Awashed With Relief

The course is over, woohoo! It's been a tiring week, but also very enriching and totally enjoyable. And yes, my Oxford Handbook of Emergency Medicine now bears Dr. Robin Illingworth's autograph. As Gollum would say, "My precioussssss..." :)

One thing I noticed about the A&E exam format is how diverse emergency medicine truly is. I mean, in the vivas and clinicals, we can face anything from medical to surgical / orthopaedic to paediatric cases, and are expected to discuss a broad spectrum of conditions in pretty great detail, including obscure things such as luxatio erecta ( go look it up :)). This is in contrast to your conventional internal med / surgical exams, where you sorta know what to expect going in. For us, examining an abdomen can be anything from an enlarged inflamed gallbladder ( surgical ) to a uterine fibroid ( OBGYN ) to polycystic kidneys ( medical ). Quite scary if you think about it!

One of the reasons I enjoy emergency medicine so much is because of the diverse mixture of cases, and how we use concise history-taking and a quick but directed physical examintion, +/- simple yet carefully ordered tests to delineate the patient's problem(s) and decide on disposition ASAP. It's a tough task, and the ER is always hectic, so seniors often have their hands full with a few cases at any one time, with junior docs coming over to ask them questions or show them X-rays. I'm a little daunted by the prospect of turning registrar, but it's an unavoidable rite of passage, so I'll make sure I'm prepared for it. Must always remember not to lose my temper. :)

And speaking of multi-tasking, a few hours ago I had a major case of running around when 3 not-so-simple cases came into resus in quick succession. I had an old lady with a scalp laceration and an arterial spurt, a severe asthma, and an 18-year-old thalassemia major / poorly controlled diabetes with clinical signs of meningitis. I just kept going from patient to patient, setting lines, ordering meds, taking cultures, catheterizing, giving antibiotics, tracing blood tests, calling the registrar upstairs to expedite admission. At the end of it all, I just slumped in my chair and hoped I didn't forget anything in the whole mess. I'm really tired right now, which is why I'm a little worried. :)

I heard that 22 people applied for 9 emergency medicine traineeship spots this year. Whoa, that's amazing! Looks like it's gaining popularity, which is good 'cos we need more ER physicians. The best scenario is to have all ERs run purely by trained specialists. You can bet the number of complaint letters will drop drastically if this happens. No more ammo for you, Straits Times! :P


Two of my predictions for American Idol 3 wild card winners turned out to be right -- ie. George Huff and Jon Peter Lewis. The former is such a likeable person, a la Ricky Smith from AI2. Jon, on the other hand, has prompted me to nickname him "spark plug", a term I chose because of his very dynamic personality and on-stage antics. Did you catch him singing Elvis's "A Little Less Conversation"? It's a difficult song to pull off, but he did it effortlessly. Simon may have hated the performance, but Jon garnered the majority of votes from the audience, and became America's Choice for 2004 ( Clay held that title in 2003 ). I predict big things for this little fella. He's the one to watch!

By the way, there're only 4 guys out of the 12 finalists this time round. Kinda pathetic, but they'll definitely give the girls some serious competition. I can't remember any of the females except for Fantasia. And the other 2 wild card choices of Jennifer and Leah are extremely dubious. Leah is the equivalent of Carmen ( from AI2 ) -- young, pretty, has a bit of a voice but can't do anything decent with it. Jennifer might turn out to be another Kim Locke -- not so great to begin with, but later improves and goes far in the competition. Well, we'll just have to see, I guess.

I'll be putting my textbooks aside for the next 6 weeks or so. Will be busy with moving house and running a whole lot of errands, plus attending various meetings / weddings / concerts. I have only 1 more off day for the rest of the month. So sad.

One more hour before midnight. Can't even keep my eyes open, yaaaaawn.