Just about the most annoying question that medical student like me come across is 'Which specialty to you want to do?'. People love this question: patients, doctors, nurses, parents, relatives, strangers. Why do I hate the question? Because I truely don't know. So is more than half of the medical students. We are seeing new things everyday and everything new we see would interest us in one way or another. But I have to say I do think about this question more intensely nowadays. Finals is looming and before we know it, we'll be asked that same question in our job application form.
I love acute stuff. My favourite placements are A&E and emergency assessment unit. I love to see fresh patients, thinking and making diagnosis from scratch, getting investigations to confirm my diagnosis and see the patient benefit from my immediate management right in front of my very eyes. The variety of presentations and the hands on approach turn me on. I also like the teamwork, communication and support from your peers. I know I would be under pressure all the time, but that's exactly what I am after. The downside would be the lack of opportunity to form long term therapeutic relationship with the patients. But that's not entirely true. In my short 4 weeks stint in A&E, I came to know an alcoholic man living on the streets who came in every other night quite well.
I'm still keeping my options open. I think I'm geared more towards medicine rather than surgery. The one type of disease that perpetually gets me excited is vasculitis. I find multisystem involvement because of the underlying pathology fascinating. I hated surgery because I found it boring, yet this perception has changed since I was allowed to scrub in for the first time in my life. I'd love to learn all the physiology behind anaesthetics, yet I find the working condition (sitting through surgery, listening to beeps, plotting obs charts) rather unbearable. However I won't mind working in ICU. I used to like psychiatry, but not anymore. I loved the stories of delusions, before I realise that most of them are just the same. The pace is just too slow for me. GP is ok, I had two brilliant placements, one OK and the current one horrible, and it's the horrible one which puts me off completely. The variety is there, but the support is not - you work on your own most of the time, which will depress me eventually. Lots of paperwork. Yet it's so rewarding when you become almost a part of someone's family, and home visit is the best part of being a GP. Most of the time the only treatment that patients needs is so simple - a pair of lending ears, good explanation and reassurance, which my current GP fails to realise.
So this is my elaborated answer to the annoying question. Please resist the temptation to ask me again.
.
Saturday, November 15
Sunday, October 26
A fantastic last week of Rheumatology/Orthopaedics
Monday was so eventful. In the morning, I was at Hemsley House in Salford for a consultation process event with the PCT about the future of the Horizon Centre. I was so happy to meet Naj and Rebecca, and a few asylum seeker patients. I love talking to asylum seekers – I feel I interact with them really well and reminded me of the good times I spent doing voluntary work with refugees and the SSC in Horizon. I was glad to see so much support from the patients to the Horizon. And I am determined to do my bit for them as well. Plus there were free sandwiches. After that I attended the evening surgery back at the GP. Right after that I rushed back to Stopford building to deliver a workshop to some medical students on MDG 4&5: Maternal and child health, which we (Two friends and I) have been preparing for ages. It went really well, I think people enjoyed it and we received plenty of positive feedback. I too enjoyed it thoroughly, teamwork was great and it was a rewarding experience. At night, the PBL group went to Cloud 23 at the Hilton for Khai Wei’s birthday. I ordered a cocktail, I didn’t like it very much – smelled too alcoholic. But I really enjoyed the view, the amazing night scene of Manchester. Then we also went to a few more places. I was getting more tired then so I went home early.
On Tuesday, lecture only started at 1pm so all of us had a lay in, which was appropriate as I felt lightheaded as I woke up. I bought a pair of boots for myself – it felt nice to wear at the time but over the week I realize that the heels are simply too high for my liking. But I have to say it does look rather stylish. After the lecture, I went up to the orthopaedics and rheumatology wards and talked to one patient each (atypical gout and rheumatoid arthritis with vasculitis). I then went to the French class and reached home at 9pm.
On Wednesday, we started off with Rheumatology bedside teaching at 10am. I requested for knee examination today. Dr Herrick said ok and found a patient with knee signs for us. Then I was asked to come up and examine the patient’s knee. It was slightly nerve wrecking and I fluffed around for a bit. Yet I know it’s meant to be a teaching session, a good time for me to make mistakes so I’m not too bothered about it. We also saw a patient with ankylosing spondylitis. Next we went to the RA patient I met the day before. Dr Herrick found out that I have seen her before the day in my own free time. And she said that’s very commendable – my heart leaped in joy. So I told the group the lady’s history before everyone went on to examine her grossly deformed hand. After lunch, I attended Dr Herrick’s rheumatology clinic, which did not end until 6pm! I missed the Crossing Borders meeting as a result.
Thursday morning, I went to a fracture/orthopaedic clinic, and I'm glad I did because it was one of the most enjoyable clinic I have ever been to. It’s like me being back in A&E or the acute wards – I clerked the patients and then present it to the surgeons and see them together later on. The surgeons were really casual and friendly lot, and very flattering – the consultant said I know too much, that I know more than many of his SHOs do and that I should read the books less! Afternoon onwards was slightly duller; we had a group revision sessions in rheumatology and orthopaedics. After that I spent the small time gap to do some essential shopping – got mummy some free gift of facial products. Then I was off to the chorus rehearsal. We had a replacement conductor today and I learnt a few new things from him. I like the part we sang and I think my sight singing skill has improved a wee bit.
Friday morning was PBL. I brought some (unhealthy) breakfast for the group – Jaffa cake and Snickers, seeing that it’s the last PBL session for this rheumatology/orthopaedic rotation. It finished early. We were then informed that lunch time lecture was cancelled so others went home apart from Khai Wei and I. I said I wanted to go to theatre and Khai Wei followed. We went to the ward and clerked the patient about to go to theatre. I am so glad that we went. It was the same cool consultant and registrar that I met in clinic on Thursday who were operating. We saw the anaesthetist giving spinal anaesthetic. And then we were asked us to scrub up. I fumbled a bit as I have never scrubbed up before, but managed in the end. It was such a fun experience. I helped hold some retractors and hammer the prosthetic joint into the tibia.
On Saturday morning I went to another chorus rehearsal. It was really fun, although there were a few shouting from the conductor. I am so proud to be in soprano 2 – undoubtedly the best section in the entire choir. Later on, after a quick food shopping, I went to the gym to build up some muscles and increase my lung capacity. I then chatted with my family, and then made roast dinner for myself (which turned out yucky).
Today is Sunday. The clock goes backwards for an hour so I slept for an extra hour. I plan to have a relaxing study day today, maybe go to the gym for a bit.
.
On Tuesday, lecture only started at 1pm so all of us had a lay in, which was appropriate as I felt lightheaded as I woke up. I bought a pair of boots for myself – it felt nice to wear at the time but over the week I realize that the heels are simply too high for my liking. But I have to say it does look rather stylish. After the lecture, I went up to the orthopaedics and rheumatology wards and talked to one patient each (atypical gout and rheumatoid arthritis with vasculitis). I then went to the French class and reached home at 9pm.
On Wednesday, we started off with Rheumatology bedside teaching at 10am. I requested for knee examination today. Dr Herrick said ok and found a patient with knee signs for us. Then I was asked to come up and examine the patient’s knee. It was slightly nerve wrecking and I fluffed around for a bit. Yet I know it’s meant to be a teaching session, a good time for me to make mistakes so I’m not too bothered about it. We also saw a patient with ankylosing spondylitis. Next we went to the RA patient I met the day before. Dr Herrick found out that I have seen her before the day in my own free time. And she said that’s very commendable – my heart leaped in joy. So I told the group the lady’s history before everyone went on to examine her grossly deformed hand. After lunch, I attended Dr Herrick’s rheumatology clinic, which did not end until 6pm! I missed the Crossing Borders meeting as a result.
Thursday morning, I went to a fracture/orthopaedic clinic, and I'm glad I did because it was one of the most enjoyable clinic I have ever been to. It’s like me being back in A&E or the acute wards – I clerked the patients and then present it to the surgeons and see them together later on. The surgeons were really casual and friendly lot, and very flattering – the consultant said I know too much, that I know more than many of his SHOs do and that I should read the books less! Afternoon onwards was slightly duller; we had a group revision sessions in rheumatology and orthopaedics. After that I spent the small time gap to do some essential shopping – got mummy some free gift of facial products. Then I was off to the chorus rehearsal. We had a replacement conductor today and I learnt a few new things from him. I like the part we sang and I think my sight singing skill has improved a wee bit.
Friday morning was PBL. I brought some (unhealthy) breakfast for the group – Jaffa cake and Snickers, seeing that it’s the last PBL session for this rheumatology/orthopaedic rotation. It finished early. We were then informed that lunch time lecture was cancelled so others went home apart from Khai Wei and I. I said I wanted to go to theatre and Khai Wei followed. We went to the ward and clerked the patient about to go to theatre. I am so glad that we went. It was the same cool consultant and registrar that I met in clinic on Thursday who were operating. We saw the anaesthetist giving spinal anaesthetic. And then we were asked us to scrub up. I fumbled a bit as I have never scrubbed up before, but managed in the end. It was such a fun experience. I helped hold some retractors and hammer the prosthetic joint into the tibia.
On Saturday morning I went to another chorus rehearsal. It was really fun, although there were a few shouting from the conductor. I am so proud to be in soprano 2 – undoubtedly the best section in the entire choir. Later on, after a quick food shopping, I went to the gym to build up some muscles and increase my lung capacity. I then chatted with my family, and then made roast dinner for myself (which turned out yucky).
Today is Sunday. The clock goes backwards for an hour so I slept for an extra hour. I plan to have a relaxing study day today, maybe go to the gym for a bit.
.
Saturday, October 25
Old lady in orthopaedic clinic
On inspection: Index finger was missing on the right hand
Me: Why is one of your fingers missing here?
Old lady: My husband bit me. I had to had it removed
Me: (Speechless...)
Me: Why is one of your fingers missing here?
Old lady: My husband bit me. I had to had it removed
Me: (Speechless...)
Sunday, October 5
PBL dinner party
My PBL group had a potluck dinner on monday. I made 'Prawn cake mummy's special'.
Other food on the table were:
Other food on the table were:
That was a hell lot of food. We had 12 courses in total! Some of the people were so overwhelmed that they went back home and dreamt about the dinner.
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Monday, September 29
GP (1)
Sometimes sitting in with GP can be very frustrating. For a start, I resent the university forcing us to attend the GP every monday throughout the whole of the fourth year. That's a fifth of the time spent at the GP. And it has to be a full day - I was told off for going back to the hospital one monday when the GP let us off at lunch time. I'm not saying that there is nothing to learn in GP surgery. I just feel that our time as medical student is limited, I much rather be learning and seeing as many specialised things that I might not see again until I qualify as possible. For example, I spent the last four weeks attached to Neurology and I am still not sure if I am absolutely confident diagosing and managing neurological disorders. I thought four weeks were simply not enough to grasp everything in such a massive specialty - and this is worsened by compelling us to spend bloody 20% of the time seeing cough and cold, sick note, medication review etc. The community medical education advocates argue that the common things are what we are expected to face most of the time when we qualify. But people expect doctors to know not only common things, but also a breadth of weird and wonderful disease. Whether it's rare or common, it's irrelevant. I mean that's what people go to doctor, isn't it? Every sensible parent know sore throat in children is quite normal and may well be aware that bit of calpol, fluid and rest will suffice, but they see the doctor 'just to get it checked out'. I certainly want my doctor to have at least seen some very ill patient, so when he sees one himself, if he cannot diagnose it, he would at least think about it. There's an old saying in clinical medicine 'if you don't think about it, you'll never find it'. One day I must compile a statistics on the proportion of time we spend on each specialty throughout medical school.
GPs are not all bad. When I do get enthusiastic tutor, the day can be rather enjoyable, sometimes to the point of inspiring me to contemplate a career in GP. When I am allowed to do stuff, like taking history and examination, apply plaster, dip some urine or play with baby for example, I'd be even more elated as oxygen fills my dying brain. Unfortunately, medical students are shoved to the corner for the entire surgery most of the time.
This semester, the GP is a let down. He's alright - he goes through the PBL case with us before the start of surgery every morning. But he just rambles on and on. I like to talk and demonstrate my knowledge but I hardly have the opportunity to open my mouth. He's so patronising. We are fourth year now and he talks to us like first year students. More often than not, my monday morning freshness is killed just 10 minutes into his incoherant lecture. With the patients, his listening skill was awful (doesn't surprise me - it's all about him talking). And my goodness, the way he drags his sentences drive me up the wall! However, the good thing is that he does arrange patient with conditions relevant to our PBL case for us to meet each week. So PBL wise he's been quite helpful.
To be continued.
GPs are not all bad. When I do get enthusiastic tutor, the day can be rather enjoyable, sometimes to the point of inspiring me to contemplate a career in GP. When I am allowed to do stuff, like taking history and examination, apply plaster, dip some urine or play with baby for example, I'd be even more elated as oxygen fills my dying brain. Unfortunately, medical students are shoved to the corner for the entire surgery most of the time.
This semester, the GP is a let down. He's alright - he goes through the PBL case with us before the start of surgery every morning. But he just rambles on and on. I like to talk and demonstrate my knowledge but I hardly have the opportunity to open my mouth. He's so patronising. We are fourth year now and he talks to us like first year students. More often than not, my monday morning freshness is killed just 10 minutes into his incoherant lecture. With the patients, his listening skill was awful (doesn't surprise me - it's all about him talking). And my goodness, the way he drags his sentences drive me up the wall! However, the good thing is that he does arrange patient with conditions relevant to our PBL case for us to meet each week. So PBL wise he's been quite helpful.
To be continued.
Sunday, September 7
Gloom
Sorry about the somber post. Don't know why am I feeling so gloomy and grumpy lately. Maybe it's the weather. Manchester weather has been terrible!
Rain rain go away
Come again another day
Ah Yen wants to go out and play!
.
Rain rain go away
Come again another day
Ah Yen wants to go out and play!
.
Monday, September 1
Guilty conscience
I am beginning to doubt if I have made the right decision to work in this profession. I am a perfectionist, by nature and nurture. I hate mistakes. It used to take me very long to get over a tiny thing although I'm getting better at the art of ignorance (or any better word for it?).
There were many times when I have done things the wrong way and have result in some damage. I am going to give three examples:
1. Tanjung Rambutan visit while I was in college
It was a work experience visit in the forensic psychiatric ward. I found it extremely interesting talking to rapists, murderers and other offenders about their illness, One particular guy showed me the various long scars of self harm across his neck, tummy and wrists and how stigma from his family meant that he had to be locked up in the unit for the rest of his life eventhough he was cured (since his family was not prepared to receive him back home which was one of the conditions for discharge).
Then we went on to observe some consultations with the house officer. A guy was trying to convince us about him hearing voices from Erra Fazira (a local singer) and that they were getting married. I distinctly remembered that all of us - the doctor, the medical assistant and us the three students burst into laughter and couldn't stop laughing for another 5 minutes. The patient was reduced to tears that we thought it was a joke, and the medical assistant threatened to put him in seclusion if he was to throw a tantrum.
I didn't actually think it was unprofessional until recently when I thought back and realise how horrible was that for the patient. We were encouraging him to keep to telling his 'wedding plan' while continuing to laugh uncontrollably, as if watching a comedy. Sure, I can blame the more experienced staff for not setting the right example. But I wasn't coerced into following the crowd. I was genuinely amused with the patient's story and wasn't giving any thought about he would feel in response to my behaviour. Perhaps that was one of the early signs to suggest that I lack the human quality required of a good doctor.
2. Old man who loved his sago pudding
I don't know much about this old man's history as the ward doesn't give handover to auxillary nurses. After spending a few minutes with him, it was obvious that he was bed bound and he was trying hard to talk but I didn't understand most of what he said. Dysarthria? Could it be stroke? Anyway from his body language I could tell that he wanted the unopened sago pudding in front of him. So I opened it and put a spoonful in his mouth. It was quite a watery bowl of sago pudding. He seemed to enjoy it. Only that as soon as he tried to swallow, he coughed and made some gurgling noise. I instantly felt uncomfortable and hesitated. Before I could think, he was making gestures to want another spoonful. I looked around his table to see if there was any powder to thicken the fluid. There wasn't. So I gave him another spoon. The same thing happened again. He struggled to swallow. So I told him that I didn't think it would be a good idea to carry on. But he wouldn't take any of that. He really wanted some more, and was making more vigorous gestures for more of the pudding. I gave in. Then he choked again. Only then I decided that I must insist to stop and I explained to him why I did it. He looked really disheartened. I rarely see hospital patients with such good appetite. I felt sorry for taking away the pudding that he loved so much. I told his staff nurse what happened after that.
A few hours later I walked pass this old man, and I heard something funny. He was wheezing so loudly that I can hear it without a stethoscope. Shit - I've definitely given him aspiration pneumonia. Shit shit shit!
But there was more bad news to come. I was allocated to the same ward again a few weeks later when the staff told me that he has succumbed to a nasty chest infection and that he was dying. They are just trying to keep him as comfortable as possible. My heart sank. I was swamped with a terrible sense of guilt. I wanted to read his medical notes but I couldn't bring myself to. What if it really was me that made him go downhill to the point of disrepair? I tried to redeem myself on that shift by giving him good patiance and care. But in my heart I knew the damage has been done. I am really sorry.
3. The ligature made of paper towels
I was at a young people's unit of a psychiatric hospital. I hate working here. I have never heard more alarms going off or seen patients being restrained more often anywhere else. I find it awfully difficult to get through to teenagers, even for a normal conversation. On that occasion I thought it was not going to be too bad because I knew all of the patients having worked here not too long ago.
I shouldn't have been complacent at all. I brought a girl into the toilet. We were supposed to supervise them but I wasn't clear if I should have a clear view of them all the time. 'TURN AROUND', she shouted at me. I thought it was understandable to give her some privacy. She then went to the sink and washed her hands when she finished and we went out. I didn't notice anything suspicious.
About an hour later, one of the staff asked me if I saw her taking any paper towel out of the toilet. I said I didn't but I did admit that I wasn't really looking.
I was just walking along the corridor after dinner when I saw that girl with her hoodies over her face and upper body. She wouldn't answer anything I asked, and wouldn't let me see her face and neck. So help was summoned and four people were needed to restrain her to take the hoodies off her. It turned out that she had made a ligature by tying knots from several paper towels and she actually had the ligature around her neck!
Again, I was overcome with a deep sense of guilt. Given that she was able to physically resist four people while trying to remove the ligature, she probably wasn't dying in any way then. Yet I just can't get over the fact that (had we not caught it in time) she could have been died, and the reason would be me: because I didn't watch her properly in the toilet. Things like that really knock my confidence off. I don't think I would be going back to any young people's unit to work again. I can't bear to see things like this happening.
___________________________
I think I have been extremely naive to believe that to be a doctor is to help alleviate human suffering. Patients are always physically, mentally or emotionally vulnerable when they come into hospital. They often have lost independence and are at the mercy of the staff to help them around. And what do we do with this more often than not? We use to our advantage for our own convenience. It's just so easy for us to do harm, to be negligent, to make mistakes, to be ignorant. I always pride myself as patients' advocate. I know no one is perfect. But sometimes I find it hard to forgive myself. If a person dies because of me, what amount of forgiving is going to bring back someone's daughter or granddad or good friend? After all the things I have done do I still deserved to be trusted?
One of the GPs told me even after 30 years of experience, things like missing cancer diagnosis still happen to him once every two or three weeks. Does this mean that I HAVE to ACCEPT that mistakes just happen? Because I don't think I can practise medicine knowing that there is a chance that things will go wrong because of my incompetence. Maybe I should consider doing histopathology or something like that - that way at least I know that I am not directly responsible for a person's life.
Sorry if this piece doesn't sound coherent. My brain is churning.
.
There were many times when I have done things the wrong way and have result in some damage. I am going to give three examples:
1. Tanjung Rambutan visit while I was in college
It was a work experience visit in the forensic psychiatric ward. I found it extremely interesting talking to rapists, murderers and other offenders about their illness, One particular guy showed me the various long scars of self harm across his neck, tummy and wrists and how stigma from his family meant that he had to be locked up in the unit for the rest of his life eventhough he was cured (since his family was not prepared to receive him back home which was one of the conditions for discharge).
Then we went on to observe some consultations with the house officer. A guy was trying to convince us about him hearing voices from Erra Fazira (a local singer) and that they were getting married. I distinctly remembered that all of us - the doctor, the medical assistant and us the three students burst into laughter and couldn't stop laughing for another 5 minutes. The patient was reduced to tears that we thought it was a joke, and the medical assistant threatened to put him in seclusion if he was to throw a tantrum.
I didn't actually think it was unprofessional until recently when I thought back and realise how horrible was that for the patient. We were encouraging him to keep to telling his 'wedding plan' while continuing to laugh uncontrollably, as if watching a comedy. Sure, I can blame the more experienced staff for not setting the right example. But I wasn't coerced into following the crowd. I was genuinely amused with the patient's story and wasn't giving any thought about he would feel in response to my behaviour. Perhaps that was one of the early signs to suggest that I lack the human quality required of a good doctor.
2. Old man who loved his sago pudding
I don't know much about this old man's history as the ward doesn't give handover to auxillary nurses. After spending a few minutes with him, it was obvious that he was bed bound and he was trying hard to talk but I didn't understand most of what he said. Dysarthria? Could it be stroke? Anyway from his body language I could tell that he wanted the unopened sago pudding in front of him. So I opened it and put a spoonful in his mouth. It was quite a watery bowl of sago pudding. He seemed to enjoy it. Only that as soon as he tried to swallow, he coughed and made some gurgling noise. I instantly felt uncomfortable and hesitated. Before I could think, he was making gestures to want another spoonful. I looked around his table to see if there was any powder to thicken the fluid. There wasn't. So I gave him another spoon. The same thing happened again. He struggled to swallow. So I told him that I didn't think it would be a good idea to carry on. But he wouldn't take any of that. He really wanted some more, and was making more vigorous gestures for more of the pudding. I gave in. Then he choked again. Only then I decided that I must insist to stop and I explained to him why I did it. He looked really disheartened. I rarely see hospital patients with such good appetite. I felt sorry for taking away the pudding that he loved so much. I told his staff nurse what happened after that.
A few hours later I walked pass this old man, and I heard something funny. He was wheezing so loudly that I can hear it without a stethoscope. Shit - I've definitely given him aspiration pneumonia. Shit shit shit!
But there was more bad news to come. I was allocated to the same ward again a few weeks later when the staff told me that he has succumbed to a nasty chest infection and that he was dying. They are just trying to keep him as comfortable as possible. My heart sank. I was swamped with a terrible sense of guilt. I wanted to read his medical notes but I couldn't bring myself to. What if it really was me that made him go downhill to the point of disrepair? I tried to redeem myself on that shift by giving him good patiance and care. But in my heart I knew the damage has been done. I am really sorry.
3. The ligature made of paper towels
I was at a young people's unit of a psychiatric hospital. I hate working here. I have never heard more alarms going off or seen patients being restrained more often anywhere else. I find it awfully difficult to get through to teenagers, even for a normal conversation. On that occasion I thought it was not going to be too bad because I knew all of the patients having worked here not too long ago.
I shouldn't have been complacent at all. I brought a girl into the toilet. We were supposed to supervise them but I wasn't clear if I should have a clear view of them all the time. 'TURN AROUND', she shouted at me. I thought it was understandable to give her some privacy. She then went to the sink and washed her hands when she finished and we went out. I didn't notice anything suspicious.
About an hour later, one of the staff asked me if I saw her taking any paper towel out of the toilet. I said I didn't but I did admit that I wasn't really looking.
I was just walking along the corridor after dinner when I saw that girl with her hoodies over her face and upper body. She wouldn't answer anything I asked, and wouldn't let me see her face and neck. So help was summoned and four people were needed to restrain her to take the hoodies off her. It turned out that she had made a ligature by tying knots from several paper towels and she actually had the ligature around her neck!
Again, I was overcome with a deep sense of guilt. Given that she was able to physically resist four people while trying to remove the ligature, she probably wasn't dying in any way then. Yet I just can't get over the fact that (had we not caught it in time) she could have been died, and the reason would be me: because I didn't watch her properly in the toilet. Things like that really knock my confidence off. I don't think I would be going back to any young people's unit to work again. I can't bear to see things like this happening.
___________________________
I think I have been extremely naive to believe that to be a doctor is to help alleviate human suffering. Patients are always physically, mentally or emotionally vulnerable when they come into hospital. They often have lost independence and are at the mercy of the staff to help them around. And what do we do with this more often than not? We use to our advantage for our own convenience. It's just so easy for us to do harm, to be negligent, to make mistakes, to be ignorant. I always pride myself as patients' advocate. I know no one is perfect. But sometimes I find it hard to forgive myself. If a person dies because of me, what amount of forgiving is going to bring back someone's daughter or granddad or good friend? After all the things I have done do I still deserved to be trusted?
One of the GPs told me even after 30 years of experience, things like missing cancer diagnosis still happen to him once every two or three weeks. Does this mean that I HAVE to ACCEPT that mistakes just happen? Because I don't think I can practise medicine knowing that there is a chance that things will go wrong because of my incompetence. Maybe I should consider doing histopathology or something like that - that way at least I know that I am not directly responsible for a person's life.
Sorry if this piece doesn't sound coherent. My brain is churning.
.
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