Wednesday, November 05, 2014

Letter 713: Anecdotes on a Spartan Life

Facebook seems like a lifetime ago. When, once, I had spent too many unnecessary hours scrolling through my Newsfeed, clicking the "Like" button on certain pictures and status updates, browsing wonderfully shared pieces of writing and sharing other articles in return, I now have no time for frivolous activities as such. The funny thing is, though, I don't miss it. People have been known to go on "Facebook fasts" (as evident by their status updates-- how about that!), and I wonder if they came out of their fast feeling digitally detoxified to a certain extent? My last activity was almost 4 weeks ago, and although I sometimes have the urge to post ultra-adorable pictures of my dog, I just haven't felt like doing so. The most active I've been lately is posting birthday wishes on Facebook. And I'm quite contented with that. 

The other day, I almost walked 10,000 steps just wanting to get one sheet of paper laminated. That's right. One sheet of paper. First, I approached the theater secretary, who confirmed my suspicions that we didn't have a laminator in theater, so she directed me to the Stores area around the back of the building. Took me a while to find the Stores Manager, who then said to me they could provide stationery but not laminating services, and that I needed to go to Administration. Walked from the back of the building to the front of the building and round the corner to where the newly built hospital wing is, which houses administrative staff in cubicled corners answering phone calls in hushed tones. The pervasive sound in that area has always been the fervent clicking on the keyboards-- all those emails to send, memos to draft and distribute... must be hard work, because no one could tell me if there was a laminator in the Administration area. After circling the area and finding no answers, someone said to try the old Adminstration offices, so I walked back to the bowels of the hospital, making my way to the old offices, only to be told by the girls there that the laminator is housed in Switchboard. At this point in time, I didn't know if I should be mad or laughing, so I did both-- I laughed madly. And people wonder why I don't go to the gym. Shaking my head and suppressing a sigh of frustration, I headed to the Switchboard operator, who eventually confirmed the existence of a laminator. All that walking for one sheet of paper. That night, I tucked into a bucket of KFC without the slightest bit of remorse.

I think it's all the walking. And the long periods of fasting. Some days I feel like I've lost weight, and I'd be craving greasy foodstuff such as pad thai or a good ol' pub burger with chunky fries on the side. I went to the tailor's the other day to get my bridesmaid's dress altered, and had to take 10cm off the bust, the waist and the hem, respectively. Two of my colleagues asked if I'd lost weight, and I said no, I didn't think so. Maybe I'm re-distributing my fat in other places. Damn you cortisol.

I buy books. Lots and lots of books. I just never have time to read them nowadays, although I am continuously deluded by the possibility that I would get to finish at least one new book by the end of this year. It's hard to read a proper book when your choice of reading material is a medical journal when you're in the toilet, or a textbook when you're in the passenger seat of the car. New titles sitting on my shelf since August, some read, but mostly untouched, are:

1) Christopher Hitchens- Arguably
2) Alain de Botton- Religion for Atheists
3) James Franco- Palo Alto
4) Italo Calvino- Invisible Cities
5) Nassim Nicholas Taleb- Antifragile: Things that Gain from Disorder
6) Charles Bukowski- Hot Water Music
7) Anthony Marra- A Constellation of Vital Phenomena
8) Paul Auster- Leviathan
9) Haruki Murakami- Colorless Tsukuru Tazaki and His Years of Pilgrimage
10) Mikhail Bulgakov- The Master and Margarita

The flipside of being so assiduously immersed in my new role is that I have a newfound appreciation for slowing down. Many moons ago, while hurriedly making my way to the labour ward for an epidural, I remember my mentor-- who was strolling 10 steps behind me-- telling me this, "Jun, you walk too fast. When you walk slowly-- like I do-- you'll live on a different plane of existence." At that time I brushed his comments off with a nervous laugh, as I was keen to get on with the epidural. Over time, his words stuck with me, and that was how I started winding down despite my insanely hectic roster. It was probably why I started doing yoga. Yoga came to me one day like an awakening. It is my form of meditation, just like archery is to celebrated author Paulo Coelho. Frankly, I have not mastered the art of sitting still to meditate. Being more of a doer than a thinker, I prefer to be a little bit more active. Yoga provides that perfect balance for me. The most soothing action, I find, is that first act of unrolling my yoga mat on the floor. I try to practice yoga at least 3 days a week after work, and although that is not always possible, it has helped me achieve a sense of inner peace which I did not believe was possible within myself .

Colonoscopies [noun, plural of colonoscopy]: a surgical procedure where you can literally suck the shit out of people.

Medicine is not just about saving lives. We all know this from as early as our medical school days. It's about that human touch. Reaching out. Asking if they are alright. Yes, it is always glorified on TV-- we all know that taking a patient to theater doesn't just happen at the snap of a finger; you have to ring the theater nurse-in-charge and argue firmly explain why they should open up Theater 3 for you when there's a possible Caesarean section happening or an emergency lapatoromy being prepped as you speak. You then have to ring the anesthetist up and have a bloody good reason for him to come in at 10 o'clock at night to put your patient to sleep. You also have to notify the nurse-in-charge of the ward or the bed manager so that they can find your patient a bed when you're prepared to wheel him out of the operating room. If you think your patient needs ICU support, you must also convince the ICU people why they should turf one of their sickies off to a normal ward to make space for your post-op patient. And of course, no doctors-- emergency or trauma teams-- would actually have the time to wait outside for an ambulance to pull up so that they can be the first ones to wave a pentorch over their eyes and dramatically declare that they're "coning" and that we need to "move them to theater, NOW!!!". Television is so misleading.

Long, languorous Sunday afternoons aren't supposed to be spent doing exam questions. They are meant for picnics in the park, or curling up on the sofa with a good book and a mug of green tea. They are meant to be fallen asleep upon, gently easing into their soft, quiet folds so that when you wake up a few hours later, Sunday afternoons will still be filled with that muted glow of the setting sun, delicately plucking you out of your mid-afternoon slumber. That's right. Long, languorous Sunday afternoons aren't supposed to be spent doing exam questions.

Me: So, what was the reason for this kid's circumcision again?
Surgeon: Parents.

After turning 25, we'd all know someone in our generation who's pregnant or who's already a member of The Parenthood. It's even more ineluctable with the omnipresence of social media in our lives: the 12-week ultrasound scan of one's fetus on Facebook, the X-Pro-ed photo of a smiling kid on Instagram, the picture of a newborn circulating on Whatsapp group chats... Suddenly, everyone's attending baby showers, gushing over the new lightweight aluminum stroller like it was the recently-launched BMW i8, and throwing #oneyearold #birthdaybashes for their kid who's probably not going to remember this event as much as their social-media-savvy parents. Well, here's the thing: I was watching Sex and the City re-runs on Saturday night TV, and Season 1, Episode 10, titled "The Baby Shower", resonated with me when it comes to Carrie and Miranda's opinions on babies and "The Motherhood", as Miranda aptly names it-- the cult in which "they all think the same, dress the same, and sacrifice themselves to the same cause-- babies". It's not that I'm terrified about being a mother, but the knowledge of antenatal issues (reflux in pregnancy, hyperemesis, anaemia in pregnancy-- hello, I'm already frigging exhausted as it is-- weight gain, pelvic pain, back pain, gestational diabetes, pre-eclampsia... do I need to go on?), as well as being privy to what happens during labour and delivery, is enough to put me off. I like kids (most of the time anyway), but I'm afraid I like dogs more. My dog is my baby, and lately, he's been sleeping with us, in our bed. His favourite spot is that narrow space between my husband and I. And this morning, in that dreamy state of being half-asleep and half-awake, I realised that my dog had scooted up next to me and was resting his head on my chest, his heading bobbing up and down along with the rhythmic rise and fall of my chest. As I snuggled closer to my husband, who had turned over to give me a cuddle, I drifted off to sleep again, my hand on my dog's back, with my husband's arm draped across mine, and it felt as complete as a family could be.

Thursday, October 23, 2014

Letter 712: Private Conversations in Public Places

There is a Gentle Giant in town that every one fears, loves and respects at the same time. His 7-foot frame towers over most dwarfy townsfolk, and his booming voice commands instant attention. Yet for all his gargantuan physique and seemingly contumelious demeanor, he is actually a softie who makes clown faces at toddlers and is an invaluable teacher in the observations of human life:

Lesson 1
On the passing of meconium and the subsequent splatter of fecal material all over the sheets during a routine vaginal delivery, and my aghast reaction to it:

"Don't worry Junnie. It's just Vegemite."

(Yeah, except Vegemite tastes better -__-)

Lesson 2
On the benefits of having 2 cars:

"So, Junnie, I had a flat tyre as I was coming outta my driveway."
"So I heard. Did you change the tyres?"
"Nah, I just changed my car."

Lesson 3
On the Psychosomatic Back Pains that come in full of angst, wanting repeat scripts for narcotic analgesics and/or specialist referrals:

"So, about that lady with the back pain..."
"She's mad."

"Oh, you know the guy who wanted a referral to see the neurosurgeons...?"
"He's mad, too."

Lesson 4
On the failure to retrieve a baby via Ventouse suction from a primigravid woman's birth canal:

"Aaaahhh... FUCK!!!"

Lesson 5
On me being too hard on myself for missing a potentially fatal diagnosis:

"Jun, we all make mistakes. Look, I make mistakes too, but with my experience, I may make less mistakes, but nevertheless, I still make mistakes. We make mistakes because we're tired, we've had a long day, it was an unusual presentation, or, like you, we haven't got much experience. In time, you'll learn that no doctor is perfect, much as we all like to be."

Lesson 6
On me inducing a vasovagal reaction after attempting to insert a cannula into a guy:

"Young lady, do you always make men pass out in your presence?"

Lesson 7
On the mushrooming of speed cameras in town lately:

"Jun, beware of speedos."
"Well, do you want another speeding ticket in the mail?"
"Oh... you mean speedos as in speed cameras, not the swimming trunks!" *facepalm*

David Duchovny in Speedos that are now worthy of its place in the Smithsonian. #hotdamn

Lesson 8
On the dangers of being a surgeon:

"Surgeons don't know how to treat diabetes; they don't know how to treat asthma-- all they know is how to cut up a lesion or a body part, and leave the bloody mess to the physicians!"
"And your point being...?"
"Jun, Jun, Jun... I'm afraid you're starting to become one! Ain't that scary!?"

Lesson 9
On handling stoic, obstinate German stock:

"He's German, and you don't tell Germans what to do. They tell you what to do... So he wants to see Dr. L instead of Dr. W? Fine. Refer him to Dr. L then."

Lesson 10
On managing the pediatric patient:

"Most of the time, you don't really treat the kid. The key is to treat the parent."

Lesson 11
On managing hyperchondriac/ overanxious patients or those with significant fixation of symptoms:

"... In addition to her UTI, she's also got significant fecal impaction, which I think is most likely the cause of her constipation as there's no history to suggest other causes. Are you happy to give her Microlax (enema)?"
"Nah, just give her some Augmentin Duo Forte-- she'll probably get diarrhea and that'll settle her constipation as well as her UTI."

NB 1: I wrote this piece in my intern year, under the tutelage of a mentor who would later have a profound influence on my career choice.

NB 2: I've had this post in my Drafts for almost 5 years and have refrained from publishing it till now, not because I had anything else to add (what you're reading is exactly the same from 5 years prior when this post first materialised), but because there were 11 Lessons and the Obsessive-Compulsive Perfectionist in me didn't like how there was 11 Lessons and not 10, 15, or 20. 

NB 3: So why am I publishing it now? I realised my last few posts sounded quite sombre, so I wanted to make you laugh. 

NB 4: Are you laughing? Why not? At least I know how to manage diabetes now. And asthma. Pfft.

NB 5: And also because I kinda miss this specialty and all the lessons it has to teach. Especially Lesson 5.

Thursday, October 09, 2014

Letter 711: Carrying On

There are days when you just want to listen to a whole playlist of sad songs just so you can cry. Days when you feel like one cup of coffee is not enough, so you have another, and another, and another, and before you know it, you've had your 5th cup by 2 in the afternoon, and you're still yawning away. There are days when you are so exhausted to the point where you cannot sense your limbs, and you walk, disjointed, like a zombie whose legs are leading its torso down corridors assaulted by the stench of blood and urine, and haunted by the ghosts of people long dead from the endlessly futile effort at saving them. There are days when your mind becomes an empty sphere, devoid of all ability to focus, because it's been overflowing with all sorts of topics you've had to study for, and yet it's telling you that this is not enough, that you should have, and could have, done more. There's always more to do, more to learn, more to remember. And there are days when your heart tells you you're doing the right thing, and that deep down you're a good and kind and strong person and that although you can't change the world, you harbour the hope that one day, the world might change just that little bit, and that people will start to become more understanding instead of shouting at each other across the operating table, and that people will help another human being in need because it is in our nature to reach out to the helpless, instead of demanding for something in return. There are days when you sort of lose faith in your fellow human beings because they are so horridly self-centred, and then there are days when you sort of lose faith in yourself because where has all this kindness led to? To nothing but deeper cuts to your fragile heart. 

Today is one of those days.

Sunday, September 21, 2014

Letter 710: Late Nights/Early Mornings

I sometimes have this irrational, inexplainable feeling that something bad is about to happen. A fear of the unknown. And lately, it has been bothering me a lot more than usual, but the annoying thing is, I don't know why, and I don't know how to swat it away like a summer fly. It's been eating away at my diligence and sucking my energy levels dry, so much so that come weekends, I'd wake up in bed early, fall asleep again, wake up at the first rays of the sun, fall asleep again, and wake up when the sun is harshest at noon. And then I'd hate myself because I'd wasted the whole morning in bed. It's almost as if I'd fallen into a tunnel of my own undoing, a dark, narrow hell hole in which the light is a million miles away, and I can only pretend I've morphed into a field mouse again, tunnelling my way through the darkness with trepidation and a small sliver of hope that I'd find my way out, once more, a little scarred, but at least overall, a whole lot stronger. 

Sunday, September 14, 2014

Letter 709: An Ode to McDonald's

Disneyland may be the happiest place on earth, but if there is one happy place in my world, it is McDonald's, birthplace of the Happy Meal and pleasantly soggy shoestring fries.

I came to this particular conclusion on a particularly disheartening Friday night when, at merely ten-past nine, every local establishment we went to in search of a late dinner was met with the phrase "I'm sorry, our kitchen's closed". The bartender at the local pub was a little more gruff as he uttered these words while wiping down the carefully polished oak counter, whereas the bright-eyed bespectacled waiter with the magenta hair at the local bakery was a little more rueful, apologising for the fact that he could only serve us desserts and nothing savoury from the kitchen.

Tired, grumpy, and having no other choice for chow except for fast food, this was how we found ourselves pulling up at McDonald's and stepping into its brightly-lit entrance, which is always a welcoming sight for hungry souls from all walks of life. The idea of eating fast food (again) repulsed me, but we had no food in the pantry, and the only other alternative was to whip up some instant noodles at home, which neither of us were keen because we were both exhausted after a long day at work. So it was either going to sleep on an empty stomach, or going to bed with a full-fat meal digesting in the pits of my belly overnight. Neither option appealed to me, so that made me even more grouchy than Oscar the Grouch. What the hell kind of a Friday night is this when you can't even find any food at 9pm at night? Not even bar snacks FFS! 

As soon as I stepped into McDonald's, though, something magical seemed to have instilled a renewed sense of joy in my sullen core. Although I wouldn't refer to 9pm as "late", I have spent many a late-night in various McDonald's across various locations in Australia-- this one included-- chowing down on grease that may have contributed to my increasing LDL levels but making memories that will last a lifetime: post-clubbing, post-birthday celebrations, post-drinking sessions, post-accidents, post-oncalls, during oncalls, pre-exams, post-exams. I have also spent a portion of my daylight hours growing up in McDonald's: there was the first McDonald's my mother took me to (at Gurney Drive), the McDonald's where I celebrated my 16th birthday with the person who would later become my husband (on Ipoh Road), the McDonald's where I first experienced a McCafe coffee (Hindley Street), and then there were the various McDonald's in which I stepped in just to buy a chocolate sundae on warm summer afternoons, or the ones which served as pit-stops for coffee breaks along the stretch of unending country highways during our regular road trips. 

Capitalisation and commercialisation have, to a certain extent, created a safe haven in my world, a place where happy memories are conjured alongside Happy Meals, a place I could count on to curb my hunger pangs when every other place has failed to do so. It is a place where I seldom see any unhappy children, and it is a place where adults can retreat to for a quick catch-up over coffee, or just to have some me-time flipping through the newspapers and sipping on Diet Coke. It is a place where school boys bring school girls out on dates, and it is a place for school kids to study. It is a place that appeals to the young and the old, and in that, it is a place dear to my heart.