Letter 427: Shoe-Knows?

Do you know? It's that time of the year again. A season dictated by sleepless nights over agonising decision making. There is a shoe-closet full of uncertainties, but oh, if only they were as certain as the shoes arranged so orderly in their place according to colour, heel, and functionality-- it would then be pointless to lose sleep and agonise over which pair of shoes to pick.

~*~

At one point I had been too comfortable with heels-- the higher the better-- disregarding the fact that I may at times stagger treacherously in the dangerously vertiginous yet elegant-looking stilettos, which serve to broadcast my appeal in all but one minute before breaking my back and quite possibly spraining my ankle the next. Now I could certainly yearn for the comfort of something more practical-- like ballet flats-- in which I could twirl and do little dances-- even on ragged surfaces.

~*~

But I now realise that no matter what, I would certainly be most at ease walking barefoot. At least then I know I am walking on sunshine; treading on cloud nine.

Graduation day, 7 months earlier-- though it almost seems like a lifetime ago.

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Letter 426: Cranberries

Lately, whenever I hit the sack for the remaining 6 hours of the day, I doze off so quickly that my GCS falls to a score of 3 instantaneously within seconds of having my eyes closed. I don't dream any more. Actually, come to think of it, I haven't had any dreams in a very long time.

夢: Dream(s).

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Letter 425: The Opposite of Fate

OPEN

I once thought I had chosen the right door. This was because I saw a stream of light illuminating the cobbled alley to which I thought was my route of exit. Not once was I even remotely aware that at the far dark corner which would greet me at the end of the alley stood a brick wall. So confident was I of this egress that I strode along the alley not bothering to carry a torch, only to run into the wall and repeatedly smash my nose against it because I was so convinced that somewhere on that brick wall where light doesn't reflect off, there has got to be another door that would lead to my absolution. Alas! I was in the dark, and it was only when I felt the warm, sticky blood trickling down my nose did I finally accept the fact that I might have chosen the wrong opening.

Singapore, June 2008.

CLOSED

There are no doors here, only the soft, gentle breeze that brings a mild foreshadowing that the winds are changing. You are at the same place. The river still flows. Yet you feel different. You see things from a different perspective now. You used to think that the river exudes a lucid stillness; now, you see the tormented undercurrents swirling below the surface. Somewhere beyond the shore, strains of Bob Dylan bobs across the river and finds its way to your ears. He is singing about some changing times. How eerily prophetic. You shudder, not knowing whether it's the cool touch of the zephyr, or the fact that you're about to let go all that you ever thought was perfect. The wind continues to tug at your hair, but it is shorter now, and it is refusing to be tousled.

Singapore, June 2009.

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Letter 424: Venti-Sized Verbosity with No Sugar

My venti-sized latte is perched precariously on the edge of a makeshift table in the hall while I am furiously clicking away on my keyboard in an attempt to de-stress. It is still cafe sua in a sense, all but disguised under chocolate powdered foam and a recyclable plastic cap, millions of miles away from its condensed milk-infused Indochina counterpart served ubiquitously on the streets of Vietnam. It is contained in a crimson paper cup the shade of which is unmistakably associated with a certain coffee chain in South Australia. But I don't taste the coffee. I want the kick. I am de-caffeineted, even on a day when I have the luxury of sleeping till noon and not being woken up by the startling buzz of my alarm clock.

There is always time for cafe sua in Vietnam.

Surgery makes you appreciate the importance of off days. It is only the end of my first week in Surg, and already, I feel overwhelmed and exhausted. My body has been running around like clockwork, and my mind, in circles. Surgery demands a lot, and allows no space for breathing, nor room for mistakes. Clutching a multitude of patient summary lists, drug charts, IV orders, case notes, checklists and what-nots, while working my way around The System trying to chase blood orders, consults, lab results, radiology reports and wandering equipment, I had inadvertently realised that I could no longer afford the luxury of spending as much time with my patients as I would have liked to.

This depresses and frustrates me. A lot. Because I care, basically. I care about my patients, and I want the best for them. But it's hard to go the extra mile when your day is interrupted with a million other mundane things to tend to, such as "Bed 25's jelco's fallen out/ tissued, can you please put another one in?", or "Bed 7's bloods have hemolysed, can you please repeat another set?".

Sleep is a short-lived necessity; to dream of faraway places is an chance luxury.

On my first Surgical Long Cover yesterday, I was on my feet-- literally-- from 7.30am till 9pm. I was running a one-man show covering the entire surgical ward, plus the outliers (ie surgical patients on non-surgical wards). My pager was constantly beeping, sometimes to the point where I couldn't even answer it because I was busy tending to a patient's immediate fluid needs.

Towards the end of my shift, I came to the stark realisation that
1) I hadn't eaten nor drunk anything since my morning cup of coffee at 7am-- my fluid intake was less than sub-optimal, even going by fasting standards;
2) I hadn't gone to the toilet for the entire duration of my 13-and-a-half hour shift-- my urine output was probably less than some of my post-op patients';
3) The last time I ran a marathon wasn't even half as tiring as compared to my cover shift;
4) It is humanly impossible to finish all the tasks listed on the whiteboard, no matter how much a perfectionist one is-- non-urgent jobs will just have to wait;
5) It's called a Cover because, for all intentions and purposes, it also carries a deeper connotation of which I shall let you clever people figure out.

Life is not easy in a remote fishing village where its main source of income depends heavily on only a handful of tourists who are willing to part with their few million Dong for a clay whistle, yet this little girl of no more than 6 manages to smile ever so sincerely and unsuspectingly at the world.

Earlier in the year, as I was ending my previous 2 rotations, my nurses came up to me and told me to "keep smiling", saying cheekily "don't you forget that smile young lady!". And I had been naive enough to believe that this would never happen. I now know why I had been warned. Something inside me had died over the past week. I had ceased to smile. That flicker of hope somewhere deep down inside me had been snuffed out by the burden of expectations heaped upon it. It had fizzled, and I had blatantly refused to relight the fire of probabilism.

And I am afraid, afraid of turning out to be the embodiment of misanthropy like so many others that I have witnessed; afraid that my ideals of medical ethos are clashing with the practicality of medicine in the real world-- is this how medical practice is supposed to be?

Longing for some sunshine and sanctuary.

*This post is written without the intention to vent. Writing is one of my many forms of stress relief, and right now, my inspiration comes from the wards. I do realise I have no grounds to rant when my Malaysian/ Singaporean counterparts are working 36-hour shifts (or more) when they're on cover. It is merely to provide insight into hospital life and reveal the disappointingly hurtful truth that sometimes, reality and the nobility of the profession do not blend well.


**Pics taken at Hanoi, Halong Bay, Hoi An and My Son Sanctuary (UNESCO World Heritage Site).

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Letter 423: The Doctor's Solution to Weight Loss

I have discovered that the quickest way to lose that post-holiday cumulative effects of one-too-many banh mi and too much cafe sua da is to be a surgical intern.

Look! A drip in the health bunker at Cu Chi Tunnels!

Breakfast: Cutting my sleeping time from 5 hours to 4-and-a-half for a bowl of cereal or 2 miserable pieces of toasts?? No thanks. Just pass me the coffee. STAT!

Lunch: Practically non-existent. 3pm gulps of coffee if I'm lucky.

Dinner: You mean (the long-overdue) lunch?

The Temple of Literature in Hanoi has a spelling mistake *LOL!*

Being a surgical intern also fast-tracks one towards osteoporosis. Since starting Surgery, I have not seen the sun at all. It's pitch black when I drive to work, and the sun's already set by the time I make my way home (cos it's winter now). I don't even know if it's sunny or cloudy or rainy during my working hours. I can only judge from the clothes people wear when they visit my patients in the ward, and whether they're carrying a brollie or wearing a beanie or both.

Although I don't miss Vietnam's humidity, I do miss having some sunshine in my life at the moment.

Having said that, perhaps now's the time for me to lose my tan and become as fair as my olive complexion would go :)

**This piece is not intended as medical advice for weight management, of course ;p

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