A mizdiagnosis

Why did I choose medicine?!

Sunday, September 27, 2009
The power to kill
He was a 'transfer-in' from the intensive care unit. He was placed in my cubicle, to be looked after by me.

I didn't like what I saw when they brought him in. He was scrawny, didn't smell right, had a tracheostomy that was so poorly maintained I could hear the amount of phlegm in it everytime he breaths. He had 'tuberculosis' and 'alcohol' written all over him. When I had finally gone through his notes, I'd learnt that he was a known case of tuberculosis admitted a month ago with severe chest infection requiring intubation and was supported by a machine for a long time, then developed a pneumothorax, then had another lung infection again. To make things short, he had one messed-up pair of lungs. Plus, I saw the words 'poor social support'.

Great, not only I have to look after this guy for a long time, I have to keep contacting the social welfare department to find a way to support him so that he can leave the hospital.

It's hard enough to take care of someone with a long-standing disease. It's harder when you're stuck with someone who is so uncooperative you'd want to yell at him everytime he refuses to eat. Then comes the part when your specialists and medical officers take one look at him and you can tell that they've given up on him ever leaving this hospital alive. Rounds will take less than a minute, all orders are 'continue the same' and finally, I'm stuck with the load of making sure his trachoestomy hygiene is maintained, his feeding is supervised, his arterial blood gases are satisfactory, and my patience and temper are in check.

Then that day came. The nurses told me he was gasping. His oxygen saturation was so low. We pulled the screen, prepared for resuscitation, but something inside of me told me, "Let him go." And there I was, 90% sure that that was the decision that I was going to make. "Let him go. If you intubate him now, he's only going to suffer more." 5 minutes later the rehabilitation team came, and the medical officer saw what was going on and I'd let her take over since she was more senior to me. They'd intubated him and he was back on the life-support machine. I could see in his eyes when he became more conscious, "Why is that tube back in my mouth?!" He didn't look happy about coming back to life.

My specialist and medical officers weren't too happy about him being back on the ventilator either.
"Should have just let him go."
"His lungs are so badly damaged. He'll never be off that ventilator now."
"Even if he walks out of this hospital, his quality of life will be horrible. Who is going to look after him?"

I was more angry with myself than with what was happening around me. I didn't become a doctor to make decisions on whether a person should be allowed to live on. I would usually leave those decisions to the family members. I've never felt so cold in my spirit as I did when I saw this man gasping for life. Days went by and I did my rounds as usual, reviewing this patient. Everyday I'd wonder, "I'm glad the rehab team came and took over, but would he be better off otherwise? Why did God intervene and brought the rehab team? Does this guy have a chance at walking out of this hospital, and living his life, despite what most doctors think?"

Yesterday, I'd learnt the truth. My colleague told me that my patient was unresponsive. By time I saw him, he was gone. We did the usual resuscitation but we all knew that he was gone. I now know that it wasn't God that told me to let that patient go a few days ago. God brought the rehab team, not to save him, but to save me. This time when my patient died, he left at God's decision, not by another human being's.

May his soul rest in peace. Thank you Lord, for saving my soul as well.
posted by Sha @ 12:36 AM   3 comments
Tuesday, August 18, 2009
Growing up fast
2 months of general medicine posting over and done with. 2 more to go. Around 60 more days, 20 more on-calls the most.. I'm dying to get out.

I'll admit that the subject is getting more and more interesting. I'd only started appreciating how we manage all the various medical conditions in our adult lives once I was sent to the first class ward in my hospital.

Whenever someone hears that you are posted to the first class ward, their first reaction would be, "Good-lah! Very relaxing one."

Relaxing, my foot. Hehe.. forgive my language.

I have been cursed in this medical posting. I call it the 2-cubicles/2-wards curse. I was made to take care of double the amount of patients as compared to other housemen in my ward since the day I'd joined in. When everyone is just handling 6-7 patients, I'm in charge of the well-being of 14-18 patients. When others get posted to the first class ward, they had a partner who'd share the load of their 10-16 patients. When I was there, I was left alone to take care of 19 patients and do errands for the 8 patients in the cardiac care unit for a week. It's exhausting, wei.. one time I was actually in tears behind my face mask because I was running around taking bloods, completing discharges, making phone calls, setting IV lines, taking ABGs and blood cultures, tracing clinic cards and scan results all by myself and at the same time running to the Dengue ward that I was on call in to see to admissions during the lunch break. I had nothing to eat from morning all the way to 4pm. The only thing that kept me going was, "Housemen before you had it worse. You are blessed to have this 'few' patients. Don't complain."

When my medical officer was quarantined for contact with a positive H1N1 patient, I was made temporary 'medical officer' of my first class ward by my consultant as we were short of medical officers to come and take care of the first class ward. So I had to start my day at 5.30am to go through my patients and do my rounds with the consultant. That turned out to be the most challenging moment of my housemenship. It's so different when you take on the position of the MO. You have to be more thorough, you have to present your cases better.. Because it's more embarassing to miss out on something important in front of a consultant than in front of a medical officer.

At the end of the day, I was glad for the experience. I came out of the first class ward back to the general medical ward more confident with myself and able to work faster. My consultant gave me a pat on the back and a patient told my consultant that I was the only houseman he would allow to set his IV lines. I found it embarassing, but my consultant smiled and said, "I guess your life is completely in her hands now."

Even a week after I had left the ward, the nurses came begging that I'd come back and re-set his IV line. "Dr Sasha, I was praying the whole day that you would come."

What better compliment would I need?

Now when a houseman complains about dying of exhaustion with the amount of work in taking care of their 6-8 patients, I just sit back and smile cos I've done all the work with my 15 patients by then. Haha.

Suddenly I'm quite excited to be a medical officer.
posted by Sha @ 10:00 PM   2 comments
Monday, July 20, 2009
Hi. Wow, it's been long hasn't it? I was always trying to find a way back, but always looked at my blog and said, "Forget about it."

I didn't think anyone noticed my absence and would actually mention about it. Thanks Jules, it was nice to know I was missed and I hope motherhood is more wonderful than you had imagined it would be.

One year of housemanship has gone by and there's another year to go. Dear God, I'm getting sick of it. Yet, I'm still not ready to take the next step. MOre responsibilities. MOre demands. MOre pressure. MOre headaches. MOre expectations.

MO-ship...God help me when I'm finally a medical officer next year.
But I honestly don't mind MOre money coming into my bank account :p

OK, back to housemanship. I loved being a houseman in surgery. It was the first baby steps I took and I was lucky to have seniors who held my hands when I needed support yet they were willing to let me go run free on my own, and yes, also fall on my butt only to learn to get up again stronger than before. O&G will always be refuge to me for that's where you'll find me hiding in the hospital; with my 'mothers' aka midwives in the labour room, with my best girlfriends aka Priya & Shilpa aka O&G MOs in the clinic or wards. The paediatric ward became the love of my life. The only time you'll ever see me smile during my on-call was in the general paediatric ward. In this department I've found my sense of purpose, my first mission: to teach where I felt teaching was needed the most. All for the children's sake. Maybe I do have my father's genes.

Now I'm in the medical department. After finding everything I've wanted in the paediatric department, entering any department after that is heartbreaking. I'm counting down the days until I can open my paediatric book and start studying for my exams. Each time a paediatric MO or specialist see me, it's always, "When are you taking your exams? Quickly come back to paeds." One specialist even introduced me to another specialist, "Oh, you know Sasha? She's my paeds MO."

As you can see, I'm surviving well enough.. but there are good times and bad times. Fortunately for me, God has been kind and has blessed me with challenges that I was strong enough to handle and surprises that were too wonderful to describe. Imagine an on-call where I only had 10 patients to look after the whole night because for some odd reason there were no new patients to occupy the remaining 40+ beds in my ward, and also to disturb my 6-hour sleep :)

The only thing missing in my life now is a shoulder to cry on. I've realised that trying to be a strong, independent working woman takes a lot of hard work. I may have a lot of friends around me at my workplace but I still get lonely from time to time. Every conversation is about how someone had the worst call, the worst superiors, the worst patients. Everyone is challenging one another to become the one who's had the worst day at work. And me being me, I'll always end up keeping my mouth shut and wishing to be somewhere else, with someone else. I'll keep wishing I was with my best friends, spending one night venting out my frustrations and also sharing my joys, knowing fully well that they'll listen, and give me the big hug that I've been dying for for a very long time.

When this is all over, I'm going to take one look at my hospital, say my goodbyes, turn my back, and disappear for 2 months at least. When I'm ready, I will come back, refreshed. But at the very least, I want to come back much MOre stronger than I've ever been.

One more year to go, God help me.
posted by Sha @ 7:48 PM   2 comments
Monday, January 12, 2009
"Basic principles"
There's been enough entries about work. I thought I would talk about something else this time.

I'm weird. I have the tendency to watch certain movies again and again and again and again... If I was sitting in front of the TV, going through all the Astro channels, if I had to choose between a new show or movie that I thought would be interesting to check it out, and a show that I've seen and enjoyed awhile back, 90% of the time I'll watch the latter. Even if I decided to watch the new show, I'll keep turning the channel back to see which part of the old one is showing, just so that I don't miss the good parts.

It's like how I choose food also. I would rather order what's familiar and guaranteed to satisfy most of the time, and occasionally try out new dishes.

Anyway, I was watching 'Hitch' a few days ago, which is like the 10th time since it came out in the cinema I've watched it. I don't know why. I can't help myself. I don't remember liking it all that much when I caught it in the cinema, but the more I watch it, the more I like it. The more I'd feel connected to the movie.

OMG. I wonder if it's some form of hypnotism. Haha..so lame..

I AM SO SARA MELAS. We even have the same initials.

Everything about her is almost the exact thing I see in myself. I see it more now since I've started working. How she gave up her time off at a beach to go back to work? That's so like how I'd hang around the labour room or come back to ward if I thought I could help around, when someone with more sense would run back home immediately. How's she always has a way with words? I wouldn't say I'm great at it, but I do know how to talk my way into getting stuff done for me. How she'd show everyone that she doesn't really care about being single? How she's protective over family? How the only guy who could sweep her off her feet was a guy who knew what he wanted, tried to get it, failed miserably but still managed to do it with flair? How she'd use her brother-in-law as a cover to make it look like things are going good for her? How she's absolutely lousy at seeing things as it is, and always makes the wrong assumptions?

She's not 100% me but she's almost there. The good thing is that the movie had a happy ending :)

Sigh. I think O&G is starting to get to me. All I see are pregnant, married women. And their husbands. And pregnant, married nurses and female doctors. When I hang out with my MO friends, the girl-talks will be about husbands, children, being pregnant and marriage. I've lost count how many women have asked me whether I'm attached, married, on-the-way to marriage, or whether I've been pregnant before. I found myself helping a fellow colleague buy a Christmas gift for her 4 year old daughter, and I was feeling so weird looking around in the toy shops or baby shops.

I like it here in O&G. But I think it's about time I leave this department. Before my maternal instincts start kicking in.
posted by Sha @ 10:05 PM   2 comments
Tuesday, December 30, 2008
2008: Year of achievement
I'd promised myself that this year would be one full of achievements.

As I have mentioned before, 2007 was one full of personal growth and I wanted to make 2008 the product of all the internal reflection I've done in 2007.

And what a year it has been. I kept a diary where I would record every single achievements that I was proud of, no matter how small it might be.

The year started with me being drunk. HAHA. I was in Batu Pahat, in the company of my 4 closest medical batchmates, sipping on wine. But that was the time I knew who were the friends that I would always want to keep in touch with. I'll always miss the days where life's biggest decisions were, "Where to eat dinner tonight?" and the greatest adventure was driving to Johor Bahru just to catch a movie. Thank you for your friendship, eventhough it came at the end of our medical school life.

Passed my exit exam from medical school! 5 years of torture came to an end in one day, and all was good the moment I went up on stage to get my medical degree. To add icing to the cake, I was asked to give the graduation speech, the first female graduate to give one in my university. As if that wasn't good enough, I'd received a lot of compliments for giving a good, meaningful speech and my family were so proud of me that day.

Organized my batch's graduation dinner. All was good and a perfect ending to a wonderful 5 years where I've gotten to know so many great individuals who have in many ways influenced my life.

Read: The OMG post

Travelled to Queensland to stay with my best friend. Linda, hope you're doing OK. Miss you lots! Hope working life will be a great adventure for you as it has been for me...muaxx..

Read: My trip to Queensland & Goldcoast

Got to watch Formula 1 finally, with the perfect companion :) Thank you for your friendship and for listening to me cry when I'd started my working life.

My most expensive date

Rearranged my parents' home when they were away at Shanghai. Tried out my internal designing skills. I think I did a good job making the place neater. Unfortunately, more than 6 months later, everything looks messy again. Haha. Oh well, I've tried my best.

Survived Induction course in Malacca and Biro Tatanegara in Negeri Sembilan. Enuff said. Seriously, it's a test of your patience and self control. Thank God I was with my medical batchmates.

Got to do my housemanship in the hospital I'd wanted. My first choice! No regrets yet as I knew all along that I would be getting a good enough (if not the best) training there. Plus it was in a town I loved staying in. Started in the surgical department and now in my third month of O&G. Over the next one and a half years it'll be Paeds, Medical, Emergency Medicine and finally Orthopaedic.

Found the perfect partner in crime during my housemanship. Though we knew each other from medical school, I'm so grateful that I had a dependable person as a close friend (platonic one, don't get funny ideas), one whom I knew I could call at unGodly hours to ask for help. I may have been irritated over a thousand times with him, but I will always be thankful for the times he was there when I didn't ask him to. I'm the luckiest houseman who has a fellow houseman who not only gives me the motivation to push myself to be better, but also one who's made housemanship an enjoyable period in my life.

I'm finally living in the perfect home, having my independence, getting paid and learning the art of surviving in the real world. Paying bills, managing money, driving myself around, running errands on my own, finding my own house, fixing and furnishing my own home. Nothing beats living the day knowing that I'm capable of taking care of myself and those around me.

Travelled to Cambodia! Fell in love with Siem Reap and will definitely make another trip.. I can't stop thinking of how wonderful it was to go there.
Made so many new friends in the most unexpected ways this year :) I'm so happy.

While I could probably think of so many more great moments, at the end of the day, I'm happy, content and in love with life. May God bless your life with joy, beauty, love and adventure, as He has blessed mine. Goodbye 2008, you've taught me so much about myself, you'll never be just another year to me. Hello 2009, this year you'll show me how exciting life will be when I choose to be spontaneous and break all the rules.

Are you as ready as I am?
posted by Sha @ 9:39 PM   3 comments

Name: Sha
DOB: 6th July
Email: shasynergy@gmail.com

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