"If you can force your heart and nerve and sinew
To serve your turn long after they are gone,
And so hold on when there is nothing in you
Except the Will which says to them: 'Hold on!'"
-Rudyard Kipling, If
Medicine, particularly Internal Medicine, as a specialization is very fulfilling. You get pure satisfaction seeing your patients improve. Your heart leaps when they tell you "Thank you Dr., you made me well." Great as it is, it's a very very very tiring job. It's so tiring that I begin to envy all those who take an 8 hour job with day offs to boot.
The high learning curve of keeping up with current therapies and technicalities, the pressures from consultants breathing down your neck because you made a lapse of judgment, the humiliation of being made to realize that your management is not so good, the frustrations from stupid nurses who can neither have the initiative to plot a basic vital sign chart nor monitor the blood sugar of a patient, the intricacies of dealing with your co-resident's psychological make-up, and the pestilential disturbances from patients' bantays all boil up to something I don't want to face day by day by day. I am amazed at the "masochisity" of these residents who have already adjusted to this kind of grind. This reminds me of Orwell's seminal novel, 1984 where all the workers gladly accept this kind of life without even questioning the injustice that's built in it.
At each turn of the screw wherein each manpower and life-support disappears, fulfilling my obligations here in this facility is getting to be more difficult. It has that feeling of spreading myself too thinly. How? Hmmm... While on ER with all the toxic patients, nurses from the wards refer to you for management for their deteriorating patients. After two minutes, the wards calls you up because someone's cardiac rate went bye-bye.... Or in the morning after rounds, you eat a 15-minute lunch and go to the OPD only to be disrupted by a call from your consultant that he/she will do rounds with you. Something like that. Imagine a hospital where only 2 residents go on duty for the night and in their hands lay the power over life inside the ER, ICU, and the wards. It's unbelievable. What's more amazing is the fact that they are honed to perfection in this kind of situation. Our recent graduates have proven their worth during their last years and I am confident that the training in this God-forsaken Somalian facility can bring the best in a resident. The question is: can I see myself here toiling like a laboratory rat for three long years (while the rest of the world passes me by?) Perhaps. It's still too early to tell.