Sunday, April 29, 2007

am sad! wrote a whole post on A&E rotation and it poofed into thin air. rubbish!

anyway will attempt to recap what has undoubtedly been the learning experience of my whole rotation.

was happily clerking and examining patient in resus room during a lull in the evening on wednesday, when we were yelled for to standby for a collapsed case.

by "we", i mean the rest of the very well-prepared team. i stood in a corner and freaked out, not quite breathing, and trying to make myself as invisible as possible. if you've figured out that i'm quite useless at cpr, you're definitely right. the life saving course we took has left me scared of performing cpr, especially with the admonitions about how i would cause the patient to have massive fractures and liver lacerations.

thank God my seniors, x and y, were around. they were so excited, yet so calm about it. it wasn't their first cardiac arrest case, but they were by no means experienced either. they noticed me quaking pathetically in a corner, and y came over to ask how i was doing, and tried to help me overcome my fear.

the patient was rushed in with EMTs in tow, he was an old man who was roughly, oh, twice my size. and i'm not anything like those skinny waifs you see on the runways, to put it nicely.

he was asystolic, and the team instantly bagged him and intubated him, pumped him with drugs. it was so fast i barely noticed anything, they did it with such confidence and experience.

x heroically performed compressions whilst y tried his best to allay my fears, talking me through each one of them. after succeeding in calming me down and telling me it'd be best if i tried sooner rather than later, i stepped up to take x's place. the poor guy was sweat soaked and exhausted, yet still managed to yell encouragement to me.

y located the spot for me and cheered me on as i started compressions, telling me to look at the defib monitor to see how i was doing. x felt the femoral pulse and nodded his affirmation that i was doing right.

and boy, it was surreal. the feeling of pumping someone else's heart, of holding someone's life in your hands, it's incredibly surreal. everything kind of faded away, nothing mattered but the monitor and the compressions. it was as if i no longer had any fear, i was born to do this. i was calm and composed and knew what i was doing. it must have been the change that everyone talks about but you never think will happen to you.

y took over when he saw my rhythm was faltering, and between the 3 of us, we must have kept it up for about 20 minutes. each time we stopped to check the rhythm, we were full of hope that we might bring him back. but each time, it picked up hopefully, only to slow down into a flat line.

the decision was made to stop him after the 8th time he flat-lined.

i was rather disconsolate, to say the least. yet x and y took the time to comfort me, to tell me that we'd done all we could for him. it takes a miracle to bring a patient back usually, they said. he just wasn't meant to have a miracle maybe. plus he was really old.

the doctors even came over and told us we did well, and thanked us for helping.

only later did we find out that he had been unconscious for nearly an hour before he was rushed in. his family had thought he was sleeping as usual. so our efforts were as good as no efforts, we couldn't have done anything to save him, it seems.

that went a long way towards making me feel better, and i could see the relief on x and y's faces. so they too, felt some measure of relief.

sometimes, you do everything you can, but it's not enough. God gives and God takes. and who are we to fight that? it doesn't mean that i feel no sorrow, that i'm dehumanised. it just means that i choose to accept what happens. i do feel sad, i wonder how his family feels. it's the most terrible thing in the world to lose someone you love. i know how that feels, personally, and wouldn't wish it on anyone, ever.

but i'm really thankful for the 2 wonderful seniors who were so concerned about me. these are people i know i can trust in the future, they'll make wonderful doctors no matter which field they choose. these are people whom i respect.

and i've realised cpr isn't that hard after all, it's actually manageable on a real patient :)

as for the patient, may he rest in peace. at least he felt no pain. thank you.

Thursday, April 12, 2007

am on A&E/ emergent rotation right now. it's helluva tiring and i need sleep! =( i miss psych already!

but emed is wayyyyyyy fun and i'm loving it. i'm awake when i'm on the floor and i just have such a good time! my iv setting skills are better than my groupmates (despite me having the least practice in surgery posting - that's what you get for being a type b person - you get shoved aside easily by the many hungry types As lurking by your side) and i can't help but feel a little smug over that. i even feel like shouting:" HERE"S TO YOU SUCKERS!!!!" when they can't get an iv in even though it's mean, i know. but having been shoved aside perpetually, it's just a rush of repression! heh.

but that aside, i love emed. so far i haven't learnt much, but it's been alot of fun. suturing, blood drawing, setting ivs, reading ECGs.

and soon, you begin to think: hey, this is the life i could lead!

for now, posts will be slow and trickling, depending on how much sleep i get on the floor.

and to angry medic: i passed my test!!!! hooray! i really thought i would fail. how's your exams!

Wednesday, April 4, 2007

and so, i bid adieu to psych med with a sham of a test to be held tomorrow. (which i will still study for anyway even if it's only 20 minutes long - because i love psych!)
(and that is exactly what i feel like doing to myself right now)

it's simply too bad i lost my head in the clinical test today and yabbered on ditzily in front of my examiners. i knew the answers, damnit! i studied and clerked and i knew what i was doing. but why why why do i always fail at the final hurdle? i have no problems doing calls, my interns say they're always glad to have me around because i'm actually of some help. but why why why do i always freeze up and flunk my way through the test? in a tutorial i'm fine, i can handle most things. but why ONLY in a clinical test do i screw up? and royally at that.

i really have got to learn to keep a handle on my anxiety and keep a cool head. no one wants a doctor who loses her head ever so easily. but it's galling, especially when i see my colleagues, who worked half as hard as i have, sail through the test with ease and flirting with the testers (no i'm not joking!) at the same time. ok maybe it's just being subjective, where i come from, students are renowned for claiming not to work hard but rushing right home after school to start hitting the books. so maybe i'm wrong.

but enough of all this negativity!

i had a real sweet lady for my psych test today. the most hilarious thing was: i met her right outside the door whilst waiting for my friend in front of me to be done with her test. she was happily chowing down her snack and looked pretty happy. and of course, me, being the clueless medical student (i should really change my blog to shouldn't i) happily smiled at her and made small talk. i had no idea she was my case!!! so imagine my surprise when i sat down and she was led into the room. GOODNESS. apparently one of my other friends was so smart he clerked the patient outside the door and used the time in the test to arrange his answers. pfwahhhh i say. be honest boy!!!!

but it's so scary. i couldn't tell what in the world she had, in that short time i had. it could have been anything, i had 4 differentials but didn't know which one i should have said. schizophrenia, bipolar, depression with psychotic features or ptsd. it's freaky, what she says. i only hope it's not true, i felt so sorry for her, if what she says is true and not some sort of a delusion. i mean, attempted rape repeatedly? i shudder to ponder that. i mean seriously, how wrong can that get. women suffer in silence, and only 25% report sexual abuse. it's still a huge taboo.

i don't know what to do or say. i could only stare at her and throw out another question, i don't know what iwas asking. i don't know what i was doing. i kind of blanked out after trying eliminate my differentials and trying to decide whether what she told me was really true. i think i'll make one helluva lousy psychiatrist!

Monday, April 2, 2007

am smack in the middle of psychiatry posting right now, with a test to be sat for come mid-week. psychiatry, has been as i have expected. i adore it!

it's probably the most interesting posting ever, where else would you get to listen to people all day and hear the most fantastic stories ever? and it's such a wonderful lifestyle, psychiatrists never rush from one place to the next. they wake up comparatively later and end early, by 5 pm. and they do get plenty of sleep on call!

it's simply fascinating and i'm enjoying it hugely. some would disagree with me and say that: oh it's such a crap career. we can't do anything for these patients. but to the patients, to have someone to hear them out without judging, is the best thing you can do. they suffer so much, more than others with "acceptable" diseases and illnesses, for it's only what goes on in their heads. there may not even be anything physically wrong with them.

somehow, i couldn't help but think back of dr dork and shiny happy person whilst i was clerking. it's amazing how pervasive the blogosphere is becoming in my life, and how easily i link all these things together, with almost no thought at all given.

i do like psych very very much. but i don't know if i can handle the emotional drain every day from feeling so much for my patients. i'm very emotional and i'm more likely to sit there and cry with the patient rather than telling them to get out and snap out of it.

on another note: another year in cheerleading has come to an end! we've done our best and i'm happy although we didn't win, i'm happy with myself for nailing every stunt i did. it's probably my last year so i'm glad to end it on a happy note for myself. we'll see how things go schedule-wise for next year before i commit to another year of brutal training! but life has been good.

to kim: no i'm a base too! high fivc! :D basing is such fun, i feel strong. hoho