Tuesday, May 23, 2006

About my non-blogging work

KHANG n. work

I have received a number of e-mails requesting me to write more about myself. There is a temptation, I must confess, to write about absolutely everything that I encounter on a daily basis: the books I read, the TV shows I watch, the people I meet and the work I do. Blogging is so much easier like that. But I refuse to write anything personal. Simply because I enjoy the blog-anonymonity and the virtual identity a blogger can create. Blog-writing for me is a modern-life therapy. This is not a Freudian slip, I will explain what I meant by therapy.

This blog is special for so many reasons. It has given me a creative platform, that I do not have in my working life. It has given me a voice, that I feel I am lacking in my haste to build my career.

This time only, I will fulfill those e-mail requests. I will write about myself and my profession.

I work in a busy Accident & Emergency Department in London. I have been a doctor for almost 4 years and have climbed up the ranks by pleasing people, passing exams and putting in more working hours than rest. No, I am no different than most newly-qualified doctors, I just happen to land myself a Senior position in one of UK busiest A&E departments. We see 100,000 patients a year (I will let you do the maths and work out how many we see each day- this is the formula: [X + Y/T]/R). Whatever.

In my mind, this is the most honest job in the world. Hence a dream job. There is nothing more satisfying then to fix a broken person and return the guy to society.

Let me take you on a journey through a day in my working life and I will let you decide which is more intense: a episode of the TV series ER or this. Let's choose a day you might also remember.

Saturday, 13 May 2006. FA Cup Final Day. West Ham v Liverpool.

Wife woke me up because the alarm didn't. Dinner has been prepared. My ultra short hair makes grooming and washing so much easier.

Sat on dining table. No time for conversation. Apart from the occasional nods of culinary satisfaction.

Out of the house. 5 minutes' walk to the train station.

Train arrived on time.

Arrived at the hospital train station. 6 minutes' walking journey to the hospital. The town was quiet. West Ham must have lost the Cup Final. "It's going to be a quiet night" I said to myself. I checked the score on my mobile. 3-3. I must have missed a good match on telly. "West Ham lost on penalties".

I could hear football supporters chants on the way to work. These West Ham supporters are gonna wash their sorrows by boozing themselves silly. I brace myself for the night ahead.

Arrived in A&E department. It looks very civilized for a Saturday evening. I gave an open palm gesture to Nurse Mary. She said,"I know. It may not be busy now. You just wait." The smile on my face quickly faded.

On the A&E shopfloor now. I cleaned my stethoscope with an alcohol wipe. This was more ritual than conscious effort.

I did a quick check on the number of juniors we have this evening. I have one doctor on Kids Casualty, three on Majors & Resus (for medical and surgical emergencies) and three on Minors (for trivial, non-life threatening injuries). Well-staffed. Good start, no sickies.

Spoke to Charge Nurse. One senior nurse called in sick. Never mind, we will soldier on.

I saw six cases in Minors, six cases in Kids and two cases in Majors. Pretty straight-foward so far. Ankle injuries from sports. Facial injuries from alleged domestic abuse. Metacarpal fractures from punching door (a West Ham supporter! The door was fine he reassured me). One non-cardiac chest pain. One asthmatic. Diarrhoea and vomiting in one-year olds.

I needed a short coffee-break. I don't smoke, so my vice is caffeine-based.

"SENIOR DOCTOR TO RESUS!" I was summoned to the Resus area. An ambulance arrival is expected in 8 minutes. "What's coming in?" I asked (in my Kuching accent of course).

"Thoracic stab wounds!" Came the prompt reply.

"How many?" I demanded more information.

"At least 2."

"Ah. 2 stab wounds."

"No." The nurse corrected me. "2 patients".

"In that case we need to 2 resus teams. Have you put the call out?"

The Resus nurse looked at me as if saying,"OF COURSE!! YOU DO YOUR JOB DOC, I DO MIND!"

We have assembled two teams, the other team was headed by the Surgical Registrar. I have been in trauma call countless of times but the adrenaline rush is still palpable, albeit more subdued.

The paramedic brought in the two stab victims. The room was quickly taken up by helpful junior doctors, nurses and curious-looking Police. Being the trauma lead also means that you are responsible for crowd control in the Emergency room.

"Can those not involved please leave the room?" Even the Police were starting to get sick hearing my voice. Sometimes, I think a deeper voice would have given me more authority. And looking like a young Chinese foreign doctor also does not lend strength to my Senior position.

We worked on those patients in a methodical textbook fashion. Non-nonsense. Everyone knew their role.

"Check the mouth!" I gave my sea-captain-like orders.
"Is the trachea central? Percuss the chest. And then ascultate."
"Pulse? BP reading?"
"What is the GCS? What is the pupil response?" "What do you mean you cannot get blood?"

STANDARD. And absolutely no room for creativity.

We were in the CT scanner for full body scan. There were multiple stab wounds. These two men were lucky that no there were no significant injuries to the organs.

The radiologist picked up a minor kidney contusion in one of the patients. That's kidney bruising to you and me. "Insert a urine catheter and monitor the urine production". The young nurse looked at me puzzled. "Never mind, I'll do it." I offered.

Half-way through my 12-hour shift. This was my 6th continuous working day. I was exahusted; we were exhausted, but people were still coming in. The drunks, the pub fights, the old and confused ones... the list doesn't stop.

We were told never to discriminate anyone when it comes to emergency treatment. But I have little empathy for drunks and heavily intoxicated souls after ecstasy or cocaine use. My junior sensed this in me and they would normally see those drunks before I even go near them.

I needed another coffee-break.

Continuous cases of alcoholic casualties. Also saw a young lady in her early pregnancy with bleeding problem. Picked up a couple of flu cases. It amazes me that people rather wait in A&E for everyday flu symptoms then to just rest in their warm homes. Saw a distressed 6 month-old child with unstable knee-patella joint. Sutured a scalp wound. Saw a diabetic emergency and drove the sugar down with the insulin syringe driver.

My rest hour. (Time to check my e-mails and see what kennysia and The Star have to say about the world)

Saw three more cases. I take twice as long to see a case at these hours. Spoke to a depressed man, who had earlier stuck his head out on a train platform. The train narrowly missed him. He looked shaken and remorseful. I didn't need another morbid tale in A&E. We saw a decapitated body in the morgue last week. The dead guy was more successful in his suicide bid. This one survived it and desperately required psychiatric evaluation and support.

The junior docs this evening were excellent. This was luxury, not getting pestered by queries and request for help every hour. By 8.00am, I was mentally and physically drained. Ready for home and bed. To get myself ready for Day 7 of another 12-hour shift.

Some paper-work before home.

This is why I don't write about work and about myself. And this is why blogging is such a healthy escape from reality. Did I say blogging was a modern-day therapy? Most definitely.

I will be back this time next week! See you after my Indian Ocean holiday.

SISUAHLAI CHARITY FUND UPDATE: Let's swap our way to RM5000/-!

Francis H20 was the first swapper, are you our next?



Anonymous Anonymous said...

v. cool

May 20, 2006 8:58 PM  
Anonymous AJ said...

Thanx for sharing,Doc. ;p

We'll catch up again after ur well-deserved break. :)

May 21, 2006 10:22 AM  
Blogger Sisuahlai said...

Thanks again. More pictures and entries soon.

May 21, 2006 2:21 PM  
Anonymous Laksa said...

have a great holiday, bro. LXG is kinda dry without your input...

May 23, 2006 2:32 PM  
Anonymous Hijackqueen said...

Wow! With all your schedule like this and you still have time for a nice blog. Kudos!!!

p/s: All this while I thought you are a female.

May 24, 2006 1:10 PM  
Blogger Pink Cotton said...

wow...im gonna stop complaining about my job from now on 'x'

May 24, 2006 2:07 PM  
Anonymous AJ said...

SSL & Laksa...Weiseh! You guys have your own League of Extraordinary Gentlemen...I must kowtow to both of you. :p

May 24, 2006 3:29 PM  
Blogger robin said...

i gotta admit... u blog pretty well for a doctor with sugh tight schedule !!! Simply amazing...
didnt know you are a doctor though.. didnt know u are in UK !!

May 25, 2006 12:27 AM  
Blogger FH2O said...

Thanks for sharing. Nice post. :)

I'd heard snippets of rumours that you were a doctor but now you've confirmed it! To their credit these ppl were good at protecting your anonymity! ;)

May 29, 2006 3:06 PM  
Blogger Kelly Siew said...

I admire ur aspiration to be working at A&E and one day in A&E sounds even more intense than the esipodes in ER or the book 'House of God'! Makes me embarrassed that I don't have such high aspiration. then again, what am I to think so much, I still have to get thru my semester 9 exams!

thanks for dropping by my site. I'll be sure to make ur site my daily reading!

Post more!

June 09, 2006 1:58 PM  
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