Pilyoship part 2

That went better than I expected..

I had an exam and interview a few days ago for a position in (yet another) fellowship training program. When I was way younger, I used to look with awe at those people who took training a few extra steps further. I mean, medicine by itself is already challenging, and residency is definitely not for the weak of heart. Sub-specialty training in is often a must among Internal Medicine residency grads who intend to practice in urban centers, and is no walk in the park either.

After I was done with fellowship training several years ago, the concept of going for further "sub-subspecialty" training seemed like such an abstract idea for me. Maybe its because I felt that I didn't have what it takes? Or perhaps after having been in training so long, I wanted to do things on my own terms? Or maybe because I was just tired of going through the entire process?

To give you an overview of the life of a person in medical training, here is a breakdown of the average years spent in education of someone who would eventually be a sub-specialist:

College degree - 3-5 years*

Medical School - 4 years

Postgraduate internship - 1 year

Residency (Specialty) Training - 3-5 years**

Fellowship (Subspecialty) Training - 2-3 years***

For the sake of simplicity, I chose not to include the INTARMED program popularized by UP Manila.

* College courses in the Philippines are 3 to 5 years in length depending on the university of enrollment and the coursework involved.

** Residency training ranges from 3 years for Internal Medicine and Pediatrics, to 5 years for General Surgery. Not included among these are the so-called "Straight programs" offered by some institutions wherein trainees have a lengthened residency period but are already qualified to take the sub-specialty examinations upon completion (common among the surgical sub-specs like Neurosurgery and Orthopedics).

*** Fellowship training for most sub-specialties like Pulmonology and Gastroenterology last around 2 years. Cardiology and Oncology fellowships are usually longer by a year. I have little idea about the subspecialities for other feilds, but I know Thoracic Surgeons have to take an extra 3 years after their General Surgery residency.

People may opt to take things one step further and pursue either a new sub-specialty (like one of my bosses who is BOTH a Pulmonologist and Oncologist), or delve further into the specialty by choosing a focused area of study to concentrate on (e.g. Interventional Cardiology, Hepatology (Gastroenterology), Sleep Medicine (Pulmonology). The length of this further training is variable, depending on the extent of training required.

From what I have seen, specialization can range from all-out fellowship programs lasting a year or two, to short trainings abroad (2 weeks to 6 months) for the emerging and newly-established fields of study.

Medical practice has been continuously evolving by leaps and bounds the past few decades, and the growth of specialization was inevitable, since it is necessary to keep up with the tremendous amount of new research and advanced techniques.

Having said all that, I made the decision to go and try for further training. Since my practice is in the highly competitive environment of the metropolis, its easy to get lost in the background noise and be considered irrelevant unless you have something that can help you stand out. ;)

I just hope everything eventually works out in the end.. :)

Nabunutan ng tinik

I wanna give credit for this image, but its been like 5 years already and I'm no longer sure where on FB I found it.. Sorry.. :(

At long last! I'm finally done with my clinical research requirement and can now apply for my diplomate examinations! *whew!*

Now all that's left is to prepare a presentation to be given at the paper presentation event a few months later.

I decided since the end of fellowship that I would be focusing solely on getting the paper and presentation done first before moving on to studying for the boards. The reason would be twofold..

1) It would pressure me out of procrastination to finish my paper since further delays would eat into my study time.

2) I'm not really too much of a multitasker, so simultaneously studying and doing the paper would prove disastrously counterproductive.

As is typical of me, I would like to take this momentary lull to thank everyone who made finishing the paper possible :P :

- The Big Man Upstairs, who has seen me through all sorts of different trials, examinations, lectures, presentations, researches, personal tragedies, and whatnot. Thank you for always guiding my way..

- My family for always putting up with me :P

- My Other Half for always being the voice of encouragement and motivation, who drives me to get off my ass and just do it!  :D

- My ulttra-chill consultant adviser, Dr. Ging Ladrera, who was there every step of the way, from raw conceptualization until the final draft review.

- Dr. Joseph Obusan and the rest of his Radiology staff for their invaluable support during my data gathering phase. I hope the results of this study will be of use to you as well. :)

- My batchmate and the present queen bee of LCP, Dr Raiza Visita, for kindly allowing me to occasionally print research-related documents at the fellows' callroom.

- The MICU staff, for allowing me to use the bizbox during downtimes so I could get my data on point.

From the bottom of my heart, I thank you all! :)

Stressed to the nth level

I'm on duty today, as the Senior House Officer, no less. I hate the anxiety that goes with it, and everyone knows that I hate being on duty as SHO.. :( In fact, I would take ward or ICU duty over SHO any day. :/ ER duty? nah, I'll pass.. Well, I hate being on duty in general, and since the end of training is finally near, I feel that it couldn't come soon enough.

I just can't wait until the sun goes down and everyone else goes home. There's a better feeling of calm and control that goes with the twilight..

It was far from my intentions to start off the year with another negative post, but this is my outlet, and I realy, really need to let off some steam.. Now, where do I begin?..

I find it really sad and unfortunate that the department is the way it is a present, and thus I can't wait for the year to end so I can be rid of this place.. The pressures that I feel here are unbearable, and that's just one aspect of the problem..

I got to spend some much-needed quality time with my Other Half yesterday, and it reminded me of the things that really mattered most in life. :) As always, the best dates are those wherein we were able to have long talks about the stuff that matters.

On a side not, a little funny story happened as well. We were just hanging out at an area of the mall overlooking the big chritmass tree at the lobby when a group of schoolkids in uniform, probably grade 4-5, approached us and asked us if we were koreans! :P Before they asked the quesion, I was a little bothered coz they surrounded us and I thought I had to beat them off with a stick lest they were actually little pickpocketing bandits. :P But I guess all they wanted was a selfie with actual koreans. XD

Argh.. Staying here is such a drag.. I actually can't stand being with most ofthe people here anymore. At least the juniors are a little better and seem a bit more fun to be with. :P

I went on a journey yesterday with one of my batchmates to ditribute invitations and posters for our forthcoming postgraduate symposium. We went aound the metro delivering the materials to hospitals mainly in the QC area. We made a stop at a nearby Burger King for lunch and since it was subsidized, I decided to give their most expensive burger a go. :P It was delicious, although I think I would have ben better off eatinga double patty instead of a burger with other types of meat interspersed with it. Yes, there was indeed a cacophony of different flavors, but I'm a burger purist, and this I think the flavor should be rich but not all over the place. :)

We just had another incident which further conviced me that I do not want to stay here any longer than necessary.. :/

I'm tired of all of this.. Of all the callroom drama, the ever-changing curriculum requirements, the shallow interactions..

I can't help but wonder how different things would have been if alittle adjustment here or thre was made earlier on, and right people wound up at the right place..

Sigh.. I can whine and pine all I want forthings to be different, but the fact of the matter is that it won't be. All I can do is adjust to make the most of a sad situation in order to survive and hopefully make it through unscathed..

Hmm.. now its 6pm.. things have quieted down a bit already..I hope this lasts the night..

2017 "YearStarter"

I'll admit that I was a bit lazy to write my annual yearender blogpost last night, so I decided on a compromise, to make a post on the first day of the new year. :)

As usual, Christmas has come and gone, and in this instance, the New Year celebration as well. So, here I am holed up in the hospital for the first duty of 2017, and I hope this will be a quiet one so as to not interrupt my annual retrospective..

This year has really been a struggle for me, and I bet for a great number of you as well since this has been a very difficult year all around.. My umpteenth "Senior Year" found me finding solace in the fact that I no longer had to man the Emergency Room, but I was now straddled (once again) with the responsibilities of being the highest official in charge (especially during night duties). With this, I am forever grateful for my formative years back at the old hospital where gutsiness and confidence were bred into our systems, by force if need be, due to the overwhelming demands of a government institution. Having said this, the "senior's load" was surprisingly still quite heavy, and I'm not just talking about the responsibilities of being senior to a group of newbies to the trade, but the task list seemed to grow heavier as well..

I was grateful though for the opportunity to head out-of-town due to a midyear convention, but boy did it come at a price! Being a contestant for an inter-institution debate is no joke! While all my compatriots were lounging around and resting, I was busy burning the midnight oil even up until the night before the event! :P Apart from that, the little challenges that came my way seemed to all stack up on a regular basis. I have had barely enough time to catch my breath and get my bearings when I had to move on to another equally challenging time-limited objective. And given my penchant for both procrastination and being OC once I got started on my work, this combination proved to be very deadly indeed. :(

Having said all that, I really enjoyed my stay out-of-town, and will definitely return with loved ones in the future :D

This year was not all about toxicity though.. This is also a year where I began seriously contemplating how it would be like if our family finally got our very own car. Granted we are working with a relatively small budget, but there are numerous offerings out there, and the priciest may not always be the best choice. ;) Steps have been taking, and we have been reading up on a lot of stuff as well, but we admittedly have a long way to go.. but at least we got the ball rolling, right? :)

This year I was also able to meet up with my Other Half's friends, and she was able to join me and the guys on a couple of BNOs as well. Things seem to be going quite smoothly, and I pray that this continues in the years that follow. :D

I guess the theme this year for me was exploring the limits of, and going beyond my comfort zone.. I guess it's also a part of growing up (?) but one cannot ignore the fact that there is someone else that helped me overcome these barriers and continues to inspire me to be brave to this very day. ;)

I guess I could say that I really grew more this past year, both in knowledge and experience as a doctor, as well as in love and wisdom as a person.. Even though it has been a bumpy ride, I am grateful for the year that was, and I face this new year with nervous anticipation for a brand new start! :)

A few resolutions would also have to be in order, since this technically still is a yearender post. The resolutions would be as follows:

- Spend less time (close to none if possible) on Facebook. It's a great time sink, and it stealthily consumes more time than you would expect, giving you little in return.

- Less time online (including game time) and more time interacting with the real world. This one is a no-brainer, and deleting applications is a priority

- Live and love more. As I will be set free from the constraints of the training schedule, I can finally try to live life the way i was meant to be lived.

- Travel? (As budget allows though)

- Blog more. I know it seems to go against the principle of the second one, I can still create these intellectual exercises offline and just jump in to post for a few moments.

- Be a better brother. Not just to brother dear, but to the BNO bros as well

- Be a better son. (duh!)

- Make time for the Big Man Upstairs. Its been a long while, we seriously need to catch up..

- One last exam. I know it will still be a year from now, but fortune favors those who are prepared.

There, that should do it for now! I have now made it a goal to put up a post at least once a month so the blog doesn't grow stale. :D

Rant aftermath

Whew.. That was a long one..

I would like to make clear that I am not targeting any individuals as I have no beef with anyone from that religion individually. Its just the system as a whole that sickens me..

Enough of that.. I'm gonna draw a line on all this negativity caused by religion and go back to our regular non-religious programming..

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The UAAP season is now in full swing, and al eyes are on DLSU with their spotless 4-0 record. I think we have a pretty even field this year, and that games can go either way for the most part. A good example of this would be Adamson's 1-point victory over perennial powerhouse Ateneo off a last minute jumper near the top of the key.. I really missed the UAAP, and I'm glad it's finally back onj track. I'm thinking of following the NCAA as well. a 10-team field seems interesting, and the balance of power seems to have shifted a bit away from San Beda and San Sebastian which to my recollection have been really successful in recent years. Sana lang hindi na sila larong kalye unlike before..

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I'm in the library for research yet again. This time it will be in preparation for a speaking engagement on a much bigger stage.. It is a burden I had no wish or intention to carry,. but I guess my chief had no other choice but to put me on the chopping block since everyone else already had their turn..I just hope I could put this off without a hitch..

Long overdue

Finally! After a couple of months worth of exhaustion and procrastination, I have finally been able to revise my research protocol, and now I don't have to hide from my adviser anymore! :D Now the challenge lies in maintaining this momentum that I seem to have gained for myself..

This has been a grueling past couple of months for me to say the very least. Being SHO and ICU at the same time during duty nights for two straight months can suck the happiness out of anyone, not to mention a considerable amount of energy and zest for life. :P

Finally I have broken free, and am now happily tucked away at the sleep lab for an entire month where I have minimal interactions with the outside world and can finally have a bit of peace and quiet..

I've recently been diagnosed with Obstructive Sleep Apnea, a diagnosis which I have long suspected anyway. What remains to be seen is the severity which would be revealed when my poluysomnogram results come out. Sleep Medicine is a fascinating science, and I never thought that there would be more to sleep than just, uh, sleeping..

The implications of this OSA diagnosis however, means that I may have to invest in a CPAP device which would greatly aid in improving my sleep quality. I'm a little apprehensive though, since theses devices tend to cost a pretty penny, although the Sleep fellow says that it costs about as much as the latest iPhone.. Problem is, I'm not really fond of buying top of the line devices, so the price is still gonna hurt my wallet badly.. :(

Putting things in perspective though, I guess I'm obligated to keep myself healthy since I intend to live a full and happy life with another in the future ;), and I'll be damned if  I'd let something like this get in the way. :)

I've also been thinking a lot about purchasing a vehicle for the family. We've never really had a car we can call our own since I was a child (since we've never had the finances to do so). I'm not thinking high-end here, since it's really going to be impractical from my standpoint. I just need a reliable vehicle to get us from point A to B without any hitch and would seat my aging parents comfortably. You see, I notice my parents now seem to have a difficult time getting in and out of sedans.. but a regular SUV is out of the question due to the prohibitive cost.. Sigh.. We'll just have to wait and see what develops... :/

Growing up is really expensive business.. I guess I consider myself lucky that I still do not have kids to worry about. Seeing my bros with their families often leaves me a little bothered as to whether I can deal with all of that once it does come my way eventually,,

It has been raining like crazy lately, and all that without a definite storm in the country's area of responsibility, with the threat of massive flooding always a grim possibility. In fact, I already encountered a bit of flooding the other day as I was making my way home.. Good thing I was able to find a place to stop and wait it out.. I hope the days that follow won't be as bad..

Antisocial

There are days when I neither require nor desire human interaction. This is one of those days..

Being around other people can be such a chore, and it makes it even tougher when the very nature of your work requires engaging with others on a regular basis.. :/ 

It is yet another duty day, and by the way things are shaping up, I think I'm in for on hell of a ride..

I had a brief conversation last night with my Other Half (Hi!), and she told me that she was feeling pretty much the same way about work and what we are doing with our lives.. Unfortunately I had nodded off before I could give her a satisfactory reply.. (sorry!)

I wish I knew all the answers, but I was just as lost as she was.. Even now, with the present state of rhings in my life, I sometimes drift back to question the path I chose to follow so many years ago..

It really doesn't help that I'm not really fond of the people I'm presently working with.. Sad to say, I can even barely consider some of them as my friends. They are all just co-workers to me, some of which I may have a better understanding with than most. Unfortunately, lasting friendships does not seem to be in the discussion.. They are just really too different for me to be able to form an inrimate bond of friendship with.

I hate to use this line, but mom was right. In life, you will only meet a handful of individuals who you will consider as your true friends, and I'm glad I have my BNO boys for that.

Sigh.. Other people are just so irritating at times, and even more annoying is the fact that they have absolutely no insight that they are the root of the problem and are either too stubborn and set intheir wicked ways or too goddamned stupid to change for the better. Maybe its also due to advanced age, i dunno. I've pretty much given up figuring these people out. I've already removed the Facebook application since I was tired of all the shallowness and superficiality that is on display. I desire to have real things, real interactions, realexperiences, all of which is according to my design.

That is something I will not be able to accomplish until I am rid of training already, and the following 8 months can't go by fast enough.. :/

Compulsion

For some strange reason, I feel compelled to blog today. It's as though I'm driven by a need to jot down something profound..

Nah.. :P

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Our new president had his first Stae Of The Nation Address (SONA) yesterday, which to me seemed like a pleasant departure from what we see year in and year out, which is pretty much more of the same detached nonesense that the one in charge spout out. It was really different this time around. Although there were still shades of a well-prepared speech, our prisident made a lot of ad-libs and cracked a lot of jokes, making light of the situation and delighting both the atendees and viewers alike. He also gave the militants their free space to approach the venue, and the rallyists in turn did their part by not causing any trouble and even had pleasant interactions with the police, including the police chief himself.

Changwe has truly come to the Philippines, and I hope this will be all for the good of everyone (excluding the bad guys of course. They'll be dead :P)

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I've been contemplating getting a vehicle for quite some time now, since the one we've been using has been suffering through a plague of various maladies associated with old age..

The market is presently rife with soooo many options despite my efforts to narrow it down given my very low budget..

I never knew car research could be so exhausting..

But I've had a recent breakthrough, like just a few minutes ago, which has helped me narrow things down by a great deal.. ;)

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I should be going home in a few minutes, unfortunately there will be a Webinar (Web Seminar) later at the office, so we can't leave just yet.. :/Oh well, at least I get free grub..

Just the same..

I'm spending a bit of quiet time here at the hospital library, since I'm already done with my rounds and the callroom suffers from lack of any semblance of air cobditioning. :P

I often find myself in this kind of funk when I had just experienced a wonderful weekend in the days that preceeded.. Having had the rare opportunity to spend a full day's worth of quality time will always give anyone an emotional high.. Sadly, the crash that follows seems to get worse and worse as the experiences becone more pleasant.. Its kinda like the allusion of "the higher you fly, the further you crash".. :(

I'm personally sick and tired of this emotional roller coaster that I go through whenever I get some much-needed R&R only to return to a situation I am no longer really happy with.. :/ I really do wish things would seem a bit brighter, but I'm at a loss with how I could make things work.. Its no fun going to work everyday with an apparent cloud of gloom over your head.. I guess this stems from my general  dissatisfaction  aboit life and it's every 3- or 4-day cycle... Or maybe the SH-ICU duties for two straight months have been really getting to me na.. :( I'm sorry to makeanother badtrip post, as I know I have promised to try and be more positive in the blog, but the problems remain, and sometimes grow in complexity and weight, which defeats my attempts at supressing them..

Sigh.. Things just seem to be so depressing right now, and I have absolutely no idea why... :(

Anger Games

I just have a short thing to say.. It's really difficult to go on duty when your batchmate refuses to receive endorsements from juniors because of this or that excuse, or probably because s/he is just too goddamn lazy Sadly, the burden goes to you, being the more kinder and approachable senior, to sort things out. But then again, it is really difficult if that person does not repect the authority of the SHO just because s/he is so goddamn selfish!

These are experiences that one will remember for a lifetime, and will leave an indelible mark on the person's record and will forever taint other people's memories of him/her. I personally will not be referring any patients, nor will I be entertaining any favors for that person. S/he is not my friend, and it just so happened that we were co-workers at one point in time. I don't tolerate assholes in my friend list.

Warning: Rambling Rant ahead...

I need something, anything, to get myself started again.

On duty again today as the Senior House Officer.Man, being a SHO here is a lot different from when I was in QC.. In those early years, it was more of an annoyance, with not really much responsibility to bear, since the Chief of Clinics was always just a phonecall away, and the THOCs were handled directly by the different departments. Not so here in our institution, when the SHO has greater power and responsibility. One of the things I dislike the most as SHO is the constant level of anxiety that stays in the air in anticipation of something happening, be it a midnight call for a THOC or an unexpected call for help from the emergency department..

Lately it feels like I've just been floating along, without any motivation to do well in my work.. Is this burnout? I do not know. Frankly speaking, I have relatively little to be burned out about. But then again, the constant flow of work that I have been through in the past few months may have left me with very little in the tank..

Actually I'm feeling depressed, with very little evidence of anything to be depressed about. However, that's the thing about depression.. It just comes around without warning to bite you in the ass. :( You often have nothing to really be sad about. Your mood just turns all gloomy without warning, and it affects everything you think, say, or do, and recovery is slow and difficult.. :(

Hmm.. It's actually raining now.. A welcome development compared to the sweltering heat we have endured for the past months.. A lot of lives have been affected by the drought, especially our poor farmers in the countryside..

I wish I would be having my training under happier circumstances, but with the current situation among the trainess, especially the infighting among seniors, makes this a less than desirable place to be if one is looking for someplace to rest and "make tambay". I won't go into specifics since I feel that my blog does not deserve to be contaminated by unimportant trivialities caused by unimportant people...

Still, the office and callroom remains a relatively unhappy place, filled with unease when opposing parties are in the same room together. As for me, well, I'm caught right in the midde of it, being civil with either side, without favoring one or the other. And these guys know me well enough not to drag me into their petty squabble lest they endure my wrath. :P

On the side, I have also been reading stuff about possible electoral fraud due to supposed technical corrections done to the transparency server. This to me seems like a load of crap, and I think the media is just blowing things out of proportion, as well as the supposedly affected parties who seem to be looking at absolutely anything they can get their hands on to say that there has been foul play despite there not being any in the first place..

But then again, looking at things the other way, why would there be a need to make such a trivial adjustment to such a an unimportant thing at the even of the elections if said change would only be cosmetic anyway? The end result being that the electoral result is now in doubt.. Hay naku..

I have recently deleted my FB app from my device, in order to minimize distractions and remove myself from all the negativity that go with it. FB is good per se, but I think it has been doing more harm than good to society as a whole. Another goal of deleting FB is that I would be able to concentrate on things and people that matter to me. :) I have half a dozen pocketbooks which I have bought in the last couple of years that have yet to be read because I lacked the "sit-down time" it would take me to read these books, as I usually read each book in one sitting (yeah, I'm a book nerd like that :P)

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It is already 2pm, and I should really get started already on the paperwork (I started this entry at 10am, with pauses in between for lunch and to check the present state of the ER and the fellow manning that post.

I'm thinking of shooting hoops again with brother tomorrow, that is, if my stamina would allow it. :P Shooting hoops gives me such relaxation which I have not felt for a long, long time.. It's just you and the basketball out there on the court. I also discovered that I still have a pretty decent free throw shooting arm, putting down 6 out of 10 in one continuous sequence. :D

Drained..

Wow, that really took a lot out of me..

It's Thursday, and that means TB clinic day here at the hospital. As usual, the OPD was really toxic probably because I was the one rotating there..

Add the fact that it was SO FREAKING HOT today, and you have a recipe for disaster. I mean, I haven't felt this tired since my ER duties.. Thats how intense today was.. :(

I should be working on my protocol now, but I'm just too damn tired... :( I have to do this later though, but maybe at home na lng so I can work on it uninterrupted... :/

My Other Half has been feeling under the weather lately.. although I think it's more of vertigo. She got herself checked out by Ophtha and ENT already, and she's gonna have some bloodwork done later.. I hope everything turns out alright.. :(

Safe at my sanctum

The second curriculum year of my fellowship is in full swing, and I have been blessed by the fact that we do not have any conferences this afternoon after we finished our OPD patients.

I find myself confronting another deadline yet again, mostly due to my procrastination, but also in part to the never-ending fatigue I feel every time I go home and take to my bed..

I thought senior year would be a lot more benign, but boy was I ever wrong! Or maybe because I'm really just a toxic fellow-in-training. (*sigh..*):P

I should really get myself checked out for OSA, and I definitely will, probably during my Sleep Medicine rotation.. Oh yeah.. I need to have spirometry done as well, just to resolve once and for all the question of whether or not I am asthmatic..:P

It's been getting really hot here in the metro, and I mean that literally.. Temperatures have been constatly on the rise, as we feel the effects of El Nino.. The air is always so dry and warm, and it can get reallyunpleasant at the OPD.

The problem is even worse for our countrymen working in the agriculture sector, as the drought has caused entire crops to fail, destroying the livelihood of our farmers..

I honestly wanted to go to the gym today but thought better of it since I still have stuff to do.. XD Now I'm making a conscious effort to cut down on what I eat, though wrestling with a voracious appetite can be really difficult at times..Still, this is something I need to do in earnest for my own health and my future happiness. :D The gym can probably wait after I have all the paperwork out of the way..

Ok, that's enough of a starter post! My brain is probably revved up enough already so I should now go forth and type stuff!

(with the added motivation that I can go and see my Other Half later this afternoon ;) ) 

Cruchtime

This a blog post that I actually have no business of writing down at the present time, given my current situation, but I'm in a bit of a writer's block right now, and I often use my blog entries as a starting point to get my creative brain going, whether it be for a lengthy story for my blog,or an upcoming case conference report.

This case conference has been assigned to me roughly 3-4 weeks before, whilst I was still finishing up my  (hopefully) final month at the Emergency Room, so I really shouldn't have an excuse for not completing my output yet, but bear with me..

The past couple of weeks have been really busy for us fellows as well, what with all the different activities going on, especially the annual convention of the society which really messed up our schedules and left everyone dead tired from all the travelling and the skeletal duties, thus rendering it impossible for me to string together a coherent intellectual output of any kind since it was not really a holiday, and the workload did not change just because the lung doctors had to go elsewhere to talk about things..

So now I find myself less than 24 hours away from my report, which I hope will not be a total bust, depending on the output I can spew out in the next 10 or so hours. :P Looking back, I think this is the first time in a long long while that I have had this much free time to myself where I was able to have ample rest before I needed to work on hte report. Because these past days have been filled with ABG readings, cover rounds, and scutwork in general which left me so exhausted that I could barely work.

Though its true that there was also a bit or procrastination on my part, but there were also those times in the library where I fell asleep in front of the monitor because I was really just too damn tired to do anything!

Oh well, I hope this is enough to get my engine warmed up. I really need to get started.. :P

10 out of 10

This post was written on February 28, 2016 at 1pm

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At last, I'm finally here! The final official ER duty of my life (I hope...) 

Frankly speaking, I'm not really in the mood to celebrate anything, as the day has pretty much just begun.. :/ Nor do I think I will be when the next day finally arrives, especially since I have to slide into a new duty schedule, and thus may be too tired to do anything else..

I've been feeling down a lot lately, especially since this is an ER month.. There's just something about the whole situation that weighs heavily on my shoulders..

Hmm.. I'm kinda feeling a bit under the weather myself right now.. :/ I just have to survive this duty night then rest my ass off tomorrow after OPD so I can get ready for my return to the ward.. Sigh.. I just hope that I CAN survive this duty day..

Being depressed is something that is not new to me.. As I may have mentioned before, recent experiences during my training at a different institution had left me in desolation, and pretty much broken.. Luckily, I had the support of the people around me which helped me get back on my feet and try again anew. What followed was a whirlwind ride through training which I never expected, but was able to experience since I surrendered myself to what life has in store for me..

I really hate this ER anxiety along with all the unpleasant sensations that go with it.. :/ top it off with the fact that I'm feeling a little sick right now...:( 

8 out of 10

This post was written on February 22, 2016

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I think and worry too much, especially in uncomfortable situations that I get myself into, notably residency and fellowship training.. You see, these things are really just optional.. Nobody really compels you to go into this or that since its no longer part of a school curriculum like clerkship, or a requirement for the physicians licensure exam like the post-graduate internship.

Sigh.. I should really learn to get my head out of my ass when things get rough.. The ER is especially traumatic for me because I am not comfortable with dealing with an endless stream of patients, most of them seeking immediate attention for one reason or another. Its not easy to deal with that because i feel like I run out of compassion too soon.. My only consolation is that it will all be over soon.. (I hope..)

I kind of hate myself because of the mess I'm in, since this was a result of a conscious decision to become a freaking doctor.. 😕 As I have said before, once you realized what a freaking shitstorm it is, you find yourself way too deep into it to turn back and choose another path, which I find kind of unfair.. Other people go through life switching jobs until they find something they can live with eventually. Doctors don't normally have that luxury, unless of course you're filthy stinking rich that you can afford to turn your back on the amount you've spent on your one-way trip through medical education and just start from scratch elsewhere..

I'm normally very eloquent when I'm sad and frustrated.. I guess its due to the fact that have so much to say, and so much emotion to back it up.

A one-way ticket.. Yeah, i think i like that statement.. 

3 out of 10

This post was written on February 7, 2016

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Yup, third duty of the month.. 7 duties to go, and the end can't come any sooner.. Not liking ER duties in general isn't really helping either.. Sigh.. :/

I really just wanna rant.. I know this is getting tedious, and I'm sorry to those who are put-off by this.

I've had a relatively happy past few days since I was able to meet up with my Other Half and have dinner together on a couple of occasions. But you know what they say, the higher you fly, the further you crash. This is even moreso reflected when you have to go on duty the following day, because the taste of how much better life is outside the hospital is still fresh in your psyche..

Adding to my present woes is the fact that Ihave to give yet another report two days from now.. This should be relatively easier since the content is solely from the book, but I have not started work on the presentation yet and am just reading through the material today.

Yesterday was a rare day off, in fact, i think this was my first real day off in the last month or so, since my weekends last month still had me going to the hospital to make rounds regardless of duty status..

Fast forward to 3PM.. It's been relatively quiet for the most part owing probably to the fact that its a holiday tomorrow ( 新年快樂!), so i hope this tides over until I leave for home tomorrow..

As hard as it is to admit, I think I'm getting too old for this duty stuff.. :/ I might probably be good for one more year's worth of duties, but I think my reserve for ER duties will have reached its limit by months' end..

Now its 10PM, and I had a sudden moment of clarity and I realized that the most toxic part about going on duty at a specialty center like this is dealing with those patients who are not supposed to be admitted here.. (Primary problem is not Pulmonary)

What a way to start the month..

Late post which was written on February 1, 2016

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It's just 9am and I'm already feeling absolutely TIRED.. It's my first day back on what would hopefully be my last month at the Emergency Room.. 

I guess you could say that I hit the ground running with this one, as there was a ton of patients endorsed by the outgoing Doctor. 4 intubated patients, plus one on BIPAP.. Argh.. Looks like I've got my work cut out for me this time around.. 

As I pause and look at myself in the mirror, I realize that so much has changed.. Gone were the days where I would see a bright young doctor wannabe filled with youthful optimism and idealism. Nowadays all I see is a worn-out old dude just trying to get by day-to-day with the hope of reaching an end to all of this someday. The fire in his eyes all but extiguished in the face ofwhat he's seen and been through so far, with nary a promise that things will get any better in the near future.. A faint glimmer of hope remains though, a spark ignited by something far greater outside the confines of the dreary hospital life.. Something that he looks forward to after all this stuff is done and over with..

I still feel like I've thrown my life away though.. The best years of my life being spent drowning in some textbook or rotting away in some hospital away from the warmth of family and friends, trying to make sure some complete strangers (some of them totally ungrateful, especially the pay patients) would be able to get better whilst my loved ones suffer quietly at home..

Yes I'm being bitter about it. I have said it one too many times that the realization about the hardships of a doctor's life comes too often too late, with students having invested far too much on their education and chosen career to backtrack on find another path..

I'll admit that I used to scoff at doctors who were saying that the doctor's life is hard, and just thought that they must not be doing so well to say such things. Now I realize that they were telling it like it is.. The feeling of being trapped and disillusioned is actually very real, and depression is always looming just around the corner.. 

I'm really glad I have this blog and this device where I can type my thoughts and frustrations away.. Sorry to my readers if things seem a bit negative, but I'm just telling it as it is.. There may have been some great moments interspersed in between, but training was mostly a wild collection of tiredness, toxicity, frustration, and heartache..

I miss sleep.. I miss being able to go to bed and wakeup late the following morning without a care in the world. Lately its been so negative from the moment I wake up, especially with the entry of February, since it represents yet another 9 days at the ER for me, or collectively 216 grueling hours of nonstop exhaustion..

I wish I REALLY had the time to do what I want in life, not just steal some moments interspersed within a greater scheme of things like training, as chasing after those temporary highs seem so empty and lonely.. To make things worse, the higher you feel, the worse it gets the following day when you have to drag yourself back to the daily grind..

I find myself retiring to my bed more often these past few days, and i can actually feel the enthusiasm drain from my psyche.. Am I depressed? Probably.. I can't say that I haven't been here before. Sometimes I have the impulse to throw up my hand and say "Fuck it!" and just walk away. It's a really tempting scenario if you look at it.. 

I think I've ran out of happy things to talk about, and this blog hangs heavy with gloom and doom.. 

On the other hand...

This was written shortly after the previous post...

I'm also grateful for the chance to get away from the hospital for a while. My patients are (hopefully) pretty much stable for the past few days, except for that newly intubated one which made my morning pretty busy after going through that grueling case conference.

Hey, I guess I got through that pretty much unscathed! Thanks to my dear consultant moderator who took one for the team and gamely answered most of the weird questions asked by the consultants. I had to answer the basic academic stuff of course, but the advanced technical stuff that a level 1 fellow wound not normally know were covered by him. I'm also grateful to my consultant reactor, who really took time out to make a presentation in front of the body so that the conference would be a lot more interesting.

See, this is what happens when you let a burned-out doctor rest. He becomes a lot less crankier and a lot more insightful. :) I just hope this tides me over the next couple of days until the seniors go back to their original posts after all the craziness of the interhospital conference has subsided.

Come to think of it, i never really had the time to bask in the thought that my case conference ordeal for this month is finally over.. And to think that it was accomplished amidst a lot of tiredness and procrastination. Such wonders a looming deadline has on the productivity of a person. I think it shot up by about 200% i actually even left the house at 5am the previous day to make early rounds just so I could lounge around the house for roughly half the day, and devoted 8 intense hours to the completion of the presentation. Hehe :P

Although it is an experience I don't want to go through again.. XD

I promise to put on a much better showing next time, especially if I find the topic particularly interesting..

My ass hurts from all this sitting though.. i wonder when I will be relieved?..

This is stupid

The following post was typed the day before while at a different location

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Among the myriad of jobs a fellow has to do in our institution, accompanying patients to dialysis ranks among my least liked. It's a total waste of time, especially if your duties for the month leave you pretty much occupied. Its a different deal when you're the floater though, as you can use the tine to kick back and relax as you waste the day away. XD

I can't wait for this damn academic year to be over.. I absolutely despise going on ER duty, and i yearn to taste a bit of a schedule change beyond the Pre-Duty-From cycle that I have grown accustomed to throughout the years.. Heck, I just wanna be done with training, period!

I yearn to have the opportunity to finally live my life according to my own design.. I long to break free from the confines of a duty schedule, from running after annual academic requirements. I want to be able to take an actual vacation where I can truly rest my weary mind and body which has been worn down through the years as a result of the rigors of hospital training.. It may sound shocking, but I want to have the opportunity to not be a doctor for a while... I just want to live anonymously in peace and not be bothered by anyone, including patients. Call it being antisocial, call it whatever you like. I don't really give a crap. Chances are, if you're reacting like that, you're probably one of those kinds of people that I'm trying to get away from..

I'm really going to stick to my rule of not giving out my phone number to patients. I value my personal time, and patients have no business bothering me when I'm away from the hospital or my duties. I don't think I would love my job enough to be immersed in it 24/7. Besides, there are some other roles in life that I need to make room for in the future which would demand my utmost attention, like being a dad or a husband.. ;)