Sorry I didn't post for a couple of days. Friday was awful -- but that's putting it very nicely -- and Saturday wasn't any better. Our housemen were caught up with orientation programmes lasting the entire day, leaving us medical officers in the overcrowded wards to do everything from rounds to paperwork, updating relatives, handling collapses, and yes! blood-taking! I had 40 ladies on my hands, and due to some shuffling of ward teams which give mes epigastric pain when I think about it, I didn't eat lunch till after 3pm on my post-call afternoon ( but at least I got to leave the hospital by 2:30pm ), and crawled home only at 2pm on Saturday ( when most had probably gone by 1pm ). My deepest gratitude to the new registrar ( aka senior resident ) who helped me take blood yesterday when I told him I couldn't stand it anymore, and my fellow resident ( who was my intern just a few days ago ) for bravely doing rounds without me today ( hope the spanking new housemen are enthusiastic! ). Anyway, I spent my weekend sleeping, and feel a bit more refreshed to start the new week tomorrow. :)

Here're a couple of interesting emails I'd like to share. The first is from my old friend, while the second is written by a houseman who just entered the working force on Friday. Enjoy.


From my old pal:
Kudos to your blogsite. And thanks for your effort to update everyone in these uncertain times. Call it voyeuristic if you may, but it sure makes for good reading material, when you're in hospital and not supposed to walk around too much and mix with people.

We now do rounds with full ID protection ie. goggles, mask, gowns, gloves. That day, I was made to wear a slogan sticker of sorts on my baju ( Malay term for scrubs ) that says " wear your masks, they save your lives" or something to that effect, 'cos my name wasn't in the list that contained people who have attended the mask-fitting sessions. No visitors are allowed and that means updating by phone for the relatives. Feels a bit funny when you call them up and attempt to "update" them about some old guy who has been around for a while and for some obscure reason is still in hospital but is otherwise as stable as a rock. But I do appreciate it to a certain extent, 'cos you dun have to face difficult relatives face to face, and you don't see a whole kampung having a picnic in hospital anymore.

My exams in June are cancelled if you haven't already heard, and the UK only allows us to go up if you can afford to stay out of Singapore for 3 weeks before you take the exam. Can't afford the leave ( don't know if we'll even change over), and the summer lodging prices in UK are steep. Hence, I have to defer my attempt till October or November.

I pray that everyone I know, including you, will stay afebrile. Take care."


From the new houseman:

"So far so good as a new HO. No big scoldings and no major mistakes as yet. But it's still too early to tell as this is ONLY Day 2 of our medical career. One thing's for sure though (and it's a shared sentiment) -- we are blur about everything, work is overwhelming and how on EARTH do you senior people remember the dosages and timing of the medications? I for one am rather bad at numbers and I can foresee myself asking my MO many times in the future " Err, what's the dose huh?" I have not given my first IV bolus medication, so there is this anxiety about giving my first concoction. As medical students, we have all heard about a disastrous incident involving some doc giving an IV potassium bolus by mistake with dire consequences. I guess all this adds to the obsessive-compulsive behaviour of checking and re-checking meds to be given via IV.

Most of the new HOs have been fitted with the N95 masks and underwent some form of PPE test before we were set loose into the wards. That transient fitting session of the mask did little to warn us of what is ahead.

My first day was a rather err... sticky experience. Humid weather, sweat gluing the gown to your skin ( thank goodness we ordered some baju for the day) and the N95 mask acting as a sort of condensation device. You can feel the droplets forming as the hot morning hours sizzle by whilst you patiently stand and wait for your consultant/registrar to give their orders. The mask really left an impression on me, or my face rather! Yes, it's full armour into the wards, goggles and all, and I do appreciate that all this is necessary for this current SARS war. But there are always moments in which I really felt like tearing the mask away from my face and allowing the skin/nose underneath it to breathe properly. It really calls for tolerance. Must "ren"!

I must say the nurses and other staff in the wards were quite helpful and rather obliging in answering trivial questions ranging from how to fill in blood forms, making a community hospital referral and other nitty gritty stuff. I am covering the overflows in my ward and more than half the time, I'm by myself attempting to do changes as my MO/senior HO is in the ward helping the other HOs. But thank goodness the nurses are around and the occassional God-sent MO comes to help out with things. And yes, the phlebotomists! - great people aren't they?

The day ended at around 7.30 pm, which was a relief to me. My ward colleague had mentioned to me earlier in the morning that he couldn't wait to get back home in the evening. I was surprised, not by his remark, but because I hadn't given thought to it and was expecting for the day to end late into the night. I was all prepared to go through an arduously hot day and for the sun not to set. Thankfully, the sun DID set and my tasks were finally completed. It was with a light foot and a light heart that I stepped out of the hospital... and discarded the N95 mask into the nearest dustbin!"


SARS In Singapore
Well, the Sunday Times gave a rather optimistic picture about the SARS situation in Singapore. Seems hospital-acquired infections are being curtailed effectively, though community cases are still springing up here and there. We're all praying for the epidemic to abate, and although Grace from NYC's kind words are most comforting ( it is available in the comments section for May 1st ), I don't think any event in this generation can compare to the tragedy that was 9/11. I can still remember exactly where I was and what I was doing the night the terrible news broke -- the ER of SGH, during an afternoon shift. Our senior resident called us into the staff pantry to watch CNN, and as we stared in horror at the burning World Trade Centre tower, we got another jolt when we saw a second plane crash into the other tower. It was an act of pure evil of unimaginable proportions, and although I wish I didn't have to witness something as painful as this in my lifetime, what happened after the attacks demonstrated the amazing ability of the human race to survive.

I guess, with the advent of this new disease we now know as SARS, humans are called upon again to draw strength from each other and fight back. I have no idea when or if we'll ever win this war, but as Bill Pullman said in the film "Independence Day", "We will not go quietly into the night." And that's all that matters.