This Year Gone

It's crazy how in the blink of an eye, it is August already. 

Where the heck did the last 8 months of 2016 go? 

I recall the days of being a high school student : giggling with Manda about nonsense amidst classes, as with the days of being a carefree college student worrying about what to wear everyday so as not to recycle my wardrobe. I vividly recall the days of medical school and of my F1/F2 days where I was so much more driven and of my bright-eyed enthusiasm. 

In this last year since I commenced residency, I have come to terms with a few things: 

1) Why the previous residents I have met have been so jaded halfway through their career 

- I used to muse aloud as to why these guys would get so jaded halfway through or at the end of their third year and just throw in the ropes and call it quits. 

Sad to say, I now see why. Because I have found myself teetering on the edge of feeling so freaking fed up many times over the last year. 

Looking back now, it is difficult to pin-point down as to what drove those feelings, but I dare say that a big part of it possibly was driven by the culture in this part of the world and how I sometimes just get wronged for everything under the sun - even if it wasn't entirely my fault. If I did something brilliantly, no one ever actually acknowledged it, but the moment I made a mistake, I was given a look like I was dust. 

2) Why some people have just given up pursuing their dreams, because honestly, some things are just not worth it

- Honestly, people who have known me for most of my life will know that I have wanted to be a cardiologist for a good part of the last 5 years of my life at least. It's always been about how I need to be a cardio god: and that's all that matters. 

But truthfully, amidst the days of clerking 30 patients in the middle of the night, to 30 hour on calls that stretch into 33 hour on calls because I leave at 3 pm the next day, to days when I stare at myself in the mirror and wonder just when did I become so haggard: I question myself. 

And truth be told, I have been hesitating this year - ironically - about pushing forward with the cardiology dream. It was all I had wanted before becoming a trainee and all of a sudden, I find myself pausing at the crossroads and wondering whether this is the correct decision. Mainly because I realise that I will truly be ruining my own life in more ways than one and possibly be really museum-bound as a Cardiology reg. 

Heck, is life really worth sacrificing this much energy and my youth over a couple of ECGs and a stupid hospital where everyday I find myself getting more and more angsty with a zillion and one unnecessary things. 

3) How I have changed into someone I don't really get anymore

- Looking back at my blog entries of the past , the Gmail chats / text messages and my pictures, I realise what a different person I have become. It is difficult to put a finger down on it, but it is almost as though the 'me' of the past has faded into someone who just doesn't give a crap. 

I no longer care what people think of me. Neither do I care if I get into trouble for not doing the teeniest of things and if people hate me because I have raised their voice at them. I have ceased to care as much about my outfits and my sense of style daily. And to be honest, it is sad to say that I can no longer recall the last time I really felt happy and contented. 

Perhaps it is because I have managed to perfect the act of putting on a front after years of rigorous training. But it doesn't really matter, because I can tolerate a lot of things but it is difficult to define moments that actually bring joy to my life. Or rather, it has been so long since I have met someone I can truly connect with that I'm not sure what it feels like anymore. 

So almost a whole year of 2016 has gone by. I have yet again achieved nothing much in life. And a whole year of residency has flown past me, with little to add to my medical career besides just jumping through another hurdle. 

I guess to look at the glass as half full, there are a further 4 months to make this remaining bit of time left really count. 

MRCP-ed

It seems like just yesterday that it was July 2012 and I had just graduated from Med School, having earned the letters MBBS (London) behind my name after much effort slaving through the years. 

At that point, I had been ecstatic to take a whole year off sitting for exams in F1 and just slacking / being a glorified ward clerk (whatever rocks your boat) without having to use my brain much. 

But those slacker days appeared short-lived because before I knew it, June was here and I was signing my life away to sit for MRCP Part 1. So much for not giving a crap about post-graduate exams. In the end, the pressure from my Consultant Cardiologist trumped everything. 

I still recall passing Part 1 and jumping up and down while doing Surgical On Call, much to the amusement of my Cardiology Registrar who was completely unimpressed and said I had been over-dramatic for nothing when I said I had screwed it up after sitting it. And then Part 2 came and went. And before I knew it, I was signing my life away for PACES. 

The journey through PACES was horrendous. There were many days of people staring at me in disgust like I was the most stupid thing on earth for giving such an answer. Of reading my notes over and over again and reciting presentations in my room. Of staying back till 8 pm to practise examining patients in the hospital. Of wanting to pull my hair out because I never though I could imagine myself passing this exam. Ever. 

And the joy I felt when I received this letter was beyond description. 

Fair enough, as with most things, the euphoria faded pretty quickly and within 1 week my excitement at passing these membership exams had almost completely gone. I was one step closer to hopefully achieving that Cardiology dream, but there were still many many obstacles to go. 

But for now, I was grateful. Grateful for having flown all the way to London and passing these membership exams in my alma mater where I had passed my undergraduate exams. Grateful for everyone who helped me along the way. And grateful for the royal college for making my year such a memorable one! 

And I'm more than happy to be MBBS(London), MRCP(UK)

Now to be a Cardio God...

Wonderland

It seems hard to imagine that 2014 is drawing to an end and again, my whole year has almost passed by without me achieving much in life. I suppose I imagined myself living in a sort of Wonderland before moving back, and then I took a whole month and more to get used to this job that I had loved so much before. 

Each day when I open up my various pages of social media, besides seeing this person getting married, that person getting engaged and this other person winning some kind of top-notch award, I drag myself on to my feet and realise that I have nothing much to share with the world besides trudging to work before it is barely light.

I suppose I can't complain much. I don't live at the other end of Singapore and am lucky enough to be able to get to and from work easily. I am also lucky that now it has been almost 6 months since I started work, I am less at a loss with the different abbreviations and I know how to get to A&E back to the ward without losing my way. I have also done countless 30 hour on calls now to the point that I know how it feels like to survive without sleep for 2 days. 

However, I do find myself questioning myself over and over again if this is what I really even want. 

How distant those days of bonding with my favourite cardiology registrar over coffee in the echo room or my cardiology consultant heaping praises over my winning the audit award to everyone in the hospital seemed. Here, I am less than dust. Not that it really mattered. I had at least gotten over the fact that if I got through the day without being shouted at, I should count my blessings. 

But I hadn't realised until recently how exhausted I was doing back to back 30 hour on calls until a few days ago and it made me wonder. If this was really what I wanted out of my entire life. Running around the hospital at top speed, getting angsty at stupid A&E referrals and snapping at everyone else. 

I wasn't that kind of person and I wasn't willing to be. 

These days, the thing that makes my days is listening to Taylor Swift and 1989 on repeat, gawking at her amazing outfits and how amazingly skinny she is....how I could never ever be this skinny despite my efforts (sporadic, yes, I know...) at gymming. 

And I think back to this time last year and the days of eyelash-batting at Mr Crook and gossiping about nonsense seem so so far away. 

This year I will spend boxing day on call, NYE post 30 hour on call and the rest of the month slaving through the usual routine of work + running around the wards + getting used to this life. 

It seems that when I was so inspired and so determined to achieve this cardiology dream in the UK, the dream has never seemed to distant to me until now. 

Back for good

Back when I had first announced my decision to leave the UK for good in March, it had seemed so far away then. On top of studying for my MRCP Part 2 exam and tearing my hair out amidst consecutive on calls and questions, the one thing I proclaimed daily was that I just wanted to go home for good. I couldn't wait. Later on, when these exams had been passed and done with and there was no longer any real stress, I ranted about how I hated surgery and ENT daily. That I couldn't wait to leave this place forever. 

Truth be told, my departure from the UK was more uneventful than anything else I had ever experienced in life. It had been completely drama-free, perhaps aided greatly by the fact that we were in a mad rush to lug back my 28492 outfits and shoes that I had collected over half a lifetime in a country I had come to know so well over these years. There was no longing and bitterly missing my life in the UK after coming back here. In fact, I have almost forgotten what it was like back there - and this is what I'd like to think is what it is like to feel settled. That this decision to move back for good was none other than the right one all along. 

When I had first told my consultant of my decision to leave a few months ago, he pointed out that I had spent so many years in the UK that I was probably more 'anglicised' than I had thought over these years. Which I had to agree was slightly true and slightly not. I had come to find myself to be someone who was neither here nor there since I had left home at the age of 17. Amongst my English friends, I found myself to be 'more Chinese' than I had ever thought with my principles and yet back home, the tag 'UK Girl' never seemed to have left. Living abroad brought me the freedom and independence that made me grow into the person I was today, and this, amidst a myriad of both good and bad things that transpired - McD runs in the middle of the night, getting so wasted on 80% strength liquor, trudging 2 miles to the train station in ankle-deep snow clad only in ballet flats, coupled with short interludes of winter / easter / summer holidays gallivanting in Europe or being pampered back home....I would never have traded in for anything else ever. 

And then the one big party that was 'student life' ended, and the real world loomed ahead. Friends started to leave....one by one. For different parts of the UK, for Scotland, for the East. Boys came and went and sadly, none were here to stay. On call rotas started to shape our lives, followed closely by the pain of studying for post grad exams. There ceased to be a 'Club 168A' or a 'Daisy, Minnie and Coco' and meeting up for short European breaks  / weekend breaks seemed to be the only thing I lived for. And as much as I had professed that the past 2 years of my medical career had turned out with me having nothing to show for besides an amazing ability to multi-task and churn out discharge summaries at top speed, I had to admit that the only bit of meaning to my life was probably connecting with medicine and reinstating my faith in what I had already known - that I was a medic through and through. That it had been insane I had actually considered Colorectal Surgery and Ob Gyn for one brief point in medical school.

It feels strange to be leading the most unproductive life ever when I had hardly stopped to even breathe for the whole of May with my back to back on calls. Truth be told, there is alot of soul searching that I have been left with to do at the moment. Whether or not my incessant desire to live the Cardio dream and put up with a lifetime of stress and exams was what I would really want in the future, if life would really become as empty for me as being only about constantly struggling to keep abreast in this rat race that is medicine with no knight in shining armour riding along in a cloud of dust in the distance, if I was really cut out to be the best of both worlds in the future or if I could just handle one at a time.

But I reckon pondering never really did anyone any good, and I have come this far to achieve my fierce childhood dream of becoming a doctor. We only move forward from where we go, and hope for the best.

And for the moment, I'm optimistic that I can make it. 

Happy

And so by the goodness of God, I woke up one Friday in early May to an update on the MRCP website saying that the Part 2 results had been released and thankfully, I had passed again. Far from aced it, mind you, but hey, my aim was never to be a genius anyway.

I was riding on a cloud that night when I embarked on my second weekend in a row of surgical nights - something that mind you, I hate to the core. And then after a couple of days the euphoria passed and I started realising that even when you have passed both written parts of your membership exams, there is still so much that you don't know and there is still so much yet to come.

But for now, let's focus on happy things for the time being, i.e. that my last FOUR days of work are approaching. That this is the last time EVER I need to do bloody ENT Surgery or any kind of Orthopaedic / Urology / ENT / General Surgery on call EVER again. That my one month of freedom and holidays at home are coming up. That I might actually make it as a Cardiologist after all, now that I have leaped through yet another hoop along the way. That I drew my time at this hospital where I had built so many memories, gotten to know so many incredible people and grown so much as a doctor, to a proper close and had an amazing time at my party.

There is so much I have to say about leaving this country where I have spent such a significant number of years of my life, but I think that deserves another post in itself. At the moment, we have been so busy chucking stuff out and moving that I have not paused to take it all in.

But as this post says, happy things and happy thoughts only for now. 

Not enough

When my 4 months as a Gastro SHO was up on Tuesday, I had been building up the sadness within for a good week before. In fact, I had not anticipated enjoying Gastro this much when I first started - read: the days when my ward rounds ended at 3.30 pm, Upper GI bleeders dumped their systolic BP every 6 pm and I was sure that the bosses thought I was massive idiot with my obsolete medical knowledge coming from Orthopaedics. 

It was a very eventful ending to my last day on Gastro, in the wrong way. At 3.50 pm I opened up Patient A's chest X Ray, annoyed that it had taken them almost 4 hours from the moment I requested the CXR for it to finally be done. It was the most impressive CXR I had ever seen, think massive pneumoperitoneum with the diaphragm pushed wayyyy up. I ran over to the Oncology ward to make sure the patient had not died, and was duly impressed when I was told he was out sitting in the sun - that he had not managed to die since 24 hours ago of being admitted with these symptoms. The Consultant buried his face into his hands, the registrar who was in endoscopy rushed up 20 minutes later saying that she had just seen the X Ray....and the day ended with the patient insisting that he could still fight for his life....he had this much strong willpower inside him. No amount of 'You are going to die and you are not fit for an operation' would enter his mind. This was truly denial - the first phase of receiving bad news. 

And then my registrar gave me the cutest chocolate bunny I had ever seen and said she had had the easiest rotation this time around because I was on the wards and that I would be amazing at what I do, even if I ended up being a Cardiologist (which she proceeded to mutter under her breath - was really boring). I swear at that moment, if I had not wanted to be  a Cardiologist this much, I would have buckled and sworn that Gastro was totally my thing. 

But seriously, amidst all the chaos of the ginormous medical ward that I was based on, the crazy days of Gastro inheriting almost every single Gastro AND general medical patient in the hospital, and my 8 pm finishes with no registrar, no other juniors and no Consultant, I had come to love this job more than ever. So much so that I had only ever felt this sad once: the day I left my job as a Cardio FY1 last year.

These days, however, it is not enough to just be passionate and profess how much you love a specialty anymore. The days over the last two weeks when I have been slaving over firstly day on calls and then night on calls, when I stole every minute in between clerking patients to do two or three questions, or when I forced myself to stay up and do a paper even after the most horrible night, or when you power through 13 patients in one night on a crazy medical take and want to die from exhaustion, it isn't so easy to love this job when I am not a genius who aces the MRCP exam without having to crack my brain over all this excessive information.

Having been through med school and being a doctor humbles me time and time again and makes me recognise my own limitations - that I am far from clever and I am mediocre. I work hard and I am willing to pour all my enthusiasm into Cardiology but sometimes I am truly doubtful that this is all it takes to get me there.

If it's so hard for me to even pay attention and juggle studying + working to pass these memberships exams, I can't imagine the state I will be in for PACES, or when those specialty exams loom in the near future.

*headdesk*

Come on, you can do this. You can conquer this Part 2. A few more days of endless mugging and suffering and it will be all worth it.

VAMOS SHING! 

A New Era

It seems like yesterday that I was young and fresh. Now, I say this like I am a grouchy middle-aged lady, but the truth is that the early and mid twenties are long over, and it feels even longer ago that I was a wide-eyed teenager. Where had all the time gone in the blink of an eye? 

I see myself evolving from day to day. And at this point in time, in my late twenties, sometimes I wonder if I have gained anything in life besides a medical degree, more lines, thinning hair and a ton of weight. 

The one thing I am sure that I have gained, however, is a tasteful sense of style. Don't get me wrong, I may not be Tatler Magazine's Woman of the Year or Fashionista of the Month, and not everyone shares a similar taste in my clothes, but I pride myself on not being tacky. 

Or, perhaps, it is just that I am probably 5 kg heavier than I was when I was 16, and there is no way a person of my height and weight and well past the age of 18 could pull of micro minis, plunging halter tops and strappy sandals any longer. These days, it makes me uncomfortable to appear in a hemline higher than above my knees, and I rarely appear in anything strapless or a halter neckline. My wardrobe is completely obsolete with any tops that need a zillion stringy bits tying together and it makes me uncomfortable when a hint of cleavage starts showing in any tops. 

It also helps that these days, I am meant to be a professional who is busy saving lives and nobody would want their doctor to turn up looking like a hooker. 

Last year I was obsessed with lace. I still am, don't get me wrong. 

This year, I discovered the wrap dress. 

I have long been a fan of Diane von Fursternbug. The only problem was that I could not afford anything from DvF because I was no lady of leisure and a poor aspiring doctor who has yet to pass the membership exams could never afford DvF on a regular basis. 

So I surfed. And made a mental note to hunt down high street alternatives. 

I love how this brightly coloured piece is demure yet striking at the same time. Totally screams power dressing all over.

I LOVE this piece. The take on a short sleeved wrap dress is something that I have yet to see and it screams versatility all over.

And finally, who can resist mesh sheer polka-dotted sleeves? 

Sigh. Sometimes I wonder if I would have been better off as a personal shopper or some kind of fashionista who had her own clothes boutique rather than the struggling aspiring cardiologist that I am now. It makes me wonder how my flair for piecing together outfits comes so naturally even when I am late for work and rushing to just throw on the first few pieces I see, whereas in contrast it takes so much for me to remember medical facts, tiny details, make sure I don't mess up at work....and on top of all that, claw everyone out of my way to the top. 

If it takes so much for me to even pass my membership exams and stay focused, I wonder if my whole life is going to filled with stress, a feeling of emptiness and dreariness AND still not be able to reach the top or even fulfil my distant dream of being a Cardio God. 

Why couldn't things be as simple as I thought they were when I was 16? Why couldn't I just have all the things I thought I would when I imagined myself at this age? 

At this point in time, it looks like I will end up looking as haggard as a rag from the exhaustion of mugging for my MRCP, stressing over on calls and work AND I would still end up not being a Cardio God and NOT having a Prince Charming of any kind to prevent me from drowning under all this pressure. 

Oh well. 

CNY Festivities (or rather, lack thereof)

So as with every other year since I have been in the UK, CNY often comes and leaves unrecognised. Surreptitiously, in the dead of night. 

Since I have left London, however, it seems my CNY 'festivities' have hit a new low. Gone are the days of our 'Concord' gatherings and dinners in Chinatown, despite the shrinking number of people in our group. 

I can't for the life of me remember what happened last year during CNY. After racking my brains like mad, I suddenly recalled that I had been on a weekend ward-cover day running around like a headless chicken throughout the whole hospital tending to every medical patient in the hospital who was threatening to die. I told myself since then that no CNY could be possibly worse than this.

This year, my CNY had hit a new low. Being the solo doctor on Gastro that Friday, I had been dreading this day for weeks, having been on a two or three man team on a Friday on Gastro and still leaving at 730 pm. Thankfully though, my desperation must have been heard and God must have answered my prayers because it did not turn out to be anywhere as horrible as I had expected. 

However, my CNY itself was desolate indeed. I spent the weekend cooped up in front of my computer, stressing about not being able to finish all my work before my impending job interview and then stressing again about my lack of medical knowledge. Why oh WHY did I have to sit MRCP?

I told myself that this would be my last CNY spent in a similar fashion in this country, though. 

So what's a girl to do but research pretty cheongsams? 

Last year, I had a bit of a nervous breakdown when my good friends Sue Lynn and Leslie got married and proclaimed that their theme was Shanghai 1920's, to which I suddenly realised that I had no cheongsam and no similar 1920's themed outfit. With my mum's help who went on a cheongsam rampage in Kch, I finally managed to rock up in this: 

Which, considering the fact that I had not spent a few hundred bucks having it made to measure, turned out pretty good. Unfortunately, I had put on a ton of weight then and had not looked my optimum self, but now have a few cheongsams at hand to choose from. 

And then I discovered this Singaporean designer, Ong Shunmugan, and I knew I had to get some of these dresses next year:

What better to complete my true love for peplum than to have it in form of a cheongsam. Ingenious! 

Well, perhaps I should grace Team Gastro with my presence in a cheongsam one day. 

What say you?

Teetering on the verge

So I am not really sure how my endeavour with heels began, but I admit that I have gotten exponentially worse over the past few years. 

When I first started, I only dappled in the pool of short chunky heels and slight wedges, occasionally higher heels for parties, and for a moment when I started clinical school, I abandoned the whole thought of heels completely because of 1) The embarrassing moment of click-clicking down the hallway and everyone turning to look at you and 2) The inability to even limp home after a day of running around the hospital in heels. 

Then I discovered something called vanity. 

And when I started working full time as a doctor, I discovered that the only salvation I found from my daily routine of being told off left, right and corner and the stress of juggling 30 odd patient lives on your own in a day was making myself feel good by dressing up as best as I could. Call me crazy, but the only human contact I had who could appreciate my sense of style was largely in the hospital. 

Then my self conscience started growing with the number of comments about my dressing and it reached a stage where it was embarrassing not to keep up my 'standard' of fashion because this was expected of me without question. That was when I discovered that when you were only 5'4", the only way to look good in outfits was when they were worn with heels. 

So I started progressing back from flats to short wedges to shorter heels, to medium-height wedges. And with that it seemed, so did my pain threshold for running around the hospital while learning how to balance gracefully at this height.  

But today when I decided to embrace the whole holiday year-end festive season and dress my lace pencil skirt and peplum top with 4 inch high colour-blocked wedges for a haphazard Gastro ward round traipsing around the hospital, I decided that I might have crossed the line. 

I managed to limp, yes limp....home at 7 pm that day after having done a ward round of 16 new patients around entirely different ends of the hospital, inserted an ascitic drain, run back and forth to Radiology and whacked a grey cannula into an actively bleeding patient. 

I might have pushed my luck too far this time. 

About time for this fashionista to admit defeat before I find myself paying the Orthopod a visit in the very near future. 

One step at a time

A great deal has happened in the past week. 

From the top:

1) Met up with my favourite Kch girlies - one whom I had not seen for 5 years and the other whom I had not seen for 3. And yet our sporadic amounts of keeping in touch via text managed to make it seem as though nothing much had changed since our last encounter. 

2) Took a gamble at my ALS course on Thursday and Friday - note: read like three pages of the manual, winged my way through the MCQ in 20 minutes because I wanted to go out shopping in London and managed to make it through the real deal. 

3) Managed to not screw up my ALS practical session too badly after finding out that my MRCP Part 1 results had been released right before going in and that my friend had passed. 

4) PASSED MY MRCP PART 1!!!!! OMG it was unbelievable. I had to check three times and then almost deafened my mum on the phone. 

Bumped right into my Cardio Reg on the ward after screaming over the phone at my mum and after declaring to him that I had actually passed, he gave me a look and said "See, so all that drama and stress after the paper was for nothing!" 

To which I excitedly declared that now I want to be a Cardiologist again. 

My momentary act of drama after the exam was justified entirely, for the record. I had not been able to answer 60% of the Cardiology questions in the paper, and after bumping into my Cardio Reg on call, I had sworn off Cardio, telling him that I wanted to be a Dermatologist....oh wait, I would need MRCP for that too....no, I wanted to be an Orthopod now. Or maybe a chronic SHO. 

I was ecstatic for 12 whole hours and for a moment it seemed like maybe my Cardiology dream was attainable again. 

HELL YES. I will make it happen. Little by litle. One step at a time. 

For the time being, it is time to lose the MRCP pot belly and fat. And the breakouts. And cheer up because this could be the one good thing that is happening in my life for the moment. 

And start being serious about Part 2. 

The Dream

People who have known me my whole life will know that I tend to sound like a broken record when I tell the tale of how I have always known that I wanted to be a doctor. Or the story of how at 13 years old, I wrote an essay about how I wanted to be a neurosurgeon. 

The point is that I wanted so much to become a doctor my whole life that I was so sure that the moment I became one, my life would be complete and that the world will be whole again. 

The day I was MBBS-ed, it felt totally anti-climatic, at the most. 

The day I started my job as wide-eyed Cardiology House Officer, nothing dramatic happened either. 

In fact, it seems that the more I ponder on how much I wanted to be a doctor when I was younger, no matter what it took, I sometimes wonder how I could have known so well back then. How was it that things were so much less complicated when you were young? Whoever said that growing up and facing the real world and achieving your lifelong ambition would mean that you would finally be happy? 

These days, I don't doubt my choice in life. I could not imagine myself being anything but a doctor. 

But I do sometimes doubt my burning desire to be a Cardio God. And when I hear myself proclaiming out loud that I do not like ANYTHING - not surgery, not orthopaedics, not paediatrics, not anaesthetics, not elderly care, not even general medicine - just cardiology, each time I feel that the second voice of doubt echoing at the back of my head becomes louder and louder. 

Was I really so sure that I wanted to face a life of fierce competition and endless difficult exams and never-ending stress just to end up in a department of guys with egos the size of elephants? 

Last week, after my string of surgical nights, I could feel myself evolving from night to night. Thankfully, I did not make any decisions that killed anyone overnight, nor over the week. However, I did feel myself clenching my jaw harder from night to night. The climax was probably the third night when I had 20 admissions in one night and clerked 14 on my own. It became a bit of a joke when at 5 am I was still clerking people who had been referred to me before midnight, and I almost laughed aloud when at 645 am, the A&E SHO rang me with a "Sorry Alyssa, I have another one for you." 

At that point, I discovered a new me. I discovered that in surgery, I could see someone in 10 minutes when all investigations had already been done. Which was what I did at 645 am with bowel obstruction guy. 

I discovered that no matter how pressured a situation I was put in, I was not the kind of person to give up in exasperation or resort to tears. In fact, with my growing list of referrals on top of those I had not yet even seen, I was more determined than ever to push through the 12 hours, not sitting down for one minute and not stopping to even drink water. It was miracle that I did not faint at 8 am at trauma meeting and managed to present the cases I saw without fumbling. 

The horrified faces of the registrars and the others when they heard that I had seen 14 people in one night was apparent. And more than ever, they were wondering how I had not burst into tears at any point. That was when I realised I had become someone who was so adamant and so stubborn that I would refuse to cry even in the most dire of situations. I refused to let my weak side take over. And at the end of my set of nights, I wondered if I had turned into a fighter or just a robot who was so bitter at life that I refused to let myself stop and feel. 

And then there is this dream of being a Cardio God so badly that at this very moment, everything seems like a mere pipe dream. Heck, I can't even handle studying for the MRCP at this point and here I am fantasising about Cardiology. 

Someone once said that the best way to make a dream come true was to wake up. 

I need to wake up. 

Be it making sure I try hard as hell to pass these damn exams or to be realistic and make myself realise that Cardiology isn't all that. That perhaps it is more important that I remember to have a life as well. 

Vamos Shing! 

From Surgical F1 to Orthopaedic SHO

Hi, I am your Orthopaedic SHO. 

Firstly, I know nothing. Secondly, the only thing I like about Ortho is looking at ECGs. 

Wow, that's helpful isn't it? 

I finished my last day of FY1 12 hours later than everyone else by covering my fellow F1's night because he had to move to a different location whereas I was still in the same trust. 

It was uneventful. I doubly played a role as a Medical F1 on call as well because the medical SHO (whom I swear I have fallen in love with after last night) was struggling but remained so pleasant, each time telling me that he was okay when I repeatedly offered to help him even clerk new admissions, and kept thanking me when I helped him do odd jobs. Unfortunately, the sickest chap died despite my heroic efforts at catheterising and ABG-ing him...but an inoperable CA and an ischaemic bowel with a Lactate of 8.6 would have unlikely interested the surgeons in a laparotomy. 

It is true what the Med Registrar was saying - there is such a difference now retrospectively standing back and looking at the events that had unfurled this past year. How much better I am now at the end of my FY1 career than at the beginning. Even if it is just small things like working the system or telling the nurse to just forget it when there is minimal urine output in a perfectly well patient overnight. Hello, nobody pees at 4 am when they are asleep for God's sake! 

So it is with a tinge of emotion that I bid my first year of my career as a doctor goodbye. 

It has been full of ups and downs and it has been such a steep learning curve and despite it all, I am proud that I have come this far with the following to be proud of: 

1) I made it through all my F1 on calls and normal days without shedding a single tear. Yes, I have had my fair share of being treated unfairly and being shouted at for no reason, and making mistakes that could potentially endanger a person's life but I had refused to cry. Not once. 

2) Actually gained some knowledge clinically. Or at least I'd like to think so. At least now I clearly know what dilated loops of small bowel look like and what to do when someone is in ileus. NG Tube for God's sake. I Don't care whether the patient likes it or not. 

3) As much as I was afraid of surgery, I actually learnt some surgery from the few sporadic bouts of being a surgical house officer and actually doing something useful besides a ward bitch. I am only looking forward to learning some Orthopaedics because let's face it, I know nothing and we all know that we just have to man up and face our fears sometimes. 

4) Learnt to read ECGs properly. I suppose that was one of my better areas in medicine anyway. Nowadays if something looks weird I just holler for the Cardio reg and force him to come over and take a look even if he gives me grief. That's because I have also learnt that despite all his swearing, he isn't all that fierce and I'm not the least fazed by him taking the piss out of me. 

5) Can successfully totter around in fairly high speed in heels/wedges. Fashion comes first, regardless of your job. 

6) Am hopefully one step closer to being a Cardio God. 

It's been a good year, F1. Despite the fact that my days on Elderly Care almost did my head in and made me lose all my hair, Cardiology was a dream and Colorectal was great fun mainly because I had the best registrar in the world who even gave me a present when I left. 

And now on to embrace the world of Orthopaedics. My first day tomorrow and I am scheduled in theatre. The Consultant is not just going to throw his hammer at me, he might drill a hole through me and throw me out the window eventually. 

Good Luck. 

So you think you can doctor

As this academic year draws to an end, it amazes me how fast time flies. Perhaps the word 'academic' isn't even right in this context because I have certainly been doing nothing remotely 'academic' since I graduated from Medical School last year.

This time last year, I remember starting out as a wide-eyed house officer, clueless to so many things. Starting a weekend day ward cover less than 2 weeks into my career as a junior doctor, I did not sit down for 12 hours that day and became hypoglycaemic. I remember going up to my SHO and helplessly asking him for help because I could not cannulate someone who needed IV Fluids. I remember someone going into acute pulmonary oedema on me into Day 2 of my career. The only achievement I can hold my head high to is that I *touch wood* did not burst into tears during any of my medical on calls or nights, even when faced with the most horrendous situations.

This time in 2 weeks I turn into an Orthopaedic SHO. Perhaps I had made too many snide jokes about my wanting to be an Orthopod in the past, that this is payback time. Perhaps I might actually want to be an Orthopod after this 4 month stint, who knows.

At this point in time, it is one year of my career as a doctor down....an indefinite number of years to go.

Don't get me wrong, there are times like now when I am on my set of nights with my nose dripping relentlessly and feeling rotten, that I wish I did not have to do night shifts, and I question my obsession (or ambition) to be a Cardiologist as such. I do think that it would be nice to have a job where I had normal working hours and did not bear such huge responsibility of whether someone lived or died just because of the mistakes I made.

Recently, I notice myself losing my temper all too quickly and my impatience mounting by the second when things are slow and don't go my way. I am uncompromising and demanding and I get annoyed when people are slow to understand things that I say.

And then I check myself right there. I detest stereotypes and the typical stereotypical female doctor lusting after a high-flying, stressful job is one of a Tiger Alpha Female who makes everyone else shudder from head to toe as soon as she turns her eye on them.

The role of a female surgeon or a high-flying, competitive medical specialty such as Cardiology paints the exact same stereotypical picture. As with my entry before on sense of style in the work environment, I refuse to conform to such stereotypes just because the 'norm' is such.

And yet there are days when I find myself so excited about ECGs and chest pain and heart failure and PCI's that it is sad. Even when my days on Cardiology were as a glorified secretary, sitting at my favourite spot on the ward typing on the computer furiously and doing referrals for CABG surgery to Southampton, I missed it when I was away and on call. With the same pace on Colorectal Surgery which I once loved and actually wanted to do, I feel no such attachment to my job and in fact, got so bored towards the end of my normal days on surgery that I was becoming rather cavalier about stuff.

It seems there is such a long path ahead to trudge on in this competitive journey of pushing everyone out of the way en-route to clinching that training number - it makes me wonder if I really have what it takes to become a Cardiologist.

Or more importantly, do I really want to....that badly?

But for the moment, let's live in the present. Now that I am fully GMC-registered as a fully qualified medical practitioner, I can doctor.

Or at least let's hope so.

The Fashionista Wannabe

So I admit it. I am a sucker for all things pretty and shiny. 

And stripey. 

And dotty.

And flowery. 

And lace. 

So yes, basically I am one of those girls. I have too many clothes for my own good. The number of shoes I have could rival that of a small shoe store's. I used to have so many accessories in my jewellery box that I could have opened up my own stall in a flea market. The number of bags in my collection grows exponentially by the day despite me proclaiming after every purchase that this was the last, because I would never need any more. 

I once jokingly said that if I had not ended up becoming a doctor, I would be one of those girls at Vogue or In Style or that next biggest fashion magazine to hit the streets. 

Think Anne Hathaway in 'Devil Wears Prada'. Ideal.

The truth is, I could never imagine myself doing anything other than my day job nowadays despite the fact that it does not actually involve much brain work besides running around chasing stuff and not being appreciated for it. Bar the fact that I derive pleasure from being 'busy' these days, I have continued to develop my personal sense of style within the limited scope of my job. 

I have never been a trend-setter or one of those girls who can boldly pull off the funkiest of designs. Neither am I a fashionista - think those socialites in Gossip Girl. But the one thing I can give myself credit for is that I do have a sense of style, whether or not it is an acquired one, is another matter. 

Sometimes it makes me wonder whether I am in the wrong field of work. If only I was this good at making spot diagnoses or recognising little things in patients rather than pull this piece and that together to make a perfect match. But then I scoff aloud and check myself right there. Who ever said fashion and medicine couldn't be in the same semantic field? I may love dressing up and pairing pieces together and experimenting with different trends, albeit in moderation, but I am no fashion designer. Never. Ever. 

But there are days that I wish my job did not involve being splashed on by bodily matter or scurrying around the entire hospital looking for a blood gas syringe or trying to run after a consultant surgeon during a 2 minute ward round, just so I could possibly turn up to work one day looking like this: 

Or even complete my outfit to this extent: 

Many a time when I have lamented to my mum that I wish I had a job which involved a whole lot of sitting around on cushy chairs so that I could be decked out in heels all day long, I have gotten a "Pffttt" in response. 

You? Sit around all day long? Did you not hate Elderly Care medicine so much because there was just too much sitting around because it was just too slow for your pace? 

So perhaps while my career as a house officer draws to an end, I will stretch out these remaining days with whatever limits my work wardrobe can be stretched to and however much my feet can stand being tortured by running around in wedges all day long, and look forward to the day that I can be finally be sat in my own office. In heels. 

For the moment, I can continue living in my own shopaholic bubble to whatever extent my funds can allow me, and build towards being that fashionista that I have always wanted to be.

Incise & Drain

When I was 13, I wanted to be a Neurosurgeon. Perhaps because back then, it sounded seemingly cool. 

At some point in medical school, I wanted to be a Cardiothoracic Surgeon. It had been unknown to me then, but I had already fallen for Cardiac physiology...and more. 

Few years along the line, I was sure that I wanted to be a Cardiologist rather than a CT surgeon. 

Enter my first job and first year as a junior doctor: I was more sure than ever that I wanted to be a cardiologist, if not - medicine. 

Today on my first day as a surgical house officer on call, I ponder how I ever considered surgery in the first place. How was it that I ever thought I possessed the qualities and the personality of a surgeon? 

So much bitching, back-stabbing and heaping the blame on others already. 

ARGH. 

Give me back Medicine! Give me back Cardiology!! 

2013: BOOM!

So 2012 came and went SO SO quickly that it took me the whole of today for it to sink in that I am now at Day 1 of a fresh new start.

This year's NYE celebration was as different from last year's as night from day. I spent the day time in a comatose state, completely exhausted, having finished on night shifts. The irony was that my night before had been a state of boredom beyond words. The Surgical F1 and I sat at the mess looking at each other, he having offered to do as many cannulas for me as he could (simply because he was bored as well!) before he finally decided to sleep, and me, having watched him and the Surgical SHO snore away for every single night before this, decided to cave and join them as well. The funny thing is when you DO sleep, compared to when you don't, you wake up even more exhausted than usual each time you are interrupted to do the most stupid jobs. 

I then decided to attend a costume party with my usual outfit - a pretty dress. Unfortunately I was the only other person in the whole place to not be dressed up as something, so my constantly repeating over and over again that I was there as a 'pretty girl' could only get me as far. 

Counting down to 2013 was a bit anti-climatic to say the least. We spent ages trying to find this person or the other and when we finally did, I was already sober beyond words. It didn't help that the bartender at the club rejected my debit card and I didn't have enough cash on me, and that we had to drag my drunk friend back home in a taxi at the start of the night because she was almost wasted beyond words. We did, however, manage to have quite a bit of fun at the end of the night, despite the series of events that prevailed, with me being utterly confused at 3 am in the morning amidst deafening music and having a flashback of an unfortunate scene that had happened a few years ago. 

At that time, having a whole week off post-nights AND having the directorate forget to take my request into account that I wanted to cancel it off the rota seemed like a good idea. But with my Microsoft Office not yet arrived in the post and my wandering mind unable to concentrate on reading any book for long, it makes me despair and wish that I was actually back to the manic conditions of the elderly care wards tomorrow. It doesn't help that I started the morning of my new year with the most intense conversation ever at 5.30 am in the morning and that I was so tired today that I fell asleep at 6 pm only to wake up with a start at 8 pm. Aye, messing up my own sleeping patterns indeed. 

It is possibly slightly sad that I am spending my first day off lamenting about the fact that I wish I was going back to work rather than be left with nothing to do and to fester with a zillion thoughts in my own head, and it reminds me of the dismal times in the midst of Final Year when I was going through emotional turmoil and had nothing to distract myself from apart from the fact that finals were looming and I had to pass them by hook or by crook. 

But this is why I like my job. I like the fact that I am constantly on the go and always called to do things left, right and centre. I like that nothing is predictable day to day. I like that I am so busy all the time and when I look up it is suddenly 5 pm already. And I love the fact that my life is routine as such, and at the moment there are only important things ahead to dwell on: successfully completely F1, focus on taking postgrad exams and make the most of this damn career. Because it is possibly the only thing in my life that I can control at the moment and the only thing I can make sure doesn't go pear-shaped.

My new year's resolution, apart from learning to be a better doctor, however is to be this girl:

My figure is no 5'6" (I am only 5'4") but I sure as hell can have that bag. I will be sure of it :) 

And as Kel says, it is only another 3 more months before I am on home soil and catching up with my beloved chums again! I absolutely can't wait!! 

For the moment, I need to reignite the positivity that I had when I embarked on the start of 2012 - that this will be one hell of a year and I will take down every single lemon that life hurls at me. Because I know that this will be an even better year than the last. And I will make sure that I become every inch of a kick-ass doctor to measure up to it. 

BOOM! 

Just Because

There are only a handful of people in this world who actually know me inside out. That in all truthfulness, I look stronger than I really am. 

But since I have started this job in August, I have only gone upwards and forwards from there. Much to the point that I feel I have such good control over my emotions these days, I have almost talked myself into NOT feeling. Or rather, not actively feeling anything. 

But I am human. Just because I don't cry doesn't mean that there aren't days when I feel like work is sucking the energy right out of me. 

Just because I don't say anything does not mean that my heart doesn't break when I see that old lady tottering around the ward, being denied that cup of tea she can't have because she isn't safe to swallow.

Just because I hold my tongue and smile certainly does not mean that I feel any less impatient towards the lack of insight and initiative some people have. 

And just because I am remaining positive about my new job in Geriatric Medicine and the amount of general medicine I am hoping to gain out of this sure as hell does not mean that I miss Cardiology any less. 

The strange thrills that I get from diagnosing and managing someone in heart failure OR talking about pacemakers OR managing fast AF make me wonder at times whether I have just anchored myself because I dislike change, or perhaps...

Perhaps that I just like things that I cannot have. 

"I don't ask for much..."

This quotation brings back fond memories in a context of inside jokes and much associated laughter. It used to be something I said with a tinge of dry humour. And yet, today it actually shone through. 

It has been a week of ups and downs. At times, I did feel as though I was being crushed to death under the weight of a zillion things. At others, it felt like things could flip between going perfectly well to suddenly catapulting into disaster and crashing down upon me. 

And then there are times like these that completely make my day:

1) Sliding in a cannula flawlessly when 2 different people had failed 4 times before me. 

2) My patient grasping my hands and telling me 'Thank You SOOO much, my dear. Thank You. You have been so kind."

3) Another telling me that 'your skirt is really pretty, my dear.' 

4) And one colleague commenting in response to another's "Ohhh Alyssa always looks like she's just walked straight out of a fashion magazine. Always!!" 

And the icing on the cake is that Friday looms tomorrow and in 24 hours I will be seeing these lovely ladies:

So in fact, I did mean what I said. I don't ask for much at all. And in fact, it never takes much to make me delirious with joy. 

OMG I absolutely can't wait for this weekend!! *BIMBOTIC SQUEAL* 

Plus, I have Monday off!!!! *STARJUMP*

So this is what I signed up for...

A life of continuously rushing around the corridors of the hospital, being bleeped in every single direction and having a seemingly endless list of jobs to complete over each stretch of 12 hours. And when I say 12 hours are not enough, I mean they are not enough. 

First weekend of ward cover being on call - check. 

Horrendous ward cover oncall experience - CHECK. 

I am not much of a Drama Queen, but last night, I was on the verge of exasperation. I had to hand over a list of stupid jobs to the Nights F1 simply because 12 hours was not enough for me to run from one corner of the hospital to another in between getting bleeped every 5 minutes and sprint down to A&E for TWO cardiac arrest calls. So amidst watching two ppl die and watching a guy I had clerked in slowly deteriorate right in front of my eyes with the most deranged blood results ever, I had to mentally psych myself aloud into bringing on another day of ward cover without buckling. 

If there is one thing that my debaucles with matters of the heart have taught me over the years, it is to be stronger. And in moments like these, it has never proved to be more useful. 

So today, I cruised into 3 pm in the afternoon thinking that all was completely under control. And then things started to spiral the other way. Each time the Med Registrar saw me, he would take a look at me and go: 

"Alyssa, have you eaten all day?"

"No."

"Oh my God. Please. Go and eat something." 

And proceeded to drag me into the Doctor's office to force me to eat a doughnut. 

And just as I was leaving tonight, he took one look at me and said "Alyssa you look absolutely knackered. Are you okay?"

Yeah, maybe not. After I was bleeped to see someone who turned out to have a Pulmonary Oedema on my way to Handover at 8.55 pm. After not eating anything before 10 pm for the past three days. Maybe not. 

Not to mention all the stupid questions that I have had to ask the Reg over the weekend and how my heart just lurches each time I am faced with a really sick patient. 

I have so much to learn still. It makes me really wonder if I will ever make it to be a Medical Registrar. Or any kind of Registrar at all. 

We'll see how I feel in three years or so. 

Hello, Cardiology F1 speaking

Because that is all I say these days when I get bleeped left, right and centre to prescribe this person Clopidogrel, rewrite that person's drug chart or please come and review Mr. X who is suddenly complaining of chest pain. 

And each day, it is almost amusing when my fellow F1 and I are notified of yet another new admission into CCU, and upon asking the question "What's the story with this new patient?", it seems our telepathy skills have improved drastically because I could almost put my money on it being Chest Pain. Or Shortness of breath. Or a collapse. 

When I was a Final Year doing my Medicine and Surgery placements where I was shadowing the F1, I was positive that I wouldn't have any trouble adapting to the job the following year, simply because much of the feedback I received revolved around me being 'really efficient' or 'too useful to discard' on the wards. Yes, my knowledge was hardly there. But I didn't like wasting time and I liked making sure that everything was sorted before I called it a day. 

Now that I am a junior doctor in Cardiology for real, it seems that I had imagined myself to be better than I really was. It took me a while to grasp the Trust's IT system, almost making the then F1 whom I was shadowing frown many a time in exasperation when I asked one stupid question after another. When I finally got my mind around that, the number of errors I came up with was astounding. I would cringe each time a weird look came across the Registrar's face when I had to explain yet again why the angio images from Salisbury had not yet arrived, or the look of astonishment on the Consultant's face when I could correctly give an answer to "What are the signs of Pericardial effusion?", as though it was amazing that I actually knew something. 

So my knowledge as a doctor remains close to obsolete. And I apparently am not as 'valuable' on the wards as I had imagined myself to be. The Registrar is always one step ahead and it seems I still lack the initiative to have everything perfectly in order at each start of the day. 

Today I told my Consultant that I wanted to be a Cardiologist. Fortunately for me, he was as encouraging as one could be. Whether or not it is a feasible achievement, that is a matter for the near future, but for the moment, I have this to work towards. 

Don't get me wrong, I might be dense. And my medical knowledge might be 1/100th of a Cardiology SpR's, but I enjoy my job. I enjoy the adrenaline it brings each day from rushing around chasing stuff in between having to clerk in Primary PCI's from Cath Lab. It gives me a sense of fulfillment when I know my patients so well that I can give an accurate summary without having to refer to the clerking proforma. And it makes me proud when I manage to successfully beg the Physiologist to squeeze in an echo for my patient who is hanging on a very thin thread of patience because she has been waiting for days just to have an echo. 

I love the fact that working hard everyday helps me take my mind off everything else and that I don't even have time to be bored or exasperated with my life, or rather a lack of it. It helps me take my mind off my homesickness, how much I miss my friends and the life we had in London as med students, of how much I have suffered one blow after another to my heart in recent times, and the uncertainty of my future. Without work, it seems I feel almost empty and at the verge of withdrawal symptoms. Knowing me, it is just like me to get hooked on something else to get my mind off the issues at present. 

And at the moment, I am determined to get myself hooked on the job. 

Who knows, as far as Cardiology as career is concerned, this could be as good as it gets. 

So here's to hopefully making the most out of my 4 month Cardiology stint and stepping up to the job. They are big to fill, these boots. But I never say never. 

Vamos Shing!