Now that exam is coming in mid-December, the remaining FoCP will serve as consolidation weeks so we could get more chance to spend time at the wards practising skills and examination apart from seeing more patients and learning in greater details of their investigations and managements.
My first consolidation week centred around a variety of medical specialities like ENT (Ear, Nose and Throat), Neurology, Ophthalmology, and Diabetes.
ENT was nothing interesting. Not my cup of tea and after meeting the supremely arrogant, cocky, and condescending Asian ENT registrar who had slits for eyes (literally), the lil' interest I might have faded in the space of a second. I have a thing for people with tiny eyes but this guy just annoyed me so much. He patronised above us all implying how we didn't have the adequate skills at what we're doing! Damn you, we're only in our third month doing the practical and you're suppossed to teach us!!! Thank god I only had to see him for just a day.
Going on a ward round at the stroke ward was certainly interesting. I'm kinda personally interested in stroke so I was all excited but nothing prepared me for the experience of having the first patient I saw being put on the end-of-life pathway. The old man was rapidly deteriorating after having a brainstem stroke and he was not responding to anything being done so the entire team agreed that they would stop all intervention to allow him to pass away naturally. The ened-of-life pathway is different from 'Euthanasia' or 'assisted-death' or 'mercy-killing' or whatever you wanna call that action and it was done with the consent from the family so it was totally legit. In the process, the man was given Morphine and some other things to help deal with the pain (just in case he was feeling any) and keep him comfortable until he stopped breathing on his own. It was kinda a morbid start very early in the morning and halfway through the ward round as I was learning and taking notes while the consultant examined the patients and discussing treatments with the team, we were told that the old man had finally passed away. I've dealt with several deaths in the family so I guess I wasn't that gutted but when the F1 doctor took me to the room to help him certify the old man's death, now that was new! And just plain weird! As he taught me the steps to certify that someone had already died (call out the name, look for any spontaneous movement, elicit pain response, look for pupillary reflect, listen for breathing sound, look for heart sound, look for any pacemaker), there was this weird feeling in my stomach seeing a limpless and empty body when there was life in it only a couple of hours ago. Life is surely very fleeting it could go when you least expect it. And you'd still feel the shock even when you sorta expect it. When the F1 told me to call his time of death like those on TV, I flinched and just refused. I don't think I'm ready yet for that.
My experience for the rest of the week was then a lot milder compared to that experience. Mostly I sat in clinics looking at doctors do their things, talking and examining patients. Other times, I went around the ward talking to patients and practising some of the skills and medical examinations I need to master.
One significant experience was when I went to one of the wards to help the nurses take blood from their patients. I was given two patients and I failed miserably after several attempts. It was a lot difficult on real patients because of their poor conditions and most of the times, their hands were already bruised due to being injected by needles several times already. I thought I could do it because I always managed to do it on the fake arms we were provided to practise on and I've also done the procedure on my friends. It was really discouraging. The next day, I went to practice again on the fake arms and I could do it pretty easily.
On Friday, as I wandered around the Diabetes ward looking for patients to talk to, I saw this poster on the wall with a quote saying "Believe - Courage does not always roar. Sometimes, it is the quiet voice at the end of the day saying 'I'll try again tomorrow'" After I saw that poster, I mustered my courage to went back to the same ward where I failed to ask for patients that need their blood taken. I got three patients and I succeeded in taking their blood, two at first attempts and one at the second attempt. Three successful attempts trumps two fails so I guess was happy. Although there was always room for improvement.
It was a very tiring week but it was a very hands-on so it was enjoyable although I kinda hate the fact that by the time we finished at around 5 o'clock (normally later) it was already pitch black. Winter is coming and I really hate it!
Anyway, I'm looking forward to next week and I'm gonna go on another poking spree to get my technique sleeker. And maybe I'd practice some cannulation too!
Enjoy your week, peeps!
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