The Most Enjoyable and Tiring Day In Medical 3

Related Posts:

• My Next 6 Months (Post Housemanship)
• Part 1 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | The Emergency Department
• Part 2 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | Main Building, Side Building, Infectious Disease Ward
• My Evening Routine In The Medical Posting | Housemanship Diaries
• My First Day In Medical Posting – Tagging Day 1 | Housemanship Diaries
• My Morning Routine Being A House Officer Leader In The Surgical Posting | Housemanship Diaries
• Reflection Of The Surgical Posting | Housemanship Diaries
• My First Night Shift In Surgery | Housemanship Diaries
• Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
• My Downfall In Surgery Which Led To My Extension – Housemanship Diaries
• 1 Year Of Housemanship Update – Housemanship Diaries
• Another Good Advice I Will Remember For The Longest Time – Housemanship Diaries
• Enjoying The Journey – Housemanship Diaries

I can’t remember which day it was but it was probably during the weekend or a public holiday as I remembered that I was allocated on call who was in charge of this ward.

I was allocated to “General” on that day and was I was alone at that time. I remembered sitting at the other end of the ward at around 11am when one of my colleagues who was allocated to be covering the “Neuro” patients went to have lunch.

The medical officer on call at that time, a rather “happy-go-lucky” and rather jovial person struts into the respiratory cubicle and asked if there were any house officers available?

To which I responded, we’re right here and he came over. He asked for the person who was in charge of the front cubicles which happened to be my colleague who went for lunch. I asked what’s wrong, is there anything I can help with?

He casually replied, nothing much, just walked in and saw a patient’s pulse oximeter reading 70% under room air. Then he laughed.

Me and my friend who happened to be there at that time were shocked and rushed to the patient. True enough, the pulse oximeter reading was 70%, well, 68%. Oddly enough, the patient seemed rather comfortable and not tachypnoeic. In fact, he was surprised as we crowded around his bed, looking concerned.

I asked him if he was having any difficulty breathing which he was not. Thus, our first instinct was probably the machine was faulty and proceeded to check with another vital signs machine.

This time, it was 65%.

I proceeded to take full set of bloods while my medical officer was writing his review and my friend attempted to call my colleague.

I ran his arterial blood gas and it showed Type 1 Respiratory Failure. Considering he did not have a baseline during this admission, we do not know if this was near his baseline or a sudden deterioration.

We called the Peri ICU team and referred the patient for non-invasive ventilatory support (NIV). Imagine, not knowing why this long stay patient was ever here in the first place to summarising the reason for admission down to his current progress. It turns out, he was due to be stepped down to a district hospital for continuation of antibiotics.

Well now, he can’t.

We transferred hum to the acute cubicle for closer monitoring while awaiting the Peri ICU team.

While awaiting, my medical officer decided to check on a patient who was handover to him for afternoon reviews.

This lady was in her 60’s and was admitted for left pleural abscess, meaning there’s pus in her lungs and for this patient, the whole left lung was completely filled. Clinically, she seemed well, speaking in full sentences and laughing to her family members as well in the morning.

In fact. I was even taking her bloods that morning only to have it splashed all over me after attempting to fill the blood culture and sensitivity bottle.

I recalled walking past her as I made my way to the front of the ward and she seemed alright. However, the moment me and my medical officer oncall stood in front of her. She desaturated an started being tachypnoeic.

Well, here’s another one.

There goes the next referral to the Peri ICU team for intubation and also Urology for emergency suprapubic catheter insertion as we attempted to insert a urinary catheter multiple times but failed.

Now, all these events happened very fast but at the same time, time flew by fast. The second patient was intubated and we inserted a femoral venous catheter. My medical officer then wanted to excuse himself to settle the pending discharges in his other ward. However, the first patient wasn’t saturating well under NIV and needed to be intubated.

There goes another intubation as well as another femoral venous catheter insertion. Finally, after all the chaos, things began to finally settle down.

I proceeded to trace my coming mornings, considering that I was the only one in charge of “General” that day and nobody would be helping me. Finally, I proceeded to begin my oncall reviews. This was around 8pm by that time.

After completing my in all reviews with intermittent disturbance in between. I proceeded to aid my friend in preparation of her coming mornings.

It was close to 11pm, I was just clearing my stuffs and getting ready to go when a nurse informed me that a patient seemed rather tachypnoeic.

Annoyed and tired, I attended STAT to find a patient sitting at the side of the bed with his BiPAP machine unlatched and hanging at the side of the bed. The patient beside him then told me, he removed it himself an hour ago.

Boy… Why am I not surprised?

This is another impending intubation.

At this rate, I might as well not leave anymore.

The day was busy enough. I sometimes wonder why is it that we feel guilty to even desire to return home on time? To walk out with the family members watching us finally ecstatic to return home for the day while their family members are stuck in the hospital?

Back to that patient, I didn’t left him gasping on his own of course, I fixed back the BiPAP machine, took an arterial blood gas and alerted my night colleague and medical officer oncall to which they attended STAT.

Thankfully, the following day, I was allocated as night shift. Thus, despite returning home late, I was able to sleep in and recuperate a little before returning back to work that night.

It was a busy day but considerably a rather fun one considering that I happened to work with a rather jovial medical officer oncall and my colleague stayed back to accompany me despite her shift being till 6pm.

Working with certain people definitely helps alleviate some of the pressure of the day.

Related Posts:

• My Next 6 Months (Post Housemanship)
• Part 1 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | The Emergency Department
• Part 2 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | Main Building, Side Building, Infectious Disease Ward
• My Evening Routine In The Medical Posting | Housemanship Diaries
• My First Day In Medical Posting – Tagging Day 1 | Housemanship Diaries
• My Morning Routine Being A House Officer Leader In The Surgical Posting | Housemanship Diaries
• Reflection Of The Surgical Posting | Housemanship Diaries
• My First Night Shift In Surgery | Housemanship Diaries
• Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
• My Downfall In Surgery Which Led To My Extension – Housemanship Diaries
• 1 Year Of Housemanship Update – Housemanship Diaries
• Another Good Advice I Will Remember For The Longest Time – Housemanship Diaries
• Enjoying The Journey – Housemanship Diaries

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A Junior Doctor In Boots

Tell us about your favorite pair of shoes, and where they’ve taken you.

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Prior to having my first pair of boots in 2021 while I was in my third year of medical school, I have always dreamt of wearing boots. Be it short cut or the long ones till mid calf or up till the knee, I loved them all. 

I prefer them over heels or flats or slippers.

Partly because I have always imagined myself as a “country girl” in summer dress or jeans, always paired with boots. 

However, I’ve never had a pair of boots till I was in my third year of medical school, even that, was given by my aunt. I remembered using it to almost every occasion because it was so comfortable and versatile. The colour was dark green, an ankle length boots with zips on the side. I wore it till one of the shoe had a hole on the side and even then, I was still adamant to wear it till my mom got me a new pair of boots and threw my first pair away.

Since then, I’ve gone through another 2 pair of boots, one pair with heels and another flat. I occasionally wear the one with heels and often use the flat one. The flat one is my go-to everyday boots be it for outing or travelling or a simple trip to the market. However, I rarely use them to work. At work, I have specific types of shoes that I usually wear since I’m on my feet most of the time and these shoes gives me the sole support that I need (if you know what I mean).

But there are days when I’m feeling fancy that I would dress up a little and don a nice blouse over my black leggings to work. Those would be the days when I would wear my favourite regular pair of boots to work, which boosts my self-esteem for the day considering that it is my style, one that I feel brings out the inner-me, the junior doctor-in-boots.

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I’ve always been a foodie.

I enjoy my going on food trips with my family or friends. If I’m bored or sleepy, I would look for a snack, which again is well, food.

Thus, over the years, the weight started piling up and towards the end of primary school, I noticed that my weight posed an issue. As a child, I was overweight. 

I recalled visiting the doctor once when I was in primary school coz I was unwell and he made me stand on the weighing scale and perhaps he did say more but at a young age, all I remembered was him yelling “Your child is FAT. FAT. FAT. FAT. F-A-T, FAT!”, all throughout my checkup and as I was leaving his office with my mom.

It felt like as if I had committed a felony. When in reality, he was trying to point out on how unhealthy it is for me, somehow in a rather direct way.

Over the years, I’ve struggled with my weight. It was never constant and always up and down. I’ve tried various diets which didn’t stuck long. 

The only time I properly lost weight was when I started my housemanship journey. Amidst me eating at the wrong time, somehow the weight just magically went off. Firstly, perhaps I was too occupied with work to eat properly, hence, unknowingly I tend to practice intermittent fasting almost everyday and secondly, my movements have increased dramatically. Walking above 15k steps per day was a norm.

However, as I progressed throughout my postings, I learnt how to fit eating back into my busy schedule and the weight started piling back slowly.

I brought the matter up to a dear friend and she mentioned that perhaps, I could try controlling my food portion. I reflected and realised that all these while, I’ve been consuming food in the usual portion which didn’t had an effect on me previously as I was constantly on the move.

Thus, if there is something I seriously need to pay more attention to, it would be my food choices as well as the portion. Food is extremely delicious and good. Sadly, I would say that I fall into the category of “Live to Eat” rather than “Eat to Live”.

Hence, it’s time for me to take charge and make a change towards my food choices and start my journey towards a healthier life.

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https://theoreticaldoctor.com/2024/09/26/controlling-my-food-choices-and-portion/

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How do you balance work and home life?

Today’s writing prompt is all about that work/life balance, and I feel like this is definitely something I can talk about, because it’s something I’ve struggled with for years (and, you know, I have a job!). I’m not entirely talking about the past half decade before I re-entered the workforce, but I’ve generally been working since I graduated from high school. I started out in restaurants working as a dishwasher, a line-cook, and so on and so forth, and I didn’t really have a lot of trouble maintaining my sense of self, and the life that I had outside those walls.

But something changed.

Sometime at the age of thirty-six, my identity as a person started to shift, and started feeling like it’s been bungled around. I started to feel like I’m not really a person with goals and things that I enjoy outside the job. I started seeking out new interests, new hobbies, looking for anything to fill in this void where I felt my sense of self should be.

This continued for a long period of time. My life became working, and laying on the couch at home waiting until it was time to get back to working. This became habitual for well over a year, and my sense of identity continued to gradually slip away (I have considered that my issues and turmoil over transition may be part of this).

I stayed that way for so long, that eventually I began to feel trapped, hopeless, like nothing mattered, and that there was no point in continuing to be, if all I am is a worker who sleeps, and then clocks back in.

But, instead of seeking out harm, something inside my mind switched around six months ago. Yes, six months ago to this date.

I started focusing less on when it was time to clock back in, when it was time to get ready, when it was time to sleep, and just started focusing more on what’s happening in each moment. I made myself, no, forced myself to be present in what I’m doing in the now, rather than what I’d be doing once I return to the job that, for all intents and purposes, is not something I wholeheartedly enjoy. Who actually really enjoys their job, unless they’re a millionaire who can vacation six times a week?

But, if you want to talk things I enjoy, you need only look to my writing, my music, and the things I make in virtual worlds.

I’m still working on rediscovering who I am, and maintaining my sense of self. But this is why having a healthy work and life balance is extremely important. It’s not just about leaving yourself time to take care of home-chores. It’s not just about leaving time for other people to be part of your life. It’s also about giving yourself time … to exist. To be a person, with wants, and needs, and interests, that have nothing to do with what the corporation you work for wants or desires.

You need this, because if you don’t give yourself these things, you will end up where I was. Stuck in a void of thought, in a rut, spiraling out of control without even knowing it.

You have to be present. I’m not talking about putting the phone down and staring at the wall (although meditation is definitely also good for you). Use your phone if you want! Post on social media! But be who you are, in those moments, and don’t tumble so easily into the work you do for a living, becoming the only identity you have. I don’t want to say, “It will become deadly.” But I went so far to a place that I didn’t want to be, that my mind became numb.

Focus on maintaining this balance today. Don’t tell yourself you’ll start tomorrow, or next week. Start right now.

Speaking of work and life, you should subscribe to this website. In these times of ever-increasing prices, and stagnant pay, it would mean the world.

https://cmdr-nova.online/2024/05/18/prompt-work-life/

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I often find myself thinking in song titles. Sometimes it is movies or TV quotes, but often it’s song titles. It just happened to me as I read today’s prompt. King Crimson has an improvised instrumental track on the Starless and Bible Black record called “We’ll Let You Know.”*

When we figure out how to balance work and home life, we’ll let you know. When I am at work I am working. When I am at home I am not working. Does that make sense? That’s how it should be, shouldn’t it? Why is it so hard to do? Why is so much at home time spent thinking about work and so much at work time spent thinking about home? What’s the deal there, Robert?

It’s a problem, but it’s more of an existential problem as one rarely gets in the way of the other when something important comes up. In priority situations I am able to keep the two separated. It’s the quiet, non-priority moments that the mind wanders across the divide.

So like I said, if I figure it out… I’ll let you know.

*Just noting that both the guitarist and the drummer on this song had birthdays this week.

The song is an instrumental so there are no lyrics to tie into this discussion. Also, it was improvised on stage so they probably only ever played it once. There’s a moment in this when the bass and the drums lock together in one of the sickest grooves ever.

https://robertjames1971.blog/2024/05/18/well-let-you-know/

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