A time when i was an houseman

Not long from now i will go one step further in my carrier to become a medical officer. I have been waiting for this very moment since i am a medical student. Not to mention, it is the step nearer to become a specialist. : )
Houseman, the host of the ward, the tuan rumah of the house (quoted from my specialist), is responsible for every single thing happened in the ward including case note, xray, investigation, medication, review, presentation, patient's care, procedure.....including missing item or family members complaints. 2 years back, the time when i was still "neonate" in the game, i was so naive and innocent. I came to work every morning with the heart full of expectations and dreams. In my mind, i want to finish my round fast, take all the blood investigation and trace, remember all the cases and result in ward, arrange the case note, plan for the discharges and help the staff nurses. I tried very hard to present the case nicely to my medical officer or specialist but things do not always go smooth. Probably because i become nervous easily and my train of thought started to shake and become white out. Then, i was blamed for not knowing the patients under my care. The greatest mistake i made was too greedy. I was too obsessed with perfection and job list. I did not prioritise the job list initially. Then, i realised the more i do is not necessary the better.
I also learned that fresh graduates like me do not know how to organise the thoughts and present the important points that make people understand. Now, i understand, the rule of thumb is to know who is the audience and only tell what they want to hear. Too much of differential or description is rubbish.
Houseman is not equal to superman. we must learn our limitations and capability, do not bear every single responsibility on our thin shoulder. That is why the medical officer come into play. I learn that this is not a game for single player, it is a multiplayers game which involve medical officer, staff nurses, supporting staff and specialists. Every one has its own role. Always than not, the other players try to manipulate, abuse, misleading, threaten, blame, restrict freedom from houseman. For example, i scared to leave the round and have to resist nature call.:)
But having said that, without the tough training and extension, i would not be what i became today. Now i am looking forward to surviving in level 2 of the reality survivor game.

Dream a dream

I wake up every morning and think with my half awaken mind, why am i doing this, why am i so tired, do i get enough sleep?Never have time to succumb in deep and intelligent thought because the next thing i realised is, I am already late.

I tried to beat my own time and record each morning. I tried to punch my card as early as i could. I tried to finish the round fast and planned the discharges. Time is very precious and is boiling fast in my working life. Then,when the clock strike 5 it is again time to rush home and rest.

Is the houseman or doctor life so routine and automatic....some claimed it "auto-cruise"
Not until lately,I realised that it is not true. After read the hero story which happened in Haiti, I understood my role. I understand how important is my role in this community.

I dream a dream, I wake up with the desire for helping more people. Eventhough, what i did daily is not so dramatic compared with the hero in Haiti, but now i was preparing myself in the sense of responsibility, knowledge, skill, passion for bigger mission in the future.

I might start from a zero now, but, i would never give up until the big day where people needs me. That I would change the world to a better place to live on.....

Unforgetable moment with my favourite MO

had an unforgetable moment with my favourite MO in OT and a "psychotic patient":reason:
(before OT, she bite staff nurse's hand when doing wound inspection)
1)Before operation start, she ask for her mum and dad forgiveness
2)She also murmuring:"ampunlah aku doktoooor!"
3)before we start, the anes told her that the op is ending
4)She move her hand up to op site and touch my back and MO(cant start GA due to BA)
5)She just verbally agree, Auooong, to our request but never follow order
6)Called our consultant "Tambi" and yell:"be gentle with her"
7)After given mida, etonox and ketamine, finally she slept well
8)Anaes specialist say:"It is time to whack her!"(for revenge)

Sad, sad sad

Today as i was looking at the premature twin baby gasping for air, with severe indrawing of chest make me refresh the time when i wacth my best friend, my gold fish passed away. The helpless and frail look is so pity. Last time, i used to bite my teeth and pray hard that by God grace, miracle might happen and the fish might survive. So that, i sat beside the aquarium for half a day to watch the fish slowly slowly cease the breathing effort. I tried to put the oxigen tube nearer to the fish, but, it couldn't help as the pressure would make the fish swing in the water.
Today, i started to put my feeling onto my job by seeing "my" baby. After i conducted the premature twin (28 weeks), my heart felt heavy as the baby is really light. I know that the paediatric team is not gonna do any active resuscitation. Then, the second twin is weaker, almost like no sign of life. Quickily, I finish the other business and go beside the warmer, and observe the baby. I cant imagine how suffer is the helpless child trying to survive. The tiny baby took all his effort to inhale the gas into his lung. The skin colour slowly become fresh red to haemorrhagic dark. I cant hold my tears seeing such suffering. Why could this happen, why cant we do anything to help the child. I realised that we, doctor are useless. Then, i try to reduce the oxigen awhile in the oxigen box, and see what is the respond. Surprising, the child continue to breath in and out with all his might. In my mind, I wanted to reduce the pain the innocent child is bearing.
After delivered the baby, I saw such a relief in the eyes of the mother. She even joke with me during 3rd stage and perineal inspection. She is like putting in all the faith to a doctor to save her kid while she has done her part for delivery. Her active phase is also not a fast one. Then, by knowing the child is going to expired, i quickly bring her to the warmer. She is strong enough to hold her tears until back to the bed and start sobbing. Icouldn't help by wetting my eyes as well. But, what else we can do, as doctor is so useless.
Subsequently, I pray hard, and bring the baby to weight again, surprising, the weight is increased. The weight now is 640gm, then swiftly the paedatric team is alerted and resuscitation was done. However, later noted the child was ventilator dependent and SPO2 not stable with high setting.
Doctor is limited in effort in saving life. A lot of condition that a doctor cant do to help or taking control of the disease. And, as time slowly pass, doctor will become like robotic and rigid. He just think he had done the best for the patient, and which the others doctor would have done. And, the story end right there and then. In the view of peer, he has not done anything wrong or unethical. But, for me, a doctor is a failure.
She gave a new life to suffer and then die. i do not know whether the child is dying in peace or not. One thing for sure is, how suffering it was when if we put ourself in the baby shoe, suffocating with the sense of anxious, helplessness, weak, wish, pain is overwhelming.
I feel so frustrated and I pray hard. I think that is the only thing we, doctor can do.

Sad, sad sad

Housemanship

Now, i am the neonate in my carrier. Luckily i was posted to MIri, by God grace that life is far better than those in other hospital. I would say, Miri Hospital is the best hospital of all. Where else can have a call with 8 hours sleep?Where else can have 2 houseman covering the same ward?Life is getting better once the day of life increase.
I remember the early days when i was in OnG. I was blurred for almost everything, the most scariest is the CTG. I do not have a clue how to manage a bad CTG. It make me really frustrated and scared.
I regreted for one incident during my first call. Whether directly or indirectly, a pregnant lady who is under my care delivered a flat baby and later confirmed to have HIE stage 3. The baby was discharge from hospital with NG tube in situ. I truely regret for that incident. I depressed for 1 month and become workalcoholic in that month time.
All my friends are very supportive. By looking at my labile mood, even the Mo who scolded me on that time apologise that she should not being so harsh ans inconsiderate. One or two of my friend bring me out for liquor, i remember, i ordered a cocktail, name, sex in the beach!!I was drunk and just let the cat out.
It proved that my lecturer,a phychologist was true, i was a neurotic person. I might go insane and breakdown if I do not control my emotional well.
After waht i have said and done, everything has passed. Christmas has passed as well and I do enjoy having chicken chop alone. Life is better now but not to the best which I look forward for it in new year

fear and fancy to Miri

The day of medical student has passed, the day of having fun, joke and class are ended. A new chapter of my life is about to disclosure, more responsibility will be beared on my weak shoulder. Housemanship training is about to start.
Miri, is the hospital offered by authority, a place where mile, and mile away from my howntown. It is a place i never been and never would expected to go. I knew, this is life, to be accurate, this is a doctor life. As long as the place got people, people who need my service and help, we have to be present at the place to provide not just treatment but the best treatment in the hollistic way.
I was shock initially when the authority broke the bad news. I sweat and shiver until the back of spine. I lost my common sense and a stupid question was asked by me in shaking and frail tone: Do Miri has airport?Then, every one who present understood my fear and worry.
The journey to Miri is not simple from my hometown, Selama. All kind of transport is needed, you name it. From Selama to Kl (7 hours), KLIA to Kuching (2hours)(register at Sarawak health department) then from Kuching to Miri (2hours). You can say that I have travel from the northen part of Malaysia to West.
Now, the problem is whether i can come back to peninsular Malaysia after 2 or 3 years of services. Whatever the future stand, I kept my finger cross and say:"Mirian" here I come.