Man, I just realised the other day that in less than a month, I would have worked for a whole year as a house officer. ONE WHOLE YEAR! And I have survived. More importantly, my patients have survived. Well, most of them have……Anyway. Looking back on the last year, there are a few important things I learned. Some I learnt by trial. Others, by error. A few more I learnt after I recovered from the shock of being in that situation. I am not proud of all the things I have learnt. Some things I wish I could unlearn.

I have learnt patience! I have constantly surprised myself at how I have been able to hold my calm at the frustrating ineptitude of people around me. Especially when one gets paged about stupid things. If only the person doing the paging had stopped for a second and thought about the question they are posing, they would realise how silly it was. “The patient is asleep, should I wake him up to give him the sleeping tablet?”. Oh dear! However, I still have to learn how to channel that new found patience in my personal life.

I am learning to distinguish a potentially sick patient from one that isnt. One would think that that is what six years of medical school are about. But in reality, medical school doesnt have a clue about this. It takes a few occasions of missing the signs, and having patients crap out in front of you to bring that awareness. Its almost like a sixth sense, more of an art than a science. A patient can be perfectly well on paper, yet, one look at the patient tells you something is about to go wrong. I guess thats something med school can never teach you. I am still learning it…

The worst thing I learnt, which I wish I could unlearn, is the way in which I handle death. The first time I had to certify a patient’s death was a month into my job. He was a young guy, only 33, which probably made it a bit more difficult. But we all knew he was going to die, and there was nothing more we could do for him. Yet, when he actually died, and the nurse paged me, my heart sank into my shoes. I did not want to go into that room, and interrupt his family’s grieving, only to tell them what they already knew. That their son was dead. And then say the perfunctory “I’m sorry”, and leave the room. In movies, when the doctor says that to the family, the family starts crying, the camera shifts focus from the doctor. But the camera of my life doesnt shift focus from me. I went into the room, and told them their son was dead and told them I was sorry. And then stood there, awkward as hell. No movie had ever told me what I am supposed to do now. If I left too soon, it would be rude. And so I stayed. I felt as though I was intruding on the family, at a time when they really did not need any outside interruptions. I felt like a bull in a china shop. And I crept out of there, clumsily. I spent the next 45 minutes, sitting by myself, recovering from the shock of realising that I had just told that mother the worst thing she had ever heard in her whole life. Surely something this terrible and devastating cannot be entrusted to someone as young and inexperienced as me. Surely they need to have a consultant deliver the bad news.

After that day, I was fine with certifying death. I still feel a bit awkward everytime, but it doesnt come across to the family. Its now a practised routine. The quiet low voice, the restricted movements, the pause after I take my stethescope off. Then the quiet low voice again as I tell the family, and then excuse myself and walk out the door. And then I am back to normal again. Seems weird to me that I should be able to go on as if nothing has happened at all, while on the other side of the door, life will never be the same again for those still alive. Just doesnt seem fair.

All in all, I think what they told me at the start of the year was true. Being a house officer changes you. It makes you irritable, and you have to dig very deep not to let that irritability affect your work. It makes you realise that you are not always going to be right, and that you are going to make big goof-ups from time to time. But for me, more than anything else, it makes me realise time and again, how fickle life really is. Nothing is guaranteed.