Hospital Week

Such a disappointing game, y'know having 4 CBs doesn't mean you have to play ALL of them at the same time. Weird thing is the game was so flat that I don't even feel anger, just apathy. Seriously.

I know the last post was supposed to be continued, but I'm not particularly in a time-traveling kinda mood right now so that period of time will have to remain vacant for now.

I'm disappointed that other than that first training session 3 weeks ago, I haven't been able to shoot AT ALL. Yes, it's understandable that the weapons need to undergo maintenance, and not totally unexpected that they'd take longer than projected to be done. However, this irrational, demanding part of me can't help but be more than a little miffed that things have turned out the way they have, and that I won't be able to get my shooting fix, so there.

Complaints and random grouses aside, the past week's clinical posting/attachment has, to reuse a well-worn cliche, been an eye-opening experience.

Attached to the Endocrinology department, what we were exposed too wasn't all too different from what we'd seen at the polyclinic. Loads of diabetes cases, and issues with diabetes management, but really a step up in magnitude in the cases dealt with. If the attachment at the polyclinic mapped a patient's journey from their perspective, the hospital posting mapped their journey from the perspective of the various allied healthcare professionals. Sitting in on Sister Poh Leng's (a Diabetic Nurse Educator) consult with a particularly difficult patient who apparently had a personality disorder and refused to listen when told that his results showed he had diabetes, constantly denying it and taking a very combative stance towards her, I gained a healthy respect for the patience and dedication towards their jobs our nurses possess. It can be a very draining task, especially when she has patients coming in constantly having problems with their compliance and their conditions worsening, so to watch her be so patient in her attempts to suss out the reasons behind their noncompliance and to try to work out solutions with them was honestly very inspiring. Even more so was that after a 1 hour consult with a patient who had had to undergo an amputation and had certain other problems, and having shown the patient out of the room, she turned to us and said "These are the patients you have to take care of" and it was very evident from her tone of voice and the look on her face that she really empathized and felt for the patient's situation. It was a very visceral experience for me.


Having had opportunities to interact with and "question" some of the patients, both inpatient and outpatient, it soon became clear to me that treating patients, isn't as simple as prescribing medication and suggesting a diet plan and leaving it to them to comply. Sometimes it's not simply a matter of discipline. They may work long hours, have financial difficulties, or even be unable to eat properly because of other people at home, so understanding these, and also the fact that patients may not be entirely forthcoming about the whole picture without further prompting, or may at times opt to mislead rather than to reveal their noncompliance out of a fear of being judged is very important in working with them to manage their illnesses, especially chronic ones. An approach favouring collaboration over didacticism is required.

The ward rounds left me with mixed feelings. The ICU and HDU showed how strongly and tenaciously we're able to hang onto life, but had me wondering where/when we draw the line, beyond the very practical considerations of limitations in resources, which have the potential to open a whole new can of worms altogether with regards to ethical decisions which may have to be made. Whilst touring the wards, we met and interviewed a patient who had suffered from leprosy (the result of bacterial infections, curable now, hence its rarity in Singapore but insufficient awareness in the past means most of the inflicted who suffered permanent disabilities are often the elderly) earlier on, patients who had had amputations and suffered other complications as a result of poorly controlled diabetes and other victims of debilitating illnesses. One particular incident which sticks rather vividly in my mind was of visiting a Class C ward and seeing an elderly lady seated in a chair beside her bed. I couldn't really see whether she was restrained to the chair but she never got up, and had some kind of brace around her chest. She constantly moaned as if she were in pain, and complained; directed to I don't know who, that something was very tight and was hurting her, begging for it to be loosened. Very disturbed at the fact that noone seemed to be paying her any attention, I asked the doctor whether we should/could do anything for her. So turns out she had dementia which could have been aggravated by her surroundings; the pain might even have been psychological. But that did nothing to keep my heart from tearing to bits each time I heard her in that state, and it mustn't have been nice for the patients sharing the ward with her as well, I can't imagine what it must be like to experience that while trying to recover yourself :X I have to admit that having had little hospital experience prior to this, I was shocked by what I saw, what patients had to go through in their illnesses. I think it's important though, strange as this may sound, to hold onto this "shock", or at the very least, to not become desensitized to it, and take it as part of normal proceedings. I was a little surprised too, when in a patient's presence, our supervising doctor spoke to us very candidly about his/her condition, addressing us and not the patient, and prompting us with questions for him/her, almost as if the patient wasn't there. I understood, of course, that he was helping us to understand more about the patient's condition and to get us to think about where our line of questioning should lead, it simply felt a little awkward for all this to occur while another human being was hopefully not exactly suffering but lying ill right in front of me. I don't know whether it's something I will ever get used to and comfortable with.

Our visit to the dietician was both helpful and depressing, in that it illustrated just how hard it could be for even a relatively healthy young person to eat healthily, within the required amount of calories within a day, not to mention for a diabetic who would have to strictly control his/her blood sugar. It reinforced the understanding that calling for a change in lifestyle is not an easy task at all, and that any progress would have to be made step by step with the patient. I somehow can't shake the feeling that even if I knew I were leading an unhealthy lifestyle (which I AM), I would experience a lot of difficulty in even attempting to change my living and eating habits, which seem very ingrained in me.


No Conclusion here, nothing to see.