About crying…

“…I was just on the cusp of having one of those bone cleansing cries a woman should treat herself to at least once during a lunar cycle.”

~ Julia Romano in My Sister’s Keeper, by Jodi Picoult

Well said. I guess some of us females really need an outlet to release the stress and PMS we go through every month. Perhaps the stress and frustration leaks out together with the tears. And yes, I guess you guys can blame it on the hormones. But then again, not everything is due to PMS, ok? Sometimes, it may actually be your fault.

Anyway, am having a bad week at work. Will probably need a few rounds of bone cleansing cries this lunar cycle..

Frustrated

So frustrated. Reason? A series of collected grievances by the same person. Being at the wrong place, at the wrong time.

Just feel like strangling someone or something. Sometimes, everything just feels so unfair. But what’s new about that? Shit happens, all the time.

Guess I better head off to sleep. Will need all the rest I can get and hopefully tomorrow will be a better day.

C’est la vie.

Being idle

This afternoon, I saw a very annoying scene. I was busy running around seeing pre-op patients and having tons of work to do, when I saw four, yes FOUR housemen at the nursing station totally idle. They were simply jobless, with nothing to do. And to make matters worse, that was what they were chit-chatting about; having nothing to do.

The irony is there will be plenty of such scenes to come in the near future as there continue to be too many housemen and shortage of medical officers. I heard that there will be yet another bunch of new housemen coming in end of this month, so I guess there will be even more idle days for them…

About reading

When I was much younger, i.e. secondary school days, I could finish a novel in 1 1/2 hours or 2 hours max. Sweet Valley High, Famous Five, Hardy Boys, are just some of the many series I used to read. Then I moved on to more grown up authors, such as John Grisham, Michael Crichton etc. Ranging from 300-500 page per book, reading used to be such a leisurely thing.

Until now. Medical school spoilt my reading habits and skills. Not to mention working life.

I’ve been trying to read this book I bought in Australia 2 years ago entitled Misconceptions by Terry McGee. A wonderful and gripping storyline about medical malpractice  and a messed up family and social life; except the fact that I’ve been reading it for the past say, 2 weeks, and have yet to finish the 462 pages in that book. Not to mention the 3 weeks I took to finish reading Playing for Pizza by John Grisham.

My attention span has currently been reduced to 5 minutes per session. I have to keep re-reading the same lines each time I restart, because I can barely remember where I last stopped. Sometimes, I even forget the first half of the story by the time I reach the middle of the book.

A comment by my colleague sort of enlightened me recently. Actually it was an observation from her friend as she was more into non-fiction and spiritual books so when her friend lent her a novel, she took forever to read it, and never even finished it. According to her friend, you’re not supposed to read every single word in the novel. Just skim past the storyline, stop and read in detail the interesting parts, and skim through the rest. Simple.

That got me thinking. Perhaps when I was younger, I was happily “skimming” through the books I read, but after med school where every word matters and all that crap, I can no longer read a novel as a leisurely thing, and because I am trying to read every single word in the novel and process it like a studying material, it has made reading so so slow for me, and also taken the joy out of cramming in a novel just before bedtime.

Anyway, I am trying to regain my skills of light reading, and hopefully, I’ll be able to get back in form or at least something near it in the near future. Haha.

Shortage

What happens when people are continually leaving and no one new is coming? Yes, you said it. A negative balance and a reducing workforce. Since the workload is somewhat the same, if not more at some days, we are left with having to work a lot harder than previously, and thus leading being burnt out and perpetual exhaustion. In fact, I’m beginning to think that we’re working harder than the housemen (HOs), coz they are having more and more people and no one is leaving.

Maybe I should simplify the confusing paragraph above to enlighten those who are not in the medical field currenlty. Since housemanship has been extended to a 2 year long program since Jan 2008 onwards, from now until Jan 2010, there will be no HOs graduating to MOs. What this means is, the number of HOs will continue to increase, as there will always be new ones joining, while the rest can’t leave and be MOs until after they’ve complete their 2 years. On our side, MOs are leaving to the districts, to join the Master’s program, to become specialists, while no new MOs are being produced til Jan 2010. So it’s only obvious that there will be and currently is an acute shortage of MOs nationwide.

I think in Cindy’s department there is only 2 MOs running on EoD calls. As for my department, we no longer have our afternoon shift work and on-call relief system, which is fine for small and non-busy hospitals, but definitely torture for busy places like our shitholes. It has come to the stage that she takes more than a day to reply my SMS, and when she apologizes for the late reply, I realised that I did not even realise that she did not reply. Yes, we are that tired and exhausted.

Anyway, I don’t see a solution to this problem in the near future, at least not until Jan 2010, but I really don’t think I can last very long working like this.

Body lift

Full Name: Big Black Monokoru Boo

Age: Less than 1 year old

History: Patient initially presented with mild loss of weight with incontinence of stuffing. Previously noted to have a perforation at the dorsal surface of his body causing continuous leakage of stuffing. T+S done under local about 2 month ago. However, in the past 2 weeks, noted that patient persisted to have weight loss and a flattened look. On examination, patient looked ill, spiking fever from wound dehiscence and hemodynamically unstable due to hypostuffinaemia. Patient was then fasted and posted for emergency surgery.

Diagnosis:

1. Cachexia and sagging due to severe hypostuffinaemia

2. Sepsis secondary to wound dehiscence

Surgery: Wound debridement, body lift and re-stuffing

Surgeon: Jellio’ MD

Date of surgery: 26/05/2009

Duration of surgery: 1840 H – 1945 H

Procedure:

1. STO done on old wound.

2. Skin cleaned and drapped.

3. Lignocaine 2% infiltrated at proposed op site.

4. Wound incision extended and edges trimmed.

5. Wound irrigated with saline and hydrogen peroxide.

6. Stuffing consisting of 2 rolls of Otoban shredded, fluffed and optimised.

7. Stuffing inserted into all four quadrants under aseptic technique.

8. Skin closed with interrupted sutures using Silk 3/0.

Post-op orders:

1. Continue IV antibiotics.

2. Strictly light duty for 6 weeks.

3. Not to be squashed or sat on by humans in the near future.

4. Wound inspection Day 3, no need STO.

Just breathe

This is the 2nd time I heard Anna Nalick’s “Breathe (2 A.M)” on NTV7 with Grey’s Anatomy scenes playing in the background. I first heard of this song in one of the Grey’s Anatomy episodes in the earlier seasons. Loved this song so much that it’s my ringtone when CN- calls.

2 AM and she calls me ’cause I’m still awake,
“Can you help me unravel my latest mistake?,
I don’t love him. Winter just wasn’t my season”
Yeah we walk through the doors, so accusing their eyes
Like they have any right at all to criticize,
Hypocrites. You’re all here for the very same reason

‘Cause you can’t jump the track, we’re like cars on a cable
And life’s like an hourglass, glued to the table
No one can find the rewind button, girl.
So cradle your head in your hands
And breathe… just breathe,
Oh breathe, just breathe

May he turned 21 on the base at Fort Bliss
“Just a day” he said down to the flask in his fist,
“Ain’t been sober, since maybe October of last year.”
Here in town you can tell he’s been down for a while,
But, my God, it’s so beautiful when the boy smiles,
Wanna hold him. Maybe I’ll just sing about it.

Cause you can’t jump the track, we’re like cars on a cable,
And life’s like an hourglass, glued to the table.
No one can find the rewind button, boys,
So cradle your head in your hands,
And breathe… just breathe,
Oh breathe, just breathe

There’s a light at each end of this tunnel,
You shout ’cause you’re just as far in as you’ll ever be out
And these mistakes you’ve made, you’ll just make them again
If you only try turning around.

2 AM and I’m still awake, writing a song
If I get it all down on paper, it’s no longer inside of me,
Threatening the life it belongs to
And I feel like I’m naked in front of the crowd
Cause these words are my diary, screaming out loud
And I know that you’ll use them, however you want to

But you can’t jump the track, we’re like cars on a cable,
And life’s like an hourglass, glued to the table
No one can find the rewind button now
Sing it if you understand.
and breathe, just breathe
woah breathe, just breathe,
Oh breathe, just breathe,
Oh breathe, just breathe.

Banana bag

I heard bout this banana bag thingy in both Grey’s Anatomy and House MD. Curiosity got the better of me. Interesting…

From Wikipedia

A banana bag (or rally pack) is a bag of IV fluids containing vitamins and minerals. The bags typically contain thiamine, folic acid, and 3 grams of magnesium sulfate, and are usually used to replenish nutritional deficiencies or correct a chemical imbalance in the human body. Most often they are used in ICUs and CCUs to correct acute magnesium deficiencies. They are extremely beneficial for the sick and dying (cancer, etc.) because magnesium mitigates nerve pain and muscle pain/cramps and helps detoxify the liver and kidneys (increasing drug benefits and reducing drug adverse effects). They are commonly used for alcoholics who need thiamine to prevent Wernicke-Korsakoff syndrome and magnesium to reverse dementia symptoms.^[1][2]

Folic acid is yellow in color — this ingredient makes the fluid yellow, hence the term “banana bag”.^[1]

The typical composition of a banana bag is Thiamine 100 mg + Folic acid 1 mg + MVI 1 amp to 1 Liter of Dextrose 5% and Normal Saline + three grams of Magnesium Sulfate. The solution is typically infused over four to eight hours.

Hmmm…

“Practicing medicine doesn’t lend itself to the making of friends. Maybe because life and mortality are in our faces all the time. Maybe because in staring down death everyday, we’re forced to know that life, every minute is borrowed time. And each person, we let ourselves care about is just one more loss somewhere down the line. For this reason, I know some doctors who just don’t bother making friends at all. But the rest of us, we make it our job to move that line. To push each loss as far away as we can.”

~ Meredith Grey, Grey’s Anatomy

The Climb

One of my current favourite songs…

I can almost see it
The dream I’m dreaming
But there’s a voice inside my head saying
“You’ll never reach it”

Every step I’m taking
Every move I make feels
Lost with no direction
My faith is shaking

But I gotta keep trying
Gotta keep my head held high

There’s always gonna be another mountain
I’m always gonna wanna make it move
Always gonna be an uphill battle
Sometimes I’m gonna have to lose

Ain’t about how fast I get there
Ain’t about what’s waiting on the other side
It’s the climb

The struggles I’m facing
The chances I’m taking
Sometimes might knock me down
But no, I’m not breaking

I may not know it
But these are the moments that
I’m gonna remember most, yeah
Just gotta keep going

And I, I got to be strong
Just keep pushing on

‘Cause there’s always gonna be another mountain
I’m always gonna wanna make it move
Always gonna be an uphill battle
Sometimes I’m gonna have to lose

Ain’t about how fast I get there
Ain’t about what’s waiting on the other side
It’s the climb, yeah!

There’s always gonna be another mountain
I’m always gonna wanna make it move
Always gonna be an uphill battle
Somebody’s gonna have to lose

Ain’t about how fast I get there
Ain’t about what’s waiting on the other side
It’s the climb, yeah!

Keep on moving, keep climbing
Keep the faith, baby
It’s all about, it’s all about the climb
Keep the faith, keep your faith, whoa

~ The Climb by Miley Cyrus