The Plight Of Housemanship Part 1

I just read an article, from Wayang Party, consisting of an unnamed doctor’s reminiscences on his hellish houseman year. Boy did it bring back a ton of memories.

Housemanship year in Singapore is divided into three postings of four months each. Each posting is a different specialty, such as general medicine, general surgery, orthopedics, etc. Guided by rock-solid hearsay and nail-devouring anxiety, fresh grads choose their poison and then spend the last precious month of pre-work freedom performing various last acts.

Then hell begins.

“A typical day begins with daily ward rounds at 8am. The house officers usually arrive half a hour earlier to prepare the case notes, familiarize themselves with the new cases and to trace results from the previous night.

The ward round which is often intimidating, seldom ends before 11am and sometimes stretches pass 12 noon if the cases are complicated. Then begins a day’s mundane work of drawing blood, doing ECGs (there were no phlebotomists or ECG technicans in those days), typing discharge summaries, arranging for urgent CT scans, talking to patient’s family etc.”

Oh yeah.

“If one is lucky to have lunch, it usually means a quick bite at the caferia provided the nurses are kind enough not to interrupt you during the precious few minutes when the new admissions will start to come in at the same time.”

Oh yeah. The takeaway-coffee lady was always my best friend.

“We had six to eight night calls a month which start at around 6pm and end at 8am the next day after which you are still expected to work till 1pm before you can knock off if there is enough manpower.”

Oh yeah. Night calls, by the way, are in addition to the normal day’s work, so you start work at 0800 today and (in best-case scenario) knock off at 1230 tomorrow, then continue business as usual the day after.

When you’re on-call, you function as (very thin) cover for the assigned wards, in which admissions, blood-taking, reviewing, collapses, and sometimes death, go on happening. These things are no respecters of time.

I remember the days when I would be too busy to even pee till 10 p.m., and then for every minute I spent in the loo, my damn pager would go off at least once, each beep signalling something else to do in some other ward.

The average amount of rest per call I got that posting was maybe half to one hour. The on-call room in that hospital contained two single beds and I was the only girl that posting… but at 4 a.m., in a state of exhaustion, I never had the energy to feel discomfited at the presence of a snoring fella in the same pitch-black room.

At worst, there were 9 – 10 calls a month, so we spent the whole time being pre-call (= anxious), on-call (= hounded), post-call (= dead), pre-call, on-call…

“I still remembered the Head of Department telling us during the orientation that “post-call” is privilege, not a right. Very often we don’t get to leave early after a hectic night deprived of sleep or if we do, in the late afternoons around 3 to 4pm.

You have to experience it for yourself to know how it feels like to be without sleep for 36 to 48 hours. Your mind gets switched off, your eyelids go drooping all the time and you get irritated very easily. The body craves for sleep and yet you have to force it to be up and running. There was once I dozed off at the bedside of a patient while talking to him!”

That year, I had my hair chopped uncharacteristically short, for reasons I can’t even remember now. My weight fluctuated like today’s oil prices. I stopped wondering why there were so many reports of housemen having breakdowns and attempting suicide. There was the potassium chloride, and there were the syringes, lying oh-so-casually in every treatment room in every ward.

“A Singaporean medical graduate from Australia quitted only after one week in the ward. On her first night call, she was so overwhelmed that she locked herself in the call room and switched off her hospital handphone. She was expectedly haul up the very next day to face the music dished out by the Head of Department who obviously didn’t take kindly to her ”AWOL” . The last I heard of her is that she is now working in a hospital in Melbourne and has settled down there.”

As much as I would hate having a colleague like that in this warzone, part of me empathizes. I was very often on the brink of giving up myself, what more someone steeped in a foreign culture?

Unexpected disappearances still happen. About a year ago, there was a ‘junior consultant’ from India who decided to come and try things out. He wore a business jacket and seized every chance to spout high-falutin theories, which endeared him to nobody, but which at least looked like signs of capability. He returned to India after about two months.

My recent favourite is the German doctor who impressively managed to get enrolled in the local registry, instead of being relegated to the ‘non-traditional source’ pool. He snagged a position in one of the best departments, turned up for observation sessions, asked decent questions and tried to be helpful. During formal orientation, he was brought to the wards. The next day, he vamoosed back to Deutschland. No more Doktor for us.

Too bad. I’d heard he was cute.

To be continued… thank you for reading this! I’m not quite done yet. I need to go put my fingers in ice water and recharge before coming back with Part 2 tomorrow. Stay  tuned. :)