It’s a very different sort of feeling, being an MO. Apart from the mountain of responsibilities that you’re suddenly expected to bear, somehow you’re expected to know how to do lumps and bumps, to make decisions, to take ownership… I guess I’m just super lacking in confidence in my own judgment. (which really, I’m not the best person to make decisions) I think it’s helping that I’m in A&E so we all like take charge of our own patients, and got to have a clear management plan before clearing the case with seniors.

It’s still too early to comment about my new job scope, cuz I haven’t got rostered into resus yet. *Heavens, just thinking of it makes my knees go weak!* (haha…) Not like drool who’s almost ‘lao jiao’, every other minute I hear the PA system go: Dr XXXXXX Dr XXXXXX to resus now!

What I like about A&E so far is that the cases are almost entirely FRESH! I’m the first to see and clerk them! It’s a good revision of medical school and a good way to test my clinical acumen!

*shivers*

Wonderful trip! :) Such a great break.

Photos up in facebook! Blog will follow over the next few days.

Oh and well I missed ALL CALLS / SMSES over the past week plus cuz technologically backward moi did not have a 3G SIM card and so was basically uncontactable in Japan. So if you tried to contact me over something important (ie. NOT insurance / bills / work-related) try again! :D

Congrats at emerging whole (both physically and mentally I hope), to enter a new phase of your life!

Oh dear, and at this juncture, where I’m supposed to be filling your heads with the endless possibilities of you healing and helping others, I’m simply just overwhelmed by the sheer amount of disappointment and disgust at a lot of others things in our profession.

Just remember to always put your patients’ best interests above yours, and you’ll never go too far wrong!

When you’re tired, hungry and plain frustrated, a task that does not take priority over some of your other tasks might take top-most priority in the eyes of others, (ie patient or their family), and if a reduction of your sleep time by 15min can bring about something of much comfort to those in your charge, it is always worth it.

At breakfast…

Other teams: Hey so your call very good right? Sleep until got pressure sores hor!

Me: Not me, I went to clerk in ED ok… My MO got pressure sores!

MO: Haha but I tell you, our reg got the REAL pressure sores! Need VAC dressing!

Remember the incident where I was raving at how people thought that HbA1c could be used to diagnose diabetes?

Well… I saw a pte GP’s referral for a patient with foot ulcer yesterday. Written plainly was…

“HbA1c 4.5% = NOT DM”

Tragic…

Today I saw the true power of the CHOP. SOCIAL OVERSTAYER - in bright bold red.

I had a social admission staying for almost a week. Got rejected by stepdown care and not able to qualify for voluntary nursing home. Family uncontactable, and hanging up the phone on us.

Just summon our best friend, the social overstayer coordinator, this lovely auntie in pink.

My patient went home on the same day.

The relative was so aggressive and oh-so-demanding…

Actually I don’t think the entire fault is hers cuz I believe there was some misunderstanding down at the ED. Apparently the dr had told her that the patient had a ABC condition, but it wasn’t written down in the ED notes, in fact it was written as ‘no ABC’ condition.

An effort to contact said dr to clarify this with this increasingly hysterical relative failed cuz that particular dr was on leave!!!

Anyway, she just started ranting and raving and demanding that I changed the diagnosis to include ABC condition, for purposes of insurance.

Sigh. I seriously hadn’t known this patient’s relative was known to be that ‘difficult’ since I was merely covering ward changes for them. It was so shocking! Really taken aback and no matter how I tried placating her it wasn’t working, ended up with her SHOUTING at me saying I was disrespectful to her, to the nurses and ALL the patients in the ward. It was downright humiliating and all the patients + their families were simply staring. Thank god Sister and Brother came to my rescue. But by then I really couldn’t tahan anymore and just walked off…

Felt so useless…

I’m still waiting to get disillusioned about my work, like so many of the others are.

Apparently he kicked something about a week ago. But did not see the doctor even though it was infected and really really smelly.

It’s like the pseudomonas full force!!!

And the XR showed the distal phalanx of one toe was gone with all the soft tissue, and when I saw him, the bone was just sticking out like that! EUW!

And when he could have just gotten away with a simple debridement or at worst a Ray’s, now he’s going to have to get a BKA. Sigh.

And then, if anything does unfortunately go wrong, they simply give everyone hell. I’d rather not touch such patients at all.

Just today, my current boss gave what I would describe as a very rational and clear presentation of various possibilities, pros/cons and associated risks of success. He was very approachable and did his best to explain everything. Yet, it all boiled down to…

The family asked him to sign a form or some sort of letter to guarantee that the patient would not need any more operations for that particular problem after this one!

简直是对牛弹琴。。。 MOOOO…

She was going to sew up the episiotomy for a lady.

HO: Sorry mdm, just a small prick and I’ll be done sewing…

Woman: WAT?!?! A small prick did THIS to me!!!

[episiotomy = a diagonal cut along the edge of the birth canal to avoid unwanted tearing/ripping during childbirth, it has to be sewn up after the delivery]

Azabu Sabo’s done up quite zen-like, with simplicity and a valiant attempt at being authentic. However, the lovely glorious chandelier just spoils the simple beauty and little bits like the chinese-looking drawers lend a tad of confusion to the japanese cultural setting.

Nevertheless, the food’s there quite affordable and prettily set up for display. In fact, you can view almost the entire menu at their official site.

For that night my gang had the following:

Mixed Fruit Bowl
They have the sugar (brown / white) at the side, which is good cuz then people can moderate the sweetness of their dessert.

Matcha Zen
This was so devastatingly sweet that my friend, for all her sweet-tooth, could barely tahan it. The culprit? The red bean paste… Haha… I’ve never seen anyone eat a dessert with such determination.

An-Mitsu
This one looks quite delicious, and the soft ice cream they have isn’t as sweet as those we normally get elsewhere… They’ve got sugar (brown/white) on the side as well.

Black Sesame Milkshake
I’ve never in my life tried any black sesame desserts before, not even the famous 芝麻糊. Took a bit of this milkshake and hmmm I don’t think I like black sesame much. Too ticklish on my throat.