Life as a medical student #17 Be A Different Doctor

When I was in Taiwan, I went to Shifen train station to release a sky lantern, inspired by the movie 《那些年，我们一起追的女孩》(You are the apple of my eyes). I first prayed for health for my family and friends. Then without hesitation, next on my list was: I want to be a different doctor.

Can you imagine that? In less than two years, I am going to be a doctor. I want to know, what kind of doctor am I going to be? I have seen both the incredibly passionate ways some of the doctors in the hospital treat their patients, and the behaviours of the others that I will never emulate in my own practice in the future. I've seen medicine serve some of its patients well and completely change their lives, while failing others. I had the chance to work on extremely effective teams and surprisingly dysfunctional ones, too. I've shared intimate moments with patients who placed their confidence in me - rather than the other senior doctors of the team - to treat them well.

Therefore I know, without a doubt, what kind of doctor I want to be.

But the truth is, I am scared. I don't know what future lies. I am afraid that one day, after committing my life to this profession, the sparks won't be there.

What if, one day I gradually become the kind of doctor I hated the most?

I believe most doctors went into medicine to help people. We want to practice medicine the right way, but too many forces today are causing us to have diminished enthusiasm for medicine. While taking care of people in their most vulnerable states, we make ourselves somewhat vulnerable in the process, too. It is hard, to stay motivated.

Therefore, I write. Ten years from now I am going to read what I have written today as a student. I want to replay the image of that female doctor, in the small consultation room of HKL, who would bend down on her knees just to adjust the footrest of the wheelchair for an elderly patient. Or the one who would put his pen down just to listen to what the anxious-looking old man was trying to tell him, and acknowledged the worry in his eyes.

Don't you ever forget that.

Life as a medical student #12 When a baby is born

As a medical student, I am blessed with chances to see and experience things other people do not get to. When I was allowed into an elective Caesarean Section for the first time, my heart pounded in excitement. I was about to witness the bringing of a new life into this world!

When I entered the room, the epidural was being administered by the anaesthesia team. Surgeons and assistants were scrubbing in, putting on sterile gowns and gloves. Doctors and nurses were moving about, readying the room for delivery. Everything was in place. Then there it was - a strong pregnant mummy sitting on a cold operating table, considering what lies before her - probably feeling scared and alone. Her partner was not allowed in the operating theater. And in these moments, she must hold onto the strong love she has for her baby. She didn't know how long she'll have to wait before she could hold her baby in her arms. She let fear washed over her, and then she let it drifted away. She must be a strong lady. All the mummy.

I made a quick silent prayer in my head for her and her baby.

And then the actual surgery happened. An incision was made in the mummy's lower abdomen by using a scalpel. A few more incisions were carefully made to separate layers of fat tissues, fascia and peritoneum underneath. After the uterus was opened, it was then time for the surgeon to reach into the uterus and pull the baby out. I could feel the atmosphere of the room became so tense that everyone in the room was holding their breaths.

I couldn't contain my excitement when I saw the tiny little baby girl out of the mother's uterus, arms flailing, lungs wailing. The room was filled with joy, everyone was delighted.

''Happy Birthday, to you, the little one. 

Welcome to this beautiful world.''

And thank you, to all the brave women who birth their children with such strength and beauty.

Life as a medical student #11 The end is the beginning of all things

It's only the beginning now

A pathway yet unknown

At times the sound of other steps

Sometimes we walk alone

The best beginnings of our lives

May sometimes end in sorrow

But even on our darkest days

The sun will shine tomorrow.

So we must do our very best

Whatever life may bring

And look beyond the winter chill

To smell the breath of spring.

Into each life will always come

A time to start anew

A new beginning for each heart

As fresh as morning dew.

Although the cares of life are great

And hands are bowed so low

The storms of life will leave behind

The wonder of a rainbow.

The years will never take away

Our chance to start anew

It's only the beginning now

So dreams can still come true.

Another year of medical school has come to an end. 

Thank you Group C1, I am going to miss all of you. 

Let's ace the exam together, shall we?

Blog hibernate mode turns on.

Life as a medical student #10 About inferiority complex

I just feel incompetent.

I remember how I was always the top of my class in high school. I knew I had to do well in SPM to get the college admission I desired and the scholarship I needed. So I scored 9A+ in SPM, enrolled in matriculation - the fastest way to degrees, and when everyone was complaining of not being able to study medicine, I was awarded the highly sought after JPA scholarship to study medicine in Perdana University. It's all been smooth sailing; everything has gone exactly according to plan. I thought I was a blessed child. As soon as I entered medical school, I realized that this kind of success is everywhere. I was surrounded by geniuses. It no longer makes me special or stand out. I don't think I am smart, in any way.

I struggled, a lot. I feel inferior compared to the others in the hospital who always seem to know more than me. I still have to look up things when I don't understand during the ward rounds and flipping my books like crazy for things I have already studied. I get frustrated and just feel like I shouldn't be there. Every two weeks we move on to a new posting and new environment. So just when I feel like I know what's going on, I am back to square one. Incompetent, clueless, and most importantly, being doubtful of my ability. Sometimes, it makes me wonder, whether I would make it, to be a good and competent doctor. Some days my best is just not good enough.

After three years in medical school, I am still struggling to learn how to be good at medicine. But in order to be the person I have always envisioned myself to be, I will continue to find my way.

Life as a medical student #9 About Death

Every doctor will experience the loss of a patient at some point of time. Some of the patients will fade peacefully. Others will fight until their last breath. Some plan their funerals, others plan a future they won't have. However, nothing in medical school prepares us for dealing with death. In my third year of medical school, I experienced my first patient death. 

On the last day of my surgery rotation in HKL, I met a lady with both of her legs amputated. Yes it was her. I wrote about her story on my blog few weeks back (You can read about it here). I fulfilled my promise and went back to her on Monday, but she was too tired and weak to have much to say to me. The amount of analgesics used on her was so huge that it made her drowsy. And for the rest of the week, other than sitting by her bed and waited, I couldn't do anything else. When I returned to the hospital after another weekend, she was not doing well. Her condition deteriorated. More and more infection. She could no longer undergo dialysis. The nurses told me her wound was not going to heal. The doctors told me her prognosis was bad. My heart sank. 

On that day, I had a long talk with her mother. Her mother told me how her daughter struggled with her health despite her young age, and she showed me a video of her daughter happily spending time with her family just few months ago. Then everything just happened, so fast and unexpected. She told me how much she didn't want to lose her precious daughter. I was on the verge of tears as I held her hands and said: ''Aunty, remember to stay strong and take good care of yourself.'' 

When I went to find the lady on the next morning, she was no longer there. A nurse told me that she had died last night.

I stood there, realizing that this was supposed to be a meaningful moment, yet I didn't feel anything. I didn't cry. I don't know why but it was not as emotionally difficult as I anticipated. I was pretty calm, maybe because the outcome was expected. Or maybe, I had no right to mourn a patient that I'd only met for weeks. I was merely a passer-by in her life. It was short, but I am glad that our paths crossed.

Does increased exposure to death as a doctor going to ease the pain, does death ever get easier? I don't know. But doctors are human too. We are frail. We should be allowed to feel.

I said my goodbye to her in my head as I left the ward. 

''I hope you had a wonderful life.''

Life as a medical student #8 My First Oncall Experience

For many housemen, on call is daunting. The rest of the world is asleep - their consultants, most of their peers, and in many cases even their supervising medical officers will be asleep. But not them. They need to stay up and be alert at the time when they are physiologically programmed to be asleep. They are responsible for admitting new patients and managing emergency cases in the middle of night. I've always wondered how it's like to be on call. So to take self-torture to another level, I volunteered to be the only medical student who was on call in Ward 18B last Thursday night. It was an impromptu one - I didn't even have enough sleep the night before, or at least had some preparation - I was working in the ward and soon when I realised it was already 10 o'clock at night so I thought I would just stay in the ward. Truth to be told, medical students are not obliged to on call, but to have a taste of it, I stayed.

Hospitals have a different character at night, so quiet you could have heard a pin drop. I was lucky to have Dr Chan and Dr Wong together with me for the night. They are the most dedicated housemen I have seen. Starting from 8 o'clock at night phone calls kept coming in. A lot of new patients were admitted and both of them were on haywire. Hence I offered my help to clerk some of the new patients. It was exciting - to assess patients first hand - because normally when we clerk patients, we would have already know what the patients were presented with by looking at their charts. (Yes we play cheat like that) Clerking new patients give me a chance to implement my own management plans and deciding my differential diagnosis. Also good for me to practise my history taking skills. 

I also got to perform procedures I might not otherwise get to do during day time, for instance, blood taking. Now this is one of the things I have mastered in these few weeks. ....Okay la maybe not 100%. Success rate 80% la kay. Still need more practice. There were so much else in the ward to learn and do. The big shock was that the majority of the job was administrative rather than practical and academic. I learnt where the lab forms were kept, how to label the blood samples, and how to send bloods I had taken. Nonetheless, I enjoyed being the housemen's assistant by helping them in and out. Well, all because I would be happy to have medical students to help me out one day when I am a houseman? :)

It was about four or five in the morning when I started to get tired. I had been up all day. I opened my patient's charts and tried to read and digest the information in it. But my eyelids felt as though they were attached to lead weights. My body went into shutdown mode. Weren't there moments when you said to yourself, what have I got myself into here?

The next morning, ward rounds with the specialists and consultants started at 8 o'clock as usual in the morning. I cleaned myself up a little and contiued to join the rounds. After having my early morning caffeine fixed, I tried hard to pull myself together until the end of the day. So this was how my first on call experience was like - I was in the hospital for a total of 30 hours.

I was so tired that all I wanted to do was to crawl into my comfortable pyjamas, plopped into my bed and hit the sack.