The Theoretical Doctor2026 – 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.
Related Posts:
- My First Night Shift In Emergency & Trauma | Housemanship Diaries
- Life After Offtag In Emergency & Trauma | Housemanship Diaries
- Day 1 Of My Final Posting – Day 647 Of Housemanship
- Surviving 10 Days Of Tagging | Emergency & Trauma Department
- My Last Shift As A House Officer in Medical | Housemanship Diaries
- Preparing For My Exit From The Medical Posting As A House Officer | Housemanship Diaries
- Surviving The Night Shift In The Medical Posting In General | Housemanship Diaries
- My First Night Shift Covering Medical 4 / Medical 5 / Infectious Disease Ward In Sarawak General Hospital – Housemanship Diaries
- The Most Enjoyable and Tiring Day In Medical 3
- Part 1 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | The Emergency Department
- Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
- 1 Year Of Housemanship Update – Housemanship Diaries
- Another Good Advice I Will Remember For The Longest Time – Housemanship Diaries
- Enjoying The Journey – Housemanship Diaries
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