Confessions of a House Officer #3 – My first CPR

‘ASYSTOLE!!!!’

a voice came from the back…

‘DOCTOR, PATIENT ASYSTOLE!!’

the staff nurse continued…

Spinal reflexes made us run to the acute bed.

Mdm X lay there, pulseless… ECG reading flat…

‘Start CPR , chest compression, bagging..’

shouted the senior HO
‘page MO oncall’

Then, we jumped onto the bed, locked the fingers together, and started CPR…

30:2

Still pulseless, asystole…

Repeat CPR… continuously…

Change rescuers, repeat CPR…

Continue bagging…

IV Adrenaline Stat…

Still asystole…

IV Atrophine Stat…

Still asystole..

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Aunty, please come back…

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MO arrived… continue CPR… repeat IV Adrenaline Stat,

IV Atrophine Stat…

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Finally, after just about 30mins of CPR, someone spotted apex beat visible, pulse
present…

Patient arrhythmia…

Prepare cardio defibrillator…

Laila squeeze some gel on it, rub them together, “CHARGE” she shouted…



Still asystole…

Continue bagging…

DeFib again, “CHARGE”



Finally, sinus rhythm…

... [phew] ...

Take ABG, Buse/creat… repeat full leads ECG…. Continues monitoring…

The MO went to counsel family members…

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This was my first performed CPR on a life patient, who actually had a successful CPR...

I learnt that:
1. The hospital can be a very scary place
2. Miracles do happens, at times
3. CPR can be very tiring… especially chest compressions…

currently suffering from biceps/triceps muscle-ache CPR induced…

i also found that working 0630-2300 daily can be super tiring... sometimes, eben longer hours... i just punched out at 0115am today,.. and tomorrow, 0630am, i need to be back in the wards... shoulder and heels & calves aches very much... how i wished for a massage, at this point of time... and a hot shower bathe... with both luxury, currently not accessible to me.. haih...

The pen is your most powerful tool.

(picture by Athena)




The pen is your most powerful tool.

Whatever you write in the stack of casenotes,
will be done for your patients.

Whatever drug u prescribed,

the nurses would serve.

Whatever management you planned.

it shall be it!

Yet, with great powers, comes great responsibilities...

Confessions of a house officer #2 – Tagging

For the benefit of non-medical related readers, allow me to first explain the term ‘tagging’. You know, when a House Officer just graduated, they are usually assigned to a senior doctor (HO/MO) whom they would ‘tag’ with. Meaning, following them around, learning about how to manage patients, how to fill forms, what should be done, etc.

So, my Tagging period started last Friday Night, 5:00 pm. We were each assigned to wards. Dr Laila and I was sent to Ward 4-1. Female Ward.

5:00 pm – Reporting


5:11 pm- Laila & I were assigned to beds to a cubicle to manage patients and do the evening reviews. (Yup! On the first day itself! Correction: at the 11th minute, literally). Which I was pretty scared at first. But of course, whenever we are unsure, we consulted our senior HOs and MOs.


Myth: Housemanship is a time for training. We can study for exams during med school and later learn how to work during housemanship.


Fact: What you learn during medical school really effect life in housemanship. And it’s not just knowledge, but also the skills and ability to analyze the patients’ condition and manage them.


Moral of the story: Make good use of medical school. Yes, you are expected to ‘WORK’ right after you graduate. Good knowledge on history taking, physical examination, investigations, and management is very important. Skills especially blood taking, branula, etc is imperative. And the best time to learn is at medical school.


12:00 midnight – punched-out. Need to be back to prepare for morning rounds 630am the next morning. Then, a bunch of discharge summaries.

So the tagging schedule in Hospital Malacca is 7am-11pm.

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shinyin’s diary:

I salute doctors. Not that I am proud of becoming one, but, being in their shoes, I realized how much they had sacrificed. Watching them, I feel sad for them. Lunch hours, Dinner dates, sometimes, even the luxury of FOOD in general, health, gastritis, peptic ulcer disease, risk of contacting diseases, needle prick injury, weekends, weekdays, holidays, kid’s report day, girlfriend’s birthday, phone calls, sleep, relationships, sometimes, even more…

Did I mention that I have only 10days of leave(cuti rehat) every 4 months, and that MCs are considered as cuti rehat? Means, I have to pay to get sick. Meaning, we cannot afford to get sick. Go ahead, abuse PCM (paracetamol), abuse antibiotics, abuse painkillers, do whatever it takes so that you can appear to be fit enough to work. Otherwise, risk losing your holidays.

And what the Pengarah Hospital promised to us during induction, about at least one day off during a week, well, it’s just a fantasy. THIS DOES NOT EXIST IN HOUSEMANSHIP IN MALAYSIA! And about what the ministry of health promised to us, about the day off after post-call (36 hours oncall), also a myth. THIS DOES NOT EXIST HERE!

So, if you are about to be a house officer, please be aware of this.

for the first time, I learned to eat alone. Not only that, I learnt to eat alone AND on the go.

I salute doctors because they had the stomach to withstand the acidic peptic juices. I wondered how much of metaplasia would have taken place.

I salute doctors because they had the ability to stand for hours, then run for blood perhaps, and continue standing for hours, then run to resuscitate patients, and continue oncall, do not sleep, and continue standing, and run, stand and run. And above all, still have sufficient glucose to supply the neurons in the brain.

Matriculations results just came out. Congrats to my evil brother, who just got into E&E, UPM. STPM results would be out soon. There will come again, the issue of top achievers not getting places into med school.

Think again, why would you want to be a doctor?

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Okay, I do not want to be demotivating.
I think it is easy to like this job, this field.
But you have to be prepared to face the harshest conditions.

do you believed in fairytales?

Confessions of a House Officer #1

I had never felt so alone in my life before.

Perhaps, the last time was some very long time ago.

Since first year, I guess. Okay, now I sounded almost like Mummy’s pet.

But hey, I think I was quite independent today, you know. I was the ONLY outstation HO who drove down to Malacca alone, without my parents or family. Even the 2 only guys from PJ had their parents babysitting them. Don’t you think I deserved some credit for that???

However, it was quite scary as well, as I did not slept well the night before, and almost doze off on the journey here. Which of course, was bad. So bad I had to stop at one of the rest area, and took a 10 minute nap, and some coffee, before continuing my journey.

Today was basically ‘REPORTING DAY’ for me. Seriously, I have not been into the wards yet. Maybe I shall find some time to go to the wards tomorrow morning, just to have a look. I had like a session of lecturing until 12.45 noon, which I struggled very much not to fall asleep.
There was 11 new House Officers reporting to work today, 2 guys, and 7 girls. Apparently, both the guys had a quarter each to stay, while 9 of us, Yes, NINE of us, did not.

So, we were offered two options, temporarily, until we get a room at the hospital quarters. One to stay in a nearby abandoned wooden house in the hospital compound (A), or staying in a new apartment about 5 minutes drive away (B), both non-furnished. When I was shown to the former, I was like, how can I survive here?

I mean, in less than 2 minutes, my skin already had flares from the overloading mass cells, and I had rhinitis relapse. Yup, the place was super dusty; probably no one had been living here for the past 2 years or so. And there’s not yet all.

About 5 feet away, parted by a single fence, was a HUGE alarm clock. Of course, my other coursemates were like happily commenting, ‘Bagusnya,… waktu subuh mesti mudah bangun’…. While the little voice in me was saying, (forgive me for my harshness), WALAUWEYYY, I HAVE A DEDICATED 5 TIMES PER DAY ALARM CLOCK, the kind that vibrates some more.

Shit. Shit. Shit.

Have I mention about the terrible sanitary condition, and the lack of facilities?
Naturally, I suggested taking a look at the other apartment, the new one, which is about 5 minutes away. Unfortunately, everyone was keener to Mr Alarm Clock. And I had no choice but to follow the crowd, as we were asked to agree upon one place to stay.

I felt alone.

Thank God, my seniors from UKM, Patricia & Yvonne, had an extra bed at her Quarters, and they sort of ‘adopted’ me. I got to stay with them for a while. So, they were my heroes who saved me from another asthmatic attack/rhinitis outbreak/atopy eczema… And my super-nice senior, Julian was kind enough to offer help and useful advices. And I’m glad Su Yin and QKK were still around for the next few days. At least I’ll have people to have dinner with me.

Otherwise… oh well… God knows what might happen to me.



I had been trying to learn the roads in Malacca today. I had learnt that:


1. Malacca had to use parking ticket EVERYWHERE you park. Which I thought was very troublesome, the scratching and time estimation thingy. Su Yin thought me how to sort of ‘cheat’ a few minutes… hehe… wow, I have a lot to learn.

2. The parking lots in Malacca are SUPER NARROW. I think after 2 years here, I’ll probably be a PROFESSIONAL in side parking!! Seriously!

3. Eventhough my friend gave directions to ‘go straight’ (in other words, follow the main road).. but the roads in Malacca Town is NEVER straight… It’s like a snake, winding…. And the one way streets makes things even more difficult. Not to forget, my naturally poor sense of directions… oh well…



I’m currently typing from the hall at the end of my block. It seemed quite scary around here. Me being the only one. I can hear the rain pouring outside, with occasional flashes of lightning, strikes of thunder. I fought the fear, the way I fought the fear all day, today.

I think I feared of not being able to fit in.

I feared that I might not be as strong as I thought.

I feared that I might give up. That I might break.

Dr XYZ warned me at induction that the first one month at our new hospital would probably be one of the HARDEST! Over 50% would be having second thoughts of ‘why am I here?’ ‘Why did I take medicine?’ … and I can’t help feeling the fear that I might fall into that category. I hope I won’t.

It’s sad you know. The quarters that I am currently accommodating is a 3-people sharing room with an attached bathroom. That’s all. YUP, that is all. No laundry area. No kitchen. No hall or rest area. More importantly, NO washing machine. NO refrigerator. okay, now that sounded almost too bimbotic, but nvm... i thought it was basic.. my senior sent her laudry to the dobi, which cost like RM3 per kg!!! wow! super-EX la... each time i go wash will be like RM10, times twice a week, for 4 weeks... hmm... RM80 per month on laundry! that also so susah, have to send clothes out...

And seriously, it does not feel home at all. I cannot imagine living in a place like this for the next two years. The social life in Housemanship was said to be almost non-existent. They have take so much away from me, sometimes, I just wished I still have some room of my own to breathe.

Do you know how does it feels, wanting to find a place to stay but there’s no one to share the place with me? And I do not think it’s very safe to live alone. I do not have that courage, yet, not yet. I surveyed this place, there is no swimming pool nearby, or squash courts, or any sports that I can play alone. Except, jogging, perhaps.

I wonder whether I need to have dinner alone. I have not tried that yet. I can imagine, even when I have the time to watch movies or go shopping, will I be doing that alone? At this point, I missed my friends and family so very much.

Well, I found there’s a MPH in Mahkota Perade. So, maybe, maybe there’s still a place where I can hang out contentedly.

Sorry, I am getting a little too wordy today.



I have a message to all :

COME TO HOSPITAL MALACCA TO WORK! COME FIND ME WHEN FREE!!

Oh well, I better get some sleep. Enough ranting for today…

p/s: some pictures of my new room :)

place to rehat

the beds...

you see what i see??

BINGO!

HOSPITAL BEDS!!!!!




>

CUPBOARDS

i got one all to myself!

yippie!!

the shower room a bit sad and geli...

sigh....

no heater... aiks...

this is the end of the beginning... the journey starts here...

~announcement~

a self-explainatory announcement... i'll remove all expressions and feelings...

it was not in one of my options, but i guess, i could adapt...

Malacca, here i come~

Princess Bimbotic going blonde @ BTN

Room: Mutiara A4

DAY 1@BTN
BTN should be fun, right? I mean, it’s just 5 days, how bad can it be?
Guess what? When Princess arrived here, Princess where shocked to see her accommodation...

20 beds to a room???

and they only had 4 fans!! super hot wehhh....

geok lian & i @ my bed
my bed

Princess is very particular with toilets...

the toilets were very small...

and we had to shower in the small bathrooms,... it's like about 4 feet x 6 feet space... and you have to try your best not to tersentuh the walls or terjatuh into the toilet bowl... but i guess, we were considered lucky... my cousin Ying Ying had to mandi berkemban during her BTN !

the washing area

the drying area

Princess did her laundry on Day 1 of induction itself. Terpaksa lor… since Princess only had limited sets of baju, only 2 to be exact… sadly to say, princess is not very experienced in hand-washing baju… not that Princess do not know how to do it, it’s just that, it’s very difficult. Especially, when you are washing jeans, squeezing them dry is damn hard weh… by the end of the washing, you get muscle aches liao… so ya… you see what I mean? Princess loved the genious who invented the washing machine.

Guess what? The dress code for BTN was made princess and the other princesses here looked either too young or too old…

Oh yes, one more thing, they served us six meals per day. Yup, SIX MEALS per day!!
Breakfast
Brunch
Lunch
Tea-time
Dinner
Supper
-wow… so many, sure will get DM and fat… haih…

DAY 2 @ BTN

Today, we were expected to complete a 2 km run in a given time:
Male : 18 minutes
Female : 23 minutes
Guess what? Princess Bimbotic did it!! And in 12 minute 11 seconds!!! Can you believe that? Well, maybe I’m over-proud over a small event… but hey, I had just proved that if you want something, you can do it!! Princesses can run too! I think the 2 puffs pre-run and post-run works… and perhaps to one point, although the physical gives up, the mind keeps going, motivating, pushing… yes, it’s a mind thing… focus..
The imaginary ipod @ the background played as Princess focussed on her breathing: in-out. In-out..
Seriously, I think I did pretty good for a girl,.. as I came in 3rd, after Jia Yi and Lian Lian… or perhaps medical students are just too sedentary… oh yes, Princess learnt something important today: Never eat anything solid before a run… Princess was worried of getting hypoglycemic, so she had a piece of bread, only to feel nauseated after the run and puked everything out… okay, not a very good sight… so, Princess strongly suggest sweet/isotonic drinks before a run…

DAY 3 @ BTN
Period pain, kill me ba!

DAY 4 @BTN
KEMBARA- when jungle trekking…. Quite fun to do it with friends… but I was expecting something more challenging though... Had a performance… sang Perajurit Tanah Air - my group got 3rd place… not bad ei?

DAY 5 @ BTN
EXAMS!!!! How I missed doing MCQ… and no negative markings! The government very generous, while UKM medical faculty very kedekut markah… did I ever tell you that the marking system here is you have to answer TRUE or FALSE… and for every correct answer, you get +1, every wring answer -1. Yup, that’s how hard our paper is, cannot simply ‘bantai’ / ‘tikam’ / guess… the dean said that, when we graduate, we’ll be dealing with people’s life… cannot simply make guesses,.. and I think he has a point…
Head up to Port Dickson for induction…

#Princess talks:
Some people said that BTN (Biro tatanegara) camps are to make one feel more patriotic, while others said that it is perhaps, just a brain wash scam… In Princess’s point of view, Princess learnt a lot in this camp. Princess had a better exposure on Politics and Princess learned that we should always hear both sides of the story before coming into conclusion…

my good friend Annisa~~

she's so sweet... i always manja with her, and she would still layan me... hehe... will miss you very much de..

amirtha & i... she's such an angel... a nice person...

the cute sharvyn a.k.a mrs thousand woodhead & i

chew yong & i heading for induction^^

the friendlty Vaish~

sharvyn, chew yong, geok lian

my roommates~
(sorry, tak sempat take everyone, some left liao)

yong sing, jia yi, vernice