It's Official

5am. Last night shift of the rotation -- thankfully -- and I realize: after 5 years of back-breaking postings, I've found one I actually HATE.

With a vengeance.

Not because of the people I work with, of course. They're a great bunch. No, this takes the whole crappy cake because I've finally reached breaking-point, and at just the right moment too. Don't think I would've been able to handle another night after this proverbial straw that broke the camel's back.

Surprisingly, counter to my previous runs of bad luck -- my last night shifts in any department are infamously BAD -- I was greeted with small queue numbers, and a slow trickle of patients starting at precisely 1am. And the kids ( and parents ) I've seen so far were pretty nice as well.

Things came to a head about 30 min ago, when -- after the initial consultation with anxious parents of a crying 6-weeker with no abnormal physical findings and a normal urine test -- I strongly recommended admission to evaluate the infant's recurrent bouts of crying. ( Better safe than sorry is our motto. Especially when anyone less than 3 months of age is involved. )

But noooo. Let us try to feed her first, doctor, then we'll let you know. Unbeknownst to me, they went to the triage nurse to recheck the baby's temperature, which turned out to be somewhere around 38 degrees Celsius ( it was 37.7 on arrival at the ER, and 37.5 at home ). Before I could screw my head on the right way -- I was really exhausted, due to some disrupted sleep earlier in the day -- the mom and dad stormed back into my room, lambasted me for failing to pick up the fever ( despite my earlier advice to ADMIT THE KID ALREADY ), then demanded to speak to the consultant. Fine. We paged her, and I left for my locker to glug down half a litre of water at one shot. Watch for the complaint letter.

Looking back, ever since housemanship, I've been through quite a bit of hell. Paeds, general surgery and internal med as an intern, followed by gastro, haemato-onco, cardio, ortho, 2 adult ERs, another cycle of surg and int med, before landing in the children's ER. Despite all the suffering -- long hours, high stress levels, at least 2 episodes of burnout, HO/MO duties -- I've never actually detested any of my rotations. I may not have been the happiest in some of them ( for various reasons ), but I definitely never sank this low in terms of morale.

It's the screaming, isn't it? I keep asking myself. All those sick babies bawling their eyes out, and the older ones putting up gargantuan fights over something as simple as a b****y throat exam %^&*^%$. Or maybe it's the parents, and only the parents. Anxious yet defiant. See my child first! But don't admit him! Hello, is anyone home?!?!

Oh I know. Let me put my finger on it right now: it's the past-midnight consults. That has GOT to be the clincher. I did 3 nights in 7 days last week, and 2 this week. Phenomenally bad. No rest. One fever after another. Countless lengthy explanations. And worse, the need to constantly speak in a high-pitched, soothing tone to both patient and family, even if I can't stand their antics.

*kid kicks me in the chest* "Oh that's okay. Just hold him tighter, mummy, all right? Good!" *force a smile even though I'm SO tempted to tie someone's arms to the bed*

Or tonight's prime example:

*kid sticks a styrofoam piece of his toy airplane up his nose, then screams the hospital down even before I put the forceps inside to retrieve it*
"Don't cry lah. I haven't even put anything inside yet! See? I'm still holding it! Why don't you look up at the ceiling? Oh, what's THAT? A dolphin? Or over there! Aren't those stars?"
At 2am in the morning, this sort of thing grates on my nerves. I try to understand the child's perspective, and granted, his parents are very nice people. But honestly, I can't take any more of this...

I was never built for paediatrics. And never will be.

Wow. I actually miss seeing adult patients. Even the NS boys. Major reality check, haha. :)

Since I'm on the topic of worst posting, let me provide the answer to the Best Rotation question. It's a bit of a tie between General Surgery and Orthopaedics, even though I've never been inclined towards either as long-term options. Rather, I enjoyed these because they were the best among my ward postings, with short morning rounds, speedy clinics, high patient satisfaction, and protected post-calls. The welfare and camaraderie provided are well-known, so I don't have to mention something that obvious, I hope. :D
Plus, I got my first A grading in ortho. A huge surprise, and very much appreciated till this day. :)

Just 30 minutes more before my break ends, then it's back into the fray. Only 2 1/2 hours to go before I say bye-bye to nights in the paeds ER. Shall celebrate with some sinful feasting later today. :P

Adios.