General Surgery – First Day
II.I.I
FIRST DAY
The beginning of my second foundation year felt a bit like a fresh start. I’d be working in general surgery once again, but this time round I’d be doing it in a different hospital, on the island of Gozo.
Gozo happens to be Malta’s quieter, greener, and more introspective sibling – an island that moves at its own pace. It’s much smaller and more rural than Malta, with rolling hills, terraced fields, and a coastline that feels raw and untouched. Life here revolves around villages rather than cities, and almost everything is within a short driving distance. That compactness shapes daily life: fewer people, fewer layers of bureaucracy, and far less of the frantic urgency you get on the main island. Things happen slower, but they still happen – just without the constant background noise.
As heart-wrenching as having to part ways with Emily was, I can’t quite say I wasn’t excited about this new venture. I’d be leaving the stale, uninspiring environment of the hospital in Malta for a new one on a different island. I may not have realised it at the time, but I really did need a break from that place. The culture of fear, the toxic workplace, all the gossip and the drama, the chaos and the commotion. It was all getting too much.
And so, with a fully packed suitcase, I set off to Gozo for the upcoming three months. I’d be staying in an apartment with three other house officers – people I was already well acquainted with. Whilst I wasn’t actively looking for comfort, it was definitely quite cosy, and we felt right at home from the very beginning. Granted, I didn’t have high expectations, given that it was fully paid for by our healthcare system, and I for one just wanted to have my own room – somewhere I could study, read, write, watch series, and enjoy some much-needed privacy. And I had that, so yeah, already a good start.
This new hospital… let’s just say it was nothing like the one back home. I mean, yeah, sure, its general layout was basically the same, despite being much smaller and lacking in more ways than one.
One striking difference was that instead of dedicated medical, surgical, and other specialty wards, there was a general male and female ward (so much for gender neutrality), alongside the critical care unit and the gynae, paeds, and ortho ones. I’d be working with Mr Vladimir, a Ukrainian general surgeon, and Wayne, this cool, chill-as-hell guy who’d be my senior.
As always, I was first to arrive. I wanted to take a good look around, orient myself, and do the pre-round I’d gotten so used to, just to get to know my patients well before officially starting. I introduced myself to the nurses, who promptly asked me to join them for the daily recital of the rosary. At that, I practically scoffed, thinking it was nothing more than a joke. Turns out, it wasn’t. I guess my refusal didn’t exactly amount to a great first impression.
I guess this was the culture shock I had been warned about. You see, Gozo is known to be more rural – its people perhaps slightly more conservative and old-school. Catholicism isn’t just present here – it’s woven into the fabric of everyday life. Village festas, church bells, statues carried through streets, and yes, the occasional rosary before starting the day aren’t unusual. Family ties run strong, people know each other’s business, and reputations matter. That closeness can feel comforting or claustrophobic, depending on where you’re standing. With my best friend – Momma Bear – being Gozitan, I was somewhat prepared for this.
I guess what I wasn’t too prepared for was the small-island dynamic of its hospital. Turns out, this one functions more like a large community hospital than a tertiary centre. Resources are limited, specialties overlap, and staff often wear multiple hats. Doctors and nurses know their patients personally, sometimes across generations. There’s less defensive medicine and more pragmatic decision-making, but also fewer safety nets when things go wrong. In fact, complex cases are frequently stabilised and transferred to the main hospital in Malta.
It would certainly take me a while to get used to all of this. But the very fact that I wasn’t in Malta any longer was already a beacon of light for me.
After shaking the whole rosary thing off, I got busy with the usual stuff. I fired up the computer, loaded the patient list, realised I didn’t need to print it on account of having just four patients under my care, and proceeded to read up on them and scribble down all their bloodwork, which effectively took me about ten minutes. After that, I went around the ward, rounded on the patients, and just like that, I was done.
Having worked with Wayne before, we forewent the usual pleasantries when he came in. I briefed him on our patients, prompting him to have the first and only meltdown I’d ever seen him having: “Woah! Dude, calm down! This is Gozo! You have to take it easy over here!”. In fact, he didn’t wanna hear any of it until he poured himself a cup of coffee and made a toast. By that time, Mr Vladimir showed up – who pretty much echoed the same work ethic.
Clearly, being the overzealous, high-strung kinda guy was gonna be of no use there. It took us another ten minutes to finish the real ward round, and after that I was basically off the hook for the entire day. I knew this rotation would be a less busy one, but I certainly didn’t expect to finish that early. The other house officers didn’t seem to have it any worse, and after a couple of hours we had already assembled at the staff canteen.
Completely conscious of the fact that there would be busier days ahead, we still knew this was gonna shape up to be one of the best rotations we’d ever have.