| (no subject) |
[Sep. 24th, 2009|11:45 am] |
Its almost 1/2 way thru what they used to call Living Hell.. Houseofficership.. something which the school never really prepares you for. Okay okay... yes there is SIP, but then, SIP experience is almost always dependent on your HO you follow. Which is why i have sworn to be a goooood HO to my SIPS haha.. which i have! So many stuff that my HO didnt teach me which i though was soooo impt and pivtol i make it a point to impart them to my juniors rather than keep asking them to draw blood for me.
Sigh, i miss the SIPs so much.. they have been a great help and great great company. And to see them transform from knowing nothing practical in the ward, to be able to discharge patient's clerk patient's in the practical world and be able to do practical medicine, its kind of an achievement.
I love to teach... maybe i shld be a clinical tutor? Patience and understanding helps a long way.
The HOs treated a bunch of SIPs for being so helpful in the ward. sighhhh miss them so much. The bill cant compensate to how much we think you guys have helped and kept us company!
On sweet leave now... so nice. I just wanna get out of Med Onco. My consultant is a crazy nut case with such a temper that is unbecoming of a person. nvm a few more days... just let him vent. Im gg to REHAB soon.
Had 2 months of SIP help. but i think i will just miss Surg/Ortho SIP by a bit. will switch to Ortho next next month with the help of 1 more sip to ease in the drastic change that is from medicine to surgery.
Being a Doktttorrr for 5 months now... so many questions still remain. |
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| (no subject) |
[Aug. 9th, 2009|09:42 pm] |
He wei jian... doing so well now... ppl really unfold as time goes by.. |
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| (no subject) |
[Aug. 2nd, 2009|11:01 am] |
Where to get such an angelic voice? WHERE... |
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| (no subject) |
[Jul. 19th, 2009|11:34 pm] |
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Sometimes i wish the friend you try so hard to meet, sometimes spares the same thought as you do. I wish it were more mutual... like the old days. now its like im the one trying it all.. am i the only one interested? but yet they meet with others? frustrating... I question myself. friends come and go. but i wished these friends came and never left. Maybe they are this type of friends, but just that somethings happening that i dont know. you know when its time for a renewal. Denial? Acceptance? hmmmm |
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| (no subject) |
[Jul. 5th, 2009|10:28 pm] |
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Is it really true that SIPs are coming CM???? Reinforcements have arrived for overworked physicians! yay! |
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| (no subject) |
[Jul. 5th, 2009|10:14 pm] |
Some ppl are just soooo irritating to work with...
I feel so compelled to change the way things work. So inefficient, unnecessary blue tape.. Where is it written in black and white that you do this and i do that? I feel so compelled to do justice.
Oh well, got a song... That's All by Phil Collins
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| Oldies |
[Jun. 15th, 2009|04:57 pm] |
Suddenly a wave of dunno what came over me post call as i sit in front of my com now...
with no target task, the mind wanders, with deep unsettled thoughts rising to the surface that were initially supressed by the conscious mind. Listening through many songs, the magic is music... Suddenly miss my music making days...
Internal turmoil.... and emotional conflict... about a long standing chronic interpersonal situation... sigh
Probably only God can cure that.
NOTHING'S GONNA CHANGE MY LOVE FOR YOU (Glenn Medeiros)
If I had to live my life without you near me
The days would all be empty
The nights would seem so long
With you I see forever oh so clearly
I might have been in love before
But it never felt this strong
Our dreams are young
And we both know they'll take us
Where we want to go
(Chorus 1)
Hold me now
Touch me now
I don't want to live without you
(Chorus 2)
Nothing's gonna change my love for you
You ought know by now how much I love you
One thing you can be sure of
I'll never ask for more than your love
(Chorus 3)
Nothing's gonna change my love for you
You ought know by now how much I love you
The world may change my whole life through
But nothing's gonna change my love for you
If the road ahead is not so easy,
Our love will lead the way for us
Like a guiding star
I'll be there for you if you should need me
You don't have to change a thing
I love you just the way you are
So come with me and share the view
I'll help you see forever too
A damn nice song to sing to and with some one... during KTV... haha
This song is one of the most beautiful songs... originally recorded by George Benson for his 1984 album 20/20. Makes my ethereal part wonder and drift from thought to thought, scenario to scenario, happy events to on going sorrows and regrets... Emo as it is, such is the power of music. Oldies stand the test the of time.
I better get some post call SLEEP. |
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| Internal thoughts... |
[Jun. 7th, 2009|07:11 pm] |
So it is... DIM. The all encompassing dumping ground for everything that dont fit a particular specialty. hahaha.. joking. But DIM has been a good much needed break from the hectic Resp Med. Slow enough to think more. but i think we are too much of care coordinators and refer too much.. relying on specialty input... i think we can be more than that...
Kena 5 calls this month... 2 HO1s and 1 HO2, 1HO4 and only 1 HO6... wth?! crap!
It must be my luck to have such nice team members. My MO is so helpful... A monash uni grad... I think being foreign trained, it helps to get out of this strict Hierachy business in singapore... where... "MO dont do discharge summaries..." "you write the blue letter".. "MO doesnt do these things..."
My Reg is from India... and by jolly is he one nice chap.. not to mention my Con who is from Mauritius!... and he is tooo another kind chap!!! btw... i think working with them is like working in another country, coz im the only Singaporean! SW's MO is from HK and her con is the same as mine.
Maybe im Medical... my cons and reg say i look medical, think medical and should do medical! hmmm. yah, med has always been interesting. Will see how it goes. I got 6 months of Surgical to go through to see whether im cut out for which.
And i dare say now... that i dislike PSY patients to the core... they really waste time. You cannot be rational with them. Not all of them at least. Never mind the Psychotic... They are psychotic to begin with. Its the neurotic, anxious, and ADDICTS that get to me! To me, they are worse than the psychotics. You think you can be rational with them? YOU ARE SO WRONG. talking to them can only feed them and waste your time... I've learnt that TIME is everything. It governs everything. Everyone talks about CBT .. CBT.. CBT.. but then hello, first requirement of CBT is patient must be willing to accept the treatment, must be motivated, must have insight. Pls... how many of them have that? even if they do, they are not willing to change, they do not think they are wrong.... Can you do CBT is hokkien? I am so not cut out to do PSY. I will just puke blood. Anyway, the PSY escape route is always Haloparidol or BZD.. "there is nothing we can do".. one or the other, doesnt solve the problem, but just makes them drowsy and slpy... enough for them to not bother you and forget abt the situation. Is that a solution? No wonder so many are locked up in IMH for yrs... 10 yrs or more. ooops? If only someone could really help them. Its a chemistry of the brain that is gone wrong + maybe there is a learnt aspect in PSY diseases.. thats y CBT and other deconditioning or other psychotherpay works... to some extent i must qualify! I believe, that at the end of the day... if you dont want to help yourself, no one can help you. thats basic with all PSY disorders i think. Its all abt ur state of mind. Patients with insight do better than those that are just clueless. Thats my basic rule.. if you dont want to help yourself, no matter how much i try, it wont be enough... if only they could understand that. I really appreciate when i see them trying.. it motivates me and themselves further... but those are only prob seen in the clinics...
I have seen another lady with addiction to opioid medication... AT NIGHT, they disturb the nurses for the drug, and they disturb me on a busy night call for the drug... i have to spend 15 valuable mins talking to her and telling her that i cant give it. Noted in the team's notes that the she had already verbally fought with the reg and con regarding the same issue.. and PSY has seen to no avail... no surprise there... and now poor HO has to talk her to not wanting the drug. Team wrote clearly.."DO NOT GIVE Opioids". I mean, i totally agree.. thats just feeding her addiction isnt it? Its a challenge man... I mean, if the con and reg and PSY have all kinda tried their best... who am i? Anyway, I tried my 15 valuable mins. 3 passives and 2 actives accumulated in that 15 mins... !@#$%... She has all the signs of an addict.. The withdrawl, the primacy.. the ..aiyah go read a PSY book. Finally, I kinda struck a deal with her since its like 5 am, to tahan a little longer till 7! then the morning team can solve her issues.. i mean they are in the best position to do so. Of course, being a HO, just make sure i exclude dangerous pathology before labelling it as supratentorial... Noted on previous case entries that she has tried this trick on other on call HOs. She will keep saying that "im not bluffing!, only Pethidine can cure my pain!.. the other doctors dont believe me.. im not addicted! im not depressed!...." yah right, like i believe... saw the PSY blue letter.. "patient is addicted to meds..".. so who do i believe? Sigh, dilemma... Thats for you to decide if your in my situation.
Right now I have another guy thats wanting pain relief all the time... Repeated admissions for pain relief... relief of cervical radiculopathy... hmm, okay, genuine pathology, perhaps genuine pain? thats okay i guess. I am happy with ppl having Genuine problems!.. but then reading on into his notes... i saw the words... "functional disorder s/b PSY"... my eyes exopthalmosed and jaw dropped.. oh man! not another one... but what is functional disorder anyway? never seen it before in my PSY book. Read up about it... and looks like all it just means is a neurotic disorder... you dont need a psy for that.. Was advised by my nurses that he is a frequent flyer in our ward... always coming in for the same thing. Pain team has seen.. and given nerve blocks, and everything on the WHO analgesic ladder, acute and chronic pain meds. The best thing is this... he says he has numbness in the Right UL, LL and Right face. Who are u bluffing?? Of course never learnt neuroanat. He is playing the typical LAYMAN understanding of "stroke", who are u bluffing? the sensory testing is so inconsistent.. and doesnt fit neurologically. who are u bluffing? good luck to PSY to deal with him... can you CBT this guy? good luck.
Dont even get me started with Anorexia...
I agree... the PSY subject is fascinating... but the REAL PRACTICE is a different ball game. The clinic stuff is all happy and nice... but pls dun forget the ward ones... they are the ones that need the help the most.
Brush with PSY in a GM ward... reminding me that MED is not just physical... its mental too. |
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| Recollect |
[May. 29th, 2009|07:05 pm] |
Its nearing the end of the 1st month of the HO calender and im already missing leaving this dept. Resp Med in the central hospital initially a SHOCKER for any new HO... has now grown on me. Kinda sad leaving the department when i just got to know it. I suppose resp is a good posting to do... A good training ground.. for which i have no doubts about it.
Consultants here range from the quirky to the naggy to the chirpy! haha.. but on the whole, good intentions abound. The Resp MSW is also another one i have to treat drinks too. What would i do without her help man! So many irritating dispositions she has help to ship of to a better place in society. I suppose, working life has made me learn more about how impt all these allied health ppl are. My PT/OT/ST/MSW/Nurses... gosh... they are good.
Although Resp is really hard work... where the turn over of patients is damn high with discharges left right and centre.. but i think there is so much to learn. Practised tonnes of ABGs..but still not quite perfect. Managed to off and seal my Chest tube... and observed a pleural tap. Was taught to do BMA + trephine by my super MO and got to practice Ultrasound guided CVP insertions on agar and fake blood vessels. haha.. Con brought me to see her do a Bronch and BAL.. cool stuff going down someones trachea. Daily Morning Lectures have also been good. Kinda like this pro teaching environment.
Really have to thank my reg and cons for always treating breakfast. Resus dog up at Doc lounge... Ice milo down at Bangawan... Half price pastries at Delifrance..., ice milo at Houseman.. sigh, sometimes, why does it have to end so soon? Work hard and home before the sun sets. With a resp posting, i hope im better at managing resp patients on night calls.. after all, im doing so many HO1s!!!!! tmd.. why always put me HO1. sian. COPD uncles, Asthma Aunties, walking pneumonia, chesty Bronchiecs, post TB, crackling pulm Fibrosis... etc
Man i will miss working in ward 63 with the other 5 HOs of different dept. Not so boring with them around.
Internal Med is next. hope to do other specialty postings in my 6 month medicine stint. Hope to do med properly before gg to the help the surgeons. haha... my fellow orthopod Hos are Int Med consultants. haha.
Sighhhh time to enjoy my last 2 days in Resp. |
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| (no subject) |
[May. 17th, 2009|08:38 pm] |
Finally the swap has occured. End are the days of SIP that were paid HO pay... hahahaha. Im gg to miss my Newly Promoted Junior MO. He has gone to do EYE at a eastern hospital... Sigh... he has taught me soooo much abt SGH MED and how to survive it and how to survive HO ship. without those crucial days under him, i would have been even more lost. In actuality, the overlap between Old and new HO was supposed to be 1 day... but with Swine... it became 2 weeks! a much needed overlap for a smooth transition...
In his place is my Senior MO now... from MED onco... he is a nice guy thank goodness... Life of HO really depends alot on ur MO... ur immediate BOSS.. in so many ways then one.
So far, after the swap, we have finally emerged behind our junior MO shadow to be full fledged HOs.... making decisions that sometimes dont matter at all. and sometimes decisions that can mean TCU grave or TCU Home. So far, im okay.. thanks to my junior MO previously and the nice Nurses of Ward 63 at SGH... SGH nurses are the BEST.... SO GOOOD.... what will i do without them.
Kinda getting the hang of working life i guess... getting the hang of being a slave...in the pessemistic way... or a HO in the optimistic way... which ever way u wanna look at life. 1 more year to full registration... its like working with a P plate hanging on u.
But so far, things are okay... had a fruitful day at work. Did much... so that when the new work week starts... less to do. :) more time for lunch and bumming around with fellow HOs that are just as slack!
Charge on my friends! |
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| (no subject) |
[May. 10th, 2009|11:09 am] |
Im post call... Havent slept in 36 hours. Its amazing why my mind is still working, my fingers still typing and muse still musing... haha
This must be the hardest $150 i have earned so far. This was my 2nd Call. HO2! 2nd most xiong HO in SGH MED. and with good reason. And to top it off... the call was on VESAK DAY! There goes my Public holiday. Hit the wards on vesak day for 7.30am rounds... and off to rush my ward's changes and complete them before all hell breaks loose at 12.. when the CALL STARTS. Vesak day call for me was worst then my previous HO1 call. I think coz by virtue of the disciplines i cover... Gastro and Endo...
Again, I managed this call Hungry... I missed my breakfast coz too lazy to wake up early to eat and so hit the wards with an empty stomach. Something not uncommon for me... but then i skipped lunch and subsequent dinner also... why? COZ i was just TOO DAMN busy... But funny... when im busy, the hunger pangs are not really there. Task orientation help to focus the mind to the task at hand... and my poor GI is left out. Hence, for the whole DAY.. no input.. and hence... no Output. my I/O are completely zero... some just stick a catheter in me! hahaha... HO2 = me, today covered a shit load of cases... and when i mean shit load...i mean shit load... Soooo many freaking Gastroenteritis today... HOW come so many???? of course they dont come from the same source, coz some were muslim, hindus and chinese, unless they eat from the same food source and defy religion. Thats not gg to happen.
3 patients turned hypotensive on me... time consuming documentation and tests to order... and another 3 went hypoglycaemic on me tooo... just have to give them a sugar boost... but is time consuming too. Not to forget BLOOD C/S... my most dreaded inx!.. SGH set sucks... how i miss AH Bld c/s set. y cant hospitals learn good things from each other?
But the good thing is that the sun will always rise from the east... im kinda tearing and yawning by then. and Morning rounds await me for morning changes.. ZZZZzzzZZzzz
Im HO1 call AGAIN on tues. I hate the secretary... she doesnt even know how to plan a roster well... MAke me do RESP as 1st posting and make me do all the busiest calls in the 1st 2 weeks.. whats wrong with her????!!!! I have to like adjust instantaneously.
I BETTER GET MY OFF-IN-LIEU... my PH gone... beginning to dread ward work.. hope things look up. I think at this point, everyone is thinking abt changing lines haha. |
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| (no subject) |
[May. 4th, 2009|11:28 pm] |
Today starts work... as a HO... a Doc.. Its not easy.. there is a huge gap between Academia and Practicality. Something that medical school wasnt able to bridge well. SIP yes... but that was like how long ago? And the system differences between the clusters makes it hard for an NHG trained personnel like me to shift to Singhealth. However having said that.. things are going ok.
Slow at first.. VERY slow i mean, but thing will hopefully pick up. My phone has yet to ring of the hooks just yet... BUT tmr, it will ring like no tmr... Everyone will be calling for your attn. Never in ur life have u ever imagined how impt you are. Its this 1 day in the many days for the REST OF YOUR LIFE when u finally get called non stop... Dr!!! Dr !!!! DR!!!!... Sometimes you just wonder.. CAN YOU STOP CALLING ME FOR 1 SECOND? We take our quiet lives for granted. Its when you are called left right centre that you kinda wonder, is this world so noisy? But ppl are sick, ppl need ur approval, ppl need things that only dr can do. So, of course they need you.
HOship is very funny, its perplex. hard to describe, but an integral part of Rite of passage to becoming a True Doc. We arent full docs yet.. HO is like ARMY. For anyone that has gone thru Combat training could understand. HOship is like a game of prioritisation and one of the goals is to keep striking off your TO DO LIST. The fast you do so, u get bonus points.. and EXTRA relax time... the slower you are... then u gg to GAME OVER. Its really a test of Skill, Brains, Physical STAMINA... climb stairs, run here and there... stay focus, stay awake.. fight hunger, thwart personal feelings from judgement. I think COMBAT training in SAF has taught me some useful skills. Coz i have some similar feelings i experienced in army last time, and it has taught me how to cope with them.
TMr is CALL DAY. HO1... busiest HO in SGH MED. DEAD. how to think fast, act fast, copy fast, type fast, and be safe at the same time? Thats the objective of tmr's night games... NIGHT RACE so to speak... who needs F1 night races, where its happening here all the time and its damn hard for you to ever get time in the pit stop...haha
Interesting 1st DAY... not to mention the Suffocation and rebreathing of my own CO2 with my N95. But now, N95 no more... y? coz USA took all of them... so left with Drager and Kimberly... but they are dwindeling tooo.. so duunnon what to use now.. use my hand and cover? There is really a shortage of masks...
My sats are dropping < 95% with that thing on... brain hypoxic, getting AMS, cant think... slow response time... haha..
Ok... slp time, tmr, is 33 hrs of non stop work. and it starts in 6 hrs!
NITE. |
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| (no subject) |
[Apr. 25th, 2009|09:20 pm] |
went to try on my grad gown today... kinda lost as to which size to pick, but i will have a rough idea. To rent or to buy? I think rent lah.. any point buying? dunno...
Got my new work line with a run of the mill phone.. Dedicated work line. Its gg to be ringing a lot...
Today was SMA Seminar. Woahh... took back so many goodies. Of which im most particular proud of is the SMA car decal... can park at SMA now. yay. the rest... some were useful, some not, some informative some for the bin, etc. But all in all a good reaping. haha. got T shirt. MIMS, files, lots of pens... etc
Tmr starts ACLS... talking abt that, they havent even given me my BCLS. Time to be a HO... its like having to grow up. MBBS changes alot of things. or at least Passing it those. Sigh. FAllen angels will not be forgotten. seriously... u all have every right to be with us now.
CSFC students are coming... and 2 batch of SIP students are gg to be rotating,... yay. some company ahhaha. think SGH medicine will be fun I HOPE. thank god for their nurses. :) |
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| (no subject) |
[Apr. 23rd, 2009|06:18 pm] |
Its time for a time check.
Im happy that its all over. ALL OVER. MBBS that is. now finally some registered qualification that i can be proud of after 5 years of hard work. ALL MY LIFE... ever since i was little, i have been dreaming of this profession. my prayers have been answered. Here i am, now with my MBBS. can add it to my barren name haha.
Registered for my Practice licence the other day and got my provisional lisence that comes in a blue card. (reminds you of Driving sch eh) and also got a nice "Red-stamped" certificate from the SMC signifying medical registration (provisional). 1 cert to frame up and slowly replace as we move from Provisional to Full registration. Its funny, but my Surg long case examiner, Prof S, signed the SMC reg cert. i could have imagine him saying to me during long case "better answer me well, for im signing ur cert!"..
Commencement is in July.. the time we get our REAL MBBS cert. 2nd cert to frame up on stately display. A testiment to the 5 yrs of my life, gone in an instant.
Oh well, MBBS is over. And i am a proud Survivor of NUH MBBS. NUH Med and NUH Surg has the highest no. of failures compared to other hospitals... by virtue of the fact of higher concentration of tough examiners... sian. why why why... but i think the different Alphabets have each their own hurdles to clear... like those in day 5. T to Z.
I havent gotten used to ppl calling me Dr. I subconsciously ignored the lady calling our for a Dr Chong. She repeated it a few times before i found out she was calling me. hmmm, got to get used to it. i politely told her to call me Victor in the end. it just dont feel right. hahaha..
okay... Time to look forward to commencement and starting work. earning a low pay. Kinda jittery abt night calls though. every HO's first fear. the 1st night call. Hope SGH medicine will be a good experience.
Going to get my working phone now... |
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| (no subject) |
[Mar. 31st, 2009|05:21 pm] |
It has come to my attention, some news which isnt that all too good.
It concerns all my batchmates... its grave and dire... to at least..
i pray that its not true. I pray that its not me. and i pray that its not you.
to say that this is the time to relax, is only part of the matter.
nothing is for certain till the 17th. and yet that date is so far.
as the day of reckoning nears, its inevitable to hear the rumours...
rumours that i shall not even dare to mention here.
you may feel safe, but there is never any way to know...
unless of course u are on the distinction viva list...
true be told, truth behold, on the 17th of april that all is let known,
pray that casualties are minimal...
for the repercussions will be beyond my scribbles... |
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| (no subject) |
[Mar. 29th, 2009|06:23 pm] |
Dear Lord
Thank you for your presence today! Thank you for placing 2 angels in the same room! Thank you thank you thank you for the shorts that were given to me. I cant complain for anything more.
Thank you. I am praying and hoping for the 17th to be a day of rememberance in a good way. I hope you will make it so for everyone of us! Class of 08/09... our time has come!
Thank you once again father!
Regards,
Victor |
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| (no subject) |
[Mar. 28th, 2009|06:17 pm] |
Dear lord,
I thank you for your grace everyday...
You seemingly help me in every way...
Its impossible to describe the way of your hands...
in which i lie now deeply within...
tmr is the last of the days...
dear lord i pray that you will make it my day...
Thank you!
Regards,
Victor. |
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| (no subject) |
[Mar. 27th, 2009|10:48 pm] |
If there is one thing i need most now... its you Lord!
Pls make this swift... the weekend of judgement.
thank you... |
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| (no subject) |
[Mar. 25th, 2009|12:50 am] |
Surgery was over as i knew on sat... dooms day 1 down...
Med and paeds up next.. the last mountain of that big mole hill...
the light shines at the end of that 5 year tunnel...
hopefully i get out of it in 1 piece...
Thank you lord for your help thus far! |
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| (no subject) |
[Mar. 18th, 2009|12:14 am] |
Okay...todays med MCQs... pwft... just ask around...
tmr MEQs... then its 70% over...
Dooms day soon... |
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