w.I.b:warung ikan bakar:
Harap-harap INI KALILAH !
Friday, June 29, 2007
This is historic. I am typing these at 6:09am, 30th June 07. In about an hour's time, I shall pass over my pager to next house officer on-call, and that would mean I have completed my final on-call(first call) as a medical HO. My last case is a Bangladeshi who just arrived here 20 days ago with pyrexia of unknown origin (most likely going to blame it on dengue or malaria), and my last problem in the ward is a not-so terminally ill patient asking me to end his life because of the severe pain that is bothering him.
Medical posting, has been both an experience filled with delights, opportunities for satisfaction and 'nightmares'. All the best to my fellow colleagues who have weeks and months left in this department, persevere, and just make those d*mned decisions!
Doctors should keep on reading, asking, and learning
Examples: 1) A senior MO in a klinik kesihatan misinterpreted an ECG for an acute MI and then send the patient to a general ward without alerting the CCU.
2) A senior MO wrote at the final diagnosis of an adult well-built TB patient who has lost a lot of weight as Failure to Thrive
3) A fresh graduate who did not know aminetryptillineaminotryptiline is an antidepressent
4) A senior HO who still cannot manage diabetes and hypercholesterolaemia properly.
My own young practice is also littered here and there with mistakes which could have been avoided if I had read more, asked more and made an effort to learn when the opportunity arises. But then again, at the end of a long day, most of us would want is just a hot shower, a warm bed, and some personal time for a meal and a nap.
Perhaps, the reason some doctors moved on to be specialists and better doctors than the rest is that they are willing to sacrifice more time to study and learn!
just about a month ago, I am 'crying out loud' and making sour faces for having to work late nights for most of the days being in charge alone in a busy female medical ward. Since then, when seniority finally caught with me, we are now in charge of less busy wards, with ample time for lunch, reading and surfing the net!!!
Life is indeed getting better,... especially new house officers - the fresh young medical graduates who are still finding it funny to be addressed as doctors, have arrived to relieve our burden.
I have a confession. I am currently very attached a book, and it is not a bible. (Please forgive me, and no, it is not a medical book)
This book is MAO: The Unknown Story written by Halliday and Jung Chang, a supposed well researched historical and political exercise. I am now currently in page 337, and I wish I have less working time and more personal time to finish this book.
This made me think, God, did you create Mao to be good or bad? If he was predestined to be the evil neo-Emperor of Communist China, why?
If not, then how did he turn so bad? Or is he really that bad or is it just Jung Chang creating more sensation and hatecriming him?
Nevertheless, this book made me realise how fortunate I was not born in China and particularly not born in Yenan or Ruijin or even Shanghai in the 30s and 40s. I am also glad my grandparents already left the Chiang-Mao China and came to British-Rahman Malaya.
I also realise however terribly dumb, corrupted and stupid the Barisan regime can be, it can never beat the montrous, hungry yet equally inefficient Communist China Party.
Dear God, please forgive me. I pray that this kind of regimes and history will not repeat itself, and I pray we will learn from this, and not to restart the opium madness, the Pacific War, or whatever madness our forefathers have gone through.
A) I went back home at only 8.30pm, though there was not much ward work. Reason - I spent an hour trying to set intravenous line for 2 patients with a colourful history of intravenous drug abuse ( they became venepuncture experts on their own bodies before I even learn a thing about anatomy ). It is ironic because they have found so much 'high' and 'enjoyment' from administering drugs into their veins, that later in their life, they have to suffer from repeated needling here and there because most of their veins have collapsed and hardened.
B) Part of the many excitement for a new medical student is getting to wear the white labcoat/overall. It made us look a bit more like a healthcare professional, and symbolically a step closer to becoming a doctor. But then, when we reach the final year, we start getting tired of the labcoat and wish we'll graduate soon because then no lecturers or staff nurses will bug you about wearing the right attire. Most house officers and almost all medical officers would do away with the overall, especially on hot afternoons. So then, the white overall - became sort of an unspoken symbol of juniority. The younger, the more amoebic you are in the medical hierarchy, the more likely you are to wear the whitecoat. It is ironic because we worked so hard in high school to get to wear the white overall while in med school, only to work hard again for our final exams in final year med school so that we'll graduate soon enough to become qualified doctors so that we do not need to wear the whitecoat unnecessarily.