Paeds & I

Flashback #4 – PART 2 : My Paedo-days

▪ 4. -I decided Paediatrics is my Passion & I was born to treat kids & perhaps be a Paediatrics HOD somewhere, someday!
-He showed me there’s more to Medicine & I was born to be a holistic doctor as long as I am in this profession.
-We both concur that I was born to be a safe, Good, ETHICAL doctor. . and (*fingers crossed*) a Specialist.

***

#Dedicated to all the Paediatricians out there, to all my bosses (specialists & MOs I’ve worked under & my ex-colleagues in Paeds.#

When I was a student, I knew I had a soft spot for kids. Some kids love me, others…well, at least none totally loathed me, I would say :p

child

I can’t say the same during internship though! With all the 1001 pricking we subjected them too, I am sure I would have earned a lot of wrath – from kids, as well as their parents.

*

But trust me when I say, I have learned alot from CHILDREN! 😀
Among which are: – Living in the Moment!
The younger they are, the more lessons we can (in)directly pick up from them.

Perhaps it was a way I made myself feel young at heart, by associating with the kiddos. Made me closer to the child in me – yeap, they did! 😀

I digress…

***

So, where was I? Yeah…Housemanship.
Prior to Paeds posting, I promised myself will assess my suitability on a possibility of pursuing that field as a future career option. First few days of tagging in the neonatal ward was stressful. All those non-stop crying babies, often they formed a symphony…and me a HO trying to pick up bloodtaking skills and learn the stuffs to survive as a Paeds HO…I thought to myself “Oh boy…how wrong was I. I will never suit this field. I might end up being a very grumpy doctor cum child-abuser some day if those babes go on irritating me with their crying”.

(This feeling didn’t exist when I was a Paeds MO though, perhaps the biggest difference was my experience & mindset – acknowledging that I was doing it as ‘a favour’ made all the difference).

 *

By the end of my 3 months (I was a so-called JMO – Junior Medical Officer back then, in my second year of HOship, thus the 3 & not 4 months rotation), I was hoping I could stay longer in the department, instead of moving on to the next – hu hu…of course, I didn’t want an extension! :p

I was inspired by the HOD, some specialists, and my Medical Officers. Their dedication…meticulousness…and their ‘touch’ awed me! My passion was reignited…minus the tagging experience. LOL. What first were screams to my ears, started to become music to my ears…like a lovely piece of orchestra! :p

*

I always had, have & will always have great respect to Paediatricians. This department might seem to be enclosed in its own bubble.
But Paediatricians not only manage Paeds’ medical conditions, but they are also anesthetist when they manage the ventilators/NICU or PICU management/&pain management, to name some. They are radiologists when they do their own ultrasound scans. And they are pharmacists who calculate every drug to the precise dose, and refer to Frank Shann so as to prevent error, when in doubt. Counsellor and bereavement officers when the situation arises. Etc etc…I can go on & on…but THE MOST HUMBLE & KINDest Specialists & Consultants I know hail from Paediatrics department too. 😀

In Summary, IMHO, Paediatricians are multi-talented & basically are capable of a lot of things, without being dependent on other disciplines. Of course, there is always an element of multidisciplinary approach, but they don’t WAIT for others till the cow comes home. For confirmation etc etc…they will involve others. And probably, they are about the most ‘obsessive’ too – a characteristic trait that I have been trying to shed over the years :p

I look at them…and then I look at the girl-in-the-mirror, and I go “Nehh….I am nowhere near their level! I am too far from these multi-talented people…”

***

On my last day of HOship, one of the MOs actually told me to hold the probe & do a headscan for a baby! With his guidance, it felt ‘wow’!!!
I still remember his words, along the line of: “See…it isn’t all that hard. You can do a scan! 🙂 Perhaps someday you can take up Paeds” – wow! How random, from a medical officer of mine who was quite unpredictable and moody at times – a man, mind you :p

I have spoken to some specialists about my uncertainty and asking for advice. I was told to sit for my Part 1 if I am keen. But however, they all advised me ONE Same Thing! Go out, gain some experience…and if you are still keen, come back to us. One specialist in particular told me, there would be alot of sacrifices ahead, especially when it comes to PICU call & the training years…

*

The day I left the department, I dropped by at MO’s passover and passed them a box of chocolates (it is not my nature to do this in other departments – I would just join the rest and chip in for ‘makan’ usually!) – they have all ‘touched’ me in some way – and definitely Inspired me!
I even presented an orchid plant for the HOD & his wife (whom we befriended) as I knew they love plants. She was pleasantly surprised, and texted me a TQ message, which included a “You are a very appreciative person, Lavanya. Thank you for your orchid.”
I only know that knowing what it is to be deprieved of things/people, is what has made me who I am today.
As a child, I thought I deserved everything – as a Right; that the world owed me!
As a young adult, I was whacked with the reality of what it is to lose it all.
And at that point of time in my life…I knew that everything I had was a Priviledge & Blessing – And I LEARNT To GIVE THANKS Daily for what I had…and to show Appreciation when it is due, instead of waiting too long…and letting it die a slow death over time.
Months later, my HOD’s wife surprised me with a text saying the first bloom turned out well, and they presented it to someone who needed Faith.

*

Paeds was the only department I would jump up and go to work DAILY without ‘another 5-minutes sleep syndrome’ @ Snoozing!!

I left the department as a house-officer, with an open mind…my only regret was NOT joining the Part 1 MRCPCH preparatory course (which was the very last time my Hospital & HOD organized it for!) while I was a HO in the department. I didn’t hear about it sooner, and it was too late to sign up for it when I entered the department…

***

So, I heeded my Paediatricians’ advice and ventured OUT to the wild wild jungles (okay..I exaggerate – it was just to the ‘Forever-Land’). As I have mentioned in that post, I had an epiphany during a getaway I initiated with brother & my friends.
2009…July: I needed a Break from work. I love Nature – the wilderness, and tranquility of a reserve forest excited me. So, the biggest National Park it was! (Taman Negara, Pahang). It also happened to be the RoadTrip that gave me immense confidence to start travelling here, there & everywhere, on my own 😉

Little did I realize it would turn out to be a soul-searching trip! It was good to reconnect with a friend I met in Uni, whom I parted ways with, and met after donkey years via this trip. Henceforth, she has become one of my closest and best buddies!
Her maturity and questioning, and me sharing my experiences as a HO etc etc…it suddenly dawned on me – It was an EPIPHANY, you could say!

I realized…I wanted to do Paeds! At least give it a try…before that I was divided between Family Medicine, Palliative Care, and Paediatrics…or even teaching – but after I decide which field I want to focus on!

***

From a blurr and confused person who entered the jungles of the National Park, Pahang; I came out a completely different person.One with a plan of action…

I made the choice out of my own free-will, without any external influences, fully aware of the possible repercussions…the sacrifices it would take, on a long winding path.
What i didn’t anticipate was a policy change that would frustrate me…and make me leave merely 20 months’ later.

***

I then submitted my transfer letter and decided on which hospital I wanted to apply to. Started speaking to my hospital director, to the HOD of Paeds there then, and colleagues there, conveying my interest…I was adviced to take the Part 1 MRCPCH exam – which was my intention already.

*

MRCPCH – …and so I did, while still in district. First attempt – kantoi! Okay…I didn’t have much experience…and with the limited study break I was granted, hmmmph. I shouldn’t be too harsh on myself.
Anyways, it was my first attempt. Will try again when I am IN THE Department.

***

FINALLY, after what felt like a war – 10 months after I submitted my transfer letter, I was out of Forever-Land!
(My district hospital’s director proved to be real pain, who did things behind our back to postpone our transfer! She kept me & a colleague longer than necessary, in the name of teaching the juniors – I retaliated by refusing to do on-calls during my period of extension, as compared to my original transfer date.)

Into Paediatrics department of Heritage City Hospital. The first hospital in Malaysia. Everytime I consciously THINK OF THIS FACT, I feel PROUD 😀 It is just the FEEL of WOW – I am serving in the Oldest Hospital in the Country!
I wonder if others did too *shrug*

Do I sounds weird? :p
So be it…

*
I enjoyed my learning curve during my stint there. I had awesome specialists & colleagues! Often we were short of Medical Officers. A series of EOD (every-other-day) oncalls weren’t a rarity – nope, I wasn’t being bullied, as after some time, I was the one entrusted with the MO’s duty roster.
(I didn’t mind that the least bit…in fact, I tried to be Fair to all, and hardly received any complaints. When I did, I tried my best to rectify/accomodate the situation. The same can’t be said for when my ‘duty’ was changed to overlook the HOs rosters! OMG…a nightmare that was!
– coming soon to this part.)
I even attempted MRCPCH Part 1 for the second time – in vain! Sigh…I knew I wasn’t well prepared 😦 Some personal factors involved. When one sheds tears and feels heavy hearted on most days when one is on one’s own…especially so upon opening the book, with a restless mind & a ‘guilty’ soul…HOW TO STUDY & PASS! Grrr…I only have myself to be blamed, for not being focused enough on what I was pursuing!
I was weak & foolish enough to allow my external factors to disrupt my peace of mind – I didn’t have sufficient mental strength back then, no totally Ignore! Indeed…often in Life, Ignorance is Bliss – when things are beyond your control/ powers.

*

I wasn’t going to call it quits just yet…hey! The journey has just begun!

I felt like I was firing bullets randomly in every direction. While having applied for the MRCPCH preparatory course in Muar in early 2011, I applied and went for the Masters in Paediatrics entrance exam. That experience left me feeling like a moron!  WHY?
When it was an open secret that an entry into the local Masters of Paediatrics programme is a sure-thing for everyone who attends the interview exam…and you are among the only TEN people who failed it
(TOLD YA, T/F MCQs with negative marking and me…we are just WORLDs apart!!!).

And a lady in the interviewers’ panel made us feel so dumb!
Her words I will never forget: “This exam is at the level of a Final year Medical Student! Are you all sure you have Paeds experience? First year exam in the programme is even tougher…if you can’t make through this one, that will be impossible. We are here to weed out potential failures, as the rate is hightest in first year.”
All along, I thought to myself : WHAT A B*ITCH!
(What kind of Teacher is one who fails to motivate, and inspire. In contrary, make someone feel like an imbecile & soooooooooo demotivating! Of course I could have rised to the challenge and proven her wrong the very next year, but…– I had enough of that ‘I suffered, so thou shall too’ MENTALITY! Typical sadistic Malaysian mentality *ptui – disgusted*. I walked out of the Interview room promising myself I shall NEVER apply to be a part of that kind of fraternity.

PERIOD)

But the Top-man was totally different. All the men in the board were 🙂 They were sooooo encouraging, asking us what do we think the problem is. And motivating us to TRY again next year!

What ran through my mind was this: If I had left more questions empty, perhaps I would have gained a few more marks? But does that mean that I know more? And the answers that I changed, perhaps was a result of overthinking…can we discuss the answers?!!

I didn’t voice it out, as I was beyond SHOCK & feeling like a Total FOOL!
And after the jokes by colleagues that perhaps my name was left out of the order (while they were calling us in batches for the group interview – and I was left for the ‘last group of Failures’) because we made it up to ‘Distinction List’!
LOL – I already had that nagging gut feeling…

And there went my ‘dreams’ of being a masters student for that June’s intake. I was the only one who didn’t make it for the entrance exam from my Hospital. Somebody more junior to me in experience got it, but what is the point when that person quit within the first few months? After all the talks about it being an easy exam – further making me feel like a fool. But, I know myself…I tried not to let all that bother me. That was January 2011.

*

I attended the PART 1 preparatory course a few months later, and slowly but surely started revising whenever possible – not much, but SOMETHING!

And I was planning to attempt it for the third time, when I felt truly prepared…targetting Feb 2011. This time, it was a personal high-expectation of DO-OR-DIE! If i didn’t make it, I will leave for another field – that much I was certain, a promise to myself.

***

The third attempt itself didn’t materialize. I quit Paediatrics before that. Not because I failed to stand up to my own set-expectation. Not because I lost the passion. I STILL LOVE KIDS 😀 But for myself…Selfish? *shrug*
(More on this later…)

owe kid my best

And for every kid that I see, I suspect I am willing to go an extra mile, compared to adults (I will tolerate a whiny kid anyday, compared to a grumpy adult, or one who behaves like a kid!) :p

***

There is ONE MAJOR aspect that I haven’t spoken about.
HOUSE-OFFICERS 😀

Majority of them were more like a friend to me! 😉 Especially the first few batches who worked under me. Isn’t it an irony that even when you are still learning, you feel responsible to teach another? And I did it joyfully, as long as the person was willing to learn…and forcefully, when THEY HAVE TO KNOW certain things for goodness’ sake, for patient care!

But from one of the nicest MOs in the department, I guess I evolved into an ogre over the months.

Let me share some comments from the horses’ mouths:

<My Early-days>
A colleague : Some new MOs are being too nice, going for meals with the HOs etc. I think we need to all be consistent in ‘teaching’ them and not being too friendly.

Me & another colleague knew she meant us. And in our defence, as we were close to the HOs, we know their ‘issues’ and it was easier for us to approach them. Rather than just sitting down and speculating.

<My MID-days>
– A HO who was doing MO call, due to shortage of MOs : Dr. Lavanya, won’t you ever get angry? My colleagues doing is even pissing me off. How come you are tolerating it? I don’t have your patience.
– A HO who is now in 1st year Masters in Paeds, S (time and again she had reminded me of this: Dr. Lavanya, you were one of those who inspired me to take up Paeds, during my housemanship.

WHAT AN IRONY! Although I eventually left, I have managed to spur some others on…Aawwww….that feels good.
Wonder if I did inspire anyone else besides S 😉

<My LAST-few months>
– 
Conveyed by an ex-colleague who was a radiology MO by then: A paeds HO who came for reporting was asked who is the garang (fierce) MO now (as the ones in the past weren’t there anymore)
The answer – 3 sekawan! 2 Malays (my friend managed to guess them) & 1 Indian MO (my friend honestly thought it was the new-girl…and was SHOCKED to hear it was me!).
LOL…this was someone I tagged with, and began my career as a Paeds MO together with :p

– Just earlier this year, my brother (currently a HO) to his new Ortho MO (a girl trained in the Heritage City Hospital) : Doctor X, do you know my sister? (her first posting was Paeds) I think she must have still been there, then.
Dr. X: (upon hearing my name) Dr. Lavanya…GARANG (fierce)

Ouch! That did hurt a bit… to know that is the kind of impression I have left on some. But I have to admit that person did get it at times from me. But none like P, who got the worse from me…and thanks to him, the OGRE in me came forth!!

*

The reason I Quit: In summary – FED UP & Super Frustrated WITH THE SYSTEM!

  • Paeds had become a dumping group ‘to train’ problematic HOs! Just because we are generally kinder, doesn’t mean we can be bullied. 3 problematic HOs at one time!!! ARGHHHHHHhhhh…and by then I was in charge of overseeing their rosters.-With the implementation of shift system, some became super calculative of their Work HOURS. Excuse me…I NEVER once (during my career with the Ministry of Health) counted my working hours per week!
  • ONE particular HO deserves my special mention, P. He should have been evicted from the system from our department itself…but nope – the outcome is very disheartening. And to imagine that my department ALMOST released him, as after 1 year of having him in the department, everyone was sick and tired and just wanted to get rid of him, I guess. *shudder* That was ONE memorable occasion where I stood up & fought for his extension & eviction from the system. Along with another, who was basically non-functional & totally unfit to practice medicine!

You won’t believe how difficult it is to get someone non-functional out of the system, but do they care a-damn for those of us who resign? Leave the country? – Nope. Until Talent-corp offers dangling carrots to rope you back home. Nobody will feel my brain drain…I doubt my brain has contributed much to this country, anyway! :p

  • It was NO-NONSENSE for me! With the (then) new shift system run for one month in Sept 2011 as a trial-run, everyone agreed it was a failure! Had more bane than boon.-Earlier on, 3 hospitals nationwide that had trial runs came up with the same verdict. But guess what, in the most ridiculous way as only Boleh-land can do…beginning November 2011, the HO-shift system was forced down our throats!That was when I lost it – what kind of leaders implement something when ALL the affected parties voted against it? So much so for democracy, just as we saw during 050513! *ANGRY*
  • A conversation among a paediatrician & a consultant (both whom I have a lot of respect for, though I have never directly worked with them before) during a course in Tin-city Hospital in November 2011 allayed my doubts and made me firm in my decision to Quit.“There are alot of experienced MOs leaving. We have gotten ourselves too deep into this (Paeds) to leave…”, said the Consultant to the Paediatrician.
    That felt like another moment of Epiphany for me! Perhaps it is a BLESSING IN DISGUISE that I failed all those exams this past years…?

***

I asked myself ONE Pertinent Question, looking at my specialists who have come thus far, but still a victim of the System!  I asked myself: If I persevere & get Lucky, and become a Paediatrician in 4-5 years time, will I Be HAPPY?

The answer, as optimistic as I tried to be…I couldn’t visualize one speck of HOPE for a Positive answer. And SO, I decided

*

So, there was NO turning Back – it was only ONE WAY for me Now…it all began with the decision to leave the country, and then to quit Paeds.

The very month I was intending to give the paper one last try, I RESIGNED from Service.
Not as a sore loser…not because I failed myself (I haven’t even taken up the challenge to myself, as in the third attempt), but as a dreamer, an opportunity-grabber who was sick and tired of the policy-makers high up there mocking on us at the ground level

And my external factors disturbing my heart and soul commenced once again at the end of 2011 – the very same time when I FINALIZED my Decision to pursue ‘The Big Adventure’!  (more on this in a future post).

All that motivated me was not the pull-factors, though people claim there are many….all that spurred me to do this were the PUSH FACTORS – 2 major ones.

As someone just asked me today: “MERAJUK?”  – Spot on! With the SYSTEM & my personal vendetta (I am not ready to write on the latter topic – too much of heartache sustained, and inflicted. It took me 7 to 11 years to put into words my ‘experience’ during Uni life, so I will let time decide if I am ready to write on this Topic, k :)).

*

Lesson Learnt:
– You don’t have to be a Conformist. DARE to venture into the unknown – you will be rewarded.
– Quitting doesn’t mean you are a Failure. Sometimes, it is because you are doing yourself a BIG Favour!
– You can’t please everyone…when all else fails – RUNAWAY! In the name of ‘adventure’…
Peace be unto all, may my actions Never hurt another, ever again.

– I may have left the department, but I left a piece of myself behind. My box full of books, notes, and past year Qs…I was happy to hear that my colleagues and current MOs are benefiting from the-box’s content! And I was JUBILIATED to learn that a good number of my ex-colleagues have passed their Part 1 MRCPCH exams recently – I will continue cheering them on, although I have bid “RIP” to my once dream of becoming a Paediatrician.

when we Pray...
 Thank you, God.

End of Flashback #4

P.S: When all is said & done, I had a lot of memorable moments and story during the 20 months’ stint. Shall share some other time…

Children, aren’t they just sooooooooooo Adorable!? And mostly Innocent? 😉

hey doc, not mp3 player

 Disclaimer: I TOTALLY Believe in LIVING IN THE PRESENT. But these flashbacks are Essential for me at this point of time. 
Each of these are 
‘soul searching’ walk down the memory lane which I have to embark on to lift the transparent veil clouding my heart and soul lately. .I suspect THIS is the real reason for my insomnia!
The best way for me to unravel myself is through WRITING & you are welcomed to join me on this Flashback Journey.
Not to brood over.. but to learn from!

If I manage to inspire someone, or prevent someone from making the same Mistakes I did. .. Mission Accomplished as a Writer ▪

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One Response to Paeds & I

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