Epilogue: A Toast to Treachery

The arrest of Inspector Salomone was a quiet affair, conducted with the discretion that only a small village like Speranza could muster. Inspector Davies, the unassuming but astute officer who had once investigated the death of Elias Thorne, led the disgraced Salomone away in handcuffs. The former guardian of the law did not rage; instead, he wore a look of terrified resignation, muttering about a “higher tempo” and a “conductor” who would not be pleased.

“I was merely the second fiddle, Moira,” Salomone hissed as he was placed into the squad car, his eyes darting toward the bell tower. “The orchestra plays on, with or without me.”

Back at the Coffee Taverna, the atmosphere was one of exhausted relief. The adrenaline that had fueled our escape from the Cigars House had faded, replaced by the heavy, comforting scent of roasted beans and the earthy aroma of Altea’s unlit tobacco.

We gathered around the table to open the bottle of Speranza, Year Zero. Altea, with the reverence of a priestess, used a corkscrew to pull the ancient stopper. It emerged with a satisfying pop, releasing not the smell of vinegar, but a rich, complex bouquet of dark cherries, leather, and… something metallic.

“To the soil of Speranza,” Anna toasted, raising her glass. “And to friendship, the only root that doesn’t rot.”

We drank. The wine was exquisite—velvety and deep. But as I set my glass down, Toe, my sleek black cat, jumped onto the table. He did not look at the wine. He looked at the cork.

With a surgical extend of a single claw, he hooked the cork and batted it toward me. It rolled across the wooden table, coming to rest against the base of the kerosene lamp.

“Look,” I whispered, the Poirot-like instinct twitching in my mind.

Burned into the side of the cork, hidden until it was pulled from the neck of the bottle, was not a vintage year. It was a sequence of musical notes. A specific, haunting trill.

“That’s not just a melody,” Marisa said, her face paling as she recognized the notation. “That is the opening bar of The Devil’s Trill sonata. It’s the signature of the ‘Maestro’—a legendary thief who steals not with silence, but with sound.”

A New dissonance

Before I could respond, the heavy oak door of the Taverna creaked open. The wind from the street blew in, extinguishing the candles and plunging us into a sudden, Hitchcockian gloom.

Standing in the doorway was a young woman, drenched from a sudden squall. She clutched a violin case to her chest as if it were an infant. Her eyes were wide, reflecting the same terror I had seen in Viviana Bellini’s face weeks ago.

“Dr. Hopes?” she whispered, her voice cracking. “They told me you could help. I am the second violinist for the quartet playing at the gala tonight. But… the first chair has vanished.”

She stepped into the light, and Ashwaganda let out a low, warning growl from his perch.

“He didn’t just disappear,” the woman sobbed, placing the violin case on the table next to the branded cork. “He vanished while he was playing a solo on stage. One moment the music was there, and the next… only silence. And in his place, they found this.”

She opened the case. The violin was gone. Resting in the velvet lining was not an instrument, but a perfectly preserved, severed finger of a marble statue—and a single, fresh cacao bean.

I looked at Altea, Anna, and Marisa. The “Conductor” Salomone had warned us about had already begun his performance. The wine was finished, but the overture to a new nightmare had just begun.

“Lock the doors, Anna,” I said, picking up the marble finger. “It seems our quiet life in Speranza is about to get very loud.”

Mint Chocolate and Shadows

Chapter 5: The Alchemy of Shadows

The hidden drawer in the hearth of the Mint Chocolate House did not contain a simple map. That would have been too pedestrian for a mind as labyrinthine as Sir Alistair Finch’s. Instead, we found a collection of translucent vellum sheets, brittle with age, covered in what appeared to be nonsense: botanical sketches of deadly nightshade overlaying architectural diagrams of Speranza’s sewer system, and chemical formulas for synthetic diamonds written in the margins of a recipe for ganache.

“It is chaos,” Anna whispered, the steam from her earlier espresso seeming to have evaporated into the cold tension of the room. “Just scrawls and madness.”

“No,” I corrected, adjusting my glasses as Toe, my black cat, jumped onto the table and placed a paw precisely on a sketch of a Datura flower. “It is not madness. It is a transparency cipher. Marisa, bring the light.”

Marisa, pale but steady, brought a heavy kerosene lamp from the counter. When we held the vellum sheets up against the flame, layering them one over the other, the chaotic lines merged. The botanical sketches faded, and the architectural lines aligned to form a perfect, three-dimensional geometry of a specific object.

It was not a building. It was a humidifier. specifically, the grand, walk-in humidor at Altea’s Cigars House.

“The gear,” I murmured, pulling the brass cog we had found in the poisoned snuff box from my pocket. “It wasn’t a piece of the Raven’s Kiss dagger. It is a key for a different lock entirely.”

Suddenly, the scent of almonds—the cyanide trace from the box—hit me with a new, terrifying realization. I grabbed the snuff box and scraped a tiny amount of the crystalline powder onto the table. “Altea, do you have any lemon juice? Or vinegar?”

“I have a lime for the cocktails,” Altea replied, confused but handing me the fruit.

I squeezed a drop onto the white powder. It hissed violently, turning a vibrant, shocking violet.

“It’s not cyanide,” I breathed, my heart hammering a frantic rhythm against my ribs. “It’s a reactants-based dye, used in the 19th century to mark fools’ gold. The poison was a bluff. A distraction to keep us looking for a killer while the thief walked right past us.”

“The thief?” Anna asked.

“The man in the gray coat,” I said, the realization dawning like a cold sunrise. “He didn’t have a limp because he was injured. He walked with a heavy step because he was carrying something incredibly dense in his lining. He didn’t bring the box to threaten us. He brought it to trigger us. He needed us to find the notes. He needed us to solve the puzzle he couldn’t.”

A crash echoed from the street outside—the sound of breaking glass. It came from the direction of the Cigars House.

“He’s already there,” I said, blowing out the lamp. “And he’s waiting for us to bring him the gear.”

Chapter 6: The Smoke and the Mirrors

We moved through the back alleys of Speranza, avoiding the main cobblestone streets bathed in moonlight. Ashwaganda, usually a creature of kinetic chaos, moved low to the ground, a silent orange streak leading the way. The air grew heavier as we approached Altea’s shop, thick with the scent of unlit tobacco and aged cedar.

The front door of the Cigars House was ajar, the glass pane shattered. Inside, the shop was a cavern of shadows. The moonlight caught the drifting smoke—not from cigars, but from a small canister rolling on the floor, releasing a disorienting, white fog.

“Stay close,” I whispered to my friends. “He wants the gear. He won’t strike until he sees it.”

We pushed through the fog into the back room, where the massive walk-in humidor stood. It was a masterpiece of engineering, lined with Spanish cedar and temperature-controlled dials. Standing before it, silhouetted against the faint light of the streetlamps outside, was the figure in the gray coat.

He turned. The limp was gone. In his hand, he held a heavy, silenced pistol. But it wasn’t the courier we had interrogated at the Coffee Taverna. It was Inspector Salomone.

The shock was physical, a punch to the gut. The weary, cynical policeman who had dismissed my theories for years stood there with a cold, calculating smile.

“Dr. Hopes,” Salomone said, his voice stripped of its usual fatigue. “I knew you couldn’t resist a puzzle. You and your wretched cats are better than any hound.”

“The courier…” I started.

“A hired actor,” Salomone scoffed. “Paid to tremble and deliver a prop. I needed you to find the location. Sir Alistair’s notes were too encoded for a simple policeman, but for a doctor with a penchant for history? Child’s play.” He extended his hand. “The gear, Moira. Now.”

Altea stepped forward, her eyes blazing. “You monitored us? You betrayed the village?”

“I protected this village from boredom for twenty years,” Salomone snapped. “Do you know what is inside this humidor? It is not just cigars. Sir Alistair didn’t trust banks. He trusted climate control. The ‘Star of Speranza’ isn’t a diamond, Altea. It is a seed. The last viable seed of the Silphium plant, thought extinct since Roman times. Worth more than any diamond. A botanical miracle that could rewrite history—and make its owner a billionaire.”

He raised the gun. “The gear.”

I held up the small brass cog. My mind raced, flipping through the pages of Days of your Dreams. ‘When the enemy seeks the time, give him the bell, not the clapper.’

“Catch,” I said, and tossed the gear high into the air, towards the open door of the humidor.

Salomone’s greed was a reflex. He lunged for it, his eyes tracking the glint of brass. In that split second, Toe dropped from the top of the humidor shelves. He didn’t aim for the man. He aimed for the open canister of fog Salomone had kicked aside.

With a precise swat, the black cat sent the canister spinning between Salomone’s legs. The Inspector stumbled, his shot going wild, shattering a jar of Cuban Leafs.

Chapter 7: The Sweetest Trap

“Now!” I screamed.

Marisa, fueled by adrenaline, grabbed a heavy jar of rock candy from a display shelf and hurled it. It wasn’t a precise throw, but it was effective. The jar smashed against the humidity controls, releasing a pressurized blast of water vapor designed to keep the cigars moist.

The room instantly turned into a blinding white cloud. Salomone roared, firing blindly into the mist.

“The floor!” Anna shouted, pulling a lever near the counter. It was the trapdoor to the cellar, usually used for coal deliveries.

Salomone, disoriented and blinded by the steam and fog, took a step back to steady his aim. His heel caught on the edge of the open trapdoor. There was no scream, just a surprised grunt and the heavy thud of a body hitting the coal pile twelve feet below.

Altea slammed the trapdoor shut and threw the iron bolt.

Silence returned to the Cigars House, save for the hissing of the broken humidifier.

I leaned against the counter, shaking. Ashwaganda trotted over to the brass gear, which had landed safely on a velvet chair, and sat on it, purring loudly.

“Silphium,” Altea whispered, looking at the locked humidor. “He was willing to kill for a plant?”

“For the history,” I corrected, picking up the gear. “And for the power of being the one to bring it back.”

I walked to the humidor. The brass gear didn’t fit into the keyhole. It fit into a small, decorative ventilation grate near the floor—a cat-sized opening. I placed the gear onto a hidden spindle and turned it.

The floor of the humidor didn’t open. Instead, a small panel inside the wall slid back. There was no seed. There was no diamond.

Inside sat a single, dust-covered bottle of wine, labelled simply: Speranza, Year Zero.

Next to it was a final note from Sir Alistair:

“The Silphium was a myth I invented to test the greedy. The true treasure is the soil of this village, which grows friendship deeper than any root. Enjoy the vintage, ladies. It is the only one in existence.”

I looked at my friends—Altea, Anna, Marisa—covered in soot, steam, and chocolate dust.

“A myth?” Salomone’s muffled voice shouted from the cellar. “You mean I broke my leg for a metaphor?!”

I smiled, picking up the bottle. “It seems,” I said, channeling the finality of Hitchcock’s closing shots, “that the Inspector fell for the oldest trick in the book. Never trust a treasure map written by a man who loved stories more than gold.”

We left Salomone in the cellar for the real police to find. The night air was crisp, and as we walked back towards the Coffee Taverna to finally open the bottle, the stars above Speranza seemed to wink. Or perhaps it was just the reflection in the golden eyes of the cats, who knew all along that the best twists are the ones you never see coming.

“How to kick off The Highest Ways: A 7-Day Trentino to Friuli Alpine Traverse”

To pull off this 7-day crossing, your strategy for fuel and gear is just as important as your ski line. Below are the specific locations to stock up and the best spots to refuel along the way.

⛺ Planning the Window: When to Book

• The Winter Window: The main winter season for most refuges and lift facilities in the Dolomites runs from early December (around Dec 5–6) through early April (around April 6–7).
• Hut Strategy: Many high-altitude huts officially open for winter around December 5 or 6. However, popular refuges like Lagazuoi may open slightly later in December (around Dec 23), while others like Averau open as early as Dec 6.
• Early Spring: The high-altitude trekking season traditionally begins on June 20, but if the weather is favorable, many huts in Trentino open their doors early in spring.
  🛒 Where to Buy Gear & Supplies
  Start your journey in San Martino di Castrozza, which serves as your primary base for equipment and food.

• San Martino di Castrozza: You will find several shops for mountain clothing and equipment. Minimarket Taufer also stocks gear-related accessories like condimenti and basic mountain needs.
• Cortina/Pocol Area: If you pass through the northern routes, the Sports Equipment Rental Pocol opens in early December.

• Despar Supermarket (San Martino): Best for fresh fruit, regional specialties, artisanal cold cuts, and local cheeses.
• Coop Supermarket (San Martino): Famous for quality and organic options, including a section for natural foods, whole grains, and healthy snacks.
• Minimarket Taufer (San Martino): Offers a wide range of “genuine products” including speck, salumi, honey, and specialty muesli (chocolate, yogurt/raspberry, or honey/nut mixes) which are perfect high-energy trail fuel.

• Cooperativa Imperial Forni: A central supermarket for replenishing supplies.
• Local Delicacies: Visit Malga Alta Carnia or Malga Carnia Formaggi for specialty mountain cheeses and select cold cuts.
• Fresh Bread: Stop at Panificio Fornese for local baked goods to carry on your final descent.
  🍰 Sweet Treats, Chocolate & Coffee
  Alpine touring burns thousands of calories, so high-energy stops are essential.
• Pasticceria Myriam (Forni di Sopra): A great spot to end your journey with traditional Friulian pastries.
• Minimarket Taufer: Stocks a variety of chocolates and sweets specifically labeled for mountain energy.
• Bar & Chocolaterie (Hotel Villa Eden, Corvara): If your route dips into Val Badia, they offer a wide range of flavored hot chocolates and little chocolates perfect for a mid-journey treat.
• Handmade Dolomites Chocolate: Look for specialized “Dolomites Chocolate” in local centers like the Gardena Center, which combines South American and African cocoa with mountain tradition.
  🍽️ Where to Have Dinner & Breakfast
• Alpine Refuge Dining: In winter, a typical hut meal starts with a platter of speck, luganega, and Alpine cheeses, followed by hearty classics like goulash with polenta or hot canederli (Tirolian dumplings).
• Baita Colverde (San Martino): At 2,000 meters, this refuge offers traditional Primiero Valley specialties and is perfect for a lunch stop or a romantic high-altitude dinner.
• Malga Civertaghe (San Martino): A mountainside dairy farm (malga) known for authentic local food like polenta and a blend of Italian and Austrian dishes.
• Rifugio Rosetta: Offers warming meals like pasta with venison or minestrone, essential after skiing through deep snow.
• Ristorante da Anita: Ideal for a traditional dinner featuring local specialties like pumpkin ravioli and sachertorte.

To help you prepare for the physical demand of this “High Ways” crossing, here is a breakdown of the daily metrics for a 7-day winter ski traverse from Passo Rolle (Trentino) to Forni di Sopra (Friuli).

🏔️ Difficulty and Terrain
This traverse is classified as Intermediate to Advanced. You should be a fluid off-piste skier capable of handling all snow conditions and comfortable with “kick turns” on slopes up to 35°.

📊 7-Day Performance Summary
The average daily climb with skins ranges from 500m to 1,100m. For a traverse of this scale, expect to skin for 2 to 5 hours per day. Day Key Stage Est. Vertical Gain (Uphill) Technical Difficulty 1 Passo Rolle to Monte Mulaz ~700m – 900m Moderate (Porphyry ridges) 2 Mulaz to Forca Rossa ~500m – 1,100m Moderate (Limestone plateau) 3 Marmolada Glacier Ascent ~1,200m – 1,400m Challenging (High altitude) 4 Sella Massif & Val de Mesdì ~600m – 700m Technical (Narrow couloirs) 5 Fanes to Tre Cime ~500m – 900m Moderate (Frozen valleys) 6 Croda Rossa to Friuli Border ~1,000m Demanding (Remote wild) 7 Monte Pramaggiore Descent ~1,200m – 1,400m Technical (Final steep lines)

🥗 High-Performance Fueling Tips

Since you will be burning between 3,000 and 5,000 calories daily, follow these fueling indications:

• Breakfast (The “Refuge Special”): Most huts provide a heavy breakfast of malga milk, artisanal jams, local cheeses, and cold cuts to provide slow-release energy.
• On-the-Trail Snacks: Pack “genuine products” from local minimarkets like chocolate-mixed muesli, speck slabs, and honey-nut bars.
• Lunch: Many huts offer sack lunches you can pack, or you can stop at valley refuges for a warm Gulaschsuppe (goulash soup).
• Dinner: Focus on recovery with protein and carbs—venison pasta, handmade canederli (dumplings), and traditional polenta.

#7DayCrossing #alpineTouring #art #bloganuary #bloganuary202401 #bloganuary202402 #bloganuary202403 #bloganuary202404 #bloganuary202405 #bloganuary202408 #bloganuary202409 #bloganuary202411 #bloganuary202416 #bloganuary202428 #bloganuary202429 #bloganuary202430 #books #castles #cocktail #cortinaPocolArea #culture #curiosity #dailyprompt #dailyprompt1804 #dailyprompt1805 #dailyprompt1806 #dailyprompt1807 #dailyprompt1808 #dailyprompt1811 #dailyprompt1812 #dailyprompt1814 #dailyprompt1819 #dailyprompt1832 #dailyprompt1839 #dailyprompt1840 #dailyprompt1851 #dailyprompt1859 #dailyprompt1860 #dailyprompt1891 #dailyprompt1975 #dailyprompt1976 #dailyprompt1978 #dailyprompt1980 #dailyprompt1981 #dailyprompt1982 #dailyprompt1983 #dailyprompt1984 #dailyprompt1985 #dailyprompt1986 #dailyprompt1987 #dailyprompt1988 #dailyprompt1990 #dailyprompt1991 #dailyprompt1993 #dailyprompt1994 #dailyprompt1995 #dailyprompt1997 #dailyprompt1999 #dailyprompt2007 #dailyprompt2008 #dailyprompt2010 #dailyprompt2011 #dailyprompt2012 #dailyprompt2013 #dailyprompt2014 #dailyprompt2017 #dailyprompt2022 #dailyprompt2089 #dailyprompt2099 #dailyprompt2112 #dailyprompt2113 #dailyprompt2115 #dailyprompt2124 #dailyprompt2125 #dailyprompt2126 #dailyprompt2127 #dailyprompt2129 #dailyprompt2132 #dailyprompt2134 #dailyprompt2137 #dailyprompt2138 #dailyprompt2145 #dailyprompt2146 #dailyprompt2152 #dailyprompt2153 #dailyprompt2159 #dailyprompt2167 #DANCESPIRITCOLOROFPEACE #DOLOMITES #dolomitesSkiTour #drinks #EmotionsFeelingsSundayPowerOfASmileMyLifeWithYouSOULCHEERFULNESSFEELINGSHOPETearsSometimesAKissIsAllYouNeedTheSilenceLifeSelfWords #Evernote #everyday #Facebook #facts #food #foodAndSnacks #fuelStrategy #gearStrategy #highAltitudeHuts #hiking #HISTORY #IFTTT #Instagram #Ireland #Irish #Island #Italy #kitchen #language #learning #LifeAndAGIRLINTERRUPTEDFriendshipAndPoisonBULLIEDKLDONNOneDayAtOfficeESSENTIALFORSURVIVINGTheBreathOfASoulMePastPresentFutureYesUAreIGotItSome #LoveAndAdventureAreIntricatelyConnectedInASummersimoSymphony #mountainEquipment #mountainGear #mountains #MYCOCKTAILWORLD #noMatterHow #noMatterHowBadIsTogetherWeCanWin #photography #pictures #Pinterest #RECIPES #refuelSpots #refugePlanning #sanMartinoDiCastrozza #skiLine #skiTouring #social #SUMMER #SUMMERBOMB #summersimoBestTouristGuidesAreYourTasteBuds #SUMMERSIMOTHEUNDERWORLD #SUMMERSIMOCOMPASS #SUMMERSIMOSCOCKTAILS #SUMMERSIMOSCOMPASS #SUMMERSIMOSGLITTERWAR #SUMMERSIMOSRECIPES #technology #TheBestTouristGuidesAreYourTasteBuds #TheCaseOfTheSilentNightingaleAndTheEtruscanDeception #ThePurringPage #TheSoundOfSmile #TOURISM #travel #trekkingSeason #TRENTINOALTOADIGE #winterWindow #winterTravel #WithASummersimoSmile

Um wie viel Uhr gehst du derzeit ins Bett und stehst morgens auf?

Ohne Auto, weil es mal wieder kaputt ist, gestaltet sich der Morgen stressig. Der Wecker klingelt um 5.30 Uhr und dann nochmal um 5.45 Uhr. Um 6.00 Uhr ist Aufstehen angesagt, gefolgt von einer schnellen Dusche. Um 6.10 Uhr muss ich mich beeilen, um den Bus zu erreichen. Um 6.25 Uhr steige ich dann endlich in den Bus ein. Es […]

https://www.meskasblog.de/?p=14190

#arbeit #auto #dailyprompt #dailyprompt1995

My First Day In General Surgery – Tagging Day 1

Related Posts:

• The Worst Morning Shift In General Surgery | Housemanship Diaries
• I Ordered A Chest X-Ray For The Wrong Patient | Housemanship Diaries
• My First Night Shift In Surgery | Housemanship Diaries
• The House Officer’s Dilemma | Housemanship Diaries
• Surviving A Month Of Tagging In My Fourth Posting – Surgery | Housemanship Diaries
• Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
• My Downfall In Surgery Which Led To My Extension – 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

My “Day 1 of life” in the Surgical Department commenced on the 4th of July 2024 which fell on a Thursday.

I was allocated to work in the side room of Female Surgical Ward (FSW) with a fellow colleague whom I’ve worked previously in the night shift in Paediatrics.

I left home around 5.45am and arrived at almost 6am and started reviewing as usual. I took some time as I read through the previous entries and used it as a guide to write my morning reviews.

Upon reviewing around 4 patients, a fellow medical officer arrived and automatically, I greeted him and followed him. It has become a reflex of mine as in other postings, we had to be like that, which is a good practice.

He was friendly and had a kind demeanour. Thus, I followed him, not knowing that he is actually the medical officer in charge of the HPB (Hepatobiliary) patients.

Usually, there will be a house officer in the ward in charge of the HPB patients, which I did not know of course, considering that it is my first day. Thankfully, I had a partner who followed the “GS – General Surgery” rounds with the other medical officer instead.

As usual, rounds with medical officers followed by rounds with specialists in the morning and as House Officers, we are their assistant and scribe. The morning rounds ended and we proceeded with tracing the joblists for each patients in our allocated cubicles and updating it in the “MOHO” group as well as proceeded to complete the active job-lists.

This is then followed by afternoon reviews, afternoon rounds with medical officers and specialists followed by the completion of the active joblists and finally starting with on-call reviews and preparing our handover lists.

Considering that I am still tagging, I had to stay till at least 10pm. After completion of the on-call reviews, we followed the on-call rounds and HPB (oncall rounds), clerked and transferred in the new patients, completion of the active joblists before finally heading home.

Overall, my first day in Surgery was surprisingly good and calm. The medical officers and specialists seemed rather kind and patient. Thus, giving me the encouragement to continue despite having heard that this particular posting seemed like a rather toxic one which only serve to instil fear in me prior to joining this department.

Related Posts:

• The Worst Morning Shift In General Surgery | Housemanship Diaries
• I Ordered A Chest X-Ray For The Wrong Patient | Housemanship Diaries
• My First Night Shift In Surgery | Housemanship Diaries
• The House Officer’s Dilemma | Housemanship Diaries
• Surviving A Month Of Tagging In My Fourth Posting – Surgery | Housemanship Diaries
• Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
• My Downfall In Surgery Which Led To My Extension – 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

YouTube | Instagram | Pinterest | Facebook | Spotify

About Me | Privacy Policy | Contact Me

#Articles #Blog #blogging #bloggingAsADoctor #dailyprompt #dailyprompt1836 #dailyprompt1863 #dailyprompt1897 #dailyprompt1903 #dailyprompt1905 #dailyprompt1906 #dailyprompt1907 #dailyprompt1910 #dailyprompt1983 #dailyprompt1987 #dailyprompt1988 #dailyprompt1993 #dailyprompt1995 #dailyprompt2003 #dailyprompt2008 #doctor #generalHospital #generalSurgery #hospital #houseOfficer #housemanship #kuching #Malaysia #medical #Medicine #sarawak #surgery #surgical #tagger #tagging #writing

The Worst Morning Shift In General Surgery | Housemanship Diaries

Related Posts:

• I Ordered A Chest X-Ray For The Wrong Patient | Housemanship Diaries
• My First Surgical ETD / ED Night Shift Experience
• My First Night Shift In Surgery | Housemanship Diaries
• The House Officer’s Dilemma | Housemanship Diaries
• Surviving A Month Of Tagging In My Fourth Posting – Surgery | Housemanship Diaries
• Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
• My Downfall In Surgery Which Led To My Extension – 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

I can’t really remember when as at the time of writing this article, I am about to cross into the second week of 2025.

Perhaps it was somewhere in October last year or early November.

It happened to be the day shift on a weekday and we were lack of manpower. 3 House Officers in the Male Surgical Ward, 2 House Officers in the Female Surgical Ward. Out of the 5 of us, I am the senior and the rest are first posters, three of which are only Day 3 into their housemanship life.

Oh dear…

We all know how busy Surgical can get and being the only senior that day surrounded by newbies, it was as good as being alone as they were not familiar with the system or the work or the procedures.

Learning does take time.

The day started with me taking care of the acute beds. The acute beds in the ward is considered the most unstable, hence it only made sense to allocate the senior, which is myself there, followed by the subacute cubicles.

The front cubicles and back cubicles are relatively stable patients. Hence, I allocated my juniors there. Usually for first posters in their first week of life, I would not allocate them independently to take care of a cubicle. However, we were desperately short staffed that day and taking care of the front or back cubicles are not easy either especially if you’ve just entered.

The day was busy enough. Started with me following rounds at acute and subacute with my medical officers and again with the ward surgeon, only to leave midway as the Hepatobiliary Team (HPB) had their own separate rounds and I was the HPB house officer for that day.

After rounds, it is the completion of the joblists. Amidst trying to complete the joblists, we had to transfer in new patients, take and send off the bloods of patients who have just entered as well as attending to any acute issues.

On that day, I had to assist with the front and back cubicles as well and in the afternoon, the juniors left for their Operating Theatre (OT) orientation.

My phone literally rang non-stop that day and the nurses kept haunting me down for everything. If only, I had the ability to clone myself…

Suddenly my phone rang and I had to assist a registrar to help tend to a visiting outpatient, attend the female surgical ward acute issues because the medical officer on-call called me as well as attend a virtual meeting.

Time flew by rather quickly, one minute I was escorting a patient, next was being called upon by this and that medical officer or registrar or nurses. To the point, my post-call registrar stayed back to assist me.

As the evening progressed, most of my patients desaturated. The annoying thing about Surgery, we had to update the whole story properly in the oncall WhatsApp Group for the day.

If only it were as easy as that.

We couldn’t just take a picture of our entry and update. Instead, we had to properly type the whole summary or stay.

I finally completed my task for the day at 10pm. It was an extremely exhausting and tiring day. One which I have no interest in relieving again.

That was probably the worst morning shift I’ve ever experienced.

However, looking back at what I’ve written, it doesn’t do justice to what I actually felt that day.

Related Posts:

• I Ordered A Chest X-Ray For The Wrong Patient | Housemanship Diaries
• My First Surgical ETD / ED Night Shift Experience
• My First Night Shift In Surgery | Housemanship Diaries
• The House Officer’s Dilemma | Housemanship Diaries
• Surviving A Month Of Tagging In My Fourth Posting – Surgery | Housemanship Diaries
• Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
• My Downfall In Surgery Which Led To My Extension – 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

YouTube | Instagram | Pinterest | Facebook | Spotify

About Me | Privacy Policy | Contact Me

#article #Blog #blogging #bloggingAsADoctor #dailyprompt #dailyprompt1826 #dailyprompt1828 #dailyprompt1829 #dailyprompt1833 #dailyprompt1834 #dailyprompt1836 #dailyprompt1897 #dailyprompt1914 #dailyprompt1920 #dailyprompt1982 #dailyprompt1995 #dailyprompt2003 #doctor #generalHospital #generalSurgery #healthcare #hospital #houseOfficer #housemanship #Malaysia #medicalOfficer #morningShift #surgery #surgical #worstShift #write #writing

I Ordered A Chest X-Ray For The Wrong Patient | Housemanship Diaries

Related Posts:

• My First Surgical ETD / ED Night Shift Experience
• My First Night Shift In Surgery | Housemanship Diaries
• My First Day Back At Work After A 6-Week-Break | Housemanship Diaries
• The House Officer’s Dilemma | Housemanship Diaries
• Surviving A Month Of Tagging In My Fourth Posting – Surgery | Housemanship Diaries
• Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
• My Downfall In Surgery Which Led To My Extension – 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

It was during my tagging period in the Surgical Posting and I was a Female Surgical Ward.

It was my first day being in charge of the acute beds and side room. I recalled one of the patients being a Urology patient. Usually, if the patient is from other departments, we are not required to review them. This patient in particular was intubated and sent to our ward to be placed in one of the acute beds for further monitoring from the Urology ward.

Upon transfer into the ward, the patient required a portable CXR for post-intubation. I did not screen through the casenote since it was from another team. The nurse in charge informed me of a new case but did not tell that the patient needed a CXR. Hence, my reply was “it’s not our patient, it is from a different team. They will review later.”

Hence, the Urology Medical Officer on call came after a while and reviewed the patient. He went to check the system and was confused as to why the chest x-ray was not done for the patient. The nurse immediately informed that I did not want to do it considering the patient is from another team.

At that time, afternoon rounds with the Surgeon was currently ongoing and I was disturbed from writing my reviews. I immediately proceeded to fill the form and had it sent to the Radiology Department to request for a portable chest x-ray.

Amidst the rush, I had wrongly written for another patient instead.

I only realised it when the radiographer came and did an x-ray on two patients at the acute beds. One, the intubated patient from another department and another which is a patient of ours.

I realised my mistake and rushed back to check the form and was met with a very angry daughter of the patient.

I admitted my mistake and was yelled at. After such a tiring week and a hectic day on top of tagging itself, I could not contain myself any longer and tears started streaming down my eyes uncontrollably.

Thankfully enough, it was just a mere chest x-ray and nothing more or a wrong operation done. Since the patient is under the colorectal team, the surgeon in charge and the medical officers in charge will proceed with their rounds again and I could not contain myself again and tears started to stream down my face again.

The medical officer in charge noticed and asked me to go to toilet, understanding that I needed some time for myself to recollect myself again. Hence, I excused myself.

After a while, I went out and rejoined the rounds and admitted my mistake to the medical officer in charge to which she laughed and said “well she has a free x-ray now and were there any changes as compared to the previous one?” To which I answered none.

She was amused considering that it was over a mere x-ray which was requested for the wrong patient that I started breaking down.

Thankfully, it was just an x-ray.

The lesson learnt here was for me to be extra careful in the future because it could have been worse and become medicolegal.

Please try to avoid doing anything out of rush or pressure and always slow down for a bit and reconfirm the patient and procedures to avoid or minimise errors.

Related Posts:

• My First Surgical ETD / ED Night Shift Experience
• My First Night Shift In Surgery | Housemanship Diaries
• My First Day Back At Work After A 6-Week-Break | Housemanship Diaries
• The House Officer’s Dilemma | Housemanship Diaries
• Surviving A Month Of Tagging In My Fourth Posting – Surgery | Housemanship Diaries
• Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
• My Downfall In Surgery Which Led To My Extension – 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

YouTube | Instagram | Pinterest | Facebook | Spotify

About Me | Privacy Policy | Contact Me

#article #Blog #blogging #bloggingAsADoctor #chestXRay #dailyprompt #dailyprompt1833 #dailyprompt1863 #dailyprompt1897 #dailyprompt1903 #dailyprompt1904 #dailyprompt1905 #dailyprompt1906 #dailyprompt1908 #dailyprompt1910 #dailyprompt1915 #dailyprompt1981 #dailyprompt1985 #dailyprompt1987 #dailyprompt1993 #dailyprompt1994 #dailyprompt1995 #dailyprompt2003 #dailyprompt2005 #doctor #errors #generalHospital #hospital #houseOfficer #housemanship #Malaysia #medicalOfficer #mistakes #surgery #surgical #write #writing

My First Night Shift In Surgery | Housemanship Diaries

Related Posts:

• My First Day Back At Work After A 6-Week-Break | Housemanship Diaries
• The House Officer’s Dilemma | Housemanship Diaries
• Reflection of the Paediatrics Posting
• Surviving A Month Of Tagging In My Fourth Posting – Surgery | Housemanship Diaries
• Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
• My Downfall In Surgery Which Led To My Extension – Housemanship Diaries
• 1 Year Of Housemanship Update – Housemanship Diaries
• Another Good Advice I Will Remember For The Longest Time – Housemanship Diaries
• The Time I Turned A Baby’s Hand Blue – Housemanship Diaries
• Enjoying The Journey – Housemanship Diaries

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.

Related Posts:

• My First Day Back At Work After A 6-Week-Break | Housemanship Diaries
• The House Officer’s Dilemma | Housemanship Diaries
• Reflection of the Paediatrics Posting
• Surviving A Month Of Tagging In My Fourth Posting – Surgery | Housemanship Diaries
• Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
• My Downfall In Surgery Which Led To My Extension – Housemanship Diaries
• 1 Year Of Housemanship Update – Housemanship Diaries
• Another Good Advice I Will Remember For The Longest Time – Housemanship Diaries
• The Time I Turned A Baby’s Hand Blue – Housemanship Diaries
• Enjoying The Journey – Housemanship Diaries

YouTube | Instagram | Pinterest | Facebook | Spotify

About Me | Privacy Policy | Contact Me

#article #Blog #blogging #bloggingAsADoctor #dailyBlogging #dailyprompt #dailyprompt1834 #dailyprompt1955 #dailyprompt1959 #dailyprompt1962 #dailyprompt1963 #dailyprompt1971 #dailyprompt1977 #dailyprompt1978 #dailyprompt1981 #dailyprompt1982 #dailyprompt1983 #dailyprompt1985 #dailyprompt1986 #dailyprompt1987 #dailyprompt1988 #dailyprompt1995 #dailyprompt2003 #doctor #healthcare #hospital #houseOfficer #housemanship #Malaysia #medical #medicalOfficer #Medicine #nightShift #surgery #surgical #write #writing

Related Posts:

• Reflection of the Paediatrics Posting
• Surviving A Month Of Tagging In My Fourth Posting – Surgery | Housemanship Diaries
• Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
• My Last Day In Paediatrics As A House Officer
• My Downfall In Surgery Which Led To My Extension – Housemanship Diaries
• 1 Year Of Housemanship Update – Housemanship Diaries
• Another Good Advice I Will Remember For The Longest Time – Housemanship Diaries
• The Time I Turned A Baby’s Hand Blue – Housemanship Diaries
• Enjoying The Journey – Housemanship Diaries

While growing up, when I was asked regarding what I looked forward towards in the future, I always had the answer.

The answer was simply, I wanted to be a Doctor (coz that’s what I knew my whole life and indirectly working towards albeit having other interests).

Thus, from primary school, next would be high school, moving towards science stream in school and pre-university in a course which would serves as a prerequisite into entering medical school. 

In medical school, my focus was always on the exams, completing that particular posting, completing that year, completing preclinicals and moving onto clinicals, studying for the grand finals, completing medical school and graduating.

Upon graduation, applying for housemanship to start practicing. I always knew that I wanted to practice in Sarawak General Hospital. Thus, that didn’t require much thinking. Working my way there, and finally, starting housemanship.

Now that I’m a House Officer, completing each posting, working towards completing a year, now focusing on completing the whole journey.

But after that? I feel lost and aimless.

Previously, when asked regarding my need to have a family, I would brush it off. Not that I didn’t want to but I’ve yet to meet the person that I would want to spend the rest of my life with and build a family.

My aim was mainly catered towards my parents. But they’re doing just fine on their own. Thank God for that. I don’t see my purpose anymore actually.

In regard to post-housemanship, I have no idea of which speciality I would like to dive into. In terms of being surgical based or medical based, the thing I learnt over this past 1 year is that I’m definitely a surgical based person. Though, I have enjoyed paediatrics very much (which I supposed is a very much toned down version of the chaotic medical posting).

I wouldn’t know, as upon writing this article, I’ve yet to complete my medical posting.

The medical field is not just tied to 6 different postings. As a House Officer in Malaysia, we are required to rotate to 6 different postings throughout our 2-year-duration in housemanship which are, Surgery, Medical, Orthopaedics, Obstetrics and Gynaecology and Paediatrics. The sixth posting, we have the privilege to choose among Emergency Department (ETD / ED), Anaesthesia, Klinik Kesihatan (Community Clinics) and Psychiatry.

However, in reality, the clinical field is vast and there are other specialities that we as House Officers have yet to enter. In terms of non-clinical field, it is another vast category.

Which of it am I?

At times I wished that I always knew of what I wanted to be, such as a Cardiologist or a Surgeon but after assisting in the operating theatres and working as a junior doctor, none of it appeals to me 100%. Sure it is interesting but is it something I would want to be doing for the rest of my life?

Having completed a year of housemanship, I thought that the answer would be clear to me by now. Yet, I’m still as unsure as I had been before. I’ve approached multiple seniors, medical officers and specialists and talked to various doctors from different fields regarding their experience. I seem to have the information but my heart was not fully captured by any of it. 

Everything seems nice and interesting. I hope that in time to come, the answer would be clearer. The least I could do at the moment is to put my best foot forward in whatever department or sector that I go through.

Related Posts:

• Reflection of the Paediatrics Posting
• Surviving A Month Of Tagging In My Fourth Posting – Surgery | Housemanship Diaries
• Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
• My Last Day In Paediatrics As A House Officer
• My Downfall In Surgery Which Led To My Extension – Housemanship Diaries
• 1 Year Of Housemanship Update – Housemanship Diaries
• Another Good Advice I Will Remember For The Longest Time – Housemanship Diaries
• The Time I Turned A Baby’s Hand Blue – Housemanship Diaries
• Enjoying The Journey – Housemanship Diaries

YouTube | Instagram | Pinterest | Facebook | Spotify

About Me | Privacy Policy | Contact Me

https://theoreticaldoctor.com/2024/09/25/the-house-officers-dilemma-housemanship-diaries/

#Blog #blogging #dailyprompt #dailyprompt1863 #dailyprompt1897 #dailyprompt1903 #dailyprompt1904 #dailyprompt1905 #dailyprompt1906 #dailyprompt1907 #dailyprompt1994 #dailyprompt1995 #dailyprompt2003 #dailyprompt2005 #dailyprompt2008 #dailyprompt2009 #dailyprompt2014 #dailyprompt2019 #dailyprompt2023 #dailyprompt2024 #dailyprompt2025 #dailyprompt2026 #dailyprompt2027 #dailyprompt2028 #dailyprompt2029 #dailyprompt2030 #dailyprompt2032 #dailyprompt2034 #dailyprompt2039 #dailyprompt2041 #dailyprompt2045 #dailyprompt2049 #dailyprompt2050 #dailyprompt2051 #dailyprompt2053 #dailyprompt2056 #dailyprompt2057 #dailyprompt2059 #dilema #doctor #doctorSLife #hospital #hospitalSLife #houseOfficer #housemanship #Malaysia #medical #reflection #surgery #surgical #write #writing

Click here for more articles & daily dose.

Sometime ago, I wrote about “The Small Change I Hope My Blog Would Make“, whereby I mentioned that with every article written and uploaded on this website would spread some form of comfort and positivity, especially within the community of junior doctors.

Perhaps I’m just simply being optimistic. I have to. That keeps me going, even on difficult days to the point it has become a default reflex for me.

Nonetheless, I love to write and sometimes I do get lost that I tend to deviate from the topic at times and divert back to the main topic at hand.

Living in this world which has its flaws and problems at every corner, I try to see the good aspect of things and thus, I try to end my articles on a good note or some encouragement, which is mainly directed at me actually. However, I never know who may be reading my written articles and perhaps just need some encouragement and kind words at the moment.

It serves as a “happy ending” just like a fairytale in which I escape in one too many times.

Click here for more articles & daily dose.

YouTube | Instagram | Pinterest | Facebook | Spotify

About Me | Privacy Policy | Contact Me

https://theoreticaldoctor.com/2024/09/21/ending-my-articles-on-a-good-note/

#article #Articles #Blog #blogging #dailyprompt #dailyprompt1863 #dailyprompt1907 #dailyprompt1912 #dailyprompt1913 #dailyprompt1914 #dailyprompt1916 #dailyprompt1917 #dailyprompt1918 #dailyprompt1919 #dailyprompt1921 #dailyprompt1922 #dailyprompt1923 #dailyprompt1924 #dailyprompt1926 #dailyprompt1931 #dailyprompt1933 #dailyprompt1935 #dailyprompt1984 #dailyprompt1995 #dailyprompt2005 #dailyprompt2008 #dailyprompt2019 #dailyprompt2024 #dailyprompt2026 #dailyprompt2027 #dailyprompt2029 #dailyprompt2039 #dailyprompt2041 #dailyprompt2051 #happyEnding #optimistic #writing