Monday, January 29, 2007

D.O.M.

I seem to be working plenty weekends, hmm.... anyway, yes, I was working over last weekend at the Medical Receiving Unit, yet again.

The weekend turned out to be really weird. In fact, the whole week was rather weird. Usually on a Monday, it would be really mad, but it wasn't too bad....instead, I think Wednesday, and Friday were the worst days. On Saturday, only 6 patients turned up on my side and only 7 on the other. I was bored to death on Sunday because only 4 patients were admitted during the whole day (1 of them died within 30 minutes though...well, she had a massive PE)

Right...I should go straight to the point.

A different patient on Sunday presented with chest pain. So, dutifully, I did my job as a house officer, ie, clerk him in, perform an examination and create a plan. While speaking to this man in his 50s (I can't really remember his age), he commented, "You are really cute."

To be honest, I actually heard what he said. But automatically, I just said, "Sorry?" And again he said, "You are very cute." I just smiled and continued to ask him a couple more questions. A few minutes later, this patient said, "Aww... you are really cute. You look like a schoolgirl...so young." I just kinda smiled (and at the same time, whispered to myself, "Oh pls, just shut the fuck up, you DOM ") and proceeded with my examination. Having explained to him what was the treatment plan for him, I left quickly.

In my heart, I kinda felt disgusted. I mean, it wasn't like he was a young hot man that gave me such comments. He was in his 50's and I dunno, ........yeww.....

Later in the evening, my SPR arrived to do her receiving ward round. I presented that DOM 's case to her and then, we both went to see the patient. While my SPR was examining him, he looked at me and told her, "She's so cute, isn't she?" I was like, "No, I'm not." And my SPR gav me a funny look, which I kind of interpreted as "Huh?!" I just rolled my eyes back at her, and ignored him.

As we left his bed, I could just feel his eyes staring at me. It was really uncomfortable.....sent shivers down my spine. I looked at him from the corners of my eyes (you know, not wanting him to see that I'm looking at him) and guess what, he was smilling to himself. eeekkkk!!!!

That was the last time I saw him. He was a DOM and I really need to stay far farrr faaarrrraway from ppl like him!

Btw, I hope you have figured out what does DOM stand for.

Saturday, January 27, 2007

Happy Happy Feet

I have officially fell in love with penguins. =P

TWO thumbs up for Happy Feet. It was so entertaining and funny. I couldn't stop laughing throughout the whole animation! I just wanted to cuddle and pinch those wee penguins, especially the part when the egg just hatched and my goodness, those feet just can't stop moving! There are certain parts of the animation, which I thought, resembled "The March of The Penguins," which was also an entertaining show. The story was really simple but meaningful. All the songs sung in the show were really groovy too (kinda made me wanna dance around too...) It certainly lifted my spirits after a hard week!

Monday, January 15, 2007

After A Week in Medical Receiving

*phew

It was a busy bee week. I would like to pen down some of my thoughts. Be warned! Some people might get offended after reading this, but hey, these are my thoughts afterall!

1. Why did the smarty pants A & E doctor wrote, "Patient must receive warfarin dose tonight," although the patient's INR was a blooming 7.2?!

2. Spent about 25 quids on taxi fare for the whole week. It wasn't like I wanted to take a cab home, but my shift ended at midnight everyday. By the time I actually walked out of the ward, it was about 12.30am....and there wasn't any trains available at that time. Well, there was a few bus services available, but I just couldn't be asked to walk all the way to the Central St just to catch one.

3. hmm....25 pounds...I could probably get 2 nice blouses with that amount of money. Looks like I have to eat grass for the next couple of weeks.

4. I hate patients who think I am judging them. Just because I asked him if were a smoker, he became angry and said back to me, "Why are you doctors always asking this question?" err...duh.... because it gives us an idea of how good your lungs are and for us to identify any risk factos. This eejit patient added, "So what if I am smoking, you start talking bad about me and saying it is bad for health. It is not like you folks do not smoke anyway." Err...duh...doctors are human too...and yes, there are doctors who smoke. But look, nobody is judging you....but if you actually are taking the effort to take care of yourself, why the hell are you smoking?? Since you were young, you have been bothered with terrible asthma...and guess what? You still decided to smoke...it is not surprising that you ended up here in the hospital, hardly able to get a single breath! sheesh. Stop complaining that our treatment is not working. In the first place, you are not helping yourself.

5. I can't get my head around why certain patients go to the A&E complaining of A, B and C.... and after being told that they need to be admitted, they decided that they want to self-discharge themselves? I know nobody likes hospital. But when you step into the hospital, it means that you are wanting to find out the root of the problem, you want to get treated, and you want to get better. So why do these ppl want to self-discharge?!! You are wasting everybody's time and effort.

6. It was a rought night for my SHO. Alot of things that happened could have been avoided. She was really pissed off and busy Unfortunately. I needed to ask her about a patient, who was running fast AF. So I said, "Sorry, I know you are very rushed off your feet, but can I ask for your opinion, pls?" She looked at me and said, "Huh! There is no point in saying that." ......*ouch She has every right to be pissed off that day...but it would be nice if she could be abit more polite.

7. Is it just a coincidence, or do patients get themselves into trouble just minutes or even seconds before I go home? For example, the time is about 2 minutes to midnight, and a nurse comes along and tell me, Mr. X is having terrible chest pain, or Mrs. Y is dropping her saturations, or (this is SO typical) Mr. Z has just pulled out his venflon?! Arrghh...it really gets on my nerves when such things happen. It is like these patients just want to make me stay in the hospital. And technically, I am still working, and I would not pass this job over to the next person taking over my shift. So....after reviewing the patient, it would be way pass my time to go home. sigh.

8. Oh...I also do not fancy nurses telling me, "This patient has just spiked a temperature of 37.9. You NEED to do blood cultures." Now, let me see....are they actually instructing me to do a blood culture?? Well, I do not want to sound like I am such a 'big' person, but I think I should be the one deciding whether or not a patient gets a blood culture done.

......so much to whine about.

I pwomise to keep my mouth zipped......for now, at least!

Thursday, January 11, 2007

Worst Day So Far

THREE deaths in one night. All occuring within 2 hours. Bad eh?

Pt 1: He looked pretty grey, with a low BP. He was not giving us much history. All we knew was he was short of breath and unwell. A chest x-ray revealed a convincing right pleural effusion. The whole of the right lung field was white. A chest drain was then inserted into him. He was tolerating the procedure well, and the chest drain went in pretty easily. Yellowish purulent fluid came out from the drain, which meant that this patient probably has an empyema (pus in his pleural cavity). All of a sudden, as the SHO was stitching the drain in place, the patient's saturation dropped from 93% to 88%, 70%, 60%, 40% ...and undetectable. This heart rate was dropping fast too...until it reached asystole. Fuck! CPR was performed and patient needed to be intubated. However, he did not survive it. It was a very traumatic resuscitation, trust me.

Pt 2: In the receiving unit, patients will be brought up to the ward after having been seen in the A&E first. An elderly lady was wheeled into the ward not too long after the event above. Her family members were asked to wait in the waiting room while the nurses admit the patient. As soon as the elderly lady was taken into one of the rooms in the ward, the nurse who accompanied the patient closed the door and said, "This lady actually died in the lift on the way here." WTF?! Looking further into her notes, the patient had a very low blood sugar level of only 1.9, and guess what? The smarty pants A&E doc gave the patient an IV infusion of normal saline?! What was he/she thinking??? Give 5% dextrose at least....but really you should have treated the patient's low sugar level before bringing her up...maybe a stat 50% dextrose? Imagine the horror of the whole situation!

Pt 3: He had a bad chest infection. His family members were informed that his prognosis would not be good, and they agreed not to resuscitate him, should he goes into a cardiac arrest. The patient was rather agitated towards the last moments of his life. His daughter left the room for only a few minutes to get something, and unfortunately, her father took his last breathe at that time. sigh.

Three different deaths in one night. Hope it doesn't get any worse than this. I was quite traumatized after the first patient. But, I still got to pull myself together to carry on clerking in other patients. Life is tough.

Saturday, January 06, 2007

Life is...

I came across an interesting statement while hanging around in the city today.

"Life is like an egg, either getting smashed or getting laid"

Just like an egg, we humans are vulnerable. In life, we get "smashed" with stress or illness, and we get "laid"...errmm, you know what that means (that's if we are lucky enough).

Wednesday, January 03, 2007

Puncturing The Lumbar Spine

I am happy with myself today. =D

As a student or even as a young girl, I have always watched doctors carrying out lumbar punctures (taking some fluid out from the spinal cord for investigations), either on the telly or in the wards. I figured it was a difficult procedure, but hey, it was not that complicated afterall.

Can't stop smiling from ear to ear....why?

COZ I've done a lumbar puncture successfully! yay!!

Mind you, my first one was carried out last week. I failed miserably at that time. However many times I've tried to angle the needle in a different angle, I did not manage to get any cerebrospinal fluid (CSF) from that patient. Poor lady. I have to thank her for being so patient with me. (ssshh...she didn't know that I have never done a lumbar puncture before). After about 20 minutes, my SHO decided to take over, and as expected, she got the CSF in no time.

Today, another patient required a lumbar puncture to rule out a subarachnoid haemorrhage and infection. Guess what? The CSF was pouring out after inserting the needle on my first attempt! =) hmm...lucky? I guess doing a lumbar puncture requires alot of luck and of course, some skills-lah! =P (kekeke....I know I know...I shall stop praising myself...)

I can't wait to do my next lumbar puncture!

Tuesday, January 02, 2007

The Most Miserable Day of The Year

I woke up this morning and turned on GMTV. Apparently, today is officially the most miserable day of the year! hehe. The reason being it is back to work for most people after a long break which began since Christmas. So everyone will be sort of dragging theirselves to their workplaces.

Actually, I think today should not be the most miserable day of the year. It is just the 2nd day of the new year. Everyone should have a positive attitude, what has happened in the past is over.....look forward! Imagine if you're already miserable today, you're going to make yourself even more miserable throughout the rest of the year! haha.

But I certainly can understand the miserable feeling. After all the fun and the dinners, it is now time to go back to routine. Sigh. Everyone must be feeling really broke right now too, having spent money on buying presents, food and booze. (I only have 5 quid in my purse). And as usual, we could blame the weather for making people feel down....it is gloomy and getting colder.

Oh well, miserable or not, that's the way it is....but to cheer yourself up, remember, summer is very near, and christmas is just another 11 months and 23 days away! :) Keep smiling!

Monday, January 01, 2007

Mi Reflejo

We are now in the year 2007. 2006 has passed really fast. So many things occurred to me last year. I suppose that is the way life is...it is never perfect and we have to just accept whatever challenges that are placed upon us. I shall attempt to recap the main events in my life this year...here goes!

January: I remember I was in Dunfermline at that time doing my surgical shadowing as a 5th year medical student. I loved the whole rotation ...learnt loads and saw many interesting things. The junior doctors whom I was shadowing were really nice to me. The only downside of it was the accomodation was very cold.

February: From Dunfermline, I moved on to Yorkhill, Glasgow for my paediatric cardiology block. The accomodation there was worse than the one in Dunfermline. For once, I was able to appreciate heart murmurs...and I am proud to say, by the end of my 4 week stint there, I was able to differentiate an innocent murmur from a pathological one. :P

March: hmm...probably one of the saddest month of the whole year for me. Split up with my loved one. A sad ending which was totally unexpected. And it really did affect me....I was sad everyday, and could not concentrate on my work. I remembered staying awake for more than 24 hours trying to complete my case discussions....

April: It was spring time. I spent some of my time taking photos of pretty daffodils. oh..and went to St. Andrews with my friends during my Easter holiday. It was a nice relaxing week off.

May: This month was filled with stress! The deadline to hand in my portfolio was near and I was not even close to completing it. I remember struggling to find the correct words to use in writing my "10 curriculum outcomes" for my uni. It was a real pain in the bum. hehe. Oh...I could still remember the stress and fear I had while waiting for my turn to face my examiners. It was the VIVA examination...and I have to say...the pressure was so great...I was worried and scared. The worst thing was all my housemates have sat for their exam and I was the last one. PHew! I managed to pass the exam!

June: Finally, my summer holidays have started! YAY! I was so looking forward to the trip to Italy with my friends. It was fun and boy, I really do miss the hot sun in Italy. The trip to Italy was fantastic and I ate like maybe 6 gelatos?! I dunno...but I know the food was great, shopping was fun and I took so many photos.

July: It was graduation time. My family came up from Malaysia, including my granny. I took them around Scotland and we ended the holiday in London. It felt great meeting my family and spending time with them. I also went back to Malaysia for a really short break (about 10 days or less). A short but sweet holiday. This is also the month where I said goodbye to Dundee and my cosy rented house. *sob *sob

August: 1st of August marked the first day of my life as a working human and a doctor. It was scary...I didn't know how everything worked, and I was in a totally brand new environment. My rented room was way smaller than the one I had in Dundee. I remember complaining of having to pay council tax and pay the rent, whilst my other friends had accomodation provided for them. (but now, I think I'm quite happy paying those fees...) 31st August marked the first time I get proper wages! yay! So happy that I spent bout 20 quids for dinner at TGIF!

September: Getting tired and stressed at work (even after a month at work??) But it was ok, as long as I get paid! Now, I could finally understand the shitty jobs that we junior doctors have to do...

October: Oh...I couldn't wait for my holiday. My parents came up and we all spent a week at Spain together. It was lovely. It was THE time to escape the cold weather in Glasgow and it was great to have a short break away from the hospital. Ate loads in Spain and bought many stuff home too. I have to admit I felt that for the first time, I did not need to ask my parents for spending money. Instead, I sponsored their trip there. hehe. It was an achievement for me, to be honest. :)

November: Back to misery...ie, hospital. I was literally dragging myself to work. haha. It was a rather busy month too because I was working in the high dependency unit and was in the receiving ward for 2 weeks. I remember being pissed with the radiologists for not wanting to do the scans that I have requested. I remember looking after a patient who was suffering from acute alcohol withdrawal. I gave him about 50mg of IM diazepam and 40mg of IM haloperidol and some diazepam too...it did nothing to him!

December: This is the month where I changed to Medicine. To be honest, I didn't really like the change in the first place. The ward rounds are longer in Medicine, and I didnt have time to have lunch. It was so much busier than working in the surgical wards. Only in medicine that I managed to do ascitic taps and my first lumbar puncture a few days ago! :) (it was unsuccessful though). Oh...not to forget, I also received a number of sarcastic remarks from my seniors. December was also the Christmas month. Although I did not receive alot of pressies, I really enjoyed the atmosphere here. The last day of the year was spent working in the medical receiving unit. I was so tired by the end of the day and just simply went to bed after midnite. The weather was awful, the wind was too gusty and hence, the hogmanay in Glasgow was cancelled!

So there you go...a small little recap of the events last year. It was eventful but there are all experiences that would teach me to be a better person I guess. I hope 2007 will be exciting!

Happy New Year my friends!

May 2007 bring you loads of joy, happiness, love and luck!!!!! CHEERSSSS!!!!!