The Pacinian corpuscle

Managing 'troublesome' family members of patients Medical wards are almost always very busy. Housemen are always running out of time. Our day typically begins before 6.30am once we step into the ward. It doesn't stop till maybe 1pm on good days after most plans have been carried out after rounds done with the specialist. If we are slightly unlucky, we might still have a short break at around 4pm. It's usually the most quiet period between 4 and 7pm. By saying quiet it means fewer admissions. But this is also the time when visitors start to crowd the ward. SN will start calling for houseman because family members will want to know whatever going on with their family who got warded. It is essentially an important skill to deal with these laymen because if you're good at it, it makes your life easier. You get to take a little more breather before the next wave of admission hits the ward.  How should we deal with these people? First, we must understand that th...

Time's passing real quick.  I only couldn't keep track of the date of the day. Every morning during crucial times when MO and Specialist are doing rounds and I had to write down the date and time. I always spend 2 more seconds recalling the date of the day. It is such a paradox when you feel that there isn't enough time to get our work done all the time, yet you only feel that the time stopped ticking 3 days ago. I went to Radio again today. Made a couple of visits. I didn't have time to think through how I should present a case the best I could -- so I just had to do everything impromptu, hoping things will fall in the right place. The department always gives me a mysterious feeling. It is dark and cold and I always don't know whom I'm speaking too and I always have to ask around for their names for documentation. I only enjoyed the brief moment when the request is granted and I get to write down patient's details on the white board in the procedure ro...

Requesting an ultrasound/CT for your patient. Today is the third time for me to go to the Radiology department to request a test for my patient. Nobody really told us how to present a case good enough to convince the Radio MO that the test is really needful for your patient. Based on my experience, the presentation must not be very formal-like. But it should consist of precise information that radiologists will want to know. I was referring a case of a brain metastasis with primary lung lesion to the department because there was sudden desaturation of the patient. I want to exclude pulmonary embolism because Well Score for the patient was pretty high. Therefore, I requested for a CTPA. Wells' criteria risk stratifies patients for PE. It is not a diagnostic scoring system per se, but it is a guide to predicting pre-test probability of PE. Clinical ssx of DVT (3) PE is first diagnosis or equally likely (3) Heart rate > 100 (1.5) Immobilization at least 3 days ...

Today is Day-10 in medical! I've started to feel tiredness tearing my body apart every morning. It's bad when I can't enjoy doing ward rounds because I feel extremely sleep. I actually almost fell asleep standing today. I only become be more energetic after lunch. My feet hurt. It feels like growing pain -- a kind of pain that I used to have during growth spurt. Maybe I'm spending too many hours standing and walking that my feet bones need to grow bigger to support my body weight. I don't know. I hope it doesn't crack. My eyes feel tired too. But I think I'm getting used to it now. I tend to blink a lot when they become dry. Sometimes I realise some patients are actually looking at me one kind when I'm doing that without being aware. I'm counting down to my next off day which is in 2 days time! Time's passing quite fast actually. And I'm always doing something. Yet I enjoy reading up a little every day after and before work. I w...

Day 4 at dengue ward and Day 8 into tagging, 6 official days left for tagging. I'm able to discharge patients fast, and finish a discharge summary within 20 minutes. I am still pretty weak at presenting cases to cater the different styles of each specialist and MO. There are not as many things to do as compared to HO at bigger hospitals. The hospital is small, everyone tends to know one another, and there are gossips. But there are good progresses too. I was able to take blood from a geriatric lady with single attempt. I was able to set a branula, with NO blood leaking or contamination of the work are, with an aseptic technique. I was able to do a ryle's tube insertion the right way. I was able to review patients faster, doing specific examinations for each patient, treating patients the way I was trained when I was in medical school. Most of all, I have gone through another milestone facing emotional stress. I was verbally abused today. That's the word I'm...

Indulging in McD's apple pie and french fries now -- it's like being in heaven. I finally could walk home slowly because tomorrow is my off day!  My ego was hurt a few times today. Not from scoldings. But just opinions and suggestions of my superiors and seniors. Sometimes these words are more intense than scoldings. But I told myself it's alright because I'm still getting used to the system and trying to blend in and speed up with my work. I've got to be happy and grateful enough to have my ward colleagues who are super funny and nice to work with. I am really thankful because they are the ones who add colours to my daily routine.  Today is a super messed up day. Dengue ward for the first day. Not guided or told what patients to cover and how to get a dengue review done the right way. MO came, but senior HO carried own with their own work. MO was too friendly I think. He's too nice and too gentle. Nope. No good. I like MOs and specialists who have specif...

What day is today? I have to constantly check on the calendar to find out which day of the week it is. Every time the curiosity succumbs in a long sigh when I found out it's only the second day I'm in the ward.  11.15pm I can't even see properly with my eyes. My feet hurt. But it do as much as my heart when I realised I couldn't perform an IV cannulation successfully. I called another senior HO a doctor. I saw a group of students making a circle around a patient's bed and I kind of miss my student life now. Of course I'd rather move on. I felt bad because I couldn't do less to share the work with Aiman, the very first senior HO that I got to tag along with on the very first day of life. I think he's really nice to allow me move in a slow pace. I mean, sometimes maybe he just ignores me and does his job because I am kind of lost a lot of the time.  I did 3 reviews today. 2 admission clerking and another follow-up review. That's actually very fe...