Final Day in Paediatrics

For a few weeks I had been craving a type of food.

There was delivery service for that food, but it was a little pricey, and I thought, maybe when I get my next month's salary (that was June 24th).

A day or so before June 24th, as I was writing a review of one of my patients at the ward counter, one of the mothers rooming in with her baby came by, greeted me and dropped a packet almost on my note. "Nah Dr, ni boleh share 2 orang. Saya memang niat nak beri pada staf wad sini." And as I looked astounded and thanked her, she handed out several more- about enough to feed 15 people.

IT WAS THE FOOD I HAD BEEN CRAVING.

Needless to say I spent no money that day and got the chance to eat something I've wanted to eat for a long, long time- and it was awesome!

I remember having to ask the mother for permission to bring her baby over so I could insert an IV line for her for the umpteenth time (the baby was super active and likes to 'self-debranulate' almost every day). She looked so upset, telling me that we have poked her child so many times. And I don't know how much gentler I could be when I coaxed her and told her the line was needed for her child to be better. IV antibiotics have to be completed, yo. And I can tell you poking human beings isn't fun especially cute babies- but someone has to do it.

I told her, I didn't like repeatedly doing it to her child, but I will try my best to be innovative and make sure the line lasts. I told her I tried my best to really secure the last line, but maybe something innovative has to be done this time around. Together with my nurse, we tried several different line-protective methods- gauze-wrapping, socks-using, blanket-bundling, getting input from one another. I think the socks helped in the end, though the mother preferred the gauze wrapping. We had to persuade her to keep the socks on her precious child and notworry too much about it swelling as the nurses will always look after branulas.

My point is, patience does wonders.
And patients can do wonders, too.

Today, I went to the ICU and saw that the patient I bagged was in a much more improved condition. The parents smiled at me. I am unsure if they remember that I was the one who bagged their son; watched as they went to their son and said encouraging words, oblivious to the fact that he was heavily sedated as I helped to pump oxygen into his lungs, silently holding back my own tears. I  watched as they cried when my boss told them his heart stopped, and then performed CPR and gave him a dose of adrenaline until his heart beat returned. I watched then. I was too stunned after what I did earlier possibly being the major cause of his complication.

But the complication can be corrected and he is alive and improving.

I wanted to inquire about his further progress, but I was too busy having my logbook and leave forms signed, and then I felt too awkward to ask. It's kinda stupid.

But there it was.
The patient I helped resuscitate was alive despite our initial fears.

The feeling is beyond words.

So many things happened in the last few weeks/days of my posting in this amazing posting.

Today is the last day, and I know, I know very dearly, that I will miss it so much. Though I doubt I would want to be a paediatric MO or further- all those tiny veins and flat babies!- I miss being a house officer here. During the time that I was in this department, it was rather heavenly.

I am so very grateful for all the people I met- my senior HOs, lovely MOs and SNs, and of course the specialists who never got absolutely, insanely mad at us for no reason.

Which will not be the case in my next posting.
My most dreaded posting. The posting that got me into a depressive episode back in my final year of medical school.

MEDICAL.

I have feelings, too...

On the verge of tears, I told my groupmates on the next shift that I was sorry.

"I had no time to do a proper passover... I was so busy until now, and now that things have gotten a little calmer all I can do is stare into space and simply... breathe."

*****

I went up and down a flight of stairs, carrying heavy items in my arms, with the adrenaline rush propelling me- the adrenaline rush of possibly having to resuscitate new lives; possibly having to see a limp, silent, blue baby- and changing it to a moving, crying, pink monster (in the best way possible). Without a drop of liquid to ease my parched throat or soothe my cracked lips, I ran around and dealt with clerking sheets, blood taking, stand-bys; Heard loud crying that soothed each of the worrying wait.

When I finally got back to the ward and had time to sit and do a review of the patients admitted, I was met with people asking me to explain my management, or confirm them, or those who simply wanted to know the condition of their children.

I tried and mostly succeeded at being positive, smiling at every one at least once.
When they questioned me repeatedly, I tried to keep my cool. I did, even.
(Then I slumped down in my seat behind the counter and held my head in my hands, holding in the pounding headache, before trying to continue my written work again- only to be interrupted within a few sentences, until visiting hours were over).

Then, after countless emergency calls and sudden orders for blood taking- over 13 hours of it, among others- I went into a cubicle where a baby, connected to various machines to monitor its well-being, lay, precariously, on some water-filled gloves. Those of you who have been in this situation probably have an inkling of what happened to the baby. My MO suddenly asked me to take its blood after asking it earlier from someone else who went away to attend another case.

I asked permission from the SN in charge of the cubicle if I could take the baby to the procedure room to take its blood. Politely. It is, in my experience, the proper thing to do- sometimes we take the baby without informing them, and get into trouble with the SN in charge for 'stealing her children'.

And the SN retorted: "Dr, takkan itu pun nak tanya saya? Dr dah berapa lama kerja kat sini? Ambil je lah, asalkan Dr letak semua benda balik dekat dia. Jangan jadi macam tadi, drip pun tak jalan lepas ambil darah!"

From at least 2 different SNs, these remarks were made to me from across the room, in different voices and tones and words.

Perhaps I intruded in their post-iftar discussion on things that didn't involve ward work. Maybe some of them were tired, too.

But none of them came as early as I did; in fact all of them arrived at most 6 hours after I started work. None had to run around the hospital and all stayed in the comfortable, air-conditioned setting of the ward. And I certainly wasn't the one who did not continue the drip. In fact, in other wards the SNs acknowledge that they will be in charge of restarting the drip and are too happy to help us do so- but that's another thing entirely.

Now, I'm usually rather bubbly. One SN in particular in the ward is constantly reminding me of how cheerful and generally polite I am. But hearing that, instead of dismissing it as usual with my apologetic grin, I kept quiet and immediately got to removing the many monitoring wires on the baby in an effort to push it to the procedure room. I could feel my expression changing. I could faintly feel the stinging of tears behind my eyes.

I was so emotional I got upset at myself.
Why was I weighing my effort against theirs? I shouldn't do such a thing! I try every day not to do it, in fact. But when someone speaks so offensively to me, I can't help the negative rush of emotions that flooded me in self-pity. That made my sincerity flicker, even just a little, into pettiness.

Perhaps noticing my change in demeanour, the SN who was most vocal almost immediately said that she was flustered with all that's been happening (in Malay terms), though it was far from an apology. I did not respond in fear of having them hear me sound upset; I kept my mouth shut and gently handled the baby, finally pushing it to my destination, as the SNs returned to their discussion.

Once there, the new tagger in the ward asked me what I was doing, and other things. I kept my answers short while trying to not sound rude. By then, in all honesty, I was thinking bitterly of how carefree the tagger is, feeling less responsible for the bulk of the work that day and not having to run around for the mere fact that she is new and not familiar with the work. But I thought again that I shouldn't be bitter; the entire time, I thought that maybe, unlike me, she is more shy and that is why she rarely asks to help around, instead asking only when she thinks she can do something. Maybe, somehow, I intimidate her. And at the very least, the small amount of help she offers me is better than no help at all- even if it came at the end of the day.

I was being very bitter, and honestly I was disappointed in myself. I might not have been so different if the ward were that busy during my tagging period.

So I concentrated on my task at hand, and succeeded, and then returned the baby to the cubicle. This time, when I asked something to the SN, she did not snap. I managed a weak smile at one of her remarks.

I wanted to run to the bathroom and cry because I was so tired and the snappy remarks they made at me were the straws that broke my back. But then my next shift came, and the understanding remarks from my colleagues- nay, dear friends- made up for it.

For as I apologetically told them that I did not do a proper passover, they patted my shoulder and told me they understood. That they've been there just yesterday, and that they will look over everything again, and that I shouldn't worry. I should just go home and rest for tomorrow.

Tomorrow.

Sometimes, all you need is a little bit of kindness...
And a place to vent.