Mastodawn

My Reflection Of 2025

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2025, was indeed a year.

The year started out great, I worked on New Year’s Day as usual in the Department of Medical and in April, I entered into my final posting, the Emergency and Trauma Department. In May, I attended my best friend’s wedding.

In July, I completed my internship and received my full registration under the Malaysian Medical Council (MMC) as well as my Annual Practicing Certificate (APC) and started locumming during my holidays back home and I also started floating as a Medical Officer in the Department of Plastic and Reconstructive Surgery. It was a steep learning curve for me, transitioning from a House Officer into a Medical Officer. The anxiety increased and I was constantly tired. I remembered my love for medicine and service fading to the point I took a long break in October to recharge and reflect.

2025 was also the year, I handed in my 30-days-notice to resign but revoke it the following day. Perhaps it was too much for me, although the working environment and superiors were more than sweet and kind. Physically, I was catching up but mentally, I was fading away.

Looking back, thankfully, I did not. I celebrated my birthday before travelling back to Kuching the following day. 2025 was also the year when my relationship ended. It was a good and lovely 19 months. Perhaps, it was just time.

November was the month I received my letter stating that I will receive my placement and I needed to report for duty on the 24th of November 2025. One thing for sure, I was sure to continue serving in Sarawak. The place? Unknown yet.

On the 18th of November, I found out that I would need to report to the Health Division of Bintulu on the 24th of November 2025.

Bintulu, that’s around 7 hours drive from Kuching. I didn’t have a place to stay nor a car and my things were all unpacked and I was just extremely busy. I packed whatever I could, shipped some boxes back home, those that I managed to do and on the 23rd of November, I flew to Bintulu.

Thankfully, the doctor-in-charge of the Health Division was kind enough to let me know which place or clinic that I would be placed at.

Yes, clinic setting. I did not apply for a clinic setting which so happened to be what many others in my batch longed for. Surprisingly, I got it!

Considering the state of my mental health, I was more than ecstatic to accept it.

2025 was also the year I moved and started working in a new place and also one that speaks a different dialect. I started doing oncalls as well and surprisingly, adapted very quickly into a General Practitioner’s setting as well as the new place. I also met another colleague who was previously my medical officer in the Department of Obstetrics & Gynaecology when I was a House Officer and made new friends and acquaintances.

Overall, 2025 was a mixed of both good and bad experiences. I felt both the highs and also went through a period of low mood. New people entered my life, some stayed and some also left. Nevertheless, I am thankful for all the experiences I went through as well as the lessons learnt.

Hopefully, I can learn from the errors that I have made and grow, making me into a better person.

Thank you 2025. Now, it’s time to move on, to 2026.

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The Theoretical Doctor Jan 5

2026 – The Beginning

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First of all, Happy New Year! I hope you have had a great start to this year and if you have any New Year’s Resolutions planned, I hope that you will be able to stick throughout the year.

I did not have any New Year’s Resolutions planned as I usually did the previous years. Mainly because I have just moved to a new place, settling in with things still pending in Kuching, trying to adapt to my working environment as well as picking up on new skills.

Thus, New Year’s Resolution? It’ll come as the year progresses.

My New Year’s Eve was spent at work and mainly in the ambulance with a dear friend as well as work colleague, however, that is a separate post for another time.

As usual, since I’ve started working as a doctor in 2023, I’ve always made it a point to work on New Year’s Day, a habit which I’ve adapted from my dad ever since he has started working at the age of 18.

However, New Year’s Day is a public holiday here in Sarawak. Thus, I was allocated as the oncall medical officer on the 1st of January as well as on the 2nd of January. Per oncall shift is from 8am on that day till 8am the following day (which means, mine ended at 8am on the 3rd of January).

My first case began with a case of wound breakdown over the right wrist, which the patient chose not to seek hospital treatment followed by another case of upper gastrointestinal bleed which was sent to hospital. This was then followed by another case of possible acute appendicitis which the patient and family decided to “discharge against medical advice” because they wanted to seek treatment in their hometown considering they were travelling and happened to be in the same area.

Upon returning home, I was called back for a case of breakthrough seizure likely secondary to under-dosage of medications. The patient had three episodes of seizure that day followed by a regular 1-2 monthly episodes. Hence, referred and sent to hospital.

Finally, I can return home. Time to get some rest since I would be working the next day. Shortly after, I was called back, a patient sustained laceration wound over the medial aspect of his antecubital fossa. Mechanism of injury? Unknown and he was in an extremely drunken state.

Otherwise, he was stable. Sadly, my medical assistant at that time could not be contacted to escort the patient to hospital and the family members did not have their own transportation.

If only, he was fully awake, I would have triaged him to green zone. However, transportation issues… Thankfully, the patient’s family has an uncle who was willing to send. The only thing was he needed some time to arrive due to the heavy rain and slippery roads.

I didn’t feel good leaving the patient behind although he was stable. Thus, I stayed till 4am until his uncle came and the patient himself had woken up.

After that, I went back home and straight away gotten ready for work since it’s a working day and I am still oncall.

The following day on the 2nd of January, went by smoothly during office hours with referrals here and there but it was manageable.

In the afternoon, another patient came in for symptomatic anaemia secondary to abnormal uterine bleeding with newly diagnosed cervical carcinoma. Her haemoglobin level was 5, who again, refused hospital referral claiming she visited the clinic for fever and not for her anaemic symptoms. After much convincing and discussion with my specialist, the patient still opted to “discharge against medical advice”.

Which makes me wonder… Why in the world?…

This was followed by dinner with my friend. I remembered thinking to myself that evening that maybe… just maybe… I would have a cold night. Enough of referrals.

However, at 11:30pm on the 2nd of January 2026, I received a call from my medical assistant that a patient presented to the clinic breathless with an SpO2 of 50% under room air, started on high flow mask and at best, it is only 90%.

Sounds like an impending intubation and CPR case.

I called up my friend immediately as I rushed to the car as she lives closer to the clinic. I needed all the help I could get for this patient. The roads were slippery and it was a rainy night. Yet, I sped. Thankfully, my friend had already arrived before me.

The patient?

I remembered seeing this patient on the 23rd of December 2025. At that time, his lungs already had crepitations with reduced air entry over the right side and yet he chose to “discharge against medical advice”. I remembered telling him that he would collapse if he didn’t go and true enough, here he was… sitting up, gasping for air.

His vitals? Blood pressure was sky high, lungs filled with crepitations but no pedal oedema, lines were set, no ECG done but we didn’t have time to waste…

I called up the Emergency Physician in the nearest hospital (which is an hour away), presented shortly and informed that we had to proceed with intubation because he was too tachypnoeic.

We prepared for intubation, informed the family members as well as explained the risk of CPR and death. The family understood and agreed.

Intubation… This was a difficult intubation for the guy was a very large guy with hardly any neck visible.

But before we could start, his GCS dropped and so did his heart rate, I started CPR while my friend attempted to crash intubate. We attempted to crash intubate and both times, it failed… I called up the Emergency Physician again and told her that we were 30 minutes into the CPR, she told me to call off after the current cycle.

My first death at a new workplace and on the third day of the year at 0027H, 3rd of January 2026.

Then, I proceeded to complete my notes for the family members to bring to the police station to lodge a police report and broke the news to the family. I was calm and so were the patients’ family. After that, I called up the Emergency Physician to thank her and then, I broke down.

I broke down because had he gone on the 23rd itself, he wouldn’t have to gone through this.. He lives alone and his so-called family members aren’t even his biological family members but neighbours and friends… I broke down because I also felt defeated… We tried our best with such limited resources and manpower…

Yet, I couldn’t save him…

If you have YET to come up with a New Year’s Resolution… At least consider this, adhere to your regular check-ups if you have any… Stay compliant to your medications, diet restrictions or any fluid restrictions if you do have…

And if something is off or not right, please RUSH to the nearest clinic or better, the hospital… Because there is only so much that we can do with such limited resources in a community clinic.

Otherwise, I wish that you have a Blessed 2026 filled with love, beautiful memories and wonderful opportunities.

Remember to have fun and do enjoy it but please do so, responsibly.

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The Theoretical Doctor Jun 8, 2025

A Junior Doctor In Boots

Tell us about your favorite pair of shoes, and where they’ve taken you.

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Prior to having my first pair of boots in 2021 while I was in my third year of medical school, I have always dreamt of wearing boots. Be it short cut or the long ones till mid calf or up till the knee, I loved them all.

I prefer them over heels or flats or slippers.

Partly because I have always imagined myself as a “country girl” in summer dress or jeans, always paired with boots.

However, I’ve never had a pair of boots till I was in my third year of medical school, even that, was given by my aunt. I remembered using it to almost every occasion because it was so comfortable and versatile. The colour was dark green, an ankle length boots with zips on the side. I wore it till one of the shoe had a hole on the side and even then, I was still adamant to wear it till my mom got me a new pair of boots and threw my first pair away.

Since then, I’ve gone through another 2 pair of boots, one pair with heels and another flat. I occasionally wear the one with heels and often use the flat one. The flat one is my go-to everyday boots be it for outing or travelling or a simple trip to the market. However, I rarely use them to work. At work, I have specific types of shoes that I usually wear since I’m on my feet most of the time and these shoes gives me the sole support that I need (if you know what I mean).

But there are days when I’m feeling fancy that I would dress up a little and don a nice blouse over my black leggings to work. Those would be the days when I would wear my favourite regular pair of boots to work, which boosts my self-esteem for the day considering that it is my style, one that I feel brings out the inner-me, the junior doctor-in-boots.

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The Theoretical Doctor Mar 16, 2025

My Experience as A Plastics House Officer | Housemanship Diaries

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When I entered the Surgical Posting, we initially did not have the privilege of experiencing subspecialities like other batches.

This was due to the fact that there were lack of house officers.

However, mid-Nov, there was redirection of House Officer allocation and suddenly, the posting was overflowed with House Officers.

Hence, subspecialities were reintroduced. The subspecialities reintroduced are neurosurgical, plastics and urology.

Ever since my first posting in Orthopeaedics, I’ve always wanted to experience being in Plastics after assisting my medical officer at that time with SSG.

Thus, during my final weeks, I was given the priviledge.

The Burn Ward is located at Level 3 of the Main Building, and is able to host at most, 10 patients, with each patient having their own room/cubicle.

Usually the burnt patients are kept at Burn Ward whereas other patients who are admitted for AVF creation or SSG are placed at Surgical Ward.

The timing for us House Officers is from 7am till 6pm, Sunday till Friday with an off day on Saturday.

During my time in Plastics, I would usually arrive on time at 7am and proceed to trace the bloods first. After all the bloods have been traced, I would proceed to help out with morning reviews.

Morning reviews are usually done by the postcall medical officer. This is then followed by rounds with the surgeons, usually starting with the acute or rather, the intubated patients followed by the rest.

Rounds at Burn Ward is only once daily. After morning rounds, we would gather at the “Handover Room” whereby the patients who are not in the Burn Ward but is being seen by Plastics as another team or as a primary team are being handed over in terms of case and progress as well as the newly admitted ones.

Next, we will proceed to follow the “Peri rounds” and change dressings if needed. Usually after the Peri rounds is when us House Officers go about our joblists in terms of posting case, referrals or bloodtakings or imaging request.

The rest of the day could be pretty chill if there is nothing going on but usually, there would be new patients to be transferred in, take blood or any post-op patients to be reviewed.

Sometimes there are cases being called and we are more than welcome to join the operation. In between, there are arterial blood gases (ABGs) to be take in between or bloods to be sent.

Finally, in the evening, prior to leaving at the end of our shift, we would prep the coming mornings and leave them nearby before informing in our Surgical House Officer’s group in regards to the “coming mornings”.

My time in Plastics was rather short-lived and I felt that there was so much more to be learnt. But my time spent there was extremely wonderful and the medical officers and surgeons were more than helpful and welcoming towards the new people into their team.

Definitely, a department that I would want to return to.

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The Wards In The Surgical Department | Sarawak General Hospital

An article regarding the Types of Surgical Wards, us as House Officers had to rotate in during my fourth posting in Sarawak General Hospital.

The Theoretical Doctor

The Theoretical Doctor Sep 26, 2024

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Daily writing prompt What details of your life could you pay more attention to? View all responses

I’ve always been a foodie.

I enjoy my going on food trips with my family or friends. If I’m bored or sleepy, I would look for a snack, which again is well, food.

Thus, over the years, the weight started piling up and towards the end of primary school, I noticed that my weight posed an issue. As a child, I was overweight.

I recalled visiting the doctor once when I was in primary school coz I was unwell and he made me stand on the weighing scale and perhaps he did say more but at a young age, all I remembered was him yelling “Your child is FAT. FAT. FAT. FAT. F-A-T, FAT!”, all throughout my checkup and as I was leaving his office with my mom.

It felt like as if I had committed a felony. When in reality, he was trying to point out on how unhealthy it is for me, somehow in a rather direct way.

Over the years, I’ve struggled with my weight. It was never constant and always up and down. I’ve tried various diets which didn’t stuck long.

The only time I properly lost weight was when I started my housemanship journey. Amidst me eating at the wrong time, somehow the weight just magically went off. Firstly, perhaps I was too occupied with work to eat properly, hence, unknowingly I tend to practice intermittent fasting almost everyday and secondly, my movements have increased dramatically. Walking above 15k steps per day was a norm.

However, as I progressed throughout my postings, I learnt how to fit eating back into my busy schedule and the weight started piling back slowly.

I brought the matter up to a dear friend and she mentioned that perhaps, I could try controlling my food portion. I reflected and realised that all these while, I’ve been consuming food in the usual portion which didn’t had an effect on me previously as I was constantly on the move.

Thus, if there is something I seriously need to pay more attention to, it would be my food choices as well as the portion. Food is extremely delicious and good. Sadly, I would say that I fall into the category of “Live to Eat” rather than “Eat to Live”.

Hence, it’s time for me to take charge and make a change towards my food choices and start my journey towards a healthier life.

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The Theoretical Doctor

The Theoretical Doctor Sep 23, 2024

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Paediatrics Posting. The posting of tiny human beings.

Looking back, I feared entering into the Paediatrics posting. I think I say that for almost every posting.

However, it was one that I fell in love with before I even off-tagged, as mentioned in one of my articles previously.

The stress level was not as bad as it was in other postings mainly because we were dealing with children. Not to say that treating them is easier, in fact it isn’t as they tend to fight back, scream or cry a lot.

I mean they’re just children.

But perhaps when I do come to work, the smile on their cute faces were enough to alleviate some of the stress and checking them clinically involves a skill as they are easily triggered.

I would find myself playing with them or calming them down. Most of the time if I were to auscultate them, they would either start playing with it, swat it away or start crying.

The Paediatrics posting is the place I started eating again amidst the stress. Irregardless of the amount of patients and work to do, there is always time for lunch or at least our superiors will make sure of that.

It was also the place where I enjoyed the long rounds in the morning and afternoon as well as I would present to specialists.

I made a good friend with a medical officer who I still keep contact with albeit having left the posting. I enjoyed the days where I would be allocated to work with him.

Having worked both in the general ward and nursery ward, the experiences were different but enjoyable nonetheless.

If there is a posting I wouldn’t mind repeating, it is the Paediatric Posting and I hope you do or will or had enjoyed this posting just as much as I did.

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https://theoreticaldoctor.com/2024/09/23/reflection-of-the-paediatrics-posting/

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Inside the Red Head's Head May 16, 2024

Daily writing prompt What’s the oldest things you’re wearing today? View all responses

I lost a whole truck load of weight back in 2022. I lost more weight than I currently weigh. I’m a little less than half the man I used to be… literally.

What does that mean in regard to today’s question?

It means I don’t own any clothes that aren’t relatively new. The socks I’m wearing at this moment might be a year old. Maybe a little more than that. They are the oldest thing I’m wearing, by far.

Now that is assuming we’re taking about clothes. What if we broaden the search a little? My Apple Watch is a little more than a year old, but probably not quite as old as my socks. My glasses are a whopping three weeks old, give or take a day or two. What else is there?

There is one thing, and it’s the winner. Two weeks from now is my 15th wedding anniversary. That’s right, my wedding ring is the oldest thing I’m wearing today and everyday. 15 years and counting, with many more to come.

I love you, Jen. I love you more and more each day.

https://robertjames1971.blog/2024/05/16/everything-is-new-ish/

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