of course i can do it, it's just i don't want this unhappy life

I need to be kinder to myself because who else is. My stuffy nose is giving me headache and I don't know where I stashed my PCM, so here goes me hiding in the surau cause the rest of the hospital is freezing cold.

I'm a good doctor. I know things, not much, but enough to not kill patients.

On Sunday when I was oncall, ED referred me a perianal abscess in our POD 40 transanal pullthrough. Child not septic and I've never seen one before, but I know this is his coloanal anastomosis leaking and he has a pelvic collection that trickles down to manifest as a gluteal abscess. I presented so to Mr. Fitri and he agreed that we need an ultrasound next morning to confirm. 

That morning the rest of the MOs asked me why I label him as pelvic collection when the thing looks like a regular gluteal abscess, my answer is that when you have an anastomotic leak that low in the pelvic, they manifest with tachycardia a bit, fever here and there as per Mr Mughni taught me. Just small things, until the collection is big enough to manifest externally. Kid ended up with a stoma and I&D. 

And then we had a POD 4 transanal pullthrough (stoma down) girl who was discharged that morning and came back that night with persistent vomiting. I admitted her thinking of enterocolitis ddx adhesion obstruction and wanted an AXR cause I need to figure why she's vomiting. Mr. Fitri said to observe first since her vomiting was non billious and her abdomen wasn't distended. 

Turns out her vomiting persist to high billious output during the next 4 days she was warded. We ended up doing an ultrasound (which showed TZ at jejunum) followed by an AXR the next day where we saw her small bowel centrally dilated with paucity distal bowel. We did adhesiolysis for her. 

Kirosha applauded me for being right. In retrospect I should have said to Mr. Fitri that I needed an AXR to rule out proximal small bowel obstruction since her abdomen wasn't distended. 

Today morning I presented a systematic review critic for laparoscopic versus open appendicectomy for complicated appendicitis in children. 

What happened was that after breaking my brain half heartedly looking for a paper, I decided on the topic yesterday evening and got complained by my surgeon "esok nak present kenapa petang ni baru tanya". Sorry miss but I have been searching few days and can't find a better one. Been mentally preparing myself for the past 1 week but here we are.. 

She said to go with it. So I went back around 6pm, dinner and date with Jehoon until 9pm plus, and only around 11pm did I open my laptop to study the CASP checklist on criticising a systematic review. Thank you Ms Doon for teaching me this thing exists and it was actually my first time using it. I finished my slides close to 2am and slept until 7am. 

And then I presented. I was preparing my script for the presentation opening with "I'm not good at this but I should start somewhere" but I didn't say those. I didn't do badly, I think it was okay. We had a good discussion.  

Perhaps these people are right. I can do this. But hey the issue nowadays is not that I cannot do this, it's that I don't want to do this. 

But I'm still here. I'm still taking one step at a time. Like that time I hiked up Maliau Rim feeling so mad because I didn't want to but I still made it up there, cursing and all. What now? 

To be a surgeon is to be a better doctor. It's a different standard. I have to improve.