Thursday, January 11, 2018

You do not Appreciate what you have, till it's Gone

It has been a year in O&G department, and I would say that I really enjoy the posting. I am now a permanent medical officer in O&G department. Still learning and striving.

It has always been my dream to take up surgery posting, ever since I was in 3rd year of medical school. However, after entering O&G department as my second posting, and surgical posting as my third posting, my dream changed. I want to do O&G.

I do not know why, regardless how tired I am, I will always be contented whenever I saw a newborn. Cuddled them in my arms, I felt so comforted. Every life is a miracle! The newborn is a miracle. They are so pure.

I realized that I lost my interest in surgery after my medical officer gave me a chance to do an appendicectomy. After taking out the appendix, I do not feel excited. Furthermore, as surgery field covers a wide range of different types of surgeries, I don't think I am so enthusiastic to try up all of it and to pursue all of them. Also, in the surgical ward, most of the post-major operation patient is still quite ill, they were placed in the back cubicle. Most of them are bed-ridden. Unlike in obstetrics, the patient comes in healthy, deliver the baby and go back home with a smile. Although, this might not be seen in all cases. There's always an exception. Post TAHBSO patient, after chemo/radiotherapy, we will still see them walking into the clinic for surveillance. But in Gynecology, it also depends on what cancer the patient has. Of course, like surgical, not all come with good prognosis. I am going to gynecology ward soon next month, I guess I will start seeing those palliative cases. It is something that clinical doctors can't avoid. It is somehow a daily routine to see life and death, in our career. However, I wish to see them less in obstetrics and gynecology field. On the other hand, I do see people who are very into all kind of surgeries, and they are very passionate about it. I think those are the one who will enjoy surgical posting more. They can even go to the hospital middle of the night just to learn. I salute them. As for me, I have other priorities :)

There's a saying, "You do not appreciate what you have, till it's gone." I experienced it! A few days ago, I was diagnosed with a benign medical condition whereby I was advised to change my department. The specialist offered to write a letter to my superior. However, boldly I told the specialist that I do not want to change department as O&G is what I love and I want to do in my life. I never know how much I like O&G till a few days ago. :) 

I always thought that the more senior you are, the less nervous you will be every time we do the emergency cases. I am wrong. I have seen that even the senior medical officer will get nervous too. All the cases are different and you never know what is adhere down there and you need to be careful. And of course, your speed is taken into account as well! Besides surgery only, you got to learn many more skills i.e. vacuum-assisted delivery, forceps, assisted breech delivery and etc. This comes with experiences. But then again, regardless of what, all I want to hear each time is the cry of the baby after baby out. It gives me a big relief!

Till now, I am very grateful to a medical officer who messaged me the day after I left O&G posting during my housemanship period, asking me if I am interested in O&G or not  =) She is no longer here. Hope she is doing great in her life now over there.

Saturday, April 22, 2017

Born in ambulance

I think most of my oncalls were busy. Last night's oncall was no exception! One of my colleague wanted the call but we ended up oncall together. Thankfully, gratefully.

As usual, we started our work at around 8 am, somehow we came earlier a bit to review patients. Morning, it was rather cool and chill. In the afternoon, labour room started to warm up and finally it was heated up at night time and early in the morning at 1 am to 4. Referrals coming in from Mukah, Kanowit, Dalat, Selangau and etc. Emergencies also happened without a single warning sign and therefore we can never tell the anaes team that, when to standby for what.

At around 3 something, I was so fatigue, yet there are still cases due seen by me. Then, patient from KK Selangau reached, was told by the escorting medical assistant that patient delivered on the ambulance. They were short of the staff and hence requested one of our staff to bring the newborn in. As busy as the war zone, we are short of staff too and after wearing a pair of gloves, I went out to receive the newborn. I was shocked to see the condition in the ambulance, with bloods everywhere and liquor splashing on the linen and in the ambulance. I saw the patient and a nurse with a blood stained apron and glove on her. It was a touching moment to receive the newborn and to see the undesirable condition in the ambulance. I guess it would be a difficult situation for the midwife to conduct the delivery in the ambulance with Malaysia well-known bumpy roads. Thumbs up for them! The cute, little crying newborn almost bring me to tears, it was just so pure! Indescribable. And I will say this is the best moment of what I am doing at my workplace everyday.

When I was just about to leave the labour room at around 6 am to antenatal ward to prepare the patients for induction of labour, one of the patient's husband stopped me at the exit door and asked why it takes so long for the wife to be in the labour room after delivery, with raised voice and firm tone.

I replied, "Uncle, it was very busy for all of us since 1 am to now, and that is why the transfer of the post delivery mothers to the postnatal ward a bit delayed."
Uncle: "My time is very urgent."
Me: "....." Too tired to explain further so I went back into the labour room and took a look at her wife in the labour room. Good thing was, I have another colleague who helped me with the patients in the antenatal ward. I will only say, different people, different attitude.

That was a roundup for my oncall yesterday. Full of emotions, and sleepless call.


Wednesday, April 5, 2017

Early days

This is the fourth and a half month I am working in O&G department. Great experience.

The scariest thing will be solo call, but thankfully, I have good seniors who are willing to help out during the oncalls. It is difficult to predict how busy is the oncall, because you will never know how many patients are going to come on that day. The call will be even more hectic if the specialist in some district hospital went on leave, basically most of their patients will also be yours!

Honestly, I hate the long working hours. I never thought that my stamina can go up to 24 hours or more without sleep! However, when the adrenaline rush is there, you won't be feeling sleepy, though physically you are already extremely tired.

The only thing that I wish for during my oncall is all the mummies and the babies will be safe and sounds by the end of my oncall. Nothing will be more important than that. Whenever everything goes well, that is a good call. The call will be even better if you get to do some procedures, but above all, still, babies crying vigorously upon delivery is the best.


Saturday, February 13, 2016

Chinese New Year 2016

Day 1 CNY: Go to work with very unwillingness, but once I saw the babies in SCN, I smiled. Received a premature baby, sent to NICU. Quite busy until my friends have to pack some food for me tho I am not the one PM shift on the day. Yeah, that's my first day. 

Day 2 CNY: Again, received a baby from OT, I was informed by OnG MO for category 1 caesar. Attended, baby unable to maintain the saturation under room air, CPAP was given and again the baby ended up in NICU. Again, that is my second day. Staff nurse in the NICU warned me, Dr. Evelyn, I don't want to see you bringing another baby into NICU tomorrow morning, don't be so "huat" although it is CNY season. Smiled at them. Babies are so determined and so strong to stay alive. Good job babies!

Day 3 CNY: Today I had my PM shift, attended 2 OT cases at my near-to-end of my shift. Things go well, thank you Lord.

Day 4 CNY: My ON (On Night) shift today.  There's a baby LO and there's acute patients in ICU. My MOs worked hard. Many babies in postnatal ward, and attended two cases at around 5, thankful to God, I was so touched when I saw the staff nurse in postnatal ward helped me to take all the serum bilirubin! Feeling relieved, I ran to OT to attend a category 2 caesar. 

Day 5 CNY: Postcall, extremely sleepy. I felt asleep while driving and .... I had an accident. The accident itself is scary, but the people involved are even more scary. Thank you Lord for sparing my life. All I have now is yours. Totally yours!

Sunday, January 31, 2016

The Very First Cry

I was in SCN for the past one week. Attended very few cases. Anyway, today was my first PM shift (6.30 am - 9.30pm) in SCN. I would say that it is quite calm, not very eventful, still satisfactory.

During the morning round, my specialist shared three things with us:
1. Have the ownership towards the patient. "The whole ward is my patient". For this, I will say that I was well trained in surgical department whereby we need to know each and every case in the whole ward. The surgeon only wants to know a few important points regarding the patient's issues.

2. Your patient is your textbook. So, learn from your patient and thank them. In fact, I have been hearing this phrase since I was in my early life in medical school and it is so true. Each and every patient is so valuable to me. I am thankful that their presence is a stepping stone for me to upgrade my skills and knowledge. They are not my burden.

3. The importance of the communication skills.

That's all.

The day went on quite cool and calm until I was called to standby for EMLSCS at around 9. Category 2, the O&G MO did the caesar quite fast. Tonight I appreciated that the first joy is to see a clear liquor gushing out (as dark thick brownish liquor, the meconium basically is not a good sign, it means the baby is in distress) and the next moment, all I want to hear is the baby giving out his or her very first cry.

The cry is like a sign of relieve, a hello from the baby that I am coming to the world, and above all, a shout from the baby that I am alive; I am strong and is coping with all the stress during labour, well......whispering to the doctor's ear that, "please give me a good APGAR score". (It is a score to rate how a baby is coping with the labour and how effective is the neonatal resuscitation).

After finishing all the admission work for the baby, I left the hospital at around 11pm, with a thankful heart that, all is well.

All that I want to hear after this in my career pathway is, the very first cry of a baby upon delivery.




Tuesday, January 19, 2016

Downfall

I enjoy this posting, but as much as I like it, there is always a downfall....

I hate it when it comes to intubation, what more if the baby couldn't make it to live. I guess maybe I am too emotionally attached. I can be super duper happy when a child recover from certain illness. And my heart sank to the bottom of the sea when a child condition become worst. 

May God strengthen the little child's parents, especially the mum. 

Anyway, I am thankful and grateful to have bunch of helpful MOs in paediatric posting. Sincerely, a positive environment give you a good spirit to go to work. At least, that is for me. I'll be going down to SCN starting tomorrow, but I missed the ward so much. Time flies, feel like I have not yet learn enough in the ward upstairs...

MOs are very approachable and they r very willing to discuss the case with u. That's how learning process goes on and on...




Thursday, December 24, 2015

Happy Posting


Happy posting. That is how I describe my current posting, pediatric posting. Don't know why, the kids make my day, everyday! It's been so long since I had this spirit to go to work, or I would say I am looking forward to go for work everyday, even my ON NIGHT shift or my PM shift (6 am - 9.30 pm). Thanks to 30 hours oncall system when I was in surgery last time, that nowadays it feels nothing to work for PM shift. Before this I felt like time is dragging slowly during my PM shift ^_^

1. Kids are innocent and cute. They are unwell when they are sick but they are super duper cute when they are well! A smile from them really melts my heart, over and over again.

2. The fun of getting the diagnosis. Thank to God that I have met a few superiors with kind heart and they are passionate. Sincerely I say, I didn't see much of these doctors nowadays. They are good inspiration for me. Moreover, they are willing to teach us, the house officers. As usual, you will get all version of ways of doing things/right procedures from seniors, friends but these MOs are willing to teach you the correct way of doing things. Some of them teach you how to get the diagnosis too. It is fun learning here.

I will treasure every moment that I have in Pediatric posting. o(^_^)o

Trying to make sense of what we are doing? - from Dr. Ch'ng LS (^_^)


Christmas present for baby E 


Promised lil R to give her this, because I have to poke her to set an IV line