Jun 2, 2009

back in the line of fire

supernova explosion destroying planets - artwork © Mark A. Garlick

after countless months of training the JMOs, finally, I am getting some first calls this month.

I was on first call yesterday.

first call, manages all wards, all admission, all referrals all day long and after 12midnight, runs the OT as well. basically running left and right, centre and out, front and back, up and down while the second call relieves all procedures, mainly C-Section in the op theater. Perks of being first call - entitles to AM off next morning. Even if it doesn't, we'll basically drop dead in clinic or have intermittent petit mal running the clinics.

when i started my first call, it was like ground zero battleground, fighting for more time, fighting for more energy, but mainly fighting for more wisdom to prioritize everything towards a safe management of patients transiting through my department.

now, it is still a battleground, but with first call, I get to talk and communicate with my colleagues in other department, basically referral in and out.

Referrals within good colleagues is always great. Here's a reason why.

NK: Hi
Me: Yep
NK: Ey, why am I helping you to resuscitate this patient?
M: Where is it? I will come, but I bet you're pulling my legs.
NK: Can't fool you. Wanna introduce a 17 years old 'leng lui' to you?
M: Is the 'leng lui' stable?
NK: 'Leng lui' of course stable.
M: What's the 'leng lui's problem?
NK: Huge abdominal mass. UPT negative.
M: Send her up to my ward, will assess and scan her from there.
NK: Now?
M: Yep.

And of course, there will always be DHs that accept referrals like it is the end of the world, even though it was within office hours and the DHs are not on call on that day. DH basically is synonym to the statement "men thinks with their penis". Take a wild guess.


Here's why i think DH is befitting to their egoistic primitive behavior.

M: Hi, have your lunch already? (Trying to be nice. But i think DH doesn't deserve it)
DH: No lar, why? You disturbing me, where got time to eat?
M: Are you in charge of this ward?
DH: Yeah, the other MO also in charge of that ward. Why you didn't call him?
M: I got your name first, and the operator connects me to you.
DH: Really ar? I already went to your ward earlier, you want me to go back again mer?
M: (you think our hospy is so bloody big ar?) Well, here's the patient that I would like to refer to you... admit for xx, noted BP high... (interrupted)
DH: how high is it?
M: 160/90
DH: how many readings? high since when?
M: slightly high since last night.
DH: why didn't refer last night?
M: I wasn't on call last night. (I'll be glad to refer you in the middle of the night next time you're on call. mental note to myself)
DH: you guys got serve her medication or not?
M: she's newly diagnosed.
DH: aiya, you guys must have frightened her till BP shoots up high.
M: Ya, may be. (Frighten, my ass!).
DH: What's her Urea/Creat?
M: Normal.
DH: Got do X-ray and ECG or not?
M: Yep, normal.
DH: Start her on stat dose of x first. So, can I come see her tomorrow?
M: Up to you. (No problem, by that time, my specialist would have referred to your specialist)

I guess a simple case of newly diagnosed hypertension with hypertensive urgency can be managed easily by starting oral medication as per guidelines, but it is always best to refer to the expert not only for the current problem, but also for future follow up and end-organ damage monitoring.

Anyway, bottom line is, I been to Medical posting before.
Surely, DH been to O&G posting before.

Therefore, since I am being scrutinized harshly on BP, ECG, CXR, Urea, Creat which I am prepared to present and interpret adequately, the next time DH is going to refer me some O&G cases, I hope that DH will be ready to tell me the LMP, VE and speculum findings, basic menses, sexual and obstetric history and Pap smear, or else my sarcasm will slice the D off his egoistic DH...

... provided that he actually have a D.


fibrate said...

Chill out man :) DHs are everywhere. They make life interesting and people like us look really really good, don't you think?

pilocarpine said...

looks really really good?