The Pensieve

heh. i’m blogging on call! it’s now 6.10am on a sunday morning, i’m wondering whether i should get to the hospital’s roof to watch the sunrise!

never knew i could keep awake that long…

after a rather boring night from 9pm to like 2am… (cuz my HO didn’t call me to see the sian cases, only interesting ones then she’ll call me…. -_-) where i just functioned as a mobile pager svc, met up with R and her MO who needed an interpreter. it so happens that this entire ward of nurses did not speak mandarin!

at about 430am, got a surprise sms from my HO regarding a quite interesting new case… followed by one patient desaturating (he did not make it thru the nite), one weird septic thingy with really fast tachy, one more new admission and just bloods bloods and more plugs. -_-

i think i’m still quite blur on my first call. hopefully, at the rest of the calls i’ll be able to perform better!

ok shall now go meditate for 45 min before i meet up with R for breakfast, then trace results and start pre-rounds.

poor R. she also probably didn’t get to sleep all nite, but at least my pace of work was much much faster than her team’s pace… they looked like they were sleep-clerking!

gosh. i’m hungry liao eh.

so it happened that the HO went off call, as her other HO and her MO kindly decided to cover for her…

it was around 2pm… lucky her…

around 2pm+, R n the other HO became ‘inactivated’ for almost an hour plus since they were stuck at a ‘veinless’ patient who needed an iv plug.

i was just innocently sitting at the nurse counter tracing my patients’ results when…

nurse 1: hey ‘dopey’, r u covering for ‘ho’?

me: errr… since she’s not here, i guess so…

nurse 1: good ok! can you write a memo to SLH for Mr A and update them about his status. then can you also churn out a medical report for Mr B addressed to EH to help in his transfer there?

me: ok… (starts to go thru case notes)

nurse 2: ah, ‘dopey’, patient’s plug fell off, help me set another plug for bed 19!

nurse 3: oh can you help me take a set of PT/PTT for bed 23?

ward clerk: ‘dopey’, patient in bed 17 is going home in the afternoon. do discharge summary ok…

me: isn’t she from renal med?

ward clerk: ya, but she’s in yr ward, so u have to do for her!

me: [churns out the prescription first (since that’s like the rate-limiting-step), hunts for HO to get it signed and off it zooms to the pharmacy! then get started on the MC and discharge when…]

MO: ‘DOPEY’ AH! your patient’s potassium was 5.7 yesterday, how come you didn’t do anything about it?

me: I told the HO and the REG!

MO: oh, anyway, you cannot don’t do anything if the potassium is so high. do a repeat K now and send as urgent. if it’s high, you have to go correct it ah. how you correct high potassium?

me: blah blah blah (on how to correct high potassium)

45 min later… discharges done, bloods done, K comes out as a freaking 6.1! ECG stat: PEAKED T WAVES

spends the next 30min struggling with IMR, resonium, iv calcium gluconate, D50 and insulin…

finally… the REG and CON arrives, and i hadn’t finished tracing results yet… but still had to update them. SIGH…

after a pathetic set of ward rounds, thankfully the MO did most of the talking, had to finish up the memo and do a repeat urgent potassium level again.

now i am one step closer to knowing how an HO really functions. How does one keep a million things in his mind and multi-function without making mistakes at all!

And so it was the fateful day where our dpt has the grand ward round…

We thought that the HO/MO would be leading the round, but guess what, our consultant… let’s call him DBC bellows… ‘ok, who is incharge of this patient?’ (in a sing-song accent)… the HO/MO start to speak but… they get stopped by DBC who then looks around for…

‘AHHH, you two are here! who knows about this patient? quick tell us about him!’

R and I were like deer caught in headlights… but luckily, we have been busy bees in the ward, copying down all the histories and tracing results… heng…

But still it was scary presenting in front of the entire group, which included…

the shuai4 one who took me for my med end-of-posting exam… *smiles* he’s back to his shuai4 look!
the TALL one who towered over EW and ahleong during their end-of-posting exam (thankfully, he mainly skulked in one corner and tried to look nice)
and a myraid of other pple i knew nothing of but looked equally serious…

So it went… one patient after another, and us steadily feeling more and more useless and getting confused by numbers and wondering who got which sided lesion…

I so regret doing the HD area… -_- at last count before i left, the HD was FULL!

***

on a happier tone, i absolutely adore this dpt that i’ve been posted to. Hope to enjoy the rest of the 6 weeks with them… though, next month, we’re changing consultants and um…. pls not let it be TALL-towering guy… *gulp* the current consultant really takes effort to teach us a bit at every patient’s bedside, practical things like maintaining INRs, which drugs to look out for… the nurses have been pretty kind to us, and treat us quite humanely haha… the HO is FANTASTIC! i think she’s really ‘powerful’! and despite being busy, she takes the effort to go through all the important things like how to write case notes/summaries/referrals/memos/IMRs/fill up forms, and practical stuff like meds, ICS…

the team also makes an attempt to get us welcome… like they make us have breakfast/tea with them… and the HO/MO always makes sure that we have our lunch with them… :)

***

the only grouch i have is that i have NO TIME TO STUDY!!! and no time to properly clerk my own patients or to give them full exams!!! i must start doing that next wk… maybe come earlier to examine them first then go trace results…

today, the consultant asked me to explain INO and the MLF and PPRF and watnots… and i just grimaced… OMG…. it was sooooooooooooooooooooooooooooooooooo embarrassing!

and i am too tired now to understand / absorb all the crossing pathways in our brainstem!

1. how to use the different kind of plug with its connector and butterfly needle (issit butterfly?)

2. how to transcribe an IMR

3. discharge / death summaries

4. prescription writing and printing

5. tracing results like a maniac

6. learning about the ICS application

7. how to mix and give ceftriaxone

8. when the nurses say ‘let me share with you a secret’… run, just run far far away… hahaha…

High of the day: setting a successful plug in an old woman with a barely visible vein popping up for a short distance of 1 cm on top of her knuckle! i thought i’d have to give up and let the HO do… cuz it was like 80% chance of bumping the vein!

my CG (clinical group, haha… it’s not cell group. and i dun understand why cell groups are called ‘cell’ groups… someone explain to me if there’s any underlying significance?)

When i first met my spanking new CG, i thought they all looked like prematurely aged, wise-word spewing yodas who mug their entire lives away… but I think after a month of interaction, i think they are actually still prematurely aged, semi-walking medical dictionaries who still mug a lot but are a whole lot of fun too! spanking yea… i think they’re getting a bit kinky judging from some performance enhancers they’ve been talking about recently…

haha so here’s an introduction…

We have our perennial group rep, poor R of the beautiful eyes who always kena sabo for grp rep. But thankfully, everyone in our grp is ultra-自动 and offered to take turns being grp rep. FYI i’ve already booked psychomed. heh. R wants to wear specs! horrors… though she looks interestingly studious with my specs, i think we cannot hide her beautiful eyes rite…

Then we have EW…
the guys in our CG went: wat’s EW? Evil woman? She’s evil? How?
Wait till she starts unsheathing her claws… muahahahahha…

Then there’s our asst class rep ‘mentor’, newly appointed member of the CRC (clap clap clap) and so-called NNI graduate…. *drum rolls* His pet phrase is ‘the signs are pointing home’…. and sometimes, even the symptoms too. His pet peeve is extracting EW and his cg pal from the wards… a feat which no one has managed to accomplish since the start of school.

Next up, prof SY. i think he is a yoda-in-making… people, all look out! He spews knowledge like a fountain… :)

Next prof, that would be prof zhuang… hehe… who analyses ECGs till you get vertigo and all the ECG rhythms look like they’re dancing before your eyes… a deep thinker and keen analyser, he is always found digging for cases in the wards. :D

Then Ian, also called Irene, when he joins our sisterhood in the faraway western front for SIP for the next 6 weeks. He’s the one whom patients mistake as our tutor. Which makes a convenient assumption sometimes hahaha…

Finally, we’ve got CH of cuz… one word *poof* I think he’s the next E**ol…

Yea, together, the boys insist that we’re the BROTHERHOOD. cuz to them, we three gals are guys too. they probably think we’re asexual or something…

BUT… after friday’s incident where the guys showed us how ‘girl-like’ they were by getting themselves lost while leading the GALS the way back to NUS… hmmm… i think we should rename our CG as the SISTERHOOD! haha…

Regarding being a doctor:

“Good enough is never enough. There’s only excellent or… nothing.”

— Prof P. Choo

I was so stunned by the professorial round.

I’ve never been so stunned before.

Kow tow to him… I shall aspire to be as observant and analytical as him. He thinks like a tree! How does he do that?!?!

omg omg omg… please let it be water retention…

I haven’t had one of those ‘moments’ for ages. Where something seemingly normal and uneventuful just makes you kind of happy, and you sort of smile in your heart (even if your face is quite stoned out…)

For the past few days, on occasion I’ve had a leisurely stroll through the plaza near my house (so i can cool down with the air-con before i hike home…) and I’ve noticed something different these days…

There are more people who are wheelchair-bound who are either independently wheeling themselves around the place or being accompanied by someone.

It’s heartlifting to finally see that society is becoming more open towards the disabled, instead of staring at them with curious, sometimes even prying looks.

It’s even more heartlifting to think of how much courage that person must possess to venture out into a public area with what many would consider a social stigma.

YO GO PEOPLE!

I shall start counting my blessings… :)

On Tuesday, my poor CG had to go down all the way to the hospital in the west for our tri-monthly ETT assessment, which they informed us of barely 24 hours in advance (thank-you-very-much), thus ruining the illusion that we could take a free half day off from the monstrously long ward rounds…

As R put it, ‘the joke was on ourselves in the end!’

Anyway, a discussion transpired between two students right after one of them finished the ETT study…

A: Hey, weren’t we supposed to use 10mls of water to inflate the ETT balloon?

B: Water? No what, I thought it’s air?

A: Really? Then… hmmm….

B: HAHAHA the water is for your urinary catheter la!

A: OOPS! I told the examiner I used water lei… haha… Anyway, later when you go in, remember it’s 4mls of air, 4 mls only hor!

B: Really? I thought it’s 10mls air?

A: Apparently not… oh, 10mls is for urinary catheter!

later in the afternoon…

A: so how was your ETT?

B: i forgot to inflate the balloon leh!

A: …

the mystery of the ‘uneven balls’…

A: hello, my friend, who is an insurance agent wants me to ask you what is the name of a certain operation…

me: oic, what was the operation for?

A: erm, it was for uneven balls?

me: uneven balls?!?! (a thousand pictures of various conditions flash thru the mind… things like cryptorchidism, chronically retracted testes, inguinal-scrotal hernia, and even the transilluminable hydrocoele!!! but wait a minute, don’t all guys have so-called uneven balls?)

A: ya… so what do you think that op was for?

me: er, uneven balls sounds really unspecific, did the doc say what condition he had?

A: erm, i dunno…. only we know that it’s uneven balls so have to do operation…

me: ok, hey wait, your friend’s an insurance agent right? the guy is doing a claim for his operation? he’ll need a medical report from the hospital for it rite… the name of the operation and the condition should be in the report rite…