Tuesday, 30 June 2015

Dream: a skiing disaster

This dream starts in a non descript carpark where I am trying to park the car. It's quite dark and I'm parking in between two poles. As I inch forward I hear a sickening screech and realise that I've scratched the left side of the car. I reverse the car slightly and inch forward again. Another horrible noise comes from the right side of the car and I realise with a horrible feeling in my stomach that I have scratched both sides.

I feel irritated and resolve not to look at the damage when I get out of the car. what's the point of looking anyway? I tell myself. What's done is done.

I get out and walk quickly to the lift. I can't remember what level I choose but I emerge into a bright airy space full of windows. Outside is a busy ski field and I seem to be standing in the ski house.

I look down and see myself wearing summer clothes. Unable to go outside, I go towards a tunnel towards the side which is also lined with large windows.

I look out at the people skiing, chatting and laughing. There are lots of families there with little kids everywhere. I look up and see planes in the distance - it's eerily quiet in the tunnel and I can't hear anything of the outside world.

I watch the planes as they come closer as if to land nearby. They descend closer and it seems as if they are going to plow into the ski field. There are several planes of different sizes and the smallest of them, a 6 seater, seems closest to the ground. 

Everyone seems oblivious to this. I move to another window to see if I can get a clearer view of the planes' descent. Then I see a large mahogany desk in the middle of the tunnel. Nothing is on the desk aside from a bronze plaque labeled "Jason Chapman, Daily Mail". 

I realise with a start that very soon there will be a disaster and Jason is going to cover the story. How do I stop the plane from crashing into the people?

I panic and wake up.

Sunday, 28 June 2015

Ramadan diaries


The idea for Ramadan
I was at a dinner party with some interesting people who had done aid work in developing countries. A few of them remarked upon how difficult the month of Ramadan is, with everyone being tired and hungry, and worst of all, people getting ill from fasting. Imagine working in the Middle East when Ramadan is during the height of summer – people working outdoors would rapidly become dehydrated and some would pass out.

So, my friend and I thought we would do Ramadan this year to experience what Ramadan is like for the millions of Muslim who partake in it all around the world. She pulled out though as she was writing her thesis, but I thought I would give it a go.

Day 1 – June 18
Breakfast:        Sticky rice, 7-11 coffee
Iftar:                Hospital omelette, peas & corn; cheesecake
Dinner:            A large chunk of sourdough
                       Dark chocolate gelato from Gelato Massi
                       Leftovers with rice

In the intervening weeks, I had forgotten about Ramadan entirely. I got up on this day as on any other day, had a quick bite of some leftover sticky rice and got on the bus to go to St V’s. Along the way I read my messages and my friend asked if this was the beginning of fasting. Had to postpone my Hugonettes crepes plans and quickly grabbed a coffee before I got on the bus. The sun was rising and Central station was painted a hazy purple that morning as I sculled my coffee and got ready for a day of fasting.


It wasn’t too hard given I was distracted with grandma related activities for most of the day. The hardest time was when she was eating and I couldn’t eat with her. The hunger was the greatest from 11am (when I usually have elevensies) to 1pm. After that the hunger faded and I just felt an intense thirst.

I broke the day’s fast with some tap water from the ward kitchen. Water never tasted so sweet before – so refreshing! I wolfed down some of my grandma’s unwanted hospital food, even the bland omelette and overboiled peas & corn tasted amazing.

Once home, I felt like I was binging as I walked around the kitchen and saw so many things I wanted to eat. I ate some bread and gelato before dinner, and realized I’d consumed in 2 hours at least double what I would normally have for dinner. I told myself that I would get used to the fasting, and that tomorrow it would be easier.

  
Day 2 – June 19
Breakfast:                    Leftovers with rice
Iftar:                            PB & banana on toast, half a papaya
Dinner:                        Palsaik Korean BBQ – Kimchi jigae, pajeon
       Late night Chat Thai dessert – dough sticks with pandan, salty coconut soup with random balls    

This was the first day of my week of work and I felt pretty good in the morning. It was a sodden day and I stood in the rain waiting for the bus, feeling like it would maybe be a good day.

I was busy enough not to feel too distracted. Again I was hungry from 11 to 1, but afterwards just felt thirsty. Around 3pm I felt pretty hypoglycaemic and lethargic, people asking me questions was difficult and my mental performance was definitely not optimal. It wasn’t too bad though as it wasn’t a busy day at work.

Breaking the fast felt surreal. Every food related sensation was heightened – the bread was extra crunchy, the papaya silky soft. Afterwards I felt manic and like I was bouncing off the walls. I think the sugar rush must have signaled to my brain “do this again! I like this!” I had a great evening out with my uni friends and barely felt tired even though it was way past my bedtime. It felt like a strange reversal of the usual diurnal variation, as if I’d spent the day hibernating and woke up for the night time.



Day 3 – June 20
Breakfast:                    Spaghetti, Shelley’s cheesecake on toast
Iftar:                            PB & banana on toast, half a papaya
Dinner:                        PappaRich Chatswood – roti canai, veg biryani with veg “mutton”
                                   Lid & Jar for chai

Without realizing it, I carb loaded myself for the day by consuming so much carbs for breakfast. I always loved cheesecake, and having it on toast was an extra treat. Though I’d only slept for a few hours as I had a big night out, I felt great in the morning.

I really struggled in the afternoon though. In the late afternoon I saw an unwell patient and as I was thinking through the clinical problems, it felt like my brain had just left the building. Then I started talking to the patient’s wife, and engrossed in the conversation, didn’t realize it was sundown. At 5:30pm I sat down to break the fast with the same food as the day before, but I didn’t feel so elated because of a terrible headache. Vincent said I shouldn’t take aspirin because it could be a subarach, but I took some anyway and the headache eventually faded.

I had dinner with Chats at Papparich and I was a bit delirious when I arrived. There was a sign outside Papparich celebrating Ramadan and somehow I thought they had a separate Ramadan menu. Never mind, the curries that came with my roti canai were tasty and I enjoyed the veg biryani. We talked about everything and anything, but I distinctly recall discussing how people present themselves to the outside world – do we set ourselves unrealistic expectations because we are comparing one side (the worst) of ourselves to a different side (the best) of others?



Day 4 – June 21
Breakfast:                    Spaghetti, Shelley’s cheesecake on toast
Iftar:                            Avocado on toast, an apple
Dinner:                         E’s birthday cake
Dinner at home with dad

I had a pretty groggy start to the morning, having being on call and woken up several times. At an hour I would usually be sitting down to coffee, I was in ED seeing a really sick patient, and the day gradually unraveled from there.

I felt less powerful than I usually am. Physically I didn’t feel as strong and I just didn’t feel like doing anything. It’s not like I thought about food much, and people eating certainly didn’t bother me. But perhaps usually in our workdays, our time to eat and drink is also our downtime, so I didn’t have as much downtime as I usually would have.

I went to visit grandma after work, and felt really tired by then. As usual I had laid out the music I planned to play that night, but I only managed a couple of mazurkas and the last three Chopin nocturnes before I felt buggered and went to bed early.


Day 5 – June 22
Breakfast:                    Oats
Iftar:                            Avocado on toast, an apple
Dinner:                         Lunchbox by dad, miso soup

I left early to get to work, but obviously not early enough. I sat in traffic wondering why I live in Sydney, and also wondering what the future holds. I thought about where I would be in ten years time, but I just could not picture myself there.

It was Monday so the registrar and consultant changed over. The mood notably changed, but I was not my usual self. Maybe with all the ups and downs of the weeks following my grandma’s broken hip, I was even more melancholic than usual. My mouth felt dry and parched by mid morning, and I wondered how I would get through the day. John barely eats but that somehow exaggerated my lack of eating. Around lunchtime I sat with the others in the tearoom but when someone came in to ask for something, I volunteered to go back to the unit. Maybe I missed eating as much as I missed having a proper break? I resolved to sit in the office for a while, but I never got there.

There aren’t really any windows in the ICU, so it’s hard to know when the light is fading. At ten to five I went to fetch my bag of snacks so I could get ready to break the fast, and I felt really lightheaded by then. I thought about how hard it must be for patients to fast for surgery (and then have it cancelled and have to do it all over again!)


Day 6 – June 23
Breakfast:                    Noodles
Iftar:                            Sandwiches and sushi from grand rounds
Dinner:                        Cabbage poriyal and a boiled egg with rice

The on call was again quite taxing, and after one of the early morning calls I decided to get up to eat. I looked in the bathroom mirror and felt like my face was all red and dry. Was this somehow related to fasting? I resolved to take some lip balm to work (which I was later accused of eating during fasting).

I decided to have noodles for breakfast, and as I was cooking them the phone rang again and as I was talking to him I was faced with a most odd decision – do I go to work and intubate the patient (and fast till sundown) or do I eat my noodles? I ate them as quickly as I could, and suffered from chilli reflux for the rest of the morning.

Post on call days are always hard as you struggle with sleep deprivation and the need to keep everything spinning. At least my team was good this week in distracting me from fasting, though they teased me endlessly about it. At grand rounds I saved some sandwiches for breaking the fast, and they tasted extra good at sundown. I felt mildly euphoric afterwards and even felt like cooking when I got home.


Day 7 – June 24
Breakfast:                    Noodles
Iftar:                            Avocado on toast, kiwi fruit and mandarin
Dinner:                         Lunchbox by dad

I had noodles again for breakfast but added less chilli this time and had more time to eat it, so no more reflux. In the afternoon I had to put a central line in and I felt extra lightheaded whilst scrubbed up. I struggled to keep my hand steady and couldn’t feed the wire onto the line. My physical performance was clearly subpar. I wondered how doctors who are fasting in Muslim countries do complex things like place central lines or perform surgery – are they exempt because they actually have to concentrate for patient safety?

Afterwards I couldn’t get the plastic drape off the patient, and I became extra annoyed by the drape. Upon reflection, my degree of annoyance was way over what it usually would have been. I had a major rant and then went around asking everyone what they thought about the drapes – the degree to which I took it was just plain silly. I got into a heated discussion about it with my boss whom I love, and afterwards felt so stupid about the whole thing. Did it really spiral out of control because of my hypoglycaemic crankiness? I felt ashamed of my own lack of self control and stupidity. As others have pointed out before, my frontal lobe doesn’t work on the best of days, but it was extra bad with fasting.


Day 8 – June 25
Breakfast:                    Lunchbox by dad
Iftar:                            Avocado on toast, banana and mandarin
Dinner:                         Four Frogs: Spinach, feta, mushroom and avocado galette; nutella strawberry crepes and lemon curd crepes

Another bad night on call. After a few calls I decided to get up and go to the hospital just before 5am. It was a dream run, hardly any cars on the road at the time. As the patient got wheeled off to theatre, I sat down to eat my breakfast, but didn’t drink enough water so was extra extra thirsty for the rest of the day.

Hungry, thirsty, tired – not a good combination.

A sick patient arrived in the afternoon and I felt like I was floating off somewhere. As the “senior” person I was asked to place the central line quickly, but I really struggled, and had to have a second stick. I knew I was under-performing as it’s been a very long time since I had to do a second stick in such a straight forward case. I felt like I was sick, maybe even worse than if I was sick. I woke up a little bit in the cold of the cath lab, and then the rest of the day just blurred by. We went out for team dinner and the food took ages to come, but I felt more or less re-energised by then as I had eaten and drunk at iftar. I was so tired by the time I left the hospital that I was scanning my apartment keys and wondering why the hospital carpark gate wouldn’t open. By the time I got home it was after 11pm and I collapsed into bed.

 Mmmmmm... crepes


Day 9 – June 26
Breaking of the fast:               Cabbage curry and eggplant pickle with roti

When I opened my eyes, I knew from the light that it was day time and I missed the time to eat. I thought I could maybe spend the whole day sleeping, but alas, my brain was already awake. After talking on the phone for an hour, the thirst felt unbearable. This is what people on fluid restrictions have to experience every day? There was a glass of water next to my bed and it was calling to me.

I sat up and looked at the glass. It looked back at me, full of precious clear hydrating fluid. I took a sip and it tasted sweet like nectar. I gulped the rest down and felt my cells de-wrinkle a little bit. I got out of bed and drank another glass. 

Then I made breakfast and enjoyed every bite. Then I had a cup of coffee and thought, this might be a good end to my Ramadan.


Final thoughts
Ramadan was challenging. Without having the cultural and religious context, fasting from sunrise to sunset was pretty hard and I got sick of explaining to everyone why I was doing it. Most people thought I was crazy, but a fair few were interested in my quest and some shared stories of being in Muslim countries during Ramadan. As a non-Muslim, it has given me some empathy to those who are fasting – it is physically and mentally tough for them to get through the day, especially when all their friends and colleagues are carrying on all the usual activities. It must also be awful to be a hungry patient, surrounded by others eating but unable to take anything by mouth.

Finally, virtual thanks to all the people that saw me though the days of fasting. I apologise for the crankiness.

Food: Blue Mountains

One weekend in May E & I decided to get away for the weekend.. sort of to celebrate the handing in of the research project and also sort of to celebrate the fact that we can just do that sort of thing.

Harris Park must be the best place to stop on the way to the mountains, breaking up the dreary Sydney traffic. Every time I go there it seems to be a little more like Little India - there are so many restaurants within the two blocks of the train station that the place is almost buzzing.

The last time we were at Chatkazz, it was a tiny hole in the wall. Now it has taken over the space next door (though the original is still open for ?takeaway) and the fitout is hipster and modern. Lots of families and couples were dining there, and the menu covers the weird and wonderful from sandwich / pizza options to traditional street food.


We hit up a masala dosa, densely packed with potato curry. The dosa is on the small side (as are the garnishings), but the batter is perfectly crispy.


And then some pani puri for the road. There is also a pani puri man in the supermarket right next to Chatkazz, he looked awesome but we were too full.

That night we ventured into Leura for the local Japanese favourite Hana. I must say I was terribly sceptical, given that the mountains are really a touristy trap sort of place and everything practically shuts down at night.


I was pleasantly surprised by our meal of housemade pickles, seaweed salad, agedashi tofu (which bore no resemblance to the real thing, but pleasant enough) and tempura vegetable soba. E had a mixed sushi platter which came with plenty of fresh fish, though the sushi looked very amateur.. or rather, rustic and homemade!



We had lunch at the Wattle Cafe in Blackheath, which was packed with people escaping from the cold. The warm logfire was certainly welcome, and the atmosphere was homely and unpretentious. I had a goats cheese tart, which was served piping hot (just what we needed) with a tumble of rocket salad on top. Good belly filling stuff that is needed for the chilly weather.



We stopped at the Hydro Majestic to admire the view. Though the temperature was single digit, it didn't stop us from enjoying a gelato - the pineapple sorbet was fantastically refreshing.



Salad with ricotta, cannelini beans and avocado for dinner, whilst watching Masterchef.



Our last meal in the mountains was at The Yellow Deli in Katoomba. What a strange place this is - could be a scene straight out of Lord of the Rings, maybe a hobbit pub? I was intrigued by the back story to the cafe - it is run by members of the Twelve Tribes who are a religious cult based in Katoomba and Picton, Regardless, the food is simple but tasty. I demolished this tofu burger which incorporated salad, sprouts, cheese, mustard and mayo, along with a pickle, pumpkin soup and a huge mug of mate chai. We did read their newsletter for giggles whilst eating, and afterwards the cashier asked if we wanted to visit the farm. Hmm...



I adore Hominy bakery and always drop in when I'm in the neighbourhood. I love their granola which is packed with little muesli clusters and all sorts of seeds. I also got some pumpkin sourdough which was dense and chewy with a light flavour and a dark caramelly crust. Lovely with cheese.