The Gunner knows the most. They want it the most. They're going to be first to the top.

There are two kinds of Gunners; the self-centered kind, who snipes his colleagues and brown-noses the consultant, who doesn't share notes or knowledge and never, ever gives tips to his colleagues. This Gunner won't stay late without reaping a rewards.

The other kind of Gunner is to be admired. This Gunner loves his work, his joie de vivre emanates throughout his interactions, conversations and study. He shares his knowledge, teaches his colleagues and encourages their zest for his passion. He lends a hand when the burden is great, thanklessly doing more than his share - he knows he does it easier than some others - his passion drives him.

He appreciates that his passion is not everyone's and is open-minded about the foibles and strengths of others. When it comes to his area of expertise, the Gunner knows. And, he knows when to ask for help.

The Gunner isn't yet at the top; that allows his charisma and determination to shine through. He's learning, so comprehensively, so passionately, so logically, so intensely. This Gunner knows his stuff.

This is the Gunner you want to treat your child.

In all the fuss of my first podcast and this week's Grand Rounds submission, I missed my second bloggiversary. As of Monday I've been at this for two years, and as graduation approaches I'm thinking more about how I want the blog to continue when the hospital system eats more of my time. At this stage I'd say it's more than likely to continue; I just can't resist a challenge!

Speaking of challenges, at the end of last year I knocked over the Razorback Challenge. Since then, I've been eyeing up my next physical endeavour. This May, I'm heading to Switzerland on a ten week Elective. And I'm taking my bicycle. The plan is to ride the Valle d'Aulps, a 164km ride with over 3600m climbing. A great opportunity, it looks to be a giant slogfest of altitude climbing, for which I'll need to spend many more hours in the saddle in the next few months.

I'll keep you updated as it unfolds. Importantly, it's a part of a larger challenge, one that extends beyond Medical School; I want to finish an Ironman Triathlon before I turn thirty.

So, in the next four three and a half years, I'll train towards swimming 3.8km, cycling 180km and running a marathon (42.2km) inside 17 hours. By the end of this year, I also plan to run a marathon. It's all about baby steps, starting this weekend with the Mooloolaba Triathlon; my first olympic distance tri.

Meantime, paediatric lectures are calling!

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The building had four stories. In a narrow street in Baoji, west of Xi'an, the damp shell of a structure housed backpackers on its top three floors. The dorms exuded marijuana, travel must and provided many visitors with a fresh case of athletes' foot or worse. The occupants sat, huddled in the subzero temperatures playing cards and sharing a bong, partly for warmth, partly just to negate the feelings of loneliness and despair Baoji seemed to extract from twenty-something global travelers. Of the twelve around the knee-high table, two wore everything they owned, another her sleeping bag on top of that. Little was said.

Downstairs was a bar and tattoo parlour. The bar was little more than a high counter hiding a half-dozen glasses and various bottles of Russian vodka and huaungjiu. Two locals sat sipping, smoking and spitting on the floor. A single bulb lit the room; more cellar than drinking house.

The tattoo parlour was silently alive. The master-tattooist had his client reclined on a massage table, a mural of ink flowing shoulder to shoulder. The scene depicted a man hunting on horseback with bow and arrow, birds of prey circled above and carp below. No prey was evident. The master-tattooist, using a bamboo cane with the client's name etched in the handle, delicately inked the area of focus, blotting the blood as he went.

Behind the massage table, an entire wall of bamboo needles sat expectantly. Each had the name of their target, smoothly, forcefully marked in the cane. Some had recent blood, dried and brown on the shaft. The tips had each been cleaned in tub of surgical spirit on the floor.

While the master-tattooist finished up a section of the mural, the woman chose her tattoo. When the time came, she sat calmly in the chair, and he went to work.

When I met her, she was concerned about her baby. At twenty weeks pregnant her newly-diagnosed Hepatitis was making things very scary; her eyes fearful above pale, yellow-hewn cheeks. This isn't my life, they said. Now a teacher, she'd traveled the world and was settled, all ready for white-picket fences, V8s and 2.4 children. This wasn't how pregnancy was supposed to be. Lovely, warm, new life. Not unveiling a life-changing illness. Not the chance of a very sick baby. None of that.

She showed me the culprit, the tattoo. The small Chinese character, no bigger than the head of a spoon.

"What does it mean?"

"Freedom."

The patient had a long history of Mersyndol usage. Years.

Today though, she had a prescription. It was for tramadol.

A note popped up on her file; "Advised patient needs a letter from their doctor before we will supply any further Mersyndol" with the usual pharmacist initials and date.

The tramadol 'script was dated the following day.

The pharmacist has only been registered a month. His wee note has given me fresh confidence in the new wave of grads.

That the patient not only listened to him but also took action just makes my heart sing.

It's exam week here, and those of us at The Coast have trekked to the Big Tertiary Hospital for clinical exams. There's a swish new building for students there, complete with a swanky common room and this wall of space-aged combination lockers. You can use them for five minutes or five months, if you want. Look at them, all patterned green and shiny and new.

Up at The Coast there's a single bay of ratty old lockers, maybe thirty in total. We even have to bring our own padlocks. At the Coast, the Clinical Coordinator puts your name on your locker.

That really speaks volumes about both Hospitals, and it's the reason I chose The Coast.

Saturday night, half an hour before closing up a hectically busy evening. We'd nearly sold out of Sharpz Kits and it seemed every asthmatic on The Coast was heading out clubbing for the number of inhalers being let loose.

Self-harm chills me. Ignoring the blood and flesh. The diminishing sensation of each nerve's tingling throb, fading to the feel of cotton sheet across shaven leg. It chills me.

In a quiet moment, the doors whirred and two girls came in, about eighteen. Both wore black cut-off t-shirts, plaid red mini-skirts, fishnets and raccoon eyes. The one with the large dressing on her arm begins to inspect the wound-dressing displays, and the other heads in my direction.

"Hey, um, we wanna get something to take out stitches and dress a cut. What can we use?"

I wandered over to the display, and casually asked a few questions. The 'cut' was about half a foot long, running down her arm elbow to wrist. It was bullet-pointed at each end by fine, linear scars running perpendicular to the newest laceration. The ragged edges, she perkily informed me, were because the knife had been blunter than expected. The on-duty Doc in the ED had stitched her up quite nicely and dressed the laceration.

There were already some finger-sized holes between the stitches; the iodine smeared in distinct, gloveless finger-prints. She and her friend wanted something to prevent infection. And remove the stitches.

"So," I asked, "why are you so keen to whip these stitches out?"

"It hurts. Maybe get some more from my other doctor. I just don't want it to get infected, 'cos that's gross."

We calmly chatted about removing her own hour-old stitches being a very bad idea and that the longer she left the cut open, not only the greater chance of infection but some other nastiness could happen. She was adamant, emotionally blunted as the knife she'd used.

We don't sell stitch cutters; they're almost never appropriate for use in the community. I further counseled regarding antiseptics and signs of infection and dressings. 'Stitches in' was the best option, I stressed.

I impressed the importance of visiting her GP the next day, and provided them with the 24-hour Psychiatry Hotline number. I felt that I was losing their audience. The girl with arms intact had begun wandering around the store, disengaged.

We moved to the till, where I slowly put the sale through; iodine, two dressings, some tape. The friend strolled over to the till to join in the sale. She had in her hand, the largest pair of scissors from the shelf. She triumphantly dropped them on the counter.

And they both stare disbelieving as I say "I'm not selling you those."