Looking Down

Today was my first experience as a house officer with hierarchy.

I have been newly trained in carrying out DC cardioversions. The procedure where a defibrillator machine is used to shock your heart from an irregular rhythm to a regular one. 

This is usually done under anaesthesia. 

This wasn’t my first DCCV procedure. Me and a PGY2 house officer walked into the theatre and waited for the patient to be put to sleep. The pgy2 has never carried out a DCCV before. The anaesthetist, a tall stranger walked up to us and immediately turned to the other house officer, looking expectantly for an introduction. 

I spoke up and introduced myself as the cardiology house officer who will be carrying out this procedure. The other house officer introduced herself. Instantly, the anaesthetist’s eyes narrowed. But it disappeared quickly and I wasn’t sure if I had seen it.

He said okay then went back to putting the patient to sleep. A few moments later, patient still not asleep, the anaesthetist turns to me and says “who do you call for help?” 

I told him I would call my registrar. He asked for their name. I gave it to him.

A few moments later he instructed a nurse to ask me to write my registrar’s name and phone number on the whiteboard in the theatre “just in case”

The temperature in the room dropped fast.

I did as I was asked.

The patient was finally asleep and I delivered a single shock to the patient’s heart. I then began analysing the rhythm. 

The anaesthetist quickly interrupted me and asked if I was happy. Well Mr. Anaesthetist, I was not in fact happy as the rhythm was still slightly irregular. I was just discussing this with the other house officer when he began taking monitors and oxygen masks away from the patient, and essentially packing up. 

I still thought the rhythm was irregular. I voiced that I wanted to deliver a second shock to the patient. The anaesthetist gave me a look and told me I should really call my registrar if I’m having “trouble”. Ie he was not going to start again and anaesthetise the patient.

I called my registrar and she said she would come up but agreed that the patient should have a second shock.

I told the anaesthetist this and he said “you shouldn’t shock her on this rhythm”. Funny how you’ve made that conclusion now instead of straight away. 

I was wondering what I should do when he said “if you’re having trouble you should really call your registrar to come and review this patient”

He then proceeded to leave. 
The patient did not end up getting a second shock. Luckily for her, her heart reverted back to a regular rhythm later on.

But I was annoyed.

Mostly with myself because I had just let another doctor make me feel small and incompetent when what I should have said was “this isn’t my first DCCV” and asserted what I know.

But I didn’t expect to run into this problem. As house officers you’re the bottom of the ladder, sure. But for someone to outright assume that I don’t know what I’m doing and make that very clear to me is just not on.

You hear a lot about hierarchy. And I’ve experienced it as a student. But this was my first experience as a house officer when I’m actually NOT incompetent at this particular procedure. 

If you look down at someone when you’re at the top of your game, forgetting that you were once at that level and still learning….. well then you haven’t learnt anything really. 

Learning point for me is to be more assertive when I know I’m not incompetent at something. And to not treat anyone else like that. 

Some people are just shocking. Would rather be in the dark ages. 

Can he just not, step on my gown. He needs to calm down.


Sometimes people make me ponder the word ‘maturity’

On my long shift at the hospital, I ran into a girl I knew from highschool. She is now a nurse at my hospital. 

6 years ago, I had a big group of friends in school whom I used to hang out with all the time. This girl, we’ll call her Betty, was in the same year as my group of friends, but not exactly part of the group. If you remember highschool, you know what I mean. 

Anyway. 6 years ago, when we were in our second last year of high school, she had organised a birthday party to which she invited only half of the people in my group of friends. She claimed to know us all but only invited some of us. I was invited, but my close friends were not. Of all the people invited, I knew her the least. I wasn’t entirely comfortable with the splitting of my group of friends because the friends who weren’t invited knew about it and told me how they felt a bit left out. So I told her very politely that I wouldn’t be able to make it. 

Since that one party, my entire group got permanently split up into the Betty squad, and those of us who didn’t make the cut. To this day that remains. I’m not bothered by it. I stopped caring about this situation 6 years ago. 

But yesterday when I ran into Betty, this happened. She seemed perfectly happy to see me and we smiled and hugged etc.

Me: hey! I didn’t know you were working here!

Betty: hey! Yes I live here now! Haha what are you doing here?

Me: oh I’m an intern here now so I guess I live here too haha! So I guess we’ll be seeing each other more now!

Betty: yeah! And maybe you’ll come to my party next time I invite you!  

We met in the hallway when we were both going somewhere so I said something like  “sounds good!” And walked away. What she said only registered 2 seconds later.

I was in complete shock. It made me wonder what kind of person would say something like that. 

That whole affair was 6 years ago. Actually it was high school so it’s basically a million years ago now. And I haven’t spoken to her about it at all. Every time I saw her after that, I had talked to her normally and she had done the same. As far as I can remember. 

What would cause someone to hold onto something so little for 6 years and bring it up to a person they haven’t seen in 6 years?? Did she expect me to stop and be like oh I’m so sorry. Let’s stand here and discuss that whole situation in the middle of hallway and clear the air.

What the heck?

It’s just so immature and sad and petty. This is in fact, Taylor Swift level pettiness to be honest. She’s clearly the kind of person who buries hatchets but keeps maps of where they are. 

It was ridiculous. What exactly does anyone have to gain by holding on to such minor grudges? Now I’m likely to avoid talking to her ever again. She made me feel glad I missed her party and didn’t join the Betty squad 

I just don’t understand continually harboring negative feelings towards someone. Especially not about something this small for this long. 

How mature is that? To say it in that passive aggressive way to someone who stopped to say hi to you. Someone who was genuinely happy to see a familiar face. Hostile much. And way way immature. 

She must have had extremely strong feelings about what I did. But even then. After a certain age, don’t issues like this become small in perspective? They certainly have become small in my perspective. What else is this person likely to hold grudges about? Omg remember that guy 10 years ago who took the last cookie at the shared lunch when I said I was hungry but didn’t want the sandwiches? He’s such a jerk. 

If I think really hard about my life, there’s only one person that comes to mind who I have negative feelings about. But that issue is still relatively recent and it was certainly not because they didn’t show up to my birthday party. And even So, if I saw that person somewhere, I would not bring up the issue – or anything for that matter. I’d avoid them as best as possible. Not smile and throw out a shady comment.

It’s just. Some people just don’t grow up. But then again, does anybody? I mean, I was bothered enough to rant about this on my blog which is supposed to be quite significant. Some might think that’s immature. But I don’t know. I find what she did/said so appalling. You just don’t deal with people that way. 

I suppose I’m grateful I won’t be doing that to anyone anytime soon.