So the other day the scrub nurse assisting me in the operation shared his story.

He was born in an African country ravaged by war. He saw his friends and family murdered violently. He had to flee his village with a handful of survivors. 1/
He jumped over the dead bodies of people he knew. He fled to another country. Lived in refugee camps and somehow made it to the UK as a refugee many years ago.

Fast forward a few years he spent 16 years working as an accountant. 2/
Since the EU, worked became difficult for him and he lost his job. He and his family returned to their country of origin and thought they could consider living in their post-war home nation.

They couldn’t fit in. They couldn’t deal with the lawlessness and corruption. 3/
Their kids struggled too. And they sought to return back to the UK.

His mum objected to them returning to the UK by not taking her antihypertensives. Ultimately she suffered a stroke and there in the village he felt the hopelessness of not being able to help his mum. 4/
Rather than returning to the UK, they took a gamble by choosing to move to Australia. He took an accounting job and soon realised the legalities of accounting was different in Australia. He had to retrain all over again.

Instead of retraining in accounting and law...5/
He decided to do nursing because he felt he wanted a career that was practical and tangible. When his mum died he promised to do something meaningful.

Nursing training was totally foreign to this middle aged man with teenage kids. He completed it. 6/
When he became a graduate nurse he remembered the day his patient died.

There was a lot of commotion and he was being contacted by nursing supervisors, educators and nursing seniors to see if he needed to take the shift off and to debrief (I never had this support as a Doc) 7/
Fellow nurses wanted to support him because he lost a patient. They were worried that he might not cope with the death of a patient.

He said, “It is sad, but that’s not the first time I dealt with death.” 8/
“As a kid I had to hop over the dead bodies of people I knew to run away from gunfire. I had to learn to be strong.”

Fast forward a few years, he is assisting me as a scrub nurse in a Head & Neck procedure. 9/
I asked, “Did your gamble coming to Australia pay off?”

He silenced the yankuer sucker and over the anaesthetic beeping said, “Australia has been the best thing that has ever happened to me & my family. 10/
“If I had known about Australia 20 years ago, I would have taken the boat to come here. Australia has give me and my family a new life.”

So I asked, what’s similar between Australia and the UK?

He replied

“Racism”.

11/
“In both countries, my skin colour and my accent, makes me less of a member of society than others.”

...

...

...

...

...

12/
I know.
I’m sorry.
4.0 vicryl & 5.0 monocryl please.

End/

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More from @DrEricLevi

2 Sep
Politicians, chefs, celebrities, sports people etc make all sorts of comments about the pandemic restrictions.

Nurses, docs, paramedics, allied health and other front line clinicians are asked to “comply to code of conduct”. Our hands are tied and sometimes we are muzzled too.
It’s the reality we work in. We can only do our best within the systemic constraints we. It’s always a challenge and there is no perfect system.

Sometimes voicing an opinion alone can be a career-ending move for some in the health industry.
Most of us are here to just get on with our patients and our lives. A few of us are here for the money and power.
Read 5 tweets
23 Aug
“Health Care Workers are heroes, putting themselves on the line” said the big people.

1 in 7 covid positive Victorians are HCWs.

But only 1 in 5 covid positive HCW caught it at work??? Where else did HCW catch COVID other than from work?

theage.com.au/national/one-i…
The attribution that majority of HCW catch covid outside work does not statistically make sense.

Because if we saw the truth and realise that HCWs are not well protected at work to do their job safely, then the workplace managers/owners will have to be scrutinised.
If anyone in my team caught covid doing our aerosol generating procedures, that’s a workplace safety issue.

Hence the noise many of us have made the last few weeks.

Good thing the old email keeps a record of conversations.
Read 8 tweets
8 Aug
It happened again the other day.

I asked for an N95 mask for my airway operating list. One hospital provided, another said no.

Yes, pre-op swabs are negative, but I spend 3-4 hours in multiple patients’ nose, oral cavity, oropharynx, larynx and trachea in one session.
My sinus cases involve me debriding the nasal mucosa, removing polyps and dissecting the nasopharyngeal mucosa.

My throat cases involve me dissecting the oral mucosa, tonsils, palate, tongue.

I’m always inches from patients noses and mouths.
My airway cases mean I’m 30cm away from a patient’s mouth with positive airway blowing into the patient and released on to my face. The airway is not secured or sealed. It’s an open ventilation with air returning on to my face and neck. Diagram below. medicine.uiowa.edu/iowaprotocols/…
Read 7 tweets
12 Jul
Note about covid test.

You can get tested on Monday.
Be exposed to covid on Tuesday.
Get a negative result on Wednesday.
Go out to meet people on Thursday.
Be mildly symptomatic on Friday (“But I was negative”) .
Then get tested on Saturday.
Only to be positive on Monday.
A negative test is negative at the time of testing. And there’s a known false negative rate (meaning you have the virus but it did not turn positive on the test).

Don’t be deluded that once you’re negative you’ll always be negative. You can still be exposed right after the test
Ok. Thanks @CraigDavid

Monday. Had a covid swab on Tuesday
I was negative by Wednesday
Went out Thurs & Fri & Sat
We sneezed on Sunday
I met this nurse on Monday
I got swabbed again on Tuesday
I was positive by Wednesday
Contact traced on Thurs & Frid & Sat
We sneezed on Sunday
Read 5 tweets
10 May
From the start of this pandemic, Australia has recorded 97 deaths. Each life is precious.

But as a doctor, I’m embarrassed when people call us heroes. There are currently 17 COVID ICU patients in the whole of Australia.

Public health intervention & contact tracing worked. 1/
Australia’s borders were closed early (we narrowly missed a potential superspreading event at the Melbourne Grand Prix).

We did not use the term shutdown, but that’s what was effectively done. Everyone stayed home except for essential work, supplies, medical care & exercise 2/
The heroes were the community. The vast majority heeded warnings from overseas and our leadership.

People adapted quickly. Work from home established. Supermarkets provided shopping hours for elderly. Community groups did deliveries for the vulnerable. 3/
Read 11 tweets
25 Apr
There are only 43 COVID patients in ICU today in the whole of Australia.

You don’t have to call us heroes because we haven’t seen a real tsunami.

Call our Public Health Officials and Medical Leaders heroes. They have saved us from an unprecedented disaster. So far.
The job is not done. Small outbreaks can still occur. But the system is now better prepared. Supply lines created. Capacity increased. Staff mentally and physically trained. Systems ready from the entrance of the hospital to the ward/theatre/ICU.

We’ve been training.
But we know that many in the community are struggling due to loss of work, etc.

Please refocus your attention and help from the hospitals to the community. We’ve got masks & scrubs donated and secured. What about getting food and clothing to those who may need them desperately.
Read 5 tweets

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