The Theoretical DoctorJul 10

The Most Enjoyable and Tiring Day In Medical 3

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I can’t remember which day it was but it was probably during the weekend or a public holiday as I remembered that I was allocated on call who was in charge of this ward.

I was allocated to “General” on that day and was I was alone at that time. I remembered sitting at the other end of the ward at around 11am when one of my colleagues who was allocated to be covering the “Neuro” patients went to have lunch.

The medical officer on call at that time, a rather “happy-go-lucky” and rather jovial person struts into the respiratory cubicle and asked if there were any house officers available?

To which I responded, we’re right here and he came over. He asked for the person who was in charge of the front cubicles which happened to be my colleague who went for lunch. I asked what’s wrong, is there anything I can help with?

He casually replied, nothing much, just walked in and saw a patient’s pulse oximeter reading 70% under room air. Then he laughed.

Me and my friend who happened to be there at that time were shocked and rushed to the patient. True enough, the pulse oximeter reading was 70%, well, 68%. Oddly enough, the patient seemed rather comfortable and not tachypnoeic. In fact, he was surprised as we crowded around his bed, looking concerned.

I asked him if he was having any difficulty breathing which he was not. Thus, our first instinct was probably the machine was faulty and proceeded to check with another vital signs machine.

This time, it was 65%.

I proceeded to take full set of bloods while my medical officer was writing his review and my friend attempted to call my colleague.

I ran his arterial blood gas and it showed Type 1 Respiratory Failure. Considering he did not have a baseline during this admission, we do not know if this was near his baseline or a sudden deterioration.

We called the Peri ICU team and referred the patient for non-invasive ventilatory support (NIV). Imagine, not knowing why this long stay patient was ever here in the first place to summarising the reason for admission down to his current progress. It turns out, he was due to be stepped down to a district hospital for continuation of antibiotics.

Well now, he can’t.

We transferred hum to the acute cubicle for closer monitoring while awaiting the Peri ICU team.

While awaiting, my medical officer decided to check on a patient who was handover to him for afternoon reviews.

This lady was in her 60’s and was admitted for left pleural abscess, meaning there’s pus in her lungs and for this patient, the whole left lung was completely filled. Clinically, she seemed well, speaking in full sentences and laughing to her family members as well in the morning.

In fact. I was even taking her bloods that morning only to have it splashed all over me after attempting to fill the blood culture and sensitivity bottle.

I recalled walking past her as I made my way to the front of the ward and she seemed alright. However, the moment me and my medical officer oncall stood in front of her. She desaturated an started being tachypnoeic.

Well, here’s another one.

There goes the next referral to the Peri ICU team for intubation and also Urology for emergency suprapubic catheter insertion as we attempted to insert a urinary catheter multiple times but failed.

Now, all these events happened very fast but at the same time, time flew by fast. The second patient was intubated and we inserted a femoral venous catheter. My medical officer then wanted to excuse himself to settle the pending discharges in his other ward. However, the first patient wasn’t saturating well under NIV and needed to be intubated.

There goes another intubation as well as another femoral venous catheter insertion. Finally, after all the chaos, things began to finally settle down.

I proceeded to trace my coming mornings, considering that I was the only one in charge of “General” that day and nobody would be helping me. Finally, I proceeded to begin my oncall reviews. This was around 8pm by that time.

After completing my in all reviews with intermittent disturbance in between. I proceeded to aid my friend in preparation of her coming mornings.

It was close to 11pm, I was just clearing my stuffs and getting ready to go when a nurse informed me that a patient seemed rather tachypnoeic.

Annoyed and tired, I attended STAT to find a patient sitting at the side of the bed with his BiPAP machine unlatched and hanging at the side of the bed. The patient beside him then told me, he removed it himself an hour ago.

Boy… Why am I not surprised?

This is another impending intubation.

At this rate, I might as well not leave anymore.

The day was busy enough. I sometimes wonder why is it that we feel guilty to even desire to return home on time? To walk out with the family members watching us finally ecstatic to return home for the day while their family members are stuck in the hospital?

Back to that patient, I didn’t left him gasping on his own of course, I fixed back the BiPAP machine, took an arterial blood gas and alerted my night colleague and medical officer oncall to which they attended STAT.

Thankfully, the following day, I was allocated as night shift. Thus, despite returning home late, I was able to sleep in and recuperate a little before returning back to work that night.

It was a busy day but considerably a rather fun one considering that I happened to work with a rather jovial medical officer oncall and my colleague stayed back to accompany me despite her shift being till 6pm.

Working with certain people definitely helps alleviate some of the pressure of the day.

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The Theoretical DoctorJun 8

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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El Mundo de ÓscarMay 22

Reflexión de Oscar «La sanidad no es lujo, es derecho»

Cuando la sanidad pública se tambalea, también lo hace una vida digna para la mayoría de la ciudadanía, se tambalea el derecho a la vida digna, la sanidad privada no debe ser el refugio obligado, luchar por lo público no es ideología, es luchar por lo que nos pertenece a toda la ciudadanía, un derecho social fundamental, un logro que han luchado nuestros abuelos y nuestros padres, para que otros u otras en nombre de una falsa libertad la desmantelen y la regalen a sus amiguetes, ¿Hasta cuando vamos a seguir permitiendo esto? ¿De verdad el sistema americano es viable? A la larga sale muy caro, una de las mayores causas de quiebra particulares en EEUU son los costosos tratamientos médicos, ¿vamos a permitir llegar a esto?, ya hace tiempo se ha demostrado que EEUU no es un ejemplo de nada, una sociedad que desquebraja más rapidamente por la actual administración de Donald Trump, debe servir este ejemplo a toda la ciudadanía para no llegar a repetirlo en nuestro país, pero bueno, me encantaría que la gente viera lo que se jugando a la hora de depositar su voto, porque no va esto de derechas e izquierdas, esto más bien va conservar lo que tanto ha costado conseguir,

Sanidad pública, es algo que debemos luchar por ella, el salud es un derecho humano fundamental, no un privilegio ni mucho menos un negocio, la salud pública no debe ser considerado un gasto, es una inversión para el bienestar de toda la ciudadana.

Abrazos, amigos y amigas, feliz Jueves.

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Shortwave ListeningMay 22

Writing Prompt: Collections

I have a collection of QSL cards. I’m not an amateur radio operator – I’m a listener. I usually listen to broadcasts on shortwave or mediumwave (rarely on longwave, because only a few stations still use longwave frequencies). In the past, I was mainly interested in catching rare signals – my proudest moment as a listener probably was when I got a QSL card from KNLS Radio in Alaska. It wasn’t really a big deal, I guess, but at the time, it felt like one.

That was in the 1980s, and I took a break from listening through the 1990s, except for the occasional listen to keep up-to-date with the news. I picked my hobby up again around 2010, and filled some gaps in my existing collection of QSLs – especially Ascension Island, which is an easy catch (because a rather big shortwave transmitter site operates from there), but not so easy to get a QSL from (because the BBC, who are the main broadcaster from there, don’t do QSLs). Fortunately, Deutsche Welle still confirmed reports while they rented airtime from Ascension. By now however, their shortwave transmissions have become a thing of the past.

As postal services are much more rarely used than in the past, many stations have switched to sending “e-QSLs”. You get an e-mail confirming your report, sometimes with a jpg-QSL attached to it. That doesn’t match the feeling of having a real QSL card in your hands, but e-QSLs are better than no QSLs.

One of these came in just yesterday – see the picture at the start of this post. "QSO" stands for a two-way radio contact. In fact, it was one-way, with the maritime station transmitting and me listening.

Overall, I have turned more into a program listener now. I’m still occasionally adding to my QSL collection, but I’m not looking at it as an active project.

To me, e-QSLs are nice surrogates for the “real” cardbox ones. To foreign broadcasters, I believe, reception reports must be nice surrogates for listener reactions to their actual programs.

To help them stay on air, we should give them "the real thing", too: feedback on their programs, questions that we may have about the countries they are transmitting from, etc..

But let’s not feign conversion when writing to a religious station. That would go a bit too far. 😇

 

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ELBLOG DE LAS CURIOSIDADESMay 15

🗞️ La pregunta del día: ¿Tienes alguna colección?

Una joven disfrutando de una revista ‘Cosmopolitan’, símbolo de la moda y la cultura pop en la adolescencia.

Hay gente que colecciona tazas, llaveros, funkos… 💁‍♀️ Pero si hablamos de colecciones con historia, yo tengo la mía bien clara 🧐: una GRAN colección de revistas.

📚 Todo comenzó con mi tía abuela

Mi tía abuela fue quien sembró la semillita: tenía varias revistas que con los años pasaron a mis manos. Eran una mezcla de nostalgia, cultura pop y curiosidades que me atraparon desde el principio. 🤍

Y, claro, yo también empecé a coleccionar desde muy chica. Algunas seguro te suenan…

💅 Revistas que marcaron mi adolescencia

  • Revista Tú (obvio 🙈)
  • 15 a 20 (clásico de clásicos)
  • Seventeen (¡el sueño adolescente en papel!)

Cada mes era un ritual: correr a la tienda para comprar el nuevo número y perderme entre tests, posters, tips de moda y las secciones que no podían faltar. 😍

Ya más grande, mi habitación se llenó de…

✨ Glamour y Cosmopolitan por todos lados

Una joven disfrutando de la lectura de la revista Cosmopolitan, rodeada de un ambiente acogedor.

Las pilas de Glamour y Cosmopolitan crecían con cada mes que pasaba. Me encantaba su diseño, los artículos, las portadas… ¡era casi como tener un moodboard físico gigante! 😅

🧠 Pero no todo era moda: también amaba la Algarabía

Una de mis revistas favoritas por siempre: Algarabía. Era diferente, divertida, interesante. Una joyita de datos curiosos que leía de principio a fin con mi snack favorito al lado. 🍫

🔍 Y hablando de joyitas… también colecciono libros de Agatha Christie

Mis otros tesoros personales son los libros de Agatha Christie 📖. Desde “Asesinato en el Orient Express” hasta “Diez negritos” (ahora Y no quedó ninguno), su forma de narrar, los misterios y los giros de trama me tienen enganchada desde siempre. 💀🕵️‍♀️

🎯 Y tú, ¿coleccionas algo especial?

Cuéntamelo en los comentarios 👇
¿Tienes alguna colección con historia detrás? ¿Eres de revistas, de libros, de figuritas o algo súper original?

#AgathaChristie #Coleccionistas #CulturaPop #dailyprompt #dailyprompt1946 #LibrosMisterio #nostalgia #RevistasJuveniles #RevistasVintage

Inside the Red Head's HeadMay 22, 2024
Daily writing prompt Do you have any collections? View all responses

Collections? You mean like, do I collect bad decisions? Failures? Things like that?

I was a baseball card collector when I was a kid. I was pretty obsessed. I still have them all. They are in a box somewhere in the cellar. I haven’t added to the collection in ages though. I can’t really say I still collect them. I collected music on vinyl/cassette tapes/CDs. Most of them are gone. I had ripped them all so now all of that music lives simultaneously in a hard drive and in my iTunes Match account. Is that even still a thing? Streaming services are pretty evil (from the musical artist’s point of view) but they are so effin’ convenient from the listener’s perspective that I can’t really stay away. I want to, but I can’t. Thanks, Apple Music. I used to have a pretty significant collection of books. Mostly paperbacks in the horror genre. Thank you, Stephen King and Clive Barker. Almost all of them are gone now. I used to have a significant VHS/DVD/Blue Ray collection too. Almost all of those are gone too.

If I had to fess up to having a collection of anything these days it would probably be electric guitars. I have four. They are all Gibsons. A 1978 Les Paul Custom, a 1979 ES-335 Pro, a 2017 SG Standard, and a 2020 Les Paul Standard ’50’s. I would very much like for this collection to grow, but it’s so expensive. I could extend this to guitar gear in general as I have a few amplifiers and a slew of effects pedals. It feels cooler to say that I collect guitars though.

I could also say that I collect office desks. I have four, technically. One for personal computer stuff in the cellar. Right next to it is a work from home desk that I don’t use very much anymore. Another is upstairs in my step son’s currently unoccupied bed room. That’s where I work from home for the most part. Then there’s one in the actual office. I’m sitting at that one right now.

We have two cats… does that count as a collection? Probably not.

Yeah, let’s go with guitars. That’s my answer for today’s question. Thank you and good night.

https://robertjames1971.blog/2024/05/22/the-collector/

#dailyprompt #dailyprompt1946 #Guitar #Music

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