Month: November 2011

3 Things My 3-year-old Taught Me

27 November 2011

This weekend my darling wife went away interstate for a training conference. Some Infectious Diseases clever doctorish stuff. Things we surgeons just do not understand, or even wanna try to understand. I always think, there are only 3 antibiotics in the world anyway, so why spend a beautiful weekend attending conferences on those 3 antibiotics?

So it was left with the trio of Father, son and the wholly MacDonald’s. (Noooo…. don’t worry, we did not go to MacDonald’s at all this weekend.) Anyway, we both survived the weekend. Mommy was surprised we both maintained healthy weights.

During the weekend, my son taught me 3 little things. I’ve been taught these things in the past, but being the simple surgeon that I am, I always need frequent reminders.

1. The Discipline of Unhurriedness

As a trainee surgeon, time is limited. I’m always in a hurry trying to get things done. I have books to read, jobs to do, patients to cut, research to complete, etc, etc. I often have the problem of bringing home that kind of surgical mindset and applying it to the general running of this household. I need to remind myself that this is not a hospital to run, but a home to enjoy. I need to stop being in a hurry. My plans for a 7am wake up, 7.30am out the door for breakfast and 0815am arrival at the Aquarium were not appreciated by my son. He wanted to chill. He wanted to take time choosing his cereal. He wanted the cereal sprinkled across the kitchen room floor. Then he wanted to run around the house in his nappies expecting me to run after him in my underwear. It didn’t matter what jobs we had to do and how much we had to accomplish by the end of the day. We just needed to play. There wasn’t a list of Reminders and To-dos. There was just me, and him. And I admit I had to fight this surgically-trained urge of goal-oriented time-managed behaviour. I had to let time go. I had to be unhurried. It was not time ‘wasted’. It was time ‘invested’ in my son.

2. HIS Happiness Matters

My workplace is full of sickness, pain, diseases, blood, sputum, saliva, snort, negativities, stress, complaints, anger, frustration, etc. Sounds like I work in a bank. No, hospitals in general aren’t the happiest place on earth. Hospitals are full of the egos of doctors, the pride of nurses, the pain of patients, and the anxieties of families colliding. It is a highly charged environment. So when I spend a weekend with my son who smiles and hugs me and says, “I love you, daddy”, that softens my calloused heart. My son’s happiness detoxifies all the poison that I’ve drunk during the week. My son’s happiness reminds me that all the hard work will one day be worth it as long as I keep my life in balance. My son’s happiness does something to my heart that no amount of fame, fortune, alcohol or even the most successful of operations could ever do. My son’s happiness reminds me to be humble and to strive for the simple things in life.

3. MY happiness matters.

Twice this weekend my son asked me, “Are you happy, daddy?” Almost brought tears to my eyes. He must have known that I am a surgeon. I am always angry, upset, uptight, obsessive-compulsive, and short-tempered. He probably sees me angry more often than happy. He knows that I bring home the stresses and demands of work. This 3 year old just wants his daddy to be happy. How could a 3 year old know that? He does not like being near an angry daddy. He wants me to be happy. My happiness matters to him.

And how often does my happiness matter to my wife, my son, my family, my workmates and my patients. I have been asked many times at the end of an operation by patient’s families if I was happy with the outcome. Patients do rely on a surgeon’s happiness for their sense of hope. Nurses sometimes say at the end of an operation, “you’ve gotta be happy with that.” Even the surgical team takes pride and walks out happy when they see the surgeon walks out of theatre happy.

My happiness matters. Not in a self-centred egoistical way, but in an others-focused way. My happiness does matter for others.

Thanks, my lovely Little E.

Fitness Program Application Form

11 November 2011

The other day, I was (gently) dobbed in by my wife to join an exercise program at the local gym. She thinks I’m getting too old and fat for her. We’re like Beauty and the Beast, she said. As part of joining up, I was given a form to fill in. Here’s my application and health questionnaire form including fitness assessment. Are you impressed at my fitness level? I’ve tried to be as accurate as possible.

 

First Name: Trainee

Surname:  Surgeon

DOB  _25/09/2001_      Occupation:   Social Media Activist

What would  your fitness level to be at this moment? Please circle closest number.

1        2       3        4       5         6        7       8       9      10      25 (incredibly fit)

(unfit)             (moderately fit)                     (very fit)

List any exercises you currently do and how often in a week

Type of exercise: Upper limb

Frequency/week: 3 times/day lifting BIG Macs

When was the last time you exercised: 1975

Which time of the day would you prefer to exercise: (Really, is this a serious question????)

  • early mornings    o late mornings    o  evenings  □ When I’ve got nothing else to do.

What would you most like to achieve in this fitness program:  Pls circle.

o Weight loss    o Muscle tone   o Cardiovascular fitness   o Flexibility     o General Wellbeing

  □ All round macho, macho man

Others not mentioned above: Really, all round macho, macho man

How hard would you like to work:     Please circle closest number

1          2           3             4             5             6            7             8              9            10

(not hard) (duh!)                   (moderately hard)                                    (very hard)

What are your health and fitness goals and when approximately would you like to achieve them?

My wife married me for my good looks. I would like to look even hotter for her. If possible within the week.

Would you like some guidance with your current eating pattern?    Yes       No, I’m happy with the local MacDonalds and KFC.

Are you pregnant?      Yes        No      NA     If   Yes, how many months? _

Are you trying to conceive?     Yes      Wife said NO!

Are you a smoker?    Yes      No     If yes, how many cigarettes a day?

Do you have any form of heart trouble?     Yes, my wife broke it the day I saw her.         No

If Yes, please detail type and symptoms: Palpitations, broken heart, hopeless romantic

(chest discomfort, unreasonable breathlessness, dizziness, fainting, blackouts)

Have you had high blood pressure  >140/90mmHg?   Yes, sometime during that honeymoon trip    No

If yes, are you BP medication?   Yes        No

Are you diabetic?      Yes         No, but I really am a sweet man.  

Do you have asthma?    Yes        No

Do you have epilepsy?   Yes        No

Do you have back problems?   Yes       No, but maybe after the exercise, yes.

Do you have any existing injuries?     Yes    No

If Yes, please describe briefly Severe generalised musculoskeletal pain after washing the dishes, laundry and vacuuming last week.

Do you take any prescription medication, pills, tablets or supplements?     Yes   No      If yes, please detail below:

If you have answered Yes to any of the above question, you may have to obtain medical clearance from your doctor before commencing exercise.

Of Phones, Pagers and Positions

8 November 2011

I still remember carrying my first pager as a medical student. It was such an honour. I almost felt like I was finally someone important enough that people need to call me. Funny I felt that way, because the pager was really there just in case our tutors needed to change our tutorial times or locations. But still, I was proud. I fantasised about getting some pages from nurses desperately wanting me to help them resuscitate a patient, or of emergency departments wanting me to attend to a trauma call. Those pages never came. A few pages we did receive asking us why we were late for tutorials.

And then I actually became a doctor. I started  getting ‘real pages’. But after a few days of feeling all important, those pages became an annoying interruption to my day to day work life. “Please take blood on bed 5”, “IV re-site in ward 5”, “Drug chart lost, please re-write”, “Patient fell off bed, pls review”, etc, etc. The pager became a constant annoying interruption to my activities. I remembered a day when I was operating and had trouble with a life-threatening bleed while receiving more than 5 pages about scripts, discharge summaries, admission forms, and other menial paperwork tasks. The ward clerk wanted to fax the papers before lunch. The nurses wanted to administer the drugs before morning tea. And I needed to make sure my patient on the operating table wasn’t dying. I couldn’t have answered the pages, but still, the nurses weren’t happy with my late reply.

A study (Westbrook, et al.  The impact of interruptions on clinical task completion. Quality and Safety in Health Care, 2010) has shown that doctors are interrupted on the average, 6.6 times per hour. We get interrupted every 9 minutes or so! 11% of all tasks were interrupted, 3.3% more than once. Doctors multitasked for 12.8% of time. The mean time on task was 1:26 min. Interruptions were associated with a significant increase in time on task (We take longer!). And doctors failed to return to 18.5% (95% CI 15.9% to 21.1%) of interrupted tasks. Every 1 in 5 tasks don’t get completed. (We forget to finish the chart, left the tap running, left the sharps on the trolley, zip up pants, tie our scrubs, finish shaving legs, etc.).

And then I started being the registrar on call for the hospital. I did general surgery, plastics, urology, vascular and of course, ENT. When I was on call, the hospital had my mobile number and home phone number. I went home, but was always interrupted by phone calls from the hospital. Dinners were interrupted, TV was interrupted, even vacuuming was interrupted (my wife is laughing cos she has never seen me vacuum). These interruptions came at any hours of the day and night. Getting calls about nose bleeds and ear aches at 4 in the morning is just not nice. But I have to be nice on the phone, don’t I? Otherwise other doctors and patients will complain.

Those who call me at 4 in the morning probably do not realise that I am on call on top of my usual day job. I still have to do my operating despite having been in and out of the hospital 2-3 times overnight. Can you imagine me operating on you with only 2 hours of sleep?

So as I climbed up in my position, my pager and phone became the yoke I have to carry, the cross I have to bear. What started off as an item of status and position has now become a reminder that I am here to serve, help and assist. Yes I am on call. In all honesty, I hate being on call. But it is my duty and my privilege. Yes, I am ready to be interrupted. Despite my tiredness, I shall attempt to help you.

Doctoring isn’t for the weak-hearted. It is also probably not for those who can’t multitask and be easily interrupted. Yes, I am a Surgeon, Interrupted.