My Australian Adventure

March 2020 is electives month and I had the wonderful privilege to take up Renal Medicine under UNSW Prince of Wales Clinical School. Who would have thought?..haha. Yet, nothing is impossible in the Lord:) This is also a welcome retreat from our very tiring clerkship rotation (still part of it, but one I was looking forward to..haha), but one that is full of learning, so it's win-win for me.

When I began writing this, I had already been living in Sydney for 2 weeks and was halfway through the month-long elective. My thoughts then were...

        The COVID-19 situation is making things complicated, and I don't know what will happen next week. Back home in the Philippines, community quarantine and curfews have already been implemented in Metro Manila. But I'm taking it one day at a time, grateful for each morning I get to wake up, assured of God's favor and protection. If I may be honest, I'm also a bit worried, but I thank the Lord for whispering peace to my heart each time I feel anxious. It doesn't mean I have the license to be careless though, He made me enter medicine after all for a purpose, so I make sure to practice frequent hand hygiene and I try to stay away from very crowded places.

My Airbnb host says I shouldn't let the virus stop me from making the most of my trip. But I'd rather be careful and come back another time, than enjoy now and expose myself, potentially exposing the people I deal with as well, including my family when I return to the Philippines. But it doesn't mean I haven't been enjoying my stay..haha..Australia is very beautiful (even the cemetery looked breathtaking to me..haha) and I'm very grateful to be here, not just for the learning, but also for the experience.  

This is also my first trip abroad alone, one month long at that, so it was very daunting at first and I got homesick during the first few days I was here. But I adjusted soon enough and I want to keep a record of my experiences as detailed as I can so I can always go back to this amazing experience:)

Day 1
I arrived safely (thank you Lord!) with only one casualty. I lost one bluetooth earphone because it fell and I could no longer find it on the floor inside the plane..huhu..luckily I still have one.
I immediately got a SIM for Wifi and an Opal card.
I thank the Lord for Loi and Kelvin, who fetched me from the airport and treated me to lunch.
Once I got settled in my booked Airbnb, I went to the grocery to get some supplies, then slept early.

It was an 8 hour travel..and I got a window seat:)

First meal with Loi and Kelvin...fresh from the flight! (in all haggardness..hehe)

I wasn't able to take pictures of my room but it was very clean and organized, and Hanny and her husband were very kind hosts. I made good use of the kitchen, and I was also provided a space for my food supplies in the cabinet and in the refrigerator. Lodging is a bit expensive in Australia but Hanny's place is less pricey compared with the others - https://www.airbnb.com/rooms/23717562?s=67&sharer_id=48720447&unique_share_id=7e19ad62-4798-44bd-a80d-3c6dd2f771d7

The neighborhood in Eastlakes was also very apt for me. All the essentials were within walking distance from our place (grocery, pharmacy, bakery, even restaurants and cafes) and I can always spend some time at the Eastlakes Reserve if if didn't feel like going home yet. 

I pass by the park (Eastlakes Reserve) on my way to and from the bus stop daily 

luto-luto din

Day 2 - First Day
I woke up early, had breakfast then prepared to go early.
I arrived before 8am, and took my time looking for the building I was supposed to go to..haha
Today's a very tiring day because aside from joining the rounds, I had to go back and forth from the hospital to the university (a bit far) in heels
Hospital Activities:
-Toured around the renal units
-Joined the doctors' rounds
-Attended the weekly teaching conference (Topic: Advanced Care Planning for CKD patients)
-Attended the Radiology Conference which I appreciated and which I hope we could also have at home

I met Gibson, Zhi and Phoebe (medical students from UNSW); Julian (intern); and Daniel (registrar). I'll be joining the general nephrology team for 2 weeks, then I'll transfer to the transplant team for the final 2 weeks.

Mishaps for the day:
- I left my glasses at The Nucleus. I left it at the table where I put it down as I was having my ID picture taken..I didn't realize it until the staff sent me an email to inform me. I got it back thank you Lord
-I lost my OPAL card..I don't know how..but because Loi told me to register it online I was able to block it and transfer all the balance to my new card..huhu..

Thank you Lord for always having my back.

I was only able to sustain logging every activity for 2 days..haha. As the days went by, I was somehow able to develop a routine:
-Wake up at 5:30am and thank God for another day (2:30am Manila time)
- Take a bath
- Have breakfast
- Walk for 10 minutes to the bus stop and try to catch Bus 357 scheduled at around 7:40am
- Arrive at the POW hospital at around 8am
- Do some reading at the hospital canteen before I go to the ward or the clinic at around 8:30am
- Go around and be a tourist if we were sent home early
- Drop by the grocery near my place before going home to check for sale on chocolates..haha

mandatory early morning selfie at the hospital for my family (part of daily updates..hehe)

       Depending on the activities scheduled for the day, I would usually leave the hospital at 3 or 4pm except on days with conferences (usually Mondays) and scheduled lectures later in the afternoon. I enjoyed the rounds and the clinics, and learned a lot from them. I especially had a great time each time I joined Dr. Fernando in the clinics. She was patient in teaching but she also challenged me with her questions and helped with my physical examination skills as well. I got to see classic signs in patients with rare diseases, that I have only seen in pictures and books. The patients were also very kind in allowing us to sit in, observe, and apply our examination skills. Their participation made a huge difference; because unlike some of the patients I had back home who weren't very keen in allowing us to attend to them because they felt that we were practicing on them, the patients that I have encountered in the wards and in the clinics thought that we have to start somewhere to become good doctors in the future, so they offered their full participation. Through my exposure, I developed a stronger appreciation of renal medicine, and healthcare in general, as I saw the impact it had to people because it was made accessible. I saw long-time lupus patients who did not look like they had it because they were managed well. I also encountered patients with Wegener's granulomatosis, sarcoidosis, and atypical HUS who developed renal complications, on top of the other more common causes such as Hypertension and Diabetes Mellitus. There were a lot of AKI cases in the wards, patients who have undergone multiple kidney transplants, and there were also patients who refused renal replacement therapy and were given best supportive care. As with all healthcare systems, there are challenges in diagnosis and management, but since they have less limitations on tests (there were many tests that I heard for the first time..haha) and resources, the only undiagnosed cases are really the challenging ones.

Also from my experience, I realized that I really have so much to work on in terms of my knowledge and physical examination skills. I will never forget that life lesson from Dr. Fernando...she said that just because we come from a developing country doesn't mean that we should limit our knowledge on the cases that we usually see. We should still know everything, so that wherever we go, we will not have a hard time adjusting. She also emphasized that a good doctor should see, note and observe things that other people usually miss. Mastery comes with practice, but not just mere practice. I should always strive to be best at what I do if I want to be a good doctor in the future. I also appreciated the conferences and the lectures for students, as well as the coordination with the multidisciplinary health care team. Doctors cared about not only the physical health of the patient, but also considered how they will fare at home, referring them to the social worker, OT or PT as needed.

I also got to see snippets of how medical education and training  in Australia are being done. We no longer had the chance to switch teams, but I learned a lot from joining Daniel and Julian, and appreciated the tutorials from Victoria (intern). We also had the chance to observe Nas (registrar) perform renal biopsy at bedside; and all the consultants were very kind and accommodating of this foreign medical student from the Philippines on electives...hehe. I got close to Zhi, a Malaysian UNSW medical student who somehow took me under her wing and toured me around the uni, allowed me to tag along and join their lectures. Their setup is very different with ours, and matches the big difference in our healthcare systems. I hope to go back for training and fellowship in the future, as the Lord wills it.

a small portion of UNSW..haha

POW Clinical School - where med students can study, eat, and access the library

As for my day to day challenge of living well in a far place alone, eventually I had less mishaps..haha..and also became better in figuring out Google maps for directions for public transport.  I truly felt the Lord's hand protecting me and saving me from the consequences of my mistakes..haha. There was one time that I did not realize that I dropped my wallet because I was so amazed of the sea creatures I saw up close at the Sea Life Aquarium, but praise God for the kind lady who called my attention..haha. I also had a problem with my GERD probably because of too much coffee (their flat white is the best!), and also because I wasn't conscious about eating proper meals on time in the first week, and He saved me by leading me to our local pharmacy (very near my place) that sold not only PPIs but also my trusted Bragg apple cider vinegar. It also wasn't all study as I got the chance to tour around the usual spots, museums, malls and markets. I even did the Coogee to Bondi walk straight from morning rounds at the hospital when we were sent home early..hehe. I also went to Taronga Zoo in office attire, in heels..haha. I preferred visiting tourist spots on weekdays, to also lessen exposure with many people, so I tried to squeeze in random visits whenever we had free time at the hospital.

when I was still figuring out how to take a selfie..hehe

About the food, the coffee, cakes and fresh fruits were my favorites! I enjoyed the steak, fish and chips and avocado toast, but eventually missed the Asian cuisines..haha. I visited the usual tourist spots and eventually learned how to take a selfie (was so poor at it at first..huhu), but my most visited place of all time would have to be Woolworths..haha. It was a short walk from where I stayed, and I practically went there everyday. On my 3rd week people started hoarding essentials because of the COVID-19 situation, but I kept coming for the chocolates...haha. I went frequently to check whether the chocolates and snacks I intended to buy were on sale and I got the best deals!!!! I also did some shopping for my sisters and myself at DFO :)

Daily grocery visit..hehe

It was truly an experience of a lifetime. It also was a test of faith because I was still there when they declared that the entire Luzon will be under enhanced community quarantine. My original flight schedule was canceled. It got rescheduled twice but all those also got cancelled. My family was worried about me as well and I thank the Lord for the wisdom and provision of resources to book the last flight home from Sydney to Manila on March 24th. I also praise him for His favor, and for allowing me to settle my requirements, with all of my supervisors expressing support and understanding of the situation. I was still able to participate in the remaining lectures via online access. My original flight booking is still for refund, but what's important is I got home safely. I spent a loooot for excess baggage, because they suddenly decided to weigh the carry on luggage, but it still won't compare to the blessing of being able to catch the last flight. I am grateful for my family especially Ate who arranged the flight for me, my classmates and friends for their prayers, and also for Ate Mary who fetched me from the airport and brought me home. I remember how much I cried that day when all was settled, overwhelmed with the experience of God's sovereignty, His control of the situation, and His love for me :)

Excited to go home! (was there 2 hours before the airport opened..haha)

I remember the flight back and I wasn't worried at all. I was careful - I kept my mask on despite the discomfort it placed on my breathing and I also performed hand hygiene frequently, but all in all I was just so grateful to be on my way home :) The amenities and service of PAL certainly helped me relax as well...so sige na nga keri na yung excess baggage fee, makauwi lang..haha..I missed my family so much and although I enjoyed the sights and all the new experiences I had, I always thought about how it would have been if I was there with them. When I arrived home, I did self-quarantine for 2 weeks just to be sure, and nowadays I'm the designated errand girl for groceries and supplies, which I am happy to do.

one of the events I physically missed - Alfie's birthday!

Thank you Lord for this experience! Thank you as well for my benefactors from the Alumni Foundation who supported this medical student's dream. I never thought it would be possible, but You provided the resources through people I do not know personally, but who believed and supported my desire to see more and maximize my elective learning experience. It made me develop a greater understanding and appreciation of Renal Medicine. I still don't know if this is the path for me because nothing is really certain, but I hope to bring with me everything I've learned as I press on towards becoming the best doctor I can be, all for your glory!

Thank you Lord! You are indeed the giver of perfect gifts! I don't deserve all these but knowing how much you love me, makes me brave to ask for these amazing blessings, trusting that you have the best in store for me, beyond what I could ever ask or imagine:)