Journal entries from my rotation in general medicine:

• • • We’re on patient 12 out of a long list of 23 to review on the wards when Dr Sugar gets a call that a twenty-something-year-old guy who was admitted after taking a cocaine overdose was unstable. We speed-walk to the other side of the hospital and find the unconscious patient surrounded by a crowd of clueless nurses attempting some new XYZ approach – since they clearly don’t know their ABCs. We somehow stabilise the guy and transfer him to ITU. His mother is waiting for us outside, distraught and in shock. “How could this happen?!” she asks, still in complete denial. “It wasn’t even a spoonful!”. William, Dr Sugar, and I exchange a look of utter disbelief. “Cocaine! He takes cocaine! I give him a spoonful myself everyday so he doesn’t take more than he should,” she pleads. “I sprinkled as much as you would pepper on a plate of pasta,” she insists. At this point, she could’ve said it was the coke fairy delivering drugs to her son and it wouldn’t have phased me. “And I always make sure the silver is clean!” she goes on. Dr Sugar pulls me aside and asks what she means by “silver”. “Perhaps the spoon?” I answer, stupidly. “Of course it’s the spoon, you idiots!” the lady snaps from her moral high horse.

    • I’m showing a med student how to insert a cannula. The patient is really kind and reassures him that she’s had a million and one IV lines over the past six months and that it’s no big deal. I demonstrate the technique and tell him he’ll be doing the next one. Little did I realise blood was spurting all over my trousers while I was explaining how easy it all is.

• • • Dr Sugar is trying to teach some med students the difference between a tympanitic and a dull sound on abdominal percussion. “What kind of note is this?” she asks. “C major?” I answer. I think it was the first time I ever saw her frown.

    • “Kindly lie on the bed so we can examine you.” The patient proceeds to lie on the bed horizontally.

    • Mr Miles is a frequent flyer. He comes in with congestive heart failure every other week. We treat him, offer lifestyle advice, and optimise his meds, but he never adheres to the plan. I figured using progressively larger cannulae each time he came in might work as a deterrent. I’m now up to a 14-gauge needle – meaning I’ve officially run out of sizes.

    • We’re paged to see a psychotic patient. He breaks free from security and heads straight toward Dr Sugar. “Where the hell are my lungs and what the hell did Christ do with them?!” he shouts, fist raised. Without thinking much about it (fuelled largely by my infatuation with Dr Sugar), I step right in front of her and motion him aside. It wasn’t my intervention that de-escalated the situation though. Nope – it was the nursing officer launching herself at him with a sizeable syringe full of sedatives.

    • One of my patients has been transferred to a makeshift ward that used to be the hospital staff canteen, opened to accommodate the rapidly increasing influx of COVID-19 patients. Positioned right in front of a glass wall facing the sun, she’s now a good five shades darker than she was a week ago. Guess that’s one way to get a tan.

    • I get paged outside of my working shift hours. “Hi doc, I know you’re not on call, but you’re the best person to ask…”. Since when did I become a point of reference for nurses? Maybe I shouldn’t be as friendly and approachable as I am.

    • There’s this one notoriously horrible ward where you really don’t want your patients to end up. As fate would have it, one of my favourites was transferred there. He’d recently been diagnosed with COVID, and while he was stable, we needed to monitor his oxygen saturations closely. Day after day I’d go to the ward only to find the nurses hadn’t charted them. Turns out they’d lost the pulse oximeter and never bothered to get a replacement.

    • William and I used an online voice-to-text app to prank Dr Sugar. We told her we were calling from HR and that she’d exclusively be taking care of COVID-positive patients from now on. We hung up before she could protest, only for her to barge into the office minutes later wearing the saddest, most defeated expression I’ve ever seen. No more pranking her.

    • My friends and I have recently started using cutesy nicknames for commonly prescribed drugs – like Zoley for omeprazole and Moxy-Cloxy for co-amoxiclav. Watching a nurse’s face after instructing them to give twenty milligrams of Zoley is absolutely priceless.