Highlights of this week:

Putting a line in an old woman during my acute day and actually getting it right the first time round and causing her minimal pain.

Using the vacutainer method to draw blood twice without missing (though the second time I had some problems keeping my hand steady and some air leaked into the vial).

Using the butterfly to draw blood twice as well. I must say even though the vial filling rate is rather constipated with this method, I really love this one better than the vacutainer because the needle is just smaller, hence my being more confident of not missing and making the process less painful.

Receiving a bright beautiful sunflower. It's the sun in my room at the moment.

Being hugged and being told that I'm dear to someone.

Meeting up with Jie jie for lunch today and seeing her after so long. She promised to take me on an hour and a half walk to the sign of the takahe, wherever that is actually. And to show me her
new toilet and bathroom when it's finished renovating.

If I avoid the topic, nothing gets solved. If I try to address it, my concerns are waved off. Had I been unlucky enough to not be able to express myself that the problem was a needs issue, would it have been just written off as a problem of perspective? It would seem as though my thoughts and feelings mean naught in practice. What one says and one actually does are in conflict.

I'm doing my oncology question and powerpoint presentation because I'm happy to do it for my group. Not because I'm obliged to do so for I could have easily signed it off to someone else, or just as easily given my path tute on Thurs and my acute day on Thurs itself as an excuse to not do it. There's a not-so-subtle difference there. Is it not obvious?

My ceroc dance is so far limited to three steps. I'm told that I should be happy with that, and that after time, once the three steps fall into routine I wouldn't be unhappy with only three steps. It's all a matter of perspective after all. I've always detested having to compare myself with others, I rather compare internally with what I have and what I want and strive to acheive the latter. But when one system gives up, the others are inclined to follow and break down. So I'm supposed to be happy with three steps because if I learn too many I wouldn't appreciate the beauty in them anymore, and I'm better off than those who don't know any at all after all.

Jack of all trades, master of none. If I have to simply be a jack who knows only three steps, then I'm probably no better than those who know none. Could I possibly be worse off? For then I know that I'm lacking and am distressed by it, wanting to be better. If I knew none to start with and hadn't a need to increase it anymore, then I wouldn't be distressed at all. Is it not better that way then?

A pet may grow or not, but if it's needs are not met, would it die? If the owner isn't worried it would die, but the pet is, is there a problem there or not? Is this a case where it's like Spongebob, when he forgets about Gary and Gary then leaves, and Spongebob then realises that he misses Gary. Why does it sound familiar? Because it's happened before but in a different setting. But then it seems the owner is happy to let the pet have needs go unmet over and over again.

The pet spends most of it's time with that of it's own, and rarely sees the owner. The owner said it is inevitable when the pet growled that it was practically weaning off the owner. The owner said that his own kind have needs too and that he had been neglecting his fellow humans. The pet understands the need, but why does the word inevitable gets used only with the pet? The pet questions the reason behind the owner's words for it feels that it does not get much more time with the owner than other humans. The owner gets upset when the pet plays with others of its kind when the pet ends up seeing more of its own kind, but yet the pet is told to be content with what it's getting even if it's not getting enough to meet its needs.

Off to read some more oncology for Friday. Acute day tomorrow! Hurrah!

House looks like a hobo in this one... :S

This is the last week of the Surg/Gastro run. Next week I'll be on Surg/ Onco. Both are parts of the surgery run though, just that the other half of the run changes midway. Which meant that both the groups on the surgery run didn't have to go through the OSCEs this week. Whereas the Cardioresp physicians and GPs that I know were all too happy to practise percussing out my lungs and moving my limb joints.

The cat has finally been let out the bag as well. The Ethics lecturer told the whole class as well that we'll be having a practical skills week in place of the Integrative week. Yay! Right now I just want to get heaps of chances to stick cannulas into people, simply because I still suck at it. Why on earth is it not the practice to anaesthetise people before doing it here, whereas it seems as though that's the case up in Wellie?? It would certainly make life a lot less stressful for me and the poor fella on the receiving end of my needle.

Starting class on Tues. Not that I feel like it. Easter holidays need to be longer :P!

ED shift was comparatively uneventful today, unlike my other shifts. Funny how there were two overdoses today. One with BDZ, alcohol and marijuana and who surprisingly wasn't dying from respiratory depression. He actually walked all the way to the hospital through the gardens, could talk pretty well too. Complete opposite of what I had imagined he would have been like. C/o a sucky life (wants to see PES but was denied by the service itself lol) and feeling tingly and weird all over (surprise surprise....). Had pretty bad folliculitis as well and kept asking for blood tests done for them (he said he bathed everyday... but I could smell him though). The other was a lady who came in comatose who had overdosed on fluoxetine, paracetamol and alcohol. Or so it was suspected. Not sure how those three can actually konk someone out that badly though, cos' she wasn't responding to any stimuli except pain. She had to be intubated. When the specialist turned to me and said you can do the cricoid, I actually panicked for a moment thinking that he had mistaken me for a TI (or someone higher up the food chain) for I thought I was supposed to cut something. Lol. Turned out I had to just push it down on that point so that I closed off her oesophagus while my supervising doctor intubated her.

R was put down for an ED shift tonight as well (I made him do it so that he can walk me home after). But seeing how slow it was he decided not to do it tonight. But he came back in the end to get me as well. For that I'm really grateful. Maybe after my acute weekend I'll make something for him (if I don't die from exhaustion as M said of Shaman!). ^^!

Mumiaks and Nana, and my two loyal devotees, worm and ball, I might be at the hospital until late tomorrow, but I've no idea what time I'm finishing. So I might or might not come online. Will post here to update though. Muaksies. I love you four.

www.chetart.com/confused.html


Our ward rounds have gotten very short now. There isn't any on W16 (and that's supposed to be our 'home' ward too :S!) but since that was where our team usually met before starting, TI, M and I were all waiting there this morning waiting and waiting and waiting for the others to turn up. It was purely by chance we looked into the next ward down the corridor and spotted the reg that we realised that they had practically done the round already. *sweat* (and surprisingly my reg actually understands what I mean when I draw the big sweat drop by my side of the head in response to something he said. Think it was something to do with his over-obsession with Arsenal and football). Only patient left that hadn't been seen was Dr M's new patient who had Cushing's syndrome. It was a good chance to observe some of the features of Cushings, though not all. There was the mood changes, easy bruising, truncal obesity, peripheral wasting, buffalo hump, lethargy and so on. She didn't get any striae or moon-face features though. She actually didn't really look what you would expect a Cushing's patient to look like, considering all the pictures we get bombarded with in second and third year. I found it quite easy to explain the disease more or less to the patient as well which made me feel kinda happy. Using simple normal everyday terms too. ^^ Didn't get to watch the operation which was scheduled that afternoon though because Dr W went on to have his outpatients clinic (with a broken arm and torn tendon? :S!!!!).

He came for the student teaching this morning as well and went through some little bits about history taking, though focussed mostly on RUQ pain. I quite like the way he teaches, and I do appreciate him coming in despite his injuries. And as said earlier, he attended the afternoon clinic as well. Good for the patients of course. I'm not blind to the good of being a workaholic of course. A good role model for a student of course as suggested by someone. Though I do wonder how much does it get before one qualifies as a workaholic? For one I remember wanting my own nanny to be home when office hours are supposed to be finished. I remember resenting patients calling up home as well because I don't want to share my parents after hours. Thinking about it now, is there anyone as selfish as me out there? Personally, while I find acute days to be a good learning experience, I don't really like staying at the hospital doing 'work/ study' for so long. It's almost like when it comes to acute days I don't have a life of my own. A one off weekday is fine of course. But I'm half dreading the weekend acute a little. And I can't make myself not go to any of the days because I'm only having a little over two weeks now on this run (as well as having to find to subjects for my two reports eeeps!!!!). Isssh.

I got rejected today as well. By a patient. I was hoping to take a history and maybe do a breast examination, but barely had I stepped in through the door, the nurse told me that the patient had specifically requested that there be no students attending to her. Sweat. Back out the door and off goes reg to do it instead. Not exactly happy but whatever. I guess this being the first time this has happened it took me completely by surprise.

Nurse Maude wound care clinic tomorrow morning at 8. Will have to wake up super early and bus there. Hopefully it won't be as ... funky ... as TI puts it lol.

My team's new house surgeon was supposed to come in today. But didn't. Because she wasn't MRSA cleared yet. Poor A continues playing TI cum HS. The poor thing can barely keep up with the stuff she has to do. And I've no idea how to write out follow-up notes yet, and can't keep up with what the consultants or regs are saying and hence can't help her. And my team is ever growing smaller. Poor Mr W (who types a lot like Nanny, just one finger less, hehe... no offence of course, cos he types awfully well for single-finger typing... just a little too slow for my comfort... had this urge to ask if he'd mind I help out. An offer which of course never made it out of my mouth. I like brushes with danger, but on this occasion, cowardice won out.) fell off his moutain bike while adjusting his sunglasses going around a wet corner, broke his right clavicle and pulled (or did he actually break it??) a tendon in his left wrist. He came in to see Miss M while I was at her OP and my jaw nearly fell off. So he'll be out of action for some time now. I'm pretty sorry, cos he's overall pretty nice and a good teacher... and dare I risk it, quite good looking. Lol. Not that I'm after the old man. Somehow he reminds me lots of nanny :S (though like Misch puts it, seems to have a volatile quality about him, which hasn't had evidence to show for it yet though. Maybe how he looks stern at times??), just maybe not as long winded when explaining stuff, and nanny probably has a longer and flame-resistant fuse. Ok, maybe not very much like nanny. Just the typing bit. *Why do I sense my neck, or rather my ears are in so much trouble come Fri night??* None can match up to the volcano yet though, even though the volcano seem to be less active these days. Heh heh.

And I saw in OP today this little old lady I liked a lot as well. I don't know what was it about her though. Actually, in general, I quite like little old white haired ladies that are pleasing to the eye and well-natured, soft-spoken, and yet have this sprightlyness still. As in a lot. It makes me wanna hug them, but I don't, of course. But anyway, she came in for follow-up and had to have her seroma drained cos there was some fluid collection there again. She had the warmest hands ever. But it hurts watching her having needles put into her to have the drainage done cos I can tell when it goes in she felt quite uncomfortable. Maybe because I've seen her hurt more before, but somehow I felt wanting to be her knight in shining armour, but yet not knowing how. Good thing she's all better and getting discharged and I won't be seeing her again, hopefully. Goodness, reading this over, it looks like I'm rambling.

Tutes today were dead boring. Unfunnily boring. Boring that I didn't what to do to help myself stay awake properly. It all started with the lecture actually. EBM tute was a total disaster. I feel really bad for the guy that he'll have to think about how to change the teaching content to suit the surg run, considering that it means that all his previous efforts are wasted. Looking at his face, which somehow on the surface was devoid of emotion, yet looking rather strained, when Misch and I explained how we felt, made me feel really sorry that things went this way. I missed my gastro tute as well today because I was too engrossed in my OP and forgot about it entirely. I'll have to chase up my patients soon and then crash Friday's tute and report to Dr B who runs that tute.

Pharmacy training today as well. I met Nick. Who was a cytologist (stopped it in the end because it was making his eyes go nuts) and now studying to be a vet nurse. Likes animals heaps as well like a certain worm out there. But that's not my point. I really admire somehow people who have the courage to pursue their changing ambitions. And have the courage to start from the bottom later in life. And have the strength and tenacity to see them through it. I have strength and tenacity to force myself through medicine of course. Though I doubt if I really ever had the burning fiery passion in me for it in the first place. And I often wonder if I'm alone in this. I'm in medicine simply because of chance and of the friends I fell in with while in y13. Not that I really had the passion for a law cum sci double degree either. But I don't have any real passion in life now I feel. I'm continuing medicine because I feel that I can't turn back. I've put so much effort that I'm afraid I might not cope with myself should part of me ever choose to turn away from it. I like meeting patients of course, but not in the setting where I feel stressed as well, simply from wanting to get the info I need (but then I suck at history taking still as well). I want to enjoy their 'company' (?) as well. Does anyone understand that sentiment or am I the only one I wonder? But no, I'm a coward because I know should I ever develop a passion for something totally unrelated and which cannot include medicine, I know I can never be able to pursue it because part of me will never allow it. I'm passionless at the moment I feel, which when I think about it, is rather depressing as well. I'm excited at the things I'm learning, because they're novel, but once it's gone, then what? I'm probably wondering unnecessarily perhaps? Part of me aspires to be better, to be a passion driven person who'll be happy doing some job she loves dearly. Hopefully that passion can be cultivated. Hopefully it'll be something I see next year or later this year.

And I should sleep now because I wanna do ward rounds tomorrow. Might pop into ED and do a shift in the afternoon if Mr W isn't able to have OP :(