Jacky Lai

  Intership differs greatly from clerkship that interns are functioning staffs for nurses, whereas clerks are just bunch of nonfunctioning foreign bodies.  My very first minute as a neurologic intern, i was asked to re-insert a N-G tube for a hemiplegic patient.  It's not quite a problem for me actually, 'cuz i've done such procedure several times during my clerkship.  Two hours later, the resident asked me to collect arterial blood for gas analysis.  Puncturing artery needs some fine techniques.  First of all, the vessel wound be engorged by tension, which means that the practitioner can only depend upon arterial pulsation.  Secondly, blood gas analysis needs strictly the arterial blood, as being an important indicator to patients respiratory and metabolic status.  I'm so glad that i've succeeded in my first four arterial blood collection, thanks to a paralyzed patient that is totally unable to resist my practice. As a matter of fact, aggressiveness during my clerkship makes the transformation of a clerk to an intern rather easy for me.  Besides, i'm very pleased with my job.  It definitly aint well paid, averaging no more than 58 NT/hour, less than 2 USD for an hour, but i'm ok with it.  It's the satisfaction what i'm seeking for, not salary.

  My first duty was a holiday-duty.  The ward was crowded that night, so we didn't have any new admitted patient.  But there was a very critical patient in our team.  He is a case of large MCA territory infarction, or severe stroke, and his family has been adviced to receive intubation.  They denied and signed the DNR permitment.  That night, i had a very bad feelings that something might go wrong.  My cellphone didn't ring for nearly four hours making me more suspicious for what's gonna happen in the next few hours.  As i was about to fall asleep "again", it rang and the nurse was speaking with anxiety. "7A-16A, shortness of breathe, unconscious!!" I jumped off the bed and rushed toward bedside.  On the way, i ordered a blood gas analysis, biochemistry panel, and electrocardiograph STAT.  When i arrived, nurses were busy maintaining his respiration.  Without any sign of hemodynamic changes, i collected a syringe of arterial blood and finished ECG.  After we stablized the patient, the duty supervisor arrived and decided to repeat CT scan at once.  It resulted in hemorrhagic transformation with aggravating brain swelling.  For most neurologists, this aint a good sign, not only for prognosis, but also too life-threatening.  We used as much mannitol as we could, and amazingly he woke up a few days before i left and spoke to me just like nothing happened.  This is some case to memorize.  As a begining of my career, this "is" a wonderful experience.

  Speaking of career, "office romance" is one of the issues that we definitely will encounter someday.  During these days in Keelung, I did have someone that came "closer" to me.  Not that we have anything unusual, it's just that one of her patients belonged to our team was very uncooperative, so I helped her out alot.  Since she's an young and unexperienced nurse, it is inevitible for her to have lots of problems.  Whenever she had a problem, she turned to me, and I never let her down.  Curiously, everytime i was delayed for lunch, she'd be the one left in the conference room (where we have our lunch and dinner).  A rumor between us started to spread, and our colleagues began to make fun of us, e.g., when i finished my lunch and left for my patients, some nurses would say, "what so hurry, Dr. Lai? Just stay for 'a while'!"; when i was busy doing my chart work, some would say, "c'mon, lunch time.  You have plenty of time to do it, someone's waiting for you inside."  I began to feel a little bit annoying and awkward, especially when we're chating.  I would like to say that this kinda relationship is not what i would prefer.  No room for error, no time for conflict.  It's too much pressure for this situation.  On the last day, she asked me if i would like to have dinner with her, it was the first time i turned her down.  No one needs this aggravation.  And last night, my roommates and i concluded that being single is one of the benefits to get through our internship smoothly, but we'd have to face some even more disturbing problems.  it'll be better to have a girlfriend rather than to be the topic what they're talking about.