Sitting in the corner of the meeting room, an off-call consultant's eyelids fall. The night registrar talks animatedly and the day team joke. The consultant's patients have been discussed and his coffee hasn't kicked in. The bounce of his chin rouses him

The round passes through a medical ward; eyes look up, eyes dart around. The octogenerian's glassed, cloudy eyes search for focus, and find wanting. The narc'd lady next door sleeps soundly, eyes rolling in an opiate fog.

In clinic, eyes have fear. Why can't my GP handle this. Or eyes of frustration, "You made me wait an hour to tell me you can't work out what's wrong

In corridors, more tired eyes. Interns, fresh faced aside from the bags, snake some biscuits from the tea-trolley between patients. Jaded admin look daggers through bloodshot Monday-itis

On the kids' ward, the eyes are bright, glossy, new. Eyes working hard to focus for the first time. Others closed tight in sleep.

The labouring mother, too, has tired eyes. Drunk on birth and hormones, sapped of energy. She battles not her lids between contractions; her sweated brow furrows for another wave. Eyes roll as she dozes.

"Anxious", say the father's eyes. He sees and feels pain; and pain is seen in him

His eyes change, her eyes change too. They see new eyes, bright, lustrous, screaming eyes. They see love.

Through tired, happy eyes.

Yesterday, I had my butt kicked by a consultant. In front of three junior doctors, it was explained curtly, ruthlessly that the way I'd charted a history from a clinic patient was woeful and inadequate.

The intern had quietly copped a similar treatment not five minutes earlier, at the same time as presenting his case; the experience was cringe-inducing, despite the intern's grace.

The consultant is quite forthright and particular; each patient's history must be documented just so in certain and exact language. I'd managed to take sufficient history given the presenting complaint, but my written order of information was, well, not up to scratch.

Ironically, my thinking and subsequent questioning were much more clear than in similar settings last year; I know why I'm asking what I'm asking as lists of differentials begin to form on my mind's slate. The last step, communicating in clearly to the consultant via written form, is not a foreign language; I just seem to smudge some of the punctuation marks.

According to at least one professor, shame and fear are the cornerstones of medical education. Neither of these emotions were particularly strong during my semi-public ass-kicking. The experience made me more determined.

I'm not in love with gynaecology, nor am I particularly enamoured with this consultant. Sure as anything, I'll go back to their next clinic. I'll take a history, write it up, and probably get whipped again. I'll do it because it will make me better.

Today I was again reminded how nonsensical some OTC combination products are. The thought was sparked by a prescription I received for Hydrozole(R). It's a non-PBS item and can be Pharmacist prescribed. Hydrozole is one of those annoying combination products; hydrocortisone 1% w/w and clotrimazole 1% w/w. According to television advertisements, of which there are many, it's apparently good for sensitive, inflamed skin conditions. I think it's crap, and most texts agree.

You see, if indeed the problem is a fungal infection then treatment, with an azole antifungal is required for 14 days after the lesion resolves (AMH, 2010). Moreover, if the 'rash' is eczematous and a steroid indicated, then a "5 days on, 2 days off" regimen is the usual treatment. Now, it's quite likely that an inflamed fungal infection occurs. And here's the kicker; at every pharmacy I work at, you can get both a steroid cream and an antifungal cream together for less than you pay for hydrozole.

What I suspect happens is that a prescriber is asked about a 'rash', and odds are, it's one of the two. Instead of suggesting the patient purchase one or t'other, they cover their bases and bow to he pressures of 6-minute medicine by writing a 'script; the prescriber's seen the TV adverts, too. I'd be impressed if most prescribers knew the cost of antifungals or steroid creams; I suspect most would pick the combination cream as less expensive. This presents an interesting challenge for those patients who "Just want what's on the prescription."

In short, hydrozole is a medicine that survives on its media profile. It's not appropriate for a simple fungal infection, excessive for an eczematous-type rash and cannot be used to treat anything for the appropriate time. Pretty much, there's no good reason to use Hydrozole(r) and even less reason to prescribe it.

So, it's now the end of my second week of O&G. Despite a holiday on Australia Day, I'm exhausted. One overriding impression I've gained so far, is that there's a great mix of ways to have baby.

I'm not talking about positions, methods or even situations; I'm talking about philosophies. For some, having a baby is about walking a certain path, with or without certain inputs or stimuli. Others simply want a healthy baby at the end, no matter the methods.

As with any philosophy, there are extremists; mothers-to-be with training in hypnobirthing and aromatics who refuse interventions or medical assistance even with triplets on board, or expectant mothers who at the twelve-week mark, plot out a date for an elective caesarian. In fact, I was getting a little frazzled by all the demands and requirements of O&G patients.

Then, as a patient was being admitted, I saw the most sensible thing I've seen all rotation. An answer to a question on the birthing plan;

It was right there, in the mum's handwriting; a raw, honest, pragmatic look at birthing. I think for many people, exerting such enormous amounts of control over the journey is to compensate for the uncertainties about the destination, both for first-time mums and multips. A healthy baby is indeed a wonderful thing.

For Christmas, Batman gave me a Rubix cube. In Dunedin my flatmate Sandy taught me how to do one, and I could remember a few of the steps, but solving it outright took some practice. After memorising the solving algorithm, I've been able to do it pretty quickly since early January. This week, I taught someone else how to do it; he's down to under 4 minutes.

Rubix cubes are one of those beautiful enigma puzzles. The average Joe suspects that the first step is to make one whole side and then loses their way. The cube when mixed up appears horrifyingly complex, yet once the method, the system, are locked away in the memory bank, it becomes a case of applying several steps of an algorithm.

Sometimes, it feels like this is the way medicine could be done. First, orientate the patient cube in the correct manner. Find the white side and ensure it faces up, and the yellow side faces down.

Step One; make the cross. Ensure you know what it is you're moving. Where you're moving it from and to, and in which order. Make a plan. After you think you've done the steps, check your work. Do the next step, the corners. Gather information, make a plan, action it, check the results.

This routine continues whilst all the steps are performed. And, in most cases, it'll work. The challenge comes in picking the cube that's had the stickers pulled off and put on in the wrong place, or the cube that can't turn in certain ways.

So, it's not really how medicine can be done at all. It's a good safe way for students to learn, to apply a system, to check results. It may not always be the quickest, but for most cubes, they'll face up just right.

But down the track, you don't want to be twisting for hours some poor cube whose stickers are just on wrong.

Five new things I've learned in the last twelve months;

1. Pharmacy isn't really at a crossroads. It just thinks it is, and has done for a good quarter of a century. In truth, the profession often struggles to define its true purpose, torn between finance, health, community and hospital. Within the profession, the best we can do is to pick our path and cop the flak that comes our way.
   
   
2. Failure is not fun. Although, it's a good learning experience, but certainly not something I'd want to experience too often.
   
   
3. Rural doctors are the true all rounders of medicine. The basics of General Practice, surgery, medicine, obstetrics and psychiatry are standards in their armoury. They are, in my experience, well rounded humans and excellent teachers. Best of all, they know when to ask for help.
   
   
4. The joy of 'returning' to competitive sport. I haven't played Grade Cricket since I was fifteen, and the feeling of standing in the field, appreciating a fine day in the fresh air, clouds wandering across the sky and physical exercise in healthy amounts is something I've gained new respect and appreciation for. The art of mastering orthodox spin bowling has provided an extra challenge.
   
   
5. Fabien Cancellara is awesome; this guy is one of the strongest cyclists on the planet, and boy, can he time trial. He's the Contre la Montre monster. In fact, this whole road cycling gig is a helluva lot of fun; you'll doubtless hear more about my cycling escapades into 2010; I even have an encore to the Razorback Challenge lined up.
   

Of course there are many more; it's back to Uni next week, whereupon medical anecdotes and insights will continue; first up, Obstetrics and Gynaecology.

It's not purely self-indulgent, either. The pair are raising money for The First Tee New Zealand charity; a crew that's about developing strong morals and ethics in young 'uns through golf.

The guys have, by themselves, mobilised their skills to create a wonderful marketing machine, and they're having a great time doing it. They're on facebook and at @puregolfchap, although I strongly suggest you check them out at puregolf2010.com