Sunday, July 23, 2006

Happy is only one letter away from a half-woman flying creature with claws

Emed's over, and in a way, the dust is still settling from an adrenaline-powered rocky ride of a posting, possibly the most exciting and hands-on posting we're likely to get until we graduate. I haven't really had time to organise my thoughts about the posting in general, and other things that happened, but I'll try not to ramble, and with luck sound coherent.

I think, all in all, there's no doubt it was an excellent posting, which shows you what goes on in the emergency department. In most ward-based postings the doctors and nurses are always complaining about how the ED admits patients that really don't need to be admitted anyway, or admits them to the wrong department and creates a whole load of trouble and paperwork for the ward staff, and after a while you get the impression that ED doctors don't really do much thinking before they admit (and the scanty nature of their clerking notes certainly doesn't help improve that impression). The posting shows you the picture from the ED's point of view, and it's really quite difficult to assess the urgency of a patient's condition while there are a dozen others waiting to be seen by you (and are already starting to barge into your clinic asking when their turn's going to be), and a whole lot of other factors I'm too lazy to think of and list. It certainly was an eye-opener for me, especially when you see patients that are affectionately termed "regulars" - those that are perfectly fine or have minor complaints and yet demand to be admitted, or claim that their condition is serious and needs immediate attention.

But that's really more to do with consultation. In the resus area all the patients need attention, otherwise they'd be down-triaged by the doctors already. As compared to other hospitals, I suppose the CGH ED is relatively not as exciting, because in all our three weeks there I only saw one person with cardiac arrest that required CPR (other people in CGH saw more than that, they're lucky) and there wasn't much of the dramatics you see on television. Most of the time, if the patients are willing to talk to you, there's an opportunity to clerk them too, so it's pretty sedate stuff. Overcrowding is a big issue for me, because I really dislike the feeling of having too many people in a confined space e.g. around a patient's bed with the curtains drawn, and when 8 students flock to surround a patient, along with a nurse or two, and a doctor, it gets a little difficult to breathe, and sometimes it's like there're so many people wanting to do procedures that it gets a bit confusing and inefficient.

I mean, sure, Emed is all about the acute care of patients, and also the posting where you get to do the most number of procedures, so it's really hands-on. I was really bad at setting plugs in the first two weeks, and I have no idea why, although I'm certainly quite good at venepuncture if I say so myself (of course they're two different things altogether), and I had a 100% failure rate for two weeks, imagine that. It ends up being a vicious cycle - you're not sure you'll succeed, and hence the lack of confidence impairs your ability to actually set the darn plug, and also keeps you from volunteering to perform them (if you know you're going to fail, why not give someone else the chance, who will likely succeed?), and lack of practice doesn't make things better. Of course, I'm not saying practising on every patient is a good thing if your failure rate is 100%. I guess you can say I'm not so proactive in that aspect; if there's someone who's eager to do something, I'm not going to fight for it. If there're too many people around a patient trying to do something useful, I'll slip out and wait for the next patient (who eventually gets surrounded by everyone anyway). It's no one's fault but my own that I didn't do much in the posting, and certainly I'm not trying to criticise anyone for being proactive (how weird would that be?), but it certainly merits thought on whether or not this way is the best for me, and whether I should change.

It's certainly best not to dwell on unhappy thoughts, but I seem to have little of the cheerful variety these days.

Ambulance attachment was another eye-opening experience; to follow the paramedic team out and about Singapore responding to people in distress, whether genuine or not, was quite exciting, though both my shifts were relatively sedate, yet again (I'm starting to think I'm cursed to suffer from insanity-inducing boredom). I followed different paramedics on the two shifts, but the same medic, and even set a plug on him (I was very sorry for inflicting such pain, but the warrant officer insisted I try, and it ended up being my first successful plug ever, so at least something good came out of it). It was nice to sit around talking to them during lull periods, though I was mostly listening while they talked, and I kind of miss conversations where you can talk about anything under the sun and yet not feel like it's a meaningless conversation. The medic I was following is a pretty funny guy, though he was a bit reticent at first. It's kind of ironic, me describing someone else as reticent. This thought came into my head that perhaps if I wasn't going to become a doctor, being a paramedic would be just as exciting and fulfilling a career, in a way.

~~~~~~

National Day approaches, and my first thought when I think of this is, wasn't the last National Day just a while ago? If this is what happens to time when you get older, I dread to think what it would be like when I'm 60. Ah, but National Day always invokes my cynical side, and this year that side is a bit stronger than before. It just strikes me that there are fewer national flags going up on HDB apartment blocks lately, if you exclude those that the happy GRC volunteers hang up on blocks facing main roads - you can always spot them readily because they positively festoon the entire block, trumpeting "Oh, look at us, we're so happy it's the nation's 41st birthday, we're positively dancing outside our flats!" It all seems a tad fake to me, this forced festivity and cheer, almost as if by plastering whole estates with banners and flags it'll whirl us all into this patriotic fervour, this passionate love for our country that can only be felt during the nation's birthday. But I still walk out of my house everyday feeling grumpy, and the flats around mine are hardly adorned with red-and-white (I live quite a distance from the main road, so there's no need to show people passing by how happy we are, I guess). I get on public transport and it's like I've come to someone's funeral. The sense of unhappiness is stifling, and not even the most enthusiastic decoration can lift me from the foot-dragging drudge of life. But it's a good thing seeing fireworks still can.

They want us to be happy, to smile for foreigners visiting our nation for some conference or other, while Singaporeans, on the other hand, still have to send letters to the Straits Times complaining about poor service. We're supposed to blind them with 4 million smiles, but they never tell us how many watts we need to make our smiles. 10 watts, or 10 megawatts? Prices for electricity are rising nowadays, better not use too much power. It's ironic that at this juncture, a survey finds us the most unhappy nation in Asia, because, that, my dear "Let's smile, smile, smile" campaigners, is the truth of the matter in our green island nation. How can we be happy, when there's nothing to laugh at? Mr Brown was funny, but he's no longer writing columns in Today, and his podcasts and blogposts have become rather boring of late, almost as if he's got a gag stuffed into his mouth. Mediacorp productions on television can hardly be considered entertainment anymore, and mostly we stick to the cable channels nowadays. Taiwan variety program parodying their politicians, now that's funny.

Don't get me wrong, I love this country, I do (and I sound like I'm trying hard to convince myself of that fact). It's clean, it's got a low crime rate, the public transport is always reliable, although a bit overcrowded for my liking, and we're not likely to get napalmed anytime soon. It's a great place to live! It was a great place to grow up in, certainly. I don't know if it'll be a good place to work in because I haven't started working, but don't get me (or a whole load of other people) started on the excellent healthcare system here. What's there not to like? If I were the hypothetical ruler of Singapore, I'd be like, "Hey you fools, look at what a wonderful country we have here, you should be happy. BE HAPPY!" What a delightful thought, it makes me a whole load happier. I'm so happy I could cry, sometimes. I hope you're happier than I am.

Avaris / 7/23/2006 02:59:00 PM

0 consumed