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My First Hour Of The Day

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What are your morning rituals? What does the first hour of your day look like?

By default I rise around 4-5am. Perhaps out of habit as I usually take my time in the morning. Sadly, this also happens during my off days even when my alarms are off. My body clock is somehow tuned to waking up at such.

As mentioned, I take my time upon waking up. Thus, upon waking up, the rain sounds which I fall asleep to would be playing in the background and I would sit by the side of my bed and slowly make my way to my kitchen which is just across my bed, since I live in a studio unit and put my kettle to boil.

The kettle is usually filled the night before and hence, one thing less for me to think in the morning. This is then followed by my morning bathroom rituals and brushing my teeth.

Usually by then, I would have been much more awake and proceed to consume my iron tablet, vitamin C and making my morning coffee which is a mixture of 3-in-1 sachet and a teaspoon of black coffee since I prefer an even stronger coffee.

If I were working that morning, I would prepare both of my 1.5L of flasks by filling them with cold coffee which I have brewed a day prior for me to bring to work.

Why 2 flasks? Well, one is not enough.

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There are days when I’m feeling hungry or in the mood, I would prepare myself breakfast. My go-to-regular is frying egg mixed with mushrooms, chopped chilli and curry leaves and adding them to my breakfast sandwich. During my time being vegetarian, I would usually grill or air-fry my premixed tofu which I have marinated with spices, acting as a burger patty and my breakfast sandwich is prepared.

There are days, despite waking up earlier, I would still miss breakfast, thus instead I would pack it for work.

After that is followed by showering and getting ready for work. I usually wash my hair in the mornings daily. Thus, prior leaving for work, I would dry my hair with a hair dryer and style it up in a bun and I’m good to go.

How about if I’m not working on that day or if I’m night shift for that day?

Usually I proceed with my usual cup of coffee or I would go the extra mile by brewing myself a pot of masala or ginger tea with the tv playing in the background of some random YouTube video on productivity, to which I’m usually not listening to and merely keeping it on in the background for some background noise.

Then, I would proceed to prepare my breakfast and start my day with some writing or studying.

Well, that’s my first hour for the day, or perhaps a little more than that.

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Iced Tea & Cold Brew Coffee

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What is your favorite drink?

As the title entails, it is Iced Tea and Cold Coffee.

1. Iced Tea

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I fell in love with tea, green tea, black tea and oolong tea in particular when I was 14 years old.

At that time, I was looking into drinks to aid my weight loss and I came across green tea and oolong tea being suitable drinks in facilitating weight loss when consumed without sugar.

Thus, I brewed my first proper sugarless green tea and fell in love with the taste. Ever since then, I started drinking it on a regular basis and it has pretty much replaced water for me.

Did it aid with weight loss?

Perhaps in the beginning, eventually, I continued drinking it because I enjoyed the taste be it warm or cold.

As I started working, I would usually prepare cold brew green tea in order for me to bring to work the following day.

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Why cold?

The environment that I’m working in can get rather warm and considering I am a person who perspires easily, the temperature of the tea eases me and provides immediate rejuvenation.

Even after a long day at work, nothing refreshes me more than a cold brew green tea served in mason jar and a straw.

2. Cold Coffee

Photo by Marta Dzedyshko on Pexels.com

I am a HUGE fan of coffee, black sugarless coffee in particular.

My love for coffee began since I was in primary school, which I think is a bad thing since children are not supposed to consume coffee.

Back then, my mother would used to prepare coffee for my father and milo for me prior to my father sending me off to school and heading to work.

Me and my father would then switch drinks after he has drank half of his drink.

Then, when I turned 14 years old, I started pulling an all nighter or getting up at midnight just to study.

Eventually, I developed immunity towards coffee and is able to fall asleep even after consuming it. Thus, I merely consume it out of addiction and routine.

As I started working, as mentioned in my explanation for cold tea, the environment is rather warm for me to be consuming hot coffee. Hence, I would prepare my mason jars of coffee the night prior and transfer it into my flask the following day.

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Surviving Tagging And Finally Celebrating Christmas In The Medical Posting – Housemanship Diaries

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In the Medical Posting, seniors were required to tag for a minimum of 10 days prior to off-tag while juniors had to tag for a full 14 days.

I was due to have my off-tag assessment and in the Medical Posting, we were required to off-tag with Physicians, meaning the specialists.

Tagging everyday in the Medical Posting was rather annoying for me since we had to stay until 10pm and being a regular early riser, I would start feeling sleepy around 8pm as that is the time I start to unwind and go to bed.

However, I can’t because I am still tagging. On top of that, since I am tagging, I would be too exhausted by the time I reach home to even consider studying. I had to prioritise my sleep more or I would crash.

Thus, I tagged for a total of 12 days which consisted of two off days. Thus, in reality, I only actually tagged for 10 full days.

In order to officially off-tag, I had to have my logbook signed by the physician who assessed me as well as to have each procedure filled and countersigned by the medical officers.

Long story short, I finally off-tagged on Christmas Eve and did not realised that I have been allocated an off day on the 25th of December.

This was perfect as my parents flew in on the 24th night. Thus, upon having officially off-tagged, I left and started getting ready to travel to the airport to meet my parents.

The following day of course was Christmas which was well spent with my parents.

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Pensamiento de Oscar «Madrid necesita un cambio radical»

Sugerencia de escritura del día ¿Cómo mejorarías el lugar donde vives? Ver todas las respuestas

¿Cómo mejorar el lugar donde vivo? Pues en primer lugar seguro que mejoraría si tuvieramos otro presidente o presidenta en la Comunidad de Madrid, alguien que no apueste por la confrontación, que apueste por lo que nos une y no por lo que nos separa, que no se haga la victima ante las críticas y que tenga valor admitir errores y mejorar, que sea honesto/a y transparente, que tengo modos muchos más educados y sosegados, que gobierne para toda la ciudadanía de la región de Madrid y no para unos pocos, ante todo que se haga justicia a 7291 personas que faltan y no se morían igual.

También en la ciudad de Madrid me encantaría un alcalde como Enrique Tierno Galván, uno de mis sueños es ser yo el Tierno Galvan el siglo XXI la verdad es esa, pero adaptado al siglo XXI, que se promueva «Una Movida Madrileña» adaptada al siglo XXI, que se promueva una explosión cultural, donde el arte, la música y la alegría vuelva a las calles de Madrid.

Fomentar la participación ciudadana, fomentar espacios Decide Madrid del ayuntamiento de Madrid y extenderlo a la Comunidad y otras localidades de Madrid.

Fomentar la sostenibilidad urbana, fomentar la mejor gestión de los residuos, fomentar el transporte sostenibles, aumentar los carriles bici en Madrid y mejorar los espacios verdes y crear otros nuevos.

Por supuesto la vivienda es uno de los temas principales de esa acción de gobierno de Madrid, promover vivienda social y asequible, también recuperar el centro de la ciudad para los madrileños, facilitando reformar las casas antiguas y promoviendo alquileres accesibles.

Por supuesto fomentar el empleo de calidad es otro de los objetivos, reindustralizar Madrid, invertir en empleo verde, poner atención también en la empleabilidad de colectivos vulnerables como mujeres, jovenes, mayores de 50 años y personas con discapacidad.

Mejorar el transporte en Madrid, mi proyecto es reinstaurar el tranvia en la ciudad de Madrid, mejorar los frecuencias en el transporte, poner el abono gratuito para desempleados, personas con discapacidad, mayores de 65 años, y poner permanente la reducción de precio vigente en los abonos y billetes del Gobierno.

Avanzar en la digitalización, mejorar sensiblemente la conectividad en las zonas rurales, facilitar el acceso a Internet en los hogares y mejorar e impulsar la digitalización de PYMES

Aumentar el presupuesto en Educación, mayor inversión en educación pública y de calidad para todos los madrileños, desde primaria a la Universidad, fomentar la educación y la cultura es un objetivo para mi prioritario.

Fomentar el comercio de proximidad y local, las PYMES frente a las grandes superficies.

Por supuesto aumentar significativamente en el presupuesto para Sanidad y arreglar de inmediato todas las deficiencias en Centros de Salud y Hospitales de la Comunidad de Madrid, revertir el proceso de privatización y volver a tener para Madrid una sanidad pública y de calidad para todo el pueblo madrileño.

Fomentar la colabaración interinstitucional, para implementar muchas de estas reformas, es muy importante fomentar la colaboración entre diferentes niveles de gobirno (nacional, regional, local) con organizaciones civiles.

Y volver a hacer de la radio televisión pública madrileña un canal para todos/as los madrileños, que ya no haya ni TeleAyuso, ni TeleEspe, hacer una ley para blindar la neutralidad y despolitización de Telemadrid y Onda Madrid.

Y seguro que me dejo muchas cosas mas, esto es una de muchas reformas que emprendería en mi Comunidad Autónoma y mi ciudad, yo sólo quiero el Madrid abierto que siempre ha sido y no el lugar antipático que parece ser para algunos o algunas, así es como pienso, por supuesto esto es muy debatible por supuesto, yo sólo quiero sentir que mi ciudad, mi región, mi país la sienta como mía y de todos y todas, así de claro.

Abrazos enormes, amigos y amigas.

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My Morning Routine Being A House Officer Leader In The Surgical Posting | Housemanship Diaries

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There are three main leaders in the Surgical Posting. One is in charge of curating the weekly schedule, the other, in charge of ward and cubicle / bed allocations as well as to reallocate if there are any people who took emergency leaves or medical leaves and the third one, in charge of our attendance at work.

I was the daily allocator. Being the “allocator”, I would be in charge of designating the house officers to the selected cubicles of both the male and female surgical wards (MSW and FSW), the Peri, EMOT and ETD as well as to look for substitutes if there are any last minute changes or leaves.

Usually, I will prep my allocation in advance after the schedule leader has done the schedule and make necessary changes along the way. The leader in charge of the schedule usually determines which person works the night shift and when as well as to approve any leaves. Usually, the house officers will be divided into their respective wards.

The night before, I usually run through the suggested allocation in the “Leaders Group” with the medical officers in charge of the House Officers to screen through.

After receiving the green light from them or making necessary adjustments, I would then upload the list in the House Officer’s group. Thus, they would then know where they would be covering.

The list is usually sent in the “MOHO” group, meaning the group containing the House Officers and Medical Officers at 6:30 a.m.

Thus, I would wake up and be on standby at 5am everyday, even on my off days as I would wait for any messages should anybody take medical leaves or emergency leaves and make the necessary adjustments needed.

At 6:30 a.m sharp, I forward the daily allocation into the “MOHO” group.

If I happened to be working on that day, I would pause in between work just to send and then go about my work.

However, if I happened to be on leave or having my off days, I would then return to sleep or go about my other activities after 6:30 a.m.

It was an interesting experience having had the privilege to hold the position as one of the posting leaders.

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The Wards In The Surgical Department | Sarawak General Hospital

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The main General Surgery wards in this hospital is located on the 7th floor of the main building which are Male Surgical Ward (MSW) and Female Surgical Ward (FSW).

I entered my General Surgery Posting during a time whereby there were no House Officers being allocated into sub-specialities. The only so-called “sub-specialities” that were available were “Vascular” and “Hepatobiliary Team – HPB”. Both of which are added under General Surgery.

Other teams such as Neurosurgery, Plastics, Urology and Paeds Surgery did not have House Officers. It wasn’t till towards the end of my service in this Posting that it was reintroduced.

Thus, our exposure towards the wards in General Surgery were limited but also made it pretty easy for us to manage.

1. Male Surgical Ward, MSW

Located on the 7th floor of the main building, it is considered the ward which is feared and avoided by many but is also where I’ve spent most of my time while being in this posting.

As the name suggests, it is mainly for male patients with underlying surgical issues or at least being managed by Surgical as the primary team.

This ward is usually avoided by many due to the overwhelming amount of patients which is twice the amount in Female Surgical Ward.

Twice the amount usually meant twice the amount of drama as well as the usual chaos.

My journey in General Surgery ended with my service in this particular ward.

2. Female Surgical Ward, FSW

This ward is also situated on the 7th floor of the main building and it is opposite the Male Surgical Ward, MSW.

As per its namesake, it mainly consists of female patients with underlying surgical issues or at least being managed by surgical team as the primary team.

Albeit it being a “Female” Surgical Ward, there would occasionally be male patients being treated there as the beds in the other wards are usually filled, causing an overflow of patients into this ward.

I started my tagging days in this particular ward and I would consider this ward relatively chiller and laid back compared to the other.

3. Vascular Ward

The Vascular Ward is located on Level 3 of the main building.

If you have done the Paediatrics Posting, it is situated in the same location as “Paeds Nursery Level 1″.

The ward is essentially divided into two, catering to both the Paediatrics Team as well as the Vascular Team.

4. Vascular Extension Ward

The Vascular Ward could only cater to at most, 10 patients. Thus, if there were any more patients to be managed under the Vascular Team, they would be placed in the Vascular Extension Ward or in the main surgical wards.

The Vascular Extension is located on the second floor of the main building, inside the Urology Ward which is situated opposite the emergency department, ETD.

During my service period in General Surgery, I have paid a few visits to the Vascular Ward and Vascular Extension Ward. However, I have never served my time there as I was not allocated to be the House Officer in the Vascular Team and also because it was a team I was avoiding.

Upon my exit from this posting, the sub-specialities were reintroduced again and House Officers were being allocated to other teams.

Thus, if you are due to experience the General Surgery Posting, I hope that you will find it as enjoyable as I did especially while working in the Male Surgical Ward.

It is indeed hectic and busy and going home on time is almost unheard of. Albeit MSW being an extremely busy ward, the medical officers I worked with as well as the specialists were kind, helpful and willing to teach.

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My First Day In General Surgery – Tagging Day 1

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My “Day 1 of life” in the Surgical Department commenced on the 4th of July 2024 which fell on a Thursday.

I was allocated to work in the side room of Female Surgical Ward (FSW) with a fellow colleague whom I’ve worked previously in the night shift in Paediatrics.

I left home around 5.45am and arrived at almost 6am and started reviewing as usual. I took some time as I read through the previous entries and used it as a guide to write my morning reviews.

Upon reviewing around 4 patients, a fellow medical officer arrived and automatically, I greeted him and followed him. It has become a reflex of mine as in other postings, we had to be like that, which is a good practice.

He was friendly and had a kind demeanour. Thus, I followed him, not knowing that he is actually the medical officer in charge of the HPB (Hepatobiliary) patients.

Usually, there will be a house officer in the ward in charge of the HPB patients, which I did not know of course, considering that it is my first day. Thankfully, I had a partner who followed the “GS – General Surgery” rounds with the other medical officer instead.

As usual, rounds with medical officers followed by rounds with specialists in the morning and as House Officers, we are their assistant and scribe. The morning rounds ended and we proceeded with tracing the joblists for each patients in our allocated cubicles and updating it in the “MOHO” group as well as proceeded to complete the active job-lists.

This is then followed by afternoon reviews, afternoon rounds with medical officers and specialists followed by the completion of the active joblists and finally starting with on-call reviews and preparing our handover lists.

Considering that I am still tagging, I had to stay till at least 10pm. After completion of the on-call reviews, we followed the on-call rounds and HPB (oncall rounds), clerked and transferred in the new patients, completion of the active joblists before finally heading home.

Overall, my first day in Surgery was surprisingly good and calm. The medical officers and specialists seemed rather kind and patient. Thus, giving me the encouragement to continue despite having heard that this particular posting seemed like a rather toxic one which only serve to instil fear in me prior to joining this department.

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The Worst Morning Shift In General Surgery | Housemanship Diaries

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I can’t really remember when as at the time of writing this article, I am about to cross into the second week of 2025.

Perhaps it was somewhere in October last year or early November.

It happened to be the day shift on a weekday and we were lack of manpower. 3 House Officers in the Male Surgical Ward, 2 House Officers in the Female Surgical Ward. Out of the 5 of us, I am the senior and the rest are first posters, three of which are only Day 3 into their housemanship life.

Oh dear…

We all know how busy Surgical can get and being the only senior that day surrounded by newbies, it was as good as being alone as they were not familiar with the system or the work or the procedures.

Learning does take time.

The day started with me taking care of the acute beds. The acute beds in the ward is considered the most unstable, hence it only made sense to allocate the senior, which is myself there, followed by the subacute cubicles.

The front cubicles and back cubicles are relatively stable patients. Hence, I allocated my juniors there. Usually for first posters in their first week of life, I would not allocate them independently to take care of a cubicle. However, we were desperately short staffed that day and taking care of the front or back cubicles are not easy either especially if you’ve just entered.

The day was busy enough. Started with me following rounds at acute and subacute with my medical officers and again with the ward surgeon, only to leave midway as the Hepatobiliary Team (HPB) had their own separate rounds and I was the HPB house officer for that day.

After rounds, it is the completion of the joblists. Amidst trying to complete the joblists, we had to transfer in new patients, take and send off the bloods of patients who have just entered as well as attending to any acute issues.

On that day, I had to assist with the front and back cubicles as well and in the afternoon, the juniors left for their Operating Theatre (OT) orientation.

My phone literally rang non-stop that day and the nurses kept haunting me down for everything. If only, I had the ability to clone myself…

Suddenly my phone rang and I had to assist a registrar to help tend to a visiting outpatient, attend the female surgical ward acute issues because the medical officer on-call called me as well as attend a virtual meeting.

Time flew by rather quickly, one minute I was escorting a patient, next was being called upon by this and that medical officer or registrar or nurses. To the point, my post-call registrar stayed back to assist me.

As the evening progressed, most of my patients desaturated. The annoying thing about Surgery, we had to update the whole story properly in the oncall WhatsApp Group for the day.

If only it were as easy as that.

We couldn’t just take a picture of our entry and update. Instead, we had to properly type the whole summary or stay.

I finally completed my task for the day at 10pm. It was an extremely exhausting and tiring day. One which I have no interest in relieving again.

That was probably the worst morning shift I’ve ever experienced.

However, looking back at what I’ve written, it doesn’t do justice to what I actually felt that day.

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I Ordered A Chest X-Ray For The Wrong Patient | Housemanship Diaries

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It was during my tagging period in the Surgical Posting and I was a Female Surgical Ward.

It was my first day being in charge of the acute beds and side room. I recalled one of the patients being a Urology patient. Usually, if the patient is from other departments, we are not required to review them. This patient in particular was intubated and sent to our ward to be placed in one of the acute beds for further monitoring from the Urology ward.

Upon transfer into the ward, the patient required a portable CXR for post-intubation. I did not screen through the casenote since it was from another team. The nurse in charge informed me of a new case but did not tell that the patient needed a CXR. Hence, my reply was “it’s not our patient, it is from a different team. They will review later.”

Hence, the Urology Medical Officer on call came after a while and reviewed the patient. He went to check the system and was confused as to why the chest x-ray was not done for the patient. The nurse immediately informed that I did not want to do it considering the patient is from another team.

At that time, afternoon rounds with the Surgeon was currently ongoing and I was disturbed from writing my reviews. I immediately proceeded to fill the form and had it sent to the Radiology Department to request for a portable chest x-ray.

Amidst the rush, I had wrongly written for another patient instead.

I only realised it when the radiographer came and did an x-ray on two patients at the acute beds. One, the intubated patient from another department and another which is a patient of ours.

I realised my mistake and rushed back to check the form and was met with a very angry daughter of the patient.

I admitted my mistake and was yelled at. After such a tiring week and a hectic day on top of tagging itself, I could not contain myself any longer and tears started streaming down my eyes uncontrollably.

Thankfully enough, it was just a mere chest x-ray and nothing more or a wrong operation done. Since the patient is under the colorectal team, the surgeon in charge and the medical officers in charge will proceed with their rounds again and I could not contain myself again and tears started to stream down my face again.

The medical officer in charge noticed and asked me to go to toilet, understanding that I needed some time for myself to recollect myself again. Hence, I excused myself.

After a while, I went out and rejoined the rounds and admitted my mistake to the medical officer in charge to which she laughed and said “well she has a free x-ray now and were there any changes as compared to the previous one?” To which I answered none.

She was amused considering that it was over a mere x-ray which was requested for the wrong patient that I started breaking down.

Thankfully, it was just an x-ray.

The lesson learnt here was for me to be extra careful in the future because it could have been worse and become medicolegal.

Please try to avoid doing anything out of rush or pressure and always slow down for a bit and reconfirm the patient and procedures to avoid or minimise errors.

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My First Surgical ETD / ED Night Shift Experience

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My first ETD “on-night” or night shift in Surgical was with a fellow junior who I considered as my senior in the posting as she was in the department much longer that I was.

Prior to joining the Surgical Posting, I have went through the Orthopaedic Posting as my first posting and people said that the ETD shift is similar to that in the Orthopaedic Posting, except that we would be taking the bloods, requesting necessary scans ourselves and posting the case.

Before I went to the emergency department, I stopped by the ward to steal some forms and stock up my “file”. After that, I went downstairs and received handover from the morning team.

During my first “ETD ON” shift, there were two medical officers as the first call. One is a tagging medical officer as she had just joined the department.

The night was rather cold I would say with minimal referrals, probably less than 10.

Every time there is a new case, we would be asked to clerk the patient first. However, usually the medical officer would be there by then and we would see the cases together.

I remembered it being “cool” enough that night that we even had time to have dinner for a while before proceeding to take our coming mornings and even rest for a while somewhere.

In the morning, we requested scans that were rejected the day before and followed rounds with no surgeon to know the latest plans, handed over to the following morning team and returned home on time.

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My First Day Back At Work After A 6-Week-Break | Housemanship Diaries

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I officially returned to work on the 2nd of October 2024.

Initially, I was stationed to work the morning shift at ward. However, a colleague of mine decided to take a sick leave on that day when she was initially stationed as the House Officer in the Emergency Department, ETD HO.

Being the Allocation Leader in this department, it is my duty to immediately look for a replacement and to update in the group with the medical officers. Not one person came to mind and I felt bad since it was a friend of mine who took a sick leave or did I feel comfortable dragging another person to cover this shift since it is a shift most people avoided.

Thus, I offered to be the ETD HO myself. It was during an anaemic House Officer period and there were only one House Officer stationed at the Emergency Department.

Hence, I went to work and stocked up my necessary supplies before meeting the post night House Officer in the Emergency Department to receive my handover.

Of all days, it had to be one whereby no coming mornings (bloods) were taken for the patients and there were a lot of active job-lists not being carried out. Not to mention scans to be requested the following morning.

Basically, there were a ton of “shits” being thrown to me and if I do not settle it myself or to push my post night colleague to help me, I would be in a mess for the day.

Imagine having just returned to work to this. Without thinking much, I started identifying the patients who had bloods to be taken and proceeded to take all of them and sent it off. After sending them off, I started preparing for scans and called the radiology medical officer oncall to present my case.

Finally, after I thought I was done, I decided to review the stranded patients.

Normally, the stranded patients should be reviewed around 7am as we would begin our morning rounds around 7:30am till 8am. Thankfully, it was the weekend and rounds began much later.

I went through my list of stranded patients and there were almost 20. 20 stranded patients at various locations.

Would I have the time to review all of them? What about the active joblists or scans? Can I rely on my post night colleague? What if there is a new case?

I remembered it being a rainy day and the referrals were initially from wards and not from the Emergency Department (ETD).

Perhaps it would be a slow day. I thought to myself.

But, I thought too soon.

Soon, referrals started piling up. My medical officer’s phone (MO) was blowing up with calls. Other sub-specialities kept reaching out for me to help them out and at one point, me and my medical officer had to split to ensure we got everything done to the best that we could.

I wished that I could literally divide myself but I couldn’t. On top of that, my right foot started to ache. I just came back from a 6-week-break. I can’t afford to go on anther few weeks. If I do, just when am I going to end this posting?

I recalled it being a terribly hectic day and I felt bad as I was mostly away, having been dragged away by other sub-specialities, escorting patients or carrying out the active job-lists. I could not really be by my medical officer’s (MO) side to see the cases.

Finally, the end of my shift approached. 7pm and my night colleague came for handover.

Despite it being the evening already, the fire was still burning strong, referrals did not stop coming in and I still had tasks to complete or I would be handing over “shits” to my night colleague.

Finally, it was around 8-9pm, I can’t really remember as I was following night rounds with the OT call medical officer and registrar. My medical officer told me to return home since the following day, I would be morning shift.

I remembered returning home that day, somewhat unsatisfied with myself. No doubt that it was a tough day, but I could definitely do better. If only my leg did not slow me. The pain seems to increase with every step I took and with every exertion I made.

However, as I remembered, I was blessed to have an angel as my medical officer oncall for that day. Instead of shaming me or being sarcastic or mentioning that I could do better, she simply thanked me for putting my best effort on the first day back and welcomed me back.

It’s angels like this who makes me want to try to be better the following day.

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While growing up, when I was asked regarding what I looked forward towards in the future, I always had the answer.

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The answer was simply, I wanted to be a Doctor (coz that’s what I knew my whole life and indirectly working towards albeit having other interests).

Thus, from primary school, next would be high school, moving towards science stream in school and pre-university in a course which would serves as a prerequisite into entering medical school.

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In medical school, my focus was always on the exams, completing that particular posting, completing that year, completing preclinicals and moving onto clinicals, studying for the grand finals, completing medical school and graduating.

Upon graduation, applying for housemanship to start practicing. I always knew that I wanted to practice in Sarawak General Hospital. Thus, that didn’t require much thinking. Working my way there, and finally, starting housemanship.

Now that I’m a House Officer, completing each posting, working towards completing a year, now focusing on completing the whole journey.

But after that? I feel lost and aimless.

Previously, when asked regarding my need to have a family, I would brush it off. Not that I didn’t want to but I’ve yet to meet the person that I would want to spend the rest of my life with and build a family.

My aim was mainly catered towards my parents. But they’re doing just fine on their own. Thank God for that. I don’t see my purpose anymore actually.

In regard to post-housemanship, I have no idea of which speciality I would like to dive into. In terms of being surgical based or medical based, the thing I learnt over this past 1 year is that I’m definitely a surgical based person. Though, I have enjoyed paediatrics very much (which I supposed is a very much toned down version of the chaotic medical posting).

I wouldn’t know, as upon writing this article, I’ve yet to complete my medical posting.

The medical field is not just tied to 6 different postings. As a House Officer in Malaysia, we are required to rotate to 6 different postings throughout our 2-year-duration in housemanship which are, Surgery, Medical, Orthopaedics, Obstetrics and Gynaecology and Paediatrics. The sixth posting, we have the privilege to choose among Emergency Department (ETD / ED), Anaesthesia, Klinik Kesihatan (Community Clinics) and Psychiatry.

However, in reality, the clinical field is vast and there are other specialities that we as House Officers have yet to enter. In terms of non-clinical field, it is another vast category.

Which of it am I?

At times I wished that I always knew of what I wanted to be, such as a Cardiologist or a Surgeon but after assisting in the operating theatres and working as a junior doctor, none of it appeals to me 100%. Sure it is interesting but is it something I would want to be doing for the rest of my life?

Having completed a year of housemanship, I thought that the answer would be clear to me by now. Yet, I’m still as unsure as I had been before. I’ve approached multiple seniors, medical officers and specialists and talked to various doctors from different fields regarding their experience. I seem to have the information but my heart was not fully captured by any of it.

Everything seems nice and interesting. I hope that in time to come, the answer would be clearer. The least I could do at the moment is to put my best foot forward in whatever department or sector that I go through.

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Paediatrics Posting. The posting of tiny human beings.

Looking back, I feared entering into the Paediatrics posting. I think I say that for almost every posting.

However, it was one that I fell in love with before I even off-tagged, as mentioned in one of my articles previously.

The stress level was not as bad as it was in other postings mainly because we were dealing with children. Not to say that treating them is easier, in fact it isn’t as they tend to fight back, scream or cry a lot.

I mean they’re just children.

But perhaps when I do come to work, the smile on their cute faces were enough to alleviate some of the stress and checking them clinically involves a skill as they are easily triggered.

I would find myself playing with them or calming them down. Most of the time if I were to auscultate them, they would either start playing with it, swat it away or start crying.

The Paediatrics posting is the place I started eating again amidst the stress. Irregardless of the amount of patients and work to do, there is always time for lunch or at least our superiors will make sure of that.

It was also the place where I enjoyed the long rounds in the morning and afternoon as well as I would present to specialists.

I made a good friend with a medical officer who I still keep contact with albeit having left the posting. I enjoyed the days where I would be allocated to work with him.

Having worked both in the general ward and nursery ward, the experiences were different but enjoyable nonetheless.

If there is a posting I wouldn’t mind repeating, it is the Paediatric Posting and I hope you do or will or had enjoyed this posting just as much as I did.

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I tagged for almost a month here.

The tagging timing in the Surgical Posting is from 7am till 10pm which is same as with other postings, except Obstetrics & Gynaecology (O&G).

In the Surgical Posting, we all have to complete a compulsory 14-Day-Tagging period irregardless of having “off-tagged”. Entering the Surgical Department as a senior or fourth poster, we are allocated to special shifts such as night shifts in ward or night shifts in ethe emergency department (ETD).

This serves as an advantage to us seniors as we do not have to work the morning shift for one week straight prior to having an off day. It is also better as it allows us to recuperate in between by not having to go to work extremely early.

However, the disadvantage is that our tagging period is somewhat extended.

As I mentioned before, we are required to complete a 14-Day-Tagging period. The night shift is not counted. Hence, the tagging duration can go up to 3 weeks.

For me, it extended up to 4 weeks due to my medical leaves (MC).

During my first week of tagging, I took a day of medical leave due to extreme fatigue and in the second week, I took 3 days of medical leaves due to extreme fatigue and COVID-19.

At the time of writing this article, I am on a 6 weeks medical leave due to my ATFL injury.

Sometimes I wonder, if I will ever exit this posting and proceed with my last which is medical.

Back to the tagging part, thus my tagging period lasted for a month.

Going to work as a tagger, I would leave home around 5:45am – 6am. Partly because I’m just tired and felt like I needed more rest because there will always be an active issue in ward and I am only able to return home at 10pm.

In the evening around 7pm, I would go for dinner after handing over to the night colleagues and completing my tasks and on-call reviews for the day. Most of the time, it would be our first meal of the day.

Some days, we would be done by 8-9pm and on some days, earlier. Most of us, upon completing, would head for dinner and head home or to just head home straightaway.

This is wrong of course but we were simply exhausted and burnt-out during the tagging period. Thus, we grab the opportunity while we could.

Towards the end of my tagging period, I started bringing packed dinner boxes and reheating them as work prior going back.

Surviving the tagging period in the Surgical Posting was hard and tiring but eventually, it did came to an end.

Thus, if you have yet to enter the Surgical Posting, the tagging period is indeed tiring as with any posting. However, try to learn as much as you can and take comfort in the fact that it does come to an end.

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Daily writing prompt What would your life be like without music? View all responses

Utterly boring.

As far as I could recall, I have always associated studying with music.

Perhaps it is because while growing up, my mom had always filled the house with music and made me sit at a corner to study whether I liked it or not, I had to study.

Eventually, I’ve grown used to, to studying with music or reading with music.

In high school, I discovered the kind of music that I like as well as the suitable time for me to study.

Thus, music and studying goes hand-in-hand or I will not be able to focus.

Eventually, I shift to Podcasts and Audiobooks while I am going about doing my chores or cooking, I am either listening to these or music.

Even my daily morning writing has jazz or lo-fi playing in the background.

There are days of course when I do not feel like listening to my music or is simply not in the mood for other musics.

Thus, “lo-fi” or “jazz” are my go-to. Still musical nevertheless.

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Daily writing prompt What things give you energy? View all responses

Working in the hospital, I wished that I had endless amount of energy. This is due to the never ending amount of patients as well as the lack of manpower.

Despite having completed your side of work, you just wished that you could help out. However, once you are done for the day, the thought of even going out is too tiring, upon returning home.

Thus, the evenings after work are usually spent recuperating and resting before going to bed to repeat the whole thing again the following day.

These are what keeps me going throughout the day.

1. Coffee

I need to have my morning coffee. I just absolutely have to.

My morning is not complete without my morning coffee as my body will feel sluggish and tired. I’m somewhat also more irritable and unable to think or move fast.

Perhaps it is the caffeine addiction speaking.

After I have had my black coffee to start the day and packed my necessary coffee flasks for work, it is then that I am ready to walk out the door and head to work.

2. Chrysanthemum Tea

I have built a liking towards cold chrysanthemum tea.

Personally, I enjoy the sugarless chrysanthemum tea. However, the ones available at work are only those in the can and has sugar in it.

Nevertheless, I still make do with it. Besides it is affordable too. Sipping that cold soothes my soul and reenergises me.

3. Cold Green Tea

In addition to cold chrysanthemum tea, I would usually prepare a jug of green tea and store it in the fridge.

This is for me to enjoy upon returning home and also serves as a healthier alternative to chrysanthemum tea which is packed with sugar.

Thus, the things that energises me are not food but simply drinks.

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“You Guys Are Angels”

This may be a biased statement and it differs according to the individual’s experience. Thus, although I do know of the controversies I may ignite. I am merely saying this out of my own firsthand experiences and as mentioned before, each person’s experience differs greatly.

MOs, short for Medical Officers.

First of all, I don’t know how do you guys (medical officers) do it, pulling through an oncall shift, just to return for another oncall duty the following day after postcall. Perhaps it is because during my current batch, we have shifted fully to the “shift system”. Thus, we have yet to experience the “oncall” system which was experienced by the older house officer batches.

I am in awe and I appreciate the determination and discipline that goes with it. Most of the time when an oncall medical officer is on duty, they solely handle the referrals from emergency or ward and sometimes both. This goes on from the start of that day till the following morning and after which they would have to help out in clinics during their postcall, wards or even in operating theatres (OT).

Most of the time, they are alone unless they are lucky enough to have a “tagger”. Thus it is them, the house officer, the registrar and the specialist that forms the oncall team.

That is if they are oncall. In the wards, they rely on the house officers to carry out the active joblists, to take the bloods, request necessary scans, to resuscitate the patient first and inform if there are any acute issues and to carry out the morning, evening and oncall reviews while they are in the clinics or operating theatres or helping out in other places.

I used to think that once we have completed housemanship, life will be better. However, after observing my medical officers and registrars, it does not actually get better, the stress is on another level, the responsibilities increases yet they pull through it with jokes and smiles. I used to think that, perhaps they have gotten used to it. On the other hand, I’m still struggling.

Medical Officers are in charge of the House Officers as well. Thus, if any pitfalls were to occur, of course we do get scolded but they are the ones who get reprimanded as well. I’ve lost count of the times when the medical officers have backed me up. Although I do know that, that is their duty but albeit the responsibilities and the stress, I’ve experienced it first hand multiple times when they would take the fall instead when it comes to answering the specialists.

There are times when I do feel their anger were uncalled for. However, most of the time I understand that it mainly stems from tiredness. The patience really wears thin and snaps easily when there is lack of proper rest.

A lot is expected of them from the specialists and on top of that, taking care of us, House Officers too and teaching us what we do not know while trusting the patient’s care into our hands while they are off to help out in a different place. They are always a call away even if we are placed in the night shift. Thus, should there be any issues, they are always nearby and there.

Yet, after work, after the tiring day and issues that occur in ward, they return home to their families and loved ones and try to go about their life, only to return and repeat it again the following day.

Some might say, well, it is their duty isn’t it? I’ve heard it before.

It is true and personally I feel that we as House Officers, although we are tired, and on top of that being tested emotionally, they are even more tired.

Thus, if there is anything at all that stems from this article, it is my deep and heartfelt gratitude and appreciation towards the Medical Officers, which are rarely said.

My dear readers, if you are beginning your journey as a House Officer or is currently going through your housemanship or internship journey, have faith, patience and to always remember to be kind. Remember that as House Officers, we serve to ease the burdens of the Medical Officers on top of learning on the job, for we will one day take their place.

A fellow colleague always mentions this sentence while I’m in my Surgical Posting, “Don’t do unto others what you don’t want them to do unto you”.

This wise line by Confucius has a special place in my heart and I hope it does for you as well. As you become more senior and familiar with the work at hand as well as build good relationships with your superiors, always remember to be humble and kind.

Do not let cockiness overcome you nor be easily angered when a fellow junior makes a mistake or asks for guidance.

We were all once in their shoes as well.

Always remember to take care of yourselves first, so you can serve others best.

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Sunday, 30th of June 2024. I was allocated to work as the morning shift house officer at Paediatric Isolation Ward 3A. It was a Sunday.

At the time of writing this article, it is September and currently in my fourth posting which is Surgery. I should be pushing into my third month in Surgery but considering my recent injury in August, I have been on 6-weeks medical leave.

Looking back, my last day in Paediatrics was extremely lovely.

Working during the weekend in General Paediatrics especially Paeds 3A meant that there is only one medical officer who will do the morning rounds, which is usually the oncall medical officer and grand rounds with specialist is only once which is in the morning.

Prior to my arrival that morning, I knew that there were only two allocated house officers on duty in the ward that day. Me and a colleague of mine.

However, my colleague was on medical leave and was unable to come to work. I started off with morning reviews at the acute cubicle as usual and continued to the next cubicle while awaiting another house officer to be reallocated.

Considering that we were tight on manpower during that day, we each reviewed the patients on our own and directly presented to the specialists.

A lovely person was reallocated and I enjoyed every bit working with her. We completed morning rounds at almost 2pm and proceeded to complete our morning discharges and take any STAT bloods.

Then, we went for lunch and proceeded with acute bay reviews and continued with our afternoon discharges.

Upon completion, we spent time talking and joking. The hours were filled with giggles and laughter till it was finally time to return home.

We returned home on time that day at 6pm.

My third posting ended on a good note as well and it was one filled with tons of fond memories. It is one of the posting that I would not mind repeating.

If you are due to commence the Paediatric posting, I sincerely hope that you will enjoy it as much as I did.

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If you didn’t need sleep, what would you do with all the extra time?

If only we had endless energy and didn’t require sleep.

Then we’d be robots.

In this evolving society whereby work is prioritised and hustle culture is looked up upon, we tend to work from the early hours till late night. Well, most of us, especially when we’ve started a new job in a new company or industry.

Working as a House Officer in the hospital setting, the work never ends nor does the patients that comes in.

In the Surgical Department, our shift is from 7am till 7pm for the morning shift and 7pm till 9am for the night shift.

The reality is that most of us come way too early just to get a head start on our reviews which most of the time is not completed, followed by completing the active job-lists, tending to new patients followed by afternoon reviews and further active job-lists and finally oncall reviews.

Then after that is done, we head home.

The tiredness stems from overwork, lack of proper sleep or rest which immediately leads to burn out.

Sometimes we just want to do more or lend a helping hand to another fellow colleague but at times it is just simply tiring and our minds and bodies are too tired for continuation of the same work.

After which, we return home and is most of the time too spent to even want to consider a night out since we would return late even if our schedule is till 7pm.

But there are things that I would love to do yet it is beyond my energy capacity for the day.

However, what if that wasn’t the issue?

1. Studying

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Yes. First of all studying.

Ever since I’ve started my housemanship journey, I’ve been omitting studying in order to prioritise work.

Well, in reality, after work, I’m just too mentally spent to even consider sitting myself down to just read. I’m not that disciplined.

However, upon being questioned during rounds, I find myself lost for words and unable to answer properly. I’m able to just give the “gist of it”.

If I had unlimited energy and didn’t require sleep, I would definitely dedicate my time after work during midnight in books and notes.

2. Learning another language

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I have always been fascinated by languages and if there is one superhuman ability I wished I have, it would be the ability to pick up languages quickly after listening to the locals speaking the language.

However, in reality, that doesn’t occur, or maybe it does to a rare number of people but I’m definitely not one of them.

Anyway, throughout high school, I’ve enjoyed learning new languages and I always wished that I devout more time towards studying them or practicing them.

3. Actually staying back late to help out at work

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I would actually love to.

Back when I first started my housemanship journey in my first posting, Orthopaedics, I used to that, at first because I was interested in learning up the fundamental skill of being a House Officer such as taking bloods and how to handle the ward better while working the night shift.

After a while, I started staying back merely to keep my friends company because in reality after going back, I’m not sure what to do and during my off days, they are at work. Thus, I was simply bored.

Now, the tiredness is overwhelming and I simply look forward to going back because I know that the following morning I would have to leave extremely early and if I do not give myself the minimal amount of rest my body needs, I will collapse.

That’s about it. Personally, if I had endless energy, I would cater it towards the things that I enjoy doing which are listed above.

Thus, during that day time, I could solely devout myself to work while at work or spend it with loved ones.

However, life is not as such and we need our rest or we will go haywire.

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https://theoreticaldoctor.com/2024/09/14/sleepless-endless-energy/

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Daily writing prompt How would you improve your community? View all responses

The best way to improve my community, my whole country, would be to do the same thing the free world did during the second world war. Just remove the fascists. I don’t want it to take a war like it did back then. Let’s give them an island or something. They seem to be okay with their cult leader visiting Jeffrey Epstein’s island so they would likely be fine with a nazi island. Then we let them think they are their own independent country and let them think they are able to sustain themselves, sort of the way many of the southern US states think they can operate without Federal funds that they get from the more liberal states they claim to despise. They can have their marches and their rallies and they can discriminate against anyone who doesn’t look like them and they can treat immigrants poorly (as if there would be any immigrants) and they can treat women like property (as if any women would go there). If they try to leave the island the rest of the free world stops them. If they get too big for their britches we slap them back into place.

Ahh, what a world that would be.

Of course I could never actually condone this because it goes against everything I believe in as far as personal freedoms are concerned. That sucks. I guess I have to stay true to myself. Bummer, eh? Still, a fascist free community would sure be nice, wouldn’t it?

https://robertjames1971.blog/2024/04/03/fascist-free/

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