Learning Chinese

Most of my sister’s Chinese friends speak or at least understand Mandarin.

She explains, “I don’t understand Mandarin because mum and dad spoke Shanghainese.”

“I’m not sure about that… you don’t understand Shanghainese either. You speak more Mandarin than Shanghainese anyway.”

“Oh yeah.”

The serious teacher

But she’s learning and for the last 2 years or so C has had a super serious Chinese teacher. There’s always a big wad of homework and weekly 听写 tests.

Apparently the teacher used to rank the kids on the whiteboard according to how many words they got wrong. Mum was a fan of her China-style methods, as are many parents here. I think after she arrived the local “Chinese school” went out of business.

Even my dad is a little scared of her. We bumped into her at the shopping centre last night and she stopped us, “I didn’t see her at class this afternoon.”

Dad had this startled look. “Oh I’m so sorry! I was going to message you this morning but forgot. She is at camp this weekend.”

The last time we forgot to let her know that my sister was overseas, she was asking us and our family friends to check whether C was trying to avoid class after school.

“There’s a big test next week. Make sure you help her revise.”

“Of course, of course,” we answered in chorus.

Chinese homework

Doing homework is usually a drag for everyone involved. But food seems to excite her and we had a few laughs. The specific topic was buffets “自助餐”.

1. You can eat as much as you want to eat “想吃多少就可以吃多少”

“So,” I asked her, “what does that mean? What do you do at buffets?”

“If you want to eat… you shouldn’t eat too much?” I laughed and said that’s probably just in our family. We try to eat healthily and not excessively and often reminds her to do the same, especially when it comes to buffets.

2. Etc etc. “等等”

The passage had a list of foods and the sentence ended with etc etc “等等”. “Oh yeah, I know that,” she said confidently, “It means stop, wait.” What? I didn’t see a connection until I realised she was right and wait used the same characters.

3. Desserts “甜点”

Next, she wasn’t that sure what these words meant. When I listed a few examples like cakes and lollies, she piped up and said, “冰淇淋！” Then I remembered the tub of vanilla ice cream (our favourite) in the fridge. Should I mention it or keep it to myself? In the end I gave her a few spoons to hopefully sweeten the Chinese-learning experience.

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A different world – part two

I started most of this awhile back when I was at clinic, which was a big contrast to the ED context from part one.

The clinic and people

The clinic is unique, even amongst the many clinics that this organisation manages. What you first notice as you drive in is the occasional empty bottle or can scattered on the overgrown grass. A white stolen car with broken windscreens in the carpark. The complimentary sprinkle of blood, left over from a weekend fist fight, on the concrete floor right outside the main door.

I’ve previously written about patients who were examples in faith and prayer. I’ve come across many other remarkable and varied Aboriginal patients and colleagues throughout this organisation. Patients such as the teen who studied down south on a scholarship at one of the “rich white schools on the peninsula”. Or the alcoholic woman, who was also a recent PhD graduate looking to get a tenure instead of ongoing casual appointments. A government social worker of two decades, who finally had an opportunity to get formally accredited. Cultural educators who saw food and resources, where I only saw one shrub and another shrub (indistinguishable from one another). Composed, articulate, and no-nonsense senior colleagues in the organisation. Health practitioners my age who did a remarkable job with both full time clinical work and caring for their 4 children, plus 2 stepchildren!

Anyway, in this particular clinic, some colleagues were great. The receptionist is one of the best that I’ve worked with and I nominated her for an award last year. Others had questionable ethics. The week before my leave we had a staff lunch together. As requested, I brought curry and “Asian” vegetables. Whilst munching on the buk choy, one colleague commented, “I normally scan one and put two in the bag. Buk choy is so expensive.” I heard but didn’t respond. Until another perked up and said, “Yeah, I’ve got this friend who works in the deli. She scans the seafood as chicken for me.” The first colleague added, “I have a friend who goes for a ‘five-finger discount’. I could never do that, you gotta pay something!”

Alcohol and social issues

“Who has woe? Who has sorrow?
Who has strife? Who has complaints?
Who has needless bruises? Who has bloodshot eyes?
Those who linger over wine,
who go to sample bowls of mixed wine.
Do not gaze at wine when it is red,
when it sparkles in the cup,
when it goes down smoothly!

In the end it bites like a snake
and poisons like a viper.
Your eyes will see strange sights,
and your mind will imagine confusing things.
You will be like one sleeping on the high seas,
lying on top of the rigging.
“They hit me,” you will say, “but I’m not hurt!
They beat me, but I don’t feel it!
When will I wake up
so I can find another drink?”

– Proverbs 23:31-35

An accurate depiction of excessive alcohol in anyone, but particularly true of many Aboriginal communities.

Alcohol and related social issues are strikingly visible on the newspapers and in the streets. Local residents routinely avoid certain parks, bus stops and streets where large numbers of drunk people are known to hang out. Businesses in the CBD are affected. Back in my ED rotations, weekend nights were filled with assaults, injuries and domestic violence, which were often alcohol or drug-fuelled. There’s coroner’s reports of horrific deaths in Aboriginal communities due to domestic violence. Childhood trauma and suicide. Petrol sniffing and “gunja” in young teenagers. Crime and youth detention.

In clinic we have a few more moments of function than dysfunction. Unlike ED, patients are generally expected to be sober when they walk into clinic. Aboriginal patients sometimes complain about their “fellow countrymen”, asking us why these “drunken mobs” are sitting outside the clinic. People are grieved by what they see of community members trapped in a cycle of alcohol and family problems. Staff worry about sick children who aren’t getting their rheumatic heart prevention due to family dysfunction. Families worry about their young ones getting involved in drugs. Some, whose lives resolve around “wine and weed”, desire to break out of this cycle – and a proportion do, with or without healthcare providers and rehab programs.

I’ll end this section with two points. Firstly, I acknowledge alcohol and drugs are issues in themselves as well as a symptoms of complex underlying problems. There’s historical, political, societal, personal etc factors that can’t be adequately addressed in a few paragraphs. Secondly, in our overly politically correct society, some may frame these descriptions as “being racist”. But how is disengaging with difficult topics doing something constructive for affected communities?

Urban sketching #3

“…The eye never has enough of seeing, nor the ear its fill of hearing.” – Ecclesiastes 1:8

Thanks C, for your encouragement even though you weren’t with me this time. “Hey, how come when you ask me to do stuff I have to do it but you don’t have to? Come on, just draw me one picture?”

Thanks S, for the guest flower-pot picture, for a memorable and refreshing trip, and the honest feedback. “Uh… I like it,” studiously comparing the picture to the scene, “But where’s this house? And that one doesn’t have windows. Did you make it up?”

A different world – part one

I’ve been spending my last single-married days gypsying around a small part of this enormous country. It’s wonderful to pick up conversations and see the years of distance, and some of my lingering resentments, melt with time. I’m surprised at the generosity and tenacity of many friendships through enormous changes within my own family life, and equally varied changes in my friends and colleagues as they graduate, switch careers, retire, get engaged, move cities, change churches, and more. It’s also been a new experience for me to actively seek out and spend time with my parents’ friends who supported mum and flew a long distance to be at her funeral last year. I long to tell her about these catch ups but I suppose they’d never have happened if she was still around because she was so social herself.

My travels took me back to work as a locum hospital resident. Whilst clinical work in itself is pretty much the same wherever, the context was completely different. I’ve forgotten how much quicker mainstream consults could happen. History taking can take a quarter of the time, patients often know or have a list of their medications and doses, you can give a script without explaining what to do with it, and people have their own mobile credit to make follow up phone calls.

It was nice to see say, an 18 year old guy, be responsible and organised enough to catch an Uber back to the hospital for a follow up review. There were some lovely older people and I kind of miss geriatric medicine. Some amusing university students too, as they caught glandular fever from each other at college, or came in with dramas post O-week pub crawls and parties. It was refreshing to not come across any injuries secondary to domestic violence, or deal with heavily intoxicated patients, despite doing several weekend evening shifts.

On the other hand, the level of entitlement was incredible. A category 4 patient, essentially recovered from her mild community acquired pneumonia, complained that we provided a “very poor service” because she had been waiting for 2 hours. A man waiting for a similar length of time to be seen for gastritis after deliberately eating “very spicy” food for an entire week complained about the ridiculous wait times and wanted me to promise him that pathology results will be available within 30 minutes. Oh you have no idea, I thought. At best you’d be waiting 4 hours for these ED presentations at my local hospital.

There were high earning government employees rocking up to ED instead of their GPs, complaining that GPs in town don’t bulk bill enough. Whilst looking up the hospitals I came across locals reviewing these public hospitals on Google, like… complaining about the food. Friends who lived here told me news stories in the past where a MP kicked up a fuss when someone in their family sat in the waiting room for hours like everyone else. Another politician tried to get a specific combined oral contraceptive pill banned in the country when his daughter had a deep vein thrombosis – um, all COCPs have the potential to increase clot risk. Plus his daughter went on a long-haul flight and had a genetic disposition to forming clots (which was discovered during the workup after getting her DVT).

The level of health concern was also a massive contrast to my usual workplace where, for example, a woman with an eGFR of 3 refused to go into hospital to start the process of dialysis.

Here, a mum brought her 7 year old son in because he swallowed a tiny bit of water and had a few coughs afterwards. A couple in their 30s re-presented after being discharged earlier that day because they didn’t know how to give oral paracetamol to their one year old – they almost didn’t let the nurse show them how either because they didn’t want the kid to spit out the medication again. Another man told me he was well informed and knew about antimicrobial resistance, but kept asking what needed to be done about his URTI – furthermore, he wanted me to confirm whether it was a “reoccurrence” of the same URTI from 3 years ago. Someone who self discharged post surgery (hence went home without a follow up appointment) tried ringing outpatients twice and couldn’t get through, so came into ED to get his follow up arranged.

I try to treat patients respectfully and listen to their concerns regardless of why they’ve presented. But I feel that some people living in our capital need a bit of perspective about life elsewhere in this country before complaining that the government doesn’t provide for or spend enough on healthcare in their city.

Urban sketching #2

Sketching with C in 2018 – half are mine and half are hers. See also urban sketching #1.

She has heaps more awesome ones done on days that I didn’t draw anything but I’ll let her share them on her own social media accounts (of which there are many). And why do teenagers want to hide all their stuff, including drawings, from family but at the same want to share everything with everyone else on the world wide web?