My first posting was Orthopaedics, 4th floor. There were a number of us there, and I was lucky to have entered the posting with 2 of my friends, on top of 3 other new ‘first posters’. Our seniors from college Izzaty and Sheila were there too, as fifth and fourth posters respectively, and we had dinner with the former just a few days before so we were less anxious.There was only 1 ward (28 beds excluding extension beds, and those things multiply I tell you) for Orthopaedics in the whole entire hospital, so we were quite luxurious, having had 20+ HOs at that time.
We had 3 different shifts; A (6am to 6pm), 2 B callers (6am to 9pm) and 2 C callers (6am to 12pm the next day). C callers would only be in charge of the acute bed (2 max each). From the A and B pool, we would be divided into clinic, Operation Theatre (OT) lister or ward work, and we would be given a list of turns for Emergency cases review by the day’s In Charge (usually a B caller). However for the first 2 weeks we had to ‘tag’; which entails 6am to 10pm shifts with only one day off in between. We needed to pass an 'off tag assessment’ by our MO Dr Kee before we can work our normal shifts. It was all very overwhelming to take in on my first day, so that day the In Charge told us to tag with our seniors (ones who had been in Ortho much longer than us; not necessarily those of more advanced postings). I got stuck with this guy, F and he was reviewing bed 20 something, and I can’t remember now what the patient was in for. I thought I would, given that it was my first patient ever as a doctor, but I was more concerned with how things worked around there.
He snickered at me at first, seeing how I had my white coat on with a handful of pens in my upper pocket, a stethoscope around my neck, a torch pen and goodness! Even a tendon hammer! I felt silly at first, and I kept addressing him as “Doctor” before he cut me off.
“Ala rilek ah. Aku pun first poster macam kau. Cuma aku awal sikit, dua bulan. White coat kita pakai hari rabu je untuk grand round. Hari hari lain tak payah pakai. Ok. Kau nak review patient pagi pagi senang je. Kau tengok orang semalam punya AM Review, lepas tu kau salin je. Macam ni, 63 year old bla bla bla underlying bla bla bla, currently dia macam mana. On examination macam mana. Lepas tu plan dia kau ikut je plan masa pm review.”
This, I have learnt after some time, was NOT the way to review patients. I also remembered how he did not even address or touch the patient before he wrote his examination findings. I remember thinking he must have been one of lazy shortcut types (had a lot of those in medical school) and decided not to follow his advice. I stopped calling him Doctor much earlier than I did everybody else.
I turned to someone else for guidance; Ann, a sturdy third poster whom I called Doctor for a whole week because she seemed so fun yet calm and knowledgable. She came in from Medical posting, and it was common knowledge that anyone who passed Medical was a reliable HO who can manage any crisis thrown at them. “Dia cakap macam tu kat kau ke Najah?” she laughed “Dulu masa aku masuk Ortho lepas Medical bukan main dia nak ajar aku macam mana nak buat wound dressing, nak review bagai. Dia tak tahu aku dah third posting. Masa tu dia nak mengorat aku tapi dia tak tahu aku dah kahwin. Bila aku bagitau laki aku, laki aku pandang dia kecik besar kecik besar je hahahaha.”