Unapologetic and Unavailable

What happens when you stop explaining your choices? Most stress is self-inflicted, and a huge chunk of it comes from narrating your life like you’re on trial. The moment you stop explaining your choices to everyone within earshot, your blood pressure drops and your calendar clears. You don’t need to justify your haircut, your job switch, your Saturday plans, or why you left a group chat. You’re not a defendant. You’re a grown adult. Act like it. We’re trained early to provide […]

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Comfortable in My Own Chaos

Daily writing promptIf you could be someone else for a day, who would you be, and why?View all responses If I could be someone else for a day? Hard pass. I don’t need a celebrity joyride, a billionaire flex, or a spiritual pilgrimage inside somebody else’s skin. I’m not auditioning for a different life. I built this one. It’s mine. Flawed, loud, dog-haired, caffeine-fueled, and completely paid for in experience. Why would I trade that for a rental personality with better […]

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Pensamiento de Oscar Iglesias “¿En que me convertiria?”

Sugerencia de escritura del día Si pudieras convertirte en otra persona durante un día, quién querrías ser y por qué. Ver todas las respuestas

Sinceramente y la verdad hay muchas veces que quisiera otra persona, por la cantidad de cagadas que cometo en la vida, desde luego es verdad que muchas veces quiero escapar de mi mismo, pero hoy hablaré de en quien me encantaría convertirme, bueno hay tantos hombres y mujeres, sobre todo del pasado, que admiro, hoy se me ocurre mencionar unos cuantos, en la política, mis referentes son duda son Pepe Mujica, Julio Anguita o José Antonio Labordeta, de lo que se conoce de ellos por supuesto, porque yo no soy partidario de crear ídolos, porque idolatrar a alguien da píe a que si luego tienen una vida oculta caerse ese mito, pero ellos sin miedo a equivocarme han demostrado una coherencia con las ideas que han practicado y predicado y eso les da muchísima credibilidad y valor, en el fondo también y es verdad todo el mundo busca buenos ejemplos y referentes.

Otras referencias por ejemplos como escritores por supuesto quisiera tener esa capacidad poética de Federico Garcia Lorca, Mario Benedetti o Pablo Neruda, en la pintura quisiera ser Pablo Picasso o Salvador Dalí, en la ciencia por supuesto Albert Einstein es el referente de los referentes, como activista una mujer Simone de Beaviour, en la música Elvis Presley, Victor Jara, Silvio Rodriguez, Bruce Springteen y me dejo muchos, que admiro pero insisto no idealizo, porque idealizar es un grave error.

Feliz fin de semana, amigos y amigas, un gran abrazo.

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My First Tagging On-Call Shift As A Floating Medical Officer

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My first tagging oncall shift was on a Sunday with a fellow medical officer I knew when I was a House Officer in General Surgery. Back then, he was having his attachment in General Surgery.

Just like a House Officer, we had to undergo a period of tagging.

In the Department of Plastics and Reconstructive Surgery at Sarawak General Hospital, I had to undergo a tagging period of one month, every other day (EOD). This is because, I am a newborn medical officer with no previous experience in General Surgery (as a Medical Officer).

This is an advantage as I would be able to learn as much as I could within a span of 1 month. However, it was also a disadvantage as I’m afraid, I would be burnt out mentally and physically considering the on-calls were on every other day (EOD).

“I can do it. If others could, I could too.” , I repeated this mantra to myself but the learning curve is going to be an extremely steep one.

During my first tagging oncall, thankfully, it was with a fellow senior colleague who I was rather comfortable with.

We started with our morning ward rounds followed by passover and peri-rounds. After we were done, we went back to the ward to settle our pending job-lists followed by lunch.

As a tagging on-call medical officer, the first call would be to me for referrals. After which, I would discuss with my senior and proceed to see the referred patient together. After reviewing our newly electively admitted patients, pre-op rounds with surgeon and demarcating the op site and pre-op meeting, we went back home in the evening and returned at night together for our night reviews which we updated in the Department’s WhatsApp Group on the progress of certain patients. Incidentally, a patient whom we were awaiting for op was called into the operating theatre and the operation ended at 2am. Finally, we returned home for the night.

I was nervous of course as I usually get anxious easily. However, I took my shower and headed to bed.

My phone was kept beside me in case I were to receive calls or referrals. At 6am, I returned to the ward and started our morning reviews as well as prepared for our morning rounds.

Since, it was a Monday, it was morning ward rounds, handover and peri rounds as usual. However, since I was still tagging, I was expected to stay till 5pm or to join the ongoing surgeries.

Thus, my first postcall was spent in the operating theatre assisting till 6pm. However, despite the ongoing operation, I excused myself to return home and rest.

The following day will be another one, thankfully, not oncall but within office hours.

Thankfully, it was a good call with a fellow senior that I was comfortable with in terms of approaching in regards to my doubts which was undoubtedly, many.

I can only hope that I would be able to survive this whole month of tagging.

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My First Day Of Locum And As A Medical Officer

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A locum or locum tenens, is a person who temporarily fulfils the duties of another; the term is especially used for physicians or clergy.

– Wikipedia.

The first time I ever tasted or ventured into locum or a so-called “part-time doctor” was on the 3rd of August 2025.

At that time, I was back in my hometown and on a 3-weeks-break post housemanship / internship at a small private clinic, yet to officially begin as a Medical Officer.

While I was in medical school, I would occasionally hear this term “locum” from my fellow seniors or batch mates, lecturers, parents or even friends of my parents. However, in order to locum, one would need to be fully registered with the Malaysian Medical Council (MMC) and possess a valid Annual Practicing Certificate (APC). In short, I had to graduate medical school, finish my internship or housemanship first, then only am I able to dive into this.

Thus, upon acquiring my full MMC and APC licence, I was looking forward to locum. Looking forward to it as well as nervous to dive into this. Thankfully, I had just completed my final rotation in the Emergency and Trauma Department.

In the Emergency and Trauma Department, there are various zones in which the patients would be triaged into in terms of presenting complaints, severity and their vital signs. The least critical in severity would be triaged into Green zone. The Green zone is similar to a clinic setting, thus, it gave me some idea on the type of cases I would be expecting.

My first locum was just 3 hours long, from 7pm till 10pm. I figured that since I am just starting at that time, it would be better to start with minimal hours in order to get used to it and also.. if I would enjoy it.

The clinic was quaint and small but equipped with basic necessities and a scan machine. The only thing that it did not have, was an x-ray facility. The moment I sat down, the patients kept coming back-to-back. As soon as I was done with one, another came.

For a first-timer, I felt it was equivalent to the Green Zone in General Hospital whereby the cases were always there but the patient load was manageable.

However, I was extremely scared.

Mainly afraid that I might accidentally jeopardise the patient’s safety in terms of mismanagement. Thankfully, by 9:30 pm, the clinic assistant stopped accepting new patients and prepared to close the clinic.

For a first experience, it was a good one despite it being rather terrifying for me.

But, we all have to start somewhere and build our confidence, don’t we?

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Day 1 Of My Final Posting – Day 647 Of Housemanship

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My first day of my final posting, The Emergency & Trauma Department, commenced on the 11th of April 2025.

Day 647, finally. Finally! I’ve pulled through and entered the last pit stop of my journey as a House Officer.

In every posting, I have always looked forward to this posting. Prior to joining, I’ve always had mixed feelings and initially wanted to join Anaesthesiology. However, a few weeks prior to entering, the other postings such as Psychiatry, Klinik Kesihatan and Anaesthesiology were removed from our options and everyone had to rotate in the Emergency and Trauma Department.

This is good. This meant more manpower.

However, just as the previous postings, prior to joining any new department, I’ve always had this fear and mixed feelings because it is after a new environment.

My fear was stumbling too badly on my first day. Thus, of course, I did my research and questioned the people I knew who were already in the posting.

My First Day began on a Friday in the “Yellow Respi Zone“.

The Yellow Respi Zone consists of patients who are unable to saturate well under room air, usually less than 90%. Having just completed the Medical Posting, the patients allocated there are primarily Medical patients or in particular, having respiratory issues such as patients developing acute pulmonary oedema or fluid overload secondary to non-compliance to their fluid restriction.

Thankfully, I have just completed Medical. Thus, I am able to apply my knowledge learnt which was still fresh at that time.

I arrived a little before 7am since the tagging shift is from 7am till 10pm, introduced myself to the medical officers and talked to a fellow friend who arrived and would be working in the same zone as well. I went through the triages and casenotes of the patients to see if there were any active cases or cases that were due tracing of bloods or referrals.

The day started off rather quietly and it was manageable. I followed the morning handover rounds at 7:45am and after that attended to any new patients or refer if needed.

Basically, when a patient comes in, especially to this zone where the patients’ chief complaint is “shortness of breath“, the first person who attends would usually auscultate or “listen” to the lungs and check the vital sigs prior to taking blood or doing a “full clerking” such as obtaining their past medical history or history of presenting illness.

The next person that steps in usually helps with the bloods and fills the forms.

Everyone worked together as a team and somehow indirectly we were communicating with one another without actually voicing it out. It seemed almost like a dance, or a workout.

Afternoon came and afternoon handovers started at 2:45pm. I met a lovely medical officer who is a junior herself but one who was extremely upbeat and more than happy to guide me.

I learnt a lot during my first day with her. She even encouraged me to consider joining this department during my floating period.

The evenings became extremely busy to which I did not really realise. Maybe because it was my first day or maybe because I have just completed my Medical Posting (and it was much busier over there), or perhaps because I simply enjoyed working with my superior or team on that day.

The day ended at 10pm and I walked back home. Thankfully, I lived within walking distance thus I saved time and did not have to worry regarding transportation or parking issues.

My first day in my last posting or rotation started off well which is something I’m more than thankful for.

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Surviving 10 Days Of Tagging | Emergency & Trauma Department

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My tagging days in my sixth and final rotation, Emergency and Trauma Department, lasted for a total of 10 days which was from the 11th of April till the 23rd of April 2025. This is excluding our one “off day” for the week.

Did I manage to last throughout the tagging days?

Not quite.

I did take a sick leave during my second week of tagging. The reason was that I was just extremely tired.

Photo by Pixabay on Pexels.com

The tagging hours in the Emergency and Trauma Department is from 7 am till 10pm, just in other postings.

The good thing about this department is that we do not need to do morning reviews. Thus, coming way early prior to our shift is unheard of. We merely come and leave on time.

However, considering that it is the Emergency Department, things are unpredictable whereby things could be quiet one moment and hectic the next.

Hence, on days which burn, it can be extremely tiring. But, completing these tagging days are a must and so on slow days where the hours seem to pass by really slowly, I make it a point to have an “hourly toilet break“. On busy days, it may be the only time that I am given a chance to sit and breathe.

On top of that, I made sure I took my lunch and dinner break. Not because I was hungry as I was used to having my meal for the day after work. It was merely my way of spending my time during my tagging days.

At 10pm, the shift is over and I leave, even if the floor is busy because the following day my shift begins at 7am again.

Finally after 10 days of “tagging“, I have finally off-tagged and shifted to “shift hours“.

Photo by Andrey Grushnikov on Pexels.com

There are no assessments in order to off-tag. as there were in other postings, which is a good thing. However, tagging in this posting felt long and seem to went on forever for me. Perhaps, this was because I was mainly tagging alone as I entered a month later than my fellow peers.

Nonetheless, I was glad to be done with this schedule and shift back to a regular 12-hours shift.

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My Last Shift As A House Officer in Medical | Housemanship Diaries

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At the time of writing this article, I am no longer in my Fifth Rotation, Medical but already in my Sixth Rotation, The Emergency and Trauma Department and at the same time, due for my last shift in my Sixth rotation as well as being a House Officer.

Looking back, my last shift in the Medical Department seemed ages ago.

However, I remembered that I was night shift at that time and was at Male Medical Ward (MMW).

My duration working in this ward was around 3 weeks. However, it was my least favourite as compared to Medical 3, Medical 4, the Infectious Disease (ID) Ward or being part of the Perimedical team. The superiors were alright but it was the vibe of the ward in general that I found unsettling that I can’t quite place my fingers on.

The night shift in Medical is from 8pm till 9am. However, on that day, I recalled leaving home at 6:30pm to go to work as we were not allocated any “long day” shifts.

“Long Day” or “LD” are those who work from 7am till 10pm. Thus from 6pm till 8pm, prior to the night shift person coming, there is a 2 hours gap which is filled by them.

On that week, there were no “Long Day’s” and everyone had the opportunity to return home at 6pm. However, who would fill in the “2-hours gap”?

Thus, I remembered me and my colleagues at that time coming into a mutual agreement and compromise that one person would stay till 7pm and the night shift person would arrive an hour earlier at 7pm.

It was a good compromise except there would be nobody to accompany us till 10pm and usually their help is valuable. Those hours till 10pm can get rather hectic at times.

I remembered arriving around 6:45pm and started receiving handover from the AM teams and was cautioned to lookout for a particular patient in the acute cubicle who was rather unstable.

Upon finishing our handover, the Medical Officer on-call for that ward arrived and things started to go hectic.

I can’t exactly remember what happened but I was on my feet the whole time and did not begin my “coming mornings” till 3am.

Thankfully, I was still able to complete them before 5am and the morning bloods were out in the system on time.

That morning during my post night shift, I was “summoned” for minimal bloods which I completed immediately. Usually during my post night shift, I would remain within the sights of the “AM team” and offer to help out where I could.

But I remembered at that time that I was completely spent. I decided to rest in the House Officer’s room and take any bloods a little later prior to my shift ending, if there were any.

Surprisingly there were none after that. I recalled seeing a junior taking the blood of a patient as I was exiting the ward and asked him as to why he did not just ask me.

He claimed that upon arriving for his morning shift, I looked rather spent and after I left to take a short break in the House Officer’s room, he just did not want to disturb me. After all, he said, it was only one patient.

I was touched and grateful. It was a small gesture. However, it’s small, simple things that sometimes touches you.

After that, I clocked out for the last time as a House Officer in the Medical Department.

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Preparing For My Exit From The Medical Posting As A House Officer | Housemanship Diaries

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Medical. My Fifth rotation.

While I was in Medical School, my favourite rotation was the Medical Posting and I’ve always imagined myself being a Medical Officer in Medical.

Thus, upon entering my Housemanship Journey, I did not choose to rotate in Medical as my first posting. Many people said that the Medical Posting is the most difficult posting of all the postings due to the patient load as well as the workload.

Thus, I began in Orthopaedics and placed Medical as my Fifth Posting. Mainly, because I wanted toenjoy it. Enjoy it in the sense that I already knew the basics and knew how to function as a House Officer and would be able to learn how to manage the patients.

However, albeit being a senior poster, some old habits retain. In the Medical posting, we were required to hand in our logbooks 2 weeks prior our End of Posting Date.

However, I approached my mentor 5 weeks prior my exit. Unfortunately, my assigned mentor at that time was not available and asked me to approach my Specialist-in-charge of House Officers at that time to request for a new Mentor.

I approached the Specialist-in-charge and was assigned a new mentor which happened to be someone I worked with multiple times while I was in Medical 3.

The following week was a rather tensed week for me as I tried my best to cram as much as I could.

I finally had my assessment with my first mentor who is a Medical Officer that Sunday. Thankfully, I passed.

2 days later, I went for my assessment with my second mentor, my reassigned specialist, who passed me as well.

The issue next was the completion of my 12 CMEs. CME stands for Continuous Medical Education which occurs once a week on Tuesdays. In other postings, only 5 CMEs were required in order to pass. Sadly, it is not the same for the Medical Posting.

Unfortunately, CMEs done online were not acceptable even if there are certificate of attendance.

Luckily, I had attended a Hospital CME some time ago and I was only looking for ONE more CME prior to my exit of this posting.

Thus, I used that to my advantage and finally, I was able to hand in my logbook and officially exit the posting.

Sadly, a few days prior to my exit, something occurred that led to the demise of a patient. But, that is a story for another article. Thankfully, that did not affect my exit from this posting and I exited, on time.

If you are due to finish the Medical Posting or any posting in general, take it as a lesson from me and approach your assessors much earlier.

Otherwise, all the very best!

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Surviving The Night Shift In The Medical Posting In General | Housemanship Diaries

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The shift that I have always dreaded but enjoyed the most were the night shifts. I dreaded it because I knew that I would be alone most of the time and afraid that I would not be able to cope with the adrenaline rush or anxiety or the craziness that might ensue. However, I enjoyed it because that meant that I will be able to sleep in prior to going for my shift and the following day at 7am, the morning team will start arriving and I am not alone anymore.

The Medical posting in general is a “heavy” posting because of the patient load. Almost all of the patients are so-called Medical patients once Surgical, Orthopaedic, Psychiatric or other causes have been ruled out, and it could stem from something as simple as electrolyte imbalance to myocardial infarction or stroke.

Thus, imagine the amount of coming mornings.

Prior to entering this posting, I’ve always enquired and listened to my fellow colleagues’ input and experiences. Most of them would say that “In the Medical posting, the rule of thumb for surviving the night shift is to start taking the bloods as soon as you arrive for the night shift”.

True enough. That is something I have practiced since and even in other postings as you do not know just when something may happen and next thing you know, the sun is rising and your coming mornings are late and the morning team have arrived and the bloods are still pending or not in the system or yet to be taken and the medical officers and specialists have arrived.

Sadly, when there is a delay in the blood investigations, there is a delay in management.

Thus, it is a tachycardic moment for me. Prior to entering my shift, I would screen through the coming morning list and upon arriving, I would usually prep my trolley, ensure my coming mornings are divided and arranged according to their cubicles, ensure enough syringes and needles are set aside as well as the alcohol swabs and cotton swabs.

Then, I will begin taking my coming mornings, usually working my way from the back of the ward then towards the front cubicle, subacute cubicle and finally, ending with the acute cubicle.

Usually in between, something will occur, maybe a patient newly admitted into ward or a patient will suddenly be hypotensive or hypertensive or hypoglycaemic or starts throwing up or wants to have a small talk.

Normally, I would not mind entertaining them. However, if I’m still due to complete my coming mornings, I would proceed to complete it and I usually will not rest until I do. At least I’ll be rest assured that should anything occur in between, I would not have to worry about the completion of my coming mornings.

The night shifts can be rather unpredictable as one minute it can seem rather quiet and calm at first and hectic the next. At times, it can get overwhelming as well.

However, have faith and know that help is always nearby and start taking your bloods as early as possible.

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