Zeal-y Thoughts

Assessment done and passed.
First lone call done and passed uneventfully, thank God and everyone else with me those 30-ish hours.
Arrangements mostly made.
Leave forms sent!

My first Cuti Rehat after about half the posting is coming up soon! :D

And although CR is very much awaited for, I have just begun to like the posting a lot. When it's not too sad. Like I said, miserable days do come, but so do easier, better days.

People who were giving you grief could turn out to be those who would be nice to you later. And vice versa. It happens.


I have also majorly learned that medical student habits die hard.

Reading is required, but reading too much and overdiagnosing simple cases into complicated cases... Not too fun for your superiors- some are more vocal about it than others. Sure you might get creds for knowing stuff, but you're a doctor- you're SUPPOSED to know stuff. The important thing is the ability to distinguish the stuff into what's more important and likely, and what is significantly less so. And in the real world, most things you see are the common things.

My HOD actually affirmed that excessively reading the textbooks doesn't really help with HO life.
Also, that no medical graduate, no matter your institution of learning, or your ranking in said institution, will start housemanship and immediately be great at it. Everyone starts confused and in need of guidance.

Everyone.

Do not mistake your achievements in medical school for how you'll turn out in the hospital. Just because you aced your clinical years doesn't mean you'll ace your first posting as a houseman. Although good working habits in clinical years are a good indicator of good actual working habits, it doesn't mean you'll immediately be as good as your more senior HO colleagues.

This also goes to how you view your colleagues- do not think you're superior.
But also, do not be overzealous in your respect for your superiors. Respect has to be present, but too much is never good. This came from a person whom I overzealousy respect (and am actively trying not to be too zealous about).


Also, Cute MO is cute.

Off-Day Thoughts: A Rant on Intentions & Many Other Things.

I lost something valuable in the wards within last week.

When I let the information slip to my MOs, they went to the ward sister about it (I didn't want to say anything to avoid exactly that).

When the ward sister was about to reprimand me for leaving my valuables somewhere unsafe, they immediately defended me and asked instead why she wouldn't provide lockers for HOs in the ward.

And proper rooms for our on-calls.

And other things but I left because I felt awkward for indirectly demanding stuff.

Point 1: I am not blaming the Sisters for it; it was my fault. Also, I don't mind napping on the floor. It's not like I ever slept more than 3 hours straight in that ward.

Point 2: My MOs (like 99% of them) are amazing.

Yesterday someone told me my valuable has been found. I'm not sure if it's really mine, but the brand is the same so I'm 99% sure it is. I am so excited.

99%.

********************

I try to control my words, but I can't really control my facial expressions. I try hard, I think, but I haven't mastered control over my face when I'm exhausted and/or stressed.

This is called moodiness and it really intrudes into professionalism.

Actively trying to combat it. It's easy to talk about now, but when I'm tired it's another thing entirely. And let's face it, one gets tired a lot in this line of work and people often get irritating, too.

So. Let's see if this will be less of a problem a few months down the line.

Maybe years. But I'm trying to be optimistic.

********************

It's weird being the person taggers look for to do procedures or ask about things when the're unsure, but that's part of being a senior- even if you're only a first poster and the other person's in his/her third or fourth.

I am glad to say I was of some service. Heheh.

The SNs start to look for me instead of my senior too, now. And so do my MOs.

I am beginning to be trusted to attend calls alone.

It scares me, the prospect, but I know of many friends who have been attending calls alone for weeks by now- ever since they went off-tag, actually. I've just been privileged enough to attend calls with other people so far.

********************

I feel... I feel like I'm still sub-par. There are questions my consultant asks me that I cannot answer and, in retrospect, were super easy. Ones I can answer are simple and I still sound doubtful that even my consultant notes that doubt in my tone, with amusement. My consultant isn't mean, in fact she's amazingly encouraging despite her strict work ethics, but I respect her so much that she intimidates me.

And this is stupid, guys. 

Do not be intimidated excessively by anyone, especially if that person isn't even mean. It just blocks your thinking process with self-doubts and imagery of unnecessary repercussions. Take it from me.

It's okay to make mistakes. It's okay to not know stuff- sometimes.You're only human.

But make sure you know things you're supposed to know, and do not repeat those mistakes.

Do not care too much what others think about you- it's half the reason why you're so scared of getting scolded, maybe even more.

But I know, I know: It's easier said than done.

Like I said, sometimes I ask my seniors to tell me where I fall short, toughen my heart for the criticism, and take it into stride for future improvement. I care too much; some just adopt a more easy attitude and let things slide while still improving, which is amazing but realistically something I cannot relate to.

So I see some improvement in my work. I better; it's almost been half the posting already.

But there are still multitudes of things I have to improve upon.

Reminder to self on this almost halfway-mark to EOP:

Focus on your good traits. Do not focus on your feelings when making mistakes, rather focus on how you could improve yourself once those mistakes or shortcomings are identified. Do not dwell on what others may think of you, positive or especially negative. Do your job, and improve, for yourself and for an increasingly better service towards mankind.

Intentions must be kept noble, at least at heart. It's okay to be selfish in times of most stress, though- you're only human. But remember the ultimate goal of why you joined this field instead of taking, say, Geology or English Lit.

Your father invested a lot of money and effort into you.

Don't let it go to waste.

Make your family, friends, and teachers proud.

But don't focus on that pride because it will destroy you with a persistently-inflated ego.

Intentions, intentions: Keep them pure. Keep them noble.

Not the Best of Weeks.

It was an eventful on-call period.

Almost twice the actual capacity of the ward.
Calls every other hour.
Malfunctioning equipment.
Weirder cases than most days.

What even.

It doesn't help that humans are humans, and some are more snarky than others and make it a point to call you out on your shortcomings- like they're the only ones who are swamped with work. All they care about is getting their work done on time.

Luckily I had a nice colleague and an understanding and super helpful MO for that call.


I had a mortality case that involved me.
It involved me days before the mortality happened, and it hit me hard, being one of the first people to see that patient when he/she was stable. Even though my management was sound and the patient remained stable for many days afterwards- even if the patient didn't deteriorate while I was directly in charge of his/her care. My mind was full of 'What if's for at least a couple of days afterwards.

It took me a while, and several different people of different ranks, for me to get over it. To stop mainly blaming myself.
"Mainly"- because a small part of me, inevitably, can't help but feel responsible no matter what people say.

It pains me to know that the caretaker of that patient lied to my face about one of the patient's symptoms- at least one of the symptoms. And though for that caretaker the lie seemed small, for us it is significant. It could have meant a different investigation; a totally new approach.

It could have meant saving the patient's life.

But what's done is done.
The patient is gone. To a better place.

And I'm still here, forever remembering my first mortality.
But dwelling on "What if"s wouldn't help anyone most of the time- least of all myself.


It hasn't been the best of weeks, so here's to hoping tomorrow will be a better day.
Even though I'm so tempted to just collapse from all the work I had to do despite the hours of sleep I had since my post-call; So tempted to take a leave to avoid having a day like the last on-call I had... But like I have told myself again and again, there's no telling what tomorrow will bring. Perhaps more days like the one I've had; but perhaps it will be one of those great days which are mainly uneventful and just filled with great people and enough time to sleep instead of 30+ hours of staying awake, zombified.

Until I experience the day I do not know.
So hope for the best and expect the worse. That is how this life will always be.

Welcome~!

There are new HOs coming in already. In fact, I think today might be their last day of hospital orientation, maybe, in my hospital. I'm not so sure.

Welcome to the hospital life, taggers! Your not-so-senior seniors will be too happy to help you. We're all in the same boat.

Keep your intentions good and cast your ego aside*, and you're good. :)




* - Where applicable.

Off-Day Thoughts: Volunteering

I made a fool of myself in front of my colleagues and some of my superiors today.

I did it by volunteering for something I was unprepared for... because no one else wanted to do it.

I can't look at my kind MO and just leave him hanging with imaginary cricket sounds in the air when he asked, 'So who among you first posters want to go in front?' It's unfair to his time and honestly I have to do it anyway in the future. It's not like I got assessed...

Actually maybe I did but now it's too late to think about that.

Anyway, I volunteered because I can't NOT volunteer.

When everything is over and people have laughed their fill (because I'm a goof when I don't know things so far), in the end a friend questioned why I volunteered when I said I was unprepared. She was like 'Why, I thought you were so keen to go.'

But like I said, I knew I wasn't prepared. I just knew delaying the inevitable isn't helpful, and I tend to have this tendency to offer myself when no one else volunteers for something you may consider good.

I have to say though, you learn a lot from your own mistakes. It's better to learn from others' mistakes when you can, however, so don't look forward to mistakes! Just take them as they are when they happen and try not to repeat them.

Also, all things considered, better goof and panic during a role-play than the real situation :)


Also at the end of everything my MO said 'Good!' to me, so my goofing must have counted for something...


On that note, I've been forcing myself to be increasingly independent. Passing over cases to the superiors in the morning on behalf of my group, handling the ward alone while my colleague goes somewhere, doing obviously not-so-easy blood taking and clerking. I'm not as fast as senior posters or HOs, but I can see myself progressing both in skill and knowledge. Not to the extent that it's braggable, but enough to make me want to work more.

Enough to make me feel more at ease with the working environment.

Except I'm still clueless in many things. In the end, barely a month of experience cannot compete with a year or more spent in the hospital in various postings- not entirely. I would ask my group mates to tell me where I fell short, although I know I would not be too happy to hear them, so I can improve. A major part of this is putting my stupid ego aside and just listening, and internalizing those facts so that I may be better to myself and to others.

A lot of this is possible because my busy working environment is relatively stress-free. My superiors, as I have said repeatedly, are very helpful and kind. It is the perfect kind of environment to learn and grow!

And yes, by grow I also mean girth-wise :p

Cucuk.

"Tengok tu, doktor tu. Adik tak duduk nanti doktor cucuk."

"Doktor, tengok ni xxxx nakal sangat. Cucuk dia sikit!"

Parents, older siblings, aunties and uncles, grandmothers and grandfathers.

Please.
Stop this scare-mongering.

It doesn't help us, and it doesn't help you.
Sure you don't care how it doesn't help us...
But let me tell you why it doesn't help YOU.

Children are innocent. Naive.

When you promise them something, they expect it to be delivered.
Undelivered, they feel betrayed. They acknowledge- the more you do it- that what you say is rarely true. They tend to mistrust your words.
Hence they become belligerent and ignore your threats, because they already fathom that your threats are never carried out.

Get it?
Your child can become stubborn because of what YOU say; what YOU deliver.

Saying I- or my colleagues- will come over to poke them whenever they misbehave is clearly a threat never to be carried out. I don't know about your beliefs, but we only poke when we have to; we don't poke if your child misbehaves or throws a tantrum, no matter how tempted we get.
Sorry, we're only human.

So don't threaten your children using us.
It makes them mistrust us.
More importantly, no matter how small, it plants tiny seeds of mistrust on you, too.

And you're the person they will see for years and years after they leave the hospital.


"Adik kena makan, minum banyak-banyak. Kalau tak doktor mai cucuk." - this is sorta true, actually.
But don't force them to eat if they're feeling nauseous and tend to throw up. Rather, encourage them to eat, no matter how small. A few spoonfuls of porridge is also fine. Start slow.


In the end, if we decide they need an intravenous drip, or have to take their blood to run some tests, it's for their own good. Despite what you may think, we do NOT enjoy poking your children, or bleeding them. I have yet to meet colleagues or seniors who enjoy this task. We do it because we must; because it is our job. We are not experimenting on your children.

When you cucuk your children to be terrified of our presence, you make our jobs more difficult.
Thus making our job more slow.
Thus making your child's healing process slower.

And when calming your child takes up more time, that means time taken from other patients waiting, too.
And the burden- that dosa- is on you.

How's that for scare-mongering?


Please, don't cucuk your children to be scared of us.

Flipping BHTs at Warp Speed

"Present this case to the specialist. I am not familiar with this patient," said my MO to me during a morning round. My friend who 'covered' this patient in the morning review was nowhere to be seen, carrying out one of the many things we have planned earlier with other patients seen by the specialist. Contrary to what the MO believes, I wasn't that familiar with the patient.

But familiar enough.
I have been taught, since tagging period, to know all the patients.

So- flipping through the BHT as quickly as I could- I presented the case to the specialist.
He asked me why the antibiotic regimen was changed a few days ago.
More flipping, then I remembered that the patient had some abscesses and that was why the initial Abx regime was started. I almost forgot about the abscesses because the bandages covering them were gone now, since they were resolved.

I told the specialist that.
The specialist added, after more flipping, that it was because of that, but her condition wasn't improving, hence the change- and her condition has been improving since, hence sticking to the current regime.

It was like he was teaching me, indirectly.

He reviewed the patient, and the ever-grateful father thanked him a lot, saying he has been helping ever since the child was born (she was admitted into the NICU for various reasons).
My specialist smiled, gestured to the rest of us and said 'We ALL helped one way or another'.
The father thanked us all again.

After that patient, my MO patted my back/shoulder before moving to the next patient.
Small gesture, probably meant nothing, but it made me feel better.

This was also the specialist I presented a newly-clerked case to a few days prior, and he argued my diagnosis- raw and unfiltered by any MO- but then I justified my reasons for my diagnosis, and he listened, and after having looked at my plans for a while, said, 'Continue the plans, then'.

And my heart exploded with pride and gratitude.

I have moments when I feel horrible, but I'd rather not dwell on them. And to be honest, small horrible moments tend to fade if you don't focus on them.
I do remember a lot of more negative moments, too. I can't help it, I'm not like a colleague who easily dismisses negative things and moves on. I tend to dwell. But I'm trying.

Good thing my moments here are more positive than not.

My first month assessment is coming soon. God knows how scared I am.
I'm reading old presentations from medical school since I lost my paeds protocol.

I should read that too.

There are so many things to reeeaaaaaaaddddddd!