Thursday

7 am meeting with the working ophthal people (as opposed to the researchers) was a joint meeting with radiology and pathology to discuss difficult to diagnose cases. Things that cropped up were an MS presentation, rare tumours, Wegener's granulomatosis, that sort of thing.

After that, it was off to observe an ectropion repair, and have it explained really well by the professor/consultant in a one to one setting for about an hour, while his reg's did the operation. It was actually really good and interesting teaching - lots of diagrams, and relating it to what was happening in the operation as and when. Although I imagine this only sounds interesting to medically oriented people, I can assure that this was very good. You don't get that kind of teaching opportunity very often in medschool - to be a professor's sole focus of teaching attention for an hour.

We then chatted about the different healthcare systems, because I was interested in how Australia's works. Basically, it's complicated, and I'm not sure I understood all of it correctly, so take the following with a pinch of salt.

At the State level, there's NHS-style public healthcare that's free and open to all, but massively under-funded and has long waiting lists (no surprises there). It was originally designed to treat those who couldn't afford private healthcare (they intended for a tier system of healthcare? I dunno), but naturally has taken all comers. This actually runs parallel to a private system that's backed by the Federal government, for which people pay for bits of, and then need health insurance to cover the bulk of the costs, but are treated by consultants and have basically zero waiting (again, similar to UK).

It might sound similar to the UK, because it is, in a way. We have the overworked, public hospital behemoth of bureaucracy that is the NHS dealing with most cases, and then we also have a small private sector and health insurance availability for those that want it. But in Australia the Federal gov't really backs the private system all the way, and you've got State governments trying to support their NHS equivalent without the funding that the Federal gov't can muster. In the UK it's traditionally the gov't supporting the NHS that gets them the votes (whether or not they live up to those promises of support).

Apparently the Federal gov't "incentivises" the wealthier population to get health insurance, by offering those earning above a certain amount per year a tax break if they have it (the idea being that at the other end of the scale, they aren't taxed as much and can't afford insurance?). This actually sounds rather good to me - incentivise the wealthy to stop getting freebies from an overworked public system that was originally designed to only treat those who couldn't afford to pay, and at the same time it makes the wealthy feel like they aren't paying for other people to mooch off their hard-earned dollars. It's like offering cheaper health insurance. I don't know how successful that ploy is.

I have a long ramble saved now, debating the ethics and my viewpoint behind this and the NHS and healthcare provision in general. I may publish it another day, when I have another think about it and edit it lots. I don't it to be inflammatory to people, and I know what I'm like when in the middle of a debate (even with myself) and things can get a bit exaggerated and extreme as arguments are followed to logical conclusions. I also tend to be quite tangential at times. It'll be more of an open question, as I feel like I'm missing a point somewhere in my feelings on the subject. I haven't done much in the way of journal or paper reading on the topic either, so it's likely 'uneducated' from that angle.

Anyway, that was interesting. Then it was wondering around the area outside of the hospital a bit to find some lunch - there's an entire high street nearby that seems to have sprung up purely to service hospital patients and staff during their breaks. It's all food places and same-day dry cleaning and opticians (and a pathology lab for some reason).

More project work in the afternoon. Had a desperate need for fruit today, so bought some bananas on the way home.

Results tomorrow. Terrifying prospect. It's constantly filling me with dread at one moment, with thoughts of failure, to elation the next moment with thoughts of "what if I pass?" 

I will likely be a gibbering wreck in either scenario.