Sign

I was involved in an accident today and while my first instincts were not necessarily very pleasant thoughts, I think that God works to teach us in ways that are beyond us. I read this in the daily bread. God is good.

When we experience tragedy, we may wonder about God's goodness. Is God always good? Yes, He is. He doesn't promise that bad things will never happen to us, but He does promise to be "our refuge and strength" (Ps. 46:1). He doesn't promise that we will never walk through heart-wrenching circumstances, but He promises that we won't be alone (23:4). God is good - no matter what suffering we are experiencing. Even when we don't understand, we can say with Habakkuk, "Yet will I rejoice in the Lord, I will joy in the God of my salvation" (3:18) --- Cindy Hess Kasper

God is good.

Signs
being on a drip and in hypotensive shock really does put things in perspective. the next time i see a patient and put a plug in, i will actually know how it feels. and i won't just simply think what a whiner when the patient says that he's dizzy from vertigo even after all the meds we pump in him. it really takes one to know one. trust me, beta histine is a life saver when it comes to dizziness. i don't know how, but it is. and postural hypotension and syncope is genuinely scary even for a HO who has seen tonnes of it and knows the treatment for it. super thankful to jonathan and victor and my sips who have been covering my ass while i am at home sippering and whining and shitting and puking my life away.

i haven't been the nicest person for the past month in neurology in my attempt to get things done. haven't always been the nicest to the nurses or to fellow doctors. i still haven't figured out the balance yet. what do you do when things should be done and you have already been nice one too many times? is it alright to then tell people off for not doing their job? i don't think that my previous way was right either, to just simply accept it and smile it off?

anw, here's a nice song that i have been listening to. i don't know if they meant it to be christian and i have been googling it but haven't gotten any answers, but i guess it's solace for anyone even if you aren't christian and don't really like the use of the word lord. housemanship can be really trying and it would be a whole lot worse if i didn't have all of you (including my super duper nice MOs who actually listen to me whine about doing admin and not admonish me about it and my cons who actually perk up and give me a pat on the back when i say that i might give int med a chance).


Show me what I am looking for by Carolina Liar
Wait, I'm wrong
Should have done better than this
Please, I'll be strong
I'm finding it hard to resist
So show me what I'm looking for

CHORUS
Save me, I'm lost
Oh lord, I've been waiting for you
I'll pay any cost
Save me from being confused
Show me what I'm looking for
Show me what I'm looking for…oh lord

Don't let go
I've wanted this far too long
Mistakes become regrets
I've learned to love abuse
Please show me what I'm looking for

CHORUS
Save me, I'm lost
Oh lord, I've been waiting for you
I'll pay any cost
Save me from being confused
Show me what I'm looking for
Show me what I'm looking for…oh lord

Show me what I'm looking for
Show me what I'm looking for
Show me what I'm looking for

CHORUS
Save me, I'm lost
Oh lord, I've been waiting for you
I'll pay any cost
Just save me from being confused
Wait, I'm wrong
I can't do better than this
I'll pay any cost
Save me from being confused
Show me what I'm looking for
Show me what I'm looking for
Show me what I'm looking for
Show me what I'm looking for…oh lord

I cried during call yesterday. It wasn't a terrible call, but I don't deal with young oncology patients very well. I had a call to see a DIL max ward patient who had stomach cancer with mets and BP was dropping. I went to the bed and I saw the usual bunch of relatives who keep vigil by the bedside and a little girl speaking to the patient clutching to a winnie the pooh stuffed toy. The little girl was the patient's daughter and she couldn't be more than 7. The next thing I did was the worst thing that I ever had to do in my life. I had to tell the family that the patient was not doing very well and it was possible that she might pass away that very night as the BP was not well sustained despite multiple fluid challenge. The whole family was very calm, but the little girl just burst out crying and ran off to another chair and started to say that I don't want my mommy to die. I went to speak to the little girl and she asked me to save her mommy. I think that I probably started to cry a bit then when I explained to her that we were trying to help her mommy and let her be comfortable and if her mommy passed away, it would be to a good place. It was terrible and I used a terrible winnie the pooh analogy. The girl was inconsolable and the grandmother was trying very hard to be strong, but it was obvious that her pain was the greatest. I can never imagine the pain of having your child go before you and of such a slow and painful death and having to take care of your grandchild at the same time. I went to the toilet to cry after that.

i agree with shihui. it doesn't mean that just because we smile and we finish our work faster than the rest means that we are super happy/slack. it just means that we decide to be more efficient and it doesn't mean that i am not in pain/sick just because i smile and i continue to be nice to patients. things don't get done faster if you scowl or are mean about it. might as well be nice about it and maybe people will help you out along the way! super glad that i have super nice fellow HOs who are willing to take my call when i hobble.

joke of the day
me clerking a patient with ankle pain in chinese

uncle, how painful is your ankle in chinese? (while peforming simmonds and palpating for swelling/tenderness)

not as painful as yours. i think that mine is ok. i can still walk.

you realise that the government/public owns you when you can't take MC without feeling bad and you go back to work even though you can't really walk/hobble. it gets even better when the doctor tells you that you shouldn't really weight bear for a week and then you explain to him that you are a HO and you have to a call to do and there's no coverage if you are away, and he says maybe you can take 3 days MC because the ligament appears to be torn? and then you tell him that you have a call on Wednesday and you only cover ward 74 and A&E and then he pauses and says hmm. Just tie the bandage really tight and take 75mg of voltaren and you should be able to survive your call. and then you hobble away to get the meds in hand and take only 1 day MC and curse yourself for falling down a bunch of stairs when you really can't get any MC.

Patients with congestive heart failure, significant lung disease such as chronic obstructive pulmonary disease, patients expected to have nocturnal arterial oxyhemoglobin desaturation due to conditions other than OSA (e.g., obesity hypoventilation syndrome), patients who do not snore (either naturally or as a result of palate surgery), and patients who have central sleep apnea syndromes are not currently candidates for APAP titration or treatment. (Standard)

A 2005 study found that OSAHS was associated with an increased risk of sudden death between the hours of midnight and 6 am, as compared with the general population (sudden death more common between 6 am and noon).

I really like both of my MOs personally, but somehow, I felt left in the lurch yesterday even though I was reassured multiple times that I did fine. They do teach and let me go post call which I am very grateful for. I am upset that no one came for a while, but I can understand why they didn't come because there was nothing that they could have done. I am pissed off that I didn't do some stuff earlier as well. Sigh. I really do like them and I feel bad that I feel upset that they didn't come? I don't really know how to explain it. It makes it worse when they say not to worry and they will fix the mess. I don't like all these conflicting feelings. I hate this blame game.