saw my first code today. was doing uro rounds today when the announcement came over the pa, "attention all medical staff, code blue in ward 4-." the screens were already pulled round the patient, and the nurses had started the preliminaries. everything was rather peaceful actually, even when this assorted group of doctors streamed in from the other wards. everyone was milling around, and the patient's doctors were letting their colleagues in about her. heard the words "gcs 4", "dnr not decided"," for conservative management" and "not viable". suddenly all these phrases that i've heard in hospital took on a new meaning. here was a patient in asystole, and the decision whether or not full resus measures would be taken depended on all those words. meanwhile the patient had been intubated, the cart full of medication brought out, and my tutor and MOs had turned the cpr and bagging over to another group of doctors. we carried on with our rounds as if nothing had happened. very very surreal.

yesterday my gs team performed some cheem operation (esophajectomy kiv gastrectomy + colonic conduit) that lots of people were talking about, so much so that the surgeons from the other teams were hanging around outside the OT hoping for a chance to catch a glimpse of the action. the patient was suffering from what we thought was an esophageal tumour, but which ended up to be a gastrointestinal stromal tumour (GIST). very rare because GIST make up less than 3% of all GI neoplasias, and only 5% of these are in the esophagus. whatever the case, he presented last week with hematemesis and had not experienced any other symptoms before this, no LOA or LOW, nothing at all. was there at the beginning when they had first opened him up; all the surgeons took turns putting their hands inside to feel for the mass, which was next to the aorta. i think the op turned out all right, and i hope he can get back on his feet asap.

learnt a trick of the trade from my gs tutor today. it's rather ridiculous, and i nearly burst out laughing this morning while he was doing it. haha.

random thoughts:

#1. the world is freaking small. sent off two friends yesterday and was pleasantly surprised to see people from my secondary school, the other jc, and medicine popping up at the departure hall. turns out everyone somehow knows each other; we don't even need six degrees of separation as someone said, three would suffice.

#2. i miss dancing. i mean, i'm nowhere near those fantastic turns and splits and jumps, but i miss moving to music. missC, if you're reading this, we gotta get the classes going, and try to watch wade robson next month!

#3. being in medicine requires absolute dedication to your work. if my tutor's schedule is anything to go by, you'll be out of the house from 6am to 6pm, plus you gotta do night calls twice a week, even on weekends. lots of juggling skills needed huh.

#4. this isn't a random thought, but certain conditions in medicine can be so mysterious. was going through browse and found something called a pilonidal sinus, which contains hairs and is susceptible to infection. it is usually found in the midline over the sacrum, but, wait for this, it can be found between the fingers in hairdressers. the theory is that they're either congenital or acquired when hairs drill their way into soft tissue.

uro posting starts tomorrow. yahoo.

Bad Day

Where is the moment we needed the most
You kick up the leaves and the magic is lost
They tell me your blue skies fade to grey
They tell me your passion's gone away
And I don't need no carryin' on

You stand in the line just to hit a new low
You're faking a smile with the coffee to go
You tell me your life's been way off line
You're falling to pieces everytime
And I don't need no carryin' on

Cause you had a bad day
You're taking one down
You sing a sad song just to turn it around
You say you don't know
You tell me don't lie
You work at a smile and you go for a ride
You had a bad day
The camera don't lie
You're coming back down and you really don't mind
You had a bad day
You had a bad day...

...and tomorrow shall be better, because what i see in my life today will not be the same tomorrow. heh.

blogging from the library of the chalet hospital while waiting for night duty to start, which begins officially at five. it's the midway point through this posting, and while i know that i'm learning more every day than compared with my previous posting, i'm starting to feel the lethargy creep in. am trying to go through what my tutor pointed out during ward rounds, but nothing seems to be going into my sleepy head. not even a cheery robbie williams jazz piece can perk me up.

i so need a holiday. ugh.

'tis sad to be sick on one's twenty-first birthday. sigh.

can't believe that steve irwin's dead. used to watch his show on animal planet like every night after dinner. it's such an irony that it wasn't the crocs he handled every single day that killed him, but a lone stingray. sad, sad, sad.

was feeling like crap yesterday and today because i think there was something wrong with the tofu that i ate for lunch yesterday. i know this cuz miss j also had tofu and experienced the same symptoms the same time as i did, ie epigastric discomfort and nausea. put myself on clear feeds (soup and fruit juice) for dinner and lunch today. only allowed myself a little bit of meat and veggie. muaha, this surgery thing is very real now huh.

another reason why i was feeling like crap was the behaviour of certain people. this being a very public blog, i will of course not divulge the details, but whatever the case is, showing the teeniest, weeniest bit of respect to your future colleagues never did hurt, so why do some people behave as if it's so difficult?

never mind. i'm on a wonderful team and for that i feel blessed. heh.

it's been a packed week. dean's meeting, night duty, simulation training. haven't done as much reading as i should have. sigh.

dean's meeting threw no surprises, though i think some of us are still wondering about the electives. no decision has yet been made whether to keep our elective period the same as before or to combine them to have a super long four-month stretch. applications for electives have already opened i believe, and indeed those for a few universities have already closed! so the longer this thing remains inconclusive (like the histo results for one of the patients we know), i guess our elective plans have to be put on hold.

night duty was only vaguely interesting, perhaps because we're used to the medicine night duties which consists of clerking and blood taking. we started with yet another rounds, then clerked three patients briefly (they were all in varying amounts of pain and discomfort) before finding ourselves with nothing to do, not even bloods! we followed a patient down to the basement to do a scan, then ran back to the SICU when some patient's blood pressure crashed. she was asystole on arrival. after that there wasn't very much to do, and we realised that if we didn't go back to the lounge by ten, we wouldn't be able to retrieve our bags, so we left. hope to see more proceedures on my next duty.

we had simulation training at the nursing school today, which was intially a little dry (how many units of insulin? of kcl? of normosaline?) until we got to the mannequin station. the three cheeky boys from my cg did all sorts of funny things to make us laugh. hilarious. we all got to "intubate" the mannequin, which was pretty hard because the neck was so stiff. crazy. my hand was all red from trying to view the vocal cords.

it's been two weeks into our surgery posting, and the three Jays have noticed that we're starting to use swear words (eg. wah lau, s***) more often, very unlady-like. surgeons have no qualms about using such words in front of everybody don't they? heh. and morning rounds are such a rush that they sometimes utter funny things. one reg told an elderly man, "uncle yao ambulate hor, yao ambulate", to which the patient nodded solemnly. today my tutor, torn between trying to give advice to the patient and teaching us at the same time, told a lady," auntie if you don't move around, your veins will thrombose and you'll have a pulmonary embolism!" it was too much for her to handle, so she just stared at him. muaha. he later rephrased that of course, but it's sometimes really quite hard to "translate" all that lingo isnt' it?

got back my medicine grades yesterday. not that fantastic, but i must be grateful no? will work harder for surg. now, where did i leave my scott's?