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HOUSE OFFICER LUNCH

Can I remember my lunch during house officer time? 

Every morning at 5.30am, my alarm clock from my beloved BlackBerry phone rang( I missed BlackBerry era),  it's time to get up and start working again.  The water feel so cold even when the heater is on.  Taking shower with my eyes closed. 
Put on my shirt,  pray,  lab coat ( when was the last time I wash that coat?).  Not a big problem,  I will change to a new one later at my hospital.

5.50am. Trained to do thing quick in just 20 minutes I'm off to work.  I will have my breakfast later in hospital. Luckily my house just a traffic light and 2 round about away from hospital, i will reach hospital at around 6.00 am. 

Work start at 6.30 am but when you start working at 6.30am, that means you are already late.  The heck to that,  I am off work at 12 midnight last night,  I don't care if  I am late or not in the morning!  Unfortunately,  I do care... With 70 patirents cranked up in the ward with us only  5 house officer,  it could not be worse.   2 house officer are dedicated to acute ward taking care around 10 acute cases.  Oh,  I hope it's my rotation in acute ward!  They sure are busy but we...? How can we see 60 patients in 1 hour? 
Damn it! when one of our team MIA ( missing in action).  Granny die I supposed.  Every week there will be someone's grandmother die.. How is that even possible? So 3 of us now with 60 patients.  

They will be no team meeting or whatsoever,  everyone know what they are doing,  just go and do work.  Doesn't matter what happen,  you need to see this 60 patient.  Prioritize first, the one that need to be seen urgent need to be seen before our medical officer arrived.  See patient does not mean just look at her face and say are u ok? ....  See patient means,  ask them if they have any problem, listen to their weird complain, physical examination, and  write everything in the case note. 

 F--- it when you open the case note and you see last night plan..! 

 FBC BUSE/CREAT CM.

 That's mean you need to withdraw that patient blood for test.  Heck! I only have 30 minutes and another 20 patient to review.  Fock this guy who plan this last night..! That guy is me, myself.  Damn it!  I should have prepare the form for the test, at least, but I am too tired to do so before I went back last night.  Drawing blood means putting your safety precaution gear on,  prepare your needle and syringe,  whatever you need,  then explained to patient what you are going to do...

Suddenly that patient said,  "wait doctor,  I feel tired and nervous.  I'm phobia to needle and blood,  can you wait for a moment?" 

No lady I don't have a moment,  give me your damn hand or I stab your heart with this syringe! I wish I could say that,  but this is professional line of work I am doing.  So,  i will reply with a smile,  jot down her name and bed number,  and I will be back later to entertain her.  I really have no time now.

So,  as usual,  morning end up with a lot of scolding as we did not finish our review ( WTF!  We only left the last cubicle with 6-8 patient inside.  We complete most of our work.  Or, we were scolded due to no blood test were taken! ( I forgot that damn lady who have needle phobia.  I promised to be back but I never did).  Breakfast as usual consist of scolding by our MO.  Our sister and mother name frequently involved,  poor them,  they must be still asleep or having a nice breakfast at this moment.  It's 7.30am.


8.00 am,  if there is department meeting they will be held at this time and if not, specialist will come at around 8am to 8.30am. We We will have our second breakfast at that time.  More scolding by specialist.  Our real breakfast,  we haven't taken it yet. 
Specialist round usually drag till 10 AM, that's clinic time.  The boss need to go to clinic.  Perhaps specialist also rushing in his or her work because they also have so many thing to do.  That's why they always angry... I comfort myself.  It's not me.  It's not me. 


So,  the unfortunate one will stay in ward and complete all the work,  all the order that need to be carry out,  do cpr for that dying patient,  and the lucky one can go to clinic. 

It's not that lucky after all,  there are 300 patient waiting and you will have no time to even shit or pee.  Our work in clinic is pretty simple though,  just clerk patient,  then discuss with our MO or specialist,  she will recheck whatever you have clerk and give plan.  It's pretty simple.  Just that we need to do it fast.  If not,  the clinic will drag until afternoon.  You don't want to do that.  You want to take your lunch.  I've already skipped my breakfast. 

It drag on...   At 3 pm,  only a few people left. Medical officer will discuss where they will take their lunch.  There a few decent restaurant near the hospital.  I love the chicken rice restaurant.  The chicken is tender,  variety of side dish... But wait,  our MO already left...  We house officer,  our place now, is in the ward.  Nobody ask if we already had lunch or perhaps breakfast for God sake! 

With empty stomach,  back to ward.  Afternoon review already completed by the staying HO in ward.  How can she and he finished it?  Well evening round usually a bit more simple. Just update the plan that you have done in the morning.  MO ward round at ongoing around 3pm. Finish if no problem by 4 or 4.30pm. Usually we need bed for new admission so we need to discharge patient.  Usually 20-30 patient discharge after morning round, the time when we enjoyed ourselves in clinic.  The ward HO must be having inflammation with their hand muscle discharging all patient.  Yet they will be another 20-30 admission by lunch time.  So no lunch for them also.  Now the ward is full again,  we are here,  the 5 of us including the MIA HO (finish burying his granny I supposed).  Our job now is to discharge another 20-30 patients as ordered by MO or specialist.

It's 4.30pm. Patient and their relative already lining up in front of the counter.

 "how long do we need to wait?" says says the the angry son of of patient. 

"you all makan gaji buta ka? Buat kerja pun lambat.  Tadi pakar cakap jam 2 sudah boleh balik!! " says another angry son of of patient.  

Yes,  specialist said that at 2pm maybe but she or he is not the one who going to finish the paper work.  We do.  Discharge mean,  summarizing all the notes we have made everyday,  writing a right diagnosis,  write the medication,  sign all forms and blood test result to make sure we did not miss anything.  Then the nurse need to record their name,  get appointment date for them and then double check the case note again if we miss anything then discharge.  This will take around 10-15 minutes.  Sound quick.  Repeat the task for another 30 times and when your case is at the bottom of the stack,  you just need to wait.  Be patient. We won't drag you until morning.  We won't postpone the job to the next day even if we missed our breakfast and lunch.

5 pm,  hopefully everything turn out to be ok.  Discharge almost complete.  Maybe we should take turn and get some food to eat.  Hell no.  I do not know why time like after 5pm, patient choose to Desaturate, to collapse,  and here we go again running here and there.  The drama continues...

It is usually at 7pm,  when our work finished,  check our oncall list and we are not oncall.  Look around and pretend that we did not see that oncall fellow resuscitating a dying person, then we can get out and get some food.  
 
But I just could not let my friend there alone (usually only 1 person oncall per ward) pumping that person chest.  In the end i end up helping him,  owed him when I'm oncall,  he use to stay to help me shock a VF patient.  I need to help him.  A patient doesn't matter anymore when you are tired,  your friend is, because they are the one who are going to help you in need. Honestly though.  I really don't care about that dying patient anymore. He or she wouldn't make it.  But my friend will be there the next day. 

As time goes,  it almost 10 pm,  I am tired.  My hair look like I'm just woke up in morning after getting drunk the previous night.  My unwashed lab coat stained with fresh blood adding to the collection of old stained blood.  The lab coat room already closed so I don't care,  I will use that back tomorrow,  the heck if it's stained with hep B virus.  Who cares? Infection control did.  But why they closed that lab coat room so early.  I will change the lab coat early in the morning tomorrow.

As I drive through the closed restaurant nearby the hospital(that chicken rice place closed at 9.30pm, the only open restaurant is mamak stall selling curry full of germ as they cook that curry in the morning- I will still ate that! ) I have a thought. Is this the dream life you dream before you choose to be a doctor.  Before you click send on that online application form to enter medical school?  

No! I never thought my life would be this hard. 

But i will still do it because I already chose this path.  Why I keep this path?  It's a lie if I said I want to help people,  to help patient.  Patient is the utmost important thing.  I lie if I said that.  I lie if I said I'm in it for the money.  We are overworked and underpaid,  where's the money at?  I lie if I said I'm in for the title doctor.  Calling yourself a doctor will only invite many laughter at you.  Who respect doctor anymore?  Look at the news,  the social media,  doctor is the one to be blamed.  I feel ashamed bearing the title of Doctor with this kind of people nowadays.  Most of the people nowadays!  Nobody trust a doctor anymore. They trust pilot more than a doctor.  A pilot ask not to smoke,  nobody smoke in airplanes.  Doctor ask not to smoke,  patient will ignore like we never say it or we never exist.

Why I'm in this game? It's because of the experience.  The knowledge that I gain with all the experience I had.  The reality I realized when I'm at work.  To see how sick is our society,  literally not just from the illness but the sick mentality they had. The more they deny modern medicine,  deny our advice, the more they will reveal how poor our education are in this country.  The poorest education people usually the one with more knowledge. The one that bring Wikipedia printout or whatever anti vaccine or anti modern medicine site they found over the Internet. 

That is why I keep staying in this game.  And somehow someway I will always keep my oath to save a patient life and you don't need to worry about that,  I will save your family first before seeing my sick baby daughter at home for sure.  This line of work is still professional and it always be professional. 

So...  What is my lunch when I am a house officer?  I could not remember because I rarely had it.







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