a lil note

to the blood bank MO

today i requested 3 pints of WB for the same patient who collapsed in the ward

i told him that the patient is going for op TRO ectopic pregnancy and i need 3 pints of WB

so there he was............... shouting at me over the phone

so, u need the blood to push up the BP?

HOW RIDICULOUS?

YOU ARE REALLY SO RIDICULOUS LAR

hello blood bank MO, do u know that ectopic pregnancy can rupture and patient can end up having haemoperitoneum? then the BP will drop.... patient will go into shock?

what if one day your wife gets an ectopic and the MO blood bank does not allow the whole blood?

if you think that i am ridiculous, i will say that u are brainless

good night

PLEASE BE REMINDED THAT U WERE ONCE A HOUSE OFFICER

to those new MOs, please be reminded that you were once a house officer!!!!!!

i have heard plenty of stories about new MOs. Most of them are so arrogant and it is never easy to approach them.

there is a young nulliparous lady who collapsed in the ward today. Ooi and me attended the patient stat. we ordered the vital signs to be taken stat. Noted that BP was lowish. it was 82/52mmHg and upon examination patient was cold + clammy. patient is not hypertensive nor she has any preexisting heart problems. I ordered the diligent nurse to run 1 pint HM fast to push up the BP. Patient soon regain conciousness. I told Ooi to call MO stat because patient collapsed in the ward ( as every case in O&G has to be discussed with MO). While waiting for the MO, i set another large bore brannula. It was not easy. all the veins were collapsed.

so, there comes the new MO and the first thing she asked both of us was............' annie, ooi... u orang dah poster ke berapa? ' we told her that we were both 4th posters. There came the bomb from her. ' u know patient collapsed rite? why can't both of u call a 6th poster to attend the patient '..................i got irritated. so, a 4th poster should not resuscitate a patient? we tried our best to stabilize the patient, did all we could...........and yet this is what she told us. i guessed only 6th poster got the brains to resuscitate patients. all the 4th posters should just be the clerks! both of us may not be the best HO but at least we did something. we did not leave the patient alone. is it wrong again?

i just don't understand why would new MOs be so biatchy and arrogant. whenever i inform a non reactive CTG to biatchy Dr M, she will say ' nanti aku mai lar.... u nak aku buat apa??' how could a MO take things so easily. O&G is about saving 2 lifes. irresponsible MOs should never take up O&G

i used to respect MOs for their knowledge, for the responsibilities...... but now, i am so sorry to say that i look down on them. stop complaining about HO. You were once a HO. No doubt that we will do mistakes. If we do, teach us. Don't complain...... so if MO does a mistake, is it acceptable?

slut vs biatch

so, is slut a better word than biatch?

everybody does mistakes. nobody is perfect. i did a mistake today for not informing high BP in a 5 years old child with acute glomerulonephritis. well, i was so tensed up for my presentation. who will not be stressed up? i will get extended if i do not present for CMEs. i had totally forgotten about the high BP. blamed in on the aging brain cells. Biatchy Dr L made a big fuss over it. She shouted at me so loudly at the nurses' counter. As usual, i was so lazy to explain anything. I was gullible enough to join this profession one year ago and thanks to those pathetic assholes out there for moulding me into a smarter person. I had learnt that no matter how well i try my best to explain, nobody will listen because I am just another useless houseman. I admit that it is entirely my fault for not informing my medical officer about the high BP but is it necessary to tell boss about it? the child was perfectly fine, did not throw a fit nor he had projectile vomiting. why can't she just scold me in the ward and forgets about it? why must she be so biatchy? now...............do you have to be that biatchy to be boss's pet? then she demanded me to write an explaination letter for boss

well, she is just a chronic MO. she does not have the authority to ask me to write an explaination letter! Damn it! i will write the letter willingly if boss wanted it. why must she be so biatchy again?

all in all, boss scolded me on her behalf. i am still pissed at her
i am not going to call her a slut because slut is a better word than biatch!!!
so biatchy woman!! i will be better than you one day!!
you are lucky that i am not interested in this field
otherwise, u will have to write for me and i will shout at you like how u used to do to me and my fellow colleagues. ' ohh biatchy Dr L, can't u write faster? why is your handwriting so ugly? '

for goodness sake, you were once a houseman!
do you have to be so mean to your HOs?

at least boss is nice enough to appreciate what i have done in the ward and telling me to take this as a lesson. no wonder, Dr K said that i am a bad HO. maybe i am. i had always been notorious. i am trying my best to be a good girl. what else do you people want from me?!!!!!!

So Dr L, FUCKED OFF!!!!!!
i will be better than you one day

gonna read my ECG book today..........

in the end, slut is still a better word than biatch.

guilty

my baby has finally knocked his lil knuckle on heaven's gate. well, he is not biologically my baby. since i started my paediatrics rotation, i had been calling my lil patients 'my babies'. i talked to them. i cuddled them and sometimes its so nice to have them in your arms. they are tiny, warm, cute, rosy pink and active. Unfortunately, this baby was an exception. he was never active. Since he was tachypnoiec at birth, he was put on nasal CPAP for 14 days. He was perfectly fine until i was in charged of the ventilatory section of NICU. Blamed it on the death angle who has never failed to be my best friend. he was then intubated and requiring triple inotropic support. soon, he developed all the complications of prematurity - intraventricular haemorrhage, necrotising enterocolitis, jaundice and septicaemia. his septicaemia was so bad that it had led to panophthalmitis. we had no choice but to suture his eyelids to prevent exposure keratitis. when my specialist broke the bad news to the baby's parents, i felt like weeping. that was when i saw the never ending love that parents have for their newborn. Seeing their critically ill child brought tears to the mother's eyes. Being a strong devotee of buddhism, i believed that every sufferings will come to an end. God must have loved this tiny baby more than any of us. He was then gone, being supported only by ventilators and inotropes. His mother did not want us to off the ventilatory support. For goodness sake, that was her only child and soon i learnt that his father had an extramarital affair. How pitiful..... she lost her son and her husband. she has nothing left.

All in all, I hate cheaters and false hopes. I hate people who don't even know how to treasure me as a friend. For those who think that i am even worst than those unwanted people in your life, please stay away. I just want to be your friend. is it so difficult? I don't think i need you at all because i have a bunch of awesome girlfriends.

i guessed its time for me to pay more attention to the people around me. i just realized that even CCU staff nurses are taking good care of me. they changed the bedsheets for me and gave me a new blanket to sleep whenever i am postcall. Some of them are just like my mother. they made me feel so at home in SP. i felt so ashamed of myself for not knowing their names. i am so sorry if i had neglected anybody. i will grow up and be a better person. muacks!!

where has the sunshine gone?

it has been exactly 2 months since i stepped my lil feet into internal medicine. All the senior HOs gave bad remarks about this department. Obviously i was scared to be a medical HO. Did not apply for medicine as my 2nd posting but i guessed i was given medicine for some reasons. I don't believe in God but i should just clasped my hands and thank him for putting me in medicine. Otherwise, i won't get the chance to meet some of the nicest people on earth. most of them left and i am feeling a lil bit bored.

i guessed i have to learn how to be responsible for all the silly things that i had done. I posted a comment in facebook and my big boss got to know about it. I was merely dictating what she scolded me and for that, i am being punished. I tried to be strong but its not easy to be one. Promised myself that i will still stay cheerful in medicine but i failed. somebody once commented that i brought sunshine to the department. I wonder where the sunshine had gone.

now that i am being punished, i have to work extra hard

1) i have to do all the discharges on my own without help

2) i have to clerk all the cases that came into the ward on my own. nobody is supposed to even take blood for me. i can manage 9 cases in 4 hours. that is another record

3) i am not allowed to go to the clinic

4) i have to do morning rounds alone with my MO when all the other HOs were sent to the clinic. it was not a tough job cos i know all the cases in the ward.

5) whenever boss is on call, i have to be on call

6) whichever ward she is posted to next month, i have to follow her to her ward

7) all the simple procedures in the ward would be done by me

8) all the scans will have to be spoken by me to the radiologists

9) all the NIA forms is to be filled up by me

10) i have 9 on calls this month. the others got 6 calls to do

all in all, i guessed that i am doing one man show in the ward

i am taking this punishment as a challenge

will prove to her that i am capable although i am a slow learner

i shall survive

everybody is talking bout my facebook story in the entire hosp

i hope they will stop doing so

the other specialists can't stop laughing at me whenever they see me around

one of them wanted to refer me to psy

for goodness sick, i am not depressed yet

lesson of the day : miss annie is not going to be active in facebook for the next two months

tears of guilt

69/ chinese/ uncle

was admitted for sepsis secondary to infected sacral sore, acute on chronic renal failure secondary to dehydration, infected left lateral malleolus DM foot ulcer, hypochromic microcytic anemia - post transfused 2 pints of packed cells, diabetic and hypertension

his wife noted that he was staring blankly at home, not responding to call and gave a history of poor oral intake for the past one week.

we did a plain CT brain for him and noted to have hypodensities over the right caudate nucleus and right external capsule. this is his 3rd admission for recurrent stroke.

started him on ryle's tube feeding and he was tolerating orally for the past 6 days

we had to maintain his low BP with inotropes.

his GCS was always 11/15. he had always wanted to tell me something but there was no voice

his non hemiplegic hands were always grabbing mine

somehow, i knew he was begging me to release him - we had to restraint him for he was strong enough to pull out his ryle's tube

that day, i weaned him off from his NPO2 as he had an oxygen saturation of 99 %
unfortunately, he started to desaturate that night itself and stopped breathing at 5.30am
pupils were fixed and dilated, unresponsive to light

his 'so called' filial sons came
i had to break the bad news to them that their papa was no longer around
they were then sobbing, squeezing out tears of guilt


they had never been to the ward, unless i called them over
i wanted them to learn how to feed the old man by ryle's tube and how to take care of the bed sores
i was at the verge of scolding them through the phone
what is the point of crying when it is too late to do so?


this is the first uncle who passed away under my care
i had blamed myself for weaning him off from his nasal prong oxygen
but then, medical patients are just so unpredictable
they just choose to desaturate and knock on heaven's door

my first proposal

i was attending to a 3 year boy who had degloving injury over the right arm when the uncle over the next bed had a severe bad, productive cough. he was breathing harshly with polyphonic wheeze. he was still able to speak in full sentence. there was sputum on the anterior aspect of his chest. i attended to him stat, put my stetoscope deligently over his chest, straining my ears to listen to his breath sounds. he had prolonged respiratory phase with ronchi. he must be having an acute asthma attack. i put him in propped up position, ordered the nurse to nebulised him stat with ventolin.

Then, he was pretty much comfortable. i probed for more history and found out that he has LOW of 1.5kg, LOA and had TB contact. we did a mantoux test for him.

out of a sudden, he called me..........

patient : Dr, u sudah kahwin ke?

me : tak tau...................i don't want my patient to know anything about my personal life

patient : mari lah... Dr... kalau you belum kahwin, jom kahwin dengan saya

me : tak mau

patient : kenapa??????????????????????????

I ran out from the cubicle, stunned. when i read his social history. he is a 61 years old / malay / male who is unemployed, married, stays in an old folks home and has 4 children

how is he going to take care of me?

i am not that stupid to become a stepmother of 4 ok?