Paying tax - why?

I received my tax assessment today. Before you stop reading - tax is hardly the most thrilling subject - I want to talk about what else was in the envelope.

There's a tax receipt which explains where my tax dollars were spent. It shows how much and what it was spent on. I think this is an excellent way to educate about the value of paying tax, but for some reason it feels like a cynical exercise.

The first thing I noted was that the level of Australian Government gross debt has increased from $257 billion to $320 billion. That increase has happened under PM Abbott and Treasurer Hockey who used to talk about a "debt and deficit emergency" but now they say there isn't one.

Unsurprisingly, welfare is the biggest proportion and payments to unemployed people is the smallest share (apart from "other").

Health is second highest, then the list gets interesting. Defence received more of my tax dollars than education ($5 more to be precise). I'd like to know more about health spending - for example how much of it goes on subsidising private health insurance for people with money compared to mental health services.

Recreation and culture gets the smallest amount. Luckily I prop them up by paying to go to art galleries, concerts, plays and other cultural activities.

Any mention of the environment is screamingly absent and I can only hope that some of the money going to "fuel and energy" is for development of renewable energy.

There's more information on the website. I love their commitment to plainspeaking:

Understanding tax

Australians pay tax so the government can provide services to the community.

Good to know.

Immigration is the category that upsets me because I know that I have no choice but to financially contribute to the immigration detention centres where innocent people are kept in concentration camps.

I wonder what would happen if tax payers could direct where our share of taxes was spent? I know that it wouldn't necessarily be practical, but it would be interesting to ask people. My decisions would be very different from those of the current government, but I don't resent paying tax.

Thanks to the Australian Government for the information!

Tangles and angles - 50 shades of white

Today was one of those days where I spent the day in bed. I had a shower, got dressed and left the house with no nod towards hair and makeup. When I arrived at work I stripped and donned the gown of no dignity. (Luckily I had a clean out of my underwear drawer yesterday and can vouch for the decency of all my undies.) At the mention of a set of nasal prongs, a sling and a strap on IV, people start to give me funny looks. No, I wasn't filming the sequel to "50 Shades of Grey". I was working as a simulated patient for physiotherapy students today.

I love working with students who are still relatively inexperienced in their profession. It's so interesting to see the problems they encounter and be in a position to give really useful, practical feedback.

It was all about tangles and angles today. My left arm was in a sling after a (simulated) shoulder reconstruction. My right arm had the IV line for my PCA (patient controlled anaesthesia). That was simulated too. No drugs were flowing. Suddenly, a simple action like sitting on the side of the bed becomes a manoeuvre requiring a project manager and a crane booking. Adding to the drama is a very short gown, an educator sitting at the foot of the bed, and sheets that slip and slide and stick to the gown of no dignity. 

"Just swing yourself over and sit on the side of the bed." I hear the instruction and know that even with a simulated post-operative site, I'm not going to ":just swing" myself anywhere. They give detailed instructions about bending my knees, pushing down with my heels and using my right hand to lift and shift towards the edge of the bed. Bending the knees involves giving the educator full view of my nether regions. Lifting and shifting involves all the bed clothes shifting with me. The hospital gown seems intent on moving in the opposite direction to me and soon I am marooned on the very edge of the bed, gasping for air as my windpipe is almost severed by the demon hospital gown. (Who called them "gowns"? They are the least gown like garment I can think of. When I think of a gown, I'm thinking Christian Dior and red carpets, not this white apron masquerading as a functional garment.)

Compounding this is the fact that I'm wearing a sling. I'm then offered another "gown" to cover my back because "we're" going to try walking. They're very focused on the walking, even though it's my shoulder that's had the operation. Obviously, my briefing left out the information that I work as a circus acrobat where I'm regularly walking on my hands. The second gown is tied on the back "like a Superman cape", but of course, is as much like a Superman cape as the first gown is red carpet worthy.

There's a realisation that I've gone one way and my IV and nasal prongs are coming from the other side of the bed. They're also attached to me. We go through a further set of complex movements to reduce the risk that I will be mistaken for a chicken trussed and ready for the oven.

The students were terrific today. They're still at the stage where their thinking processes are slow and deliberate and nothing is really instinctive. I was often left in an unsustainable position while they discussed what needed to happen next.

The one thing I can't simulate is blood pressure and oxygen saturation - it's actually mine they're measuring. My sats were a bit low today - probably because I was holding my breath as I was precariously balanced on the edge of the bed. On the other hand, my blood pressure was a bit higher than usual - again probably because I was being choked by the hospital gown.

Oscar-worthy.
© 2015 divacultura

Angles and tangles seems like an apt description of life as a physiotherapy student.

What did you do today?

Mental Health Awareness - it's up to all of us

It's World Mental Health Week and it's great to see and hear so much happening to educate us about mental health.

This week I'm at the College of Mental Health Nurses Conference in Melbourne talking to people about the mental health clinical education toolkit that I've produced for St John of God Health Care. It's giving me the opportunity to meet nurses who are working in all kinds of places but all share one thing - a commitment to quality care for people who have mental health problems. I've met nurses working in hospitals; nurses working in Medicare Locals; community nurses working in cities and regional areas; nurses working in prisons, other forensic settings and assessing asylum seekers . There are also educators from hospitals, other health care providers and universities.

ABC has programmed lots of interesting things under the banner of "Mental As". What a fantastic contribution to the education of our community. I think some of what I've seen can really make a difference to creating supporting understanding and empathy in the community. Monday night's Q & A on television had a panel of people talking frankly about mental health in rural and regional areas. The panel included a psychiatrist, a comedian, a lived experience practitioner (something I've just learned about), a politician and a CEO from a community organisation and the quality of the questions and conversation showed just how much we're thinking about mental health and experiencing in our daily lives. (You can catch up on the show, read a transcript, see the questions posed and learn about the panellists on the website.) It was stimulating television: I was challenged. I was moved. I was educated. I was frustrated. I was angry. I was relieved.

Last night - again on the ABC - the first episode of Changing Minds aired. It takes us inside the psychiatric unit at Sydney's Liverpool Hospital. I regularly visit private mental health hospitals, but am not exposed to the clinical interactions. I see patients walking around and always greet and acknowledge them. I know that my experience is more than most lay people would have, but going inside a public ward where people are sometimes there under the Mental Health Act was a new experience.

The focus last night was on three people who have bipolar disorder and were in various stages of treatment for manic episodes. We saw Patrick towards the end of his stay and then back at home. We met Glen who is up and down. We met Sandra who is at the beginning of her admission showing nasty irritability and disordered thinking. I struggled with my own reactions to these people and admired the good humour and empathy displayed by the staff. Sandra was very suspicious about the medication a nurse was dispensing, initially denying they were correct. She insisted the nurse go through each tablet, explain what it was and then put it in a particular place. I was rolling my eyes from a distance and was so impressed to watch the nurse who patiently and respectfully responded to Sandra's needs.

What I've noticed is that all this conversation really does work against stigma. I believe this is the first step necessary for healing and understanding in our world.

Last night's program has also helped discovery within my own family. One of my family members has bipolar disorder and each of us has our own experience and attitudes as a result of living with this person. I've been open about this in my close circle, but have not talked in the wider world. The raising of mental health awareness has helped me understand that there's value in sharing my experience and insight with others. I have several close friends who also suffer with depression and anxiety. I know from talking to them that understanding isn't always there.

What's your experience of mental health? How are you engaging in the conversation? What can you learn to help understanding of people who have mental health problems?

If you're at the conference why not drop by the Australia Catholic University stand and say hello?

What to do when you meet someone famous.

Fame. Infamy. Celebrity. Many people crave these things like air, but I wonder what it would actually be like to be so recognisable that complete strangers think they know you. If your fame is over, then how do you reinvent yourself while the rest of the world sits on the sidelines reacting to you in accordance with their view of who you are and what you're capable of?

I had an encounter today which caused me to ponder these things. (I'm not going to reveal who this person is out of respect and professionalism.) I was playing a character and only interacted with this person while I was in character. I knew the identity of the person I was to work with beforehand so it wasn't a complete shock when I walked in, but there was still that strange moment of recognition. It felt like I knew this person and then remembered the truth. 

The work we were doing together was very far from the field in which this person had achieved their fame; this may have made it easier to forget about who they "had been". 

That idea of "had been" crossed my mind and I thought about how awful it would be to have to fight against an outmoded image of yourself. Reinvention - or even just progress - can be challenging for ordinary people. I can only imagine what it must be like when the world has you boxed into a particular place in that world.

During our encounter, nothing was mentioned of the old world. What a relief that must be!

The bigger lesson from today's experience was a reminder about meeting people as they are, with no preconceived ideas. Being present, interacting in the moment and responding according to how they are today is a good thing to do with anyone.  A deep level of authenticity and honesty is possible if both people in the conversation are doing this.

I'm pleased to have had the opportunity I had today. My only regret was that I didn't have the opportunity to engage with this impressive person as myself. Truthfully, I may have been a little bit star struck when it was all over.

What did you learn today? Who did you meet today?

Lights, camera, action!

It's been a very big week. As usual, I was doing many different things for many different people, but this week included something out of the ordinary. I was making two films and my role was behind the camera.

I'm collaborating with a university in the field of clinical supervision and my partner and I pitched that we would make some films as a catalyst for discussion in the workshops that we will design and deliver.

We had two films to make and two days in which to make them. I wrote the script which was more like a blueprint for the narrative of each scene around which the actors would improvise. We had a director, camera operator and audio engineer. My partner was the clinical adviser on set, teaching the actors how to look like they were taking blood pressure and other vital signs and props master. That left me as producer, assistant director and floor manager. After two days, I was exhausted and gained a real appreciation for what it takes to make even a simple film. My job was all-consuming because I was flicking from creative story-telling to manager of the set, people and time frames.

At one point, I heard my name called by four different people. All I could do was take a breath and deal with each person.

Even my broadcast journalism skills had a workout. We did some vox pop interviews of students to get their stories and perspectives about clinical supervision and feedback. I stood beside the camera and chatted with four young men to get them to relax in front of the camera and to incorporate my question into their answer. I remembered the appeal that interviewing had for me all those years ago.

My next task is post-production. I'll sit with the editor and we'll use all the footage we took to tell the story that I wrote. I'm really excited to see how it turns out.

One of my lessons from this experience is that everything takes three times longer than you think and you just have to keep going until you're finished.

The other great thing I noticed was the need to have complete trust in the team you've assembled. Everyone must be doing their job and you must trust that everyone is doing their job. I had no capacity to step in and take over anyone else's job. If I had, that would have left a big gap where I was supposed to be. It's a great leadership experience, because everyone is required and no one can give less than 100% every time and all the time.

My partner took a photo on set which you can see on Instagram. He appeared as an extra, but I was too busy doing all of the things I've mentioned, that I missed taking a photo.

Art triumphs over science

I had a satisfying moment yesterday when I was co-facilitating an education session for a group of second year nursing students. My co-facilitator was a very experienced nurse herself and able to cover all the clinical information that I don't know. (I cover the communication and empathy components). I love these sessions because I always learn things too.I

We had just watched a mental health simulation with a female patient who had come to hospital believing she was having a heart attack. She wasn't - she was having a panic attack and it was revealed she had a long history of severe anxiety and agoraphobia. There was plenty to talk about.

My colleague led a discussion about the appropriate drug choices and how they work. We also discussed the side effects and other physical impacts of the drugs. Then we talked about "S.L.U.D.": Salivation, Lacrimation, Urination and Digestion. One of the students asked was Lacrimation was. None of the group knew, but I did.

"It's tears," I offered.

They all looked at me completely surprised. (I'd shared that I had no clinical background.)

"The "Lacrymosa" in the Mozart Requiem, is the movement about crying. I just figured the Latin was probably related."

They looked at me completely surprised again.

This little moment reminded me how handy a broad arts education is. Language is the basis of our communication, understanding and knowledge and I can usually work out most things. It helped me on a game show once when I had to name the South American city who name meant "mountain view". "Monte Video", I answered. I didn't "know" the answer, but I'd worked it out based on the language.

Yesterday's insight wasn't even gained from a language class, but from long exposure to Latin and other languages when singing in choirs!

More and I more I realise how important and useful my broad arts education is. It helps me navigate the world.

Considering "Utopia" and Australia's history

A friend told me that I had to watch "Utopia", John Pilger's film about black Australia. (I was about to write that it was a film about the current situation in black Australia. I feel like the current situation has existed for a while.)

While I was emotionally engaged by "Utopia", I had a niggling question throughout and that was about balance, objectivity and notions of "truth" in journalism. I'm not sure what I think about that. I am well-read on the history of Australia, black and white, and struggle to understand the intentions behind government policies, both in the past and now. I've concluded that this film is not objective and is a construction meant to tell a particular story. Is it propaganda? I don't know - probably because I sympathise with the view presented - but I think it's certainly a pretty important piece of activism.

I remember believing in the ideals of balance, objectivity and truth. There was a moment of youthful naivety when I actually thought I could achieve it. I no longer believe those things are possible. The best thing that we can do is sample widely and seek out as many viewpoints as we can.

Despite having these misgivings, "Utopia" is worth watching as part of the search for viewpoints.

Vox pop interviews on Sydney streets on Australia Day confounded me. How can any adult truly believe that Aboriginal people like to live in extreme poverty and deprivation? That actually they choose it?

CCTV footage of the mistreatment of an Aboriginal man in police custody, shows the rough handling by police dealing with a sleepy drunk man who inconveniently leaves his blood on the floor after he is thrown to the ground by police. We then see him left alone in a cell as he dies. The film reports that he had been taken into "protective" police custody and his life could have been saved. He basically died from neglect.

We then hear about the death of an Aboriginal man in the back of a jail transport in Western Australia. He died in the metal mobile cell after temperatures reached over 50 degrees Celsius. The coroner said he had basically been cooked to death. The Corrective Services Minister at the time seemed to be sorry for what had happened and that she had considered resigning. She said she hadn't resigned because she wanted to do something. She organised cultural sensitivity training.

What does cultural sensitivity training have to do with a failure to respect another human being? It seemed to me that this Aboriginal man in custody was viewed as so different from us, that he must not have been viewed as human.

Over to Rottnest Island and we discover that the resort rooms were once the cells of an Aboriginal concentration camp. The tourist leaflet about "historic" Rottnest Island does not mention the prison history, the hangings that took place and the mass grave nearby.

A man at the Australian War Memorial is asked why wars fought on foreign soils are commemorated, but the "frontier wars" where Aborigines fought to defend their homelands from colonial takeover are ignored, as if they never happened. It's a good question.

Stories of the Wave Hill strike where Aboriginal workers and their families went on strike for over 7 years in an effort to be paid and fed properly, made my own struggles for fairness as a union official seem inconsequential. Another tale of exploitation of Aboriginal workers is told about cotton chippers at Wee Waa in northern New South Wales. One of the activists talks about the planes spraying pesticides flying over and spraying while he and his fellow workers were working in the fields. Not even human, kept going through my mind as I watched.

I don't know how this happens. How can we regard other human beings as less than ourselves? How can empathy fail us so completely? And of course, I write this as a relatively privileged white woman who has access to what I need - more than  I need, actually. Is it comprehensive brainwashing? That the so-called history wars have been successful in separating white Australians from our awful history?

I spent three years of my primary schooling at Moree Public School. Moree is a town in northern New South Wales with a large Aboriginal population. I remember being terrified at the prospect of going to school with blackfellas. Fresh from Canberra Grammar, I had met one Aboriginal boy. He was the adopted son of the minister at our Anglican Church. I wonder now where he came from. Had he been stolen? Of course, pretty soon, we were all just kids together and colour didn't  matter so much in the classroom.

Corporal punishment was used liberally and certain teachers had a fearsome reputation as wielders of the cane. I was in grade 4, Miss Hoolihan was taking an art class. Eddie Pitt flicked paint at me. It was friendly play. I painted his arm. We were warned. We didn't listen. Both of us were reprimanded and told to go to see Mr O'Connor. Mr O'Connor was known to have broken several canes on the hands of badly behaved children and I was terrified. For this minor transgression, play really, we were to be caned by Mr O'Connor!

Eddie Pitt taught me something about courage as he led the way. I really didn't want to go. We arrived at Mr O'Connor's classroom to discover that he wasn't there. Eddie Pitt comforted me and said not to worry about it. He was probably used to being regularly physically punished by the ripe old age of about 8. My mother was furious and advocated strongly for me telling me that I was not to receive the cane. Ever.

Eddie Pitt's mother might have advocated strongly for him too. Or she might have wished she could, but didn't know how. Or she might have been so subjugated by the white men that she accepted that her son would be beaten regularly at school as part of all they could expect from their lives.

I know that Eddie Pitt is probably dead. Statistically, it's likely that many of my Aboriginal classmates, especially the boys, are not longer with us.

I found myself ashamed to agree with one person interviewed in the film who said he thought that foreign aid was probably required to help us all. I don't know what the answer is, but I suspect that educating all of us and facing our history is part of it.

What do you think? Have you seen the film?

I was able to watch "Utopia" on SBS on demand TV. It expires in 5 days.

Power dynamics and patient feedback

This morning I was working with one of the health sciences schools at a Melbourne university. I happened to be working with the same student I had a couple of weeks ago when my character was one day post-operative. I remembered the student, but I think he became confused as he wondered whether he was supposed to remember me (even though I was playing the same character). Sometimes what happens within a simulation takes on a life of its own.

The student who was working with me was professionally polite, but a little cold and formal. He needed to relax a little to build better rapport with my character who was gung-ho and very motivated to get on with her rehabilitation. In the feedback afterwards, I gave him a quick refresher on rapport building and he looked like he'd heard it all before.

The main thing I talked to him about though, was quite personal and is an example of why feedback from simulated patients is so powerful. The student had a cold and was sniffling and fighting nasal congestion throughout our consultation. On several occasions he apologised for his cold, which I noted as a sign that he was aware of what I might be noticing. Great. What wasn't so great was when he wiped his nose with his hand and then moved in to touch me as part of my treatment. I considered saying something during the consultation, but it didn't really fit with my character, so I suffered through the hand-to-nose-to-knee sequence several times, silently giving thanks that he wasn't my dentist.

When I gave the feedback he looked shocked and was very apologetic. He told me he wasn't aware that he'd been doing that. I know that hand hygiene receives heavy attention throughout health education and continues into the workplace, so I was surprised to see this behaviour. I suppose it highlights why there are signs everywhere with instructions about how to wash your hands or use hand sanitiser properly. (Don't forget to do the back of the hands too!)

I know that it would be rare for a real patient to tell their allied health professional to wash their hands after they wiped their nose. This is because of the power dynamics and powerful protocols in play, as we align to playing our designated roles.

How's your hand hygiene? Would you stop someone from treating you if they had wiped their nose just before touching you? 

All the world's a stage.- including the hospital ward

Here's what my office looked like on Friday:

My favourite workspace
© divacultura 2013

I spent the day lying in bed and receiving bad news, repeatedly.

Sometimes I was required to react angrily and other times I was directed to be shocked or disbelieving. Usually I reached the point of tears, depending on the interaction with the particular doctor.

Students (practising surgeons) were receiving feedback on their communication and ability to manage emotions. Generally they did very well. What struck me during the debriefing was how sincere they were about wanting the best outcome for their patient (me). Where a mistake had been made, they were appalled on my behalf.

Wardrobe and special FX done.
© divacultura 2013

In the debriefing after scenarios where I had been directed to be angry and was introduced to the students by my own name, some of them looked a little wary. I always wave and smile and introduce myself in the friendliest way possible to prove that the threat is gone. Once they realise this, I notice many of them looking at me, fascinated. Only a moment before I was lying on a hospital bed, the day after my operation, attacking them and wanting to find someone to blame; yet there I am, moments later, looking and sounding completely different.

I love this work!

One of the students had a lovely way of contextualising each piece of information he provided. He explained afterwards that we all come with stories - the patient, the doctor etc - and that each event or interaction adds to that story. I loved his way of thinking. He was wonderful to talk to - empathetic, respectful and caring.

Wardrobe and makeup was really easy. Hospital gowns are the least flattering garments on the planet, but they ARE comfortable. The bandage on my arm is to keep my fake IV in place and I have a hospital bracelet to make sure I'm identified correctly as the simulated patient.

As in life, my simulated husband's presence was repeatedly requested by the doctors. My simulated husband was not there when I needed him. He was running his simulated business but was going to pick up the simulated children from school and come in later in the day.

Everytime I cry during these jobs, I receive questions about "how do you do that?" I now borrow my friend's response: "How do you do surgery?"

In my line of work, all the world IS a stage and they don't call it an operating theatre for nothing.

My favourite gig OR why I was being paid to lie in bed and wear pyjamas.

"I can't believe that you don't have a brain injury!" Ordinarily these words might be an insult or cause for concern; today they were the best compliment I received all day. Today I was being a simulated patient in a ward with three others and a mannequin.

The patient had fallen off a ladder and now had a brain injury. Such a simple thing and suddenly this woman is confronting a completely changed life. Her walking, eating and cognitive function is affected. After my recent mishaps (the bag falling on my head and my knee injury) I have new perspective on the fragility of being okay and fully functioning in the world.

Be careful on ladders!

This week I've been working with different groups of students across the full spectrum of healthcare. Saturday and Sunday was the gynaecologists and obstetricians; Monday and Tuesday it was mental health nursing; Wednesday I was working with orthoptics students; today was nursing, physiotherapy, occupational therapy, social work, nursing and medicine and tomorrow, international medical graduates. It's such a privilege working with these students as they develop their skills and identity within their chosen field. Mostly they are excellent - really interested in people and ready to help; occasionally I notice that they've already lost their empathy.  I think it's because they focus on skills and knowledge and forget there's a person at the centre of it.

Yesterday was the first time I've worked with orthoptists. They come with a lot of equipment and have spent their time practising their technical and clinical skills on each other.  I noticed that many of them didn't explain what they were going to do before they approached the simulated patient. They would just lean over and peel the simulated patient's eyelids back and wonder why there was  a reaction. The were great with equipment and not so great with the people. I asked if any of them had ever suffered the complaint that the simulated patient had (double vision).  None of them had. I asked if they had considered what it would be like to have double vision. None of them had. I asked them who drove to university that day. Sadly most of them had. I asked them how they would have made their way to university if they had double vision. They started to think about life from the patient's perspective. Here was the "ah-ha" moment.

A few of the nursing students today had already developed what I call "nurse tone". There's a particular brand of condescension - talking overly loudly, slowly and using terms like "we" when they mean "you". I really hate that.

Working as a simulated patient has made me a better real patient. Talking to my GP the other day about a referral to a specialist, she asked me what kind of doctor I wanted. "A good one" was my response. She asked me if I was okay with someone who is very direct. Initially I said yes, but then I pictured myself in conversation about my particular issue with a very direct person. I realised exactly what I wanted AND what I didn't want: "I want to be a person, not a [insert body part here]." My GP selected a different doctor for referral.

I'm not sure I would have had the awareness of being a body part, or an illness before working as a simulated patient.  Many times I turn up to play a role and am not referred to by my own name, let alone my character's name.  Instead we gather to cries of "Lungs in here!", "Cancer in room three!" and "Depression follow me to the basement!". So the rot has started to set in as administrators and educators strip the person from the situation and turn us all into cases.

I push back, not moving until I'm referred to by one of my names. I correct people who say they've been happy to "use me" as a simulated patient, suggesting instead, it's a been a pleasure to work with them.

It's wonderful that health care education now gives students the opportunity to work with simulated patients as a proxy for real patients.

Spending the afternoon lying in bed, wearing pyjamas and talking to enthusiastic young people is a gig I love!

Hanging out at hospital

Lately I've been hanging out in hospitals, walking past hospitals and thinking about hospitals.  I'm fine, by the way.  I've been working as a simulated patient, managing a mental health simulation project and often grabbing a coffee and sandwich in the cafeteria.

Walking through the ground floor of the busy Alfred Hospital in Melbourne I'm struck by being amongst the walking wounded.  There are people on crutches, arms are in slings, people have tubes in their nostrils, they trail drip stands.  Walking outside, there is usually an array of people assembled out on the footpath smoking.  Today I saw a woman sitting at the tram stop wearing a pink dressing gown.  She had a tube going into her nose and she had to move the tube out of the way so she could put her cigarette in her mouth!  With the weather becoming cooler as we approach winter, I was surprised to see a man standing in bare feet, wearing nothing but a hospital gown out on the footpath getting his fix.

The other thing that is noticeable is the incredibly detailed conversations people have on their mobile phones in lifts and hallways.  Today I travelled six floors with a woman who was describing her potential liver failure and the fact that the doctor is recommending extreme changes to her diet to avoid the need for diabetes medication and that all of this needs to happen before surgery could be considered.  Her tone suggested that she could have been booking a carpet cleaner or organising her car for a service.  I looked at her again - she did seem to be a funny colour.

Having spent the day working with paramedics (being a simulated patient and giving feedback on their communication) I then visited the Medicare office to lodge my claim for some recent medical expenses.  The place was packed!  I had to squeeze into a space between two people who looked like they had been there for a while.  After five minutes the voice of the automated queue lulled us into calm - "A123 go to counter 4".  I had A 138 so it would be a while.  Twenty minutes to be exact.  There were ten counter bays and there were staff at three of them to begin with.  After a while, closed signs went up at two of the bays and the voice of the automated queue fell silent for ten minutes.  Then two people came back and things started moving again.

An older man expressed a lack of patience for waiting.  Two people with exotic accents asked when is a quiet time to come back and how long would they have to wait.  Someone was told it would be four weeks before they would receive their Medicare card.  A good looking man wearing a jumper with the logo for King Kong the musical came in - one of the dancers claiming for a work related injury?  Largely people sat in silence and played with their phones.

A138 was called to counter number 4 and within 90 seconds my claim had been lodged and I was being advised that the money would be in my bank account tomorrow.  Surely there's a way that could be lodged online?

This week is a week of health care education: today was the paramedics, tomorrow is mental health, Thursday I'll be trained in the role I'll be playing i upcoming medical exams and on Friday I'll be at the College of Surgeons working with healthcare educators who are learning about working with simulation as a teaching tool.

In the meantime, if you want to watch people and contemplate the frailty of human existence, the hospital cafeteria or hospital footpath are rich with examples.

How's your week looking?

I'm all heart - and it's beating!

On Friday I was hooked up to an ECG machine and being attended to by several paramedics.  It was an interesting day and there was nothing at all wrong with my heart.

I was playing a role and providing feedback about communication* to postgraduate paramedic students. The character I was playing was complaining of tightness in the chest, but didn't know the paramedics had been called.  It took a lot of convincing before I would let the paramedics attend to me.  Apparently this does happen.

This resistance was the hardest part of the role.  If I really had something wrong with my heart, you wouldn't need to convince me to do something about it.

During the first scenario with the first student, I had this sudden worry as he was taking my blood pressure and pulse - I hope he doesn't find anything wrong!  I may have been playing the role of someone else, but it was MY pulse, blood pressure and heart he was assessing!

I waited, a little nervously, for the results.

The last time I had my blood pressure taken it was a little on the high side and my doctor sent me for some investigations to rule out things like kidney problems before seeing if adjustments to lifestyle**could bring it down.  My blood pressure was very good.  (The bottom number was 70, last time it was 85.)  I was amazed and pleased.  Within the scenario when my blood pressure was being taken, I was highly agitated and very stressed, but this didn't show up in my blood pressure.  Yet another of the mysteries of acting.

Being hooked up to an ECG machine is a little freaky.  It's a fairly intimidating piece of equipment.  Suddenly you can see your heart rhythms and hear your heartbeat.  I was curious to know what all the different sensors were measuring, but didn't have the opportunity to find out.  The main thing is that my heart is great!  I thought my mini health checks were a great perk for this job.

Coming at the end of a week where I've been running workshops on empathy for undergraduate paramedic students (and other health care disciplines) it was really interesting to be in these encounters.  I've learned so much about paramedics.  As I approach another week of empathy workshops, having the context of my (fictional) encounters on Friday will surely enrich my facilitation.

DID YOU KNOW the machine which measures blood pressure is called a sphygmomanometer.  Try saying that five times, fast!

*The main communication issues came down to really simple things and are useful for everyone in all settings:
1. Use the name of the person you're talking to.  Many people ask for a name and then fail to use it.  Using a person's name creates intimacy and connection within the conversation, whatever its purpose or situation.
2. Don't use jargon.  It is alienating.  Listen for the words the other person uses and reflect their language.
3. Think about where you are positioned in relation to the person you're talking to. You can change the dynamics of the conversation by changing your "level" eg standing, sitting, stepping back.
4. Focus on the needs of the other person.  If someone is resisting doing what you need them to do, find out what matters to them and think about how doing what you need will actually help them meet their own needs.

** The main lifestyle factor that's different is actually my work.  I'm self employed now and while there are stresses, I feel that I'm living in a way that is more true to who I am.  I think this is the single biggest thing that has helped with my blood pressure.  (No medication required.)

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