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Wilkommen to my blog - my name is Karin Purshouse, and I'm a doctor in the UK. If you're looking for ramblings on life as a junior doctor, my attempts to dual-moonlight as a scientist and balancing all that madness with a life, you've come to the right place. I'm currently a doctor/research trainee in oncology after spending a year doing research in the USA. All original content is licensed under a Creative Commons Attribution 4.0 International License.

Friday, 17 July 2015

Home

How else to kick off celebrating 4th July?
A far cry from drizzly England! SB, CA.
When I was very little (well, as little as I ever was. Single digits.), The Magic Faraway Tree series by Enid Blyton were amongst my favourite books.  The Magic Faraway Tree is found by a group of children, and is inhabited by a series of characters (Moonface, the Saucepan Man, Dame Wash-a-lot...).  At the top of the tree is a magical land that changes every few days.  The Land of Toys, the Land of Dreams, the Land of Presents... But when it is time for the Land to move on and change, a wind blows and the children have to run back down into the tree as fast as they can, lest they get stuck in the Land after it moves on.  Then, they wait until the next land appears for them to explore.
Ojai, CA - home of delicious
organic wines and this gem
of a spot.

Replace 'Lands' with 'Countries' and that's roughly how it feels to leave a place where you've created a home and plonk yourself back in the throes of a life you once recognised.  A friend recently described it as 'confusion/sadness/excitement/boredom/exhaustion' - a perfect summary!  Made weirder by interesting quirks such as my new phone refreshing as if it were the day I left for the USA - talk about a time warp!  People prepare you for the culture shock of moving abroad - now that I'm a few days in, they somewhat omit to mention the culture shock of moving back...  Plus, shockingly, it's administratively rather complicated moving countries (and jobs) - surprising, huh?!  Super grateful for the diverse selection of friends, close and often not-so-close, who have been in touch and made me feel less of a freak by relating their emotions, often hilarious, from when they moved back after an extended stay overseas.  People are great :)

Julia Pfeiffer point, Big Sur, CA
Morro Bay, CA. More of this next year!
I can scarcely believe 9 1/2 months can go so fast.  Some people have a baby in that time; I moved across an ocean, made a home and then moved back to start another one.  Life-changing in a different way... but life-changing nonetheless.  In less than three weeks I'll be back to being Dr Karin Purshouse - with weekends, night shifts and evenings on call, if you were in any doubt Mr Hunt - yikes.  The negativity from my medical chums is pretty overwhelming.  Lots to think about, but one thing I have learned: living abroad is awesome.  From the friends I made to the things I experienced, from the emotions it brought out in me to the things it made my brain explore, living in the USA was so much more than I could ever have imagined.  I actually loved being a funny foreigner, and what it taught me about myself as well as the world in general.  I am by no means alarmed by the idea of doing it again in the future.  For some reason, that makes returning to the UK and medical life seem a lot less scary.  I will not let my spirit be squashed before I've even started, especially not for a job I love so much!

Right.  I'm off to adjust to this crazy country I'm meant to call 'home' and continue to 'sort my life out'.  One thing is for sure; apart from one SWIMS exception, I am refusing to say goodbye to ANYONE ELSE for a very long time!
Ciao, NYC!

Thursday, 2 July 2015

Lost!

I've been reading a LOT recently on my solo tour d'USA (although apparently when you're a solo traveller with a British accent in the USA, you might as well be a people magnet... a handy time to be bilingual!).

I return the pastry pro! Learning the art of a
perfect pastry for tarts and crostatas in the
German quarter Chicago, IL.
I like books about people.  I like books that put historical or human events into context with the qualities and traits that enhance and hamper us all, from the most loving and wonderful to the ugly, selfish parts of human nature.  The reasons why I love certain books could be a post in itself - and it might seem surprising that what prompted this blog post was the book I read first and enjoyed the least out of my ongoing reading splurge.  'Wild', now made famous by a certain film, is the autobiographical tale of a woman who hikes the Pacific Crest Trail as a sort of hiking mission to heal her past, a pilgrimage of salvation.  On paper (no puns intended), I should have loved this book.  It took me a while to work out why it didn't 'click' with me - and I think it all comes down to the conclusion of the book: of being lost, and that being resolved, and that being a positive thing.  

When asked off the cuff recently if my time in America had changed me, I rather arrogantly and with little deep thought replied - 'No'.  Which in many ways is true.  I'm still all the things I was when I came to this side of the pond; hopefully just an enhanced, more wide-eyed, more contemplative version.  But something is different - and it's taken me a while to put my finger on it - and I think I'm getting closer to working it out.  Perhaps part of it is this:

For the first time, I am joyously, and contentedly, lost.  

Chicago - city of the best date and bacon rolls, free summer
concerts and ... oh so much else.  Under-rated place.  
As a medical student, then a doctor, and intermittently a scientist, everything is about control.  As a medical student, it was the transition of being the science nerd at a performing arts school to being an incredibly mediocre wannabe doctor.  It was then realising you could do that and fit in this, that, and the other (music, hiking and medical politics in my case, amongst other things!) around all of that if you were organised.  As a doctor, you are controlling your ever increasing list of jobs to do, and organising it in logical fashion with both safety and efficiency in mind.  When your patient dies, you have to control your emotions, or find an appropriate time to 'let them out', but these moments are usually short-lived.  If you are tearing your hair out, starving, thirsty and exhausted, after 13 hours of being dragged around seven floors of a hospital at the whim of several beeping machines attached to you, there is no time for frustrated tears (although believe me, I've shed plenty) - your mind is expected to be as sharp as it was on first waking.  As a scientist, any amount of panic or hysteria, unless kept in check, will spill over into failed experiments.  Calculations and cell plating require concentration and absolute precision to get your cell numbers even close to accurate.  A slip up, which might only be discovered weeks down the line, means time, money and sanity down the drain.  In all three domains - student, doctor, scientist - there are also incessant exams to juggle, where failure feels neither to be acceptable nor an option and thus self-discipline and more control are required; and that's before you have time to worry about life events throwing you a curve ball.  None of these are bad things, by the way - they are arguably necessary, and have contributed hugely to my growth as a person.  BUT....

The Acknowledgements slide for the Bindra lab for the next
3 years! Bye Bye Bindra lab :(
Ever since I finished full-time doctoring nearly a year ago, life has been alive, awake and bright, right from the two months of being a part-time/sometime locum doctor in a city I would struggle to love more.  Here in America, I've had(/made!) time to enjoy my job, but also explore, make new friends (as well as nurture, properly, old ones), and stretch my brain like an elastic band in every imaginable direction - art, music, sport, cooking, testing the extent to which I can trash my knees, science, even poetry.  I'm hugely enjoying how with each year I get older, I expect more and more from myself in terms of my brain and body, and, even if it isn't in reality, more seems possible.  Anything seems possible! The other day I had a 'pinch me now' moment when I was walking through the sunny Old Campus at Yale University with the bells playing their daily selection of harmonies for one of the last times before returning to Oxford, and realising that both of those places feel... comfortable, and like I belong.  WHAT?!  I'm just some girl who got off the country bus from Wiltshire!  And I know I am BEYOND lucky that mine has been a life without the adversities that prevent others from such participation, and hence I try to embrace it as best I can whilst maintaining the roles that supersede any personal ambitions - friend, sister, daughter, granddaughter, Auntie.  

Iconic lovin'.  By the USS
Midway, San Diego, CA.
Maybe you're reading this and thinking - 'gosh, I don't want her as my doctor now!  I liked the version that was in control!  Not the one that's lost!'.  Well, maybe you can be both.  I will still be the slightly OCD SHO(/junior resident)-on-call with the neatly quarter-folded piece of A4 paper (one quarter for each ward under my responsibility - both sides, naturally) who will make little square tick-boxes alongside the jobs to be done.  I will still occasionally run back into the hospital from the car-park because I'll think I've forgotten to check a blood test (and every time realise that OF COURSE I have).  I'm still the efficient half-German I always was.  But I like the fact that 'life certainties' - perhaps worries - that existed in my mind are no longer there.  I have no idea where I'll be ten years from now, in life, professionally and the world - and that's hugely liberating.  We spend so much time as junior doctors being expected to 'know' and feeling guilty when we don't - I've found it incredibly refreshing to realise and embrace just how much I don't know, about myself and the future as much as anything else.  In doing so, I feel about a thousand times more aware of the world around me, which has resulted in something resembling sensory overload when swapping my sweltering yet lusciously leafy 'home' on the East Coast for the friendly, crisp warmth of Chicago's parks and now the golden-earthed, tastily humid sea coast of Southern California.  For those who have never traveled alone - I cannot recommend it highly enough, and I am hugely enjoying my lone time interspersed with brief new acquaintances on a PRN basis!

Ocean Beach, San Diego, CA. Thanks to the Pacific Ocean for taking
good care of me in my absence (and more than rewarding me
during my morning runs!)
I like books about people.  I hope they help me grow and learn to see the world through the eyes of others; my patients, my friends, my family, people I see on the news, people I meet on my travels and people I have heard of in textbooks.  And I hope in trying to understand the complexities and intricacies of the human spirit, I become a better, more caring, more empathetic person - and doctor.  

Because I like people.  Even if I am a doctor who's a bit lost, surely that's worth something.  




P.S. As an antidote to the potential negativity of the 'book I liked least' - which is, of course, not to do disservice to what is a highly acclaimed bestseller written by an amazing lady! - the best book I have read thus far during this mini-American-educational-reading session was 'I Know Why The Caged Bird Sings'. WOW. Essential reading (esp for any American dwellers) for which there are not enough words to describe how much I loved Maya Angelou's PHENOMENAL prose. And now hopefully being enjoyed by its new owner :)