Painful introversion, yet again

I don’t realize how much I like being alone until I go out with someone I’m not entirely comfortable with. This is why I don’t date. This is why I’m thankful I don’t date or get asked out a lot. I do like to do some things, especially eat, which is what people mostly do on dates, but if I do something I like with someone I’m not comfortable with, the thing I enjoy doing becomes something like biting into pure matcha powder.

It takes me huge amount of time to be comfortable with someone. I surprisingly got comfy with my med school classmates a bit faster than usual because I am with them in the most nerve-wracking situations. Being in med school with them is like watching a horror movie with them. There is a special sort of bond you form with your med school group-mates or duty-mates. I particularly don’t get comfy with boys as easy as I do with girls, but my group-mates have a special place in my heart.

Last night, I went out with a family friend whom I bumped into on the way home, after a 36-hour hospital shift. He could tell I was really sleepy because my eyes were getting heavy. I blamed it on dry eyes, which I did have. He is nice and I’ve always known him as someone like an older brother. But it was weird for us to go out and eat, just the two of us, because I was used to seeing him with our families, and our other family friends, together. I’m usually comfortable with being with a guy alone, if and only if I know he has no fishy intentions. This guy opened up to me about a lot of things, his struggles, why his girlfriend broke up with him, and to be honest, I was not 100% comfortable. Once I find out he does not have any intentions other than friendship, I may actually enjoy hanging out with him. That is, if I don’t come from a 36-hour shift. I enjoyed listening to him, and I feel like I could talk to him about anything, any weird thing.

I told him about something I saw online before, and I find it quite true: introverts don’t really make their own friends. Extroverts just pick them up out of nowhere, in the middle of their alone-ness, and adopt them. My best friend from high school and college are both extroverts. I am seriously wishing he thinks of me just as a friend, because he is quite an awesome person, but not someone I’d like to be with that way.

If you walk into a room, I’m not really the most attractive person you’d find. However, I don’t think I’m butt ugly. When I was rotating in Surgery, the resident who was in charge of us, medical students, told the whole group that he overheard a surgical resident or fellow tell someone I was attractive. I tried to hide my face in my surgical gown, which we had put on because he was teaching us the proper way to put it on at that time. I didn’t know how to react. After that, our group chat was bombarded with messages about why I did not tell them about that, and who the guy was. Even I didn’t know who it was. I still don’t know up to now. He proceeded to tease me in front of the whole group about how I was a girl-next-door type. I didn’t really know what that phrase meant even though I’ve been hearing about it a lot before. I Googled it right after.

Anyway, after yesterday, I realized I was actually happy I didn’t go out a lot and don’t get asked out a lot. My identity as an introvert got more cemented. I was also thankful I’m not attracted to someone. I’m weirdly thankful I don’t have someone who likes me back, too. Simply put, I’m thankful to be alone. I love my alone time so much. I like being in control of my own time, and I hate having to reject when people ask me to go out with them. I’ve actually dodged some people a lot of times. I’m glad I get away with it. I’m glad they just kind of leave me alone. I’m really awkward when it comes to dealing with strangers and groups of people. I have never wanted to pursue Anesthesia or Radiology so much. Aside from the fact that I am really interested in those two fields, they are perfect for my personality.

I realize I need a lot of time for my identity to be rooted in God. Because if I don’t take time and effort for this, I will be a lost person. I’d be making all my decisions for myself, and I’d probably break a lot of potentially good relationships. Maybe others can live without God, but I really need God in my life. I depend on Him so much. I’d really like for this aspect of my life to be aligned with what He wants, so if He doesn’t want it ongoing right now, then I wouldn’t want that for me as well.

I just have to let Him know I would like a future husband and three kids. And a golden retriever, too.

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Pain score 10/10

Whenever there is pain involved in a patient’s series of symptoms, we try to quantify it by asking, “From a scale of 1 to 10, how would you rate your pain?” Very much like Baymax from the film Big Hero 6. It’s a pretty subjective way of grading pain. 8/10 for some patients could just be 5/10 for others, and vice versa.

For the first time, a few nights ago, when I was on duty, I saw what real 10/10 looked like. It was a 7-year-old male, who was being considered for TB meningitis. He had a severe headache. And when I say severe, he would wake from intermittent sleep, thrash around in his bed, crying and screaming, asking his parents if he were dead yet or why he was not dead yet.

It made me sad. It made me mad about all the 10/10’s I’ve heard before from patients who could casually sit on a chair and still decide whether the pain they had really was 10/10. Maybe it was the greatest pain they’ve had in their lives. But to see a kid prefer death because of pain just really tore my heart. His parents just sat beside him, not able to do anything. Beside this kid was another girl who had viral encephalitis, and was not oriented in three spheres.

The boy was eventually transferred to the pediatric ICU.

On courtship: a rant

Just a disclaimer. I am not generalizing things. It may be the same in your network, or not. I’m just ranting based on what I see in real life and online.

So they consider texting a form of courtship now. I saw a post on Facebook which featured what seemed like a chatbox of a guy messaging a certain girl, and that the girl was not replying. He kept on sending messages like “Hi,” “Good morning,” or “Good night.” The caption to that screenshot went along the lines of, “This girl is not worth the effort.”

Seriously? You call that effort? If that is effort, then what do you call my grandpa going to my grandma’s house and serenading her with a guitar, at the risk of her father getting angry at him? What do you call my father visiting my mom at work and taking her out to eat at Icebergs so he could talk to her? I asked a guy friend this particular question, and his answer went something like, “He might be scared to say it in her face.” So do you mean to have a relationship with a female robot on your phone?

I’ve always thought I was born in the wrong decade. I get freaked out nowadays whenever people check their messages through their watch. That was just something we used to watch in cartoons or science fiction films. I react whenever someone’s gadget rings and they check their watches for their messages, and they laugh at me for reacting. It’s amazing to see; at the same time, it’s scary. We’re dwelling on the potential of artificial intelligence, but that’s for another blog post.

That’s something they consider normal. So I guess text messaging as a form of courtship is considered normal. But for me, that’s not effort. Text messaging is easy for me. It’s something I do every day. It’s second nature for me to text. I text my mom when I have to send a quick message, but I at least call her if I want to tell her something. I need to hear something that is a part of her, like her voice. You can’t have a full personality behind a phone. Hiding behind a cell phone is not effort. I guess getting the guts to say something through text does take effort. But if you want to have a relationship with a person, you have to court the person, not the cell phone in front of a person.

Another thing: why is cheating rampant? I am not too exposed to this, but based on rants you see online, there will always be some form of cheating going on. And I’m not just saying just guys cheating on girls; it goes the other way around. Why? Why can’t you just have the guts to break up with the guy or girl like a decent person before you start something with another?

I guess I’m ranting because I’ve been involved an incident like this. For two times. The first time was with a guy who had a girlfriend. I’m classmates with him in med school. At one Christmas party in third year, I had too much to drink, and the next thing I know, he’s standing next to me. And because I was an idiot who didn’t know when to stop drinking, I said “yes” when he asked me if I had a crush on him. I didn’t really like him like that, but I found him cute. As in, bunny or baby kind of cute. But while drunk, I actually told him to not cheat on his girlfriend, because I won’t want my own boyfriend to do that to me. Nothing else happened. We were together the whole night, but since I was intoxicated, our conversation circled around that. I ended up not drinking for one year as punishment, and I stopped talking to him for a while.

And right now, another guy who just celebrated his fifth anniversary with his girlfriend keeps messaging me. It’s ridiculous. It’s all “Good morning,” “Good evening,” “Keep safe!” And what’s even more stupid is that it hasn’t been a whole week since I knew him. I know him because we’re both rotating in a hospital and we come from different med schools. If I were his girlfriend and I found out he was messaging someone else like this, I’d be furious. His messages are one of those I see first thing in the morning, along with messages from residents’ commands from the ICU, code blue alerts from last night, and other group messages asking about various patients. My other messages come from my family. Don’t tell me this is not suspicious. It’s ridiculous. What’s even more ridiculous is that in real life, he’s a man of few words. I know it’s not something innocent, because girls from his school were looking at us when he sat beside me, as I was eating breakfast alone.

…Boy, what are you doing?

My mom is actually praying to God and asking Him why I still don’t have a boyfriend. I laughed when she told me about this, but at the same time, I can’t help asking myself why. Am I butt ugly? I told a friend about this, and she said it was because I was choosy. But if the guys I keep encountering are like this, why should I settle? Come to think of it, that friend I was talking about just became single, fresh off a relationship which lasted six years. And yes, the guy had a history of cheating on her. See?

Why should I not wait for someone who likes talking about random things under the sun? Someone who watches science fiction as much as I do, and also thinks this exponential development of technology is alarming? I don’t even mind paying to go out to eat with someone with good heart and a right mind. He doesn’t have to be perfect, because no one is and I’ll have to be single forever if perfect is my goal. To be honest, I have yet to meet someone with that kind of soul. And I’m not really saddened. I believe it’s not the right time.

Some days are just really good, and not because they’re out of the ordinary. It’s an ordinary thing to go home after a long 30 to 36 hour duty at the hospital. But the shower I just took was seriously the best shower EVER. After 30 hours of being on duty at a hospital which does not have airconditioning and which caters to the sick — and when I say sick, I mean really sick, like multi-drug resistant tuberculosis, TB meningitis, pneumonia as a complication of measles, and meningococcemia kind of sick — that had got to be one of the greatest showers in history of man.

Yesterday was the first time I did CPR. In our home hospital, it was the boys who pumped while the girls would bag air. Yesterday, I pumped. On a 5-month-old who had pneumonia as a complication of measles, as well as monogenic diabetes. In our home hospital, those we did CPR on were elderly, frail patients. In this hospital we’re rotating in for a week, it would be all kinds of patients, of all ages, who manifested all possible complications of diseases, things we would only read in text books but we should not see in real life, because ideally, they are already controlled, by vaccines most of the time.

It’s sad. It’s also sad that I keep getting my feelings in the way of my work. I must have a slight anxiety problem. Either that or I am not owning what we are headed to — doctor of medicine. I let the little things get to me, like my lack of experience. I let the big things get to me, like what’s the point of keeping the hospital functional if all patients who come to the ER are critical anyway. Why do we make them think there is a way out, when the only way out is a miracle or death?

I hate that I like to think about these things. It makes me lose focus, like how I should be focusing on the exit exam we’ll be having tomorrow. I thought we just started rotating there. A week could go by so fast.

Random Thoughts

I gained a few pounds. I’m not even stressed for the past 2 months because we’ve been rotating for 2 weeks each in minor departments – Neuro, Psychiatry, ENT, and Ophthalmology. Okay, maybe Neuro stressed me out a bit because it was also a difficult time for my family, around that time in February, and I wasn’t really able to cope. Neuro was just a really difficult subject. But right now, I’m thoroughly relaxed. It’s 11 in the evening, and all we have to wait for are ER referrals in Ophthalmology. We don’t do rounds because most of our in-patients are referrals from other services or departments. Even if it’s a relatively relaxed field, I’m not too interested in Ophthalmology. It doesn’t fascinate me the way Anesthesiology or Radiology does. I even get bored with Radio sometimes, especially when all I have to do all day is sit in front of the computer as the resident reads x-rays. I’ve just been considering Radio because I also want to have a family, with a husband and three kids, and a golden retriever or a black labrador. I think it’s one of those medical fields when you can still have a work-life balance. Those two fields are fighting for top position right now.

Back to the what I first started talking about — I just have been loving eating, and because I have spare time to eat, I have been eating a lot. I’m on duty today, and it’s a Sunday, and I was able to watch some anime episodes from my childhood, as well as some K-pop Youtube videos. I have been studying in between, especially when we see cases I wanna read up on. I’ve been enjoying as much as I can, because the next 2 months mean a bit of challenge for me — I’ll be rotating in Internal Medicine, before our much-awaited 1-month summer break. And then we’re off for our last year in medical school.

Can you believe it? I cannot believe it myself — that we would actually come this far. I remember something I heard from worship service at church from a few Sundays ago, “Everything we have in this world is by the grace of God.” Though my faith is being tested right now, I still believe it is by the grace of God I am here. I could never have done it without Him. I could never have had fun in the process without Him.

I’m not the smartest or most intelligent kid in the house, and I’m not even sad about that. For some weird reason, there are a lot of kids in my class who are at the top, but are not doing well in hospital rotations. Gone were the days when we thought being bookish could get us through all of medical school. In the hospital, your work ethic and the way you strategize really matter. It’s part of the surprise survival games of medical school.

I specifically have something I have to overcome, and I think I’m already more than halfway through it. Other than my problematic PMS, which only occurs once a month, (which involves my having the urge to cry at the most absurd or shallow things), I am usually the target of difficult patients. We have a code name for them among ourselves. When I say difficult patients, I mean those who hate waiting at the hospital for too long and will not hesitate to embarrass at least one hospital staff in public. And by hospital staff, I mean me.

I think it’s my face. I think I have a kind-looking face which people can treat as an emotional punching bag. At first I used to get nervous of patients like these, but I just got used to them over time. They all end up apologizing to me in the end and making excuses for their behavior. At first, I used to feel my cheeks getting hot and my ears beating, but recently, I have been responding to them about how I understand them. Because I also don’t like waiting in hospitals. I don’t like waiting in general.

Seriously, it’s my face. I go on duty with a guy medical clerk who is a lot taller and bigger than I am, but they always choose to target me and burden me with their complaints. I’m glad these actually turn into learning experiences instead of something that can cause me trauma or stress. I still have a lot to work on — I tend to get touchy after a 24-hour duty and I still have to be in the hospital for 8 more hours.

But I like to think we’ve come a long way.

I entered an interesting surgery

Yesterday, I entered an 8-hour surgery. It was a mandibulotomy with wide excision of a mass on the floor of the mouth and the base of the tongue, which they suspected was cancer. What they did was they put a tube on the patient’s trachea while she was awake, under local anesthesia, because the anesthesiologists were too hesitant about intubating her, as her mass could obstruct her airway and they might not be able to salvage it in the worst case scenario.

After that, the ENT surgeons proceeded with the main event. They opened the skin, starting from the right side of the cheek, going across, then half the lip, down to the chin. And then they extracted a tooth so they could saw the mandible open to access the floor of the mouth and the base of the tongue. Of course, it was difficult to dissect the tissues because they were adherent, and they had to identify the anatomy. Correction, had to identify the anatomy. One of the attending physicians was interrogating me about anatomy the whole time, and I was horrible at it. I did get the clinical part about salivary gland tumors and their most common features, but anatomy, I failed to answer most of the questions. It was pretty embarrassing.

It doesn’t change the fact that it was an amazing surgery. After dissecting the tissues, they resected the tumor. It was infiltrating the lingual and hypoglossal nerves. There was a mass on the base of the tongue itself as well as on the floor of the mouth. They then put part of the sternocleidomastoid muscle so they could replace the bulk they removed, as well as with some gel foam, and then closed the mandible with two titanium plates, and then the skin. I was NPO for 12 hours, which was not too bad, considering the operating room was freezing and all my metabolic functions had probably been suspended, including that of my brain’s.

It was an OR my groupmates were avoiding. I wanted to enter it but I was hesitant because I was about to have my period. I did all prophylactic measures I could do, but I was probably stressing about it as well, it did not come until the day after. We were in the OR at 1 in the afternoon, and we got out at 12 midnight. After that, I still had to do ward work and respond to ER calls with my resident until around 4 in the morning. I had to wake up at 6 AM to do some rounds before endorsing at 7 in the morning. It was a toxic last duty in ENT, but it was one of the most memorable duties I would probably have this year. I had quite a lot of fun.

If I’m going to be positive about something today

It’s that in less than two years, I will finally be paid for what I’ll do as an MD.

That hit me like a train.

It doesn’t change the fact that we’ve been working 36 hours 2 to 3 times a week and we’re the ones who probably pay the hospital/ medical school the highest amount of money. Then again, we always thought we, the medical clerks, were the lowest forms of mammals. But we were wrong. We discovered it was the first year residents. They still think we’re babies. Anything we do, any mistake we commit can be forgiven and is part of the learning process. We never really get in real trouble for any mistake we do. We rarely really harm the patient, because we’re not yet allowed to truly handle them. But once you have the MD plastered at the end of your name, all your decisions, even if you are working under an attending, matter. Any slip you make will be taken against you. Even the things you did not do may be taken against you, because you’re the most junior, and you’re not allowed to protest.

Though there are some friendly departments in our hospital, you really can’t get rid of the culture of seniority in the medical field. It’s like being an MD has not only given you a license to practice – the white coat has also given you the license to become a jerk, because you earned it, because you were once at the bottom, and only those persistently stupid enough to keep saying yes to medicine are able to ascend on the ladder.

I have stopped being idealistic about medicine sometime this year. I don’t know when. I might not know how. I believe we enter medicine with expectations of how it’ll go, and we think we can always say yes to exhaustion and stress, because we are young, and we have big dreams ahead. We’re still at the beginning of the race. It’d be too early to opt for  water break.

I also think no one really enters medicine with a full idea of how it is like, even those whose parents are doctors, or those who have close relations with doctors. You only fully get it once you’re in it – once you’re working overtime, more hours than anyone else in the world, and not getting paid for it; once you start taking meals 5 hours later than intended or not at all; once you experience not taking a shower for 48 hours straight; once you don’t get to do the basic things normal people normally do. And you start to think if it’s what you really want. If it’s all worth it. Because once upon a time, you wanted to become a doctor to save the world (or at least, part of it), to contribute to the good of mankind, or to follow a giant dream.

Every day, when you are deprived of the basic things, and when much is expected of you, when you never really fully meet these expectations, you realize it’s nothing like saving the world. It’s not always having the key to people’s lives. Most of the time, for hospital babies like me, it’s dirty work the residents wouldn’t bother to do. It’s people not being friendly towards each other. It’s being in that kind of environment 36 hours a day. I have a feeling it’s much, much better for attending physicians, who get to enjoy the fruits of years of labor. For now, I’m stuck in my own trouble bubble.

I know it’ll be worth it. I don’t have to be a crucial part of someone’s life to make it worth it. Right now, every day, it’s enough that I learn something new, and to keep the fascination alive. It’s always important to keep my feelings in check, because I’m very in touch with my feelings, and anything affecting them will affect my work gravely. I guess it’s good to know where I should start. Then again, we’re not made to stop at the starting line.

I know it’s not dirty work forever. I just really want to enjoy what I’ll do in the future.