Sunday, July 27, 2008

internship, 3

andddd the postcards have been dispatched! :D

many thanks to those of you who replied :) hopefully nothing gets lost in the mail, and no worries, everything will stay with me and only me (except the postman who sees it!).

week wise, i've done 2 calls, the 2nd of which was a total and complete farce. i had 6 hours of sleep (from 1am to 7 am, undisturbed! amazing) and my intern slept 5 hours from 1+ to 6+. really amazing call. there was nothing to do! and she could even teach me!
which was kind of good because i was so tired already. but my first call was hectic, i was running around trying to do blood cultures. who knew so many people would spike fevers on a monday night?
and i had to sweet-talk this poor old lady into letting me set a plug into her tiny non-existent veins, and with my lousy luck, all the teensy yellow plugs (26 G) were ALL GONE :( so i used a 23 G plug and had to jab her 3 times before i finally stuck a vein. WHEW. i was all ready to run out to my intern screaming at 3 am in the morning if i couldn't do it, but thankfully, it went in.
i did have to run out crying for help when i walked into the room of a young teenaged girl with ulcerative colitis who was crying piteously, and her mum was standing there giving me the evil eye and i just felt SO SMALL AND TINY AND UNSURE :( thankfully my intern was super understanding and nice, and charmed his way into letting the poor girl be jabbed. whew.

strokes are getting familiar to me, although i still can't localise for bloddy 2 cents worth. but at least i can tell you if it's cortical or subcortical so that's an improvement i guess! :)

i did weekend rounds alone with my attending, FRIGHTFUL. i had no idea what i was doing half the time, i didn't know scat about my patients cos i was post-call and highly sleepy, and i'd totally forgotten my orthopaedics and couldn't present the pelvic x ray he asked me too, after which i got totally owned by him despite him not having done ortho in 10 years. UH UH :( not good!

i'm sad to be leaving, i've only got 1 week left! :( my ward intern is really sweet and nice, the residents are helpful and teach loads too. things are good :D

best to make the most of this last week! :)

Sunday, July 20, 2008


does anyone want to know where i'm from? :D my lovely government has created a series of medical postcards to increase medical tourism so i'm going to send them since they're free (and of course unbelievably corny).
if you'd like one, email me!!! :D :)

Saturday, July 19, 2008

internship, 2

this week has been a combination of good and bad days.
the bad days were really awful. so much so i wanted to come home and cry.

for example: no lunch, endless discharges and new patients, have to do blood cultures on a renal failure patient with practically no veins to be seen/felt due to massive odema, having hypoglycaemic symptoms (meaning hands shaking v badly) whilst trying to do said blood culture, only to have blood clot when i finally draw enough blood to put into tubes, and spending next 1.5 hours trying to find more veins on the poor old guy to poke and then attempting an arterial puncture only to fail miserably. NOT A GOOD DAY. :(

but yesterday was awesome comparatively- nothing to do! i even had time to take a nap and go to the staff sale on the top floor and buy oodles of cheap yummy chocolates from one of my favourite brands! lovely. even had time to drop by and say hullo to some of my favourite patients (dear me, i'm so biased) in other wards. LOVELY :D

but this student internship is good, and i'm learning lots. i can do a preround by myself now, i can do discharge summaries relatively quickly, i can refer patients and call for help (only thing is, i can't use the phone so usually i grab someone and beg for help with calling)

i know that i'm probably not getting the "full" experience, some of my friends are so super busy they leave at 930 pm, but i can't complain, it's the luck of the draw where you get posted to. at least my neuro exam has improved by leaps and bounds and i can roughly gauge power and reflexes now. so i'll be grateful for what i get! :)

i'm learning, slowly. i won't exactly survive as a REAL intern yet, but i'm getting there, i hope!

this only makes me want to study harder so i can pass my finals and get to work. somedays, i love my job! (on others, i just want to hurl blood and faint). i remember on monday, after i spoke to 2 of my favourite happifying patients and told them they could go home, their faces lit up instantly, and i was thinking: oh God, i really love this job! (this was all offset by the amazingly horrendous blood culture the next day)

but more and more, i realise that as much as i sometimes think i'm in the wrong profession (i should have been a nurse!), i think i'll survive :) we're stronger than we think we are!

Monday, July 7, 2008

internship, day 1

it's so bloody tiring. it's 1030 pm here, and i'm going to sleep.
i have to wake up at 5 (freaking) am to take public transport down the hospital which is all they way across the city, damnit.

internship is not hectic, for me at least. but it's so tiring because i'm still in the holiday mood. make that very much in the holiday mood! i kept nodding off today in the teaching session, and when the resident was giving us instructions.
what a way to make a good impression, huh.

i'm on the neuro stroke team, and our patients are located all over the hospitals, and there are so many many patients!!!! goodness me. the attendings lead the charge and it's like being on a surgical team all over again, they walk so fast, they write so fast, and they talk so fast! amazing. so much for medical rounds being relaxed affairs.

i haven't learnt much today except that there ARE reversible cause of dementia - to which my reaction was: is there such a thing? my attending promptly glared at me. NOT GOOD.

and i've done my first ever discharge summary! which took me a painstakingly slow hour. but my intern said it was not bad! :D so i'll be happy with small things :)

i'm not looking forward to tomorrow, least of all thurday, when i go on call for the first time. someone save me!!!!

Friday, July 4, 2008

and so internship beckons!

we've just received emails from our hospitals, it's official. the student internship training (1 month in medicine, one in surgery/ortho) will start for me come monday with 4 weeks of medicine in a tertiary hospital with loads of profs.

i quaked with fear through the briefing, it was all the usual stuff about responsibility and punctuality and professionalism, all the stuff you hear and you think will be you someday but just NOT NOW.

well, my now is here, and i'm scared shitless, to be honest. i'm the sort who needs loads of sleep, who does things slowly, who likes to take her time. to be honest, this all sounds frightfully demanding and i'm not quite sure if i'll come out alive, let alone unscathed!

but i'm also looking forward to it in a way, because whilst my friends and classmates have come toting home bagloads of stories of how they treated and managed patients ALL BY THEMSELVES in electives, how they were really doctoring instead of just observing, whilst i was stuck being a passive observer (although i did have loads of fun in india, nevertheless). i'm itching to DO something, to be useful, to learn something practical. i learn better by doing than by observing, i have realised.

and this is my chance. to BE someone, to DO something. nothing irks medical students more than to stand around more and be useless, we want to do stuff, to be part of stuff. and i'm determined to make full use of my 4 weeks in internal medicine, including my 4 calls.

it's a lightweight thing compared to what interns actually do go through (i've heard of 15 calls a month!) but it's something totally new to me given the fact that i am in a traditional system (read: spoonfeeding abounds). i hope to learn oodles and to prove to myself that i can do it despite my many misgivings, and to find out just how much my childhood dreams of helping people translates into reality.

i've been rostered to neurology (oh the utmost horrors, i detest neuro with a passion that equals my love for wentworth miller and james mcavoy - did anyone watch Wanted? smoking hot!), and the associate dean happens to be the consultant in charge of me. yes. small, insignificant, tiny, me. i am horrified at how badly my lack of knowledge and my detest of neuro is going to show up badly on the first day! which means i have to go mug up on strokes and epilepsy and headaches and cranial nerve palsies all of today and tomorrow.

and when all else fails, i only have to think of my first ever exam case -
a sweet old man who had colorectal cancer with liver mets at time of presentation. his prognosis was awful. i clerked him after 2999999999 (you get my point) eager medical students had approached him, and he cheerfully agreed on hearing that i had an exam. he recited his history with practice and a smile, asking me whether it was sufficient information to pass and didn't bat an eyelid when i had to return to ask him some more questions that i'd previously missed.
i passed the exam in the end (just barely), and full of gratitude, went back and sat with him for a good 2 hours, just talking about his homeland and his youth. it was a good 2 hours of learning for me, and not in medical terms. about life, love and loss.
before i left the hospital for my next rotation, i ran back into the ward to say goodbye to him, telling him i was leaving. as he wished me luck, and i the same, neither one of our eyes were dry.
i never found out what happened to him (partly because i didn't want to) and i've forgotten his name by now. but i won't forget his kindness and his smile.

i haven't come across many patients like him since then. but i guess your first patient is always the most memorable. i don't expect to have the time to do that for all my patients, but if i can even do that for one, i'll be more than satisfied.