Another Day

It's my 6th day of being on-call today...very night when I reach home about midnite, I feel very hungry. I would eat something and then fall alseep in front of the telly. Simply knackered. Unsurprisingly, it has been busy....and I have reached the stage where I really could not be bothered to do anything...but I got no choice. Every morning when I wake up, I would tell myself, "It's just another day." To make matters worse, its Wimbledon time...and I wish I could stay at home and watch Federer or Rafael play tennis.....but nope....have to go to work! Sigh....hope the weekend will be peaceful for me.

I Wonder

The whole event yesterday magnified. Luckily I did explain to my senior what happened last night, because at 9.30 am today, the bloody SHO called up my senior to complain. She complained that there wasn't any medical review for many days. Apparently, medics were supposed to review the patient daily. But heck, we are no psychic....we wouldn't know that you wanted the review daily unless you tell us so. Everyone agree?

To make matters worse, the plastics consultant phoned my senior to ask what the hell was going on. Anyhow, my SHO was right, if they want to be anal about everything, let them be. As professionals, we need to be as polite as we can...and that would make them ashamed of themselves.

I couldn't help but also feel that the whole thing must have been sparked by me. I wondered whether I did the wrong thing. I wondered whether if I had been more polite to her the whole event would not be as complicated as it is now. I wonder.

And So I Cried

Have any of you felt so angry that you cried? Well, I ended up in tears today after work.

At about 5.30pm, I was still in my own ward trying to sort out an ascitic tap and pleural aspiration, when a SHO from plastics phoned the ward. She asked to speak to one of the medical staff. So, I answered the call. The SHO asked me to review one of the patients in her ward who was going for a skin graft tomorrow. I told her that all my seniors have left the building (it is already 5.30pm!). She insisted that someone needs to see the patient to decide whether or not this patient is medically fit enough for his skin graft, and whether or not he requires a blood transfusion. The patient was last seen 2 days ago by my consultant.

As far as I know, I have only met this patient once, because he was transferred to plastics for management of his skin infection the following day. I do not know what has been happening to him after that. I am aware that this patient is being cared by both the plastics and medical team.

I informed the SHO that I am only the junior house officer and if she wanted a senior review, she would need to page the on-call medical SHO. She cheekily said, "You have to page the SHO, because I do not know this patient that well." hmm....excuse me? Aren't you the person who is going to perform the surgery on this patient? "Well, to be honest, I do not know him very well either. I have only met him once, and I do not know of his progress thus far," I answered. Again, she insisted that I should page the on-call SHO to review the patient. "Right ok," was my answer.

2 hours later.....after I have sorted my ward out, I decided that it is not appropriate to contact the medical SHO on-call, as he totally does not know the patient...and by right, it should be my seniors that review the patient. So I thought I would just pop up into the ward to find out what the main issues were with the patient and if possible, try to sort them out.

At the ward, I looked into the patients notes and found that someone has spoken to the medical SHO about the patient, and a plan was in place. The patient was to get his 2 units of blood transfusion. So I told the nurses that they should proceed with the plan. And just as I was about to leave, the telephone in the ward rang, and it was the plastics SHO on the phone. She asked to speak to me.

"Right, first I was told this patient was for a transfusion. Then, someone told me that patient is NOT for a transfusion, and now you're telling me that patient should get the transfusion. So which one is it?" said the SHO.

"I do not see anywhere in the notes that stated that patient is not for a transfusion...so it would be wise to follow what the medical SHO has written down, ie, to transfuse."

"Right ok. You medical people always see the patient and do not do anything for them."

"If you are not happy with our treatment, please speak to the consultant about it."

"Now, can you crossmatch this patient then?"

"Err...no."

"Well, this patient has joint care and I am NOT your house officer. You do not need to ask the nurses to phone me up and ask me to crossmatch the patient."

"Neither am I your house officer. I never did ask the nurses to contact you about that. They did it themselves.."

"Fine. But I am totally swamped...so busy. You have to crossmatch the patient. You medics just leave everything for us to do."

"But the patient is in your own ward?! You wanted to know whether you can transfuse him...and I said ok. And now you want me to send a crossmatch sample?"

The SHO kept ranting away about how taking the blood sample is my job and releasing her anger at me. She was bloody rude. You know, she is on-call...and I am not. Why do I have to do her jobs?!

At the end, I know I was losing the battle, and I just said, "Fine ok," and slammed the phone down even before she could say anything further. I told myself to take a deep breathe and just take the blood sample at 7.45 pm!

After that, I left the ward....and mumbled to myself, "Fucking bitch." I felt so angry at the way she spoke to me, trying to sound all high n mighty and so bloody cheeky!!! I was very angry until I cried. It wasn't so much that she was being rude to me...it was more of the fact that she was just being so unfair.

Favourite Food

I've been sleeping all night long...had a splitting headache all day yesterday. It was awful. Dunno why...but I will blame the warm weather mixed with chilly spells as the culprit. Lucky that the headache is away now.

Anyway, yes, favourite food. I would say my ALL time favourite would be the one and only nasi lemak. =) The simpler the nasi lemak, the more delicious it is. I do not mind eating just the sambal and the nasi...yum yum. Crazy eh?

I know I can prepare this dish myself, but I can never make the sambal like the ones sold at the market back home.....sigh (makes think about the delicious spicy nasi lemak that mum usually buys from the market at home!). I remembered the last time I went home, which was during CNY, all I ever ate nearly every morning was, yeap, nasi lemak! hehe. (Think my arteries are probably 50% blocked after that trip!)

hmm...besides nasi lemak, I do enjoy asam laksa, maggi mee goreng (especially the one at Steven's Corner) and dim sum. =) Now, I am REALLY homesick.

Michael Buble - Home

All of a sudden....I feel very homesick and feel like going home....hence the song. Enjoy people!

A Big THANK YOU & HUGS

Thank you all my dear friends for your birthday wishes.
Those of you who called from Singapore/Malaysia....I am thrilled & happy to have received your calls today.

Thank you to Laura & George, for the lovely dinner tonight.

Thank you all for the presents. I really loved them all.

Thank you to my nurses and fellow colleagues at the hospital for your warm wishes.

I had an amazing day. I couldn't help smiling all day. I felt really blessed and lucky to have known people like all of you out there.

Believe it or not, my patients bought me a birthday present today! It was a box of celebration chocolates and a birthday card....aww....it was really sweet of the 3 of you.Thank you.

Thank you. CK for the cocktail shaker....will try to practise my cocktail making skills! =)

Thank you Green Pea for the lovely present...I do like it alot. In fact, I have put it on for 2 days dy. hehe.

Thank you. Helen for the birthday balloons that you put up on my door today....I am really surprised to see them when I came home!

Thank you SzeLeng & GeakPoh for the lovely dinner last week, and the wonderful presents as well.

Whoever I have missed out, you know who you are, and I thank you once again.

A quarter of a century old....what the heck. Life only just started. =D

A BIIIGGG HUG for all of you! Cheers!!

Happy Birthday to Me!

Happy birthday to me
Happy birthday to me
Happy birthday to sawling
Happy birthday to me!

How does it feel like being quarter of a century old? Just the same.

Now, back to my "birthday pledge," which I made in May. Lets go through them one by one.

1. NO more chocolates from now.
Failed miserably.

2. RUN 3 km in 30 minutes effortlessly.
Yes, I did it!

3. STOP ranting about the daily happenings in life.
Probably ranting less, but I STILL rant.

4. EAT more heathily.
I am trying my best, trust me.

5. SMILE more. Frown less.
Did ok.

6. READ 3 books.
Now, I read half of The Da Vinci Code, and about 2-3 mags. Does that count? Can la...I can bend my own rules. keke.

7. LOSE some weight.
Failed miserably too.

8.GO wall-climbing.
No one to go with. So didn't attempt it.


So...guess it wasn't quite successful, but oh well, nevermind. It was just for fun. Quite sleepy now....going to bed....but at the same time, I wanna stay up for longer on my birthday, because it is only once a year I get to celebrate me. keke =P

Plans for the day? NONE. I am planning to sit at home and chill.

M.O.N.D.A.Y. again.....

Monday. Never liked Mondays. Something normally happens on a Monday.

What happened today?

1. Well, to start with, the ward round took ages! It didn't finish till about 12pm, and it wasn't finished at that time. There were still 2 more to be seen.

2. Tried to get in contact with the person on-call for a specialty, but no one answered the page. Finally, I managed to speak to the person after like 5 pages!

3. An awful cardiac arrest occured in the ward opposite mine. I heard the emergency buzzer and went across. I knew something wasn't right the moment I saw the nurse pushingthe cardiac arrest trolley. Arrest, yes, that can occur to any patients in the ward. But it was a visitor that actually arrested! She didn't make it in the end. Her mum, who was sick patient, was devastated. (Imagine, we had to get the mum out of her bed, so that her daughter can be resuscitated!!! Awful!)

4. An emergency admission from the diabetes clinic at 5pm?! Arggh....I mean I could, of course, let the person who is on-call from 5pm onwards to sort that patient out, but that would be pretty irresponsible, I think.

5. My friend was being pretty nippy to me today, dunno for what reasons...probably because she's been nipped at by the sister in her ward. But hey, do not need to lash it out on other people ok?

hmm...can't remember what else happened today. But it wasn't till nearly 7pm before I left the hospital. Cooked something really different tonight: aubergines, spinach, asparagus, chicken with salsa sauce?! How weird is that? Oh well, need to start doing some work. *yawn

Hello Miss Sunshine!

Sunny sunny sunny!

I really needed the sun. I soaked myself under the hot sunshine today. It sort of lifted up my spirts a wee bit. Now, what did I do today? Ah yes, I treated myself by making a trip to the hair saloon. Finally, after months, I got my hair cut today. My head feels so much lighter. =)

With my new hair cut, I decided to head to town for some retail therapy (and to show off my new style-lah! =P). It wasn't like I bought anything. haha... I'm telling a lie. I bought a book by Mark Haddon (the writer of The Curious Incident of the Dog) and a pair of shorts. hehe. By the end of the day, I was actually sweating because the sun was burning, but I didn't care. You do not get such nice weather in Glasgow that often. Oh, I managed to eat an ice-cream too! It was my first time eating an ice-cream from the Skinny Cow range....and it was hell of a yummy low fat lolly!

I spent the whole day by myself. hmm...pathetic I know, but I actually enjoyed it. Having said that, I did not speak to anyone except to the cashiers and the hairdresser. I couldn't get hold of any friends....but its ok, peacefulness is a bliss. (damn it, hmm...I think I am not making sense here....ah well.)

Fed Up

Yes. I am fed up.

I know I am at the very bottom of the pyramid....but that doesn't mean I can pushed about.

Senior: Now why are there 6 patients for me to see and no one around to discuss the case with me?

Me: That's why I am here. (duh!)

Me: This patient is query for a CABG.
Senior: I do not know if this patient needs a CABG. Why are you asking me?

Me: This patient is query for a pacemaker insertion.
Senior: I do not know if this patient needs a pacemaker. I DON'T KNOW. (and threw the notes on to the trolley).

Now, what is the point of being a cardiology SHO3 if you do not know a single thing! Look, I know you are very busy, cardiology is short of staff, you have sick patients, but you know, there is NO excuse for you to be rude to other people.

Me: I have managed to get IV access in this patient. He really needs his IV fluid + potassium because his potassium is very low.
Nurse: Oh right. Ok.

.........4 hours later, IVs were not up yet. But as she was about to do it......

N: Oh dear, I was just about to put his IVs up, but he pulled the venflon out.
Me: Right. (at the same time thinking to myself, it should be up a loong time ago)
N: Would you mind putting another one in?
Me: Right ok. (I do not have a choice do I? I know you are busy...but you still managed to get your 2 tea breaks for the day...and what I was doing? Sorting out the whole ward all day without any food!)

N: Dr, this patient is query a UTI. I have not been able to send off a urine sample for culture.
Me: Well, try your best to get a sample.
N: Do you want to start him on antibiotics?
Me: He is already on it.
N: No he isnt.
Me: Yes he is. Let me show you.
N: Ahhh right...I see it now.

(arrghh....irritating!)

=D

I walked into the ward this morning looking straight at the bed where P was located.

I smiled from ear to ear the moment I saw him. He was sitting up having his breakfast, without any oxygen mask on. When I approached him, he even waved his hand at me and smiled. I was so relieved and overjoyed to see him well. =D He told me he was feeling GREAT! hehe.

I quickly walked into the doctor's room to announce to my seniors that P was still alive. We were all very happy that we have managed to treat him. =D

Today was a ok day. I finished work at about 6 pm and decided to walk home from work because the sun was just fantastic. I had made dinner plans with my friends, SzeLeng and Geak Poh. We had dinner at "The Two Fat Ladies." I have to say, although the food was abit pricey, it was really really good. We opened a bottle of white wine and sat down to chat for quite awhile. It was really nice.


Tonight was actually a pre-birthday dinner, as SzeLeng put it. hehe. Geak Poh bought me a box of chocolates and Sze Leng got me a really nice bag! In fact, it was a bag that I have been eyeing for quite sometime now. =) After the main course, we had a cup of coffee each. All of a sudden, the lights in the restaurant dimmed. I thought that the electricity supply has cut off or something. Then, the waitress who has been serving us started to walk towards our table with a light source behind a piece of paper. I thought she was holding a candle behind the paper to kind of brighten up our table. But to my surprise, a birthday cake was hidden behind the paper!!!

She said, "I heard it is someone's birthday today. So here is the cake. I would have sang a song for you but I really can't sing." I was really surprised. Speechless. Happy. Touched. Geak Poh bought me the cake. As the birthday gal, I made a wish and blew the candles. It was a sponge cake....yummy.

At the end of the day, I must be the happiest gal on earth. Glad to have great friends and they really cheered me up. =) Thank you guys....really appreciate it! Hugs to all of you!!!!

Depressing Day

AAAAAAaaaaaHHHHHHhhhhhhhh.......................


AAAAAAAAAAAAaaaaaaaaaahhhhhhhHHHHHHHHHHHHHHHHH..............................


Ok. Shut up Saw Ling.

I am feeling kind of ....errmm... dunno what word to use.... depressed? in a daze?

I dunno. Again, it is one of those days, in which I felt crap.

This is pretty weird, considering that I did not feel like that for patients in the gastro ward. Probably because I think most of their illnesses are self-inflicted. But in this cardio/endocrine/general medicine ward, it is really sad seeing people die in front of my eyes.

Today was a very great example. The events were as follows:

13:00 I inserted an IV cannula into P to prep him for his CT scan.

14:00 ATSP re: funny turn. P is known to have absence seizures and has diet-controlled diabetes. He was fasted from morning for a CT scan. When I approached him, he was acutely confused (he wasn't like that before). His vital signs were normal, and blood sugar level was 4.6. He seemed to be having a tiny seizure. Although I know that it is not THAT low, I decided that maybe I should pump some glucose into him, since he was fasted.

15:00 Patient's BM better, but he was more agitated. Whenever I asked if he was alright, he said, "Ok. Ok," and made funny lip-smacking sound. He was trying to climb out of bed. I thought this was weird. And decided to give him a tiny dose of lorazepam to calm him down.

15:30 Asked by the nurse to seem him again. This time P's face was purple. His oxygen saturations dropped to 83%. I started him on trauma mask and this only pushed his sats to about 92%. He became tachycardic, and an ECG showed ST depression on leads V4-V6, which were not present before. His chest sounded horrible and I thought he was in acute pulmonary oedema. I gave him a bolus of 80mg furosemide and he did get some diuresis from it. He was also in respiratory acidosis. I felt that I was out of depth. Because whatever I was doing obviously wasn't working. I tried to call my seniors, but the operator kept giving me the wrong page numbers. Finally, I got hold of my registrar, and he came in no time. He started P on a GTN infusion. When I left, P's condition was generally deteriorating. I think he is not going to make through tonight.


I find it really disturbing how a patient can just be so unwell within an hour or so. The fact that P was actually complaining to me about why he needed to be fasted for the scan, and how fed-up he was with hospitals, made this event a shocking and depressing experience. It is times like this that made me feel that I should not be a doctor. I feel depressed seeing him so blue and grey....sigh. =(

No Connection

*sob *sob *sob

My wireless is not functioning!!! It was working fine on Monday night. Then all of a sudden, I lost my connection..... and since then, I can't get it back. I have tried reinstalling the whole router, but it didn't work. How?!

Looks like I might need to ask them to pull the connection into my room....arrghh....

Really can't live without my internet...I mean I can connect my PC directly to the modem. But this means that I can't use my PC in my room. This is not good at all, considering that I need to complete some online stuff this weekend!!! =(

I will try to sort it out tonight again. Wish me luck.

ps. note that I'm writing this from the pc in the doc's room. keke. (hiding away from tonnes of job in the ward).....

Delirium in The Morning!

I woke up this morning at 5.30 am with confusion.

What day is it today?
Is it Saturday or Sunday?
Am I supposed to go to work today?

Those 3 questions rang in my head early this morning. I sat up almost immediately the moment I opened my eyes. I looked right at the clock and felt slightly relieved that it was still early. My heart was pounding from the sudden burst of consciousness.

It took me about 2-3 minutes before I worked out that I have been working over the weekend and it is a Monday. Pathetic I would say.

...

Its past midnight, ie, it is early Monday morning.

My eyes are weary, my calves are aching, the soles of my feet are burning......

Tired. You know, sometimes you are so tired that you just can't fall asleep? Bizzare.

And I hate Mondays......time to go to bed. And have to be back at the hospital in less than 8 hours.