today i cried again. and i was, am still, bitterly disappointed in myself, so old still want to cry. same old fucking trigger. this time in the ward. get a grip.

and then i realise, i cant remember the last time i cried. so it's a setback, but it's also a milestone. and after that i picked myself up (straggledly) and continued with the work. and it felt damn fucking good after that, albeit having to stare down sns and jms and patients with red swollen eyes.

plus point, the hod took it upon himself to sit me down with coffee (in the pantry, 3in1 nescafe. think what starbucks ah) and decided to get to know me better. awesome tactic, the distracting of. instead of everyone else who usually makes me cry harder (with mostly embarrassment) by trying to comfort me or asking what's wrong. so at least now i got to learn something about india.

minus point, shit damn embarrassing ok let specialist mo ho sn jm see me cry. be stronger dammit. personal is not the same as important. i am seriously contemplating getting a tattoo of that. as a matter of fact, another great distraction was deciding where on the body.

it's funny though how i am slowly orbiting away from the pharm world. they're still good and kind and nice people (and a couple of snakes, in contexts oriental and occidental) but now the safehouse is the ward. it's a bit of a frightening illusion. after all, there's no one to get my back in the ward...

among other news, i remember how hans was crowing about his toxoplasmosis case in seremban. so now i have one here, and g6pd deficient at that. ha, singularity.

incident reporting

1. ivig for itp.

dose, 400mg/kg for 5 days. pt 70kg, total 30g per day. how to infuse? try 0.6ml/min, if after 30mins no reaction, increase by 0.2ml/min til max 4.8ml/min.

and then, it was infused at 0.6ml/h, increased to a grand total of 1.6ml/h 12 hours later. i didnt check. i know how the infusion pump works. it should have struck my brain. i deserve to be cut down by lightning.

patient not responding to the ivig.

2. ivi pantoprazole for ugih.

dose, 8mg/h for 72h. i dont know how i calculated, i told them to dilute 80mg in 100ml, infuse at 0.8ml/h. padahal it's nowhere near what it should be of 10ml/h. sn asked me whether i was sure, two shifts later. luckily the patient hasnt bled out.

3. vinblastine 10mg for abvd

prp supplied vincristine 2mg, and like the hero i am i didnt check. oh gosh i didnt check. this is the first thing you learn as a prp, countercheck, countercheck, countercheck. actually what i learnt first was the pen is your best friend... but anyway. i didnt countercheck. luckily the mo did. no bonus points for me from her, though.

3 damn fucked up stupid mistakes in 2 days. i hope the itp guy responds to the ivig soon. or not rm10k per day down the drain. how do i reverse this? i cant take leave, the ward is too messed up. but my brain is tired, and i am not even finishing the work i should be doing. and the work that i do end up doing is worse than cannot pakai, it's a downright liability. i need to get out of this walking dead frame of mind and actually function. i need to disregard all the stress i feel about research and the resentment i feel about the department and the demotivation i get looking at mr surgical, and just focus. please Lord help me focus for the next week. please help me focus.

hep hep

hokay. going to the ulus next week. starting second day of audit dalaman. with our favourite pharmacist.

quite excited actually. except when i think about conversation with mr aforementioned la. but oh yes to be away, away, away.

remember when we first went over to the uk and cherry-flavoured yoghurt was yucky cos it just tasted like cough syrup?

seems like pharmaniaga people are branching out with the flavourings lately. was making sy cloxa and it tasted like pina coladas - serious, smelled like some kind of tropical mix and had the bitter aftertaste you could just put down to alcohol. and the dynapharma amoxy smells like mango or something.

so yeah poor kids. they're not gonna really have fun with the cocktails when they grow up.

checklist

dont need to go on being angry. you dont have to answer to anyone, now.

30 mins more and then get on with work. you've lots and lots, and lots, of work to get done. remember june 15. and june 17. remember june 7. remember september, unless you want march. remember this friday (damn!).

start making your plans. your time and tide waits for no man, anymore, and you're your own person again. make the most of it this time around. by yourself, now, you've to do this by yourself.

dont kill yourself with work though. let it energize, not deplete. and exercise 20 minutes twice a week.

concentrate! it's the year of the fox and the bell has begun to toll.

It gets better

I was chatting with one of my trainee and she sighed. She told me how life sucks as a student. She lamented about the things she has to go through, explaining her tough times with painful details.

She thinks the future will be filled with better prospects when she starts working. She told me about the things she's gonna do, and the things she's gonna leave behind finally. She looked at me with hope and asked me what I thought of it - if things really get better when I started working.

Seeing her in a sorry state, I tried to assure her. I said yeah, life sucks when I was a student too. And not to worry, because you're right; it will change for the better when you finally join the working force. Because now, life fucks.

I left her in shock. Either from the rude awakening or from the obscenity or both - I dont know.

I should stop being an ass to my trainees.

*DISCLAIMER: In case you get offended, the story above is purely fictional. And oh, no animal was hurt.*

antifungal resistance

apparently there's only this one dude who is some expert on everything fungal and antifungal, and he's spanish, and he publishes his complete papers free online, and oh bloody hell they're in spanish. sigh. research makes me insecure dammit. i wish they'd just give me a topic and i work on it. this oyster thing just makes my malaysian education system byproduct of a mind tremble and quake.