Starting Out: Housemanship

I think it’s hard. I think it’s been incredibly hard to work as a house officer. This is the harsh truth.

Just today, I made a mistake and it hit me that what really bugs me the most is the constant anxiety that something can go wrong, anything, everything, any time, any day, whenever. It happened today and I felt absolutely helpless, regretful and can only hope that all will be well. It is time like this you would wish that someone will tell you “it’s alright, we all made mistakes”. But the reality is this, you are not allowed to make mistakes, they bring dire consequences, and you know it. I supposed this is the job we all signed up for as doctors.

Happy days, unknowingly entering the reality of medicine.

11 weeks and counting. That is how far I have survived through housemanship. In all honesty, I think the work is doable. I think it can all be managed as long as you are resilient enough to push through the day, with your mental health in the right state of mind, and your mindset and attitude in the right places. I think for the most parts, housemanship is survivable. But who am I to say that when I’ve only completed half of my first posting?

I’ve known friends in other hospitals, unfortunately in a less ideal workplace environment (and culture). The work is undoubtedly demanding. Bosses are demanding. Superiors are demanding. Some days, there is so much work that you you just cannot help but feel like the whole damn world demands from you. That makes it all so difficult. But for the most part, it’s still doable, I think.

I spent the first 4 weeks, in fact even now, still familiarising with the system. It was frustrating at first, when you are expected to function like every other individual, yet when you are so unfamiliar with how everything works. It was hard, really hard at first. By the fifth week, you’d think you’d get a hang of it. But every day continues to be a challenge. One day you would be ask to get a neuroconduction study, and you would be like “How do I do that? Do I need to refer neuromed?”. Other days, you’d be asked to request an ECHO, and the same thing goes “How do I do that? Who do I call? Where do I go? Do I need to refer cardio?”. But this isn’t the best part. When you finally get a date, say for an ECHO, your bosses will tell you to get an earlier date. Say that these bosses round at 4PM in the afternoon. You’d now be stuck in a daze and be like “What do I do? Who do I go to? Where do I go?”.

It’s challenging when it’s demanding.

It’s challenging when there’s so many plans.

It’s most challenging when you know so little of the system and you are just not equipped to handle the workload.

I think when you are a first poster, naturally everything would be difficult. You would literally wake up every day and think that the job is hard, and you would just rather give up. Truthfully, the challenges every day and the things people put you through, the way the environment and culture pushes you through, every day it gets an inch closer to the threshold where you can no longer tolerate. After all, why put yourself through such lengths?

Naturally, every job has its own difficulties. No doubt. As healthcare professionals, your job is to prevent death for as long as you can. Some deaths are inevitable, i.e natural death, patients with really poor prognosis etc. But little do you know, every little plan you carry out every day has its risks of causing death. One tiny mistake can ripple out in so many ways. Say, terrible handwriting, you may have mistaken a 100 for a 10 for medications. Too much or too little, patients can die from it. Sometimes you get so tired you may miss things out. Some things that cannot be missed out, inevitably gets missed out. Some days are just terrible days, and it happens.

But I supposed when we get into this career, we all know what we signed up for. Or do we not?

Once a student, I think I do know some of it. But I never knew the reality of working through it. It is so much harder.

Now, actually working through it, I understand the complexity and the true nature of the job. The nature of the job? It demands so much from you, and yet so little comes back to you.

Once with hopes and dreams, great ambitions and desire to achieve so much, now you are just so tired everyday that you would want to do the bare minimum and survive through it. That is all you can think and do. That is simply because the work is demanding, and you are just exhausted every day.

Let me now venture into passion. Undoubtedly 80% of the individuals, today, entering medical school would probably say ‘born out of passion’. Yeah I would agree, passion gets us started. Passion puts us through 5 long years of education. Passion drives us to do better, pass our exams, shine in front of our peers, and in fact gratify our innate need to succeed. Passion gives us that.

Passion is the ultimate driving force for one to study medicine, and to graduate with a Bachelor of Medicine, Bachelor of Surgery, or the equivalent of it.

Passion puts us through all that.

But passion does not equip us enough for the demanding workload that you never realise existed. Passion now no longer exist. Passion now dies because everyday is about securing your mental health, getting yourself through and pulling yourself together, for the next day.

Remember, passion gets you through 5 years. But the 5 years after? You are ultimately on your own to fend for yourself. You are now an independent worker, you now have a need to earn for a living, a need to survive through a harsh (sometimes) toxic environment and a need to support your family and yourself. Passion for learning is not the same any more now that you are working.

Learning back then, working right now, is far different in terms of gratification, satisfaction and expectation. Simply, less gratified, less satisfied and unfair expectations.

Putting all together. You would now probably notice the contradictions within my article. I started of by saying it’s hard. Then I say it’s doable. Then I say it’s challenging and demanding. So, what is it? Which is it?

Here’s the truth, there are days where it’s incredibly difficult, and days where it felt okay. Some days are chill days. Some days are busy days. Some days you get bullied, some days you don’t. Some days your bosses are nice, some days they are not. Every day is a different day. In spite of all the challenges, we still wake up every day going to work. Because how can you not? Remember, you now need to earn for a living, you now need to live your own life. It is a constant juggle between maintaining your mental health and the need to sustain a living. The best you could do is just pray for a no nonsense day, and that every day is a good day.

For those who struggle in housemanship, especially if you are starting out, I feel you, and I know how challenging it is. I cannot help but wonder, would it be the same 10 weeks later, 20 weeks later, when you are a bit more familiar with the system and experienced with the work? After all, in practice, medicine is rather repetitive. Could it be extra challenging for us now, just because we just started? I mean look at the 4th and 5th posters. They seem to be doing fine? I think.

11 weeks and counting. I personally have an innate desire to complete my housemanship, it is the lingering thought that I will not be able to, that bothers me everyday. We still try to be positive every day, anyway. After all, what else can we do?

2 thoughts on “Starting Out: Housemanship

  1. First of all, I must say what a wonderful piece this is. As a first poster myself, your experience resonates so well with what I’m experiencing too. Sometimes I wake up thinking “what the hell am I doing?” but some day I wake up thinking “this is not so bad. I can do this!.”
    Its no doubt a constant dilemma but whatever we do, we can only dust ourselves off and push through another day. I agree with you though, this is tough and sometimes confusing but soldier on, Darien. It will soon be over before we know it.

    Liked by 1 person

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