Life as a Junior Doctor

Around 2 years ago, I was writing the post: 1 down, 5 more to go and without realising it, I'm in my last posting now. Left with the posting that I dreaded the most: Paediatrics. Everyone has this one particular posting that they dislike the most and for me, Paediatrics is that posting because I'm not really a fan of little humans. 

The Paediatrics posting itself is separated to 2 major subpostings: NICU and General Paediatrics. As I'm currently relocated for the second time due to COVID, but this time in a tertiary hospital. Thus, there are multiple subpostings within general paediatrics such as Oncology, Nephrology and Neuromedical. 

Not sure whether its good luck or not, I started off with General Paediatrics. Everyday is a battle with those little humans. How I miss procedural works on adults (At least they don't shout into my ears). It is a dilemma everyday as you know you can't get mad at them because they are afraid but you are secretly annoyed/tired and just want to get your job done. The few voices that you can hear from outside the procedural room everyday are screams, cries and "Baby Shark Doo doo doo". I have played so much baby shark that its currently no. 1 on my suggested list on Youtube. Other than screams and shouts, we do get some pretty funny stories from the procedure rooms. I have colleagues that were bitten by toddlers (We just wanted to get a little blood :'(), toddlers that fake cry and when you tease them, they become flustered and also children who were not knocked out by 5mg of IV Midazolam prior to lumbar punctures (Adults would have passed out with that dose).

Done my neuromedical sub-subposting last week. It was quite an eye opening experience as I was able to witness all sorts of seizure patterns. I was even able to see a few rare genetic disorders which lead to recurrent seizures. Looking at different kinds of EEG patterns nearly made me cross-eyed (EEG is way beyond my brain capacity to understand). I'm thankful to my specialist who was kind enough to try to explain them to me although I just stared at her blankly the whole time (I was not having absent seizure I think, maybe I need EEG too). Thanks for your patience.

Currently, I am 1 month into this posting and hope I am able to come out of it in 1 piece 😐

Cheers!

Thought Monkey

Today marks the last day of my Surgical posting. It has been alot of back alley interrogation and body excrement handling.

Through these 4 months, I have been through loads of ups and downs. From being the chillest posting to one of the hectiest due to lack of manpower. From handling 2-3 patients to handling a whole lot of 25-30 patients alone.

 So how's surgical overall? For a person that enjoys hands-on and fast results, surgical has been fun. Although I did not managed to do any open appendicectomies (did not encounter them during my last month as EMOT HO) but at least I've managed to do a saucerisation of a back carbuncle. I have enjoyed the last month of this posting more although we were working like we are in medical because my new medical officers has been very helpful (some of them were my senior HOs during my first month of work). Just when we are about to get used to things, then it's time to change postings (damn! 😅)

One of the few things I have learnt after transitioning from a student to an actual doctor: Work smart AND hard. There will be days that you will feel like breaking down and giving up but always remember why you started this. A senior once told me that if you have not cried even once during housemanship then you are not a houseman because that is the purpose of these 2 years: to break down your walls and make you rebuild them with thicker materials.

2 days ago, a new batch of housemans started work. It did make me think that I was in their shoes just about 4 months ago. How time flies~ (although it felt like a year or so). I do pity them for coming in during this messy period with the lack of seniors to teach but that is life. No more medical school style where people can repeat a few times until you understand. It's "see one, do one" style. It's a field that sometimes scolding does make you remember things better so please bear with it. You might feel very wronged at times but before that, make sure you have tried your best. If you had done so, then there is nothing you can change but at least, you know there is nothing more you could have done for the patient but you didn't.

I hope my words would be able to enlight some of you and make you bear through these 2 weeks of dreadful tagging. Just keep trying! We are too young to give up and blame the world at this age!

I will be starting my medical posting tomorrow. So I will be going through 2 weeks of tagging again as well. ALL THE BEST TO ALL OF US!

Photo by Nicholas Kampouris on Unsplash

I was doing on call the other day. Once I entered the ward to get updates of patients and pending jobs from my colleagues, I was informed by the nurse that there would be a patient coming to the ward from Emergency department having transferred from another district hospital. Great, what a start of a night shift.

Upon further questioning, the patient has actually collapsed while she was being sent to the ward. CPR was commenced immediately and she revived, however, with a poor prognosis. When she finally arrived the ward, the anaesthetists were preparing to intubate her since she was not very stable.

I was able to get history from her children while the anaesthetic team was attending the patient. Marie (not patient's real name) was actually fairly active at home, able to talk and take care of herself prior to her illness which started one week ago. She began to lose her appetite, coughing with greenish phlegm, fever and occasionally having shortness of breath.

She was then admitted to a private hospital yesterday when she began vomiting and feeling lethargic. The staff at the private hospital mentioned to the family members that Marie needed ventilation support due to her breathing issue so she was referred to general hospital as the ICU rooms at the private hospital were fully used.

Despite living alone at home, her house was actually surrounded by her 10+ children's houses which meant she has a very good family support. Her husband has passed away years ago and she was supported by her children since then. She neither smokes nor consumes any alcoholic beverages. Besides, she has been a housewife since her marriage.

After the anaesthetic team has done their job, I went to review Marie and did some documentations before attending other patients in the ward. One hour after that I had to draw some blood from Marie to check her oxygen level. When I approached her, she looked weak and I felt there was no palpable pulse!

Calmly (with mildly shaky hands), I asked the family members to wait outside and pulled the curtain while asking the nurses to bring in crash trolley and cardiac monitoring machine. Marie's GCS was already 3/15 so I cannot assess her consciousness level. I checked both the femoral and carotid arteries, no pulse detected. listened to the heart, not beating, Checking the eyes, both fixed, not a good sign. ECG showed flat line. CPR was commenced immediately.

In the meantime, the nurses called the Medical Officer and shortly she arrived and I explained the whole situation to her. After attempted several rounds of CPR for about 30 minutes with 2 shots of adrenaline injected through the cannula. Marie was then pronounced dead and CPR was stopped.

My medical officer then proceeded back to ED to see cases while I have to break the bad news to the family members. Truthfully speaking, it was one of the hardest things to do as a doctor as nobody wanted to hear bad news, let alone death. With a heavy heart, I met them and told them about Marie. They were really devastated upon hearing her passing away.

To us, it might be another death that happened in the ward, but for Marie's family members especially her children, their world was torn apart. Being such filial children with close-knit relationship with their mother to the point that they bought houses surrounding her so that they could take care of her all the time, their one and only mother who had been by their side all their lives was now dead.

It makes me ponder upon the meaning of life whenever I see patients die in the hospital. Life can be short and uncertain at times. One day you are alive, the next day you might fall sick or die for whatever reason. Hence, it is important to live a happy and meaningful life instead of the opposite simply because #YOLO.  Have a think about it. Cheers.