Happy

I'm happy now. Because I'm beginning to enjoy my work very much. And I don't think about Mr V on a daily basis anymore. The trip to Hong Kong helped as it was great way to experience new experience and open up my mind. Now I'm so looking forward to Europe.

I haven't submitted my CV because now I want to give emergency medicine a shot for some time. I enjoy the resuscitation bit and all.

My "I was in Hong Kong!" photo

Hong Kong in 3 days

The non-stop rain sends chills down my spine. I think it's probably only about 24-26deg celcius. xD How on earth am I going to survive 8-18 deg celsius Hong Kong? Haha. Can't wait.

I'm very happy with my current work at the moment. I admit being too impatient in the beginning when I started working. Now I have to shamefully pretend not to remember that I made my unhappiness known to several people. Several key people. xD

I haven't send my CV. After Hong Kong. I find myself looking at other prospects. I don't know. Singapore looks quite attractive.

Someone queried why I would want to do Forensic since she noticed that I enjoyed clerking patient and investigating.

Hypoglycemia

The hospital director announced during the houseman meeting that I was the Casualty and Forensic MO... so funny! Hahaha! Yes, I've been appointed to assist a Paediatrician to "manage" the coming housemen... had the first meeting today... I actually became the intermediary (is there such a word?) for the admin for housemen because I was the most junior MO there and just left housemanship recently. :) Anyways, since I'm not the main person in charge and it's a pediatrician who I know is very capable, so I decided to take up the challenge, after all the scheming to avoid the responsibility.

I saw a man in his 50's today who was brought in by family members for abnormal and agressive behaviour since last night. He has underlying hypertension and diabetes on treatment. Otherwise he was appparently well, no fever, just woke up in the morning and started to talk nonsense, punched his cousin once, falling of the bed, refusing food, beating his chest like a gorilla, farting loudly and laughing loudly after farting. After stat doses of haloperidol and diazepam, and physical restraint, we finally managed to get his blood for investigation. His blood sugar level was 1.5! IV D50% 50ml was administered immediately. He became completely normal after 10mins! OMG.

I've officially broken up with Mr V. :) I'm a free woman. I can smile again. xD

To heal a broken heart

My heart pounded like a stampede by a passing herd of wild buffalos and butterflies flutter excitedly in my peritoneal cavity. When. I. Saw. Mr V.

I saw at a distance when he was crossing the narrow road from the old ward building to the casualty building. I instinctively adjusted my collar and pulled back any flyaways back onto my newly washed and fluffy and perky hair, and quickly glanced at my reflection on the entrance glass door.

My heart called out to Mr V, wanting to tell him that I've missed him terribly. He didn't see me, so he kept walking and finally into the building, and quickly was out of my sight.

A pang of regret. Which quickly became a relief. Which in turn became a transient heartache. Which finally became resignation.

Don't worry, it takes time. No one is expected to heal from a broken heart very quickly.

Laws of attraction

So I received a prompt reply from the forensic institute director asking for my CV and making no gurantees except a promise to write a recommendation to KKM to support my transfer to KL. It's a start, and as usual, I'm hopeful, except that doesn't rectify my current situation fast enough. (o.O <=== the disturbed look)

I don't know why I feel so unhappy working in the emergency department. I feel grossly under-utilized. The only thing I gained from my brief time there is seeing the "true colours" of the referee on the other end of the phone. Now I know who's lives I'm going to make a living hell whenever I get a chance.

"Don't get upset, get even." (xD <=== the lemak laughing look)

Now I guess I have to be a little patient. I'm giving everyone the whole of January to sort things out. I'm going to send my CV. Then I'll wait for the hospital director to make her move. After I'm back from Hong Kong, I'll start pestering everybody.

Plan B would to accept the placement in Medical, yes OMG a stint as a medical MO. I'm contemplating whether I should talk to Mr V about my intentions of going back to Surgery. I know in my heart that he'll do something to get me back but do I really want him to? Maybe this time I'll just do everything myself.

Yes, talking about Hong Kong, I'm not particularly excited at the moment because my work situation is taking my time and concentration, but I'll psyhe myself in the next few days or so. I need to contribute a little to the plans and activities when we are there. So far, I've left everything to my travel mate, and so far she hasn't complain, but I don't want to feel that I'm a parasite.

The other thing, I'm interested to pursue the concept of "Laws of attraction", hence my resolutions and love list on the side panel for me to see every day.

Now it's the right time for the laws of attraction to do their stuff.

The first crossroad for 2009

The new job wasn't actually as I imagined or envisioned. I know, I know it's been only 3 days. It's worse than JPL in terms of seeing the type of patients and the stoooopid shift hours. It's sooo disgusting that we work just a few hours in a day at the casualty when our colleagues work like doggies in the other departments. It's quite bad for self-esteem. Besides, I'm so so disoriented with the shift hours and soooooo bored during the extra free hours waiting for my shift.

So I did a drastic thing today. 2 drastic things actually. Firstly while waiting for my 10am shift today, I wrote a long email to the forensic institute director in KL, asking for a placement in the institute. I subtlely hinted by middle of this year, but if he was to tell me that there's an opening next month, I would gladly pack everything and move on to greener pasture. Then at exactly 4.30pm while waiting for my shift to end at 5pm, I called the hospital director and went straight to the point about not being happy in the casualty and requested for either placement in anaesthesia or back in surgery OMG I know. The director will consider.

So now my life again has reached a crossroad. Over the next few weeks or so I need to make life-altering choices, once again, and it's so scary exciting.

2009 Resolutions

Before talking about resolutions, very appropriate to reflect a little on 2008.

In terms of career and job satisfaction, 2008 was a pretty good year with my exodus to Sandakan. Totally enjoyed my 6-month stint with the surgical department, though the year started slow at JPL. Effective 1 Jan 2009, I'm making my move to the casualty department. I pray I would find it more challenging and more stimulating, just like how I like it. :)

In term of personal goals, I have no regrets because I started off last year with the aim of just getting new experiences and just taking the time to decide what I want to do further in this field. Though now after one year, I'm still not sure of my future path, I'm still excited and motivated to thread on.

If there's one aspect of my life that I regret in 2008, it would be pertaining to matters of the heart. I just hate myself for allowing myself to fall in love with Mr V again, only to realize once again, that I couldn't have him. It's like I'm thick at the head, stupid, unteachable.

So my simple resolutions for this hopeful new year:
1) Travel as much as possible
2) Work smart, not to be too terribly selfless
3) Keep my hair long!
4) To make a career move by the 2nd half of the year
5) To pick up photography again
6) To socialize more, time to look for a mate :)
7) NEVER to fall for Mr V's charms ever again
8) Read more
9) To take care of myself better, a little more vanity in order
10) Eat healthier

Holiday

Christmas came and quickly passed. One week at home flew by, another week to indulge as much as I can. I feel rested and overly well-fed, and enjoying increasingly everyday the joys of sleeping in. My new year resolutions in a bit.

My other half

My heart is leaping with joy! 5 FREAKING more days to flying home! Miss dad and mum, Pheobe and home. So insanely happy that I'm like a machine, running crazily all over the place during my busy calls quite in a pleasant or rather emotionless demeanor. Not my sour-face, unfriendly front I usually put up during crazy busy calls to prevent people from interrupting me. I'll be having my last call on Thursday. Yipee. *squeak* ;P The only thing, yes, the only thing is, I feel intermittent waves of strong emotions everytime I think about Mr V. Yes, Mr V again. He is unknowingly making it very hard for me to forget him. Everytime I'm angry with him or upset with him about work, and he realizes it, he would 'make it up' by talking so nicely and tenderly to me, making sure he stands near me, touching me, encouraging me, calming my sometimes short-temper outbursts, being just the sane and level-headed half. But the fact is, he is NOT my half.

Weaning period

8 more days to go before I finish with Surgery and move on. I can't wait. I just went through a hell of a weekend with 3 consecutive bad EOD calls. And I'm EODing again this weekend starting tomorrow. But it's ok because it's going to be my last. Hopefully after this I'll appreciate my "free" time more. I used to complain like nobody's business when I was too free when I was in JPL. Ungrateful kan? :)

My weaning off process if successful so far. It's only difficult when he gives me a certain look, a look on a face that I can't hate, and I can't stay pissed at for long, even when I try very hard to.

The elusive milestone

I'm the most pathetic and silly girl alive. I just had to feel all depressed when Mr. V mentioned something about his daughter. I was commenting about a mother's account about how her 11-month-old son climbed up to a stove and caused a pot of boiling water to splash all over her back. How can a 11-month-old child who can barely walk managed to climb up a height to a stove? Using his upper body strength? A 11-month-old child? Maybe children nowadays skip several milestones at a time. Anyways Mr. V immediately responded by saying, "My daughter can do that too!". He said it with a twinkle in his eyes and with such pride. I think he interpreted my reaction as he was boasting and immediately said, "Actually more like reaching out and grabbing things". He thought I thought he was just being the kiasu father or something. What he didn't know that I was so sad and hurt to the core of my being that I'll never share that joy with him.

Tragedy

Truth be told is that I closed my blog because I was not discreet enough about Mr. V in the past. Me and my big mouth. That was back then some 2 years ago, but things like this follow one a lifetime. And now that I'm working with him, it would be highly inappropriate and may create a stir. So until I'm sure that I'm thousands of miles away from him, and no longer professionally affiliated with him, or when I'm ready to come out of my shell and profess my devotion to him when I'm old and grey, only then, and then only, I'll open this silly blog of mine for everyone to read. And maybe then only I'll read it or a random sympathizer who would enjoy a tragic love story. Yes, a tragedy.

Another lifetime

I'm ashamed to admit that I'm more tormented about "leaving" Mr. V when I leave the department before Christmas. Even more so than being tormented by the dragon boss, for which I can't wait to leave as soon as possible. Yes, my hatred for that sorry old man has escalated over the weeks. So I keep telling myself, "3 more weeks, 3 more weeks... just hang in there...".

But how about Mr. V?

This, however is interjected rudely by self-pity and a very severe heartache. Self-pity because I always have this feeling that I always love a man that I can never love, so to so that I'm having bad thoughts like hoping something disastrous would happen to Mr. V's marriage or his wife, giving me a chance to be with him, because I would be a more understanding partner, much more than her. Severe heartache because he's so good to me and I can't respond. He is always asking whether I'm ok with such concern, always making body contact with me during ward rounds, not in a sexual way, just with gentleness and fierce protectiveness.

I dread that I have to go through that most horrible "weaning off" phase for the second time. I remembered that not too long ago, about 2 years, I was in the same position, so so tormented, and so so vulnerable. But I managed to pull through, so I'm hoping that I would be successful second time around.

I wish we had met in another lifetime, so we could fall in love and be together.

I wish.

Emotion check

I've decided that from this moment onwards, my blog would be for my eyes only. I always thought that I was open enough to share my life with anyone at all who would read my blog, perfect strangers, and more daring, with people I know like my family and friends. But I'm ashamed sometimes to show my weaknesses and my struggles. I feel like a failure when I cannot control my emotion, when I feel so affected by something. I guess I know I am human to have all sorts of insecurities, it is just that I am not ready to share so much.

OMG tearjerker

@ Yahoo! Video

Breakaway

Spotted the proboscis monkeys during my trip to Sukau on Sunday. It was a beautiful and picturesque river. It was the perfect breeze, the perfect chilliness, the perfect pleasant and unpleasant passing odour. It was the perfect quietness and the indeed the perfect solitude despite sharing the boat with 5 others. Spotted also the long-tail macaques and pig-tail macaques.



The 2-hour lazy-paced boat ride made me think happy thoughts and relive my happy moments in life. It rejuvenated me and helped calm my tormented and unsettled soul. My spirit soared as a white-belly eagle flew above us.


After such an exhilarating experience, it was not unsurprising that I felt so lazy to wake up and drag my 2 feet to work this morning. Oh how I am dreading work nowadays.

Bad week

I had quite a horrific week at work. My boss was in his bad mood the whole week, jumping at all of us. And my calls were terrible. Stupid referrals and patients dying on me.

My big boss refused to believe me that a trauma patient had flail chest because he could not see the flail segment. That was because patient was on positive-pressure ventilation. And because the fractures were not clearly seen on the radiographs, he said the patient did not have flail chest and asked me to change my diagnosis. And he refused to see my video captured on my handphone just because he claimed that it was not taken from an angle showing both sides of the chest symmetrically. I was so hurt with the blatant mistrust. But I didn't change my diagnosis and continued to manage him as a patient with flail chest. My colleagues saw the video and agreed with me that patient had flail chest and subsequent repeat chest radiographs showed rib fractures over my "alleged" flail segment. I'm glad I did not change my diagnosis because I know what I saw with MY OWN EYES, for goodness sake. But I just went own with my work, and I didn't show the old man the subsequent films that showed the fractures. It was enough for me to know that I was right. The worse part was that my colleagues did not stand up for me eventhough they saw the flail segment and chose to remain silent. Maybe they knew the old man's ways enough to just not be bothered with him too much.

Then there was a 72-year-old woman who was just recently discharged well from our ward after an anterior resection for colorectal cancer. She presented during my call with acute renal failure needing dialysis on the same day. She gave me a history of hematuria (blood in the urine) for one-week which lead me to a working diagnosis of urolithiasis with obstructive uropathy causing the hematuria and renal failure. So medical took over her for dialysis and she came back after a week to our surgical ward. During our grand ward round on Friday, my boss got the history of vaginal discharge with blood from the patient's daughter instead and proceeded to do a speculum examination. The patient indeed had foul-smelling vaginal discharge. He proceeded to the working diagnosis that patient had a pelvic collection causing the vaginal discharge and started scolding me for missing that history and ordered for an ultrasound scan for the patient. He gave a long lecture regarding proper history-taking. I was thinking hard how the pelvic collection became vaginal discharge and caused the renal failure. The following day, my colleague who did the ultrasound abdomen reported that he did not find any pelvic collection, but he found multiple renal stones instead! Muahahaha! The old man just glared at my colleague and proceeded to the next bed.

Then my call on Thursday was a nightmare. I was looking forward to my free weekend going into that call but the demise of a 33-year-old lady with septic shock and severe diabetic ketoacidosis will forever haunt me. She was referred to surgery for a back abscess and during admission her blood sugar was sky high and her vitals showed that she was septic. For some reason that was missed during her admission and she was left acidotic for 12hours and finally she deteriorated needing intubation. She was ventilated in the ward during my call, so my colleague passed over her case to me. She was so ill that she asystoled several hours post-intubation. I resuscitated her and did CPR for a record 1hr, but I could not save her. Her 5 young children were wailing and crying outside the curtain while we were resuscitating her. And when I finally gave up on her heart, I squatted at her bedside where her lifeless body laid, angry at the inadequate care she received, angry that I could not save her and frustrated because I did not know how to tell her husband and 5 children outside the curtain. I composed myself and pulled open the curtain slowly and looked for the husband. When we made eye contact, he just knew, and he broke down.

After that incident, I was so shaken that I could not sleep and I had several bouts of breathlessness. The following post-call working day, I felt numb and I couldn't keep my food down. And I had the worst headache in my life. And when I related the incident to my only confidant of a colleague, I was close to tears but I just had to hold it back and move on, because I had other patients depending on me. Luckily my parents called me that evening and just hearing their voices made me feel better. I went home that evening, took a quick shower and collapsed on the bed. Now the headache is gone, but the heartache is still palpable.

Smile

I noticed that I've not been smiling. It's easier to not smile actually. And I know that I have a stern face. So I have been wearing surgical mask in the ward. It's my way to have a little privacy when my life (which is my work) revolves around people; patients and their irritating relatives.

But tomorrow I want to smile and evoke that pleasant feeling that we all have inside, so that I'll enjoy my work more. Wish me luck.

Child's play

This 40yo man suffered a heart attack and was treated with streptokinase. 2 hours after the treatment, he was referred to me in the middle of the night with sudden drop of GCS. Urgent CT brain showed a massive left intraventricular bleed. OMG poor guy. The heart attack would have killed him but the treatment killed him instead. Intracranial bleed is a known side effect of streptokinase. No surgery could be done for him because of the streptokinase which was a huge risk of bleeding intraoperatively and because of the recent cardiac event. Basically he was sentenced to death. He asystoled twice and revived and hung on until the following day, when he expired in the ICU.

I'm counting down to my holiday 20 DECEMBER 2008. I'm just so tired of the continuous work and stressors at the moment. I'm now looking forward to my transfer to the Casualty Department in January 2009. After a lot of soul-searching, I've decided that I want to make the move and get on with my life. I've done the old-fashion tabulation of "pros" and "cons" of moving to the Casualty Department.

Cons
1) I'll miss ward work terribly, something that I'm actually quite good at
2) I'll definitely miss being oncall and attending to emergency surgical cases
3) I'll miss Mr. V and my colleagues whom I've grown fond of
4) I have to work shifts in Casualty department :( I prefer office hours and fixed oncalls

Pros
1) I'll get to do more postmortems!
2) It's been my intention from the start to get emergency department experience for my "back-up" future plan if my forensic aspiration doesn't work out
3) No more pesky relatives to deal with! (This is the bit I hate the most working in the wards)
4) I'll be able to take leave before CNY 2009 for a trip to Hong Kong with my housemate!
5) No need to work under Dragon King anymore haha and with my collegues who have blind loyalty (I love them but...)

So with my child's play tabulation of "pros" and "cons", I've decided my future for the next 6 months at least. :) I'm happy, so now I'll officially stop my stress-induced binging spree for the past 3 days with my low-fat marble chess cake from 7-Heaven. Yummy.