In Fairness

While talking to the other half it struck me that no, it wasn't always like this. Being a doctor wasn't always rough - I enjoyed my housemanship.

Pause. Crickets chirping, and somewhere in the background the sound of locally-trained claws coming unsheathed.

Sure, I did my housemanship overseas where everyone's a wimp and nobody there works as hard as we do here, etcetcetc, people actually go out and drink on wednesday evenings and show up bleary eyed the next day for work, shock horror.

And horror of horrors we started work at 8.30 am, long after sunrise (especially in summer when the sun came up at four).

No horror stories there of people trudging to work at 6 am and leaving at 9-10 pm, sometimes midnight. No whinging about the tedium of running around ad nauseum arranging scans and taking bloods etcetc.

The thing is, we did work till late - not every day perhaps, but often enough. I remember well still being on the wards at 8.30 pm and bumping into my urology sister Cid who was also working past her hours and laughing about it. I remember how the other housemen used to be there too, and when the NHS started enforcing the calman act how we used to change into civvies and go on working.

There was something different about the feel of it all; we did it for our patients, whom we knew well and actually gave a damn about, and for the sense of cameraderie we felt for each other. We were happy.

It's the whole rat in an electrified cage thingie; the houserats here are trapped against their will receiving electric shocks unpredictably. Depression sets in.

We dictated our own suffering, we opted when to suffer and when not to, and we justified our pain in our heads as sacrifice, for other people so they wouldn't have to hurt so much.

I was happy as an SHO too, working crazy shifts that had me walking home in the wee hours past frozen lakes and leaving footprints in the snow. Same story.

The truth is being a doctor isn't all doom and gloom, and it isn't all drudgery and tedium.

I watch my housemen constantly losing their struggle day to day, and I watch myself occasionally berating them for not getting things done quickly enough, and I can't help but think maybe it doesn't have to be like this... Maybe there's some way to fix this mess. Maybe we could start work a little later, maybe enforce laws to restrict doctors' working hours -- transforming overtime into an act of volunteerism and selflessness. Maybe we'd be surprised at how good we really can be, at heart... instead of dictating that anyone failing to make the cut as a tireless mule is a "failure". But as each day passes yesteryear fades in memory and I begin to forget the way it used to be...

I'm still happy being a doctor, from time to time. I love stitching little things together, and I love being senselessly irradiated as I twiddle some wire down a long, narrow tube. But there's the crux - "from time to time".

In fairness, maybe it's possible to float through medicine on goodwill, selflessness and happy thoughts -- just not here, not now.

The Retelling

Talking to a friend of a friend the other day, or rather was being plied by him for answers about what it was like to be a doctor.

Listening to him tell me he wants to make a difference, and help where he can, when he can puts me in mind of a different time and place...

I was him once, all earnesty and bright eyed, waggy-tailed sincerity. An army of old men telling me to be prepared - do you really really want this; you must really want this, because the sky's the limit but the sky has a low ceiling... a legion of old men couldn't dampen my hopes.

A panel of four interviewers listening intently while I tell them just Why; tell them about how my father (whom I love a great deal but just can't bring myself to show it - it's just how I was raised and who I am now) treated my grandmother in her last days as she succumbed slowly and painfully to the ravages of hepatocellular carcinoma; watching his stoic silence as he put up her morphine, watching how he made the long trek across the island every day to be there with her after work... watching as the life drained out of both of them day by day made me realise I wanted to be like him; I wanted to be Good. Perhaps it showed in my eyes as I babbled incoherently, who knows : but the interview panels wanted me. And I wanted them, because they didn't throw me tired, bitter lines like "Why Do you Want to be a Doctor aside from Saving lives and All that Crap"... but simply wanted to know about me, and why I wanted what I did, as much as I did.

Cut back to present day, and I'm telling him : this fuzzy feeling you have right now isn't enough; it will melt away - it's inevitable. We can't be that person all the time, and as time passes you'll be that person less and less. You need something more... you just have to really, really want this; i'm mindful how I was told the same thing once upon a lifetime ago, and I thought secretly, but I'm not like you, I'll be different... and I secretly pitied the doctor on the other side of the conversation intimating that he was burning out; I'm not like you, I won't falter... I know I really, really want this.

And I realise how futile it all is; or perhaps I'm just choosing the words wrong.

So for those of you hopeful bunnies for whom its not too late, and for the rest who I would like to share this with - S, I wish I could have told you this since you told me what being a vet was like, and Agent J, who's busy saving the world right now and loves me enough to feel outraged on my behalf...

Being a doctor is getting that phone call after 3 gruelling hours of medical statistics made Hard (ie taught all wrong) and racing back to hospital at ten pm to fly into OT. Not because you want to impress the boss, or even because of a sense of duty to help him out while he vanquishes the monster, nor even because you owe it to this poor patient whose liver just keeps packing up post liver transplant, but because you need to know what went wrong, and you need to learn how to fix it; because you need to be there, for no particular reason. You just do.

Being a doctor is scrubbing out at one am, and gazing glassy eyed at the desolate, deserted road stretching out before you.

Getting home and eating cold carbonara out of the fridge because you're so damn hungry you can't wait the two minutes it takes to nuke it back to life. And marvelling at how divine it tastes - cream is such a wonderful, wonderful thing!

Dropping your clothes in a trail behind you like Hansel and Gretal did (well, perhaps those were tidbits and not clothes, but clothes would make for a more exciting story, no?) as you meander towards the toilet (say hello, late-night cockroach) to wash the sebum off your face and out of your eyes.

Flopping into bed and picking up that biostats book because time is short, and tomorrow is another day - and thinking Thank God this is me having an Easy Time, imagine if I was full-time right now.

And yet feeling - yes, this is what I want. It sucks ass, and some of my friends are being paid triple my salary and don't have to fork out thousands of dollars for radiation protection wear. For high powered operating binocular spectacles. For all sorts of things the government will shriek at when I try to claim it from them.
And said friends are working maybe half the total number of hours I am each week.

But it doesn't matter, because this is... me.

Legacy

The thing about blogs is that they immortalize us.

The last time I spoke to Slinky she was still with The Boy; she was worrying about the future and where things were going. That's how long ago it was.

Reading Slinky's posts about Labradorboy, and Captain Starlight (although it gets too a bit too intimate and iccky for comfort) I can't help but marvel at how much happened in the span of a year.

The Straits Times article didn't make any mention of Celina Chua being a blogger; I suppose being a straight cut-and-paste job from the Australian newspiece it wouldn't have done...

The thing about blogs is they immortalize us - but usually only an impression of us, whether it be that part we want to be best known for, or whether it be that part in us that we wish existed, or want the world to believe really exists... Online personas are like that... Look over a long enough period of time and the cracks in the mask start to show.

Sometimes we write down what we really think, sometimes we hide what we think for fear of persecution or ridicule. For some they're vehicles to advertise their "faces" or their lifestyles, but for some others they're private journals laid bare to the world for all to see.

I guess, as House puts it, everybody lies. And almost everybody has an agenda.

But once in a while people just write - about their lives, their loves, their pasts and presents, their doubts about the future and the things that make them laugh and cry... and yes, perhaps as some of Singapore's "top bloggers" are wont to say, these people aren't really bloggers.

Perhaps they're something else, because who knows what a blogger really is in these crazy mixed-up days?

These people, the way they write... their blogs pay them tribute after they're gone. They capture their essence in some way, and let you know who they really were. They make you feel and empathise with the writers, even through that one-way looking glass of yesterday. And perhaps they make you wish you had known the writer a little better.

And I realize again what I realized a while ago: that even though I had not been happy in years, even though I am chronically sleep-deprived and exams are in two weeks, even though I'm always broke and I have no idea where my future is headed, I am happy with my life. -- Slinky, Saturday October 31, 2009

I'm glad you were, Slinky. I'm glad.
Be well, now.

Farewell

I first met her online, in the immediate aftermath of the last breakup when I was feeling a little distraught and betrayed, and the gradual creeping realization that I'd been a terrible judge of character - of my own volition - and loved and trusted someone who I shouldn't even have been friends with was starting to set in.
I was at turns bitter, disappointed and resigned, and was spending a lot of time hanging around the lab working on a project because of the quiet and solitude it offered me away from trivial thoughts of red flags that I had ignored, balances in relationships, people taking other people for granted, and whether it was inevitable to stray when absolute trust was gifted; I needed to do.
I think it was a Sunday afternoon; I remember the evening sun streaming in. I messaged her on a whim, she was one of the strangers on my gchat, friend of a friend, and author of a blog which I liked to visit from time to time.
She was studying for an exam - either path or physiology - but took the time out to listen and offer what comfort she could. We spoke in between doing our work far past sundown and got to know each other. I remember she was funny, humorous and a good listener. And that she was happy - so happy - to be chasing down her dream of becoming a veterinarian, under all the growly resentment of having to mug for the malignant "basic" science exam-monsters that I once slew myself.
Everyday life got in the way, and we spoke less and less frequently. She flew back once and rang me up, and we came within a hair's breadth of meeting up for a coffee, but our schedules were just a little too busy and it didn't quite happen.
Life went on, and she became The Person who Posted Funny Snips about Being Assaulted by Horses and other Farm Animals on my facebook wall. I took it for granted that she would always be there, and that we would meet someday in the distant future; that she was a stone's throw away on gchat and sms. I treated her the way I treat most of my friends, which is poorly.

I saw the post by one of our mutual friends on facebook yesterday while I was dozing off in the tea room waiting for the operation to start; I followed the link and read the newspaper article. And somewhere along the way the pieces finally fell into place, in my muggy post-call, food-deprived head. My God, this person - this faintly familiar firstnamelastname - was Her. Double whammy, She was dead.

Dead in the worst possible way, at the prime of her life, in a trivial moment that cost her her life, driving her family back to the airport, the unlucky sole non-survivor of a tragic accident, dying on site just as help arrived with her family incapacitated all around her. Five weeks away from graduation, from attaining her dream.

Dead and gone. Her facebook wall is flooding over with sadness, with people pouring out their grief about missing her and hoping that she rests in peace; that's what bubbly, cheerful, brave people get when they die.

It's just not enough.
What they deserve is life; to be going on doing all the things that we loved and knew she loved doing.

Goodbye Slinky. We never met you and I, face to face, but you were one of the few good people I'm honoured to call "friend".

I'll miss you.

Apathy

Life passes by, and suddenly it seems I'm teetering on the brink of senility forgetting which day of the week it is. Give me another minute and I'll be on the other side of the looking glass, the guy in the hospital bed wondering why he's in hospital as hypoxia eats away the last vestiges of his sense and sensibility.

I remember what it was like to be a houseman; I really do. And I remember all the times I spent with L and A and D (hmm. my three closest friends. Left anterior descending... laugh) wondering about what we would be when we grew up.

I remember falling in... like... (because first reaction's always denial when it's real innit) with ***** surgery, impressionable baby houseman that I was. But there were so many possibilities then, and we all of us fancied ourselves a little bit of a House ourselves, a little bit of a Carter... Even bits physician and cool ER physician. No committments, just trial and error, a series of torrid affairs and blah relationships with subdisciplines, a life squandered. Come full circle, here I am again for real now after shopping thrice around the block for something else I could fall in like with and coming up nearly empty.

There are a few things I like, and they center about fine work; not because I fancy myself an artist but because there's something wonderful about sitting down and losing a few hours of your life doing something that feels slightly beyond your grasp and capabilities... and getting there against your own expectations.

Cruel irony then that thanks to the boss's excellent teaching I found myself flying through a laparoscopic operation today when in contrast I spent the rest of the day labouring on my own through much smaller operations.

All very boring.

Take home message, time flies, buildings collapse, people die, bad shit happens, and we turn into old farts.

I'm becoming a stereotype, blogging about work all the time. Work is becoming my life. Everything I feared, once upon a lifetime ago when I was roaming the streets of London as a free man are here and now.

And strangely, it's so very hard to care.

******

The other half is following xx's blog, and keeping me posted about her wedding and how her posts are blatent advertorials, her comments about expecting only the best if she has to pay for stuff because everything's given to her free these days, the rags to riches fairytale and forgotten roots, etcetcetc.

I find myself saying, well she wanted all this and she got it; good for her... and finding it... somehow unsurprising. Hard to really care.

And, well, really. Good for her... on to more interesting news...

sigh

It's been a while.

Enough time to witness some bad things go down and wonder about healthcare and doctors in general in sunnyland. And to watch my boss recoil for fear of rocking the boat / repeating previously failed outcomes, and realise that perhaps one day i'll be like that too.

Listening to someone tell me today that I ought to complain to MOM about my seven day work week I felt like laughing.

And just tonight....

sitting down all ready for dinner, then the telephone call... we want to send for your case; we'll call you when we're sending ok?

hmm enough time for a shower then.

shower... riing.... hello? your patient is in OT now.

fume.
helter skelter pell mell back to work (twenty min, record time) dash in to OT, and .. voila, the gas men are only just wheeling the patient in to start the spinal.

sigh.

Without a clue

Yesterday's news was all about a diplomat who allegedly ran down three people, killing one. Mainstream media went orgasmic, going to the extent of casting a verdict even before the trial had commenced (and in all likelihood will never begin thanks to diplomatic immunity). It was the kind of behaviour you'd expect from bloggers acting amateur sleuths (nancy drew without a clue) but not from people tasked with some form of responsible journalism. It reminded me how our supposed bastion of information is at the end of the day just another tabloid catering to the whims of a few.

Found out about the incident retrogradely; one of the consultants mentioned in passing on new year's eve that someone was getting the "gift of life" in emergency theater (ie a transplant). Didn't take much to connect the dots as more information came to light.

Badness begets badness. The perp who hit and ran deserves to be brought to justice whoever it was. But the lynch mob jumping the gun and pointing fingers with bloggers at the helm ought to be brought to task too.

The reality of the world is that neither will happen. Such is life.

*****