Metcall. Metcall. Unit: Cardiothoracics

Week 2 - Let's get the show on the road

1st day of the week was boring, so after ward rounds I decided to sneak into the department next door: Cardiology. I've never seen certain procedures being performed before, so when I saw the list in the ward of scheduled angiograms, implanted cardiac defibrillators and pacemakers.. I decided to pop in to their cardiac catheterisation lab for a look. The cardiologists are friendly and the nurse told me to put on a lead apron, a lead skirt and a thyroid guard (something like a mini pouch around your neck).. at the end of the angiogram, I walked out of the room feeling like wanna die man.. the lead suits are HEAVY and tedious to wear, like carrying a huge backpack.

Decided to come back in later that afternoon to observe a defibrillator being put in (like a pacemaker) - suited up since it's like an operative procedure. My goodness, the nurse (not the doctor) grilled me on the cardiac anatomy. Indeed I learnt something new - the right ventricular lead goes into the heart via the superior vena cava, so how does the left ventricular lead goes into the left side? Good question, since you can't really poke the pulmonary vein or aorta (high pressure).. apparently in the right heart, you find the entry into the coronary sinus and into the cardiac veins on the surface of the left heart. So my homework was to read up cardiac anatomy.. had to leave midway as the cardiology registrar was having trouble locating a good cardiac vein site.

I must admit that I did struggle as well during this rotation, as I was finding it hard to be organized with the amount of medical information to handle – not knowing how to juggle between reading up on the specialty I am in, and revising my basic sciences, even Year 3 students answered anatomy questions better than me in tutorials, and other Aussie Year 5 students know things and can relate with the doctors on stuff which I didn’t even know. I was also quite concerned about assessment modules which I have to write up, unsure whether I am doing enough to satisfy my supervisor’s expectations, or ‘under-doing’ it. Anyway, I did ask God for something good which I can share this week, since I was rostered to give testimony during Lifegroup.

2nd day of the week, I woke up and looked at my alarm clock. 6.30am already???!!!! Aiyoh, here we go again dashing to the bus stop without a proper breakfast.. but fortunately I informed the resident beforehand that I was going straight to theatre.. Managed to witness the surgery for the patient whom I clerked last week, but he encountered difficulty because he had a urethral stricture - they could not catheterise him (I think even the urology team who came ended up traumatising his urethra), so they put in a suprapubic catheter instead. The surgeon expressed concern that infection might compromise this surgery to replace his stenosed aortic valve, since his previous admission was for urosepsis - so he suggested postponing the surgery coz it is not something urgent. I was like, "What? Err... God, can make him not postpone ar? Coz if not, it will already be too late for me to find a patient to follow up pre-op, op and post-op - coz its a short rotation. And I do not believe in copy and paste exactly from the notes without seeing the patient, which other people do." The surgeon decided to go ahead eventually. Yay, and I do thank God for this little blessing, but then I asked God, "Can You take it 1 step further ar? Coz I believe You can do much more than we can ever imagine."

After the gruelling 7-hour surgery on this patient, I was told they are starting a heart transplant case next door - it was a golden opportunity coz if I'm not mistaken, I was told that the hospital is the only heart and lung transplant centre in the state of Victoria, and one of the biggest and busiest in Australia. Furthermore, they don't do transplants very often, only an average of around 2 per month. 1 team of surgeons operated on the patient, the other consultant and registrar flew off 7am that morning to get the donor's heart from Cairns, Queensland. So the plane was scheduled to land at 4.45pm, and a helicopter would be bringing the heart and the surgeons to the hospital from Melbourne airport. I dashed to the emergency department at 5.15pm, and asked the receptionist perhaps the most silliest question I have ever asked in my life (Oh might as well, since I might never get such a chance in the future): "Hi there, I'm a medical student attached with cardiothoracics, and I understand that they are flying the donor's heart in for a transplant via a helicopter.. Can I go to the helipad please please? *innocent look*" I think the receptionist also look at me one kind *speechless* duno how to respond, but yay, I followed the nurse to the hospital's helipad (a restricted area). It wasn't anything special lar, just for the experience coz I was imagining my photo being taken like one of those ER doctor drama series running from the helicopter with the patient on a stretcher - I think it looks COOL :p lolz but anyway, nothing dramatic - just as the chopper landed, immediately we made our way to the theatre. It was a crowded OT, as many people wanted to watch, but could not get a very good view. Oh well, saw one half of it, the other half should not be that much of a miss as they connect the heart to the blood vessels. Left around 6.30pm. What an exhausting day.

A phone conversation in the ward between a nurse and the wife of a Chinese patient who spoke little English, discharged after a bypass surgery:
Wife: Hello, my husband you discharged.. he on the toilet floor not moving.
Nurse: You saying he collapsed at home? Quick, you need to call an ambulance! Bring him back here for observation.
Wife: Har?? Why call ambulance? Wait I check on him. I think he waking up a bit.
Nurse: Ya, but you still need to call somebody? Your family doctor?
Wife: Nobody around. Close already. How ar?
Nurse: That is why I said... CALL AN AMBULANCE!!!!!!!

Usually I fast and pray over lunch, but for the past few days my stomach has been playing up, so I decided to have some food at the cafeteria on one of the days. Unexpectedly I bumped into an old friend, who used to be a senior I met in 2006 during transition camp. I haven't seen him for a long time already, so we chatted a bit, I think he's 1 of the residents in the ward upstairs. 1 thing I totally did not expect was that he found out that I was doing the same rotation he was a few years back, and immediately he asked me for my so that he could email me his modules and let me have a rough idea of how to do it.. I was just left amazed yet speechless..

Indeed, I started off these 2 hectic rotations not knowing how I will pull through, but God has taught me to lay down myself, put my trust in Him as my source of help, and as Philippians 4:6-7 would mention, “Do not be anxious in anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and minds in Christ Jesus."