when you don’t like what’s happening

In the medical field, your seniors are like idols… Supposedly they are put there on that spot to inspire you, so that one day you can be in that spot too to inspire the juniors that follow you.  Like in any typical medical series like Scrubs or Grey’s Anatomy though, there are those seniors that are just out there to get to you, to make your knees weak so that you’ll realize that you are not cut out to be a doctor.  These people I have learned to handle.  You just take what they say, let it go in your left ear and out the other ear.  These things should make you a better person, because like the saying goes, “What doesn’t kill me, makes me stronger.”

But this article isn’t about the power-hungry residents of teaching hospitals… It’s about the other kind of terrible doctor.  The ones that are in my opinion, unforgivable, and should never be copied.  They exist.  I know for I have seen this a lot.  But never to the extent like the one I saw yesterday.

Right now, I am rotating in the OB-GYN department.  It was a relatively benign time, and so I decided to take a breather and read on my case.  Then I heard yelling from outside of the Labor room.  It seems that a knew patient has come in.  The difficult kind.  Not the annoying arrogant type, but the silent type with mixed and confusing answers.  The patient was pregnant, but did not seem to be in a healthy state.  She kept her eyes low and refused to answer directly.  I could tell that they wanted to know the answers quickly because this patient looked like she could die that very night.  She had bruises on her body, with one particular bruise on her pelvic area.  And as this fragile patient sat on the wheelchair provided for her, some of my seniors (no names promise) swooped down on her.  They started yelling at her to make her blurt out what really happened to her.

In Tagalog, they said:

“WHY ARE YOU COVERED IN BRUISES?! WHERE IS YOUR HUSBAND?!”

“YOU KNEW YOU WERE PREGNANT AND YOU STILL DIDN’T GO FOR A SINGLE CHECK UP?!”

“HOW MANY TABLETS OF MEFENAMIC ACID DID YOU TAKE?  3?! DON’T YOU KNOW THAT’S BAD FOR YOU?!”

“YOU ARE THE MOST DIFFICULT PATIENT WE’VE HAD TO INTERVIEW THIS WHOLE NIGHT!”

This patient apparently never went for a single check up for prenatal care because she had no one to go with and she didn’t have any money.  A few days ago she was severely beaten up by her own husband for reasons she would not divulge.  This result in blows to her pregnant abdomen, cause her placenta to bleed (abruptio placenta).  For the pain, she took Mefenamic Acid 3 times a day for 3 days which caused her to start vomiting blood streaked material (NSAID induced gastritis).  They are also thinking of a coagulopathy or bleeding disorder (Disseminated Intravascular Coagulopathy) that could potential kill her.  And because of this, her 21 week old fetus was already dead for days inside her womb.

I could see why the residents were stressed about this patient, because she wasn’t a typical pregnant patient that they just had to deliver.  There was going to be a lot of explaining and managing to be done.

But I just couldn’t see why they had to resort to verbal abuse.  To think that this patient already suffered so many injuries from her own husband who probably verbally abused her as well.  Patients see us doctors as saviors right?  I could already see your faces shaking in disappointment.  I couldn’t help but feel ashamed that I was a witness to this embarrassing deed.  I don’t mind getting verbal abuse from my seniors because I know that they just don’t want me to make fatal errors in my own practice.  But verbally abusing patients to teach them to seek help urgently?  Do you think that patient is going to come back to such a mean doctor again?  I don’t think so…

There are just some things that I could never stomach.

I told my friend Hannah about this… She told me that there are just some people who are all brains but no EQ…  They know all the diseases and management, but when it comes to patient communication and rapport, they just don’t cut it.

I know I got a lot to learn regarding textbook knowledge and clinical practice guidelines.  I am just an intern after all.

But if there is one thing I will never forget, it’s that there are problems that you cannot solve by yelling.

If that’s what I need to be in order to be a smart doctor, well, no thanks.

Please don’t let me turn into them…

it must be the hormones…

That must be it.  My unstable hormones have caused my dramatic self to go haywire again.  I realized one reason why I was so happy yesterday.  It’s because I did things that required me to think of only those things, hence the problems that I had were put aside.  Well today, I had too much silence.  Silence in a mall?  Yeah, when you’re alone it can be pretty silent.  You’re head wells up in thought.  Why am I walking in a mall when I have no intention to buy?  I know I don’t have any money and yet I am here, looking at all those expensive things.  I guess it’s the dream.

Why did I ever go into that movie theater?  I used to go to the movie houses by myself a lot during med school.  That’s how I was deemed a schizophrenic by my colleagues (just because it was mentioned as a description of a typical person with a schizophrenic personality in one of our classes).  I guess I was just real curious about that movie “Sweeny Todd: Demon Barber of Fleet Street”.  One thing made me snicker as I bought the tickets though.  The lady (who was not as nice as that barista from my previous blog entry), was highly suspicious of my age.  Sweeny Todd apparently was an R-18 movie.  She looked at me with those crunched up eyebrows of hers and asked me if I was in college or high school.  I stared at her with disbelief and told her “Maam, I am a post graduate student.  I am a doctor!” and that made her HESITANTLY give me a ticket.  Honestly, do I really look that young?  Is it my fault that I don’t wear make up and that I never grew that tall?  Not that I’m complaining.   A lot of people would give whatever they had for my youthful face (hahahahahahaha…)  Then again, a lot of patients wouldn’t take me seriously either because of this same face.  Instead of calling me “Doctora or Maam”, the patients would call me “Ineng” (a Tagalog term for “little girl”).  4 years of college and 4 years of med school and months of internship, and I get the title “Ineng”.  Fantastic right?

I am getting a flight of ideas again…

Then I went to Starbucks to get a glass of iced cafe latte… best to drink either while you are studying or if you’re having a chat with somebody.  Seeing as I was alone that day… The fact that I was in a “socializing” area made it worse.

This is what happens when you are stuck, or shall I say “married” to your career.  You got friends in the inside, but it’s rare for you to hang out outside the walls of the hospital… Come on, they got other better things to do.  This is what happens when your old friends have gone and got married to their own jobs.  It’s damn hard to make a schedule just for a chat over a cup of coffee.  In a few months I’m gonna be high-tailing out of this country.  As exciting as the ending of my internship is going to be, it also marks the ending up being a student.  My friend known as MacGreen said in her recent blog entry, that we are nearing the age of unemployment.  Right you are sister!  Allowance… GONE.  But the point is, right now, I miss having a constant companion.  A friend (or a more than friend) that’ll be waiting for you on a coffee shop down the street with a book in hand to greet you with a warm smile who will ask you how your day went.  Why don’t I have one of those?  I got roommates… Obviously with their own lives to run.  I am not even asking for activities that require doling out money.  I just want to sit in a coffee shop (or in my dorm)… or in SOMEBODY else’s dorm… to HANG-OUT!

If my parents see this (which they probably will knowing that they know my blog address) they are probably going to think that I am now really hormonally imbalanced or mentally unstable.  Is this DEPRESSION?  As much as I love family gatherings, being with a friend is something that seems so easy to acquire for others but for me it’s something really difficult to attain.

I must be the saddest bloke in history…

I bet I wouldn’t even be writing in a blog if I had any good friends to talk to.  Whenever I try to talk to my roommates (no offense guys you are the best and I don’t expect much from you…) I feel like I am always interrupting their studies.  We laugh a lot, but bonding?  I don’t think so.  How about your own colleagues at work?  That’s the point… They are your workmates… if you complain to them about work, I bet they are just going to say, “Well you’re not alone sister, we are going through the same shit.”  How about family members?  My parents are going to say “Well that’s medicine for you… Stick to it, if they can do it you can too.”  Well that’s beside the point.  I know I can do it, it’s just that I want to mope for a while.  You can’t expect me to be happy and chipper everytime I cure a patient.  That’s SICK!

Writing all this stuff down made me realize why I am so lonely.  I got this friend who I used to hang out with all the time.  Must have been one of my best companions.  But years ago, we got into some problems and we just lost touch.  We started to talk years after, but we never saw each other again personally.  Even if I offer myself as company, my friend would say “Sorry” or “No, thanks”.  You don’t need company.  I didn’t want to act so direct, but as I sat in Starbucks tonight, I sent her a message through my cellphone.  I told her that on Monday, I was available.   I’ll be off work, so we could hang out, unless she had a date or has plans with the family.  It was her birthday on Monday.  I wasn’t expecting her to say yes.  But I was hopeful.  Well, she declined my offer.  She didn’t have any plans on Monday, but she also didn’t feel like celebrating.  Truth is, I wasn’t just offering my company so that she will be happy on her birthday.  I was offering my company because I needed company.  Yeah, the bigshot doctor (or the lowlife intern) needed to have some friendly conversation time.  Can’t a girl have some girl talk for a change?  If she ever found out that I wrote a blog about her for the whole world to see  she is probably going to bury me alive.  But hey, I have feelings too… Hard to believe, but yeah, I was hurt.  Our friendship has come to a point where I have to choose my words when I talk to her.  It has come to a point where I have to offer my time, when I used to be just THERE for her, no need for stupid invitations to hang out.  When you are friends you just HANG OUT!  You don’t fling yourself to a friend for them to notice you… It almost came to a point where I just wanted to tell her “HEY!  I know you got problems, but maybe you can set them aside for a while and comfort ME for a change?”

Friends put aside their own problems to stand by their comrades… It’s a give and take relationship right?

It’s 12:04 AM… I still don’t have somebody physically to talk to…

Let me ask you guys… Do I have to tell her directly that I want to hang out with her because I miss our friendship, and because I am the one in need of company?

Sometimes I just wish that somebody new would come along…

I never ever replace my friends…  I just open up my heart for new ones that’s all…  But it looks like that chair across mine at the coffee shop will remain empty for a long long time… That chair beside me at the movie house is empty too…  That did it, I am officially a trainwreck.  Still with all of these emotions… I don’t even qualify to be a diagnosed case of Major Depressive Disorder.

I gotta get up for work in 5 hours… Might as well just sleep to forget my problems…

Message me if you wanna have a cup of coffee…

happy

You read a lot of blogs that talk about how crappy their lives get (my blog included), but there ARE days when you just can’t help but view yourself like you are like those people in vitamin commercials that say “More energy, mas happy!” (translated as more energy means more happiness).  These are the days the keep you moving forward.

After a long and tiring 24 hour duty in the OB admitting section, the day started about great for me because I did pretty well during the summary rounds.  As predicted, they asked me most of the questions since I was the only one decked with a patient last night.  And with the little time I got to read, I was able to survive the interrogation.  YES!!! Man, you have no idea how much my shaking hands and tired face with my unkempt hairstyle seemed to glow after that.  Students like me live for this moments of triumphs.  Because unlike people who are par excellence, there are people like me, PLAIN ME.  The student who just gets by.  Damn, it really felt so good.

I went home and immediately fell on my comfortable bed… With luck I was able to wake up just before I met with some people for a coffee-shop transaction.  I hurriedly went to the nearest Starbucks cafe and ordered my usual Java Chip Frappuccino, and there he was: the kind barista.  Not just kind, but I-am-happy-to-be-a-barista-and-I-am-not-just-being-kind-to-make-you-come-back-for-more-coffee kind.  Our conversation went like this:

Barista: So are you a UP student?

Me: Yup.

Barista: That’s cool.  So what are you studying?

Me: Medicine.

Barista: Ahh… Are you a first year or second year?

Me: I’m an intern already.

Barista: Wow! You look so young!

Me: Naks.  Thanks for the compliment.

Barista: Cool.  Enjoy your coffee!

I am so easy to please right?  Sometimes a compliment can seem so fake, but sometimes it can be the best thing you should hear after a tiring duty.  Work makes you forget to take care of yourself.  But when a complete stranger compliments you on your youth, then it makes me light up all over again…

Next happy story?  Don’t worry I got more.

As I sipped my Frap, a familiar face walks up to my table.  Nikko Faller!  My childhood friend.  He tried to teach me tennis when I was young, and I didn’t really do well.  Anyway, it’s been 7 years I guess since I’ve seen him.  He stroke up a conversation with yours truly.  He told me that he is almost done with his Nursing course.  He asked how I was doing, and I told him that I was ok.  A reunion with a good old friend is a treat!

Then late tonight, I went to the gym after a long long hiatus.  I was able to join my favorite Body Jam class. The new music was amazing!  It was just a one hour workout, but I felt so rejuvinated afterwards.  All the stress was gone!  I was able to forget the ton of books I had to study.  I was able to forget that a girl like me doesn’t have a special someone (yes I think about that sometimes especially when it’s real quiet).  With all those fun people around me, all strangers, all with no inhibitions about dancing in front of people they don’t know, it felt like I was in a party where everybody was invited.  No one cared if they weren’t able to dance on cue or if they didn’t have the perfect figure or if they didn’t have the sexy hips.  People just came to dance.  ^_^

All of that happened in one fantastic Friday.  It doesn’t matter if my day is gonna suck tomorrow.  Today, I am happy.  Hope you get to have your own happy day soon. ^_^

shifting dullness

Shifting dullness… It’s actually a physical finding that pertains to ascites, or to put it more plainly it’s like having abnormally large amounts of fluid in your tummy.  But when you are talking intern-lingo, when we actually say “I am experiencing shifting dullness right now.”, we mean we are in the state of adjusting to a new rotation or environment.  Right now that’s exactly what I am feeling… SHIFTING DULLNESS.  As I probably described in my earlier write-ups, medical clerks, interns and even residents have a schedule of departments to rotate in.  Like right now, I am in my second day in the OB-GYN rotation.  I am going to staying in this rotation for 2 whole months, and then later I am going to shift to Orthopedics.  That’s where we got the term shifting, I guess.  And when I personally come into a new rotation, I become this robot that kinda acts slow, still trying to get into the natural speed of things, trying to remember what I learned last year in clerkship, etcetera etcetera.  If you’re lucky, like me right now, you’ll enter a new department on a post duty status, meaning you don’t go on 24 hour duty on your first day, and you don’t have much work to be done, so you kind of get the chance to ease your way in.  But if you’re UNlucky, you enter the rotation as a duty intern, where you spend your first 24 hours running around still trying to recall, “What labs do I have to request for again?”.  It’s like riding a bike again after years of not getting on one.  You know what to do, and you’ve done it before, it’s just taking the time to seep it’s way into your system again.  Usually it takes a week for shifting dullness to subside, but letting it get to you makes you look lost.  And so now you know exactly how I feel at this particular moment.  Tomorrow is my 3rd day in OB-GYN, and it will be my first duty in the OB Admitting Section, where I get to see people frantically wanting to get in coz their water bags broke.  Please pray that my shifting dullness is cured by tomorrow.  And as extra precaution, I am going to be reviewing from this point forward.

Doctor Beans, signing out.

sit down and think

It’s been a while since I last wrote in here.  For the past few weeks I have been on “vacation”, as a community medicine rotator in San Juan, Batangas.  I had a really fabulous time!  We got to go to beaches, sing using videoke machines, and hang out with not just our block but with other blocks in the rotation.  So here I am again, thinking about so many things, but having nobody to talk to.  Maybe YOU would like to listen…

 Idol Season 7

Whenever I go online, I think back on all the things that I have already written here.  Most of them are my experiences in the hospital, and when January comes, I start talking about American Idol a lot, so be ready for all the comments that I’m gonna be throwing at them.  It was too bad that I was still in the community when Idol season started.  I always wanted to have a chance at auditioning at Idol.  I suddenly realized that by next year I might be living in the US already.  What if I decide to audition and for some miracle, I get to go to Hollywood?  Would my parents allow me to stop my studies for a while?  It’s just for a few months… It’s not like I have the big goal of being the next American Idol.  I just want to know what the judges would think.  Will they even show my audition segment?  I have never entered grand contests like that before, usually I would only join in school competitions.  Ack, too much thinking again.

OB-GYN Internship

Today my rotation in OB-GYN started.  I got to sit down in my first summary rounds and staff conference.  Lucky me, I was too anxious last night that I got up early and brisk walked to the hospital.  Next time I really have to get up earlier than that, so I could have some breakfast first!  Like tomorrow, we have clinic time right after the conferences.  I REALLY need to get some grub time!  I think the OPD tomorrow is going to be a long one since we are still adjusting to hospital life again.  I hope the nervousness I am feeling will make me study more efficiently.  I just gotta constantly remind myself that I’ve been through OB-GYN before.

Gotta cut my thinking time short… See ya!