Tuesday, March 03, 2009

On case clerking

Ok. So turns out paeds med is a horror if you need to clerk cases. The target is 100 cases by the end of PRP year, and out of the year we'll only be doing 3 months clinical. So I need to clerk an average of 33 cases per clinical month.
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But sigh there's only so much of tonsillitis and exacerbation of asthma and febrile fits and pneumonia that I can take. And these just require some antibiotics syrup or PCM so there's nothing much for discussion, really. I spent half the day dragging my feet in and out of the ward, totally uninspired. Afternoon when I went in, I checked the register and ah-ha, new admissions. One of the babies had steroid resistant nephrotic syndrome. I was immediately alert, and to my horror, I actually found myself pumping my fist in the air. But seriously lar, I became abashed a little, for while I had a new case with potential, the case is also actually a sick patient. So my gain = his pain.
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Turnover rate in paeds is really really fast, children recovers fast. But there are 2 or 3 who are more or less permanent residents there, and sometimes when I do allow my mind to wander, I do wonder how it's like to just stay in a small room, separated from everybody else for months. How it's like to lose your previously waist length hair. How it's like to have tufts of hair today, and to lose them just overnight, the next day completely bald. How it's like to have IV lines set in both hands. How it's like to see the nurses and the doctors wearing protective measures, while setting up the infusion machine, while you, the patient, the medicine is going straight to your veins dang it, cytotoxic or not. Sigh. I hope they can get well. They're much too young to be facing illnesses like that.
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Sick kids aside, hospital staff getting their blood screened. Did mine yesterday. The lab technician who drew my blood is this dude that I dispensed for a few times in OPD. I dont know whether I imagined it, or there seemed to be a look of glee as he presses gently on my arm, looking for a vein to poke. As if he's saying haha, my territory now. He totally scared me when he said it's a bit hard to find. Then, I clenched my jaw. I remembered the 10 year old earlier yesterday who had his IV line set (in layman's term they poked his hand with a needle), and he looked so brave about it. So I gathered some courage from that memory and I watched as he slowly pierced my skin, and I watched with morbid fascination as I saw the syringe filling up with dark coloured blood. My blood. His hands trembled a little from holding on to the syringe a little too tightly. That helped the blood flow somewhat. Finally, it's done and I went home with a plaster and a bruise.
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A bit scary but at the same time I feel liberated because I dared to watch it happen this time around.

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