Wednesday, August 16, 2017

Falling below expectation

In a way, looking back, I felt I was indifferent at best & negligent at worst.

The nurse called me last night about a late admission. This patient was supposed to have surgery this afternoon & I would usually see & assess on the morning of the surgery. Not knowing any detail of this patient, I refrained from giving any medical advice over the phone, lest it was inappropriate. Besides, once I start getting involved, I know the nurses will call me for every discomfort the patient may complain of throughout the night.

Therein lies my predicament. I am a doctor and yet I want a good nite of uninterrupted sleep, because I am not on call.

At my age, I dislike, & try to avoid, on-call duties, because I am on my worst behaviour without sleep.

Tuesday, August 08, 2017

Grumpy old men

I've always held the belief that as we get older & approach the sunset of our lives, we tend to be less uptight & bothered about trivial matters. But 2 recent encounters with my colleagues didn't attest to that.

The 1st, already in his mid-60s, was upset when we met in the doctors' lounge. I casually said he's come early to the lounge for breakfast. It was about 10am then. Apparently he took offence to that remark, that i implied he has no patients in his clinic. Hey, buddy, lighten up lah - it's a downturn that is affecting everyone - why do YOU think I am also in the lounge having breakfast?

The 2nd encounter just happened today, also at the lounge. This mid-50s chap remarked that I was being cynical & sarcastic when I mentioned that he was on a rampage with the food. He was already on his 2nd helping then. Hey, buddy, lighten up lah - the food is for everyone & there's more than enough to go round, even for 2nds.

So apparently I have offended 2 colleagues in as many weeks. Maybe I should look at myself. Maybe I am the grumpy one.

Sunday, August 06, 2017

The elective posting

It's time for the daughter to pick the hospital elective posting for next year.

Her 1st choice is a popular district hospital 160km away because there are more hands-on & practical experiences there. She will have to find new accommodation in the district & may be on the road often.

The 2nd is the city hospital only 12km away & 25 mins by train. On top of that, she already lives near the train station. For logistic reasons, being a foreign student, I much preferred she remained in the city.

As it turned out, she was allotted the city hospital. I was glad. And I forgot to mention that had she been posted to the district, she planned on getting a car & driving the 320 km round trip every week.

Phew!

Thursday, August 03, 2017

1st Christmas in the UK

this would be remembered for the wrong reasons.

i was on-call & the 1st case for the day was a 70+ year old lady for a DHS insertion, a procedure to fix a broken hip. the standard anaesthetic technique in that hospital was to give a general anaesthetic supplemented with a local anaesthetic (epidural).

the general anaesthetic went smoothly but i had some difficulty with the lumbar epidural, resulting in the accidental puncture of the dura. instead of abandoning the epidural & just have the general anaesthetic, i proceeded against better judgement to attempt again at a different (higher) level. after administrating the full 20mls of the local anaesthetic, true to form, the blood pressure crashed & the patient heart stopped. resuscitation was unsuccessful.

i can't tell you how angry i was with myself for such a novice mistake. maybe i was indifferent, maybe i was over-confident but i will never, ever forget how a lapse in concentration resulted in this unnecessary death. one good thing that came out of this was the unwavering support the consultants gave me, even at the inquiry for peri-operative morbidity and mortality.

i want to believe this made me a better doctor today & that death was not in vain.

Tuesday, August 01, 2017

Last day.

Having worked at the hospital for 25 years, from a shoplot practice to a new independent medical centre, and then to be part of a major healthcare chain, you'd think she'd be missed when she finally retires.

Truth be told, I can't remember the last time I have worked with a nurse so obnoxious, I just dread if we had to assist surgery in the same theatre.

I won't miss her. Seriously. Honestly.