Tuesday, November 22, 2016


On the plane to KUL
I have decided to write down a recount on my 2-week remedial surgery that I needed to do after I technically finished 4th year.

Just In case you didn’t know, I was told to do extra work for surgery by my consultant, it was the next day after this happened here. Since then I have this love-hate relationship with surgery. I’ll tell you more why.

Day 1
I was attached with a different team than I had before, which was a relieved upon knowing it a week prior. I had two consultants, Mr W and Mr L, who are known to be very good, keen on teaching and nice as compared to other teams in the surgical department.  Mr W is a very nice man, he smiles a lot and not intimidating. I had a good first impression, when he smiled at me at one occasion before. Mr L, on the other hand, is a very simple man, he doesn’t really express himself much, he does whatever he needs to do. He is, I can conclude very difficult to understand. I had a locum registrar by the name of BI, who I didn’t know was the registrar till like, almost the end of the day. Interestingly enough, there were two house surgeons in the team, JH and SN, which I had mistakenly thought JH was the registrar (because BI was not there during the ward round). We also had a TI (6th year student), AI in the team who was helpful to me.

After I did an awkward introduction to both of my consultants, we went straight for ward round, which was very quick and straightforward as usual. I was trying my best to adapt with it, as I was just coming off psychiatry, just the Friday before. During the ward round I heard about Mr L and Mr W talked about patients to be taken to theatre on that day. I thought we probably on call on that day (Monday) but I was so in denial (but yeah, Mondays are our on call day it turned out) which I was so not keen about because it was my first day back in surgery, and I needed time to adapt to it.

After ward round, both consultants went separate ways. Mr W went to day surgery unit to do his elective, short surgery lists. Mr L, as expected, was on call on that day, and went straight to the acute theatre to do the acute lists. From the first time I met them consultants, I always have an inclination towards Mr W because he always look a bit more harmless and benign than Mr L. I was very intimidated by the way JH looked at me/treated me during the ward round, so I just wanted to be with the person that I can be comfortable with. So I was not keen to go to acute theatre because JH and BI will be there to assist Mr L. I probably wouldn’t be scrubbed up anyway if I go to the acute theatre, so I went to day surgery unit with Mr W and spent the whole morning there.

After lunch break (which I didn’t eat anything because of all many days in 2016, I choose this day to fast) I had to find something to do so I hung around the ward and help with the house surgeon and the TI. Helped them with discharges, bloods etc etc trying really hard to find reasons not to go to ED because I was deliberately avoiding JH, who I thought was the person I had to deal with if I went down to ED.  However, there were not many things to be done, and it was almost 430pm which SN would finish his job anyway. So because it was on call day, I, as a 4th year is usually expected to stay till about 9/10pm-ish, tag along with the registrar, talk to patients, discuss it with the reg (short form of registrar) or go to acute theatre, because those are the ways to learn effectively in this run.

I was contemplating to stay till late or not, it was a really difficult decision. I was not keen to be on call on my first day back in surgery but at the same time, that was my first day and I had to show myself enough to the consultants. So, I decided to stay, heavy-heartedly. I went down to ED to find JH and BI, who weren’t really interested of my existence there. I had to open my mouth and asked if there was a patient to see. JH, bitterly said yes. He was half-scolding me of not turning up in the acute theatre during the day. I kind of foresaw that to be honest, I didn’t think I could really run away from them, and to think that my grade was depending on the feedback from everyone in the team, that scared me a bit. Half of the time when I was in ED with the reg, I was feeling really dumb, or rather they made me feel dumb, not knowing what to do etc. It was really frustrating. It took a lot patience and courage just to calm myself, that I was here to learn and this was a part of the challenges that I had to face.

Later that night, with a heavy heart, I made an effort to go to the acute theatre to see a laparoscopic cholecystectomy and also a laparoscopic appendicectomy. It was Mr L who was doing both surgeries. I felt like there were butterflies in my stomach, (and the fact that at 8pm I hadn’t break my fast yet) as I went into the theatre without being acknowledged by Mr L. I just sat there looking at the screen of what Mr L was doing. It was so darn awkward. I felt like I should just go home and not be here but I kind of stuck now. I would imagine it would be rude if I left halfway during the surgery. So I stayed. I was struck when Mr L suddenly looked at me and asked me questions about the surgery, which I answered poorly due to nervousness. It was obviously the wrong answer. Surprisingly, he just went on and give me the answers. At the end of both surgeries, I was awkwardly standing in the theatre waiting for the right time to leave – I thought it would be best to leave after the consultant left.
Suddenly Mr L was looking at me again and said:

“That’s it for tonight, you’ve seen the bread and butter of general surgery in one night.”

Which I answered briefly with a simple “Yup”… with no further questions/remarks – because that was my biggest problem, not knowing how to interact to people of different cultures than me.

Since meeting with Mr L, half of the time I was trying to understand and trying to get to know about him. What he likes, what he doesn’t like etc etc. Half of the time, maybe more? I didn’t know what was he thinking as he rarely expresses himself, didn’t smile at all and not showing any facial expression most of the time. I thought he despised me, or angry at me or just, you know felt like I was a nuisance and don’t really care about me. But he kind of changed my perception towards him, a little bit after what happened in the theatre that evening.

I went back home at 930pm that evening and had my first meal of the day. I had thought to myself, it would probably be better if I just stay with the same team I was attached before because I already know the consultants and didn’t have to get into this guessing game all over again  because it was so pretty darn tiring…

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there's always a little truth behind every "JUST KIDDING ", a little knowledge behind every " I DON'T KNOW ", a little emotion behind every " I DON'T CARE ", and a little pain behind every " IT'S OKAY "