Thoughts

I think I need to tune down my bitchiness a little bit. Even Julia said I can be scary, aiyooo.

He said I can be a bit stroppy at times. Ok, I accept that. In my defence if I am not assertive and firm, nothing get done.

I can give a lot of examples, like when the nurses keep going on about low BP & afraid to give diuretics, he is peeing too much & he gets dehydrated etc.... He has aortic stenosis & drowning in his own fluids god damned it & this guy need help with his diuresis. Took us 4-5 days before his kidney responses to it. He won't do well with inotropes, trust me.

I think nurses have too much power these days. I have nothing against nurse practitioner, but they didn't go to medical school & it does make the differences. They didn't recognized red flags nor understood the disease processes. Its like when I spoke with ITU nurses why they do daily paracetamol level on patients, they said they just do it because that is what they do. That is incorrect.

Cranky & drained...

Aiyoo, I am damned tired la...7 continous working days, had 9 more to go including 3 nights & 1 on-call days.

Esok kena present in journal club meeting.

And now my consultant is getting excited about doing another presentation together in 2 weeks time.

Have to do another audit & since F offering free labour when she is doing psychiatry, might as well use it.

Again sad leaving the team. I might not get another chance to work in a team where the boss will call you an insomniac if you send an e-mail or update an e-portfolios after midnight, a possible recreational drug abuser if you sneezes/grumpy in the morning, or an alcoholic if you called in sick due do dizziness from gastroenteritis (this one for you F & I might have make an occasional mention of your rum collection.Hihi). Here to you & me, we make such a good team & I will miss us coming late to work!

This reminded me to J. Man, we are bad and J even took time on Friday to do her facial! I hope you are loving your new abode & work in London J!

A gesture

Today, my consultant makes a gesture that makes me really think - this guy really has a soft spot (like a baby sister) for me. Please don't think otherwise.

He asked what's that on your shoe? He bent down & touch my shoe!

He probably the best person I worked with, and it saddened me that I will be leaving Cardiology. I will never ever get a consultant who I can argue my case and makes my feeling totally transparent & not having to bite my tongue...He told K he thought my seniors must have spoilt me rotten when I worked at the tertiary centre.

I was really upset over a small matter when I was on-call over the weekend with another consultant who refuse to acknowledge my opinion ie you don't refer every single chest pain to cardiologist,you don't refer every single first pneumothorax to respiratory consultant don't refer every single anaemia to gastroenterologist. A general physician should be able to deal with this matter when they are on-call. Then all the dirty work of referring process has to be done by us! I was seething with anger, literally and just have to call D to get things off my chest. Not just that, not being able to make a concrete decision, I might as well be the lead. And monyet punya A&E sending patient to CCU without courtesy call to me.

And there I was membebel about all this to my consultant; didn't he knew how opinionated I was. And as a payback, I have to listen to his bebelan about social services & nursing home (we have a lot of long-stayer waiting for nursing home). The most ridiculous thing I heard is someone waiting to go to a nursing home which hasn't been built yet....And some other crazy mad things like surgeon want to dump this post-op complications on us, AF running at 65 & GP started on digoxin etc...

Man, I am going to be really sad. And I am moving to the team which I dunno which one is the worse, the senior or the most untrustworthy (with no insight)junior? So prepare for an orgy of depression,swearing, anger and tears as well in the next 4 months.

Our relatives come over from London at weekends to visit our house in Liverpool.Its a pity I was on-call. Hubby being the host & looked like they are going to come over more often! Cepat la January!

Mentally prepared

I feel much better today.

Time off, albeit short, really does wonder to your mentality and emotions.

I am going to be happy & feel good about myself. Start preparing my CV for my next year of training and suddenly realised I really did accumulate quite good experience in a number of medical specialty - cardiology is the best (loving interventional cardiology), but its not the field I dare to venture since consultant cardiology posts in the UK are incredibly incredibly competitive. Reminiscing my highlights in past years; I have learnt so much. I remember crying after my first cardiac arrest; the first months working as a doctor and how I don't feel cut out to do it,surviving my first day of F2 as cardiac arrest leader, my first patient who survived cardiac arrest after I shocked him when he went to VF etc...

I will survive this year.

And I want to go travelling the world with hubby,learn photography together and just be happy.

Some more craps...

Thanks for the birthday wishes; my only wish is actually to get away from this place.

But what do you know, as usual work & work. I have 16 days direct working days ahead of me incl 3 days oncalls & 3 night on-calls. Its madness.Some of my ST colleagues are doing nights week after week.&^$%(^#@%**medical staffing.

Not having a great today; but survive intact otherwise.K is literally having an angry fits in the ward today as all his intructions & management plans are not acted upon at all. I told him already, don't trust anyone, just do it yourself.

Me....aku paling bengang dgn jururawat yg berlagak pandai nak mampus. But because I know my cardiology, you cannot fool or push me - I know what hell I am doing. I always respected the other profession but man, don't these two really push my BP up.... We all know this duet - one incredibly annoyingly pushy person, the other one, just because he did work at tertiary centre many many years ago, think he is above anyone else...I did give him a very sarcastic comment few mths back after his very inapproapriate laugh when I sent this patient to CCU. Geram nak mampus, but I won't expand further.Nanti macam2x pulak.

Incompetent switchboard mishandle my bleep system around noon time & I didn't know people couldn't page me until 16:00.Never knew a switchboard this bad. I guess that is one good thing.

I don't like myself being angry all the time, but if bricks of shits keep falling all over and around you, and you ended up being the one who clean & mop the mess; who wouldn't?

Of note, who the hell give the power of ordering CT brain to discharge co-ordinator (esp in 16 yearr old patient who already has MRI brain twice)?? Livid, livid.

Just some crap I need to get off my chest..

Its a crappy round today.We running out of beds...and by God,I am done with this whole social stuffs..

This one patient of ours...I just couldn't put my fingers into it.Why oh why..should she have this hyperkalaemia and low magnesium. Is it just the kidney?? Why do I feel there is other explaination? Grrr....


YESTERDAY....

As I am writing this, I am currently on my journey back to the island. Before this 4 blooming hours ferry ride kills me, I am going to write these thoughts in my head. Who knows, I will look back and think its funny hahaha.

Gosh, I have become a bitter person...

My birthday is coming and all I have is work commitment to do successive weekend oncalls back to back.. Don’t ask how it ended up that way but I am not the worst case scenario. At least I don’t have to cancel my pre-booked flight and some people not even get paid for it. How night shift translates into normal working hours is beyond my imagination. I have a sneaky suspicion this is not entirely legal, so until I get all my facts right, you won’t hear much of that from me.

Our 5 years anniversary coming up and I am not allowed to take any leave cause everyone booked theirs wayyy in advanced. So I am stucked all through Christmas & New Year. Come January and they will know what hit them – evil laughter.

Leona’s version of Run reduces me to tears.

You realized what a beautiful city Liverpool has turned into watching it from the ferry over the Birkenhead side and from the flight. It feels more and more like home.

We have such a lovely weekend; I feel really sad when I left home. Keep trying to reassure myself this is temporary and only 8 months to go. We got to reminiscing our life in Switzerland a few years back and I really missed those times. I missed the train rides that take me such heavenly scenery; the Swiss German, the ferry rides across the lakes and the Japanese cuisines. One of the best memories is when the train coming out from the tunnel and the snows flakes fall on the train, it feels exactly like being inside the snowballs. And by God, I missed Paris. Note: plan holiday soon, after the interviews dates, renewing visas etc..

I can just imagine my consultant laughter if he read this, knowing I am such an emotional wreck. Hey, at least I am not the one who laughs through the whole consultation with this really funny patient of ours during our completely mental PTWR that last 4 hours straight....


He just couldn't stop teasing me about being married as a trainee (gee..what would he says if he knew I got married during my 3rd year at med school). He keeps moaning about how much his job will end up costing his marriage. I personally that we all docs have this love-hate relationship with our jobs; and no matter how much we whines about it, there is something that make us hooked like a junky.

Drained

So damned tired.On-calls.

Its going to be a crazy month anyway.Its only like 7 of us on the rota, the locum is not even safe to do nights and we all get dumped & literally coerce to do the bloody on-calls back to back.

Am coping better, but I am just so damned physically tired walking up & down to ITU, CCU,wards & A&E and the endless calls. Sorry mate, my priority is to see patient who is gonna go off first if I don't do something and I can only do my best to see who is next in the queue.

This doesn't include the gynae & surgical ward. Mentally exhausted, and this is not good.

Uh,uh...also found out in the year 2000, the island air ambulance crashed near Liverpool - I think all killed including patient, partner & the crews.

The flight

I just had to jot down my memory of my first flight to Isle of Man while the memory still fresh.

Since the direct ferry journey Liverpool-Douglas,Isle of Man has now stopped for winter months (and I now know why - refer to the worst boat journey), all 2 of us (since K flying to Manchester; that's where he lived with his wife) have been forced to take the flight or ferry to Birkenhead/Heysham.

The flight is tiny and it reminds me of Proton Saga somehow. The stairs to go into the flight is only like 4 steps,only 2 rows of tiny weeny seats on each side.I really pity any morbidly obese and any big burly Caucasian man. Thank God I am tiny.Seriously, if you have 2 obese person, they need to be repositioned so the flight is sort of balanced with the cargo.

Because it is tiny, you feel everything.

Very short flight; I think only take about or less that 20 mins.

The interesting bit is the landing.

Ho,ho. When we landed, the flight went bump bump. You know, like meloncat-loncat. Even our guest lecturer, the academic intensivist (ie anaethetist) guy from University College London Hospital said when he landed, the flight landed sort sideways and it is as interesting as his flight journey at Mount Everest camp. Seriously, if there is gales, the flight also "boing-boing sideways".

Then the annoying bit is the 20 pound taxi ride from airport to my flat. I thought this guy is blindingly tapping me dry. The journey is not far at all, if anything it is more or less the same distance from my house to Liverpool airport, and that cost less than 10 quids. Then I asked all my colleagues, and they all say yes, they are all charged 20 quids-ish for hospital-airport journey.Aiyoo..

I wish I can sign my own transport certificate.

One new thing I learn here is signing plenty of my patients air ambulance and charter flight certificates for inter-England medical interventions/treatment.. We don't have any haematologists, dermatologists, neurologists or neurosurgeons on this Island. I mean seriously, if you have blooming aneurysms, you need a lot of luck. The air ambulance probably take 2 hours to organise and if the weather is bad, you cannot leave the island at all - otherwise you risked not just killing the patients but air ambulance crews as well.

I am the ever optimistic person, ha!

The new dawn

I just couldn't stop myself from shedding a tear or two whenever the TV plays the election results, videos of the street party, people crying, Obama acceptance speech etc...

I watch and read the full transcript of his speech. Its breathtaking, in its content and its delivery.

He signifies a new hope. Every man and woman who work hard will be rewarded at the end; this is a value that many of youths of the Western world seemed to have forgotten.

Trials & tribulations

Oh, finally.

I have to switch channel in the last 2 laps; I thought he had it. Its gone, the prize gone. Then, I switched channel again, and surprised! He wins!!!

Finally Lewis is rewarded with the championship he truly deserved, despite that bodoh Belgium results.So truly unfair,when Schumacher did it, guess what? Nothing!

Truly deserving winner.

Hats off to Massa. He yearns it. Next year maybe? Of course unless Ferrari plays its 1st & 2nd player card.

I know he wins by the skin of his teeth, but he taught me a lesson. Letting go your old ghost and get on with it.