Goodbye 2009

The last day of 2009. Got no time to reminice the past year. I was on morning shift. Was a busy day as expected. I treated a lady who crashed her motorbike to a stone wall, who miraculously just had a stable maxillary fracture and needed some stitches. A mother and son with gastroenteritis. Some earaches. And just at the end of my shift I got an emergency call. The caller said the patient is unconscious and not breathing. I was expecting an elderly person with a heart attack, but I was quite surprised to see a young lady with a rope mark on her neck. This 35 year old seemed to have committed suicide. She was already asystole but we still tried. I'm quite disappointed to fail the intubation 3x, what ashame. But I gave my best. I hope she rest in peace. What a case to close my last shift of the year. 
Then I got a call for an appendix surgery at 9. So here I am. In my scrubs ready for surgery, as the last thing I do in 2009.  No complains. Though I thought it would b fun to spend my new year with my mom. But I don't know why I said yes to this surgery. I also called T and told her I want "I love you" to be the last thing she hears from me his year. I miss her. 
Well, I got to go now an appendix is waiting to be removed.
Goodbye 2009, the year full of experience I will never forget. But I am looking forward for more exciting things in 2010 and start a new page in my life :)

I wish i had her ring on

2 days to the new year. More patients. My first patient today was a friend's son. He had fever for 3 days, with no other symptoms. So I ordered a CBC and Anti Dengue. The result was trombocytopenia but neg dengue. Hopefully the kid will improve. 
The next patient was a lady who fractured her toe. I also suspected a cuboid fracture, so I put her on a short leg posterior splint. She was in tears when I told her about the fracture, but she was nice and very cooperative. 
I lost my concentration a bit when seeing a father & daughter with common cold. The patient was nice, even the kid was good and followed my instructions on exam, but it was the mother who was healhy that made me lose concentration.. plus I didn't have a pen. The mom was very "jutek". It made me feel uneasy. I even asked them to leave and wait outside so I could think and work on my report. Then I called in the father (I didn't want to see the grumpy mother again) to explain the meds. 
After that I had a man who strained his hamstring and gastrocnemius. It's a good thing I had a quick look at the orthopedic textbook, so i could confidently explain him not to worry. He was okay.
My last patient was a lady with high fever & dehydration. I suspect she has dengue. I admitted her. Don't know the result yet. 
Well, overall it was a good day at work. 
I came home at had a nice chat with my lovely T. It's 4 months now we've been together. We already had our ups and downs. But each day I get to know more, makes me feel I love her more. We had a 2 hour chat, which is probably the last online chat we have this year. She makes me laugh, I make her laugh, too. I love seeing her laugh and have a big happy smile on her. We also talked about me coming out. The only person that matters for me to come out to is my mom. I told her about my mom and T actually senses that possibly my mom wouldn't be too surprised. Hmm, that does give me a thought. But I just have to "grow balls" as she said to come out. 
One last thing that I was quite upset of myself is not using her ring. I took it off because I don't want much question from my family about the origins of the ring. I do love having it, and would use it on any other day, it's just that it's loose for my fingers and get tangled in my necklace. I wish I could use it on my finger because it does remind me of her and how much I mean to her. She did look sad that I didn't have it on me. I can understand that. I would be too. Hope I can make it up with her.  

Medicine is art

Mood today: Good.
It's holiday time, Bali is getting crowded with tourists, which means I'll be busy at work. 
Today I got an interesting case of vaginal bleeding. It's more likely to be DUB. But that women was bleeding a lot. However, she was very calmed and had minimal complains. I was tempted to consult obgyn. But I decided to give 5 days of primolut and see how it goes. Her Hb was quite concerning however still by clinical judgement she looked fine. These are those cases where u use ur instincts to work. I'll follow up in 5 days and call her for her progress. (have to write it down in my to do list).
Talking about clinical judgement, my emergency call patient on  Sunday is a case of unmatching clinical findings and test reult. I had a 69 male patient with sudden hemiparese of the left side. He was sleeping at that time. Clinically I diagnosed him as non hemorhagic stroke. But he ct scan did show a hyperdense area at the central sulcus, possible bleeding? I was still unsure when I consulted the neurologist. But she confirmed it was a subarachnoid bleed. Today the patient worsened, and the repeated ct scan did show an ischemic area concordance to the clinical findings.
As I always said medicines is art.
My last case at "injury time" was a teenager with open fracture. She was crying and screaming and there was also vomit. I thought she had a massive head injury. Luckily there were no other injuries. I'm quite content because the process went quite smooth until I handed over to the ward doc. 
When everything goes smooth I just feel happy and proud of myself. Hopefully the surgery tonight will go well.
Now I'm getting ready for my uncle's 60th birthday. I'm excited to open the champagne I bought from Singapore :) 

Christmas in Singapore, feeding my pain

When do u kno ur over a past relationship? Memories can flare up at any time. Ur heart just suddenly feel uneasy. U feel that emptiness in ur stomach. U try to get rid of the thought but it keeps coming back. 
It happened to me.
Christmas in Singapore, I thought I was strong enough. But in the last day I gave in. I called her. At first I felt relieved. But when I got home, my mind can't stop thinking of her again. And the dream I had about her really made me wide awake. So I text just to show I still cared. We had a nice civilized texting, wishing each other well. I was expecting to feel better, being big hearted. But I didn't. I just found myself drowning in the sadness again.
Sometimes I wonder would it just be better not to know at all? Just leave all the feelings and memories deep down inside? Maybe. 
I can never run away from my past. I know that. I might just need more time. Not try to test myself. Leave my past not run away from it. 
But I still feel blessed for the loving people surround me. I hold on to this thought a lot to cope through all this. 
Phew, this is tough. But hey his is life.     

Baksos Natal

My church came up with an idea to make a charity medical treatment program. Yesterday was the day. I had 2 friends helping. One a friend from work and the other was her friend who actually just came to Bali for holiday.

Yesterday after morning shift, I went home, prepared my luggage to take. And at 10 pm I picked up my friend. We had to go late night because my friend had to work afternoon shift. So we arrived at Bedugul at 00.30 and went to sleep. Then next day we were ready for the charity program.

It was a huge success. From the target of 100 people, we actually treated 144 patients, we couldn't treat about 30 people, because we ran out of medicines. That was 144 patients in 4 hours, with 3 doctors, so its an average of 12 patients per hour per doctor. Phew. Tired. But it feels good when you can help people who really need the help.

Emptiness

Unexplained emptiness. That's what I've been feeling for a few days. Don't know why. Just feeling it. What to do? Focus on now and not worry about it. Maybe in time I will get a reasonable explanation.