Abbreviations

BPAD = Bipolar Affective Disorder

BPSD = Behavioural Problems Secondary to Dementia

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Orientation to Time

Me: "What year is it?"

Patient: "Now what do you mean by that? What year is it now, or what year is it in October?"

Me: "Um ... what year is it now?"

Patient: "September"

I give her a point for knowing the month.

Me: "And what year is it?"

Patient: "Not a year I should be living in"

Me: "Do you know what day of the week it is?"

Patient: "Well it should be Sunday. But it's not. It's Tuesday"

Me: "Very good"

Subjective Cuteness

My dog Sprite is the cutest animal in the whole wide world. That has always been my firm belief.

But then I tried taking photos of our two dogs on the weekend.  My sister's dog 'Doggers' looks exactly the same in photos and real life. Sprite, not so much. Her photos do not look cute at all.

Doggers looks just like this in real life

Sprite, I believe, looks much cuter in real life

And then I had the shocking realisation - what if she's not as cute as I think she is?

And then another thought - it doesn't matter.

A Banana and an Orange

The "Frontal Assessment Battery" (FAB) is supposed to be an objective measure of the functioning of the frontal lobes of one's brain. The frontal lobes deteriorate in certain types of dementia and people become disinhibited, lose mental flexibility and are less able to conceptualise material.

I did the FAB test on someone who'd supposedly had a bifrontal lobectomy (both frontal lobes removed) and they scored points, which says something about either:

1. The brain's ability to compensate

2. The surgeon's ability to remove parts of the brain, or

3. The FAB test itself

I'm not a huge fan of the test itself. Some of the questions are quite difficult, because it's not clear what you are being asked. Take for example, question 1.

"In what way are they alike?"

1. A banana and an orange

2. A table and a chair

3. A tulip, a rose and a daisy

Try answering them now.

There is only one correct answer for each.

1. The only correct answer is "they are both fruit". "They both have peel" is a partial failure and you don't get a point. "They're nothing alike, what a stupid question!" will also get you 0 points.

2. A table and a chair are both furniture. Yes, they "both have legs" and technically they are both "optional", but only "furniture" will get you the mark.

3. A tulip, a rose and a daisy might be "strange bedfellows" to an avid gardener, but unless you say that they are all flowers you will lose a mark.

Not an impossible test, but hard work for patient and examiner. I've included the link above if you feel like testing someone you know ...

Circle of Life

When I was younger we used to have bushes around our house that had very pretty purple and white daisy-like flowers. Unfortunately the garden snails loved them, and whilst they didn't do much damage to the plants, it was really annoying to have an enormous snail breeding-ground right in front of the house.

So we acquired some ducks which, in case you didn't know, are snail-eating champions.

Unfortunately duck eggs are a funny blue colour and nobody ate them because we also had perfectly normal chook eggs to eat.

So we made cakes to use up the duck eggs.

And then we got sick of the ducks because they're messy and awful, so we sold them all. Nobody wanted a whole flock of ducks, but our Vietnamese neighbours bought a pair every week until they were all gone.

And then we pulled up all the plants.

And that, kids, is the circle of life.

Busting

Patient on Psychogeriatric ward: "I couldn't piss before and now I'm fuken busting for a wee"

Correctly interpreted by a nurse as: "I've forgotten where the bathroom is"

Firefox Fail

Just in case you didn't know, I am not somebody you want to have around your computer. I can crash the uncrashable, freeze the unfreezable, download viruses from perfectly legitimate sites and uninstall programs without your permission. So it's helpful when computers give very specific reports of what has gone wrong - like this one from 5 minutes ago:

Home

Just past 6 o'clock on Saturday morning, Qantas flight QF82 touched down on the Adelaide runway.

I left home in May and now, four months, three continents, ten countries, several travelling partners and countless eye-opening experiences later, I am home at last. Right up until the last day I couldn't imagine my little adventure ending ... an outlook which resulted in much scrambling to pack, finish assignments and do last-minute souvenir shopping (none of which I completed successfully).

Somebody asked if I'd returned as a whole new person and no, I don't think so - I think I'm the same old person who's now seen a lot more things. A lot of things that I'd never hope to see again, but have opened my eyes a bit more to the world. 

It's a big place.

Transport in Cambodia #2

Some more of the transport options in Cambodia ... where a vehicle's capacity is only limited by how much freight or how many people you can physically load into it.

Riding in style in a "cyclo"

Honda Daelim, not the romiest family vehicle

A very full truck

The family bicycle

One full van

The pig truck

Choosing style over safety ... or something

Indian

My sister, with her brown eyes, dark hair and olive skin, is an ethnical puzzle to most people she meets. French waiters think she’s Spanish. My Japanese housemate was convinced she was Japanese. Customers at work think she might be Croatian, maybe Puerto Rican, possibly Italian, but never Australian.

My boyfriend’s parents are Khmer Cambodians, but everybody in Cambodia thinks he’s Chinese.

Me, I’m Australian. Nobody’s ever questioned it. 

And then I stepped into theatre in Phnom Penh and the surgeon paused operating on the cleft palate in front of him to declare that I looked Indian.

Maybe, I thought – with a cap and mask on, if you were too far away to see me properly. But no, my boyfriend revealed later that the surgeon had spent several minutes discussing the point with him the day before. He was actually convinced I was Indian.

Must have been my accent.

Ravi

Ravi the security guard is a cheerful young man. For 12 hours a day, 7 days a week he sits at the front of the apartment in his blue uniform. 

He makes $3/day working for the security company, who pick him up in a truck at the end of the day along with all the other guards in the neighbourhood. With his $3 he can buy a meal of noodles from a street-seller for 75c, so as long as he doesn’t buy a drink he may just come out on top. Unlike the night guard who wears civilian clothes and is allowed to sleep on the job, Ravi has $1 deducted from his pay if he is caught sleeping.

Still, he greets us with a smile and “arroon sous day” or “good morning” when we emerge at 7.30am. He always rushes to open the gate wide for us to pass through. If the tuk-tuk driver accidentally takes me past the apartment, he’ll run out and flag it down so I get home safely.

He makes friends with the little boy from down the road, who hangs out near the fence so they can listen to the radio together. Sometimes we buy him dinner and he thanks us profusely, even though it’s the same 75c noodles he’d buy for himself. 

He's got another job lined up closer to his home town, where he'll make a little bit more money and might be able to save for the future. All the best, Ravi!

Bory

On my first day of placement, my boyfriend’s parents kindly organised a tuk-tuk driver for me. After “auditioning” several drivers (making them all compete for the best price), they finally settled on Bory. For $6/day Bory would pick me up at 7.30am, take me to the hospital, and then pick me up again at lunchtime. If needed he’d take me back in the afternoon, or I could have him take me to the market. For an extra charge we could go further to the main tourist attractions.

For the entire 6 weeks, Bory was never late, and he never stopped smiling. 

He wouldn’t let me pay him at the end of the first week, preferring to wait and get the month’s worth as a lump sum. I imagine he dreamed all month about the things he could buy for $120 in Phnom Penh.

He frequently got lost, but he always quite happily stopped for directions and never charged extra for the scenic route. In his broken English he would explain how he got confused, and then laugh about it.

I’m not convinced Bory is a real tuk-tuk driver. When he wasn’t driving me around, he’d hang out with our security guard and his tuk-tuk driver friends. Other tuk-tuk drivers would yell out “tuk-TUK!!” to anybody who walks past, hoping for business. When people walked past Bory, he did nothing. My boyfriend’s parents actually had to call him over to discuss business that first day.

Maybe he’s a secret millionaire. 

Photos

Today was my last day of Paediatrics in Cambodia. Yesterday I brought my camera in and took loads of photos, including a few of the kids in the HIV ward. I printed them out this morning and handed them to the parents, who proudly showed them to all the other parents in the ward. 

Soon enough, all the parents were gathering up their children and demanding that I also take their photos.

Luckily there were only 12 families, but in the end I made three trips to the photo shop and spend many thousands of riel (almost $3) printing them all out. It was great seeing the kids’ smiles and how much the families appreciated the photos - many poor families don't have a camera, so photos are a rarity.

Most excited to receive her photo was the cleaning lady I'd snapped on the way to the printers. She was happy that I'd even taken her picture, and then when I printed it out and put it in her pocket as she was hanging out the linen she almost cried. She looks like she's scrubbed in for operating theatre, doesn't she?

Pink Stethoscope

The pink stethoscope teaching a first-year nursing student what pulmonary TB sounds like.

Around the Hospital

A few pics from around the hospital ...

Group physiotherapy session

Stepping through the hospital doors

The indoor playground. Those kids spotted the barrang (me) and started yelling "hello!" while I was still miles away. So cute!

Random vans in the hospital car park

Not official hospital transport - kids on a sack truck

The HIV ward

Weighing scales in the triage area ... and a Christmas outfit!

Happy Fathers Day

Happy Fathers Day to all the Dads out there!

Especially mine because he's the best.

Electrical Safety

"What leftover electrical cable?"

Powerline, Phnom Penh

Iced Coffee

I am such a master of the Cambodian language (Khmer) that I can now order iced coffee for my boyfriend and myself. "Pbee cafe d-doh gore d-goh" (where the oh is a sharp 'o' as in 'hot', sorry but proper phonetic spelling confuses me). It translates to two coffees with milk and ice. Unfortunately I mastered this at exactly the same time as the girl at the hospital cafeteria memorised our drink order, and now she doesn't even let me finish.

So in Kep this weekend, I saw a street vendor and seized the chance to prove myself. I knew it was all going to come down to my amazing Khmer when the girl greeted me with "hello sir", and I announced that I would like "pbee cafe d-doh gore d-goh". Seeing that I was alone, her male assistant held up one finger and asked if I would like "pbee" (two) or, holding up two fingers, "pbee" (two). I held up two fingers and said that I would like pbee. Two.

Then she made an iced coffee without milk and I quickly cut in and said "d-doh gore" (milk). In English she replied "you are getting a different one. With milk" and handed the black coffee to someone else.

Then she made me two iced coffees without milk and got all annoyed when I asked her to put milk in them.

Back to the hospital cafeteria for me.

Choeung Ek

Choeung Ek ... a place where brightly coloured butterflies dance in the trees, hens raise broods of cute chickens, locals fish with nets in the large dyke ... and thousands of men, women and children were murdered and buried in mass graves, victims of Pol Pot's Khmer Rouge. 

It's hard to believe that this "autogenocidal" horror occurred not 40 years ago. Harder still to believe that such a beautiful place as Choeung Ek could have been the site of so many executions where soldiers killed their fellow Cambodians by striking them with ox-cart handles, pickaxes, bamboo sticks and other sturdy pieces of equipment, so as to save on ammunition. And almost impossible to believe that  the Khmer Rouge wiped out almost a quarter of Cambodia's population through starvation, torture and mass-murder and still held a seat on the UN for another 15 years. 

Oh, world. You are so messed up.

Broken bones

Sign in the Killing Fields

Some of the thousands of skulls on display