Paeds Ortho

Some update. I passed MRCPCH Part 1a and 1b. With good scores if I may add. I did work hard to prepare for this exam and I am so glad that my effort had paid off. I am proud of this achievement.

I am now 'floating' in the Orthopaedic department. I was actually unclear of my role. I am in the HO roster, assigned as the Paeds Ortho team's HO, as I have promised to help out since we are short of HOs at the moment. The difference is that nowadays I consult my seniors less and tend to just go ahead with what I think is appropriate in terms of clinical management. But I do not sign MC as I have not obtained my full MMC registration number, and I avoid signing on operation consent forms. Last Friday, we were chatting and I accidentally let slip to prof, who is also our head of department, that I am actually neither doing shift work nor oncall. On Monday morning, prof delivered the news that I will be assigned to do the MO calls. It was a mixed feeling. I am happy that I am upgraded to do MO's work and would be able to earn some extra cash. On the other hand, my luxurious ways of working office hours would be sorely missed. On the next day, we had a visiting professor from Indonesia joining our round. Prof introduced our team to the visitor and a sense of pride overwhelmed me when prof introduced me as 'one of our new MOs in our team'. I actually smirked uncontrollably. So embarrassing  Now I feel I have to really up knowledge and improve to live up the standard of being an MO. 

As opposed to my expectation, I really enjoy being in my team now. The main reason is the bosses. The two professors heading my team are great old school doctors who give much emphasis on how a patient is clinically to determine diagnosis and treatment, as opposed to fancy tests and scans. A 7 month old boy came in with high fever, not moving the left hip, all the signs pointing at septic arthritis but because the ultrasound concluded that there isn't one, the MOs did not treat for the condition. Prof listened to the story, took one look at the child and sent the boy straight to OT. Impressive enough, needle into the hip, pus poured out. It was septic arthritis. Unlike the MOs, prof trusted the clinical presentation rather than technology, and he made the correct diagnosis. I could have gave him a salute. There were other examples. In general, there is less unnecessary referral and requests for scans in Paeds Ortho team compared to the other Ortho teams because our profs are more sensible. I like learning proper medicine from these sensible old school doctors. It also reinforces my believe that Paediatric doctors (physician or surgeon) are simple cleverer and more conscientious doctors. Even though I am the most junior in the team, I have never felt the hierarchy preventing me to ask questions and express my point of view. In fact, prof would always ask what I thought I would do before he suggests his management.

However, ortho is ortho and I cannot deny losing interest when conversation starts to veer towards operative technique, anatomy... I am in the process of trying to continue floating in the real Paediatric department, where my real interest lies. We will see how this pans out. Should be interesting. 

There is a previously-known-to-be-stubborn kiddo in the ward now. Prior to this, we needed to change his dressing under GA or sedation every time as he would scream through the roof when anyone touched his foot. But, as of yesterday, I have managed to tackle him and we are good friends now. With me he was so cooperative that he held his hand out still for me to poke him to take blood, not making a sound and concentrated on his breathing just like I told him to. So cute. After that he even gave me a pack of his sweets. Today was not the greatest day. I messed up a case in my presentation. Prof wasn't happy and I felt disappointed with myself. But after that, I went back to the ward and played with this kiddo. He cheered me up and made my day.

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