Dignified and Truly Professional

"Dr, Klinik XX nak hantar satu patient. NCC*, non-local post-SVD** 3 hours ago at home. Patient unconscious--"

"--S^#T!" I responded in the most dignified manner possible.


There are several cases that warrant the most dignified response possible when you're located in a remote setting over an hour from a specialist hospital:

- Maternity cases with a high chance of morbidity and mortality
- Paeds cases (especially under 5 years old) with a high chance of morbidity and mortality

Those two are the most important to remember; the rest are nowhere near as frightful.

Because at the end of the day,

even when the patient was roused from a deep and seemingly unrousable slumber by you;
even if the blood pressure picked up and heart rate dropped rather dramatically after your fluid resuscitation;
even if the patient managed to arrive at the referral hospital with almost-perfect blood results, normalized vital signs, fully conscious and cheerful;

if the patient dies at the referring hospital
- leaving you flabbergasted as to what the heck happened there after all that??,

YOU
ARE
GUILTY
OF

...

SOMETHING.
Trust me.

Cry two nights in a row and then, puffy-eyed, go to the mortality meeting and explain how you have done everything within your means to help the patient; fingers will still point toward you for something completely out of your immediate control.

How would you think the patient will die because of a diagnosis you cannot arrive to, simply for the fact that it hasn't developed yet at your center nor do you have the facilities to diagnose it?
Doesn't matter, you were the cause for not having prophetic powers.


Conclusion:
1) Mortality meetings exist solely to shift the blame and not, as they are touted, to improve patient care, avoid further mishaps or 'banana trees fruiting twice'.
2) Don't become a doctor. It sucks.***




*NCC - non-clinic case
**SVD - spontaneous vaginal delivery
*** Okay it has its perks. But seriously don't do it unless you have a ten-metre-thick face and a heart encased with 5-ft steel, resilient to the most pointed misfortunes, insults and humiliation directed to you. Or just go non-clinical, heard the grass there is so green it's fluorescent.

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.

How to NOT Die When 'Informing Bosses'

One of the less fine moments in life as a house officer- or any profession, really- is the need to inform certain matters to your boss knowing, most probably, that you will be berated for the information.

Deteriorating or collapsed patients are not included- those require immediate attention and only irresponsible bosses will refuse to heed your call. I'm talking about things in the grey area of urgency, which- unfortunately- make up the bulk of our time. Additionally, these gray-area issues contribute to a major portion of our bosses' source of anger.

By bosses I mean MOs, obviously. You don't normally immediately inform your specialists of abnormalities, do you?

There is no getting around it, nevertheless.
Sure people tell you to be resilient, otherwise don't become doctor lor, but that  sentiment doesn't help much since you weren't born with the resilience of other people. Nor were you raised  the same way. Upbringing contributes to resilience too.

I am a rather sensitive person. Malays may call it the tissue heart syndrome, or 'hati tisu'. Getting a scolding will probably lower my mood for the entirety of the day- so getting scolded early in the day really affects my performance.

But I've learned some adaptive maneuvers, more or less. Mind you they're not miracle solutions, nor are they magic, but they seem to work on me a little.

Okay, a lot, since people think I barely get affected by scoldings some days it's ridiculous.
And at the end of the day, I'm still enjoying my time here which means I'm not too negatively affected.

I sincerely hope this helps others too.

• Preparing/Psyching
• During this time, you should really know your case; the patient's history and progress, and why what you are about to inform can significantly impact the patient's management and perhaps their life
• Convince YOURSELF that it is important 
• Tell yourself it is for the PATIENT- no one else is more important
• Before informing, make sure you have assessed the patient and done the basic steps of management accordingly. If you're not sure, try asking your seniors- yes, that includes your senior nurses who have seen the same management chain day in, day out for years. Bosses hate mere informants
• On the other hand, some bosses hate the idea of you giving your own prescription/management, so just tailor what you do based on what you know of this boss.
• Remember that your boss is not your God. And the moment of wrath, if it comes, will PASS soon enough (this is especially important with more malignant bosses)
• If the last point is not enough, believe that God is fair and those who are truly not well-meaning will get their due

• While informing
• Take deep breaths. Don't rush through it. Better to be a little slower and pace yourself rather than rushing irrelevant and potentially wrong information out of your troubled tongue
• Look ANYWHERE but your malignant boss's expression UNTIL YOU FINISH PRESENTING. Over the phone, this is made infinitely easier
• Remember to be unfailingly polite and humble no matter what. Not for the sake of the boss, but for your own and others in the vicinity
• Don't overthink your boss's reaction before it is received. Just keep your information- and the patient- in mind while you are informing
• If the boss starts asking questions in a scolding manner, just try your best to answer with what you know and bear in mind that any scolding you are about to receive is fine. It is totally fine. It is temporary.
• Remember your responsibility and your duty

• Aftermath 
• If you were scolded, with no positive criticism given- throw the wrathful aspects of the session into a mental wastebasket, and chuck it into the ocean- along with your anger and disappointment. No, seriously, it works, if only a little.
• Keep any positive scraps of the scolding session into your mental scrapbook of improvement (or, you know, jot the new knowledge down somewhere safe and more tangible, like a tiny notebook or your phone, where you can easily retrieve them)
• Remember, again, that you were just doing your duty and your intentions were right (see preparing/psyching, bullet number three
• Remind yourself that you are still learning- and as a house officer, that is your NUMBER ONE goal
• Look forward to your next pleasurable activity whenever you feel like stewing over the disappointing event, preferably one far away from the hospital walls
• Remember it's only a few months of your life until you're not directly under said malignant boss! 
• Remember moments when you were praised. If it's too wounded, your ego needs a boost to function. You're not entirely worthless, mmkay?

Dah.

Tomorrow is a new day!

Dear Various Staff of my Current Department...

Dear Specialists,

you don't function as our guardians.

You think you do, but you fail miserably.

Dear MOs,

screw you too.

And for those to whom this applies, love you too. Like, 2 of you.

Dear Nurses,

thank you for being our gossip partners.

Sorry for semi-snapping at you when things don't get done.

Thanks for the CODs.

Dear PPKs,

I know you are underpaid, but so am I.

Please stop taking so many breaks if your work isn't done.

Stop making me do your job.

Dear HOs,

... hang in there.

This too shall pass.

Sincerely,

(And I am not liable for what I say when I'm so emotionally disturbed),

A Highly Upset Cockroach aka HO.

.

Frustrated.

So frustrated.


I actually want to cuss and swear while crying, if such a thing were possible on such a public blog.

I have never felt so stressed in my HO life.


Whatever.

Be back soon with better-sounding posts.

Counting Work aka Berkira Kerja

No lah I'm not going to write about some vague friend here.

I'm writing about myself.

I have caught myself, time and again, 'counting work' - literal translation from the Malay saying berkira kerja. Or berkira tulang urat- counting bones & veins. Hey, that may be more relevant now.

I entered the posting with several other people.
And I found myself to be the pioneer among them.

First to get more patients to review.
First to get more acute patients.
First to present cases in the morning passover.
First to... well you get the drift.

I started bemoaning my tragic life:
Why am I the chosen one? Why do I have more patients to review than them, they are also taggers? Why do I have to go into the OT with the known malignant MO EACH time he covers EM OT? Why do I have to present two times in a row? Why me, why me, why me?

You see, hearing about this likely made you a little (or a lot) uneasy around me.
But that's the reality- I am far from perfect.
I forget so often that nowadays I have much less patients to review and the workload is so much more manageable. Although there are definitely other added stressors in this posting, I can definitely say this is a posting with minimal workload compared to my two previous postings.

I easily forget that I still have a stable job and am able to live on my own, rather comfortably, while others may be suffering from unemployment, and also countless other real tragedies.

How selfish of me to bemoan a difficult relative, or the fact that yet another patient got into an accident, and yet many others still have to be referred to my department due to whatever reason, even if they were direct results of their own mistakes.

...

I wanted this job.

No one put a gun on my temple and threatened to pull the trigger unless I took up this vocation.
I recall multiple attempts to persuade other people that I am worthy of this course. Letters, essays, interviews...

Oh God.
Why am I so weak when tested?

Yes, I am human, but I am capable of much more than this.
My lips are too fast, my temper too easily roused.

Sometimes in my head I think "Why must this patient be assigned to me? Such a difficult patient, to present to such a difficult boss..."
And almost in that same second, I rescind my thoughts. Forgive me, my patient. Forgive me, God. Forgive me, my past teachers and lecturers and colleagues- my selfishness has overstepped boundaries! Even if I don't vocalize most of my thoughts, their toxic energy permeates my psyche and results in actions that are less than pleasant. At its simplest, a distasteful expression. At its most complex, hurtful words.

It's so easy to snap at a colleague when I can feel the boss getting mad at me over the phone- "Get me the BHT for Bed 01 STAT" I would say- nay, snap- to the newer poster who was a little overwhelmed and could not answer my question.
I catch myself almost immediately and try to smile and lighten my tone, thinking that no matter how I act if my boss is already mad, his temper is hardly going to improve... But by then the damage has been done.

So easily do we hurt others while we try to proclaim that we care, that we're in this profession for noble intentions.
While we try to act our best and smile to our patients, do we extend the same gesture to our colleagues; our supporting staff; our bosses? Never mind that they're not doing the same to us.

I'm not even at my counting work topic yet, not fully.

...

"Eh AA look lah, why must I do this twice? BB hasn't even done it once! And look I got a difficult topic some more! Why is this distribution so unfair?"

Never mind that BB is a first poster who takes more time to learn the ropes compared to his fellow batchmate, CC. CC is more proactive and learns quickly, volunteering to do work where BB prefers to hide in the shadows. But do I understand BB's motives? Do I help him more than I talk about him?

Sadly, no.

A new case comes in.
I just did a procedure, and prior to that I already clerked the last case that came in.
I looked at BB, whose gaze shifted around uneasily.
"You go clerk that new case," I said. More a command than a request.
He needed the experience anyway, I reasoned to myself.

My senior already left to do an emergency operation- 'No doubt to avoid the wardwork and just chill with a rather cool MO', I thought bitterly. This senior also gave me OT time with a more malignant MO, repeatedly, while he/she goes into OT with cooler MOs without even asking any of us if we wanted more OT experience, being new and all.

Astaghfirullah.
What devious thoughts.
So easily does the mind come to conclusions that are less savoury.

I got up and went to BB.
"Okay tak?" I asked.
He nodded, and went to clerk the patient.
Full of trepidation, no doubt, but rising to the occasion- because his senior told him to. Perhaps he realized that there was no other option.

I could have been nicer.
I could have offered to clerk the case right as I returned from doing the procedure in another ward, and offered for him to stand by and watch- but this wasn't going to help him in the long run.
In conclusion, I could have been nicer. Could have had more noble intentions. But as I commanded him to clerk the case, all I was thinking about was how tired I felt.

And I shouldn't be, because come on, what did I do the entire day?

*slaps self*

This is just one simple example of berkira tulang urat.

It happens to most of us.

Some of us are just more noble, more patient, and thus more pleasant.

...

I've been told in older postings that I was a hardworker.
A good senior.
Sometimes I scoff at those remarks.
I also get snagged by selfishness and impatience.

It's just... I try to make up for it later.

I seek forgiveness from God.
Try to be more patient with those around me.
Try to be more mindful of what I say to people, even if those people agree with my complaints.

If my toxic environment affects me, my toxicity added to the environment will not improve anything in any way.

So,

I have to be more mindful.

Actively try to quash any negative thoughts- no matter how numerous. Counter them with good memories and vibes, with humility. Repeatedly tell myself why I wanted this job so much. That I can, and I will, make a difference in this system. That I will be better than my toxic bosses. That I will not treat my juniors the same.

And for that to happen, I have to start now- with my colleagues, with my patients.
If I could be impatient to a colleague who's my junior only by a few months, what's to say I won't be a malignant MO to my HOs in the future- who are my juniors by years?

If one case makes so much of a workload difference, what's to stop me from being an utter devil when people refer cases to me in the future non-stop, just because it's one of those 'J' days?

I will break the negative cycle within me before I could break the negative cycle outside.
I have to stop thinking about what I want, and more of what I need.

Patience. Resilience.
More (even more!) humility.
Knowledge- no matter how tired I may be, I can always squeeze in some quick facts. ALWAYS.

Because my patients entrusted themselves to me.
Entrusted their most embarrassing histories, body parts, habits, to me.
So I can make them feel better.
So I can heal them.

And more often than not, I spit in their faces by being lazy and impatient.
Assuming stuff about the more difficult ones.
Wishing they never came during my shift, to my hospital.

The nerve of me.

Do I know how difficult I can be if I were the one in their shoes?
I don't.
So why do I judge them so easily?

What is one more presentation, when I can learn from it?
What is one more patient, when I have the opportunity to make more people happy?
What is a kind word, when it can change the mood for an entire day?



Everybody needs to be reminded at some point.
I'm almost halfway there.
Right now is a good time for a reminder.

I'm sorry for disappointing you with this.
Perhaps later, more positive stories! :)

HOs Nowadays Only Work 8-Hour Shifts?

Recently, another story of a HO meeting with an accident went viral on Malaysian social media. Reportedly, the unfortunate lady was returning from a 30-hour shift at a tertiary hospital in Klang Valley when- presumably out of lack of sleep- she rammed into the back of a large container truck.

Her car was totaled, but she emerged from it virtually unscathed.

Thank God and the good build of the locally produced car, she's safe.

But that is only the introduction of what I'm going to write about today.


Following the shard article on a facebook page I was following, surprisingly, was a barrage of comments from naysayers-

"There is NO WAY HOs nowadays can work that many hours per shift!"

"With the implementation of the Flexi System, HOs do not work exceeding 8 hours a day. That is a fact."

"Even I did not work that many hours per shift 30 years ago..."

"Is the relative SURE the HO worked for so long? As far as I know HOs do not do oncalls now."

...

I am a current HO and I can say with confidence that quite a lot of us work over 30 hours a day.
And I am one of those people, in this current posting.

It's not because we are so generous and hardworking (though some of us undoubtedly are). By and large, the inhumane hours were imposed upon us.

Guess what, we still function- though barely. And you do not even want to imagine the mistakes that could cost our patients when a person has been awake for over 20 hours and working with almost no rest at all, then STILL expected to work further, until well over 30 hours have passed.

One of my MOs recently was taking a gander at our salary.
She thought we were getting at least 1k more than what we are actually getting.
I had a good laugh at that. Apparently, she got around that figure a few years ago as a HO- due to on-call allowances, and judging by our working hours she thought we were being compensated more fairly.

With the Flexi Shift system, we get a set amount of money per month no matter how many hours we put into our work- called the Flexi Allowance or so. Usually, this doesn't concern me in the least- I expected to work my arse off and get minimum wage (lol) even before I started working, because it's always what we were taught to expect right when we started medical school. But what truly irks me is the amount of people who do not know what is going on, and yet are so sure of what they are saying based on some statements by the authorities and higher-ups who obviously only know to make policies and not really enforce them.

And as a result, they think we are being pampered and mollycoddled, and that our voices of dissent over the injustice of it all are just a result of our lazy, self-entitled upbringing and environment.

Yes, the Flexi System was SUPPOSED to be implemented for the following factors- more manpower equals less working hours per individual equals less compensation equals more economical and effective outcome. Win-win all around.

But do we really have enough manpower?
Are the hospitals simply overflowing with doctors, and in particular, HOs?
Is there any rule out there that would strictly enforce this 'Shift System' policy with penalties for failure to comply?
Uh, no.

As a result:

• Many hospital departments still use the on-call system, or very long shift systems
• We work way more than the 'cut-off' maximum hours per week
• We still do on-call systems like our MOs, but twice a week, without weekends off, and without the 'lucrative' on-call allowance nor ability to claim our weekends/public holidays to the maximum.
• And worst of all, nobody is brave enough to change the system.

If a lone HO dares to voice out his or her dissent, he or she is quickly met with antagonizing stares and fast-tracked on the road of extension and eventually displacement to another hospital. If that weren't enough, he or she is also threatened with a delayed promotion to MO-ship for being arrogant and not sticking to the status quo. Such is the way of the medical fraternity, I have learned- many are quick to anger and say they suffered the worst, and generational gaps remain massive and for the most part, insurmountable.

Words like 'during my time' are thrown around a lot, often out of context.

Le sigh.

It wouldn't have bothered me that much if some non-medical people had the misconception about our working hours. But hearing it from our own seniors really breaks my heart. What kind of attention would we be trying to garner by faking our own working hours?

Wake up.

30 hour shifts (and more) STILL exist for HOs.

We do NOT work less than 8 hours per shift most of the time.

And most HOs do not have a place to retire to by the end of their shift. In many departments in my hospital, there are no specific rooms for HOs on-call to rest- in fact, we are not expected to rest, thanks to our 'shift' hours that are supposedly blissfully short.

It is truly disheartening at times...
But life goes on.

And the job remains rewarding if you focus on the more rewarding aspects- i.e. the care of your patients.

Sigh

Two patients, at a time, told me that my blood-taking technique was good.

Repeatedly.

But if you've read any of my previous posts, you probably would have come across the post where I said blood-taking is highly dependent on luck, apart from experience of course. And that is what I tell any of my patients who would say that my blood-taking technique is way better than my colleague's.

1. It does not pay to downgrade your colleagues. Shifts change, and luck does, too. I had bad luck with several patients who are very easy to my friends, but with me were just simply difficult!

3. The same patient may prove to be difficult several blood-takings later- the vein mainly stays in one place, but complications do occur and running/easily-collapsible veins exist (especially in elderly patients). So it always helps, to me, if I tell the patient that the ease with which my blood taking is might change

2. They should expect blood-taking to be a difficult thing- that way, they're less inclined to go to the hospital. Hehe. I'm only kidding. OR AM I?!?

4. I switched 2 and 3 and you probably didn't notice. Shifts change and sometimes patients don't notice that you're a different doctor than your friend (particularly if you're wearing a mask all the time)... So that praise might not be aimed at you.

5. Simply for the sake of humility, never be too proud of your own skills. But be moderately proud and hold on to those praises because they might be the only thing to keep you smiling on busy tiring days.

This is turning into a 'How to Handle Praise Anonymously' post.

Anyway, I wanted to say that I have some reason to be proud, at least. Internally proud, that is.

I really should stop typing for an audience and type for myself.

I felt like crap.

Got some praise.

Un-feel like crap.

...

Don't know how to do certain stuff properly.

Get scolded by MOs/SNs.

Feel like crap again.

And the cycle goes on.

Life of a HO in a normal posting.

My previous posting was indeed heaven for HOs.

Note to Self: Control Your Emotions!

"Dr, kenapa Dr tagging lagi? Dr dah pandai dah..."

Hehehe.
Occasional nice comments make my day.
You'd be surprised at how the smallest things can make your day when you feel downtrodden, and hold the lowest of the low rank in the food chain of the hospital (or at least department).


Because most of the time, comments are more like,

"Dr, takkan itu pun nak tanya saya?"

"Dr, tengok sendiri boleh tak?"

"Dr, bila nak buat *insert procedure here*?"
And all in very irritating tones.

And let's not get started on the snide remarks and outright humiliation one could get from one's bosses.

They- meaning *some* of these beloved human beings- can't see me sit and relax. They'll always ask me to do something.
Never mind that I've been working hours and hours longer than them. Never mind that they had time to take breakfast or lunch, and I didn't because my work started before either meal times and didn't stop.

But to take it personally is a waste, because had they given up on me entirely, they wouldn't call me to do anything at all. When you're so dysfunctional/lazy they give up on you, and even forget that you're working in the ward- or just ignore you altogether because they know you're too slow or tend to avoid doing things. So the fact that they keep asking you to do anything means they think you're capable of carrying it out.

Expect that they will scold you when you ask them how to perform something that, to them, seems basic. Some of them are just impatient- they'll come around when you prove that you are more capable. Or they won't, who cares- you're a HO and hopefully you won't be stuck with them for more than 4 months!


Today, I got so bloody pissed at a lot of things and it barely took all my effort to keep myself from outright shouting (I kind of snapped a little and my face might have shown it).

Then I got sad.

And then I got grateful & happy (it might have to do with the fact that I got to eat hehe).

This posting is turning me into a moody monster. It's awful. I pray I improve in terms of controlling my emotions. Pray for me.


Even the best and most patient of people have a breaking point. I've been very lucky because despite the meanness I have experienced, I could still find many kind, fun, and uplifting moments. But that doesn't mean that in that very dreary moment I could still feel unfiltered joy. It takes a lot of effort to think of life beyond that precise moment of horror.

You may think I'm writing for your sake.
Sometimes I think that too.
But I started this blog to remind myself of my moments in working life, and that means my personal good AND bad moments. I'm only human, and I'm far from perfect. I have ugly moments too. To whitewash them would be the opposite of my goal with this blog.

So forget about appearing like an exemplary HO.
This is the story of a normal HO, struggling with stupidly common HO issues like being bullied by SNs and bosses, and trying to be more competent in procedures that are easy theoretically, but actually really hard the first few times.

You may expect more blunder posts later, I think.
The best way to learn is to learn from others' mistakes and avoid them. I shall be your anonymous scapegoat when I can.
And I also get to remember how awkward I was, later in life!

~

First Day in General Medical Wards...

And I haven't cried yet!

I managed to drink!
And even eat! (A single cup Maggi for the entirety of the day, and even that after 6 pm, but still).

I ONLY CLERKED ONE CASE!
Surprisingly I still felt like I barely had time to relax.

I mean, it's hard to define the busy status of the ward and your efficiency from things like cases clerked- or any single parameter, really- because you always have to run around attending STAT calls, taking blood, reviewing dengue and investigation results and other patients that need reviewing, and you know... Take it all in. Basically your work is multifaceted.

But I was still pretty damn slow.

Most of my time was wasted on doing simple tasks for very long durations due to my ineptitude secondary to my newbness, also due to my repeated second-guessing secondary to lack of confidence secondary to lack of knowledge. Secondary to newbness.

Heheh.

I took almost 2 hours clerking a single patient from start to the moment I signed off my entry!! Three, if you count the moment when I finally had the guts to call my MO to review him (!!!). In my defense, the patient was very jovial and liked to talk, and I can't find it in me (yet) to cut him off.

It's great that God gave me a nice MO on-call, a kind MO post-call, and a gentle specialist on-call on my first day here. Also some seniors from my previous posting; ones I was actually rather close to. It's easier to transition in.

WAIT UNTIL TOMORROW WHEN THE FAMED STRICT SCOLD-EY SPECIALIST GOES FOR ROUNDS.

Please be strong, please be strong, please be strong and knowledgeable, self...

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.

Orientation Starts TOMORROW!

Oh God. Oh God Oh God Oh God.

I'm panicking.
But I haven't told you about my PTM session!

I'll tell you about my PTM session in the next post... When I'm done hyperventilating.

WHAT DO I WEAAARRRR?!?!