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The Last Words Of An Intern

In Uncategorized on July 4, 2011 at 1:19 am

Life as an intern is like walking on water, you never know when the next wave will come.

Dear whoever you are,

Almost as early as a week ago, I started to gather my thoughts about the ending of my internship and tried cramping them into a sort of finale entry for my blog, yet every time I failed to let my words flow when I turned on the writing screen. Tonight is my last shot, to write in the name of an expired intern, and before I turn into a resident / MO from tomorrow onwards. At times like this, I suppose nothing comes better than a few words from the bottom of my heart.

First of all, I want to thank everyone whom I’ve come across over the past one year – and these people include my intern colleagues in all rotations / my MOs / my seniors / my nursing colleagues / and everyone whom we shared the time working in the same wards (or battlefields). Thanks for cheering me up and giving me the extra hand whenever help is needed, during calls or post-calls, or even sometimes pre-call depressive episodes. You are a bunch of amazing people and I’m afraid I’ll fail immediately if I had to list all your names out here, but you know who you are and I just want to thank you for simply being who you are.

There are definitely ups and downs throughout the internship, and for someone who’s extra-thought-ful (by that, I mean – people with too many thoughts, like me), I’m so glad to have someone who actually attempted to understand such a stubborn person. They took the time to listen and to make me feel better about my incompetency in many aspects of life. Their support has always been vital, for without them, I wouldn’t know how to have survived the past a hundred calls. You guys are awesome.

Next thing I want to say a few words about the future of this blog – when this blog was first created, like every new habit that we try to make it our own, I intended to write as regularly as possible. But at times my writing ability is far too inadequate to speak my mind accurately, and there were occasions where I too experienced the ‘bloggers’ block’, thus it usually took me a couple of days to write and re-write, edit, and add pictures, take off a few lines, replace a few words, before I finally publicize it for all eyes to see. Yet I guess this is exactly the fun of writing a blog.

This blog was meant for fun. People asked me what I was trying to achieve with this blog, and I told them I was not trying to achieve anything but happiness, through writing down what I see every day as an intern – the lowest rank animal in the hospital food-chain. To my surprise, with the help of Facebook, my stats are telling me that there had once been more than 120 views of my entries one day after I updated my blog. It was unbelievable. I got plenty of support from the viewers asking me to continue writing, so I decided it’s perhaps time to either start a new blog with a new title (no longer an intern eh) or simply change the name of this one, either way, I’m going to keep on writing.

Lastly, about turning a new page in life, yes- I’ll be heading to the Prince of Wales Hospital in July and working in the eye department. It’ll be a nine-year relationship, and will probably be one of the longest relationships that I could ever handle. I’m nervous about starting a completely new role, but I constantly remind myself to preserve the curiosity in medicine of an intern (or of a first year med student) and remain humble at all times.

So with that, I shall end my note and keep my fingers crossed for the journey ahead. In order to wake up early mane, I shall sleep right now (if not an hour ago). See y’all.

Expired Intern.

錯得 VS 錯不得

In Hospital & Medicina, Off call, Share & Paidagōgia on June 23, 2011 at 12:59 am

距離七月還剩一個禮拜,一班新鮮出爐的未來候士民明天一早就要到自己未來工作崗位報到,展開為期一星期的Pre-Intern的生活了,在此先要恭祝我的一班朋友們開工大吉,事事順利。對於即將投身戰場,一眾未來同事都有各自的concerns,但似乎最引起大家關心的都是同一道問題:

「究竟做Houseman有甚麼事是錯不得呢?」

乍聽下去,你可能會質疑「不是嘛,做醫生的,病人都把性命交託到你手上裡,犯一個小錯都不行啊,哪有事情可以說是錯得的和錯不得的呢?」但實情是全個病房的人都知道,你只不過是一個初出茅蘆的實習醫生而已。讀過五年書並不代表甚麼事情都懂得處理的,所以有些時候,某些錯是容許的,afterall it’s part of the education, it’s part of their expectations too。況且老實說,一個候士民每日逾八成的日常工作,其實都不太直接涉及病人性命的,說俗點就是死不了人的。今時今日的制度底下,許多Houseman的工作其實只是做個Clerk而已。

但畢竟還剩下那20﹪的時間是真正Clinical的。別少看這段少少的時間啊,那可是你和 n個病人共處的光陰,那是零晨三四點MO都在休息的時間,雖然看來只有幾個小時,但總是感覺很漫長,尤其當你的Dect Phone響過不停的時候,又或者是搓完一檔又一檔的時候,你會忽然發覺那幾個小時的時間可以過得很慢的。所以趁此機會希望分享三件一個Houseman絕對錯不得的事,與大家共勉。

(一)Type & Screen

無論Call得幾甘都好,Post-call幾眼睏都好,謹記對清病人名字和ID。配錯血會死得人的。

(二)Resuscitation

幾忙都好,搓人要到。病人的status轉了做 ‘Dying (死緊)’就等同亮出皇牌,冇野比死更急,食飯頂多都是排第二,放底盒飯 & Go!

(三)Drugs

Allergy又好,Patient Identity又好,Dosage / Frequency / Drug name,全部都可以關乎人命的。Double check自己開的藥單,開錯了/劑量開大了的話,都可以令病人無辜受罪。試過有同事把 Diltiazem 和 Digoxin 混淆了,又有同事險些開了Augmentin給對Augmentin敏感的病人,幸好臨注射前得姑娘發現才不致禍來。

最後希望一眾新同事緊慎工作之餘,與其不斷問自己有甚麼事是錯不得的,倒不妨把更多的精神和attention用來發掘更多自己做得來的事,問問自己怎樣去把對的事情做得更好,或許這能給你更大的樂趣呢。

醫生和牛

In Off call on June 17, 2011 at 8:36 am

醫生的一生,有點像一頭牛。

一頭牛的天職,就是每天努力吃草,努力長大,然而人類借助牛善良勤奮的性格為自己製造方便,從此牛就肩負起犁田開荒的工作了。隨著年代的演變,社會進步牛就甚少涉足田野,反之然成為了大部分香港人每日必食的肉類之一。都市人們對食的要求愈來愈高,於是牛就開始被迫分類成不同級數的牛,長在它們身上的肉,也就賣到不同的價錢了。

噢,這批是澳洲來的,那批是日本來的。噢,這是質素最頂級的A5啊,看哪家高級餐廳出得起價錢,我們就賣給誰。噢,這批劣質牛,留給連鎖快餐廳就好了,反正賣不起價錢就是。

人們利用聰明旳商業頭腦,造就了各式各樣的牛,使本來活在同一片土地上的牛兄牛弟,自此就被送到不同身份地位的人的嘴裡去。

醫生的歸類亦然。同樣當一個醫生,有人周薪逾百萬,人稱「星球醫生」,一星期就賺一球,身光頸靚,跑車豪宅統統都有,有人則咸魚青菜白飯還要儲錢供樓。金錢世界的力量,一直都靠demand 與 supply 主導市場。優質醫生渴市,於是製造了病人搶著付鈔看醫生的局面,情況就似被炒高價錢的和牛。名牌標籤,總叫人趨之若鶩。但一個醫生的價值,是否只由金錢收入掛鉤呢?

從牛的角度而言,被人千嬌百寵、抬高身價,或許是件令人(牛)鼓舞的事,Afterall ,牛望高處,亦不失爲過吧。如何做隻優質牛,於是就自自然成為新一代牛仔牛女的夢想和目標。但久而久之,牛開始發現其實無論多努力能幹都好,和牛始終是和牛,那是新界黃牛一輩子都改變不了的事實。那是寫在基因裡的命運。

哪麼醫生呢?醫生的天職是逆天而行,改寫垂死病人的命運,叫人命不該絕。哪麼醫生又能否改寫自己的命運呢?庸醫名醫皆是醫,醫生的價值又該由誰來定呢?病人,護士,還是偉大的HA?

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