HOship - surgical posting - what to expect

assalamualaikum w.b.t...

and then came my fourth posting - surgery

by this point, dah tak boleh guna ayat,
“Saya baru lagi…”

heee

its literally already the 4th 😅

pejam celik pejam celik dahh 4th posting

after medical, O&G and paeds, i thought maybe i had finally gotten used to this whole housemanship thingy

wake up.
go to work.
get stressed.
survive.
repeat.

then surgery came along and said - cute :D

----  
welcome to surgery

surgery has its own language.

“patient dah BO?”
“dah passing flatus?”
“abdomen soft?”
“drain berapa?”
“wound okay?”
“dressing dah buat?”
“keep NBM.”
“book OT.”
“consent dah ambik?”

and of course -

“dah refer?”

:D

and suddenly, bowel opening became one of the most important questions I asked every morning.
never in my undergrad years did i imagine i would one day feel genuinely happy hearing,

"pt dah pass flatus"

alhamdulillah.
progress. :D

-----

the posting where you learn to MOVE

if O&G was full of hormones, emotions and adrenaline
surgery was full of movement..

ward

clinic
OT

then back to ward

review patient

take blood

trace result

refer

prepare patient for OT

ehh suddenly another patient deteriorates

and somewhere in between all that -

“dik, dressing bed ** dah buat?”

sabauu :D

there was always something that needed to be done
and somehow everything needed to be done now

surgery taught me that sometimes you don't need to feel ready
you just need to start moving

------

and then there was OT
there was something different about entering the OT

the scrubbing.
the gown.
the gloves.
the lights.
the instruments.

of course, being a HO in OT wasn't always glamorous
sometimes your very important surgical contribution was....
holding the retractor.

for a very, very long time

your hand starts hurting
your shoulder starts hurting
you quietly change position

“retractorrr..pegang betul2”

sorryy Mr :D

but honestly, even that had its moment..

as somewhere between retracting, assisting, suturing and trying not to contaminate the sterile field, i realized how much i actually enjoyed being there..

surgery is more than the operation

before going through the posting, it's easy to think surgery is mostly about operating
but being there taught me that the operation is only one part of it
there's recognising the sick surgical patient.

resuscitation.
pain control.
fluids.
antibiotics.
pre-operative preparation.
post-operative monitoring.
wound care.
drains.
nutrition.
complications.

and knowing when something that looks “okay” actually isn't okay.
sometimes the most important thing wasn't knowing exactly what was happening.

it was recognising -
this patient doesn't look right.
and calling for help early.

---

The People Along the Way

just like my previous postings, the journey was made easier by the people I met
there were seniors who taught
seniors who corrected
seniors who trusted me enough to let me try
and seniors who would explain why instead of simply telling me what to do.

of course, kena marah tu,,,
standard package la kan. :D

but there were also people who made those long days feel lighter
people who helped when the ward was drowning
people who taught me little tricks that no textbook ever mentioned
people who said,

“takpe, try dulu”

"you are in correct lane"

and somehow, those simple words mattered.
somewhere along the way,,

surgery felt different to me
maybe because by fourth posting, i was no longer the same HO who first walked into medical

i had seen more.
done more.
made mistakes.
been corrected.
been shouted at.
learnt to speak up.
learnt when to ask for help.
learnt that “I don't know” is perfectly fine 

as long as it's followed by,
“but i'll find out.”

and perhaps that was why i could appreciate surgery differently
there was something about the combination of thinking and doing that I liked.

you assess.

you decide.
you resuscitate.
and sometimes, you actually get to fix the problem with your hands.

there's something satisfying about that.

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.

And Surgery?

surgery taught me to act.
to recognise when something is wrong.
to move when something needs to be done.
to use my hands.
to trust my clinical judgement a little more.
and perhaps most importantly -  to realise that somewhere between the ward rounds, emergency cases, dressings, drains, endless referrals and hours spent standing in OT,
i actually really liked surgery

it was tiring.
it was physical.
it was demanding.

some days were ridiculously long.
but there were also days when I went home exhausted and somehow thought - eh..best jugak hari ni. :D

maybe that's when you know a posting has found a little corner in your heart.
not because it was easy.
but because even when it wasn't…
you still wanted to come back the next day.

rate: 4/5

xoxo, 

yanie

HOship - paediatric posting - what to expect

assalamualaikum w.b.t...

-even the smallest size glove isn't my best friend :p -

now its time to talk about my 3rd posting - paeds 

After surviving medical and the hormones-and-adrenaline roller coaster called O&G, somehow i found myself entering another completely different world.

A world of tiny humans.

tiny humans with tiny veins, tiny airways, tiny doses,,,
but somehow capable of producing very, very big anxiety :D

---

Welcome to paeds

first thing I learnt?
in paeds, everything comes with a calculation

“how many kg?”
“maintenance berapa?”
“2/3 maintenance? why not full?”
“PCM dose? bila last mama bagi ubat?”
“antibiotic dose? japp ni neonates ke toddler dose”
“urine output?”

and suddenly my calculator became my best friend

i still remember my first day in general ward - been questioned of how to calculate paeds urine output

if my last time mo read this, just know that i still simpan memory tu :D

sweetsour memory actually..initially its okay to ask that kind of question - which i dont mind at all..tapi bila u mentioned about that every single time even calculate betul pun, and make us (bukan i sorg kena) feel like we not smart enough to calculate, its unnecessary..

no hard feelings, just a little memory that still be remember till today :D

adult:
T pcm 1g QID - thats it

paeds:
okay weight berapa? 15 mg/kg,, syrup concentration berapa,, maximum dose,,

"eh jap Dr, tu berat 2bulan lepas..kejap nak timbang :D"

HAHA.

one decimal point suddenly felt like a one step into the mahkamah dunia. :D

---

the patient is small. the responsibility isn't
i think this was one of the biggest adjustments for every young Drs
everything felt more delicate.

a child may not be able to tell you exactly what's wrong

a baby definitely cannot tell you, “Dr, actually saya shortness of breath sejak semalam.. ada headache jugak sikit”

so you learn to look
how the child breathes
how they cry
how they feed
whether they're playful or unusually quiet
how they interact with their parents

and slowly, you realise that in paeds, sometimes the history isn't spoken by the patient.
you read it from them.

---

and then there's taking blood.
oh, bloodtakingg :D

finding a vein on a chubby little hand while the baby is screaming, the mother is watching, someone is holding the arm, and you're trying very hard to convince yourself -

"ada vein ni..ada..ada ni.."

u cant simply said "eh awak tak minum air cukup2 ni, vein kering"just like how it always was in adult :D

suddenly getting that one tiny flashback of blood felt like winning something.
and if dapat sekali attempt?
achievement unlocked! :D

---

you're not just treating the child
one thing paeds taught me quite quickly was that you rarely have only one person to manage

you have the child
and you have the parents
sometimes the child is completely fine, happily playing with a toy -
while the parents are the ones looking like they're about to collapse :D
yet still, understandably so.

as when you're looking after someone's child, you're looking after someone's entire world

a fever that looks routine to us can be terrifying to a parent
a child who's breathing a little faster can make a mother stay awake the whole night
and paeds slowly taught me to appreciate that fear rather than dismiss it
sometimes reassurance is part of the treatment too

---
the little things
paediatrics was tiring in its own way

the calculations.
the cries.
the difficult lines.
the endless monitoring.
the worried parents.

but strangely,
it also had some of the softest moments in ho-ship

a previously lethargic child suddenly sitting up and playing again.
a baby finally feeding well.
a fever settling.
a child who cried every single time you approached them eventually giving you a tiny smile from across the bed.

those moments were small
but somehow, they stayed

---
and just like my previous postings, i met people who made the difficult days easier
seniors who taught instead of simply expecting you to know
people who showed you how to approach a child, how to recognise when something wasn't right, and how to stay calm when a tiny patient suddenly wasn't doing well
because sometimes, surviving a difficult posting isn't only about how capable you are

sometimes it's about being lucky enough to have people around you who are willing to guide you while you're still learning

---
medical taught me how much i didn't know
O&G taught me to function amidst hormones, emotions and adrenaline
and paediatrics?

paeds taught me something a little softer
that medicine isn't always about doing something dramatic
sometimes it's noticing that a child looks slightly quieter than before
sometimes it's getting that tiny IV line
sometimes it's explaining the same thing again to an anxious parent
and sometimes,,
it's simply seeing a sick little human become a little human again

running around
playing
smiling

and probably crying the moment they see your steth again. :D

that was paeds

tiny patients.

tiny doses.
tiny veins.
but definitely not a tiny responsibility.

and just like other previous one, i wouldn't say every day was easy.
but looking back,
im glad i was able to go through it.

ppl said you will fall in love with paeds at the end of the posting

me? disagree

i tetap takminat :p

rate: 3/5

xoxo,

yanie