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Monthly Archives: December 2011

I have not clearly thought through any New year Resolutions since i started Medical School. I have been too busy working through the New Year usually.

This year is no different, except i do have some time on my hands now, but my heart is hammering and my blood pressure is pounding in my ears. I am trying not to psych myself out before my first overnight shift and my first stint ever, as the only doctor in the whole hospital. Oh, and i need to try to squeeze some shut-eye before my shift lest I AM THE ONE who collapses and warrants a MET call in the department.

But two resolutions that have popped up, and ones that have been recurring through the years:

1. Call my parents more often. At least weekly.

2. Write to my close friends more often. At least one letter to one friend a week.

Then of course, there are other things i want to do, but deep down i know it is probably more of an ideal and less of practical value.

1. Revamp my photography interest – i need to get my Flickr account in order.

2. One photo a day with corresponding caption, starting tomorrow, to remind me in years to come, how i spent each day. (I tried to do this earlier in the year, but i grew so busy that the habit never did stick.)

3. Organize photos from my travel and get the photo books ordered so i can finally put them on my bookshelf for viewing.

Then there are things that are less of a resolution and more of an obligation…

1. Study more, perhaps aiming to get a crack on Cecil’s Textbook of Medicine, so i can get started on Harrison’s, in time for my physician exams in 2014.

2. I NEED to find a way to ensure i read every issue of the medical journals i have subscribed to.

3. I want to do more locum emergency medicine shifts to raise my competency level.

All right, i better get started on UptoDate in preparation for my shift tonight. However, i have a strong sense of suspicion that it may not be too busy (i know this is contradictory) but whether it’s because everyone is partying or because it is so busy the consultants have to be roped in to help, is another matter…

Anyways, Happy New Year everyone!! May 2012 be a fruitful year for all! 🙂

In the hospital cafeteria yesterday, discussing with a friend (fellow intern) about my impending overnight hospital shift.

Yuppie:
I am going to spend the entire Saturday studying.

Fellow intern:
What on??

Yuppie (tries to control herself from hysterically shrieking and pulling her hair out in the middle of the cafe):
There are a lot of things that can happen!! It’s New Year’s Eve and the weather forecast said it will be hot! There will be thermal burns, and heat strokes and dehydration! When the sun is shining, people go swimming in the beaches! So there will be stings, and sunburns!

Fellow intern (says soothingly):
No Yuppie, it will be fine. Don’t worry. It will be the same stuff you encounter on the wards.

Yuppie (continues unabated on her tirade):
Then when night descends and the fireworks start, there will be chest pain and vasovagals. Then there will be a lot of booze and so, a lot of road trauma and glassing! There will be lacerations, fractures and soft tissue injuries. And don’t forget the depressive people on New Year’s Eve. There will be suicide attempts, suicide and exacerbation of psychotic episodes with drug usage.

Fellow intern (tries not to laugh):
I’m telling you, it will be fine. No burns, drownings, or stings.

And then at this instant, in walks a child with a severe erythematous (reddened) skin topped with multiple blisters.

Yuppie:
Did i mention burns?

Fellow intern cannot contain herself any longer and bursts out laughing.

Blimey.

I have not properly spent my New year’s Eve meaningfully for a long time now. For the past few years i have been treating it like any other day, sleeping as per an ordinary day and waking to another day, but apparently one that has automatically made me age another year.

This year was the same thing. I wanted to do something more adventurous, more exciting, but the ex-boyfriend was a bland lazy guy; and i was so annoyed by his lack of motivation that i picked up a friend’s on call shift. I was scheduled to be on call on New Year’s day, but i decided that hell, if i am already stuck with no plans, i might as well take my friend’s on call on New Year’s Eve and let him have a good time.

Which led me to my current predicament. With a twist of fate, one of the other interns scheduled to work has fallen ill to a surgical condition and we are unable to find a doctor to work the overnight shift. Guess who was the lucky one? Ahem…

Anyway, there was a lot of fuss about it because i was very afraid. I have not done any emergency shifts in this country hospital at all, and i heard it is a frightening experience. And to make matters most, there is only one doctor overnight. That’s right, one doctor to cover the emergency department and the 3 wards. One junior doctor to cover a town and its surrounding suburbs of 100,000. On New Year’s Eve, the busiest night of the year. A town where the city folks flock to for their holiday break. Incredibly sick people who can’t afford any overseas travel but decided that a country town is safer, if they ever fall sick. Hah.

And i am IT. The one intern who has never clocked an emergency shift in this hospital. The one intern who has never done an overnight shift in her life.

It was illegal of course. This arrangement, made at the eleventh hour. And the fact that so much pressure was placed on a junior doctor. The first was compensated with a triple increase in hourly wage for that shift. And the second is slowly and painfully being rectified, but will only benefit the interns of next year, and not the current lot.

Fortunately for the powers who screwed our rosters up, i was intrigued and up for the challenge for several reasons. Firstly, i am going to Guatemala, and i had better get my shit together and consolidate my emergency medicine skills. Next year i want to scratch a couple more locum shifts, which inevitably will tend to be in emergency departments since apparently it is not a very popular specialty, hence the constant lack of doctors. And i need to get more experience. Lastly, i know that there are couple of stuff i have been psyching myself out over, simply because i have never done them before and thus have a lack of confidence – such as plastering (i know, how did i manage to get through an entire year without plastering someone’s broken limb??) and CPR (again how did that happen? Really all the codes i have attended have been pretty frivolous). So when i hear my friends talk about the stuff they do, i feel incredibly worried about my own depth of experience.

Anyway, the medical director has tried to make amends, and have dangled much increased hourly wages to the emergency consultants should i need them to come in. In fact, one of them was happy to take my place because of the increased rate of pay. But for the reasons above, both of us were happy for me to pick up the shift and call them in when i am in strife.

I reckon this will be the most memorable New Year’s Eve for me. I just hope that it will not break me and ruin my spirit in this profession. THAT is my biggest fear.

I am slightly devastated. By two events. Ok, three. The third one is really more nail-biting anxiety.

I sent my parents off today. I won’t see them till, probably in a year’s time? I previously mentioned that i was getting use to this emotionally-fraught farewells, though temporary but rather extended. Now at least i don’t mope around for the rest of the day in misery, fighting back tears. Unfortunately, my mother has not even gotten used to it. Ok, so maybe instead of actual tears falling, she is now only having wet eyes, but still. It makes it more difficult for me to function!

Anyway, my dad, being the typical Eastern man, attempted to show he loved me by teaching me how to drive quickly around corners – i know i know! But it is a skill i have been wanting to master a long long time. And also he saw how i drove and he complimented me on my driving. To put this into perspective, my father does not think too highly of female drivers, and when i first started to learn how to drive, it was a tremulous time since he was completely domineering and wanted to ensure his daughter did not turn out to be one of those damned female drivers out there. So that’s a really good compliment.

Anyhow, my mum gave me a hug and my dad gave me a rather stiff handshake, which on hindsight, i found totally hilarious. I was imagining what onlookers must have thought. I don’t think dads shake their daughters’ hands so formally? Anyway, i am not complaining. My dad has certainly put more effort into demonstrating he loves us. They did finally revealed their fears for me in going to Guatemala all by myself. I am not sure how to alleviate their anxiety given that i intend to do at least a stint with MSF. I will just have to leave it i suppose.

The second event is that i finally went through my last four pay cheques at the other interns’ insistence. Apparently i have been short-changed but i never find the time or energy to go through my cheques. And they are right. I have been short-changed half a thousand. And that’s only for the last month. Now, instead of feeling elated, i am filled with dread. I am now thinking about the entire year’s wages and the errors that probably occurred and me not following up on it. I did remember that i was paid a lot less than what i am supposed to be getting on quite a few occasions, but i always never got round to checking it. I have to be more vigilant now since i have decided to live alone next year and my finances will be slightly tighter.

The last anxiety-provoking event is that i found a locum shift available for next year but since my roster is not out yet, i don’t know if i will be available! I have emailed my hospital and i am hoping they will get back to me before the shift gets snapped up. That would be mean a loss of income for me. 😦

The last few days, I have been having dinners with my parents, just them and me. We have been having quiet talks over wine and steak, and tonight we had Indian. My mum and I had the opportunity to catch up on some mother-daughter quality time. Usually when the whole family is together with my younger brother, I tend to be the quiet one, lost in my own world, whilst my brother is the animated one, engaging my parents.

Anyway, tomorrow, after lunching with my parents, they will be taking the train back into the city and then jetting out of the Workland back home just before the New Year hits.

I’m gonna be sad. I can feel it already.

When I first came to the Workland to commence my first year of medical studies, I braced myself for the emotional onslaught and quickly adapted by avoiding going back to the Homeland. Now after nearly 7 years, I’m only finally getting used to this coming and going in my life. In a way, this has shaped me deeply. I have become much more independent and in some ways cold, as I learnt to harden myself, for I have learnt that Life is all about passing by. There’s no point in holding on.

Ok so I was browsing on Book Depository and somehow i ended up on the textbook section and grew increasingly excited at the number of medical atlases I added to my wish list. I have to include a disclaimer in case you think I am a maniac who devours massive volumes of clinical text – not really unfortunately. I tend to collect them on my bookshelf and gaze lovingly at them rather then reading and assimilating those facts. But I do get around to them eventually because of the financial guilt.

But I digress.

Yesterday, of all places, In a medical fiction by Michael Palmer (the second opinion), i read about the comparison made between surgeons and physicians and I was highly amused and yet thoughtful about it because it rang true.

Surgeons are to physicians like technicians are to thinkers.

I was hell bent on surgery till I did 20 weeks of surgical, half of it under the rudest, most pompous egoistical men I ever met, and the other half under the most charismatic, kind and gentle men I ever encountered. Then I did general medicine. And I realized the culmination of medicine did not lie in surgery but in internal medicine. The pinnacle of medicine does not lie in surgery. Everything depends on the physicians. The pre-operative care, the post-operative management and the day to day maintenance of health. Only a specific subgroup of people ever make it into the operating theatre, and yet the surgeons boo-boo the work of the physicians and think themselves walking Gods of this Earth.

And the more I think about it, the more I am inclined to feel that the challenge of medicine lies in the hands of the physicians not the surgeons. If you spend enough time in theatre, you will ultimately excel in it. Similar to all other activities which involve motor skills – be it sports or music. But spend an inordinate amount of time in internal medicine and sometimes one can still be stumped by the myriad of physical signs and symptoms and still not have a conclusion.

This is the part of medicine that excites me. And that’s why I made the momentous decision to enter in the physician training program rather than the surgical one.

Merry Christmas everyone.

Christmas is very quiet today even though the parents are over from the Homeland visiting. I think I got to drum up the atmosphere by playing some carols later.

Sometimes I wonder if I’m mono polar or something. I seem to fizzle out when such occasions arise and yet I yearn to celebrate these festive days with more pomp. Maybe I am expecting too much. Maybe I watched too many movies. But I think I have to be the one that organizes such events because no one else around me seems to be doing it…

My parents got me a Christmas gift – a staggering $300 modem-router that I could not afford. I am a doctor yet I am still so poor; it’s bewildering. Anyway when it comes to the Internet, I’m still living in the dinosaur age. Or rather this country, despite being a first world nation, is lagging severely behind in its cable technology. Whinging about their services will take up a whole post so let’s just forget about it.

Anyway, I have a 5 year old modem that has no wireless capabilities. I connected my various laptops to the modem with long cables that snake through the house. Everyone who visited my house knows to be cautious lest they trip. Even the dogs, when they scamper around in the house, have learnt to be nimble and agile albeit, after a few noisy mishaps. I went with the cables because they were the most stable. Wireless systems are just not reliable.

But I was finally convinced to change my own ways. Not least because of the damn iPad. Friends and family (my parents!) tote their iPads at my place and groan when they discover I have no wireless. Also I’m sick of how untidy the place looks with the cable. And my younger dog whilst she was a puppy, had learnt to chew on one of my cables in her teething stage.

So point is, I got that modem. I was gonna pass on it after balking at the price, but my mother generously sponsored it. Which is a tad embarrassing, given she is almost retiring and yet still has to pay for my expenses! We re-fitted the place yesterday, cleaning up the cables and tidying up my study. After some hassle (which entailed calling the Internet company which took nearly 30minutes – best service in the country! *note sarcasm*), we got the wireless working and mostly everyone is happy. I still had my reservations and rightly so.

This morning, the wireless ain’t working, the signal is strong. No blaming the router cos we got the best one on the market. And supposedly I am also getting the best Internet service in town – $85/month for the most rapid ADSL in the country. Blah.

Anyway I think it’s time to get up and do some spring cleaning. We hired a skip to clear out the shed. The landlord is gonna pull the shed down (apparently it’s so old, it contains abestos??!) and erect a gazebo in its place – I’m looking forward to that. I have already looked at some of the outdoor furniture that I am intending to get.

It’s gonna be interesting since I still have unopened boxes in there from my move nearly 5 years ago. I hope more of the rubbish ends up in the skip rather than me keeping them for sentimental value, which tends to happen a lot!