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her space, her thoughts.....
HER SANCTUARY ♥
Sunday, August 31, 2008

Too lazy to blog properly right now, but since I've found two poems which (conveniently) echo my current frame of mind.... I'll just paste them here!! =P


A Student's Frustration, by JC Sanders.


Meaningless courses, with trials and frustration fraught -
From them, worthwhile intellectual fruits are reaped not.
Homework assignments, meant to be enjoyed naught,
How I wish the material was a little more capably taught.

In this class there is found little of true value or merit,
Yet a requirement the department did firmly declare it.
The exam was too hard, all of the students despair it,
But if I want my degree I'll just have to grin and bear it.




Embracing the Darkness and the Day, by Tori Zigler


I let the darkness smother me
What must be, after all, must be
And as I embraced the eternal night
I said, “goodbye,” to my friend – the light
It felt like this was to be the end
Never again would I see my friend
And so I fell in to a dark despair
How could I smile if my friend wasn’t there?
How could things ever be okay?
When I would never see the light of day!

Tears flowed from my eyes like rain
(Tears of frustration, fear and pain)
What was the point of going on?
When all that once was right was wrong!
If only I could find a place
Where I didn’t have to show my face
Where I could be alone to cry
(Or even better… Just to die!)
I wished for something to release me
From the world which I could not see
But no place to hide or release came
And the days kept passing just the same

Until the day when – by a stroke of luck
An idea was planted in my mind… and stuck!
Maybe, I thought, things aren’t so bad
If only I could stop feeling so sad
Surely there must be some way
To embrace both the darkness and the day
So I searched high and low
Until ideas began to flow
And some friends from someplace very far
(Friends who don’t know who they are)
Through their words made me see
That the only problem I had was me!
And that – though things for me are tough
I’d see (if I stopped sulking for long enough)
That not only will things work out in time
But that plenty of people have problems worse than mine!

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Friday, August 22, 2008

This little episode occured on my way back to Melbourne. Just over 4 hours ago.

There I was on the 5pm train in Seymour. It was one of those peak hours where carriages were brimming with passengers. So I sat next to a woman in her 40s. Very pleasant person, actually. We had a small chat. Turned out she was from Shepparton, and she was on her way to Melbourne. To visit relatives, she said.

She asked me where I came from. What am I currently doing here in Melbourne. And what was I reading at that time (was actually holding "The BookThief" by Markus Zusak).

I told her bits and pieces. She smiled amiably, and she later left me to my reading.

All was quite unremarkable until it was time for her to go.


She stood up, collected her bags, and gestured that she was about to alight from the train.

She leaned forward, gave me a hug and a light kiss on the cheek, then looked at me straight in the eye and said:

"Be careful. Do not always trust the people around you."

The woman walked towards the exit, and just before she left... she turned back to me - with that all-knowing look, a nod, an enigmatic smile and a slight wave of her hand.


For the next 20 minutes of my train-ride home, I was restless. Puzzled. Unnerved. Why would someone I barely know hug and kiss me on the cheek, out of the blue? More importantly, what was that warning for? What does she mean?

I still do not understand.

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Friday, August 15, 2008

An elderly man (let him be Mr. N) collapsed upon arriving at the ED reception last evening, to the shock and horror of his wife and daughter.


Pulseless.


He was rushed into Trauma room 1, with a throng of people from the trauma/arrest team. CPR was commenced immediately while he got hooked onto the cardiac monitor, was intubated and had IV access established.


Ventricular fibrillation (VF). Shockable.


The team "defib-ed" him at 150.


CPR recommenced.


Femoral pulse detected. CPR stopped.


Cardiac monitor showed ventricular tachycardia (VT). Patient regained consciousness - was confused and very frightened initially. Endotracheal tube removed, some blood in the mouth (post-intubation) suctioned, amiodarone given shortly.


Mr. N was promptly transferred to a resuscitation cubicle for close-monitoring. Further management then planned.

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All the above happened within 7-10 minutes. I could not describe exactly how I felt as I watched the event unfold. It was fast. Dramatic. And downright scary.


Apart from a sore chest, the elderly gentleman felt alright when I had a little chat with him and his family. As expected, he could not recall much of the "funny turn" he just had.


His family members, naturally still in shock, were relieved nevertheless that he survived thus far.

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Chungy was the teamleader. He later told me how Mr. N has been complaining of chest pains over the past two days. He sought help from his local GP, but instead of calling the ambulance and sending him straight off to RMH, the aforementioned GP told Mr. N to self-present at ED....


Big mistake.


Mr. N was lucky. He could have collapsed anywhere between his GP's office and ED, and not survive the attack. All because of this one GP who did not foresee the potential implications of Mr. N's chest pains (which unfortunately happened, but thankfully at ED).


Chungy said his GP could be sued for negligence.

Couldn't agree more, because I would sue my GP, should this happen to me.

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Fellow medics - don't make the same mistake.

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Thursday, August 14, 2008

Sigh. One more shift left. =(

Despite a few glitches, my three-week Emergency Medicine rotation at RMH has been fantastic on the whole, and for many good reasons too:


Reason 1:
I saw a fair number of patients, from all walks of life, with various presentations. While most of them are very cooperative, there were a fair few who were either:

a) drunk/out cold (no thanks to alcohol intoxication),

b) confused for various reasons (and thus can be combative), or

c) very emotional/anxious/aggressive/violent, again for various reasons.

Within my three-week stint, I've seen burly security guards holding down combative people, police officers keeping certain patients shackled to bed-rails. It was quite a sight to behold: hand-cuffed patients writhing in their beds, wailing and screaming, hurling expletives at us all, while the ED physicians and nurses tried to sedate them. I've seen workplace accidents and so many MVAs, some more gruesome than others. I've also seen intentional injuries - gunshot and stab wounds, potential drug overdose, just to name a few.


Reason 2:
I've seen how a trauma team "ticks". They never cease to amaze me - how they work so efficiently, how everything falls so nicely into place. =)


Reason 3:
Chungy!! XD

Chung is undoubtedly our favourite ED consultant. While many would rather leave us to our devices, Chungy tends to keep us medics busy. And in a good way too. The fact that he gives constructive feedback and his "easy-going" persona also makes things better. Learning new things and then applying them on the spot have never been this fun.

Pity he is not on duty everyday.... =P


Reason 4:
Procedural skills.

Got to practise them all!! Well, almost all of them. =P At the very least, I'm now confident with IV cannulations, backslabs and, to a certain degree, urinary catheterizations and suturing.


Reason 5:
Familiar faces.

Well what do you know - just when I thought I'll hardly (if never) see them again, there they all are.... seeing patients at ED: Alistair Miller, Andrew Mcleod and Andy Oppy, Tony Young, Wil Wilson, Jonathan Chan, Andris Elim, Shiva Badiee, Cheryl Choong, Glenn Boyce, and not forgetting the Pianta brothers (I didn't know they were so closely related!!! lol).

Can't believe I'm saying this, but: YOU HAVE NO IDEA HOW MUCH I MISS YOU GUYS!!!! Thanks for all the things you've taught me throughout Sem 8-9! Good to see you all once more!


Reason 6:
Group K.

Don't think I'll enjoy my rotation as much were it not for them. XD

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Tuesday, August 12, 2008

Don't you just love it when people still remember who you are, even though you haven't seen them for a while?

It may be just a small gesture - a nod, a pat on the shoulder, a smile. But it does go a long way for me, more so when the day seems dull and dreary.

It makes me happy, just knowing that I still belong....somewhere within the system. =)

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Saturday, August 09, 2008

My mantra of the week:

The night is darkest before dawn.


Recent setbacks have kept me thinking otherwise....


But I SHALL PREVAIL, NO MATTER WHAT YOU THROW AT MY WAY, SO THERE!!!!! =P

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Wednesday, August 06, 2008

Getting reprimanded for something you didn't do down at ED really sucks.

As for the person who actually did it - he/she didn't admit his/her mistake.

No apology given either.


@*$#&@%*!!!!!

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Monday, August 04, 2008

It's a different feel altogether in clinical settings, with real patients and REAL problems to fix.

I must admit, learning and practising on dummies (and unwitting medics) do help - lay down the basics first, so to speak. But having to apply whatever you've been doing all along in clinical skill centres in ED? It scared the sh*t out of me initially. I shudder at the mere thought of screwing things up: from "botching" veins during IV cannulations (and having to "jab" over and over again) to forgetting my suturing techniques when I come face-to-face with a laceration that needed, well, stitching. Whatever would people think of me, should I leave a trail of mess and (God forbid) calamity?


With the exception of a few, I guess we all are afraid of messing up, some way or another.


Just one week into my ED rotation, I've cannulated so many patients (and "blown" even more veins in the process) that I think I'm getting immune to the whole thing already. So screw what people may think! =P Not that I'm turning into some cold-hearted prick, mind you. Lol. Rather, I now view my time in ED as an opportunity to practise (and hopefully improve on) my procedural skills.

Of course, the same cannot be said still for basic suturing (only did it once last Saturday, and boy did my hands shake badly!!!), but I suppose I'll improve if I keep at it. =P


What I like about applying my somewhat rudimentary skills into practice is the fact I start questioning things that I normally do not think of in "theoretical settings". Like how to keep my gloved hands and equipment sterile most of the time, what could I change with the way I do certain things to increase my efficacy, what works for one patient but does not for another.... so many questions, so many possibilities. Keeps me up on my toes, and hence I'm loving it. XD


The downside of ED? It's very unpredictable - one moment it can be empty, almost serene, and before you know it, you've got your hands full.... running up to clerk a patient or two, while the nurses/doctors call upon you to cannulate, take bloods, update patient records and prepare backslabs.


Truthfully? I prefer to be kept busy while I'm on duty. There's nothing worse than having NOTHING to do at all during your shift. It sure bores me to my wits. ><"


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This is something totally unrelated to the above entry, but I just received an email from a friend, who told me about a friend of hers (in Malaysia) who has Caffey's Syndrome and needs an orthopaedic consult. I haven't done my reseach yet as to what Caffey is about and what is its usual mode of treatment, but my friend here is looking for a good orthopaedic surgeon (in Malaysia) who specializes in ortho conditions seen in children. Any recommendations?

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