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When I was working in Dubbo base hospital, I was happy that there was some really good teamwork happening, and it was nice to have specialist back-up in critical care situations. In my week there I needed to call in back up on two out of my seven nights. On one night I called in one of the most supportive bosses around in my opinion, Rose Ly, to help with the intubation of post arrest patient, and on another night I had the help of the ED director, Randall Greenberg who supported me through one of my most difficult shifts to date in managing a busy ED department on top of a motor vehicle accident and trauma. In addition to getting senior support, it was really good to work with great staff, and as usual I come away form a locum with having met some fantastic people. One of the doctor I was lucky to work with a great bunch of people, starting with being greeted by an old buddy from Wellington, NZ, who happened to be on the floor when I turned to work for my first shift– who was none other than the quietly famous Ken Looi (ED doc by night, and Unicycle world champion by day, just incase you didn’t know). I also worked with some great doctors in the ED, including but not limited to Dave my co-night doctor, and the dream team who helped out in a big way on the busiest night of the week when there was also a motor vehicle trauma. Craig, Renuka, and Rafi stayed on well beyond their shift break to keep the patients treated. Als the other specialities really pitched in, especially Jane the med reg, and the entire surgical team who were up all night. Whilst it was another non-stop night, it was good to know that everyone was part of the team, including a very friendly ward clark who I promised to email this article to when I eventually wrote it. The nurses were great too, and Mel and Sue were the two in-charge night nurses kept me in order – and I repaid the favour with a dish of guacamole on my last night.

And finally I have to mention a particular senior nurse called Rose who made my day by saying to me at the end of shift in a kind and sincere way, “You did well, and I really enjoyed working with you, I hope you come back!”. Often the end of your shift a the end of 6 in a row is when you feel like crawling into a ball and going to sleep – so thanks Rose – you're a star in my books! And thanks alos to everyone else!

Emergency health care in the public eye

Whilst in Dubbo I met friend called David Ward who was quite passionate about giving positive feedback about hospital services that looked after and cared for his wife and premature son in an emergency situation (see newspaper article). As David and I discussed over coffee one morning, when it comes to health care, and particularly "emergency work", it is easy to focus on what is not happening when things rarely go wrong, rather than what good is actually being done a daily basis. Whilst it is so imporant to study error, (one of the things that has motivated me into the field of medical education) it is also important to be aware of the other side of this, which is good health care delivery that occurs on a regular basis. It is easy to loose perspective of this, particulalry under sensational reporting, and I guess this situation is partly a result of lack of positive feedback - which is in a way what this post is all about! 

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working-in-dubbo-part-2-team-work-pysdBcyhhIhhozmJvbrH.zip (696 KB)

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It’s been just over a month since I finished working an incredibly eventful week of work at the Dubbo Base Hospital Emergency Department (ED), and I thought I’d share some reflections about the week and about doing Rural ED Locums in general. This is what I wrote in the week following my visit.

In my week at Dubbo Base I saw a diverse mix of patients and it was an interesting and challenging ED work environment. Despite being a relatively remote hospital of medium size I felt that there was a strong education focus and this feature was one of the highlights for me because “I love learning and teaching”. The Dubbo ED had Emergency Specialist cover and was accredited for ED training, and there was also a host of specialty registrars from other departments (including Medicine, Surgery, Orthopaedics, Paediatrics and Obstetrics & Gynaecology) which made it a well supported ED to work in. However, at the same time, the last week of nights was perhaps one of the most challenging weeks of work that I had done in recent years. I think this is partly due to the diversity of patients that I saw (as Dubbo covers a large area in Central NSW), which one of the added challenge of doing Rural ED Locums.

In my week I was also involved in some interesting emergency medicine, managing a range of Medical, Neurosurgical, Surgical and Orthopaedic Emergencies, which including major trauma, resuscitation and post resuscitation care. In addition to the big stuff there were plenty of regular ED presentations, and we saw lots of Paediatrics, and some O&G and acute Psychiatry. 

The challenges of describing work in the Emergency Department

Ever since I started a sting of medical research in Sri Lanka, and became interested in International Emergency Medicine, I have been in the habit of reflecting on what goes on in Emergency departments back in this part of the world. Because of this I often find myself asking the questions; - “What do we do in emergency medicine – how do these systems work? Do they make a difference?”. Because I have worked or observed medical systems without Emergency Medicine as an established specialty, my observed answer to the last question is a “Yes”. I say this for many reasons, which is why I’m so passionate about the development emergency medicine.  However, perhaps greatest difference I can notice straight away is that Emergency Medicine provides a system and process of creating “a degree of order” from within the chaos of a hospital’s acute admitting facility. Emergency Medicine’s doctrine acts promote the fastest attention to the most critically ill patients first, and also promotes the provision of a high level of medical experience early. This certainly was the case in my last week of work, as the model was operating in full swing. I was particularly impressed in the way that we dealt with Trauma patients that we dealt with at the weekend and also the instances of Resusciation during the week. 

Reality is stranger than fiction

In writing this blog post I found it difficult to capture all the professional challenges, ethical dilemmas, mixed emotions, trials and tribulations that can be encountered even in a single week of working in the ED, and conveying this scene is perhaps where theatre and film have an important role to create awareness – both for the improvement of the system, but also the education of the public.  

In addition, knowing what happens in an emergency department is perhaps helpful to the friend and family of those who working this environment, for often out of the sheer enormity of the culture shock it’s hard to describe. I for one often find it difficult to talk about what I have been doing, or going through because of a fear of being misunderstood. I think some kind of debrief is really healthy, but rarely practiced. This trailer that I saw on a TV series called “24 hours in the ER” seems to capture some of magnitude of interesting, weird and wacky, and challenging things that one sees in the emergency department.

I never actually watched the full series myself, but the trailer that I’ve included above looks as if it would be a good series to watch. I really like how this trailer captures not just the “bells and whistles” of the job, but it also shows some of the really challenging (and rewarding) aspects of helping people, such as dealing with the process of death. A lot of our work these has become about “end of life care”, and helping families through this process, which is quite different to the “ER” I watched as a medical student – but I guess things have as the population is getting older.

Many doctors and medical these days are blogging about their experiences which give provides a very important interface of communication between patients and health care providers. Kevin MD is a great blog that compiles as series of articles about their experiences, such as this post by about the experience of a medical student confronting death. 

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I recently found out that I’ve been spammed by “twitter” and it took me by surprise, so I thought I'd post this so it doesn't take you by surprise too!

So what does twitter spam look like? Last night I received this ‘direct’ message from one user who i've never got a message from before:- 

“Hey some pHey some person is making really bad rumors about you... ow.ly/a9GXY (this link is deactivated - don't copy it!)

My first response was – “wow that’s dodgy, better check out that link” – without taking a step back and thinking – “hang on a second, doesn’t this look like the kind of phrase that I sometimes see in my junk mail?”

The haste of clicking on the link in the message took me on a quick path to nowhere, but for some reason I had to sign in on my twitter account again (this is where I think the spamming device gets your password – in retrospect – doh!)

What did I do? I wrote back to the person who sent me the warning and said that I couldn’t open their link..

In the mean time I got similar messages to the one I just sent from other users saying things like, “Sorry, but I couldn’t open your link”

Then my LIGHT BULB switched ON!!

“I’VE BE SPAMMED!”

This morning when I check my emails – there are several more similar messages, but at least there was one from “twitter inc” that said;- 

Hi, trainthetrainer

Twitter believes that your account may have been compromised by a website or service not associated with Twitter. We've reset your password to prevent others from accessing your account.

You'll need to create a new password for your Twitter account. You can select a new password at this link: ..

So, in conclusion,  I may not know much about this “twitter” but I’m glad that there are people who are on the case pronto in the management! Now my password has been changed and I’m up and running again – and hopefully I am no longer spreading the spam – so to speak!

My sincere apologies & condolences to those other people who have also been “twitter spammed” – but don’t worry, whilst it’s a bit unnerving, and a pain, it does pass. 

Perhaps the moral of the story is “if you get a dodgy message”, resist the temptation to act/click, and ‘google’ it first before responding to the message. I hope that this blog post will help others who have such a message and don’t know what to do. Good luck! 

Peace out

@trainthetrainer 

Ps https://twitter.com/#!/spam  is a very useful link to learn about the type of spam you might find on twitter!

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I just watched the movie “Connected”, by Tiffany Shlain and there were many themes that resonated with me. Perhaps the theme that most resonated with me was the concept that genius lies within the "integration" of left brained (analytical) function and right brain (artistic) function, and the advent of the prominence of literature lead to an overdevelopment of the left brained activity. The movie also spoke of the interconnected nature of existence, and how science has divided and separated everything into disciplines which has made things problematic.

I walked away feeling that my own theories have at least to some degree been echoed in one film maker and one neurosurgeons projection of their minds, or at least my interpretation of it.

After the movie I had some very open-minded conversations with the folk who attended this www.wakeupsydney.com.au event, including a group of people with other diverse backgrounds whom I discussed impressions of the move with afterwards. We all seem impressed by the movie but had different reflections. One lady whom I talked to, with kids of her own, commented that she liked the movie, but also wished that it impressed "more" that the internet and social media revolution may be decieving us by leading us to feel connected on the surface, but really lacking the depth of connection that we once had when face to face was the main way that we interacted.

This film doesn’t really provide answers to the questions of today, as Jono Fisher, the organizer and founder of ‘Wake up Sydney’ events suggested, but it certainly does provide valuable perspectives and a platform for discussion which was encouraged by the twitter hashtags #connectedthemovie and the facebook page (‪http://www.facebook.com/connectedthefilm ) suggests. I think it is a necessary and interesting discussion.

I believe the concepts in this movie affect all of us no matter which field we work, and especially for those of us in education, healthcare and academia, because it is all about how we use our mind, how we process and share information, and how communicate with one another. However, at a deeper level perhaps it provided us with a potential view of some of the tools of how we can tackle solving the problems of todays world, and on a more sober note, how this challenge is something that we can no longer ignore.

I just read a great post by a medical student on their blog called "Drinking from the fire hose" talking about some strategies to improve teaching in medical students which prompted the following reply from myself. This post was in itself a response to a post on Kevin MD.com's blog about "Reward or punishment in medical training" (another good read).

Here's my response - Thanks for raising four great strategies for good teaching  

1. know your audience,

2.  Give real-time specific feedback,

3. Adopt a beginners mindset, and

4. Take time to teach,

I particularly liked the third point;

"3. Adopt a beginner’s mindset when teaching. Lead your learners down your thought process, from beginning to end. Teach your students how to THINK, instead of trying to transfer knowledge to them (the internet is better and bigger than you are)."

The beginners mindset is spoken about a lot in Yoga philosophy and I quite like it. In the game of education, we all started from a point from where we "didn't know", and moved to a point where we "kind of know" - and this process was called learning. I think the process of learning and discovery is really fun, but unfortunately under the scrutiny of poor feedback techniques (which essentially is the same as saying "poor communication techniques") that potentially pleasant experience can become painful (and often does in many peoples experience in medicine). 

Speaking as an educator I couldn't agree more with the notion that one should "adopt a beginner's mindset" as this is a great strategy. I also like your comment about "leading learners down your thought processes" as I think this is an essential step which is often missed in clinical education, particularly because of time pressure. However,  I believe the purpose of this is not to "teach your students how to THINK", but rather to show them how "YOU" THINK and let them decide for themselves of how they can either accept or reject that strategy for themselves in figuring out how "they" will think - either way having presented yourself as the model it can give them a framework for learning how to learn for themselves.  Anyway that's just my two cents! 

Great pos & good luck with your training!

Cheers 

Bish :)

http://lifeinthefastlane.com/2011/06/alternative-emergency-medicine-training/

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Click here to download:

sculptures-in-the-sand-aGwJJrEolGttnFBnqtjE.zip (2.32 MB)

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p109.mov (1.47 MB)

Here are some pictures of us creating sculptures in the sand last Sunday!

This was a perfect relaxing end to a stressful weekend, and it was so wonderful to be able to stroll down to Bondi beach for a swim with Sanna and Happy. Finishing the day with some creativity was just what was needed!

This is how it happened;- the three of us first randomly drew in the sand after our swim and some impromptu beach Yoga. I drew a heart, Sanna drew a dolphin, and Happy made a giant "peace sign" that encompassed both our drawings (but unfortunately it went right through Sanna's dolphin -Oops! But fear not this potential tragedy created an opportunity further down the line...read on and find out what happened!)

We were already content with out two dimensional images, but then suddenly, as if by magic, we were driven to carve up the sand around the images to make them enter into the third dimension! These once lifeless symbols began to take on a new form, with a sense of life and vitality injected into their core!

Whilst we were carving some people would stop and watch us as they walked along the beach. Everyone was quite interested in what we were doing, and some even looked at us as if we knew what we were professionals (little did they know that this was the first time I'd done anything like this in my life - how ironic!)

What touched me the most was the fact that all the little kids were so fascinated by these 3D drawings in the sand. Honestly, I never imagined that they would be such a point of interaction!

We would say "so what do you think this one is?" - and a delighted little one would say "er.. I think...it's a Love heart!?" looking at the image of the heart. Or when we pointer to the sunflower "it's a flower!" to which we would reply "that's good! It is! Do you know what kind of flower it is?".

We also asked the interested children whether they would like to join us in the carving process but most were non committal - and perhaps justifiably so. After all sand sculpting appeared to be an onerous and slow task (much like data analysis- little did they know what I have been doing with my time of late!).

However, breaking the popular trend, was one 8 year old girl who came back to us, after her sea bath, and started carving out the third drawing without any encouragement!

Prior to her arrival it was clear that this image had been unfairely left out. It was bad enough that it had been dissected in half (in the name of a peace symbol) but our subsequent lack of attention in the sculpting stakes, gave the impression that it was playing second fiddle to both the heart and the sunflower! Lucky for the dolphin there was this talented young girl who diligently and gracefully resuscitated life back into its yet undiscovered form. Bravo to the creativity of Children! She'd managed to create a masterpiece by the time she was being called to go home, and better still - she agreed to pose in front of her artwork right before the sea would take it back to it's point of origin!

So there you have it - "sand sculpting on the beach" - it was such fun and I fully recommend it next time you head to the beach!

PS - If you like sand sculptures - also check out this short film which makes amazing use of the beach for motion picture art!

I just heard a fascinating podcast interview Ellen Langer on conducted by Kelly Howell. 

http://www.brainsync.com/podcasts/search-podcasts/podcasts-by-date/365.html

Ellen is a social psychologist and Harvard professor who conducted a groundbreaking research project called "counter-clockwise". Her study was initially carried out over a decade ago on an elderly population, and it showed the power and potential for our perspectives and beliefs to have a positive impact on our health. This research led Ellen to a life of focussed on unlocking the potential of consciousness, and a career dedicated to 'Mindful health and the power of possibility'.

The counter clockwise study found that in a group of 80 year olds there was an observation of increased health occuring in those who expected to be healthy over just a week-long period, when compared to those who held on to their usual beliefs and expectations about their own health. 

This podcast is an easy listen and well worth the investigation as Ellen's research findings not only have the benefits that could help you encourage a healthier attitude in your loved ones who are getting older, but there's something there for anyone of any age!

After listening to this talk I wanted to  check out Ellen's website (www.ellenlanger.com) where apparently the first chapter of the book  "counter clockwise"  is available to read!

Excerpt about Ellen from the website

"…her pioneering work revealed the profound effects of increasing mindful behavior…and offers new hope to millions whose problems were previously seen as unalterable and inevitable. Ellen Langer has demonstrated repeatedly how our limits are of our own making."

Perhaps this is an important new dimension of health care research? So as researcher and doctor, "I" would love to hear what "your" thoughts about the findings described in this podcast.

How you feel these concepts apply or don't apply to your life, or your family members lives or your patients lives? (if you are involved in the treating of or healing of patients)

I look forward to reading your comments (please don't be shy!). Happy reading!

Peace out.

Bishan :)

I was recently given the opportunity to write recommendations of up to 5 books that I could recommend for a book review section in a popular emergency medicine website that I occasionally write for (Life in the fast lane). 

1) Medicine and Compassion: A Tibetan Lama's Guidance for Caregivers

Chokyi Nyima Rinpoche (Author), M.D. David R. Shlim (Contributor)

http://www.amazon.com/Medicine-Compassion-Tibetan-Guidance-Caregivers/dp/0861714784

http://www.medicineandcompassion.com/

This is a great book gives practical methods of how to cultivate "compassion" and find our inner beauty so that we can deliver better care to our patients and each other. Compassion is a quality that is easily lost under the stresses and time limitations of modern medicine, but with the logical strategies given in this book perhaps we can all improve this situation? The co-author Dr David R Shlim, is an ex-emergency doctor who gave up the pressures of emergency medicine in the US to work in Nepal in travel medicine. He set up a travel medicine clinic in Kathmandu and there started treating the Tibetan Buddhist monks who 'taught' him how to be a more compassionate doctor, something that he previously thought that maybe was something you either were or weren't born with. One such learned monk was Chokyi Nyima Rinpoche, a Tibetan Lama, who was encouraged by Shlim to share his wisdom and insight with a greater audience through this book. 

The preface goes spells out "The book is timely, as it presents an antidote to the current climate in medicine that is dominated by high technology, and an increased intrusion in medical care by financial considerations."

The book starts with a line that perhaps many of us can relate to, "medicine and compassion - I don't think I ever heard those words spoken together in medical school" and goes on to be a simply written, enjoyable and inspiring read!

(I believe this is a "must read" for all doctors!!)

2) Playing God - Poems about medicine,  

Glenn Colquhoun (Author) 2007

http://www.amazon.co.uk/Playing-God-Poems-About-Medicine/dp/1905140169

Glenn nicely describes some every day events from the world of medicine, and highlights their humanity through the wonderful medium of poetry with this collection of poems. 

As one reader said who gave this book 5 stars;- "It was a long time between poetry reading when I read this book. This made me remember why poetry is so wonderful, good for the soul. This is my favourite NZ poet and anybody who has ever had a loved one fall ill, who has been ill themselves or just who feels compassion will enjoy these poems."

http://www.goodreads.com/book/show/884441.Playing_God

I remember meeting Glenn back in 2002 when I was about to embark on my first registrar term, which happened to be a rigorous 6 month rotation in Intensive Care medicine at Waikato Hospital, New Zealand, and at that time Glenn was a GP from a remote area had just finished the same 6 months. On that day I remember seeing Glenn at the ward round table and after handing over his overnight patients after completing his last night shift for the term he gave us, a group of scared newbies registrars about to embark on one of the most challenging (but rewarding) ICU terms in the country, some useful encouragement which I remember to this day. 

He told us that no matter how scary the situation there was always guidance in this job, which turned out to be true, and when ever you felt most alone and out of your depth he always heard a voice, almost like the voice of God telling him what to do (only to realise later that this voice was none other than the deep South African accent of John Torrance, or perhaps one of the other Intensivist bosses, telling you to what to do through the department mobile phone!). There was so much humility, humor and wisdom in what he said I really wanted to check out his writings later on when I heard that there was a poetry book published by him, and certainly his writing conveys the same grace that he had in person!

(This is a good book for doctor poets!)

3) Textbook of Emergency Medicine - Vol. 1 & 2 , 

David, Brown, Nelson, Banerjee, Anantharaman, et al., (Authors)

Wolters Kluwer Health (Lippincott, Williams and Wilkins),Delhi, India 2012

http://www.emergencymedicine.in/current/news.php?readmore=121

This is an Emergency Medicine compendium and the first desk reference reference of it's kind that was developed and published in Asia. 

Word from the Chief Editor, Dr Suresh David, "Most of our emergency medicine textbooks come from the USA. From an EM academic standpoint the world is divided into the West and the East. We are currently modifying and adapting from the West. So we created a book predominantly for the Eastern hemisphere. This book is a One-Stop-Shop for EM students, EMS personnel, EM postgraduates and ED administrators. He also said that the literature came from authors who were experts in their field. For example, the chapter on Diving Medicine was written by David Greene who is an Ex-Navy SEAL. The chapters on Frostbite and High Altitude Illness were written by Ken Zafren who has experience from Alaska and Himalayas. 

Dr. Judith Tintinalli, in the foreword, mentioned that this textbook matches practices to the resources and cultures of the region, and makes clear that EM is a tangible specialty in India and South-East Asia"

I think this book is would be a useful desk reference for anyone wanting to practice International Emergency Medicine in Asia, and in particular work or teach in the Indian subcontinent!

(By the way I wrote the chapter on treatment of anti cholinesterase poisoning with my supervisor, who is actually world expert on the topic, which is how I know about this book - so I just thought I'd declare that conflict of interest with this recommendation!) 

4) Healthy Thinking: How to Turn Life’s Lemons into Lemonade

Dr Tom Mulholland  

http://www.theattitudedoctor.com/book.htm

"Dr Tom is an irrepressable enthusiast. His career has included being a Doctor, Pilot and Entrepreneur. He has been been a NZ Forest Service Forester, won a First Class Honours degree in Molecular biology and Graduated as a Medical Doctor from the University of Otago. Inspite of his impressive CV Dr Tom learned through personal experience that life sometimes serves us lemons when he lost control of his internet business and his marriage faltered.He writes about how to turn life's lemons into lemonade as he has. His book has become a bestseller and his and personal speaking engagements for individuals and businesses make him one of the most in-demand motivators in Australasia. He now now also has his own television show Dr Tom - The Attitude Doctor." - take from an internet book review (link above)

(I have only read sections of this book, but what I read was fantastic! Also my mum is a great fan of his books and her recommendations are worth their weight in gold, which why i included it in the list. I'm definitely going to get my own copy after writing this review and read the book fully mysefl!) 

This is a very interesting article I found on "KevinMD.com" which is about a Neurosurgeon, Duane Gainsburg MD, in the US who moved to locuming to create a better work life balance.

"Stress and burnout are often lumped together, but they are distinct processes. Unlike stress which is associated with over engagement, burnout is characterized by disengagement, blunted emotions, depression, exhaustion which affects motivation and drive, and demoralization. Stress produces a sense of urgency and hyperactivity, while burnout produces a sense of helplessness and hopelessness."

"In private practice, I had the pervading sense that because of all the distractions and competing agendas I wasn’t able to deliver the best care I was capable of.  There was an underlying layer of guilt, and of missed professional opportunity."

"Now, I’m paid for the time spent taking care of folks, rather than for how much I can bill for this or that procedure. It’s a four-way win – families benefit from improved relationships with their doctor; I benefit professionally from the satisfaction of providing excellent care no matter how long it takes; the hospital benefits by providing continuity of care and consistent coverage, and I benefit financially by the time I spend in direct patient contact, whether in the operating room, emergency room, intensive care unit, etc."

I am meditating 

I am thinking 

I am thinking that I am thinking 

I must try and concentrate 

I must be aware that I am concentrating 

Too much "I", how about non-self?

Must not try too hard to stop my mind wandering

Try and observe myself as an outsider

my foot is itching

my nose is itching

Did I switch off the gas cooker

must load the dishwasher

I must attend to that noise in the car

Is that the neighbour's dog barking

We used to have a dog

I prefer dogs to cats

My back is hurting

Must focus my attention on my back

I shouldn't have been rude over the phone

He did ask for it!

But being kind is better

So many nuisance calls

What am I doing next week

Will it hurt when I visit the dentist

He is a nice man

Lovely receptionist

Must write that letter

Look at the emails first

So much spam mails these days

Am I spending too much time on the Net

Another week has gone

Stop!

think of the present moment

observe the present moment

How much longer will I live

Must not waste that time

Use the present moment

Past is gone, future yet to come

Wonder what's on Telly

Is Tiger Woods playing

Looks like he is making a comeback

My swing needs attention

Hope I can play next week

It is very cold and frosty

Stop!

There we go again!

Back to meditation

I am aware and focused

It is so hard to keep the mind still

Flitting butterflies

Changing clouds

Changing moods

My knee is hurting 

Must straighten my leg

Will I ever succeed in meditation

What is the real reason why I want to meditate

Let it go says Ajahn Brahm

I like his talks

May be I should go to Perth to meet him

The live broadcasts from Perth are very good

My hips are hurting

Will my joints get worse

Will I lose my independence

Am I a Buddhist because I was born one

Jesus must have been a very good person

I am feeling hungry

Must not eat too many crisps

I feel like drinking some fruit juice

must eat  more vegetables

write a reminder for repeat prescription

Good thing I am retired

Wonder how my friends are

Stop!

back to meditation

This is not easy!

must be aware that I am meditating

must not try too hard

I am thinking

I am thinking  that I am thinking

I am aware that I am thinking that I am thinking

Poem by Mahendra Gonsalkorale.

This was a poem that was sent to me by my Dad's university buddy whom I call "Uncle Mahenra". Uncle Mahendra sent this poem to me recently in repsonse to one of my poems and I really liked it. For one, it really captures the essessnce of the struggle one encounters with sitting meditation, and I think his candid and honest description really opens the doors of "inclusivity" to those who have never tried to meditate before as well as those who have tried but finish a sitting feeling like they have failed dismally. I wrote back to Mahendra and said something to the effect as "to sit is enough" and I think it really is! I've been meditating for years and I frequently feel this way - but I guess the main thing that "experience" gives me (sometimes) is the wisdom to know that it's okay if the mind wanders when one is meditating, and it is good if one is aware of this wandering - which the writer of the poem clearly is, albeit after the fact. 

So well done for your sitting Uncle Mahendra and thanks for sharing your insights with us!

The second reason I particularly like this poem is that there is reference to Ajahn Brahm who is an inspirational Buddhist Monk who lives in Perth and quite an amazing meditation instructor. I was fortunate enought to meet him last year on my birthday (when I was working a locum in Rockingham) and we had quite an interesting chat which I wanted to write a blog article on. I never got around to it but hopefully one day soon, during one of my study breaks, I will write this, as he offered me some great insights about the use of love in practicing medicine, which I would love to share!