I’m glad to be home again 3 months later. Boy, I do really miss everything about home!! The weekend is so short… in fact, too short for me to take in everything at home in one breath. It’s hard not to slow down and enjoy home and everyone, everything in it. I feel as if I’m running at top speed and not allowed to stop. At the end of the race, I find myself exhausted and very much unwilling to leave home again.

He looks much better than the last time I last saw him which was nearly a month ago. I hope I’m not hallucinating. When modern medicine and science tells you there is nothing they can do, it is actually up to you to whether to allow that to be translated into “hopelessness”. I felt helpless and hopeless alright especially during the birth of the bad news. Yet I couldn’t quite determine if he felt the same. I wouldn’t say he gave up totally. But he isn’t trying very hard either. So when the professionals tell you that you’ve come to the end of the road, the least you can do is to pave a new path to walk on even when you’re not sure if it’s safe or if it’s even leading to anywhere. What I’m sure is that I’ll definitely break if I stand there doing nothing and surrender to fate.

Not hallucination, I guess. He definitely looks better than the last time I talked to him, trying to hold back the current of tears stinging in my eyes. I told him what he can do now is to eat well, rest well, pray a lot in the hope that his strength will return. Then perhaps the doctors will consider giving it another try, another chance, another hope. He nodded each time I said that. If he’s truly trying, I pray that he’s trying his very best. There’s one thing he doesn’t know and which I haven’t told him - I want to give him a good life and that could happen by next year when I start to earn my first real cash. I need that chance. A chance of him to be around and me giving out all of my love.

In times like this, leaving home stirs a lot of guilt in me. I wish I can be around but I can’t. I wish I can slow down and go smell flowers with him but I can’t. All I can do at a distance is to pray. A miracle will be the best, but if that’s not the case I only hope that he can be happier and free.

Episiotomy. Baby. Happy mother. Episiotomy repair. Log book. Sleep. Hehe…

I am too exhausted to even tell my tale in detail. It is similar to what CN- has described in the previous post…I clerked the patient, followed her up, listened to her scream in agony for 1 whole hour (as no one else wanted to), gave her water to drink, let her pinch, whack, slap me while she was contracting, finally gowned up and gloved up for her impending delivery, screamed my lungs out to encourage her to push and to push effectively, watched the tip of the head of the baby pop in and out of the vagina, and finally, someone else strolled in, scolded me for not giving the patient enough encouragement, delivered the baby, and left the placental mess and work for me to do, and strolled off.

Baby. Happy mother. No self-conduct delivery. No log book signed. No sleep anytime soon.

Frustrated, sleepy, annoyed, tired, aching legs, bullied, tons of backlog work to do, burnt out.

What a way to spend the weekend.

Sh+T

We are expected to conduct at least 5 deliveries on our own in this posting and you can probably imagine our anxiety when we see a good opportunity come by the labour ward - a multip (a woman who had previous childbirths prior to this) whose childbirth will most probably be faster and easier, or a primip (a woman who is having her first childbirth) where an episotomy cut is quite likely during labour. Sometimes we make a 7 o’clock cut (episiotomy) at the edge of the vaginal opening to facilitate passage of the baby’s head and to prevent severe, jagged vaginal tears. This is usually performed on a primip and an episiotomy means an opportunity to give local anaesthesia, cut at the appropriate area when the baby’s head is crowning at the vaginal opening and later on an episiotomy repair - administration of local anaesthesia and suturing.

I was exhausted by the 20th hour of my labour ward on-call when a primip turned up with a cervical dilatation of 6cm indicative of impending labour. Determined to deliver her baby, I clerked the lady, performed the necessary physical examination, monitor her contractions and baby’s heartbeat via the CTG machine and closely follow vaginal examination reviews. At 7am, I mustered all the energy and passion for obstetrics that’s left in me for the delivery when her cervix dilated to 10cm.

Come on, baby… it’s time for you to come to this world and I shall receive you with my very own hands! The mother was anxious and in pain, leaving me with multiple fingernail imprints around my wrist and forearm as “souvenirs” whenever she could reached over the bed rail to grab hold of me as I check the CTG machine by her side. With approval by the house officer, I dutifully prepared myself - wore the apron, put on sterile gloves and got ready the delivery set by the bed, swabbed the labia and introitus and taught the woman how to breathe properly and when to strain. A staff nurse willingly stationed herself by the side of the woman to be “gripped” at each uterine contraction.

Soon the perineum began to bulge and the vaginal gaping enlarged. I was elated to see the baby’s hair and felt its head pushing forward. It shall be an easy delivery with a possible episiotomy, I thought. I could get my log book signed for another self-conducted delivery and go back to my room for some much needed rest - yippie!! I was still smiling to myself when the medical officer sauntered in, saw what was happening and put on gloves to check the progress of the delivery. I stepped aside to make room for her, eagerly waiting behind her to allow me continue with what I was doing.

Episiotomy. Baby. Happy mother. Episiotomy repair. Log book. Sleep. Hehe…

A few minutes passed by. She was still there. I inched forward but she didn’t acknowledge my presence. The labour was in good progress. An episiotomy was inevitable and I was told to prepare the local anaesthesia. After the episiotomy, the medical officer still refused to budge and give me a chance. The next instant, the mother gave a full effort push at the peak of her contractions and the baby’s head, shoulders and the rest of the body was delivered! Not by me, but by the medical officer who nicely came by, took over the case from an exhausted by enthusiastic medical student and enjoy the climax of the entire labour process herself!

Who clerked the patient? Who stayed awake to monitor her progress and report to the house officer in charge once every half an hour? Who got gripped once every few minutes by the patient until the hands turned red? It’s me , myself and I!! But I was denied the chance to deliver the woman’s little prince… argh…

7am. The medical officer finally acknowledged my presence and said, “MS (medical student)… please weigh the placenta, clear the mess and repair the cut.” All I could do was to nod and comply. Then she turned and left. I continued standing there trying to stay calm.

Baby. Happy mother. No self-conduct delivery. No log book signed. No sleep anytime soon.

I smiled back at the mother who thanked me profusely for god-knows-what. I was perched at the side watching the baby being delivered into the hands of another person. Well, at least there’s a baby and a happy mother.

Everything was completed by 9am long after the next on-call group came in for their duty. A 25 hour on-call. Exhaustion, no sense of accomplishment plus frustrations. Some nice feelings to start my Sunday.

Sigh… Wish me good luck for my on-call tonight: Self-conducted delivery. Baby. Happy mother. Signed log book. Sleep Ok, I can trade my sleep and rest for that.

It’s 1.30pm and I just had my lunch after my attachment with a gynaecologist in the gynae clinic. I’ve to meet the chest specialist who is handling Dad’s case in the medical clinic at 2pm and in the meantime I’m not sure where to go so I made a trip to the computer lab. Going back to my room will take me about 5mins and in about 10mins time I gotta walk all the way to the hospital again so that seemed rather time and energy consuming. Waiting at the medical clinic means me taking an extra seat at the waiting area knowing that the place would have been sardine-packed with patients on appointment by this time of the day before the afternoon consultations start. So here I am deleting the hundreds of mails in my inbox and try to compose a post… which is basically full of NOTHING by now other than explainations as to why and how I ended up here. Crap. I think I’m losing too much brain activity to my Obstetric and Gynaecology posting nowadays I don’t seem to be able to do other things right, including activities of daily living (ADL) like eating, bathing, etc.

Jel and I have been super busy lately. Our day starts at 8am and ends at 5pm during the weekdays with morning tutorials and clinics, ward rounds, faculty lectures, department lectures, etc. We’re on-call (be on duty in the labour ward or gynaecology ward) lasting from 5pm to 8am the next day once in every 3 days and if it falls on weekends or public holidays, we gotta be in the labour ward from 8am to 8am the next day delivering babies and placentas, cutting open vaginas to facilitate passage of the baby’s head and then suturing/repairing the cut at the vaginal mucosal, muscular and skin layers. To add icing to this nice gigantic cake, we’ve to submit 4 case reports and 1 cytology report by the end of this posting.

Here’s what we need: We need sleep. We need rest. We need some time to go buy groceries. Jel’s feet are hurting after standing for many hours in a pair of old, hardened leather shoes so she needs to go shop for more comfortable ones lest her feet becomes deformed by the end of this posting. We’re not sure of what’s happening around the country or the world for 2 weeks coz we’ve absolutely no time to read the papers and even if we do, our eyelids can barely hold up. We need time to study and write case summaries.

We don’t need irrational scoldings from the nurses in the ward. We don’t need more lectures and workloads. We don’t want any more postponed classes or ward rounds by the consultants. We don’t need anyone to lecture us about “not trying hard enough”. We don’t need patients who look down on us and refuse to cooperate during history taking and physical examination as soon as they learned that we’re medical students. We don’t need patients’ relatives and friends to crowd around us, watching us like hawks and generating anxiety in us poor souls when we’re taking blood from the constricted blood vessels of a cancer patient who just underwent chemotherapy.

Final year is lovely. This whole lot of stuff that I’m learning and experiencing now are priceless and they truly make me feel blessed and lucky. Lots to see and learn. Many more to come. I can live with it. At least I’m willing to. I can trade my leisure time, sleep and mealtimes for medicine, patients and their concerned relatives. But we need more time. And we need chances.

God be with us

(Gambate Jel!)

This poem was read by my pastor at the Easter service today. I thought it was a really nice poem that captured the essence of Good Friday and Easter…

Three men were tried for crimes against humanity.
Two men committed crimes.
One man didn’t.

~ Author Unknown ~

HAPPY EASTER everyone

Back in my high school days, there was this craze of folding small rectangular sheets of paper into triangular-shaped pieces, to assemble and form various beautiful origami swans. Examples of these origami swans are as below.

Beautiful, aren’t they?

Anyway, as my friends were all so hyped-up about these swans, I decided to join the bandwagon. I bought a packet of small rectangular blue papers and started folding them into many small triangular-shaped pieces. I then started assembling them together to form the base of the swan. However, the more pieces i assembled to my work-of-art, the more I realised that it looked nothing like a swan. In the end, I decided to shape it into something else…

Saw this in my inbox…

The article ends with “The moral of the story: Don’t work too hard. Nobody notices anyway.”

How ironic. 23 other workers in the room, and nobody noticed that George didn’t move for the past 5 days. If they didn’t notice his movements, what about the stench of a dead body? Or perhaps, they all had blocked noses…

This is one of my favourite songs currently. First heard it in Grey’s Anatomy, Season 1 Episode 6.

When it doesn’t rain, it snows
Yeah, the cookie crumbles but in who’s hand?
All things said and all things done
Life is short