I started my clinical year with paediatrics, learning about neonates, babies, children and adolescents. In the NUH and KKH wards, I recall the high-pitched cries of babies, seeing playful kids running about freely in the wards as though they were in the playground, not to forget the anxious looks of parents sitting by their children's bedside, attending to every single detail of their precious ones. The posting was easily the toughest, but it was enjoyable - the kids took away some of the pain of having to start with the most difficult posting.
Then, I moved on to general surgery at SGH, the mecca for surgeons. The patients in the wards were varied in terms of age group - there were the old uncles with diabetic foot, and there were a few young ladies with breast cancer. The posting was tough, less so in terms of the knowledge part but much more so in terms of the hours involved. OT, SOC, night calls, rounds that started at 6.15am - it really takes a lot to be a surgeon.
Then came orthopaedics. In clinic, most patients seemed much fitter for op. In the wards, most patients were post-op. Many things were not more complicated than algorithms, at least for the undergraduate level. The rest were left to the HOs or blue letters.
Next was general medicine in CGH. The patients were heavier on the geriatric side, and for most of them, over the years their issues have multiplied, not only in numbers but also in dimensions. 'Refer MSW' became part of the SOP for every morning's rounds. Content-wise there were the approaches to chest pain, breathlessness, headache, dizziness, weakness, vomiting, diarrhoea, jaundice... The longer I was into the posting, the less I seemed to know. It just did not feel right to have worked hard through such an important posting only to feel that my learning was inadequate at the end of it. But I guess that is the nature of general medicine - there is just too much to learn in too little time.
The last posting was family medicine. After months of training in the hospitals it was quite refreshing to see how medicine is actually being practiced in the community. The settings could be very different, from the GP's clinic and polyclinics to the community hospital, palliative care, nursing homes and occupational medicine. The stint in palliative care was especially thought-provoking. People can react in unpredictable ways when confronted with end-of-life issues.
From the first days of a newborn to the twilight hours before one rests forever, life comes a full circle. Coincidentally, my clinical postings have taken me through a similar path - it was like going through a brief summary of life. As the time for several major decisions to be made draws nearer, I begin to wonder: how would my life story be like?
