Mastodawn

The Theoretical Doctor Aug 21, 2025

My First Night Shift In Emergency & Trauma | Housemanship Diaries

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Remember when I mentioned that I love the night shifts?

No? Well, here are the articles advocating my love for that shift:

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My first night shift in this department was in the Red Zone and I was terrified.

Thankfully, it was with a fellow Registrar who is rather patient, kind and one who loves to teach.

The scary part however was that it is the Red Zone after all and on my first night!

The Red Zone basically caters to patients who are unstable be it haemodynamically or in terms of their vital signs or that they are in a state of severe acidosis, on the verge of collapsing, you name it. Basically, how severe of a state a person must be in to end up in that zone.

The night started off smoothly with cases coming in one at a time. Alright, I kept repeating to myself, “attend them, transfer them to another bed, vital signs, bloods, fill out forms, clerk and basically just listen to your superiors”.

The night eventually turned into midnight and into the wee hours of the morning and finally the sun has risen. Before I knew it, it was 7am and the AM shift House Officer has arrived. I am not alone again.

Time to prepare for handover rounds at 7:45am.

It was better after that, having another person with me as it felt less intimidating.

At 10am, I took off and headed home. Not a bad experience for the first night shift.

The good thing about the night shift in the Emergency and Trauma is that we are not alone. There is always a team or at least your superiors are always there.

However, I don’t quite prefer the night shift in this posting. Having actually completed this posting, at the time of writing this article, the daytime shift is definitely better.

Nonetheless, in all the night shifts, albeit that it could be a terrifying one especially prior to the start of your shift, always remember that you are never completely alone even if it feels like it and that help is always nearby.

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The Theoretical Doctor Aug 15, 2025

Jobs That I’ve Had

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What jobs have you had?

Teacher

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My first job that I’ve ever had was as a Teacher.

I had just completed my STPM which is a form of pre-university course in Malaysia, equivalent to that of the UK A-Levels and I was waiting for my results.

At that time, I was on a holiday with my parents and was perusing through Facebook when I came across an advertisement on a job offer at a nearby language centre, looking for an English Language teacher.

Without any expectations, I applied for it. At least, I’d have some exposure and regularity prior to entering Medical School in September that year.

Shortly after I returned home, I received a call and an email responding to my application. I went for the interview session and was soon called back and offered a job to which I accepted.

Barista

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My second job, I was a barista at a coffee shop as well as worked at the cash register of a store, both at the same time during my first and second year of medical school after which I stopped and subsequently used to work as a waitress for an F&B company. That was my third job. My second and third jobs were jobs mainly to earn extra cash after classes amidst my free time.

Looking back, I probably should’ve just focused on my writing.

Junior Doctor

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My fourth and current job is working as a junior doctor at Sarawak General Hospital. I still am one since I started practicing in 2023 and is currently going through my sixth and final rotation (at the time of writing this article) before finally receiving my full APC or license to practice independently both in government or private sector.

Am I ready for it? Certainly not.

However, somehow I haven’t quit and I kept pushing through. I don’t know how or why and before I knew it, 2 years has flown by.

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The Theoretical Doctor Jul 10, 2025

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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novaTopFlex Jun 7, 2025

Retirement Goals

I would like to retire successfully away from the worst of capitalism, and successfully manage to ensure the most out of my final years.

The Theoretical Doctor May 18, 2025

Laughing – A Way To Destress

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What makes you laugh?

Laughing – A form of de-stressing activity. To which some may find “distressing”?

Or perhaps I’m just a little unbalanced.

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However, back to the prompt, I would laugh at almost anything actually.

Many would ask me on why do I laugh so easily or on almost anything. Honestly, I have no proper answer for it. Perhaps, the easily justifiable answer would be that it has become a form of my default reaction towards answering people.

Firstly, it softens my expression, thus making myself seem more approachable (or so I think). Sadly, that also means that sometimes people would not take me seriously. Next, it lightens the situation and prevents a tensed situation from escalating. However, it may also flip the other way around which may further escalate the situation instead as me laughing may deem that I do not take them seriously.

Sometimes, when I am being thrown an insult, I do react by first laughing about it, as a shield for myself and preventing myself from being hurt or at least giving myself some time before digesting the issues.

Then, there are times, when I am lost in my own world, which is most of the time, I would suddenly remember something funny or find something amusing and start laughing to myself. At times, it may escalate into a hearty laughter to which some might find distressing.

Nevertheless, after a good laugh, I would usually feel better, as they say, it releases endorphins, a “feel good” hormone and thus, “laughter is the best medicine”.

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The Theoretical Doctor

The Theoretical Doctor May 10, 2025

My Teenage Years

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Describe a phase in life that was difficult to say goodbye to.

Upon reading this prompt, I was reminded of my high school days. The first year of high school was very tough for me in terms of adjusting to a new school, cultures and subjects.

I went from a comfortable place to a different one without any guidance nor advice and I went from being a senior to a freshie all over again, which I did not like.

In addition to that, I had a very bad temper and used to talk back to my seniors which did not aid in my reputation. Well, that was the first year, things started getting better the following year onwards and my grades picked up. I have accustomed myself to the flow.

It was during my teenage years that I met my good friends whom I still keep contact to this day albeit not meeting much.

Looking back, I enjoyed my routine and studying very much. Waking up early was the hardest part of the day, which surprisingly isn’t one for me now, I have transitioned into an early riser.

This is followed by shower, preparing my breakfast and lunch for school, which mostly just includes me grabbing bread or biscuits and stuffing it in my bag and wait for my parents to send me off to school, which is usually my dad. He would send me off prior going to work.

I was truly blessed to have experience that.

In school, it was about attending classes, completing homework or assignments, gossiping with my friends or attending extra-curricular activities. However, the place I truly enjoyed spending my time was in the library. Thus, if I were to bunk class, I would lock myself inside the library and just study or read. The perks of being a librarian. Thankfully, my teacher-in-charge of the library always had my back if I were to be questioned regarding my whereabouts.

After school, my mother would be the one who usually picks me up from school and most of the time, we would eat outside. Occasionally, she does cook at home and as I am writing this reflection, I truly miss these simple heartwarming dishes.

This is then followed by me showering, completing my homework, studying, chilling, going out with my mom and getting ready for tuition or extra classes which are usually in the evenings or on alternate days.

Life was simple and predictable. I remembered attending multiple tuition classes during the week, mainly because I was bored being at home as I was not allowed to simply go out with my friends as I pleased. Thus, I looked forward to those evenings.

Holidays and weekends were the things I looked forward to as well and I enjoyed recuperating or simply helping my parents out with their chores, watching movies or TV shows, studying with music, writing and playing video games.

Surprisingly, what aid me in studying back in high school was due to video games. Perhaps it was the way I “destress” and it drives my mind.

I was not allowed to work during the holidays as my parents feared that once I get the taste of my own earnings, studying will no longer be a priority. However, my pocket money wasn’t great either. But I still got by and occasionally, my dad would slip in some money without my mom knowing just so I could enjoy a nice meal across the road with my friend.

The stress back then were focused on exams and completing homework. Occasionally, life dramas do get in the way, all part and parcel of being a “teenager”, having crushes, jealousy and bullying.

However, for the most part, I enjoyed my teenage years and looking back, I wouldn’t change a thing except to be more disciplined in my studying and to learn more.

Those years flew by rather quickly. Before I knew it, I was a senior and the stress of choosing a major or course and the university applications kicked in. Over the years, I’ve accumulated multiple fond memories with my friends as well which were a mixed of beautiful ones, silly and extremely foolish ones, which we do look back and laugh about during our meet-ups.

If you are reading this, I hope that you did enjoy your teenage years as much as I did too. If you are a teenager, do not fill your time with just studying, immerse yourself in extracurricular activities as well and discover new habits. It is the season of discovering yourself, and hopefully in years to come when you do look back and ponder, it will be filled with sweet memories as well.

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The Theoretical Doctor

The Theoretical Doctor May 8, 2025

Part 2 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | Main Building, Side Building, Infectious Disease Ward

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The Peri Medical House Officer Team takes care of:

The Emergency Department

Green zone
Yellow zone
Yellow respiratory zone
Green-Yellow zone
Asthma Bay
Red Zone I
Red Zone II
Decon
CSSD
EDOU

Main Building

Side Building

Infectious Disease Ward

SDC (Surgical Daycare)

In this article, I will be sharing my experiences as a Perimedical House Officer covering main building, side building, SDC as well as the Infectious Disease (ID) ward.

As I previously mentioned in my previous article, the work begins from 7am till 6pm (short days), 7am till 10pm (long days) and 8am till 9am (night shifts).

Covering this part of the hospital meant taking care of “stranded patients” which are medical patients who are lodging in other department wards as there are no space or beds available in the main medical wards. Usually, patients like these are somewhat stable enough to be left on their own without constant supervision. Those that do require, are usually left in the Emergency Department or transferred straight to medical wards.

The Main Building

Taking care of the Main Building meant that one would have to cover:

2nd floor: Urology Ward
3rd floor: Male and Female RTU Wards
4th floor: Labour Ward
5th floor: Maternity 2 (Antenatal Ward), Maternity 3 (Postnatal Ward)
6th floor: Female and Male Orthopaedic Ward
7th Floor: Male and Female Surgical Wards

On some days, there would not be any perimedical patients in certain wards. Thus, there are days that we do not have to go to these wards. On bad days, there are perimedical patients on every floor and the patient count will be extremely high.

During my time serving in the main building, I was blessed enough to have a partner. Thus, despite the high volume of patients, it felt manageable.

Upon my arrival, I usually begin from the highest floor and work my way down. Thus, I begin from the 7th floor by checking with the TL or Team Leader to identify new cases and update the list followed by tracing the blood investigations.

This is to ensure that the patients are not missed during rounds.

I proceed with doing this in the wards of every floor till I am done prior to beginning my morning reviews.

Usually by then, the Medical Officers have arrived and are proceeding with their morning reviews.

Sometimes, we join in and sometimes, we are asked to review the other patients and on our own until the specialist arrives.

Upon the specialist’s arrival, we would all meet up at one place to begin out rounds.

Rounds in perimedical is similar to that in the ward. The only difference is that rounds are once daily and the patients are all around the place.

In between, there would be new transfer ins, attending to acute issues of which the nurses from other wards would call or inform the House Officers from other departments.

After that, it is followed by preparation of the coming morning bloods. The wards and bed numbers are labelled on top of the forms and kept in the ETD for the night House Officers to take.

The Side Building

The Side Building is less hectic than main building and that meant we had to cover:

3rd floor: Neurosurgical ward / Neurosurgical HDU, ICU extension
4th floor: Paediatrics Orthopaedic Ward
5th floor: Gynaecology Ward, Ophthalmology Ward

As usual, upon my arrival, I would begin at the topmost floor and check for any new patients as well as to trace the bloods.

After all of it is done, I begin my review in the ICU Extension 2 Ward. The ICU Extension 2 ward consists of unstable, intubated patients of various departments.

Usually by the time I begin my morning review, the specialist would have just arrived and we begin our rounds.

After the ICU Extension 2 is followed by Neurosurgical Ward since they are located at the same place, then Neurosurgical HDU.

Upon completion of morning rounds is followed by carrying out the active joblists, discharges and requesting for radiological scans.

Similar to Main Building, the coming morning bloods are prepped and kept at the Emergency Department for the night house officers to collect.

SDC – Surgical Day Care

SDC is the Surgical Day Care as per the name. Usually patients who are admitted here come in on the day of the procedure itself and is discharged in the evening.

However, when the wards are fully occupied and the Emergency Department is overflowing with stranded patients, the SDC converts temporarily to host the stranded patients.

At max, the patient load is only two cubicles full and the patients being admitted there are usually relatively stable.

Similar to main building and side building, I begin my day with tracing the bloods, x-rays or any relevant radiologist reports before beginning my review and rounds with the medical officer and specialists.

The Infectious Disease Ward

The Infectious Disease Ward or “ID Ward” is located in a building separate from the main or side building.

Previously, it used to be the House Officer’s Accommodation. However, it was subsequently converted into a ward.

The ward consists of two floors with each floor containing 6 isolation rooms for each floor. Upon entering the ward itself, one has to change into the hospital scrubs and prior entering the ward isolation rooms, one has to don apron, shower cap and gloves, the standard PPE.

The casenotes are not allowed to be brought in, thus all reviews are written outside.

What do I do if I were stationed to at the Infectious Disease Ward?

The house officer allocated to the ID ward are those from the Peri Pool, meaning our shift is from 7am till 6pm for short days.

Thus, upon my arrival, I would change into the hospital scrubs. Then, I would proceed to trace the bloods. The bloods sent from the ID ward are usually late. Thus. It would either be pending in the system or yet to be in the system.

Next, I will begin my reviews, first to the newly transferred in patients followed by the rest while awaiting the medical officer.

There is a whiteboard consisting of the names of the patients in the isolation rooms. Usually in the morning prior to entering the isolation rooms, we would have a short round and presentation with the ID consultant with the whiteboard.

Thus, during my time there, I would constantly update and personalise it according to my style which would be easier for me during my presentation with the ward consultant.

After that, we will all proceed to the isolation room. As House Officers, we are the scribe and assistants of the medical officers. Since, we are not allowed to bring the casenotes into the isolation room, thus we will type everything inside our phone and transfer it onto paper after our grand rounds with the patients.

Rounds at the Infectious Disease Ward is only once daily.

After the completion of rounds, just like any ward is the completion of active joblist.

Personally, I enjoyed my time in the Infectious Disease Ward a lot, mainly because I was given the autonomy to customise the board as I liked, present to the consultant myself and was asked multiple questions during rounds and having discussions which I find rather stimulating and enjoyable.

On top of that, I even had time to return home for a quick lunch every time I was stationed at this ward.

In the afternoon, some patients on high oxygen support may need arterial blood gases (ABGs) at certain time. If not, it is the preparation of coming morning bloods and transfer ins of any new patients.

Being in charge of the other places is considerably less hectic than being allocated in the Yellow Zone which can get rather crazy at times as there is massive movement of patients constantly. It actually feels like as if I am at KL Sentral during peak hours.

However, do not fear if you are allocated into the Peri Medical Pool. The workload can get extremely hectic and it can be rather messy. But, always try your best to learn as much as you can during your period serving there and to enjoy your journey.

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Part 1 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | The Emergency Department

An article regarding my life as a Peri-Medical House Officer in my Fifth Posting, The Medical Department (Part 1).

The Theoretical Doctor

The Theoretical Doctor Apr 28, 2025

Part 1 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | The Emergency Department

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Upon entering the Medical Posting, I was stationed into the “Peri-Medical Pool”. My “birthplace”, so-called.

Prior to entering the Medical Posting, many of my colleagues commented that the Peri-Medical pool is probably one of the worst place to enter considering that it is rather hectic, busy and messy, not to mention the joblist is never ending.

The working shift for a Medical House Officer is as such:

Short Day (SD): 7am till 6pm
Long Day (LD): 7am till 10pm
Night Shift (ON): 8pm till 9am

The Emergency Department in Hospital Umum Sarawak is rather huge and consists of:

Green Zone
EDAU
CSSD
Yellow Zone
Yellow Respi Zone
Green Yellow Zone
Red Zone I
Res Zone II
Decon

Usually a House Officer is allocated to take care of more than one zones.

For example:

Green Zone / EDAY / CSSD
Yellow Zone / Green Yellow Zone
Red Zone I / Red Zone II / Yellow Respi Zone

When the amount of manpower is high, the job gets done quickly and keeping track of the patients is easier.

However, in days where we are stretched thin it is rather difficult.

The Day Shift

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Since I entered the Peri Medical Pool on my Day 1 of tagging in the Medical Posting, my working hours were from 7am till 10pm every day till I offtagged.

I begin my day by first tracing the casenotes of the patients in the zone I am allocated to, snap pictures of the chest x-rays, any relevant radiological reports as well as to trace their bloods.

If bloods were not taken or not in the system, we would then proceed to “summon” the post-night team for help with their bloods.

After all the patients have been traced and the Google Lists have been updated (this is to aid us during our rounds as well as following up on their location later, to ensure that they are not being missed), then I would proceed with my morning reviews.

The morning reviews are just as usual as any morning ward reviews, rounds with the Medical Officer and Specialists and finally carrying out any active joblists.

Since we are in the emergency department, there is usually no afternoon reviews. It depends on the medical officer. Most of the time, rounds are just once daily.

After we are done with our morning joblists, we have to actively screen through the patients in our allocated zones as there is constant movement of the patients in both in and out of the emergency department.

Thus, this means assisting the current on-call team for the day with any STAT bloods or STAT radiological requests as well as updating their progress.

On most days, it is manageable despite the chaos. However, on days where we are lacking in manpower, the difficulty sets in.

The Night Shift

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The night shift begins at 8pm till 9am the following day or until we are done with our “summons”.

I was blessed enough to have gone through perimedical with a partner. Thus, there were two House Officers allocated for the night shift.

As night House Officers in Peri-Medical. We are expected to continue screening through all the casenotes for any new joblist or patients in all the zones in the Emergency Department as well as to assist in any procedures, take STAT bloods or request STAT radiological procedures.

In addition to that, we also have to cover the main building and the side building. This means, if there are any medical patients lodging in non-medical wards, we are in charge of them as well. Most of the time, it is just new transfer ins, sometimes, it is attending to any acute issues.

This is then followed by taking the “coming mornings” or bloods of the stranded patients in the Emergency Department of the lodging patients.

The amount of patients in the Medical Department is extremely high and thus, the medical patients can be stranded up to days in the Emergency Department which can even last till they are being discharged.

Thus, this ensures that the patients are being continued on their treatment irregardless of their location within the hospital.

The night shift as a perimedical house officer can get rather hectic if there are back-to-back influx of new patients in the Emergency Department, tons of coming mornings as well as acute issues in the ward.

In the morning, the “summoned” list can get rather extensive and chaotic as well and can be rather endless.

Hence, on top of the constant walking about the whole hospital, it can get rather tiring. But like I said, it is doable and manageable.

In fact, I enjoyed life as a perimedical house officer a lot.

If you are due to join Peri-Medical, fret not. Keep yourselves equipped with necessary forms and just work quick and as fast as you can.

On some days, one might get lost in the sea of chaos. However, stay strong and know that help is always within reach and that you are not alone.

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My Evening Routine In The Medical Posting | Housemanship Diaries

An article regarding my Evening Routine while I was serving as a House Officer in my Fifth Posting, the Department of Medical.

The Theoretical Doctor

The Theoretical Doctor Feb 4, 2025

My First Night Shift In Surgery | Housemanship Diaries

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My first “ON” or “On-night” or night shift in General Surgery was in the Female Surgical Ward with a friend whom I’ve known since around my first posting but have yet to be in the same posting together till our fourth posting in General Surgery.

We were blessed enough to have at least 2 people per ward for the night shift.

Our shift as “on-night” in Surgery began from 7pm and will usually last till all the discharges are done the following morning.

Upon my arrival to the ward, I was informed that one patient in particular had no urine in her CBD (urinary catheter) bag and that she felt like urinating but was unable to void. Considering that she had a urinary catheter in-situ, voiding should not have been an issue.

I attended STAT and assessed her. She had a mass over her abdomen which was hard, non-mobile but had smooth edges, around 15cm by 10cm, a rather large one which I assumed was a tumour, probably pressing onto her urinary bladder as well.

It did not occur to me to check if the patient was previously passing urine, it also did not occur to me to check her intake and output chart. All I could think of at that time was, she felt like voiding, she is in pain, there is no urine flowing into her urine bag.

Thus, I prepped the trolley to reinsert a new CBD. I donned my plastic apron and prepped my materials needed and proceeded to clean the patient’s vagina and reinsert a new urinary catheter in as probably as sterile as I could, bedside.

Upon insertion of the new urinary catheter, there was no urine outflow. Thinking that I may have blocked it or inserted not all the way in, totally abandoning my theoretical principles learnt, I proceeded to reinsert about 3 times and each time was met with no urinary outflow but there were bloodstains from the urethra.

I called my partner for help and he proceeded to help me in informing in the oncall group and referred to Urology medical officer oncall who was rather grumpy.

It was during his referral that I realised that the patient had been anuric (not passing any urine) for sometime now. Clearly, she would not have any urine output and although she felt the need to void, it would not have been an issue considering there is a urinary catheter in-situ.

I had unnecessarily caused trauma and I felt foolish for acting prior performing a thorough examination and understanding her case.

The Urology medical officer came and reinserted a CBD to which she asked us not to remove and to request for an ultrasound the following day for assessment as she suspected that the tumour over her abdomen had infiltrated into her urinary bladder or urinary system.

That was settled but definitely ate up a huge amount of our time because of my mistake.

Subsequently I was rather slow and there were a few post-operative patients and new patients admitted into the ward. Hence, I proceeded to do the needful. By the time I was done, my partner had completed taking the blood for the whole ward and at that time, it was around 3am. I could sense the back-to-back disappointment I have caused him and at that point, I have given up on apologising.

We then proceeded to complete our planned discharges of the patients and by 6am, started tracing the blood results of the patients before retiring into the house officer’s room for a break.

In the morning, as usual as in other postings, we would be “summoned” in the group to take any bloods or to start our discharges.

We returned home around 11am and our post-night shift was followed by an off day.

Personally, I felt that I could’ve done a lot better as I was rather slow that night. However, for a first night shift in Surgical, it was not as bad as it seems.

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The Theoretical Doctor Feb 3, 2025

My First Day Back At Work After A 6-Week-Break | Housemanship Diaries

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I officially returned to work on the 2nd of October 2024.

Initially, I was stationed to work the morning shift at ward. However, a colleague of mine decided to take a sick leave on that day when she was initially stationed as the House Officer in the Emergency Department, ETD HO.

Being the Allocation Leader in this department, it is my duty to immediately look for a replacement and to update in the group with the medical officers. Not one person came to mind and I felt bad since it was a friend of mine who took a sick leave or did I feel comfortable dragging another person to cover this shift since it is a shift most people avoided.

Thus, I offered to be the ETD HO myself. It was during an anaemic House Officer period and there were only one House Officer stationed at the Emergency Department.

Hence, I went to work and stocked up my necessary supplies before meeting the post night House Officer in the Emergency Department to receive my handover.

Of all days, it had to be one whereby no coming mornings (bloods) were taken for the patients and there were a lot of active job-lists not being carried out. Not to mention scans to be requested the following morning.

Basically, there were a ton of “shits” being thrown to me and if I do not settle it myself or to push my post night colleague to help me, I would be in a mess for the day.

Imagine having just returned to work to this. Without thinking much, I started identifying the patients who had bloods to be taken and proceeded to take all of them and sent it off. After sending them off, I started preparing for scans and called the radiology medical officer oncall to present my case.

Finally, after I thought I was done, I decided to review the stranded patients.

Normally, the stranded patients should be reviewed around 7am as we would begin our morning rounds around 7:30am till 8am. Thankfully, it was the weekend and rounds began much later.

I went through my list of stranded patients and there were almost 20. 20 stranded patients at various locations.

Would I have the time to review all of them? What about the active joblists or scans? Can I rely on my post night colleague? What if there is a new case?

I remembered it being a rainy day and the referrals were initially from wards and not from the Emergency Department (ETD).

Perhaps it would be a slow day. I thought to myself.

But, I thought too soon.

Soon, referrals started piling up. My medical officer’s phone (MO) was blowing up with calls. Other sub-specialities kept reaching out for me to help them out and at one point, me and my medical officer had to split to ensure we got everything done to the best that we could.

I wished that I could literally divide myself but I couldn’t. On top of that, my right foot started to ache. I just came back from a 6-week-break. I can’t afford to go on anther few weeks. If I do, just when am I going to end this posting?

I recalled it being a terribly hectic day and I felt bad as I was mostly away, having been dragged away by other sub-specialities, escorting patients or carrying out the active job-lists. I could not really be by my medical officer’s (MO) side to see the cases.

Finally, the end of my shift approached. 7pm and my night colleague came for handover.

Despite it being the evening already, the fire was still burning strong, referrals did not stop coming in and I still had tasks to complete or I would be handing over “shits” to my night colleague.

Finally, it was around 8-9pm, I can’t really remember as I was following night rounds with the OT call medical officer and registrar. My medical officer told me to return home since the following day, I would be morning shift.

I remembered returning home that day, somewhat unsatisfied with myself. No doubt that it was a tough day, but I could definitely do better. If only my leg did not slow me. The pain seems to increase with every step I took and with every exertion I made.

However, as I remembered, I was blessed to have an angel as my medical officer oncall for that day. Instead of shaming me or being sarcastic or mentioning that I could do better, she simply thanked me for putting my best effort on the first day back and welcomed me back.

It’s angels like this who makes me want to try to be better the following day.

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The House Officer’s Dilemma | Housemanship Diaries

An article regarding my dilemma on which department or speciality to pursue in after completing my 2-year-journey as a House Officer.

The Theoretical Doctor