Saturday, 24 December 2011

My abnormal life

In my last post, I sounded rather appreciative of the whole anesthesia/critical care thing. While it's certainly not a lie, I have to admit that it's not the complete truth either. Here's the other side of the story:

This rotation drains the life out of me. I'm starting my 3rd week and already I'm surprised at how strong I turn out to be. But, Friday morning, my body totally gave up inside the changing room. I slept for half a day that day. I vaguely heard sounds of people coming in and out of that room, some wondering why I was where I was (sprawling on the floor), and at least one saying to her friend that I might be ill.

I hadn't caught the flu or ebola, so by that definition, I wasn't ill, thank you very much. But I did feel like a walking dead. For almost 3 weeks now I live an automated life. I complete my SOAP notes, I do whatever the nurses tell me to do, I march to the lecture room and sit through the entire lecture wide awake like a good student, I prep all my OR patients,... basically I still work effectively. And yet I'm isolated in the triangle of OR-ICU-changing room, and when you get isolated, you can't help but change. I change. Now, planted in my consciousness, is the new duty to be awake at the most ungodly hours. And the rising sun is a sign that the day has ended, and that it's my turn to sleep. Strange.

When I finally got some days off this weekend due to Christmas, I slept for 18 hours, with around 4 hours of medium-level wakefulness and aimless internet browsing in between. So I've noticed, to make up for, say, 6 hours loss of sleep, you can NOT just take another 6-hour nap. This thing is not mathematical. The amount of time you need to recover is MORE than the hours lost.

This cycle is made more vicious with the fact that my med school had not delivered anesthesiology lectures separately. Anesthesiology was spread out in pulmonary system, pharmacology, and surgery lectures. Before, this trick worked out nicely---my teammates and I had quite a pleasant sail through other rotations, because we are accustomed to integrating different stuff together. But in anesthesia rotation, it doesn't work too well. The logic in anesthesiology is somewhat different. So here I'm trying to combine studying from scratch for the [what shaky] foundation and cramming everything I've got for the bricks. Coupled with the currently abnormal biological clock, I'd say it's pretty hellish.

Sunday, 18 December 2011

An update, finally

Pushing away the almost convincing sense that nobody is reading this anyway, I'm gonna say that I'm happy to be back in the blogosphere.

My dentistry rotation went okay, despite the fact that one team member quit in the middle of it. Also, we (I, especially) had had a little tension with one of the dentists regarding our papers. In all honesty she wasn't the most knowledgeable dentist. I mean, she even got upset when I [politely] asked for some reading recommendations since we were running out of references. Thought we were lazy, I guess.

I quickly learnt that we should leave her alone and asked the other dentists instead. There's this oral surgeon whose knowledge about general medicine is quite vast; it was very enjoyable to discuss things with him. And then there's a forensic odontologist who is also a police Colonel. She's a bit like Professor McGonagall; stern-looking, but somewhat motherly and very considerate. She was behind-the-scene middle ground between us and the upset dentist.

All in all, dentistry is not my favorite rotation and definitely not my thing, but I did learn one or two handy stuff in there. I learnt a lot about odontogenic focal infection, and the anatomy of the jaws and surrounding structures. Everything else was nonsense to me.

Right now I'm starting my SECOND week of anesthesiology and critical care. Things have been fun, not to mention enlightening. I used to have a negative image about operating rooms. An OR in my mind had been associated with a lot of yelling and tremendous stress and a demand for impeccable attitude (and cleanliness). After spending everyday in the OR though, I manage to develop a surprising fondness for it. The environment isn't that stressful. Not much yelling going on. Maybe one or two surgeons swear to themselves when they see something outrageously strange about a patient's body (like during one case where a plate was screwed too tightly to the ulna, requiring the orthopedist to re-break the bone to release the plate), but it stops there. And only some spots have to be sterile, otherwise it's a normal floor, normal walls, normal ceilings.

So that's my little personal achievement.

Plus, I like the green. Or the blue. Is it an unwritten rule that the OR has to be either green or blue? I hope so.  The colours are very relaxing.

We do our night shifts in the ICU. It's a unique 7-bedroom place. Most patients here can't hear you, can't understand you, and can't react much. On the first days, our job is to make ourselves familiar with objects and instruments and where they're stored and how to use them. I have successfully located commonly used items such as the suction tubes, urine bags, gauzes, cotton balls, alcohol sprays, epinephrine auto-injectors, syringes, essential drugs, and examination gloves. The ICU is a simple four-sided room but some objects are so typically placed that you have the learn it in order to quickly find them.

What I dislike the most about shifts is the paperwork. But so does the greatest diagnostician in the world.

Well, until next time!