Vampy's Weblog - Life of a Medical Officer

After almost 4 years of med school, I'm finally hurtling towards the finish line. I just finish my last term which is examinable. Studying for this last exam was doubly nerve-wrecking. Not only I had to contend with the usual exam stress but the added stress that this is the last hurdle before I finish med school proper. It didn't help that the questions asked in the exam were unexpected and thus I spent the entire afternoon after the exam biting my nails while waiting for the results to be out. When I read my email that I passed, it was a great relief and it dawned upon me that this is really the last time I will sit for an exam as a medical student and the next time I take any exam would be in 3-4 years time when I sit for the specialty exam if I become a trainee.

The term that just ended was psychiatry. It was a great term - it really open my eyes to the world that the "mad" lived in. It taught me that in most cases the patients are more afraid of you than you of them. The experiences were interesting to say the least. It also made me realized how easily it is to be too involved in a patient. The strange thing is that while you are in it, you do not realize it until you sit back and reflect about your thoughts and reactions. Initially, I was intrigued by the presentation of this patient but over time, I found myself drawn into the life of the patient. I felt really sorry for the patient and found myself thinking if only the patient is well, what a great parent the patient would be. As I interviewed the patient on numerous occasions, I learned about the goals, aspirations and dreams the patient had. Suddenly, this isn't just a disease but a real-life, 3-dimensional being who have feelings and dreams. In the end, I had to distance myself deliberately to prevent myself from losing all objectivity. Even now, I wonder to myself whether the patient is doing well and hope that the patient would remain well.

From this term I realize that some doctors would happily refer a patient to the psychiatry team for reasons which under usual circumstances are perfectly understandable. For example, a patient who just underwent a major surgery and have all kinds of drugs and pain relief pumped into them would be drowsy and may not make much sense if someone tries to talk to them. That is NOT a psychiatry problem but rather because of the drugs that the patient is on. Also, an infection in a patient especially a elderly parson can make that person act "crazy" but that's because of the infection and NOT primarily a psychiatric issue. Treat the infection and the patient no longer acts "crazy". A "difficult" patient who is rude and aggressive to a doctor may NOT be a psychiatric problem especially if the patient is not "difficult" with other health care workers. Have they even considered that the problem is with themselves rather than the patient?! That's not PSYCH, that's called bad interpersonal skills!

My final term which beings in about 2 weeks (finally! 2 weeks of holiday!) is essentially a term to get us used to the work of a doctor. We are expected to function like a junior doctor (and not get paid) except we are not allowed to prescribe medications or rather we are not allowed to sign on the the prescription. But in any other aspects, we are treated like a junior doctor. I'm really looking forward to it as I have been allocated to paediatrics neurology which I had done during my paediatrics term last year. I'm back in the land of kiddies! No more adult problems for the next glorious 8 weeks! Unfortunately, as an intern in NSW, we are now allowed to do paediatrics. So after these 8 weeks, the next time I can do paediatrics will be after my intern year next year... Sigh...

I have not been posting for a while because it's been busy - honours submission, assignments due, exams preparation, clinics and lectures. It's been quite a roller-coaster ride for me. First, I have decided to withdraw from Honours. I don't want to get into the details but suffice to say, this was a decision that was difficult to make and I'm just glad that it is done... Now I can concentrate on what is important to me - MBBS.

I had my turn at the Birth Unit. It was a very interesting experience but a long week. Waiting for the birth of a baby is a long process... I have been to 2 deliveries so far and they took more than 12 hours to deliver. I know this is normal but until you are sitting there listening the the fetal heart beat, measuring mum's BP, temp, heart rate every 30 minutes, you won't realise how long those hours are. I'm not blind to the fact that mum is obviously in significant discomfort (Thank god for epidurals) but having to sit there and do the observations every 30 minutes is just tedious... Having said that, I'm glad to experience it cos' you do form some sort of a attachment to mum and family because in those 12 hours or more, you would have ample time to talk to them. So in a way, you become drawn into the family circle even if it's for that 12 hours or so. You learn bout the sister who is klutz in the family or grandpa who refused to ask for directions, husband who snores and so on...

I manage to witness a normal vaginal delivery and boy! am I glad I'm not a woman... Husbands out there listen up... You bloody hell make sure you support your wife throughout the pregnancy and delivery because I'm sure if you were in their position, you would be screaming your head off... Just imagine a grapefruit passing through your anus and that's putting it mildly. So don't complain when your wife ask you to drive and pick up jelly donuts in the middle of the night. The other delivery I saw was meant to be a normal vaginal delivery. However at the last minute, baby's heart rate was dropping and remained low. We had to call for a code so that we can deliver the baby by emergency C-section. Baby came out screming and crying but mum was in a bit of a trouble because her blood pressure became low and was not breathing properly and thus was transferred to the ICU. But I'm happy to say that both mum and bubee are doing well.

I'm so glad that O&G is over - I passed the exams! Don't get me wrong I did enjoy myself in the Birth Unit and most of the lecturers were fantastic but I can't imagine myself doing it for a career.

I just got the results for my intern allocation next year - I was not allocated to the hospital that I have been training in for the past 4 years... I'm going to Newcastle... Initially I freaked out cos' I know nothing about Newcastle. I was wondering when I have to move over there, where should I look for apartments, how am I getting there from Sydney and so on. However, after speaking to the hosp admin and a couple of seniors who are working there, I'm much calmer... I know some may say for goodness sake that's still a few months away but you have to understand that I'm a CONTROL FREAK! I need to know stuff. I don't like to be OUT OF CONTROL. Anyway, today is my final day of my 1 week break... I went around Sydney taking photos during my break...It was good fun. I'll post it on my gallery soon. Tomorrow marks my first day in my last examinable term - Psychiatry.

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.