Inertia

I really don’t feel like studying tonight.

I have been procrastinating since yesterday afternoon!

There is a lot to cover before the exams, and I should be alot more motivated than this!

But I really can’t bring myself to face the books…

What should I do?

😦

Beyond belief

One of the student ODPs said to me yesterday that she would request to be anaesthetised by me should she ever need an operation.

Flattered, and exceedingly so.

Work related nightmares

I’ve just been startled awake by a work-related nightmare.

In my dream, I had just given a guy a GA for an emergency appendicectomy. He regurgitated- initially I was very thankful that I had placed a cuffed ETT for airway protection as you do for these appendixes, then I panicked cos I could not remember if I had asked for cricoid pressure during my induction. Had this guy aspirated in the short time between induction and ETT insertion? Then, the guy starts to do something funny with his ventilation. The ventilator bellows are moving and his sats are thankfully still maintained, but his airway pressures are through the roof and the capnograph displays a funny trace. Was he not relaxed enough and thus breathing and coughing against his ventilator? I could not find the atracurium in the cupboard (why did I even look there, they are in the fridge!). The man then starts to brady down to about 40bpm and I turned his volatile concentration down, or did I turn it off? The alarms are beeping, the monitors are not showing any readings- is my monitoring equipment faulty? Argh! Help! And then I woke up.

I hate having these nightmares. I think they are a reflection of all the worst case scenarios that I think about and fear daily. I mean, I know this imaginary guy in my dream wasn’t exactly crashing- but I know full well that he could do, and when he does, he will crash within a matter of seconds. SECONDS! My mind has certainly not been trained to problem-solve at such speed, and my inability to do that scares me. I mean, I know that I am not expected to know everything after only 4 months into the job, but hey! This is someone’s life we are talking about here! I know full well that I can always call for help, which I will do if necessary, but my own pride also tells me that I don’t want to handover a mess to my seniors and so I pressurise myself to get up to scratch!

I’ve made so many mistakes in my last 4 months of training. I’ve encountered airway and cardiovascular emergencies that have scared me out of my wits. I’ve been left clueless about what’s happened in the 1-2 minutes that it took my patients to deteriorate and for my seniors to solve the problems. Basically, I have been left shit-scared (pardon the language).

My confidence has been decreasing exponentially on a daily basis and I think I am having a little crisis at the moment. I mean, I have no doubt that this is the career path that God wants me to pursue, but the “getting there” has been plagued with one traumatic moment after another, and one mini-disaster after another. I’m just fed-up now, and want to become super confident and super good at my work. I can’t wait for the day when people will breathe a sigh of relief when I make an appearance at a difficult situation, and I can’t wait for the day when I will also know that their confidence in me is justified.

I want to be unbelievably good at my job.

I want to be proud of my job.

I want to love my job.

Please.

Disease

I wanted to post this seperately from my previous post on love, as this topic is a lot more heavy and sad.

A couple from my church have 3 beautiful daughters. Their middle child (lets call her R2) was diagnosed with leukaemia (ALL to be precise) last year. She has been receiving cycles of intravenous and intrathecal chemotherapy for the past year, and has had her share of suffering in her 3 years of life. She has had regular admissions to hospital with neutropenic sepsis, suffered crankiness on her steriod treatment, received nasogastric feeding, and been poked, prodded and scanned in every direction. We were hopeful that R2 would get better as she achieved remission and was kept on maintenance therapy; unfortunately, R2’s disease has relapsed. To relapse on maintenance chemotherapy is a very poor prognostic indicator, and her paediatricians have quoted a 100% mortality figure without a bone marrow transplant. R2 is now back on intensive chemotherapy, and she will receive a homologous bone marrow transplant from her sister once remission is achieved. What is hard to digest though, is that her chances of cure remain at only 15-20% with BMT. The family are struggling, with dad staying in the hospital daily whilst mum looks after the house and 2 other children at home. They must be so emotionally and physically exhausted– it has been a year since R2’s diagnosis, and just as things seemed to be getting better, R2’s condition has taken a turn for the worse again. I pray that the Lord gives them strength through it all, and that He will please preserve R2’s little life. I pray that the people around them (me included) will be supportive both practically and spiritually.

All this news has taken my mind back to the days when I worked on the haematology ward and the bone marrow transplant unit. I remember that it was one of the most emotionally trying times in my career as a doctor. I cried more times during those 4 months as a haematology SHO than I had in my other 20 months as a doctor. At that time when I thought I had over-compartmentalised my emotions towards patients and therefore had come almost to the verge of being stone-hearted, the haematology patients made me human again. I developed strong relationships with my patients then, and every negative turn in their condition made my heart ache for them. I remember writing a reflective diary entry then, which I will share here:

I am not one who would usually let things that I see at work affect me for more than a few hours after its time of occurrence. Whether it is the breaking of bad news, or even the death of a patient, I just deal with it there and then and carry on. That’s what I have learnt to do in the last 20 months of being a doctor—compartmentalise my feelings, almost to the point of being cold and stone-hearted. I mean, how else do you cope with the everyday stresses of work if one was to cry with every weeping patient, or mourn with every grieving family? There is no room for dwelling in emotion.
 
Nevertheless, these last couple of days have really broken me down as a person and as a doctor. As I witness the suffering of my patients on the haematology wards, I am beginning to feel my human emotions hit me like an unexpected tsunami. Young patients—they are the ones who really affect me the most. Patients who are my age—they should be enjoying the vitality of youth and embracing the freedom to live their life to its full. They should be out there frolicking in the sun, trying their hand at dangerous sport, experimenting with fashion, falling in love…
 
Yet here I see them suffering. Young people my age, who spend more time in the hospital than they do at home, whose best friends are the nurses and doctors in the damned institution. They are youths who suffer broken relationships as their disease places immense strain on their boyfriends, girlfriends, and even their familial ties. They are youths who have lines and drips attached to them, infusing toxic medications that cause them to be sick, that makes them bald, that inflict pain, that puts them at risk of life threatening infections. These are young adults who live everyday praying that their disease has not come back. Others are fighting to live one more month, one more week, one more day.
 
Watching these patients suffer this week has really reminded me of how broken and imperfect our world is. As mankind seeks to pleasure himself and as we bathe ourselves in sinfulness, this world is never going to be perfect. Suffering is a reflection of our brokenness. It reminds me of our desperate need for the peace and perfection that God offers through his son Jesus Christ. One day, when he comes again and the heavens and earth are made anew, there will be no more weeping, no more crying, no more suffering. On that day, man and woman, young and old, we will sing to the Lord and bask in his love forever. 

R2, I am praying for you.

First night shift

I haven’t done nights in a while (4 months to be exact).

Tonight marks the first of my Anaesthetic on call nights.

我怕。

Dear Lord, please hold my hand.

J

Fear of the on call week

Really dreading the 0830-2030 on-calls for the next four days.

Dear Lord, please help me through it all.

Colossians 3:23
Whatever you do, work at it with all your heart, as working for the Lord, not for men.