finally...
my sixth posting - emergency department
the last one.
after medical, O&G, paeds, surgery and ortho, somehow i had reached the posting that once felt sooooo far away
final poster. gituh
:D
there was something strange about saying that.
as i still remembered being the blur first-poster HO walking into the ward, trying to figure out where everything was, scared of missing something, scared of getting scolded, scared whenever my phone rang..
as i still remembered being the blur first-poster HO walking into the ward, trying to figure out where everything was, scared of missing something, scared of getting scolded, scared whenever my phone rang..
"did i make a mistake?"
"pt mana yg i terlepas pandang ni?"
the overthinking prior accepting the call
and now -
ehh dah 6th poster dah?
apparently. alhamdulillah .
----
but ED didn't really care how many postings i had survived
ED had its own way of humbling everyone.
and now -
ehh dah 6th poster dah?
apparently. alhamdulillah .
----
but ED didn't really care how many postings i had survived
ED had its own way of humbling everyone.
--Welcome to ED
there wasn't really a typical day
you could start your shift thinking,
- okay, nampak macam tenang hari ni
never say that.
never. :D
because somehow, five minutes later -
“ambulance call!”
“pt desat!”
“pt gasping kat bed **!”
“BP dropping!”
“Dr, patient fitting!”
“polytrauma coming!”
and suddenly everyone starts moving.
that was emergency.
things changed in seconds.
the patient who was talking to you five minutes ago could suddenly become the sickest person on the floor
and you learn very quickly -
never be too comfortable.
Red. Yellow. Green.
one thing I liked about ED was how different every patient could be.
one minute you're seeing URTI.
next, abdominal pain.
then chest pain.
then a child with fever.
then trauma.
then suddenly - dahh atas katil CPR pt
everything i had learnt from the previous five postings somehow started coming back.
one thing I liked about ED was how different every patient could be.
one minute you're seeing URTI.
next, abdominal pain.
then chest pain.
then a child with fever.
then trauma.
then suddenly - dahh atas katil CPR pt
everything i had learnt from the previous five postings somehow started coming back.
medical appeared in the chest pain, stroke, sepsis, asthma and DKA patients.
O&G returned whenever a pregnant patient walked through the door.
paeds returned with every sick child.
surgery came back with acute abdomens and surgical emergencies.
ortho returned with every fracture, dislocation and trauma.
and suddenly i understood why ED was such a fitting final posting.
it felt like...
everything, everywhere, all at once.
---
ABCDE became more than something from a book
during undergrad, ABCDE was something we memorised.
Airway.
Breathing.
Circulation.
Disability.
Exposure.
in ED, it became something else.
it became instinct.
you learn to look at a patient from the end of the bed and ask yourself -
is this patient sick?
sometimes before the blood results.
before the X-ray.
before the diagnosis.
before anything else.
something simply tells you - this patient is not okay.
and then you move.
monitor.
IV access.
bloods.
ECG.
oxygen.
fluids.
call senior.
resuscitate first.
figure everything else out along the way.
ED taught me that sometimes you don't need the perfect diagnosis immediately.
sometimes you just need to recognize that someone is dying...
and do something about it.
during undergrad, ABCDE was something we memorised.
Airway.
Breathing.
Circulation.
Disability.
Exposure.
in ED, it became something else.
it became instinct.
you learn to look at a patient from the end of the bed and ask yourself -
is this patient sick?
sometimes before the blood results.
before the X-ray.
before the diagnosis.
before anything else.
something simply tells you - this patient is not okay.
and then you move.
monitor.
IV access.
bloods.
ECG.
oxygen.
fluids.
call senior.
resuscitate first.
figure everything else out along the way.
ED taught me that sometimes you don't need the perfect diagnosis immediately.
sometimes you just need to recognize that someone is dying...
and do something about it.
----
the adrenaline was different here
O&G had adrenaline.
surgery had adrenaline.
ortho had trauma.
but ED?
ED somehow collected all of them into one department. :D
there were shifts where everything happened at once.
one patient needed attention.
then another.
then another.
the phone wouldn't stop.
the monitor wouldn't stop alarming.
someone needed a referral.
someone needed a procedure.
someone's blood result came back terrible.
someone suddenly deteriorated.
and somewhere in between -
you realised you hadn't eaten.
or peed.
or sat down.
O&G had adrenaline.
surgery had adrenaline.
ortho had trauma.
but ED?
ED somehow collected all of them into one department. :D
there were shifts where everything happened at once.
one patient needed attention.
then another.
then another.
the phone wouldn't stop.
the monitor wouldn't stop alarming.
someone needed a referral.
someone needed a procedure.
someone's blood result came back terrible.
someone suddenly deteriorated.
and somewhere in between -
you realised you hadn't eaten.
or peed.
or sat down.
but strangely...
there were days when I went home completely exhausted and thought - i actually enjoyed that.
----
there were scary moments too
ofcourse, ED wasn't all excitement.
there were moments when i was genuinely swayed.
there were scary moments too
ofcourse, ED wasn't all excitement.
there were moments when i was genuinely swayed.
the first few times standing beside a critically ill patient, you realise how different textbook medicine feels when there is an actual human being deteriorating in front of you.
the monitor isn't a question stem.
the blood pressure isn't just a number.
and there's no answer waiting at the bottom of the page.
you have to decide what to do next.
sometimes quickly.
sometimes with incomplete information.
sometimes while everyone around you is moving just as fast.
and i think that's where i learnt one of the biggest lessons of ho-ship -
being scared doesn't mean you can't function.
being scared doesn't mean you can't function.
it just meant
you acknowledge it.
then you do what needs to be done.
then you do what needs to be done.
and sometimes, you don't win
ED also showed me a side of medicine that i don't think you ever completely get used to.
sometimes we do everything.
CPR.
Drugs.
Airway.
Shock.
Again.
Again.
Again.
ED also showed me a side of medicine that i don't think you ever completely get used to.
sometimes we do everything.
CPR.
Drugs.
Airway.
Shock.
Again.
Again.
Again.
everyone working around the same patient, hoping for one rhythm change, one pulse, one sign that tells us - keep going.
sometimes we get it.
and sometimes,,
we don't.
then suddenly, a room that was so loud becomes quiet.
the monitor stops.
the gloves come off.
and somewhere outside that room, someone's family is about to receive news that will change their life forever.
those moments followed me home sometimes.
they still do.
ED taught me that medicine isn't always about saving someone.
sometimes it's about knowing that you tried.
sometimes it's about being there.
and sometimes it's about accepting that despite everything we know and everything we do…
we are still human.
----
The People Who Made ED, ED
and then there were the people.
the MOs.
specialists.
fellow HOs.
and then there were the people.
the MOs.
specialists.
fellow HOs.
nurses.
MAs.
everyone moving together when things suddenly went wrong.
i met seniors who trusted me enough to let me try.
seniors who corrected me when i was wrong without making me feel dumb.
seniors who stepped in when i was overwhelmed.
people who could somehow still joke in the middle of a horrible shift.
people who would quietly ask, “dah makan?”
--when everyone knew the answer was probably no. :D
emergency can be chaotic.
but when you have a team that works together, the chaos somehow becomes organised.
and i think that's what made me enjoy it even more.
you rarely survive a resus alone.
MAs.
everyone moving together when things suddenly went wrong.
i met seniors who trusted me enough to let me try.
seniors who corrected me when i was wrong without making me feel dumb.
seniors who stepped in when i was overwhelmed.
people who could somehow still joke in the middle of a horrible shift.
people who would quietly ask, “dah makan?”
--when everyone knew the answer was probably no. :D
emergency can be chaotic.
but when you have a team that works together, the chaos somehow becomes organised.
and i think that's what made me enjoy it even more.
you rarely survive a resus alone.
----
ED had always be my favourite since medical school
and somewhere along the way, i fell even more in love with ED
i don't know exactly when it happened.
i don't know exactly when it happened.
maybe somewhere between the ECGs, trauma calls, difficult IV lines, resuscitations, referrals and endless shifts.
maybe it was the variety.
maybe it was the adrenaline.
maybe it was because i liked having to think quickly.
maybe it was the feeling of seeing someone arrive terribly sick - and watching them become a little more stable because of what the team did in those first few minutes.
or maybe it was simply because ED felt like the place where all the little pieces i had collected throughout housemanship finally came together.
whatever it was…
i liked being there.
even when it was exhausting.
even when it was chaotic.
even when i went home replaying cases in my head thinking,
could I have done something differently?
maybe it was the adrenaline.
maybe it was because i liked having to think quickly.
maybe it was the feeling of seeing someone arrive terribly sick - and watching them become a little more stable because of what the team did in those first few minutes.
or maybe it was simply because ED felt like the place where all the little pieces i had collected throughout housemanship finally came together.
whatever it was…
i liked being there.
even when it was exhausting.
even when it was chaotic.
even when i went home replaying cases in my head thinking,
could I have done something differently?
i still wanted to come back.
and perhaps that told me something.
and perhaps that told me something.
----
and then, just like that, housemanship ended..
six postings.
it sounds so simple when written like that.
Medical.
O&G.
Paediatrics.
Surgery.
Orthopaedics.
Emergency.
in between those six words were countless days and nights that felt endless.
calls.
rounds.
blood taking.
cannulas.
referrals.
scoldings.
mistakes.
tears that nobody saw.
tiny victories nobody else would understand.
patients i probably won't remember.
and patients i don't think i'll ever forget.
there were many days when i wondered -
can i actually do this?
apparently - i did.
and then, just like that, housemanship ended..
six postings.
it sounds so simple when written like that.
Medical.
O&G.
Paediatrics.
Surgery.
Orthopaedics.
Emergency.
in between those six words were countless days and nights that felt endless.
calls.
rounds.
blood taking.
cannulas.
referrals.
scoldings.
mistakes.
tears that nobody saw.
tiny victories nobody else would understand.
patients i probably won't remember.
and patients i don't think i'll ever forget.
there were many days when i wondered -
can i actually do this?
apparently - i did.
not perfectly.
not without mistakes.
not without help.
but I went through it.
medical taught me how much i didn't know.
O&G taught me to function amidst hormones, emotions and adrenaline.
paediatrics taught me that tiny patients carry enormous responsibility.
surgery taught me to act.
orthopaedics taught me that broken things can slowly be put back together.
and ED?
ED taught me who i was becoming.
someone who could walk towards the sick patient instead of away.
someone who could function despite being scared.
someone who didn't always know the answer, but knew how to start.
and someone who, after six postings, still wanted to learn more.
maybe that's why ending housemanship in ED felt right.
as it wasn't really an ending.
it felt more like the beginning of the kind of doctor i wanted to become.
from that very first day in medical,
to my very last shift as a house officer.
six postings. one very long journey.
and finally -
HO-ship completed.
Alhamdulillah.
rate: 5/5
maybe that's why ending housemanship in ED felt right.
as it wasn't really an ending.
it felt more like the beginning of the kind of doctor i wanted to become.
from that very first day in medical,
to my very last shift as a house officer.
six postings. one very long journey.
and finally -
HO-ship completed.
Alhamdulillah.
rate: 5/5
xoxo,
yanie
