No, no. I have not killed any patients...yet. The reason for the title is because there is actually such a book in each ward in the hospital I'm working in. Why would anyone be so morbid and name it the "Book of Death"? Cos' it is a really a book about what to do when a patient dies. Surprisingly, there's a lot to be done when a patient dies. First you have to certify a patient has actually died. It's more than just saying "Time of death: blah, blah blah". You actually need to check whether patient is breathing, whether a heartbeat is present and of course, TV's favourite potrayal - shining a light into the eyes.
Then we need to fill in the death certificates if we think thet the death is not a coroner's case. This is where the book of death comes in. There's a set of criteria that would determine if the death should be reported to the coroner. If not a coroner's case, then we have to fill in the death certificate and cremation certificate. Filling in the death certs more complex than just putting in the person's demographics. You actually have to think about what really caused the death of the patient and it has to be specific. You can't write "Cause of Death: cardiac arrest".
Although formally, I do not start work on the wards till Monday, I have to go for a handover today. For this term, I will have to wake up at 5.45am for most days! 5.45am! The last time I had to do that was when I was back in the army! I really could see myself being chronically sleep-deprived this term. After the handover/ orientation of the wards me and 2 other interns would be in charge of this term which ended at 6.30pm, I'm exhausted and I wasn't even doing much. This is not a good indication. The scary bit of this term is that there is only the 3 of us - fresh interns looking after the wards most of the time. The registrars and consultants would be in operating rooms most of the time so in essence it's up to us fresh interns. It's scary to think about that. It did not help when I asked the outgoing team whether if patient in our wards crashes often and her replied is "Often enough." Yes, I'm suppose to call for a code when it happens so that the crash team comes but while waiting for the calvary to arrive I'm suppose to stablise the patient. How scary is that?!
After this one week of Orientation, next Monday would be the real McCoy. Now I know why some of my seniors who were doing their intern year said "I wish I could introduce myself as a medical student again."
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