so i'm in india right now!!!!!

many thanks for all the comments - i'll post up photos when i get back! nothing much yet, sadly.

we're in a small rural hospital that has 75 doctors. it's a non teaching hospital but there's a tonne of nursing students cos it has a nursing school. the nurses here actually wear white caps and it's just adorable! the students wear short white coats and white punjabi suits, the staff nurses wear white saris and generally look gorgeously dignified. their saris never seem to stain or get dirty!

the heat is amazing and i'm suffocating, it's about 38 degrees C here and only bound to get hotter as the days pass. the fan in my room isn't much use, it beats hot air around the place. yikes. mosquitoes and flies abound in plenty! i keep swatting flies in hope they'll stop coming near me, but i guess i should give up soon. heh.

the outpatient load is incredible. there's people queuing up at 7 am in the morning!
i'm doing O&G right now and it's pretty much the same as back home, but my friends doing paeds and medicine have been wowed by the spectrum of patients they've seen! most of them present in the late stages so it's usually florid presentations.
rheumatic heart disease is prevalent - all sorts of murmurs come into play
dysmorphic syndromes is another one

the list goes on - there is much to be said for the lack of sterility here, but they manage.
gloves are rewashed, masks are washable, not disposable, they dont' wash their hands with chlorhex/alcohol handrubs!
i'm getting pretty good at eating with my hands though! :D the canteen ladies have been so super sweet, they ply us with extra stuff cos they know we're foreign.
i've taken to wearing the punjabi suits as it's so super hot!
alright back to the labour ward!

i'm leaving for india in less than 24 hours!

will blog if i get the chance to :D

meantime, stay safe and have lots of love! :D

tlm - all the bestest with your finals!
jess - see your email :)
xavier - all the bestest for your exams!
harry - continue enjoying yourself in clinicals :)
ms-ellisa - hope that ankle gets better soon, poor girl
cal - i hope your Bsc is wonderful!
dragonfly - enjoy your gyming! :D

shrink - keep smiling, i love your blog!
liana - you're almost an attending! so exciting :)

oops i guess i'd better explain myself about my career choice!

after re-reading what i wrote, i guess it really does sound like i want to do paeds or neonatology. but the reality is, i hate paediatrics because i'm totally useless when kids cry (i only feel like slapping them to make them shut up - i have not a single patient bone in my body when faced with a crying/screaming/temper tantrummed/etc. kid, and will make an awful parent, i know). plus, paeds makes my brain hurt. i went home with headaches everyday from my paeds posting. there is SO MUCH TO KNOW, and there is so much at stake.
i must admit, a part of it comes from spending time in the hospital as a kid. i detested hospitals and doctors for a long long time. so doing paeds was facing up to all these hidden/repressed memories!

and as for neonatology, i actually did consider it, but i always feel massive twinges in the neonatal wards - the babies are so tiny, and all fighting for their lives. i feel even more helpless, and i really can't bear that they're so helpless and i can't help them.

i have way too much respect for paediatricians and neonatologists to even consider going into their field. it requires far more brain power, patiences and loving kindness than i ever could possess.

i know i also waxed lyrically about ENT/otorhinolaryngology some time back, but thinking hard about it, i realised as fun as it is, i really can't see myself doing it everyday for the rest of my life. i like it very much, but i'm not as passionate about it as i am about OB/GYN. it's interesting, sure, i like it and i enjoy it extremely. but it doesn't get me going first thing in the morning, it doesn't get my adrenaline pumping and my heart racing. it feels exciting, but safe at the same time. and i'm the kid who usually rides the biggest rollercoaster in the amusement park! but ENT is a close choice behind OB/GYN and urology.

urology is much fun! :D that can't be denied. i have lots of fun seeing patients, in the OT and out, i like clinics and it's pretty simple yet you get lots of hands on fun. but it's also a male discipline, for a large part. and i still prefer women's problems to men's problems because i can relate.

whereas, in OB/GYN, i'm dealing with (mostly) motivated patients, who know what they're in for, who are coherent, who are adults and (usually) sensible. the big difference between kids and adults. i love doing deliveries, i love the way the father steals up to the baby after the delivery and ogles over it, the way he kisses and thanks the mother after the delivery, the way they both cry (mother openly, father secretly) whilst looking at the baby, the way the mother eagerly reaches out for the baby and holds it so tight. i love that.
i love picking up the newly bundled baby and looking at it in awe and amazement. and the way the parents show the baby unconditional love.

i love gynae, and how cervical cancer is the most treatable cancer in the world, there's even a vaccine for it! gynae surgeries are simple and understandable, the anatomy is clear and usually a joy to behold.

there is much i love about OB/GYN! :D

so the part about the grasp reflex being the best thing in the world? it's true. but i was thinking more in terms of delivering the baby rather than taking care of the baby. that's all. :)

and right after i put my big, fat foot down and decide, once and for all which specialty i'm interested in, today, i encounter something that just about cements it :)

i was in the ex-premmie clinic today at the big city hospital, because my tutor runs clinics both there and at the women/baby hospital. so she kindly treated us to lunch and gave us a lift there! how lovely she is, really :D i adore her to bits!

and whilst she was talking to the parents, my friend, P, and i will interest ourselves by playing with the babies and doing a developmental assessment as best as we can on them :)

and today, whilst we were seeing a pair of twins, i was happily playing with the younger one, when she just reached out and grabbed my little finger tightly and refused to let go. there is seriously no better feeling on this earth than having your hand held by a little one. such is the power of unconditional love! :D

OB/GYN, i say :)

today i watched an episode of house that made me put my foot down and decide to stop waffling on my specialty choice :)

OB/GYN it is, i hope! :D

i'm so super sleepy, having just watched "oliver twist". that is one mighty cute boy! i'd love to kidnap him home - the eyes alone would do me in.

that aside, the last of my internal medicine remedial is safely over, with an mcq test (in which they repeated more than half the questions!).

so now, i only have 2 weeks of child development left to get through before i fly off! :D i can't begin to tell you how excited i am about flying off!!!

child development has been boring - because i'm not learning anything. we spend most of our time sitting by a small computer screen straining to hear what's going on in the room (we're watching through a camera on the ceiling in the next room) whilst the pyschologist asks questions.

forgive me, but honestly, i didn't ask for this elective to learn pyschology, i took it to learn about ADHD, ASD, CP etc. behavioural paediatrics.
thankfully, we're going into the real clinic tomorrow to play with the kids (and hopefully brush up on our developmental assessments as well!) and that should be alot more interesting.
note to self: BRING COFFEE

i went back to my last hospital on friday to attend grand rounds, it proved mighty fascinating (we saw a video of a laparoscopic AAA repair, congenital malrotation of the gut and others!). and then, my MO stepped up to present a case, and it sounded familiar - i realised it was the poor guy who came in with a perforated viscus and was throwing up blood that i saw in the A&E!

as my MO said the words,"inserted a foley", he turned to me and WINKED. omg i could have died on the spot. how lovely. but it was good to know the poor guy was alright! :D

it's been a week since i've returned from mountain climbing!

it was, truthfully, the scariest experience of my life. but also one of the best!

i can't say i've managed to overcome my fear of heights, but i know i can push it aside somewhat, and that's a step along the road of recovery? :)

making our way to the summit in the pitch blackness of the night, with only moonlight to guide us, was terrifying once we reached the rock face and had only the rope for safety. i didn't dare to look back at all until i was safely seated on a rock (jumped on it to test if it was steady!) and the view just blew me away. :)

but for now, it's back to hospital! and i'm starting a 3 week elective in child development. it's not as interesting as it sounds, because so far it's been very very boring. hopefully things will perk up after a bit!

doing surgery calls was really interesting. this elderly gent came in complaining of massive abdo pain and constipation, the medical officer was all ready to write him off as having intestinal obstruction until he started vomiting coffee grounds right in front of us. the chest X Ray showed no free gas, puzzlingly, and the vomiting became really really really bad.

they tried to put in NG tubes but somehow it kept lodging against the wall so it couldn't suction anything. and the poor guy was just moaning in pain. poor thing!
in the midst of all that, the MO yelled at me to catherise the guy, so i tried. i honestly, honestly, tried. now guys, please don't kill me.
the first thing i said after cleaning and draping was," where's the hole! omg!"
to which the MO replied," there! SO BIG"
uh-oh.
so i looked. and i looked. and i stared. and i FINALLY found it.
try as i might, i just couldn't catheterise him. after i injected the lignocaine, i couldn't stuff the catheter in!
in the end, the MO put on gloves and showed me how to do it properly. sigh.
well, it was my first catherisation after all!
after this whole debacle, he turned to me and said,"missy, NOT GOOD. you better learn to catheterise male patients soon! and FAST. go get some experience! i can't believe you didn't even know where's the hole!!! tskkk."

uh-oh.

right now, i'm missing surgery muchly, i really don't quite like paediatrics. hmmmmmm