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Almost 2 months since starting to work as a paediatric junior doctor, now I wonder at my chances of being a paediatrician.

Casualty days are non hectic these days as #COVID 19 curfew order is in place. Most days are spent managing a few cases that present owing to either being real emergencies or just parental over care.

Having a bunch of downtime at hand and it would be sacrilegious not to use it for my post graduate training.

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"We will have eternity to celebrate the victories but only a few hours before sunset to win them."

Amy Carmichael

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"It's okay not to have friends but do not have 'enemies' within the hospital".

Our Consultant during morning ward rounds

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Edgy day at surgical clinic

Our Consultant was bit on edge today, blasted us (4 junior doctors) for no reason. And to make things worse he happened to say "you all know nothing and he (pointing at me) knows a little". Didn't know how to react, my co colleagues looked at me as though I have committed a crime!!

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I'm back. Will be posting more regularly.

#peace

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Epileptic seizures. Fixed the confusion of the formerly known as “simple” and “partial” focal seizures. #medicine #postitpearls #doctors20 #FOAMed #FOAM #MedEd #FOOAMcc #FOAMus #FOAMEMS #illustration #USMLE #medicalstudent #medicalschool #education #art #drawing #anatomy #physiology #pathophysiology #emergencymedicine #criticalcare #nursingstudent #neurology #seizures #epilepsy

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How to Study Like a Harvard Student

Taken from Sophia Chua-Rubenfeld, daughter of the Tiger Mother

Preliminary Steps 1. Choose classes that interest you. That way studying doesn’t feel like slave labor. If you don’t want to learn, then I can’t help you. 2. Make some friends. See steps 12, 13, 23, 24. General Principles 3. Study less, but study better. 4. Avoid Autopilot Brain at all costs. 5. Vague is bad. Vague is a waste of your time. 6. Write it down. 7. Suck it up, buckle down, get it done. Plan of Attack Phase I: Class 8. Show up. Everything will make a lot more sense that way, and you will save yourself a lot of time in the long run. 9. Take notes by hand. I don’t know the science behind it, but doing anything by hand is a way of carving it into your memory. Also, if you get bored you will doodle, which is still a thousand times better than ending up on stumbleupon or something. Phase II: Study Time 10. Get out of the library. The sheer fact of being in a library doesn’t fill you with knowledge. Eight hours of Facebooking in the library is still eight hours of Facebooking. Also, people who bring food and blankets to the library and just stay there during finals week start to smell weird. Go home and bathe. You can quiz yourself while you wash your hair. 11. Do a little every day, but don’t let it be your whole day. “This afternoon, I will read a chapter of something and do half a problem set. Then, I will watch an episode of South Park and go to the gym” ALWAYS BEATS “Starting right now, I am going to read as much as I possibly can…oh wow, now it’s midnight, I’m on page five, and my room reeks of ramen and dysfunction.” 12. Give yourself incentive. There’s nothing worse than a gaping abyss of study time. If you know you’re going out in six hours, you’re more likely to get something done. 13. Allow friends to confiscate your phone when they catch you playing Angry Birds. Oh and if you think you need a break, you probably don’t. Phase III: Assignments 14. Stop highlighting. Underlining is supposed to keep you focused, but it’s actually a one-way ticket to Autopilot Brain. You zone out, look down, and suddenly you have five pages of neon green that you don’t remember reading. Write notes in the margins instead. 15. Do all your own work. You get nothing out of copying a problem set. It’s also shady. 16. Read as much as you can. No way around it. Stop trying to cheat with Sparknotes. 17. Be a smart reader, not a robot. Ask yourself: What is the author trying to prove? What is the logical progression of the argument? You can usually answer these questions by reading the introduction and conclusion of every chapter. Then, pick any two examples/anecdotes and commit them to memory (write them down). They will help you reconstruct the author’s argument later on. 18. Don’t read everything, but understand everything that you read. Better to have a deep understanding of a limited amount of material, than to have a vague understanding of an entire course. Once again: Vague is bad. Vague is a waste of your time. 19. Bullet points. For essays, summarizing, everything. Phase IV: Reading Period (Review Week) 20. Once again: do not move into the library. Eat, sleep, and bathe. 21. If you don’t understand it, it will definitely be on the exam. Solution: textbooks; the internet. 22. Do all the practice problems. This one is totally tiger mom. 23. People are often contemptuous of rote learning. Newsflash: even at great intellectual bastions like Harvard, you will be required to memorize formulas, names and dates. To memorize effectively: stop reading your list over and over again. It doesn’t work. Say it out loud, write it down. Remember how you made friends? Have them quiz you, then return the favor. 24. Again with the friends: ask them to listen while you explain a difficult concept to them. This forces you to articulate your understanding. Remember, vague is bad. 25. Go for the big picture. Try to figure out where a specific concept fits into the course as a whole. This will help you tap into Big Themes – every class has Big Themes – which will streamline what you need to know. You can learn a million facts, but until you understand how they fit together, you’re missing the point. Phase V: Exam Day 26. Crush exam. Get A.

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how to avoid education burnout

have 3 achievable goals a day: having a laundry list of things to do everyday is super unrealistic, and you just end up feeling bad about yourself because you didn’t accomplish your goals for the day.

leave your sundays open: i love sundays because they’re my day to chill out and catch up on school work that i wasn’t able to finish during the week.

recognize when you’re at your emotional limits: forcing yourself to get work done when you are unable to comprehend your study material does not benefit anyone.

learn how to say no: people will ask you for your time and it will stretch you to the limit, whether it be at your job, in your extracurriculars, or in your personal life. know when to step back and say no.

take care of yourself physically: take breaks, go for walks, shower regularly, get enough sleep, eat healthy, see your friends

celebrate your accomplishments: go out to eat with friends after a big exam, indulge in a night off after a busy week with some netflix and wine

make a study plan beforehand: it can be daunting to see how much work you need to put in to a class or task beforehand, but this allows you to spread your work evenly so you don’t become overwhelmed.

learn how to ask for help: it is very rare that people make it through school, whether it be high school or university or any graduate program, without needing the advice of others or just a kind soul to vent to. find that person.

never forget your hobbies: you will need things that keep you sane. if you love to play music, write, play volleyball, or cook, make you sure you don’t lose these things. they will become your escape when times get tough.

log off from time to time: it is exhausting to be constantly connected to social media and your email. just physically disconnecting from these for a night to take care of yourself can really help you clear your mind.

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Open blebectomy for recurrent spontaneous pneumothorax

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are any of your printables free? i love your stuff but it’s not really in my budget right now

Hey, yes! Here are all my freebies:

2018 monthly planner printables

2018 student printables (includes 2018 overview + calendar, daily + weekly + monthly planner, 30 habit tracker, class overview and timed worklog)

weekly study schedule

weekly planner (monday and sunday start)

weekend planner

daily planner

assessment planner (4 and 10 day options)

subject to do list planner

study session planner

studying printable pack

exam revision printable pack (includes revision checklist, formulas + definitions sheet, essay + project planner, weekly schedule)

note-taking printables (includes dotted, grid, lined, cornell method)

organic chemistry printable

literary techniques and devices sheet

100 days of productivity tracker printable

motivational monday printables

Also, all of my desktop and phone wallpapers are free to use xx

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A perfect little Acid Base cheat sheet

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Heylo everyone! Clotting factors are substances in the blood that act in sequence to stop bleeding by forming a clot. Here is a mnemonic to help you remember them ^___^

I Fibrinogen  II Prothrombin III Tissue factor IV Calcium V Proaccelerin, Labile factor VI  Unassigned – Old name of Factor Va  VII Stable factor, proconvertin VIII Antihemophilic factor A IX Antihemophilic factor B or Christmas factor X Stuart-Prower factor XI Plasma thromboplastin antecedent XII Hageman factor XIII Fibrin-stabilizing factor

Image 1: Clotting factors mnemonics “Fresher’s Party Tonight, Come Let’s Sing And Call Seniors, Please Have Fun” “Foolish People Try Climbing Long Slopes After Christmas, Some People Have Fallen” “Fit Pants, Tight Collars, Loose American Shirts Are Cool Says Pretty Heroine Farah” My favorite mnemonic is the pretty heroine one.. I drew it too :P Sunglasses = Cool ;)

Image 2 helps you draw the coagulation cascade

Intrinsic pathway is activated by subendothelial collagen Extrinsic pathway is activated by tissue thromboplastin Another mnemonic: 1972 WEPT 1972: Factors 10, 9, 7 & 2 W: Warfarin E: Extrinsic PT: Prothrombin Time Factors X, IX, VII, II are Vitamin K dependent. Warfarin acts on extrinsic pathway, prothrombin time used to check it. If you know this, the other one is the other one. Heparin acts on intrinsic pathway, partial thromboplastin time is used to check it.

Image 3: Hemophilia mnemonic

Remember in hemophilia, bleeding time is normal, PTT is increased. Hope you remember :)  That’s all! ^_^ -IkaN

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Today, I hugged a stranger.

Today, I hugged a stranger.

And I didn’t know his name.

We had just operated on a young man, probably in his late teens.  He sustained multiple gunshot wounds to the chest and abdomen, and was in critical condition.  When he lost pulses in the trauma bay, we cut his chest open and spread his ribs.   His lifeless body laid there as we held his heart in the palm of our hands, and pumped it – over and over again – to mimic life.

We pumped his heart tirelessly, afraid to let go, afraid to give up, afraid to say ‘enough’. And just when we thought we had lost him forever, a flicker of hope jarred us as his heart began to beat again.  We rushed him to the operating room, and a team of anesthesiologists, nurses, and residents met us in the room.  We worked together quietly and efficiently, all too well rehearsed.

“Male in his late teens, multiple gunshot wounds to the thorax and abdomen.  He has a left femoral cordis, and two large bore peripheral IVs.  A resuscitative thoracotomy was performed in the trauma bay.  Aortic cross-clamp time was 2053.”

That was all the information they needed as we worked to put him on the table and prepare his body for surgery.

In two hours, we were not able to control the bleeding.  He was in critical condition.  We packed his chest, and temporarily closed it.  He will need massive resuscitation in order to survive more surgery.

I was unsure if we would save his life.  I was unsure if this young man - in his late teens - will ever grow to get married, have children, or see the colors that form when the rain meets the light.  I left the operating room, defeated.  

And there he was – sobbing in a corner, alone.

He was in his mid-40s, wearing a grey shirt and muddy boots.  Judging by the mud on his soles – remnants of the rain mixed with the Earth - I can tell he worked in construction.  He had a muscular build, and by the smell of his shirt, I can tell he was working all day.  I walked up to him as he held his face in the palm of the hands, and I stared as single tear drops fell onto his worn jeans like summer rain. And I grabbed his head and pulled him into my chest.

I embraced this stranger as he sobbed into my chest, leaving behind small little patches of despair and pain.

Today, I hugged a stranger.

I hugged him with the hope that I can lift some of this pain from his shoulders, with the hope that I can take on some of the burden of his hopelessness.  And I felt my eyes well up with the same pain, as I thought of my patient – a male in his late teens with so much to live.  As I held him, I felt his sobs move to a slow whimper.  I wiped my tears, and walked away without saying one word, without looking at him in his eyes.

I went to a nearby bathroom, and sat on the floor.  I needed time to think, to feel, to gather myself.  After a few minutes, I washed my hands, washed my face, and walked back to the operating room to check on the patient.   The chief resident on the team had re-opened his chest, and was massaging his heart.

“He lost pulses,” she said, as she motioned me to take over compressions.

I pumped his heart in the palm of my hands – over and over again – to mimic life, but his heart laid still.

Everyone went quiet.  

We bowed our heads in understanding.

___________________________________________

I stood behind as the team left to prepare for new cases.   The air was warm and thick in the operating room as I cleaned his motionless body of blood.  The nurse and I moved his body onto a stretcher – his bloody Tommy Hilfiger boxers remained on the operating room table.  We worked together quietly and efficiently, all too well rehearsed.

The phone rang – like an old, nasty alarm clock – and pierced through the thick air.  It was another nurse on the line telling us that the family has arrived, and wanted to see the body.

We wheeled him to the recovery unit, and the nurses prepared the room with boxes of tissues and cups of water.  I took one last look at him before I departed, and felt my eyes well up with indignant pain – another young victim of gun violence, taken too soon.

As I leave the room, there he was walking toward me, toward his son’s body – in his grey shirt and muddy boots.

He took one look at my eyes, and embraced me.  He pulled my head into his chest, and by the smell of my scrubs, he could tell that I was working all day. He embraced me as I sobbed into his chest, leaving behind small little patches of hopelessness and pain.

Today, I hugged a stranger.

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Much needed break before starting internal medicine rotation.

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One of the greatest tragedies in life is to lose your own sense of self and accept the version of you that is expected by everyone else.

K.L. Toth (via naturaekos)