Quality of Life

An 80yr old lady comes into the clinic. She's strong (for her age), sharp mind, good hearing, good eyesight, can walk fairly well with a cane for assistance. She's had a good life - her children have their own families and are doing well. A son is taking good care of her.

She has cancer - a big one in her neck. But otherwise she's fine. She wants to get an operation because, well, it's cancer...

How can I make her understand that it's not that simple a decision? A few years earlier, it would be an easy decision.

She might not survive the surgery. If she does, she might not fully recover and wish she didn't get the surgery in the first place. If she does survive, she might not survive the radiotherapy and chemotherapy that has to come after the surgery. If she does survive, she might not fully recover. If she does fully recover... that's a lot of "IFs".

How can I make her understand that the extra time the surgery MIGHT give her could be spent bedridden and totally dependent on her relatives?

How can I tell her that if she doesn't undergo surgery, she might even die of old age before the cancer kills her?

But then again, I'm not even sure of any of the above. They are all just possibilities.

And yet, I know more than she does. And I know once she undergoes surgery, there is no turning back. The end of her life is inevitably near and the cancer might not even have an effect on her lifespan. And surgery could.

Timed Out

It took 5 years before I finally pushed myself to start residency training. I hated the fact that I would have no time of my own once I started training.

Now, after almost 2 years into my training, I am being coaxed to plan when and where to spend the 15 days vacation leave given to us every year. Reality is I can't afford to go anywhere. What's worse is I don't really feel like going anywhere. Maybe things would be different if there was that "someone" I could spend time with.

I was always afraid that residency would rob me of time for myself. I never expected that I would have some time off and yet have no desire to use it.

Bottomed Again

It was a good 4 months of having a taste of being higher up in the food chain. It was too good to last. The newest member of our department is going to quit (for personal reasons).

It isn't even final, but the ’requests’ are already starting. "do this." "do that."; and what I hate the most - the changes in our schedule. Instead of scheduling their lives around our work, it’s my sched that will get thrown around again.

That’s the way it is in the hospital hierarchy they said. And for a time when I was not at the bottom, I was told to exert my ’seniority’ by ’delegating’ tasks. That’s not my style. I don’t ask others to do what is mine to do. If that is the way one exercises his or her seniority then I’ll never become a senior.

What's worse is that the next applicant to be accepted might be another female... WTF!!!

2 Weeks Notice

She was about 4 or 5 years old and at the outpatient department for the 2nd time since last November because of a foul-smelling stuff coming from her right nose. Her nose was so swollen the first time that she was prescribed antibiotics and told to return after a week. But she wasn't brought back. The swelling subsided and even if the bad smell was still there her parents thought she would be ok.

She was brought back because the smell became stronger. All that could be seen in her nose was the mucous, and something black. And the smell... like something rotten.

She denied she put anything in her nose. But there was something black inside. It took almost 20 minutes to get it out - a now corroded battery which had been in her nose for about 3 months. With medications the smell will eventually disappear. But the battery had already leaked and could still cause the bones of her nose to collapse. Only time will tell. Hopefully this time she'll be brought in for follow up.

This is going to be something I will routinely see in the specialty I've chosen (finally). And the more I observe in the out patient department, the more I seem to be looking forward to start the training. Hopefully I'll also enjoy the major operations.

In 2 weeks I'll be starting my pre-residency. No salary for about 2 months. And there'll be 2 of us vying for the slot. I hope after 2 months it'll be me