Monthly Archives: March 2011

Exhaustion

I started my surgical rotation. I have to say it is pretty pathetic that I don’t even have time to read the daily papers.

We are so busy it is almost insane. I have not enough sleep – it’s not possible to sleep earlier because I’m not even back from work yet. What the hell right?

I am seriously considering a career in surgery, but just on my first day on the surgical wards, I was questioning the wisdom in my decision. One of the surgeons did not head home for three days! The other junior doctors are also struggling to keep awake on the drives to the hospital.

Now I wonder if it’s kinder on my future family and a greater difference I can make if I pursue a career in medical administration instead. This system really needs to be revamped or one of us doctors will break eventually. And the wider community will probably not hear about it because we are such a close knitted and protective group.

That’s tragic.

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Soccer

I didn’t turn up for my soccer training today. Was too tired. I could only feel disappointment and resignation. There was nothing i could do about it. I was already dozing off on the drive home from work. It was a struggle. This need for sleep. I had to take a nap or risk a crash tomorrow.

Also I need to break the news – I got a new puppy. She’s a miniature Pinscher. Got her last Saturday as company for my dog. The puppy turns exactly 10 weeks tomorrow. I named her Fleur. More updates soon!

Medical mistakes

Just made the first medical error of my career. Though not fatal, I have been feeling terribly upset, disturbed and appalled with myself since.

I know medical mistakes are bound to happen. It’s inevitable for every doctor. But the feeling of incompetence is hard to take. I just have to learn, get over it and move on. It has been a long time since I made a mistake.

My senior doctor called twice to reassure me that it’s ok it’s normal and part of the risks of the procedure. I must have sounded aghast over the phone. I rang my friends and they did their part of reassuring me.

The only positive thing out of this whole event was probably me being able to keep calm to manage the situation acutely before paging the senior doctors. I probably turned very pale; I could feel the blood draining from my face at that point of time – doesn’t happen too often I can tell you.

Shit. I think all along I must have believed I could avoid making mistakes by being very careful. Now I know that’s impossible. You can be the best and the most careful, but shit can still fall on your head. Jeez.

Next time if I am having difficulty, perhaps it is better to risk being yelled at for not trying hard enough (and deemed incompetent) than to cause a complication from trying too hard? But even then that sounds wrong. Really it is all a balance of mistakes and good calls.

Although I loathe to say this but it is probably good that this happened so early on in my career. Better to learn now than through a calamity as a senior doctor.

Also I am very surprised by the support offered to me from my senior doctor who is usually very strict with me. She even started thinking of the mistakes she had done in the past and relating them to me just so I won’t feel alone. I was very touched by her gestures.

Anyway time to get over it. Medicine is all about taking risks. I have to live with some of the consequences. Sucks to be the patient but falling sick is never fun.

Preoccupation

Not sure what’s with me, but i have been so preoccupied with DOGS that i have been neglecting everything else and it is starting to really annoy the hell out of me because it is creating an obsession.

I have not been able to properly practice my flute – actually the other thing is i am now not really keen on taking the Grade 1 exam. I am not quite sure what it will prove, but it certainly is creating a lot unnecessary stress for me at the moment. Plus i am supposed to find a pianist because 2 of the exam pieces require accompaniment. This is just too much effort. For now, i am just putting off thinking about it…because i am thinking about DOGS. Wtf.

Been trying to commit new language vocabulary into my head but i ultimately always get distracted with the internet – with checking the kind of dogs people are putting on sale and those that require good homes. I hear no word from the rescue organization that i emailed last week, and with each passing dog, my desire to foster a dog lessens, and the determination to get a SECOND dog increases. I am not very sure when this all started. All i recall was an innocent click of a dog advertisement, and this brick wall came tumbling down.

In fact i have been pondering about this decision for the last two weeks – actually i have been thinking about getting a second dog ever since my dog graduated from the obedience club, but the debates comparing the pros and cons of getting a second dog have intensified over the past two weeks. So much so, i have already discussed with the Housemate and even my mum. I pretty much narrowed down the kind of dog i wanted and the Housemate and i had a look and we came to a decision on the breed. I emailed the breeder two hours ago. I found the name i would like to call the dog an hour ago. O_o

Dear Lord. I really need this obsession to end because i really WANT to start reading some medical stuff and practicing and revising the assortment of music and language lessons i am doing.

On another note, i had the best soccer training on Tuesday ever. We capped off our intense training with several sprints and i am pretty pleased with myself because i did quite well. Also the coaches have been discussing the players’ positions – i hope i get to play in midfield.

Wow…third post in a row

Somehow over the weekend i managed to arranged my schedule such that i had most of the day to myself. I spent them sleeping in, lazing in bed, waking up and then back onto the couch with the dog to read my novel. I even managed to start and complete reading a novel (Equinox by Michael White) over the weekend! I rarely have such days to myself and i don’t complain about it. Having a day or two to myself is a fantabulous luxury but i have realized i end up spending a lot of time on the internet, searching for activities to further fill up my days. I have also been doing a lot of self-psychoanalysis lately, and i wonder if such behaviour (of constantly needing to fill up my days) is healthy…

Anyway i jumped onto Book Depository and ordered a few more books, mostly Spanish children books. I have been reading El niƱo con el pijama de rayas and it has been time-consuming as the level is a little too advanced and not suitable for me at the moment. It takes about one lesson to get through the page – mostly grammer since i can easily look up the meanings on my dictionary. But the main problem is that it is using Spanish that people do not usually use in speech. Therefore it is not very helpful at the moment. Hence i bought a couple of children’s books, hopefully i bought the right ones this time. (For those interested, i bought El blog de Daniel, No preguntes por Mozart and Roca Roja). Also bought the latest new books in the Sookie Stackhouse series (Dead and Gone and Dead in the Family), and the first book of The Hunger Games! I am excited.

All right, time to do some Japanese revision, read the papers, feed the pooch and then head off to bed. Basketball social tomorrow (oops, did i forget to mention? Yup, i joined the club for a weekly session!)

Death

I came in the morning and did my usual routine of retrieving my ward list and scanning the list for any new patients. There was one, a terminally ill patient. Someone who understood her situation and opted to go peacefully. I walked past her room quietly, throwing a glance in. The patient i saw had a face so gray, i thought she was already dead.

We visited her on our rounds. I introduced myself. She gave me a smile so warm, i was disoriented. People who are about to die should not look so…happy? She reached out with her hand; i did not offer mine. I did not want to touch her, but then i was appalled at my manners. I could not even hold her gaze. The usual questions i normally ask my patients remained frozen in my throat. Do you ask a dying patient how they feel, are they feeling better or what plans they have for the day?

Just as we were about to exit the room, i reached out and held her hand. She clasped my hand in a surprising grip and smiled at me again with an encouraging look. I could only muster a weak smile and could not wait to exit the room. My head was churning with emotions. A dying stranger was comforting me because of her impending death instead of the other way around. What logic was that?

Throughout the day, i would not enter her room. I usually smile, greet or stop for a small chat with my patients, but for some reason i could not muster the courage to talk to this lady. I do not know how to converse with a lady who has no more hopes and only a final destination to arrive at. What do we talk about? What can we talk about? Everything else would be so mundane and pale compared to where she is heading to.

The next morning, i glanced in her room. I thought a face could not get any grayer, and that expression must be a mask of impending death. I have never seen that look before. 15 minutes later, i was paged. My patient had moved on. I felt a jolt of shock hit me. That was not a mask i witnessed; that was death itself. I just did not recognize it when i saw it.

I was asked to pronounce her death.

I hesitated. The senior doctor saw the look on my face.

“This is your first dead patient?” she asked incredulously.

I nodded mutely.

Instantly her expression softened.

“I will accompany you into the room,” she said and i was very grateful for that.

I knew what had to be done, but i never had to go through the motions before. Hell, i only did one week of palliative care in my 5 years of medical school. Now i wonder how we managed not to learn more about palliative care when it actually dominates every aspect of medicine.

I was afraid. This lady was dead but she was not a corpse to me. A corpse did not look like that. A corpse is one i associate at crime scenes and funeral parlors, not one that still retained some sort of human resemblance. I was frightened that she would rouse at any minute and yell at me to get my frigging fingers off her.

I did the sternal rub, determined to elicit a response. The senior doctor had to gently tell me to move onto the next stage. I auscultated the chest – it was silent, yet i held my breath and my stethoscope, waiting to hear a sound, any sound. It was weird. Then i palpated for the carotid pulses, and i knew i will not find one, yet i held my fingers to her throat, waiting for one. It was all so surreal.

Then i lifted her eyelids to look at her pupils and that was when i knew she was dead. Not because her pupils were dilated but because the eyelids did not slid back in place. I gaped in shock.

“Close her eyes Spud,” the senior doctor said.

I did as i was told. I have never known the eyelids do not move automatically back in dead people. Clearly i know they will but somehow the dots did not connect.

Then i wrote the death report. I carelessly looked at my watch and recorded the time of entry. The ward clerk ambled over, peered over my shoulder, noted the time and said, “That shall be her time of death.”

I stared wordlessly at her. How can such an insignificant action to one be of so much value to another, especially when it is not accurate?

I hope i never have to do that again.

 

Animals

I find it remarkable how animals can bring out the softer sides in people, no matter how testosterone-laden they appear to be. One of my language teachers recently bought a kitten. He is the masculine sort – the type that scorn at kids and scoff at effeminate males; the alpha male that keeps himself in tiptop condition (but not like one of those disproportionate bodybuilders) and refrains from expressing his emotions too outwardly. With the new arrival of the kitten, i was amused but not surprised at the change in his behaviour. He coos at the kitten, kisses the kitten, and very tenderly greets the kitten when it wakes up after a fitful snooze. Unbelievable. It was nice to observe how animals with their pure innocence and lack of pretense, bring out the gentleness in people.

On that note, i have also applied to be a foster carer for rescued dogs. I have submitted an application, just in the middle of being processed and vetted to see if i am suitable to be one. I have been thinking of getting a second dog for some time but my previous experience really scared me. I am so damn afraid of getting a dog that is the complete opposite of my current one – it makes training and daily work a living nightmare. But i have never ruled that possibility out, even informing the landlord of my intentions. I guess that’s where i am quite fortunate to have a supportive landlord (*touchwood!* lest i just jinxed myself) and to have been able to find a property with a massive backyard with proper secure fencing.

I was doing some research around and some calculations of my finances – it was highly probably i will end up adopting a dog from a shelter just because it was a more altruistic thing to do. Anyhow i was browsing through many websites when i realized that foster carers are in demand. A message from one such organization particularly resonated with me – foster caring is like having a dog without the long-term commitment and i will be doing good ultimately. The catalyst was probably the lack of patients in the hospital currently. I have been caring for TWO patients the past two weeks and just bored out of my damn mind. I don’t know how that happened but apparently we are an efficient team. I did not even have discharge summaries to complete! Along the same line, i also impulsively signed my dog up for agility classes. She used to attend classes but ever since she passed her basic obedience, i could not be stuffed making the long drive to the club for intermediate obedience lessons. I did not see the point of enrolling the dog for intermediate lessons anyway. But i re-discovered the club (i don’t know how i could have forgotten!) near my old house where i used to take the dog for her puppy classes. They have agility classes. So there we go.

There are also more activities i have planned including a trip to a canine country club (clearly such establishments are smart enough to capitalize on owners like myself ) for the dog to roam in the lagoon, sheep herding clinics and finally a solo road and photography trip for next week, something that i did not have the time to do since 2 years ago. I am quite enjoying this at the moment, and am excited at the prospect of being a foster carer. But if that falls through, that will be fine too as i have resolved to play a bigger part in volunteering in animal welfare, but in ways different from the times i used to volunteer at the dog pound. I will blog about it when i am doing the work, otherwise it it is just empty words.

Oh, and martial arts? Since i have stopped BJJ because i cannot resolve the hair issue, i have found another discipline to consider (again something that i have considered after Judo and before BJJ but somehow seemed to have forgotten, gosh these memory lapses!). (Hint: Iaido or Jodo).