As my time in HKL comes nearer to an end, there is much to reflect upon.
Currently in a posting notorious for its busyness (other admin stuffs), despite being a little depressed at the beginning of my rotation, I am glad. I am thankful to be able to do many cataracts and work with a team of good people. It’s a Monday tomorrow and usually I will be sleeping by now as I have to prepare myself for OT tomorrow. One case only la but I can’t sleep.
I am just thinking. No surgeon will want a bad outcome. It is a horrible experience for the patient and it’s most often than not, permanent. I was just thinking of a patient CM told me during her recent review. Patient was left aphakic intraoperatively due to PC rent and vitreous loss. While with a +10.0D lens, BCVA of 6/6 was achieved, a subsequent secondary IOL implantation did not help regain the patient’s vision. The story was that another surgeon offered to do the case but the newly minted specialist was confident in proceeding with the case. I believe that everyone deserve to learn —simple or tricky case. They are steps that we have to take to emerge as better surgeons. But at the expense of what, I am not sure. God, I can only pray you will answer my parents who have never failed to pray for me during those OT days. Please, let me have the skill and humility to bring out every good intention I (we) aspire for the patients.
Which brings to the next case. Anita and I saw a young girl who was referred with 2/12 history of LE acute onset exotropia and found a suspicious retinal mass with inferior retinal detachment. She broke the bad news to the poor mother who started sobbing and while walking home, she told me how much she felt for the mother as she also has a daughter. It then struck me that I was nonchalant. To me, it was something ie further investigations to be done in order to determine the type of tumour and if there was any mets and treatment to be commenced. Suddenly, I realized that medicine has turned me into a robot. It’s always next next and then next plan/action and I was shocked, ashamed and terrified. What have I become? Have I been drowned by the numbers of cataracts to fulfill, the retina fundus that needs to accurate for my superior, the retina block that needs to be executed perfectly etc. Maybe it’s the time, it’s the period, it’s the age that I suddenly felt vulnerable again even though I thought exam has long passed. The one thing that constantly come back and haunt me even until the age of 35. Ok too much emotions. Period.
Later that night of my last call in HKL, SL called me to inform me about an Indonesian guy who had LE full thickness laceration wound with canalicular involvement. It was horrid to see so much tissue loss and a huge chunk of his face/periorbital region covered with blood and degloved. At 3am, I told SL “ADMIT ADMIT LET’s GO IN”
Unfortunately, this foreign worker has no money for admission. Neither does he has money for procedure. Looking at his state, I don’t think anyone will have the heart to charge him or send him home without stitching him up. So, the very green me and SL tried our best (despite the tissue loss) and also begged plastic (thank you for coming) guy to come and stitch up the deep tissue lateral to the eye. The patient was amazing with super high pain tolerance. I think ED didn’t charge him in the end. Reflecting, I just hoped that he has minimal lagophthalmos and I really need to brush up on my suturing.
Maybe it’s time to take up some hobby or sports. My swimming BD routine is not even helping me to relax that much. Don’t mind me swimming is a great sport. The first plunge into the freezing pool at 6ish and night time is always difficult but that moment of chill hitting the body and then my brain makes me feel truly alive. It gives me clarity going through my thoughts and even talking to God. I think i will miss this time a lot. Please give me somewhere with a covered swimming pool 🙂
Ok signing off. Goodnight. Pray for a good OT day tmr. Fingers crossed. Thanks mum and dad for always praying for me I love you.
Doctor on FIRE 