Thursday, March 29, 2007

one of those things-lah

Miss KosKos’ birthday is tomorrow. We’ll be sharing the same age ‘till I turn a year older in a fortnight. She’ll be taking us for dinner and the theme or perhaps dress code, to put it correctly, is Dress!! Literally we’re all required to wear dresses and to dress up :) I love dolling up. I’m torn between wearing something grown up, something youthful (think bright red and blue polka-dots on white base) and something more traditional / classic. I don’t really want to look like the only bubble-gum pop amidst the other monotoners. I’m in the middle of planning my party too. I think I’m gonna make this one pretty darn good ‘cos it’s my last Indon birthday (yahoo!!). I’m so glad that there are so many celebrations going around ‘cos it gives me a good reason to GET CUTE and pretty.

My patient died the other day when I “jaga”-ed. That’s why I was feeling crummy early this week. It was the first day of Internal medicine and I was the first on duty. I’ve never been the first to start out the “jaga” sched so this was definitely a very unfamiliar territory for me. I’m usually like the ones at the end (‘cos of my name) and have korek-ed enough feedback to at least look confident on my first “jaga”. After reporting to the resident-on-duty me and this other girl started to take the vitals (blood pressure, pulse rate, respiratory rate, temperature)… I was supposed to monitor 2 patients very closely: Renal Lupus (current problem hematemesis – vomit blood) and a chronic TB patient (current problem dyspnea). Later in the day as I was doing my follow-up I found that the Lupus chick’s bp had dropped from 110/70mmHg (normal) to 60/40mmHg (BADD!!). I immediately rang the resident in charge.

(crappy enactment of conversation)
moi: Dr! The girl’s blood pressure has dropped to 60/40!Resident: Is that so? OK the patient is going into shock. Do start fluid resuscitation and loading immediately.
moi: *figuring*
Resident: OK then, is that all? Bye.
moi: *still figuring*
Resident: *puts down receiver*
moi: … OMG.

Apart from OBGYN I’ve never really been left to handle patients on my very own. There’s always a resident in-charge looking over my shoulder, breathing down my neck really… which I now find to be the better alternative than having to be absolutely independent in having to make decisions. I know this is good training to allow me to finally muster enough courage to fend for myself but this is my FIRST “jaga” in Internal Med. Don’t I require supervision?? I went to the nurse station for help in loading the fluids but all they did was go to patient’s bed, watch me clamber about and left. WTF?? Aren’t nurses supposed to ASSIST doctors?? Anyway there wasn’t time to be fussing over responsibilities. I made the patient’s husband squeeze on the Sodium Chloride infusion as I took the blood pressure. He alternated with his brother-in-law ‘cos it’s tiring sh*t to squeeze plastic bottles above your head. I don’t blame him. As I watched them load the fluids in I watched the blood pressure slowly creeping up the scale and settling at 80/50mmHg. We stopped guyur-ing and I allowed the infuse to drip by itself in its fastest pace. I then went to pause of a drink of water. I realized she fell into shock ‘cos her bloody family shut her i.v off when they were helping her to sit up or something. Damnit!! I totally told them off sternly. Dunno why I was so garang though. Maybe bad mood. I usually try to be sweet.

So tired… She stabilized at 80/50mmHg for quite awhile so I left her for abit so I could tend to other things. I had just dozed off when her father woke me up in a hurry. There was a certain fall in his face that made me sense that there was something VERY wrong. I rushed to her bed and found her motionless on the bed. Argh crap!! I checked for pulse. Probably felt like one random beat or something so I immediately began on CPR during which a senior nurse quickly brought the ambulatory bag to aid in resuscitation. My crappy partner was asleep in the other room so there was noone to call the doctor on the landline (she wasn’t answering her mobile)… MAN. I took a brief pause to gather energy and ran to the landline when the resident walked in. She checked the chick’s pupils and it was fully dilated with no response. She gone liao. ECG: flatline. The wailing began. Oh well. I was thanked for my efforts but it failed to make me feel any better. It gets easier but it never gets any better when a patient of yours die. Sh*t. Seriously. Sh*t. *sigh* one of those things-lah…

Something random…
(msg)moi: PLEASE HELP ME GET AN ANYA HINDMARCH ‘I’m not a plasticbag’ bag from sainsburys or dover st market or her boutique. It’s only £5!!Sophiekins: U f*ckr u shdv sd the bag was cmin out in april. I ran 2 evry sains in lpool evn tk a taxi 2 the big one in g*d knws whr n no1 knew wat I was sayn!
On another occasion…
moi: Giles for Mulberry: VRY IMPORTANTE mace keyring in black £195 and clutch in black £395. Mulberry Manchester. Call n ask if they hv those 2 items esp keyring. If yes, reserve n go buy thm nx day. if don’t hv I will buy online wateva available. Black mace sold out online :(
Sophiekins: Yeah I’v reservd it. I gt the last keyring.
moi: clutch?? Did u get tat 2? OMGGGG I cannot believ u got d last keyring!! Giles 4tune on our side. I’m planng a small but gr8 bday get2geda. Theme is floral.
Sophiekins: I’m nt a moron. I cn read. Yes I gt the clutch. Hw fun wish I was ther bt nd 2 fin my work. Ur lucky I took a loo break 2 mk ur call.
moi: I’ll consider tat my bday gift. Shelbulous!! I’m cutting down on spendg cos of d new car. Last 2 trips I didn’t buy anytg. Parents pleased.

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