I remembered few months back, when I was told that I could go Johns Hopkins for my oncology rotation - I was really really overwhelmed with joy :) No pre-reggers have been to JH for oncology attachment - most go to National Cancer Centre, so when I was told that I can go JH - I really really was very happy. Secondly, it's Johns Hopkins! No 1 Hospital in USA - medical excellence, great patient care, prestige, skills, research - ALL there! Plus the latest technology. It will be an eye opening experience I believed. And I have been to NCC for my FYP - I've had enough! Hahaha..
And I really like JH the morning I stepped into that place. I was following the CEO and the team during ward rounds - and it felt really different. Together with a medical consultant, oncology medical officer, the nurses, nursing director, and pharmacist - we went from one room to another, examining each patient and planning the treatment for them. I saw a really desperate young chap. A very young man indeed, and I saw books on prayers and bible beside him.
And suddenly I feel that it's so true that man seldom think of God and what He can do until the day they become desperate with life, and death. Whenever I see such patients, I really really feel like sitting down with them and give them a gentle touch.
Well JH doesn't have that many patients in the ward because not many can afford the bills that accompanied the name of this hospital. Most patients here are foreigners and very very rich locals who are willing to go ALL OUT to get a CURE for cancers.
Something very different of US culture is that they value pharmacist input much. What ever you said - they listened VERY attentively. And chemotherapies are very deep and intricate drugs that will kill if not properly titrated or dosed according to conditions of each patient - the more they will listen and value pharmacist's input. I love the way things work here - a very integrated multidisciplinary approach. Following doctor rounds in AH is very different, people are less receptive - and I am sure it's the same with other hospitals. I hope that one day what I see in Johns Hopkins will happen in AH too.
However, it was also after the first day that I felt hard to go on. I was in the inpatient pharmacy and I felt really ill-treated. I really felt very bitter, very crushed and disappointed. And I was "banished" from the room most of the times. I struggled very hard with my bitterness because I had to stay around somewhereno matter what. There's no where I could go. I had to be in JH and in the oncology wards. And my Day 1 really ended with a low-spirit Hooi Ching who really felt like giving up.
And I needed to present a case on Friday, and the case chosen for me was a complicated breast cancer case - triple negative (ie no targets to hit during tx) and a very progressive and unfortunate case. I was really disappointed because she did not attempt to go through an overview of breast cancer with me, nothing NOTHING. and then i was banished out with this case.
First - this is a very specialized field which a novice will need guidance to start to even comprehend the complexity of cancer, chemotherapies,radiotherapy and disease management.
And my patient's case notes - 1 YEAR + thick.
HOW HOW HOW??!
The "coldness" radiated from her really plunged me to a shallow pit for some time.
Why God always put me into situations :( From AH to JH, just weird scenarios and situations will come my way. Am I such an unlucky fella who always get shits.
It took me some time to pick myself up. At least when I realized that the ward has wireless, I became so relieved. I then can use my itouch to surf net to search for information or find answers to the queries I had while reading the case notes (because she didnt allow me to touch any computer - and this is so so abnormal -_- ).
2nd day was better. I have gathered that whenever I get into these shitty situations, it also gives me another opportunity to experience God in a more apparent manner. My greatest consolation was that because I am so special, that's why the people and situations I deal with, have always been the special ones.
1 - I am the ONLY pre-reg in singapore doing oncology attachment in Johns Hopkins for 2 weeks --> I guess that's quite a breakthrough.
2 - I do not care about what people think of me, because I like to face God in all that I do, albeit out of norm at times.
3 - I know that God doesn't put me here to let me die, but rather to rely solely on Him and watch how He will turn situations around for my advantage.
With these few realizations, I became more peaceful. I slowly digest the case notes and understand my patient's conditions. I don't know how to treat breast cancer but at least I managed to get help from huilin to print the NCCN guidelines from AH (YES she doesnt even allow me to print guideline that is absolutely relevant to everything that I am doing! ).
The greatest surprise I got was that God actually increased my interest towards the case. A triple negative breast cancer patient (this is rather bad, because all sites negative means that your drugs have no target to hit!) and the cancer has spread to brain, liver, lung and bone. It gave me a very good picture on how an aggressive breast cancer can progress and amazingly, I understand the story as time goes on.
Suddenly I see the reasons that God wanted me to be the one dealing with this situation:
1- Breast cancer is No 1 cancer of death in women
2- My hospital is gonna have an oncology dept in the new hospital and I can play a part in it!
3- Rarely people has triple negative breast cancer - and this patient suddenly plunges me to know the whole breast cancer in greater depth because she is difficult and I have to keep reading widely to understand it better, thanks to no help
4- God wants the people who bully me to be embarrassed
5- God wants me to know that nothing is impossible only if I fix my eyes upon Him and His works in me
The presentation to the in-charge went well. She was pleasantly surprised and mentioned she didnt expect a pre-reg to be able to deliver a presentation this way, with such details. The other person claimed the credit - saying because she always made me go and read case notes. -_-
I felt really happy do you know?
Not because I did a fabulous job, but more on the fact that I now really really know that God never leaves me and He will support me with tonnes of strong spirits and make me shine despite situations - only if I also put my entire heart and soul to seek Him and His perfect will in every of my situations, and not to be blinded by what's seemingly bad.
And I started to sympathize her. Because I heard people saying bad things about her, complaining about her etc etc.. And suddenly I became softened towards her. For someone who doesn't see the wrongs in herself and keep living on like these around people who said such things behind her for 10 years - so innocently pathetic.
Now that I am in the main oncology pharmacy, learning more with the in-charge, I really really feel rewarded. I know more things will come - difficult people, difficult situations, hopeless scenarios - But above all, i know who's in control and that suffice. (He always turn shit into gold:) )
1 comment:
HC always lights up a dark room. :)
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