Staging the Malignant Tumour & The Norm.

I'm lucky now that I'm in such a positive environment.

This is probably the department with the most relaxed, least angry bosses in the hospital.

Also the department which people from other departments are always condemning, but whatever.
Condemning other departments is normal, no?
At least in any hospital with departments to condemn.

And although that is the norm, it is rather toxic.

I rarely- RARELY- hear my bosses in any department defend their colleagues in other departments.
It's weird.

Why?
Because it's the norm.
That's how their seniors worked, and that's how they work now, and that will be us in a few months.

In fact, I know of some people who take pride in being known as 'The Malignant Senior HO'.
They take pride in the fact that fellow malignant bosses also approve of how scary and intimidating they are to their junior colleagues, their fellow staff, and patients. Apparently, being 'malignant' is encouraged- and a sign of aptitude!

And hey, take a gander at how they will run their future department soon!

Mocking other people.
Mocking other departments.
Mocking other hospitals.
Especially those that are considered 'beneath' them.


Repeatedly, I have called up certain departments to request- kindly- for a process to be expedited, or an investigation that requires expertise not available in my current facility, only to be shot left, right and centre even before I could even begin to tell my story. Simply from the introduction which indicates my HO status, the previously semi-warm greeting plunges into icy tundra, and all hell breaks loose.

Telling my seniors or bosses (with amusement, because that's how you're supposed to wave it off) only results in further remarks on how that is expected and usual, and that it somehow builds character.


I was quite surprised to find that there are decent people out there, who, when faced with the fact that we simply do not know how to properly present relevant details, will actually teach instead of scolding or slamming the phone down.
They realize that we are not experts in the field as they are, and accept it with patience.
They persevere in teaching us, so that we may do better next time.
Besides, it will definitely benefit them in the future.

Just as it benefits our health, mentally and physically, to encounter such positivity in our working environment.

These are the types of people that should be the norm in this field- this career that demands so much time and energy devoted into the caring of others--

--and yet 

they are 

the minority!

I don't even have to ask why.

It's because we accepted that things should be tough for us.

We accept that
those supposedly higher in rank have the right to scold us unnecessarily;
that despite how wrong they are, we should strive to accept their words and not defy them.

We accept the hierarchy that has been established, blindly, and do not strive to improve our own fraternity because 'it's working'.

The hospitals are running, people are coming, so it's working.


In the journey after medical school going to fully-licensed medical practitioner, we lose our humanity and accept this so-called 'norm'. Come MO-ship, almost all of us are same ol', same ol'.
Those who don't accept this status quo are shunned by the fraternity, then ultimately leave for greener pastures (private practice or leaving the medical field entirely).

And what a shame. What a bloody waste of talent and resources.


I notice that the department in which house officers thrive- stay happy, and excited to work- are those in which the Head of Departments have zero tolerance for HO bullying.

They do not condone harsh teaching of their HOs by the MOs or other specialists or healthcare staff.
They tell their staff to treat the HOs like their younger siblings; to respect them as human beings and junior colleagues.
They actually will tell their MOs NOT to do something right in front of everyone, when they think it's wrong.

These thriving departments are not the departments which justify their MOs' legendary repute for yelling, screaming and borderline physical abuse because 'conditions are stressful'.
Sure, they say, your MOs will shout at you at first, but it's okay because they will be better to you once they know you're able to do work. And you will learn either way, if you're a tough HO, because remember, only tough HOs make it through!

And this attitude is exactly what needs to be corrected.


But who am I?
Just a HO, green from the pastures, with nary a ring to put to my career span.

Going Back

There are many ways in which people gauge the status of a houseman.

Competency, that is a no-brainer. Are you able to manage the common emergencies or cases? Perform the basic procedures without much difficulty? Diagnose a life-threatening complication of your patients in ward? A competent houseman is, more often than not, a good houseman.

Then there's knowledge. This contributes to competency. Safe to say, most of us have knowledge, because let's not forget that the journey to becoming a medical student wasn't easy- at all. More often than not, it's just a matter of doing proper revision, and more frequently. Otherwise, everything our specialist taught us during the rounds just fly out our memories within the span of a week (or less).

But attitude... Now that's something to contend with.
How would you gauge attitude?
What defines a houseman with a good attitude?

It's easy to speak about it theoretically, I'm sure. But this is probably the facet that is hardest to evaluate objectively.

A houseman may seem very competent and knowledgeable to her bosses, and hardworking too, but shunned by her colleagues. Turns out, the houseman shirks from work during all times except when her bosses are around.

Another houseman who seems likable and hardworking, but avoided and talked about by nurses. Competent enough, but lacking in communication skills and the tact to deal with people who are seemingly under him.

And on and on.

It's very hard to judge a person when you only see them for a total of less than 6 hours in a 70-hour work week. In those few hours, that person may be having the most difficult time, and have done some major blunders that do not define the person at all. After all, to be human is to err.

But that is what happens.
Because, like it or not, first impressions do matter.
And second impressions.
And maybe third ones too.

So how to define attitude more objectively?
Therein come the logbooks with the attendance records and multisource feedbacks, and other things associated with them.

**********

Attendance is a very fickle thing.
For the most part, it is believed that the longer hours a houseman works, the more positive his attitude is, and thus a better houseman he will be. However, in those supposed punched-in, punched-out hours recorded, how did the houseman fill his time?

There are housemen who diligently come and go on-time. And these are scoffed at, because they do not put in extra hours, and must thus be less hardworking.... Right?

Those housemen who leave late on record, now those are the hardworkers! ... Right?

Anyone who's been a houseman these days know that this is not entirely the case.

I know of people who punch in on-time, and punch out extremely late almost each shift.
These are the same people who disappear while they're supposedly on-shift, doing God-knows-what and leaving the abundance of their other co-workers- because yes, nowadays there are more of us working and the days of single-person shift are fast coming to an end- to deal with the work.
These people will unfailingly be there when bosses come and act like they've done all the work.

These people will disappear again afterwards.
And well after their working hours are over, they come back to the hospital to punch out.

Whereas those who come and leave right on time aren't necessarily lazy. They spend the required hours doing all that is required of them and maybe more, and by the end of the day they deserve to punch out on time. After all, some of them have families to come home to; work is not their entire lives.

And yet we define the attitude so easily based on some scraps of paper that supposedly record our hours.

**********

So, I've been in this leave early (aka on time) or late dilemma too.
But then I realize, it's all so simple- if I don't come to work merely with the intent of pleasing only my bosses or other authorities watching over me. I come to work for myself, and for something larger than me and my bosses.

And there is an omnipotent being monitoring all my moves.

So people may think I go back early (aka on time). So what, if I know I've done all that is required of me?
I have also gone back late because I was helping others with their work.

No matter what happens or what the people monitoring my time card may think, I know that I've earned my keep. I know what I have done and what I would have shirked. And God certainly knows more.

And if I'm doing right by Him, then nothing can truly throw me off my course.


Not that I have ever had attendance issues.
Nor has this been a raised issue for me.

I am on both ends of the spectrum.
I have clocked in some rather long hours too in the past years of my life.
And I have clocked in some punctual hours, too- more so now that I have matured enough to care less about what other people may think.

It's just an interesting issue because I heard of a colleague bragging about how he/she is always around within 30 minutes after the supposed end of shift, and this colleague has a habit of disappearing within working hours and subtly leaving work for other people to settle.

Longer working hours are not entirely impressive, people.
Get over it.

So if no one in the ward needs your immediate help, and your work has truly been done (or any appropriate work passed over), then go home.

But God help you if your friends are dying for help and you hightail out of the ward like a convict on the run.


P.S.: Housemen in Malaysia get the same pay no matter their working hours. It varies slightly depending on where you work in relation to where you live, and your seniority. Other than that, we do not earn extra for the extra hours we put in, or which public holidays we work in.

I'm in awe~

Perhaps I was too afraid to jinx my experience so far, but this has got to be the most relaxing posting I've ever gone through.

Ever.

I'm just in awe.

Well, in awe at how superstitious I've become, but also at how amazingly nice this posting has been on my mental status.

Bosses are way nice.
Workload, most days, is negligible.

And not to mention, generally this department has a really quick turnover rate. Results are easily seen. And people get happy with their after results.

Not that there weren't unhappy people (they ruined some of my days, I tell ya) but that's a given.

Except I haven't been doing the bulk of what this posting even says- SURGERY.

Most of my work is in the ward!
Or in the emergency department!
Or in an ambulance!


Man, good stuff!