Monday, June 30, 2008

"You know, you come from nothing - you're going back to nothing. What have you lost? Nothing!"

Today is my last day of freedom. I spent most of today at the hospital where I will be doing my first rotation as an medical intern. Most of the morning was spent listening to our intern co-ordinator giving the overview of what was expected of interns and following the intern I will be taking over. After a dim sum lunch, more work was done (which I will further elaborate on) ending with a census meeting and journal review. I was at the hospital from 09:00 to 19:00 and that should be a NORMAL day for a doctor.

So how am I spending my last day of freedom? I should be spending the night learning how to perform resuscitation, how to perform a chest drain and all the other malarkey that goes with being an intern. But I have decided to spend my time by watching "Top Gear" and surfing the Internet. I want to spend the final hours of having no responsibilities just doing sod all before I have gained power come July 1st. One of lecturing doctors during pre-internship likened us to Spiderman - "With great power comes great responsibility." Essentially what the doctor is say is true. We medical students have been given powers we never had before - performing procedures, giving out drugs and doing resuscitations.

On that last point I should state I watched and participated in my first resuscitation. It was awkward, exhilarating and saddening all at the same time. It was 15:25 and my house officer got the call that a ninety-one year old patient had suddenly suffer from a cardiac arrest. We raced up three flights of stairs and already there were already two medical officers and numerous nurses there resuscitating the patient. For the first twenty minutes, I was there doing nothing, feeling stupid (not knowing what to do) plus felt being in the way. I tried to stay back whilst everybody was doing something - chest compressions, bag inflation, intravenous access, blood taking. I should also say that I also felt a bit guilty. This was a patient I admitted in last Thursday and I was wondering if I did anything wrong or did I miss anything. Even though it was five days ago, there have been numerous checks beforehand and she was well before, there is always some nagging part of your brain that tells you might have done something wrong.

After about twenty minutes, all the nursing and medical staff were getting tired. I was given the chance to perform chest compressions. It is not as easy as in practices on dummies. Getting enough strength to perform chest compressions and not being tired is very hard. I also think I broke a few ribs during the process, hearing the familiar cracking sound during my compressions. Yet it is all part of the process of learning and experience. I know it sounds terrible but that how everybody learns. It also part of the educational process to deal with death, as in this case as the patient could not be revived. We were also performing resuscitation whilst the relatives were just a few feet away balling their eyes out. Once the medical staff knew the patient could not be revived, we made the patient look presentable to the relatives. This is all part of the grieving process, since I don't think anybody wants to see their beloved one in that state.

So how did I personally handle the situation. I did feel slightly guilty that I couldn't save the patient. I think everybody does in those situations and you wish you could have done more. Yet I felt strangely numb that somebody has died in my hands, that I'm not feeling anything. Is it because she's so old that I think her time has come? Or is it due to my depression, that I feel apathetic towards everything including death?

Sometimes I wish I could feel something, even if it is bad, rather than feel nothing at all.

1 comment:

Dutch said...

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It’s considered Mr. Shem’s most ambitious work.
Anyone interested should visit for more information.