Vampy's Weblog - Life of a Medical Officer

Doing a term in Obs and Gyn is not doing any good to my food cravings... Every now and then I would get food cravings like KFC, chocolates, mangoes, etc. But being around pregnant mothers all day is making me crave more often than usual... Like today I suddenly have a real craving for ice-cream after the antenatal clinic in the evening. I was planning to go get it but had to attend a Intern Info talk and by the time it ended, the only place that sells decent ice-cream was closed! So here I am craving for ice-cream with no outlets! This is the time when I miss the convenience of Singapore where I can get decent ice-cream even past midnight on any day of the week.

Anyway, I booked tickets for Phantom of the Opera here in Sydney. I'm really looking forward to it as I missed 2 performance of them back in Singapore because I was taking my 'O' levele and 'A' levels exams then. Also Anthony Warlow is in it so it should be a great show. I got really good seats... I'm 3 rows in front of the stage... Cool... So I have Michael Buble's concert coming up and then Phantom of the Opera next...Fantastic...

This is one of those days where the horoscope would say "Stay in bed and cover your head. Do not attempt to go out." Well, that basically describes the day I had today. First I got almost got my head snapped off in the operating theatre today. I entered the operating theatre and saw that everyone was busy trying to settle a patient for the surgery, so I decided to just stand in one corner and wait for all the activity to die down before introducing myself to the consultant. Moments later, the consultant looked at me and asked if I was a medical student. I stepped forward and said yes. The next thing I knew, the consultant curtly said to me, "It would be good if you introduce yourself instead of standing there in the corner." I was just flabbergasted. I mean, there's just no way of winning... some consultants will snap at you if you interrupt them while they are doing something and another would snap at you if you don't interrupt them...

Then I made a fool of myself later in lecture by not able to answer a question or rather, I only got half the answer right. So I was relieved when it was time for me to head home. I should have taken a hint and just rushed back home, slammed my door and hide under my covers. But no... I had to stop by the accomodation office as I thought I should give the receipt that I have paid for the rent to the manager. I showed her the receipt and the then she suddenly said, "Are you one of those who is behind on their rent?" I was what?! I told her no and that this was the first bill I received since I moved back to Sydney. Then she turned all chummy and patted on my shoulder and said "You're a good man." I'm sorry... but just a moment ago, you practically accused me of defaulting on my rent and then now you are all friends... Sorry?

Anyways, I glad that the day is over soon... Hopefully it would be better tomorrow.

I got to feel a pregnant mother's tummy today and I felt the baby's back and limbs just by touching on the tummy... How cool is that?! I know those who have been pregnant or have been a father would not find this exciting but I think it was just amazing. I also got to use the ultrasound to listen for the baby's heart beat. It's exhilarating to hear the beating of a baby who is still inside the mother's tummy. I also saw the look on the would-be mother's face when we showed her the ultrasound picture of her baby - a look of bliss. In those few seconds, I almost felt that she was talking to her baby in her mind. That's the love of a parent at its most obvious and touching moment.

However, not all is well with another pregnant women who's latest scans showed that the blood flow in the placenta (the membrane that surrounds the baby) is decreasing hence oxygen delivery is lower and as a result, the baby brain is trying to compensate by dilating the blood vessels in the brain in order to deliver more oxygen to the brain and heart while shutting down blood delivery to the skin and limbs. Thus a decision was made to deliver her baby tomorrow via C-section which I'm going to observe tomorrow. Hopefully, both mother and child would do well tomorrow.

I started my term of Obsterics and Gynaecology or Obs & Gyn for short today. We were taught to do a pelvic exam and Pap smear today. WE were told to practice on plastic models at first which was easy enough. The plastic models needed a bit of extra push and pull to insert and extract the speculum but at least you know there's a cervix in there. Then, we were asked to practice on real people. I have to say that these women who volunteer to allow medical students to exam their nether regions are very brave. I mean, it's a uncomfortable examination (ask any women) and having 6 medical students to probe and poke in that region does not make it any better. So a huge thank you to those brave women who volunteer to allow us to practice. For guys who don't know what a speculum looks like, a picture below will illustrate why the examination is rather uncomfortable.

A photo of what a speculum looks like.

However, it would have been better if the instructors who arrange this exercise to get women who have intact anatomy in that region. The women I got had a total hysterectomy. It's good for me to be able to insert the speculum in but I really would appreciate the practice to see an actual real life cervix. I mean I need to know if my technique will allow me to visualise a normal cervix. But as the woman had a complete hysterectomy, there's no cervix to visualise except for a horizontal scar at where the cervix was. Also, as part of the pelvic exam, I have to feel for the uterus, ovaries. But again, as the woman had no ovaries and uterus, I can't be sure if I'm doing it right and what it feels like in a normal woman.

Yes! I shocked my first living breathing patient yesterday! Essentially, the patient's heart was beating too rapidly and as a result the heart was not pumping blood efficiently. So we had to shock the heart to bring it back to normal. It was like on TV - I called for everyone to clear and then shocked the patient. Luckily for the patient, one shock was enough to bring the heart back to a somewhat normal beat.

There's this taboo in ED - never say that things are quiet... because Murphy's law dictates that once you said that, all hell will break loose... Well, that's essentially what happen today... In the first hour that I was there, all was Q-U-I-E-T... beds were empty... and then all hell broke loose. 4 trauma cases came in through the BAT phone (as in the cartoon "Batman" - when the police chief wants to summon Batman for help) within the span of 15 minutes. All of them were motor-vehicle accidents or MVA for short. (Don't read further if you are squirmish.)The most serious case belongs to a patient who literally had a side of the lower leg sliced off like a ham... I can see the leg bone quite nicely with parts of muscles still hanging, not to mention blood...

My elective term is drawing to an end... Next week, I'm starting Obsterics and gynaecology - babies here I come...

Talk about imbicile! I was doing some grocery shopping today and was coming down the escalator when bunch of punks decided that it was funny to press the stop button on the escalator. Seriously, how is that funny or fun?! Really, why the hell do God give them brains so that they can press stop buttons on escalators.. they should just be born with a bird's brain and that's being kind to them... If only brain transplant was possible I'd gladly transplant their brain to someone else who needs it...

Anyway, to more important stuff... Yesterday I decided to stay overnight in ED cos i have not had the opportunity to do an overnight shift... I went in at 10am yesterday and only ended at 8am today... What did I realise from this experience? My brain cannot function properly after 20 hours of no sleep... By 5am, my brain was grinding to a halt... So there's another good reason why I can't go back to Singapore for intern... 36 hours shift is going to kill me...

I had a couple of interesting days in the ED the past couple of days. I saw 2 major trauma cases within one night. Both of them are self-harm cases. The patient had slashed her major blood vessels on her arm and stab her abdomen and had taken some unknown tablets. She was only found several hours later and had unpalpable blood pressure. The other involved using a sharp object or razor and essentially stuck it into his throat - essentially giving himself a cricothyrotomy. He was found in a pool of blood though conscious. Because he had lost so much blood, he was shivering as the body could not maintain his body temperature.

I was allowed to do my first suture! I was asked to suture this patient who basically had cut his toes from glass. He had to have 6 stitches all in all. I have to admit that even after watching several other doctors suture wounds, it feels different when you have to do it. I was shaking initially. I could see my hands trembling when I gave the local anaesthetic and my first couple of stitches. But as time went on, I began to relax. When I first started, essentially I was concentrating so much on the wound that it's as if only the patient's disembodied foot was there. I took quite a bit of time to suture those 6 stitches which I'm sure other doctors would have been much quicker. The patient's father came in just as I cut the last stitch, thankfully. On the whole, I really enjoyed suturing and hope that I will get the chance to do it again in the next couple of weeks.

Alrighty, time for me to go and experience human civilization - I'm going to the city!