Taking a Break

We hope to return to our regular ranting after the season...

Lessons from My Houseman Year - 9

Lesson 9 - And this too, shall pass

No matter how long the patient list is, the ward round will end.

No matter how many admissions there are, the call will end.

No matter how tough you housemanship is, it too, shall pass.

The crap you have to take now is not the rest of your career, and it most definitely not the rest of your life.

Now pull yourself together, get out there, and let’s save some lives.

Lessons from My Houseman Year - 8

Lesson 8 - Love One Another

"Two are better than one… for if they fall, the one will lift up his fellow: but woe to him that is alone when he falleth; for he hath not another to help him up. "


Workload is never going to be equal, even if you each cover the same number of patients and wards, because each patient is different.

Some days you will be swamped, some days you will finish early.

You know when you are swamped that you will appreciate help from your colleagues who have finished their changes, so you know what to do when you finish early.

Lessons from my Houseman Year - 7

Lesson 7 - Every clinical encounter is a chance to get sued

Depressing, but nevertheless true.

Every clinical encounter carries with it the chance that the patients or his family may seek to bring a suit against you, with or without just cause, and whether they actually stand a chance to win.

The reason why I bring this up is not to scare the wits out of you, but to remind you that what you do has the potential to do so much harm, that a whole subspecialty of law exists to prosecute/defend you, and there is even a special insurance you need to buy (in case you get sued) before they would let you practice.

More importantly, the law represents (or is supposed to represent) the collective expectations of society. So if you feel you are going to do something that will break a law, you might just being doing something wrong.

Lessons from My Houseman Year - 6

Lesson 6 - Don’t Panic

There are many things that you can fail to do when faced with an emergency, but the one thing you will get reprimanded for failing to do is failing to call for help from a senior doctor.

So remember: the priority in resuscitation is not ABC, but CABC.

You want to write that down somewhere.

Lessons from My Houseman Year - 5

Lesson 5 - You have a right to be angry, but no right to be cruel

Your job sucks.

In fact, it sucks so much that they have to make it a 'requisite' that you have to go through before you can become a 'real' doctor.

It stands to reason that the frustrations and setbacks you face on the job will make you disillusioned, depressed, and angry.

But here’s the important bit: You have the right to be angry, but never the right to strike back in anger.

You may not be able to control how you feel, but you must control how you react, because you are now in a position to do an enormous amount of harm to fellow-men who are suffering.

Do not give in to the anger.

Primum Non Nocere.

Lessons from My Houseman Year - 4

Lesson 4 - Be Ignorant, not Stupid

Not knowing how to insert a chest tube is being ignorant.

Inserting a chest tube when you don’t really know how to do it is being stupid.

Despite what your seniors tell you, nobody started the first day of housemanship knowing the correct dosage of every drug and having done every single procedure at least twice.

Ask.

Ask to be taught. Ask to be shown. Ask to be taken through.

At the end of the day, it’s better to be called 'stupid' by your registrar (when you were really just ignorant) than to be called 'stupid' by the judge.

Because he would be right then.

The Doctor is Out

angry doc will return with his "Lessons from My Houseman Year" series next week.

Those of you who are doing a surgical posting (GS, Ortho, O&G) as your first posting should head over to Dr Barbados Butterfly's blog and read her "Tips for Surgical Interns" series (right-hand column).

Those of you who are doing a medical posting first... well, God obviously hates you, so who am I to care?

World Health Day 2006

7th April was World Health Day.

This year, WHO's World Health Report focuses on shortage of healthcare workers, in particular in Developing Countries.

The Report touches on several interesting topics.

Chapter 5 of the Report discusses 'Managing Exits from the Workforce' and the issue of migration of healthcare workers and how nations cope with this phenomenon.

Chapter 6 discusses the erosion of trust in healthcare workers, and how this trust can be regained.

Makes for good weekend reading...

Lessons from My Houseman Year - 3

Lesson 3 - The Secret of My Success

Time exists so everything wouldn’t happen all at once.

Ask any doctor and he or she will tell you that the secret to surviving housemanship is the ability to prioritise.

Every nurse, every senior doctor, and every patient or his family will think that the task they have just requested/demanded of you is the most urgent one and must be attended to immediately.

But you must know better.

You don’t?

Well, I would tell you… but then it wouldn’t be a secret anymore, would it?

Lessons from My Houseman Year - 2

Lesson 2 - It’s a job

Some say it’s a calling, some say it’s a privilege.

Get over it – it’s a job.

You get paid for doing it, you have bosses to report to, working hours, colleagues who will irritate you, 'clients' who demand things from you, and a performance review at the end of the posting.

There are things that are expected of you.

Deliver.

Know the rules and regulations of the workplace and the terms of your employment and the contractual obligations. Know what you are supposed to do, not just as a doctor, but also as an employee.

And when the day is done, go home.

You still have a life, you know.

Lessons from My Houseman Year - 1

Lesson 1 - Your mission, should you choose to accept it...

When I started my housemanship, my registrar told me that my mission was "to make it through the year without getting sued".

After all these years I still can’t think of a mission to trump that one.

Well, except maybe to avoid suicide.

In fact, I make it my daily mission now. (The not-getting-sued part, not the suicide.)

You see, all the rest - learning, getting noticed for traineeship, laying the foundations for a successful and satisfying career – are all important; but if you do get embroiled in a court-case, well, they won’t matter anymore now, will they?

So don’t kill anyone. Or yourself.

Not before you complete your houseman year anyway; God knows housemen are the rarest type of doctors we have…

Just four laughs

Tag, now I'm it!

Four Jobs I've Had in My Life
1. Doctor
2. A conscript soldier
3. Temporary Library Assistant

Four Movies I Could Watch Over and Over
1. The Godfather
2. The Godfather II
3. The Godfather III
4. The Untouchables
(Mmm… organised crime…)

Four Web Sites I Visit Regularly
1. Well, all the blogs on my link list.

Four Favorite Foods
1. Apple pie
2. Chendol
3. Dark Chocolate
4. Gulab Jamun
(Yes, dessert is the reason why I have meals.)

Four Places I Would Rather Be Right Now
1. Angkor
2. Fort Cochin
3. Kamphaeng Phet
4. Luang Prabhang

Four Most Wonderful Places I've Ever Been
1. On a roller coaster.
2. In a cold shower on a hot day.
3. In a hot shower on a cold day.
4. In an Operating Theatre.

Four Books I Could Read Over and Over
1. The Cunning Man – Robertson Davies
2. The Razor’s Edge – Somerset Maugham
3. Siddharta - Hermann Hesse
4. Are Dilbert comics considered books?

Four Songs I Could Listen To Every Day
1. Speak Softly Love – Andy Williams (It’d have to be, right?)
2. Watching the Wheels – John Lennon
3. No More Lonely Nights – Paul McCartney
4. My Sweet Lord – George Harrison
(Sorry, Ringo.)

Four Reasons I Blog
1. To ease the pain.
2. To laugh.
3. To remember.
4. To sit in judgment on oneself.

Four People to Tag
1. aliendoc
2. Dr Crippen
3. My Disciple
4. Dr Dork (you can consider this your 'welcome home' gift)

Lessons from My Houseman Year - Introduction

I've always thought that the person who decided to start the HOPEX (House Officer Posting Exercise) term in May had a sick sense of humour, with May Day being Labour Day.

If it were up to angry doc, he would have housemen start work on April Fool's Day. Just think of all pranks you can pull on them newbies...

Anyway, seeing as it is they will all be too busy to read this blog come May, angry doc will post his "Lessons from My Houseman Year" over the next few weeks.

Good luck, newbies.