IV metoprolol for hypertension (clearly GTN would have been a better choice). What would I do if I saw him doing something that would be unsafe for the patient? The bigger issue is after the matter, he tried to downplay the mistake to the bosses by saying "it was a slow push"; clearly lack of insight is an issue here.

So what do we do with this ugly duckling? Can we wait for him to turn into a swan? WILL he turn into a swan? None of us are excited about studying with him and certainly this will affect us next year but at the moment, it's all just questions in the air. For now, let's just help the remaining four SRMOs get jobs for next year.

Just got notified of jobs for next year. Apparently Monash feel I'm going to make a good anaesthetic trainee. However, the same cannot be said for some of my colleagues and there was the awkward moment in the Whatsapp chat group where people announced they got a job followed by those that said they missed out.

What are you supposed to say under these circumstances? "Sorry to hear you missed out on the job"? Or should you remain silent and let the awkward moment dissipate? Or maybe you should change the topic to something else.

So far, three out of twelve people have said they don't have a job for next year. That's a fail rate of 25%...higher than expected for the SRMOs who pretty much spend the whole year doing anaesthetics. I suppose there must be people who miss out for each job position but the feeling is terrible when it's someone you've worked with for the whole year.

Different specialities often have different perspectives when looking at a patient, sometimes to the exclusion of other details. On Friday, I was looking after a patient who had a prolonged procedure for an elective parotidectomy, it went until 7pm and beyond. The mass was the size of a tennis ball so I can understand why it took so long to excise it without damaging the facial nerve.

When talking about this case with Yeu Sheng, her first question was "What type of malignancy was it?" It was only then that I realised that I actually didn't know. I shrugged and said, "I presumed it was malignant, they had to do frozen sections to make sure it didn't spread to the scm. The only thing I care is whether it affects my airway really.... The diagnosis doesn't make a difference to me."

Interesting to see what our blinds spots are if we don't pay attention to all the details :)

Ever look at yourself after a busy night shift? Or after a shift where things just don't work out for you? Our job typically is so soul draining that vital exhaustion sets in, often many hours before you finish. I have seen this in my eyes when I get home sometimes, the look of vacancy and fatigue that's more ingrained than just the bags under the eyes or the wrinkles at the edges.

Just walked past one of the night doctors leaving Clayton, don't know her but she had dead eyes. Her gaze was so vacant, I could have sworn she was sleep walking.

How does one avoid this? Not sure really... There isn't any effective way that I'm aware of. Some turn to alcohol, some exercise, some binge eat. Who knows?