survivors' reminiscence

After four months, finally I am joining the ranks of the survivors - those who had suffered the boot camp that is HRPZ II 's O&G, and made it alive, without major mental or physical injuries.

Alhamdulillah, I can never thank Allah enough.

When I looked back, I had actually experienced pretty much everything there is to experience in an O&G posting. The labour room, the O&G clinic, the wards, the triage where district health clinics send all sorts of weird referrals, the OT, and of course, the A&E - all bear witness to my learning moments, especially since emergencies have a way of happening when I am around.

I begun as a newbie who hardly knows anything about O&G. The last time I did any serious studying on the topic was sometime in 2009, when I did my O&G posting in Fairfield General Hospital and had my November OSCEs. On my first day in the department, I was a lost soul who couldn't even find the cervix during vaginal examinations, let alone comment on the dilation of the cervical os. I stayed positive - I will surely made it.

Nevertheless, the coming events quickly challenged my resolve. Like REALLY REALLY challenged it. Plain and square, I DID NOT KNOW WHAT TO DO.

I didn't know how to review patients and present them properly to seniors during rounds. I didn't know what plans to make for which patients. I was all thumbs when delivering babies. I got panicked when babies went flat and nurses were telling me to help resuscitate them. I was scolded by Paediatrics MOs when I made clumsy referrals.

When making notes and clerking patients I kept making so much mistakes that MOs got tired of nagging at me. I get insulted for being so helplessly lost while assisting in the operation theatre. Add to that, working long, long hours with little rest and little food makes my head buzz, my reactions go slow, and I got scolded more, which was a vicious cycle that is slowly getting at me. There was one occasion when I felt pushed to the brink and answered back, very emotionally, at an MO who was nagging at me - I assure you the outcome wasn't pretty.

I am not exaggerating. My early days in O&G was rather bad, and quite dark. My parents had to bear listening to my crying and telling them I couldn't do this, I wanted to run away and never come back.

Throughout life so far, I thought I am a fighter who never backs off, who holds on, and never runs away. The first few days in O&G taught me otherwise, and the realisation of my own fallibility is a very humbling experience.

I don't know where does the strength come from, for me to continue trudging on the path - between the labour room beds and the wards, and the operation theatre. Almost every time I went to work feeling apprehensive and scared, what kind of tribulation is awaiting me. What kind of patient will I encounter, what kind of disapproval will I get from my MOs today. What kind of insult to my self-esteem - almost nonexistent at times nowadays - will I receive on this particular work shift. Those questions play along almost every time I walked down the stairs of my quarters, crossed the main road and brought my feet along the corridors leading to the O&G department far, far at the other end of the hospital.

And as stories like this tend to go, of course, the strength comes from Allah SWT. Indeed, when human beings feel so helpless, so weak, with nobody - nobody at all to turn to, they will turn to Allah. They will turn to Allah with all their hearts, with all their hopes and fears, presented them before Allah, acknowledging their own wretched state and begging Allah to care for their affairs.

And of course, Allah listens and cares for their affairs, as He always does. The little tests are only proofs of His love - to remind wayward humans to come back to Him, to render our dependence on Him absolute, and to cleanse us of our sins.

Those darker days began to get further and further away, as I began to gain confidence and start to enjoy the profession. I have encountered critical patients having all sorts of emergencies, and (with the presence of my MO and specialists) know what to do, within my capacity as a house officer. The calls to the operation theatre no longer bring a chill down my back, only a twinge of annoyance at the amount of paperwork I have to do after the baby/tumour/cyst/whatever was out.

When in charge of wards, I feel happy walking through the door and immediately heading to the first bed, flipping through the notes and making my own. When being second call at nights, I feel comfortable let loose, on my own, taking care of four maternity wards from 1.30 pm today till 7 am tomorrow morning. I walk up and down the labour room, checking on patients, examining them as necessary, delivering babies if I need to - and resuscitating them if they don't cry or went blue, reviewing CTGs with all sorts of patterns - reassuring, suspicious, or plain ominous that send shivers to your neck, making referrals and writing letters to various departments... as if I had never been the panicked lost house officer on her first posting who simply doesn't know what to do.

Now I am good at things I thought I will never be able to do.

Of course, I still have a lot to learn. MOs still get pissed with me from time to time, and specialists still get unhappy when I answer their questions wrong/ present cases clumsily/jot down notes incorrectly. There are still times when I get "OMG what to do what to do I'm so dead"... and there are times when I just get so overwhelmed with piling jobs I wanted to cry.

But life is so much better now, and it only reminds me of how much love and care Allah has given me.

I thought of those patients having BP crises, eclamptic patients fitting before my eyes, the ominousness when my fingers feel the widely dilated os of a mother with big baby or footling breech who ABSOLUTELY must not undergo vaginal delivery, the cord pulsating under my fingers during prolapsed cord accident, the mother with pulmonary embolism who died before my eyes after frantic active resuscitation in the ICU...

I thought of the long corridors lit by yellowish lamps in the wee hours of morning, the dominion of the second call doctor who has to go back and forth between wards, sometimes trembling with exhaustion. I thought of the labour room, perpetually bright and alive with the drama of life's arrivals. Where exhausted doctors curled up on the sofa or on the glass desk, hoping to catch a few minutes' sleep, only to be woken by shouts of "Doctor, a premature patient in labour is arriving!" or "Doctor, there's a patient with PV bleed need to be attended stat!" or perhaps, "WHERE's the HO WHO'S SUPPOSED TO GO INTO THE OT NOW?! Patient's already on table!"

And where once, about six patients were waiting to be seen at the admissions area, five of whom were leaking liquor, it was two a.m. in the morning and I was the only doctor who must see them all, preferably before five a.m., then present them to my MO. I remember feeling so tired and overwhelmed but realising that if I don't see them, nobody else will, and as long as I'm not dead or collapsed, I must see every single one of them, clerk their notes properly, take all the samples, and send them off to the ward after my MO sees them later.

Most of the time, maybe that is the thought that ran through us doctors' minds when faced with piles of jobs that sometimes feel impossible to do - if we don't do this, nobody else will, so as long as we're not dead or collapsed, we must complete these jobs. Then when we finally finish, we go home relieved, to sink into our beds and get a few hours of sleep before starting the cycle again next day.

InsyaAllah I'm starting on Medical tomorrow morning.

May Allah keep me always.