Purpose of this blog
When I started out blogging, I wanted to blog down my experiences as a final year student preparing for the MBBS. When I passed the exams, I felt that my experience as a HO would suffice me to continue my blog.
It has, and it has been such an experience.
I glad I managed to capture my many emotions and thoughts as I went through the HO-ship. And no doubt, I will spend many hours re-living the HO moments when I read through my previous posts.
My introduction to this blog is: "Tackling life's issues: as a final year medical student trying to figure out how to juggle family, relationships, studies and sports."
And to motivate myself, I had this quote: "Use what talent you possess: the woods would be very silent if no birds sang except those that sang best." -Henry Van Dyke-
Now, as I finish my HO journey and start on another longer journey, I guess this blog has out-lived its purpose.
Do I continue to blog? This question has been bugging me for some time and I haven't quite made up my mind. But I will take some time off.
One good thing about this blog is that I've actually made quite a few friends through the blog and strengthened some friendships through it as well.
I don't know how many people actually are still reading this blog, and how many will actually miss this blog. But thank you to those who have visited my blog, left comments. Do continue to keep in touch.
Till then.
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Do keep in contact with me via email (
daigoleow@gmail.com)
For the new HOs
As you begin on this exciting yet apprehensive journey, you will realise many things.
You will realise that there's many things to be learnt, yet some theoretical knowledge may not be practical.
You will realise that you are pushed to your limits, yet know that your limits are actually further than you thought.
You will realise that no man is an island, yet will feel lonely during your nightcalls.
You will realise that some patients just irk you, yet realise that you are doing this job because of them.
You will realise that your whole life is consumed by work, yet you yearn to have time off to do other things.
You will realise that this journey is hard, yet you will feel a sense of accomplishment when you finish the journey.
Good luck in this journey.
The next step
From HOs to MOs.
12th month HO
I quote someone, "No one is more dangerous than the 12th month HO."
I disagree with that statement. The 12th month HO is in fact the safest HO, because the experienced HO knows how to handle the different scenarios that can happen to a patient and is able to institute immediate life-saving measures promptly. Other than being proficient in the daily procedures, he/she is also able to navigate the hospital administration and get urgent scans or operations arranged.
If I may alter the statement, "No one is more dangerous than a HO who doesn't care."
And that is the pitfall we must refrain from. Although the end seems near, patient care is ever ongoing. We cannot stop caring and must always do things in the interest of our patients.
Unexpected
When you least expect it, life turns around and whacks you in the face.If you take life for granted, it will disappear in an blink of an eyelid.Grab life by its horns, and learn to live every moment.Appreciate everything and everyone in life, and live without regrets.~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
In remembrance of a loving grandfather...
Yoga-man
Omm...
I feel really stretched and relaxed
Omm...
Even though it was expensive
Omm...
I think it's worth the experience
Countdown 1
21 days more to go
Changes
Go do your changes.
That's the term we use for the work that is ordered during the morning rounds.
It's encompasses a wide area of stuff, from:
- taking blood
- getting scans
- doing discharge summaries
- referrals and reviews
- updating family
- off drains, lines
- inserting lines
- summarising old notes
- retaking history
And I'm sure the list goes on and on.
But whatever the changes are, we just have to do it.
At the start, I used to wonder why some of the changes are ordered. And also their significance in the management of the patient.
But somewhere, somehow, along the way, I've stopped wondering.
Because sometimes changes are ordered too arbitary.
"We haven't done bloods for a week, let's repeat them."
"Go get this scan urgent. I want it by today."
"Refer this patient urgently for left little toe itch."
It doesn't matter what the changes are, we just have to do them.
It doesn't matter how useful they are, we just have to do them.
It's too routine, we don't have to think.
Just do them
The 1-man HO
Tired = SatisfyingFlustered = Challenging
Yardstick
A measure of a man is by the way he handles the obstacles in his way.A measure of a surgical HO is by how he/she survives the vascular team posting.Please pray for me.
Waht!
fi yuo cna raed tihs, yuo hvae a sgtrane mnid, too.Cna yuo raed tihs? Olny 55 plepoe tuo fo 100 anc.
i cdnuolt blveiee taht I cluod aulaclty uesdnatnrd waht I was rdanieg. The phaonmneal pweor of the hmuan mnid, aoccdrnig to a rscheearch at Cmabrigde Uinervtisy, it dseno’t mtaetr in waht oerdr the ltteres in a wrod are, the olny iproamtnt tihng is taht the frsit and lsat ltteer be in the rghit pclae. The rset can be a taotl mses and you can sitll raed it whotuit a pboerlm. Tihs is bcuseae the huamn mnid deos not raed ervey lteter by istlef, but the wrod as a wlohe. Azanmig huh? yaeh and I awlyas tghuhot slpeling was ipmorantt! if you can raed tihs forwrad it.
Blue skies
Work has barely started and I already miss the sunny skies.
If I wasn't working...
- Waking up after the sun rises.
- Having a Mac's big breakfast, just before it stops selling them.
- Spending the whole day just lounging.
- Running in the hot noon sun.
- Watching drama serials the whole day.
- Cleaning up my room.
- Just pondering about life.
- Making a gift for my love.
- Eating non-stop and worrying about putting on more weight.
- Climbing the whole day.
- Catching up with old friends.
- Exploring the island.
PEACE
Finding peace.
The ones at our side
I have a bad temper.
Those who know me may know it, or even experienced it.
When I'm in a bad mood, and I don't feel like talking to anyone; I shut everyone out.
Everyone.
I take my family for granted, not realising that they are the ones behind me, besides me, when I need them most.
I lose my temper for no reason, often I just want to be alone.
Maybe it's just my lonesome personality; maybe I just want to keep my troubles to myself.
But whatever it is. I realise I should not take them for granted.
I should appreciate them, because if I don't; I'll live to regret it.
Helping out
Vacuumed the floor today. Realised how long it has been since I last did chores. Ever since HOship started, I've been so tired after work to even help out at home. My parents have been tirelessly keeping the household going and clean. Thank you mom and dad.
What are we struggling for?
Like mice we run in this maze of life.
Trying to earn our keep and a lifestyle we yearn for.
We spend our whole lives doing this, hour in hour out.
But what do we really yearn for?
What makes us happy?
What is happiness?
Does this road that we are running on lead to happiness?
Are we sure? Or are we hoping it does?
Because if it doesn't, then we would have been running for nothing.
Because life doesn't repeat itself.
Leave me alone
Sometimes we all need some time alone.
Passive HO
The 'passive' passive HO:1) Phlebotomist
2) Paracetamol prescriber
3) Cleans up other people's mess
The 'active' passive HO:1) Ensures patients get the necessary treatment and medications
2) Provides prompt emergency assessment and treatment
3) Gives continuity of care over the night
Helpless
There are times when I feel helpless.
When faced with a task that I cannot do, no matter how hard I try.
Sometimes we all need a little help, but we may not know where to find help.
And asking for help just seems so difficult.
But whatever it is, just think of the patients.
First do no harm.
Traumatised
Approval
Con: So Dr Leow, when are you all changing over?
Leow: on the 5th, Monday sir.
Con: You know you are welcome to stay on if you like.
Leow: ... ... Erm, Thank you sir.
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Didn't know if it sounded like a compliment but I think I'll take it as one. Anything to make my day a happier one is good.
Working Sick
Even though it's been acknowledged that if one falls sick, one should not be working. But even then, I hardly take MC when I'm sick.
In fact, I continue to work even in times of flu and fever.
Because sometimes I know, if I am resting, someone else is suffering.
Maybe it's bad for the patient, spreading germs and bugs around, but I really don't see how I can take MC and be comfortable resting at home.
Sian ah
I've been feeling quite in the dumps lately, ever since the CNY.
Can't quite put a finger on what's the cause.
But just can't help but feel that everyday is just a passing day.
Routine, mundane and boring.
No mood to do anything else, just feeling tired and very lethargic.
Doesn't help that I get a headache every few days and is down with the perennial flu.
Ah... Sian ah...
What's my limit?
A recent article in a local daily states that the optimal number of patients to doctors is envisioned at 1:1.
(And as we currently fall at 2 patients : 1 doctor, we are encouraging the influx of more foreign doctors)
As an individual, I wondered how many patients can I handle comfortably without acknowledging that maybe patient care is compromised at some point.
As most healthcare departments work in teams at the moment, we must consider that if the team consists of 2 SCon, 1 Con, 1 ACon, 1 Reg, 2 MOs and 1 HO; there should be 8 patients x 2 =16 patients for the HO to manage. (which is really quite a bit)
Of course some will say16 patients is not a lot, but it really takes 1 ill patient to keep you busy.
Having worked in teams with >50 patients and also in teams with <10 patients, I've felt that any number up to 16 is a realistic number that I can stretch myself to, before I start feeling that I'm not giving my best care to every patient in my care.
Of course, some patients need more attention than others. And having the help of an MO , especially with an ill patient is invaluable.
Routine changes are expected, it's the unexpected sudden urgent changes that can turn the whole day from a normal peaceful day to a 'oh my god, it's bad' day.
What's my limit? Is it too low?
Sigh
P: What is this blood for?
D: It's for tumor markers.
P: Oh.. I did this before in the clinic. So if it's high, it means it's recurred right?
D: It was quite a while since you last had this test.
P: I hope it's low.
D: We hope so too.
P: Okay, thanks doc.
D: ... ...
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Knowing that the scan showed liver mets. This conversation was emotionally difficult.I do not know how to break the news to him. Just hoping to take things a step at a time.
No easy way to learn
Con: So Dr Leow, I hope you are learning.
L: Yes I am sir.
Con: A lot of people just do things without thinking, I hope you are thinking.
L: Yes I am sir.
Con: That's the hardest part of teaching. Teaching people to think.
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"We would never learn to be brave and patient if there were only joy in this world."- Helen Keller -
Johnny Clerker
After clerking multiple elective cases, clinic admissions and A&E admissions for days, the Johnny Walker slogan keeps coming to my mind.
"Keep Clerking."
The Hospital
Recently I've been watching this
taiwan drama. So far the first 6 episodes has been pretty good, touching on the issues of ethics both in patient care and in work; and also about the politics of the hospital beauracracy.
Although the resus scenes do not quite adhere to ACLS guidelines (CPR for VT?), but it doesn't really bother me, besides I think the cast is good-looking enough to distract me from all that.
"I swear to fulfill, to the best of my ability and judgment, this covenant: Make the care of my patient my first concern; listen to patients and respect their views; recognize the limits of my professional competence; be honest and trustworthy; make sure that my personal beliefs do not prejudice my patients’ care; avoid abusing my position as a doctor; and work with colleague in the ways that best serve patients’ interest."
