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review 2017-07-13 04:58
Reaping Havoc (Reaping Havoc #1) by A.J. Rose
Reaping Havoc - AJ Rose

Too many words in this one. I was skimming like no-ones business!

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review 2017-05-01 01:23
Star Surgeon by James White
Star Surgeon - James White

Star Surgeon starts off with Conway treating an alien of a sort he’s never seen or heard of before. It turns out that his newest patient’s species is seen as somewhat godlike by those aliens that know of them. They’re purported to be immortal, and they have a habit of gradually making themselves the supreme ruler of a world, solving its problems (I was left with so many questions), and then leaving. They are always accompanied by a companion of a different species.

Conway’s efforts to treat his patient, Lonvellin, impress it so much that it later insists he help it and the Monitor Corps with a problem it’s having on the planet Etla, which is part of a larger Empire made up of several planets. Etla used to have a thriving population before it was hit by one horrible illness after another. To make matters worse, Etla’s natives are deeply suspicious of beings that look different from them, so they refuse to accept help from anyone except the Empire’s Imperial Representative, who rarely stops by. Earth humans and Etlans just happen to look very much alike, so Conway and the Monitor Corpsmen are able to sneak in, assess the situation, and try to help. Unfortunately, the situation is much worse than anyone realizes and deteriorates to such a degree that Sector General finds itself caught up in an interstellar war.

I think this is my second full-length Sector General novel, although I’ve read a bunch of Sector General short stories. So far it looks like one of the nice things about the full-length novels is that they gave the author the time and space to show readers things that weren’t directly related to solving medical mysteries. Star Surgeon shows readers one of Sector General’s recreational areas (as Conway tries to convince Murchison to take their relationship from “friends, sort of” to “dating and maybe even having sex”), and I learned that there are apparently 218 human (or at least DBDG) women at Sector General, not that we ever learn the names of any of them besides Murchison.

Unfortunately, Star Surgeon turned out to be less focused on medical mysteries and more of a war book. Lonvellin’s medical issues were dealt with fairly quickly, and Etla’s problems were revealed to be less medical and more political (and absolutely horrifying). That left the interstellar war, with Sector General at its heart.

This book’s tone and message reminded me strongly of the story “Accident,” available in the Sector General omnibus Alien Emergencies. The specifics of how Sector General was evacuated were fascinating - in addition to concerns about moving sick or injured patients, every species’ general physical needs (gravity, atmosphere, temperature, and more) also had to be taken into account.

Unfortunately, Sector General’s evacuation and the events that happened afterward were also a bit emotionally draining. Sector General was intended to be a hospital capable of catering to any and every alien species. The evacuation and Sector General’s transformation into “what amounted to a heavily armed military base” (104) were both painful.

Once again, I can’t help but wonder about the economics of the Sector General universe. Money still seems to exist and be necessary, because it took great gobs of money to build Sector General in the first place. The damage Sector General sustained during the battle and the hospital’s evacuation and repurposing should probably have financially wrecked it. And yet it apparently recovered just fine, because there are many Sector General stories and books that come after this one.

As much as I like the idea behind the Sector General series, the books and stories have several recurring problems. One of those problems kept rearing its ugly head in Star Surgeon: sexism. Since the series is usually careful not to assign a gender to any of its aliens, except in one instance where a particular alien species cycles through genders during the course of its life, that means that most of the more blatant sexism involves Murchison, the series’ only named human woman (that I know of).

If Murchison ever appeared on-page without some mention of her appealing physical form or features, it was rare. Also, just like in Star Healer, Murchison requested to be allowed to use an educator tape, only to be shot down by O’Mara.

“‘As for the girls [he means the nurses],’ [O’Mara] went on, a sardonic edge in his voice, ‘you have noticed by this time that the female Earth-human DBDG has a rather peculiar mind. One of its peculiarities is a deep, sex-based mental fastidiousness. No matter what they say they will not, repeat not, allow alien beings to apparently take over their pretty little brains. If such should happen, severe mental damage would result.’”  (132)

And then there was this, said by Murchison to Conway:

“‘I...I asked him to give me [an educator tape], earlier, to help you out. But he said no because…’ She hesitated, and looked away. ‘...because he said girls are very choosey who they let take possession of them. Their minds, I mean…’” (141)

Am I the only one who thinks that explanation sounds uncomfortably sexual? At any rate, while I’m thankful that at least one Sector General fix fic exists, it doesn’t stop the burst of anger I feel whenever I come across things like this in the original books and stories.

Well, even though I hate the series’ sexism, I love its “doctors in space” focus. Unfortunately, this particular book was grimmer and had less in the way of medical mysteries than I preferred. It wasn’t a bad entry in the series, but it wasn’t quite what I was hoping for when I started reading.

 

(Original review posted on A Library Girl's Familiar Diversions.)

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text 2017-03-20 03:25
Emergency overhaul for Mount Gambier Hospital after review sparks major concerns

 

Country Health SA will invest $536,000 into a major overhaul of Mount Gambier Hospital's emergency department following an extensive review into the regional South Australian hospital.

 

The review, conducted in late 2016, was in response to concerns surrounding patient safety and inadequate emergency department staffing levels raised by hospital staff and the public.

 

Australia's former Chief Medical Officer, Professor Chris Baggoley, and Critical Care Nursing Director, Mr Andrew McGill led the review, the findings of which were released on Wednesday and communicated to staff.

 

The review cites reliance on locum employees, the experience level of staff and a lack of medical leadership as key issues facing the facilities emergency department.

 

Among the 22 recommendations were to appoint a new emergency department director, to review and restructure recruitment processes for junior registered medical officers (RMOs) and the introduction of an electronic patient tracking system in the emergency department.

 

Country Health SA Chief Executive Officer Maree Geraghty said Country Health SA had accepted the review's 22 recommendations and was in the process of working through the timeframes for their implementation.

 

"Implementing all of the recommendations will take some time, but as each one is completed it will strengthen the high quality of services we provide to the local community," Ms Geraghty said.

 

The review also recommended the appointment of additional staff, including a triage nurse, emergency department nurse educator, two medical registrars and a paediatric registrar.

 

Despite the report finding the performance of the emergency department has been declining since 2013, Ms Geraghty believes the department still meets high performance standards.

 

"We're really not far off at all. I think Mount Gambier continues to nearly meet all of key performance measures in terms of the delivery of care.

 

"I think the senior team is now working very closely together, both from a senior management team and the senior clinicians in the emergency department.

 

Former emergency department Director Dr Trevor Burchall, who left the role after the review, told reviewers he found it 'increasingly difficult to provide clinical leadership' and was concerned he was unable to find time to teach within the emergency department, particularly during the last year.

 

More patients through emergency department

 

Patient flow through the emergency department, which was overhauled as part of a $27 million redevelopment in 2014, also came under the microscope.

 

Reviewers observed no clear bed management procedure was in place to support the 24-7 flow of patients and said the absence of an electronic patient tracking system 'significantly impacts work flow and patient care'.

 

Also recommended was a review into admission procedures into the emergency department in relation to rising numbers presenting to the emergency department.

 

The number of people seeking treatment at the hospital's emergency department had increased by more than 22 per cent since 2012-13, with nearly 20,000 people presenting to the department in 2015-16.

 

Response to recommendations mixed

 

The Australian Nursing and Midwifery Federation (ANMF) called Country Health SA's response 'grossly inadequate', saying the timeline of implementation was vague and uncertain for staff.

 

"We are deeply concerned by the response of CHSA when they say things such as that they will give further consideration to nurse practitioner staffing in six months’ time, given that this issue has been the source of contention for several years," ANMF Director of Operations and Strategy, Rob Bonner said.

 

"The time for action, as acknowledged by the reviewers in their recommendations, is now."

 

Mr Bonner said the union had not been advised of the recommendations in advance of their release and staff at the facility were only informed of the review conclusions on Wednesday.

 

Nursing staff interviewed by the reviewers reported a number of issues, saying patient assessment was suffering, they could not access regular in-house education and triage nurses should be additional to base staffing levels.

 

Mr Bonner said the union would be seeking further assurances and specific detail on the recommended measures and would meet with members at the hospital in coming weeks.

 

"We need to work through how we support the staff through that change process at the hospital," Mr Bonner said.

 

Local MP Troy Bell welcomes funding

 

Member for Mount Gambier Troy Bell said he was initially concerned about the review being independent, but both reviewers had come highly recommended.

 

"It's really not an independent review when someone from the department does the review," he said.

 

"The correct term, I would say, is a departmental review."

 

Mr Bell said the increase in funding for staffing levels was welcome news.

 

"To me, it validates the raising of these concerns and that clearly, there have been issues regarding understaffing and supervision, which is what people on the front line were coming into my office and telling me."

 

He said it was too early to tell whether the recommendations would address all the concerns raised, and said he would like to address 'bottlenecks' at the emergency department.

 

"It is reported to me the amount of people who go to the emergency department because it is a free service that are better suited going to see their local GP."

 

"There are free services without going to the emergency department."

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review 2017-03-19 12:38
Sometimes it's hard to be a doctor
Didn't Get Frazzled - David Z. Hirsch

I’m reviewing this book on behalf of Rosie’s Book Review Team and thank the author and Rosie for the ARC copy of the book that I voluntarily chose to review.

I’m a doctor and I must admit this book brought many memories for me (although I studied Medicine almost ten years earlier than the character Seth in the book and in Barcelona, Spain, where the system of medical training is slightly different to the one in the US that’s portrayed in the book): the shared experiences (some pleasant, some not so much), the trials, the discoveries, the surprises, the stress, the uncertainty… I’m sure anybody who’s studied and/or worked in a health-related field will be able to identify with much of the books’ content, especially the struggle between the need to offer the best care and the reality of what is available and how specific services work. Not all patients are patient, not all colleagues are helpful, and no matter how hard we try, things don’t always work out.

The story is told in the first person from the point of view of Seth, who has always wanted to be a doctor and manages to get into Medical School in New York. His long-term girlfriend, April, goes with him, and they hope that being together will help them both survive the experience, but that proves not to the case. Trying to juggle the pressures of Medical School (that with the regular schedule, on-calls and studying leave little time for personal life, especially if the significant other is not another medical student) and a relationship that is changing proves complicated, and when the relationship ends, Seth finds it difficult to move on. Whilst Seth, the medical student, is usually successful at navigating the intricacies of his training, acquiring knowledge, and trying to deal with both patients and staff, Seth, the man, has more difficulty managing his emotions. He relies on his friends, explores relationships (some that confuse matters even more) and by the end, might have found somebody new. When one of his trainers says of him that he doesn’t get frazzled, he decides to adopt it as his motto, and he manages to live up to it, at least in appearance, most of the time. But he has moments when things get too much for him and then his coping mechanisms are not always the best. He goes above and beyond his duty for the patients and we’re sure he’ll make a good doctor, but he’s far from perfect and only a human being, after all. We see him interact with some of this friends too, most of them medical students as well, and that offers us different perspectives on the effect the training has and on how it affects people’s lives. It also allows us to see him in a more relaxed environment and get a better sense of what kind of person Seth is.

The plot, such as it is, is the process of transformation of a somewhat naïve student into a doctor, more or less ready to face professional life and it follows the chronology of his studies, from first year eager student to an experienced third year who’s teaching others. There are amusing (although some readers might find some of them gross) episodes, some to do with medical school and others with everyday life (cockroaches and mice included). There are also some sad and touching moments and some inspiring and reflective observations. At a time when medical care and its provision is a matter of much debate, this book, that illustrates the experience from the perspective of those directly engaged in providing it, can help personalise the issue and return the focus where it should be, patients and the caring professionals. As I am a doctor, I’m not in the best position to comment how much of the material might be too specialised and medically-based for the general readership to enjoy. A fair amount of the book consists of following medical students through training, be it studying anatomy, attending post-mortem examinations, going through a very special gynaecological examination training, and also descriptions of cases they have to treat (many among the less privileged echelons of society). Due to this, I would not recommend this book to readers who don’t enjoy books with a medical background, and in my opinion, it is more detailed than what is usually found in TV medical series or some fiction such as medical mysteries.

This is a well-written book that gives a very good idea of what life as a medical student in the US is (or at least was in the 1990s). The characters and the anecdotes have a realistic feel and it will be particularly appreciated by those in the health professions or considering them as an option.  Readers who enjoy medical fiction would gain a better understanding of the realities behind the fiction by reading this book. Not recommended for people who are squeamish but it will be an inspiring read for many.

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