Dap's Rant Space

To my beautiful friend,
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I love the fact that I have you to be silly together with. It takes the edge of all these being adults business and responsibilities and impossible standards being thrown our way. It's unfortunate how sometimes the going gets real tough, but the tougher gets going. It's unfortunate when sometimes we have to cry. But I just want you to know that I'm always available for running around at night with Dog, for the cafeteria RM2.30 chocolate ice cream, for the chicken dances, for the going all starry-eyes in Belle's or Popular, for the bleeding money Starbucks mornings, for the cds in the car moments, for toasts in Kopitiam. It goes without saying that I'm always around if you need a hug, or a pair of listening ears. I just draw the line at tapai. Nasty stuff, that.
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I'm glad we're doing this together (including the whole idol crush on Dr Spiderman and the freezing Sunday morning walks to St Mungo's back in final year). So skip along now, or do your chicken dance. I think you're awesome, and don't you forget that, or let people lead you to think otherwise.
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Love,
Dap

Ok, guys, Dappy means business. So I'm plopped on the bean bag on the bed, case notes on the right, BNF within visual field and paeds protocol on hand. I'm ready to start working on the clinical case presentation this Friday (yes, it's already Tuesday, I know!)
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But first, social obligation to update this stuff. (And I know trying to do work when I'm on the bed is hardly going to lead to anything productive but I'm so tired and I still need to get this done so there's gotta be a compromise somewhere.) Anyway. I haven't been around much due to forensic, which is all over now phew. So as of Monday, I changed stations and for the next 2 weeks I'll be in the production unit, followed by 2 weeks enforcement. I'm missing paeds, so I've been going in and out, doing part-time clinical in paeds on my own accord, to clerk a few more extra cases and to do follow up. Had lunch with the paeds specialist head by chance, and went back to ward to see Dr Spiderman with the sniffles. My little J is fighting off the pseudomonas, my chemo guy is temporarily discharged home before his next chemo course, my neph syndrome boy is already on prednisolone, my severely malnourished girl is finally moving about, they still don't know what's wrong with pale little baby girl who likes my earrings and little A with the rashes and with fits.. they just found out he has a tumour in his brain so that's quite sad.
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But yeah, clinical case this Friday so I'll be presenting one from the clinical month in paeds. Such sessions are notorious, so let's hope I won't look too shabby as a Swiss cheese after the whole thing is over. Banyak tembak-menembak going on, but not as horrible as That One Friday that left the interns all fuming. But I'm determined to show courage under fire. Go, me.
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Weird transition from clinical where there's life and human emotions to the sterility that is production. It's so odd to be sitting in that unit removing shoes and wearing slippers provided if you please. Spent the last two days referring to master formula and provided assistance (by sticking labels) while making potassium chloride by the 200ml-bottles. The chloroform in it made me dizzy for a bit. Played with a huge 19G needle and a syringe to practise making amphotericin eye drops. I really wouldn't want to make any needlestick injury with that. Met my old friend the sterile room with its HEPA filter, laminar flow and UV light so everything is strictly aseptic in there. Haven't done the whole spacesuit thing since FMT in Semester 6 when everyone was all giggly looking at each other in their inner wear. Idiota.
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I was given an ultimatum of sorts by the housemates today. Farewell trip to Brunei this weekend or else. But to the family and to Tiki, you must be happy I chose you guys, because I prioritize and I promised, and yeah, how many more farewell events for the same person la dey. So, Swiss cheese or not, whee! weekend home again for me, and I really need to start working on it. Ta.

The boss is contemplating an A&E project which means 12-9pm shift for the PRPs. Frankly it scares me a lot, because what am I going to do when I get thrown in that acute, emergency setting. I certainly am not trained for that, but at the same time, the prospect thrills me. But it's all just talk for now, so we'll see how it goes.
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Third last day of paeds medical oh I'm gonna miss you lots, and you too you doctor who appreciates me. It's tiring sometimes, but most of the time it's pretty rewarding. Today was one of those uninspiring days, but I got through it. Spent the first two days of the week in Kuching for the forensic course. Pretty cool seeing the IMU batchmates from SGH (Sarawak General Hospital), especially Wei Meng, who is apparently hot stuff and the most eligible bachelor around haha! (this is for fellow P105-ers benefit) and Cherie Lai and her look-like-denim skirt. It feels like IMU lecture hall, just a bit, and it was comforting like that. I think I miss my batchmates.

Someone told me yesterday that she is envying the glow on my face.
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Why, thank you. It's the combination of the weekend mental recharge, so to speak, and the fact that I had a baby with sickle cell anemia who got transferred to ICU. Sometimes I wish I am not so christina-yang about the patients I have to clerk. But the fact is, when 80% of admissions are due to asthma exacerbations, tonsillitis or febrile fits; it's hard not to get excited when you see a baby being given thrombolytic, because then you start to question why. Until you figure out sickle cell anemia can cause stroke, so 3 y.o. with a suspected stroke is whoa.
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But yes, you still can envy the glow on my face. My weekend was goood. (Plus I went to this new facial place which was amazing, especially on the shoulder massages.)

I'm standing at the crossroad. I don't know what happened today, but I'm finding myself standing now, at the end of the day, at the crossroad.
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How do one gain the wisdom to judge what things in life are worth fighting for? When picking battles, how would one know which to go for? How do one gain the courage to change the things around them? How do one gain serenity to accept the things that one have no power to change?
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I love this hospital, but I loathe the politics. I hate. Hate. Hate.
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Which is why I'm at this crossroad. My Christian side beckons me to forgive, to tolerate in silence, to pray for thy persecutors. My human side however begs me to lash out, or at least, speak up so maybe things can change for the better.
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I want respect, I have my dignity, I have my integrity. I want to be able to look at you with respect and not with fear (plus respect can only be earned). I want to be not sick when I look at you. I want you to tell me when I make mistakes, not pick up the phone and bitch to your other cronies what stupid thing I did today. Tell me. Inform me. Reprimand me. Do not go behind my back. Do not let it simmer. Do not make it personal. This is a professional relationship, you have to tell me when I do mistakes, because first do no harm. This is not about you and me, this is about the patient we're treating. Which part of patient-oriented service don't you get?
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Ugh. Seriously, you guys are supposed to be seniors and the preceptors, dang it. So teach me.
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Teardrops threatened to spill in the workplace, not so much of anger, but of tiredness and frustration. So which road to take now? Speaking up needs courage, but so does forgiveness. When in doubt, always decide for the greater moral good. You and I know where I'm supposed to go from here, but dear Lord, this is the hardest thing to do. When all I want to do is put my foot down and stand up for myself. When all I want to do is to hold on to the anger which I feel is very justified.
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But because I know this is what you want, I'm praying for the desire to forgive, for the grace to be humble, for the strength to keep on smiling during hard times and for family and friends' shoulders to cry on when it gets too tough. And I also thank you for the seniors, the good ones who try to protect us from the bad eggs. I thank God that at least I know there are people who have my back.
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Because this is the higher road I know I must take, eventhough my human instinct that yells self-preservation says no, I will take it, because this is the only road that can lead to anywhere worthwhile.
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I'm sorry you readers have to see/read me when I'm like this. It's just that it really has been a trying day. But I'll be better, it's weekend soon and I'll heading home. :)
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Afterthought: Thank you, Lord too, for Vanessa. My nicest moment today was when she saw my distressed face when I put down the phone, came over and linked her fingers through mine. Thank you, because that was a great comfort, looking at our fingers interlaced like kids, our hands swinging lightly as we walked away from the office.

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.