med school mumblings...

Sunday, November 30, 2008

100 Days

it's 100 days to the big exam, and very appropriately, this song was performed at the end of today's service, sung beautifully by angie.

Jesus Take The Wheel


She was driving last Friday on her way to Cincinnati
On a snow white Christmas Eve
Going home to see her Mama and her Daddy with the baby in the backseat
Fifty miles to go and she was running low on faith and gasoline

It'd been a long hard year
She had a lot on her mind and she didn't pay attention
she was going way too fast
Before she knew it she was spinning on a thin black sheet of glass
She saw both their lives flash before her eyes
She didn't even have time to cry

She was so scared
She threw her hands up in the air

Jesus take the wheel
Take it from my hands
Cause I can't do this on my own
I'm letting go
So give me one more chance
To save me from this road I'm on
Jesus take the wheel

It was still getting colder when she made it to the shoulder
And the car came to a stop
She cried when she saw that baby in the backseat sleeping like a rock
And for the first time in a long time
She bowed her head to pray
She said I'm sorry for the way
I've been living my life
I know I've got to change
So from now on tonight

Jesus take the wheel
Take it from my hands
Cause I can't do this on my own
I'm letting go
So give me one more chance
To save me from this road I'm on
Jesus take the wheel

Oh I'm letting go
So give me one more chance
Save me from this road I'm on
From this road I'm on
Jesus take the wheel
Oh take it take it from me
Oh

Monday, November 24, 2008

RIP

just received news that another of the patients we cared for in haematology passed away last night. he was 24.

there was a time when palliative medicine appealed to me. now i have my doubts.

Saturday, November 22, 2008

My Two Cents' Worth

mumbler would just like to say that some people need to wake up, grow up, and give up being so self - centered and childish. also, to learn when to shut up, and to have the b-s to deal with things head on. even women don't whine and b-h so much.

and this is the current song in my head now. very appropriate given the angst and cynicism built up over the past one month.

There's A Fine, Fine Line



There's a fine, fine line between a lover and a friend;
There's a fine, fine line between reality and pretend;
And you never know 'til you reach the top if it was worth the uphill climb.
There's a fine, fine line between love
And a waste of time.

There's a fine, fine line between a fairy tale and a lie;
And there's a fine, fine line between "You're wonderful" and "Goodbye."
I guess if someone doesn't love you back it isn't such a crime,
But there's a fine, fine line between love
And a waste of your time.

And I don't have the time to waste on you anymore.
I don't think that you even know what you're looking for.
For my own sanity, I've got to close the door
And walk away...
Oh...

There's a fine, fine line between together and not
And there's a fine, fine line between what you wanted and what you got.
You gotta go after the things you want while you're still in your prime...
There's a fine, fine line between love
And a waste of time.

ps apologies, this is the best video of the song i can get on youtube.

and it was great to meet up with a good friend for (second) lunch today. all by coincidence, all in good time, and to think i was tempted to skip this morning's tutorial to catch some sleep. sometimes it's great to be led like this, because the day always ends up much better than you anticipated.

Friday, November 21, 2008

Before I Move On

sip has been an interesting experience. the people, the lack of responsibility on my part in terms of making clinical decisions, the patients...these factors and more have made the 2 months seem more like a muted holiday rather than part of the curriculum. my most recent team had the most varied personalities, including a female mot who's very jovial and a reg who cracks the most whacky jokes (with a straight face i must add) whenever he is tired. we have this silent communication language with our eyes, and some of us have er...a common trigger for laughter, which today would have spelt disaster for me if i hadn't managed to run off in time. i think the other doctors around me must have been wondering why i was in stitches while aurora-ing an lft. haha.

the down side of sip is of course finding out who's what and who's not amongst your batchmates. the reality of working (hospital) world is introduced to us, and it's disappointing to see how some people have reacted to it. i guess it's unavoidable right? i'll just have to learn to work with people like that.

and to add to my cryptic comment (which might not be so cryptic after all): witnessing first hand how easily a guy can loose himself of emotional attachment to a specific person overnight is scary. always knew that men are better at such things than women (duh) so i shouldn't have been surprised, but seeing the change made my head spin for a bit. mumbler is rather unscathed (not completely, despite being detached from the situation) so don't worry, but in summary, men are -cryptic-. and that doesn't change with age and marital status. haha.

Monday, November 17, 2008

To Comfort Always

click here for photos that speak a thousand words. and to think that xdr-tb is getting increasingly rampant as aids spreads. view the website here.

Sunday, November 16, 2008

What A Difference A Week Makes

mumbler moved to the hepato-biliary team this week, and her work has correspondingly increased. more cases, more discharges, and more walking. the team is quite big but at least everyone seems to work well together. one thing bad about being a big team though is that we silly sips have had a hard time trying to order drinks for team breakfast the past week. almost every day the orders are wrong because there are so many combination of drinks - kopi bing, kopi bing siew dai, tea c, tea ping etc etc. quite a mess we've made...but fortunately no con/reg has realised it. haha.

there has been some moving and shaking in this sip, and mumbler has been slightly upset by it. perhaps she was spoiled by her time at grand ol' dame haemato, but honestly, what she has witnessed here has made her angry, and wanting to get out of this posting asap/stat/pronto. all she can say here is that sometimes, people should think carefully before they complain, because some unpleasant things have been repeated back to me by seniors outside of central hospital, from other departments. some are even generalisations and i don't appreciate that at all. no names were dropped so far, but i'm aware of the incidents that gave rise to the complaints, which of course i'm not at liberty to discuss on this blog. so think, people, think. ours is a small community and there's no point souring relations like this.

it's been a roller coster week so far, let's hope my last week in surg sip will be quieter.

i really can't wait for it to be over.

Tuesday, November 11, 2008

Some Things...

...About Ward Work
check out this letter to the online forum. in summary, the writer is expressing her dissatisfaction of at receiving lousy service from local doctors, compared to those overseas. read also the comments made by the readers. it's not the first such letter, and it'll definitely not be the last. am too tired to blog properly but here are some thoughts:

1) medicine is really more of a service industry nowadays, rather than a noble profession.

2) people often demand too much, and this has nothing to do with respect to how much they pay to stay in the hospital. by "too much" i mean expecting the doctor/ team in charge to give their absolute attention, or for an instant diagnosis (after one x ray and one blood test) or for us to promise no complications during a procedure. doctors are humans, we need to spend time with the numerous patients that pass through the doors of a restructured hospital, we need time to investigate (however heard of a murder that was solved in a day?!) and only God can promise you "no complications".

many apologies if this sounds a bit harsh, but mumbler spent nearly two hours during exit rounds today dealing with something like these, so she is in a cynical mood. more accurately, it was the reg who did all the talking (hats off to him man, he was so composed throughout) and the two cases were very different, but by the time the rounds ended and our changes were settled, i was starting to question my ability to cope with such things for the rest of my career and wonder how much of medicine is treating people's anxieties/egos/misconceptions as opposed to curing illnesses.

...About People
mumbler is disappointed with some people. she saw it coming, but nothing quite prepares you for it. it seemed funny when parodied in our playhouse segment (that's for another post) but isn't so funny when it really happens.

cryptic thought: there are some things a girl knows, and can only keep to herself. what she can only do after that is to shrug it off and move on.

Monday, November 03, 2008

Scattered Thoughts

mumbler is quarter way through her surgical sip at the central hospital. everyone's nice and all, but having nothing much to do in between morning and exit rounds really drains me. and the waiting for the exit rounds. i was kindly let off by my ho this evening, because the exits were still not happening even after six. and considering that we're so close to the final m, such wandering around isn't very reassuring!

since we're on the topic, mumbler wants to whine about the silly iv cannulas that central hospital uses. the cannulas are weird, so much so that i can't use one hand to remove the stylet. what happens is that i need two hands to pull out the stylet while sliding in the cannula, but when i do that i let go of the skin, which results in the vein recoiling, and i go through and through. argh!! i know my plug setting can't be that bad, since i still can take blood fairly easily, so it must be the cannula right? right?!

i had my one and only surgical call last friday. continuous rounds of blood takings with the r1 kidnapping me for dinner and blue letter referrals. surprisingly i wasn't sleepy at all and was quite awake even at three in the morning. in contrast, my eyes were barely open and my mind all wooly by midnight when i was on active call at the grand ol' dame. must be something about the kopi at kopitiam. heh. slept for less than an hour, but was grateful that the room wasn't too cold, unlike the one i had during medicine posting, which had a maddeningly cold aircon that directed icy wind to my lower limbs and prevented me from sleeping soundly.

my call ended off well, but it didn't start out very promisingly. first, during pre-rounds, mumbler was yelled at by a nurse for taking the files. i mean, how exactly does she expect any doctor to pre-round without taking the files? if i were a dashing young house officer or a much senior doctor, i doubt she'd dare open her mouth. she, of course, is one of the black sheep, as they say. during the night call i even had nurses preparing the stuff for iv cannulation, who were encouraging and friendly, and who made my call a breeze really, so i'm very grateful for nurses i've met so far. just not her. haha.

and well, guess whose file i was taking a look at? a known case of ca colon, with mets everywhere. fell the night before, fractured his skull and began to bleed into his stoma. by morning rounds he had already lost nearly 2L of blood through the stoma. alert, he was complaining about his back pain, telling us we should ask his wife since she knew his condition well. his wife was in tears as the consultant explained that palliation was our goal, no longer curative, and she uttered the most heart wrenching question i've ever heard in my 3 years of clincals, "how much time will he leave me with?"

he died three hours later.