White-coated ramblings: (7) Death happens.


Source: Google images.

Ever since my first shift at Internal Medicine rotation, I’ve accustomed myself to the fact that people die all the time; Internal Medicine  wards are the terminal station for the chronically ill, and I came to believe that Death lives in there. But I have always dreaded the moment I would witness someone die. It happened today.

In an Egyptian governmental hospital, It’s always the same scenario; relatives insanely knock your door asking you to come see the patient because he had “fallen silent”. He was an 80-something man with multi-system issues, and his pulse had gone unpalpable. My heart sank. My shift had almost ended, and I was there, on my own. He was on a wheelchair. Some worker should move him to a trolly so we rush him to the ER while I start CPR, but nobody was there. There’s only one working elevator at the floor that serves doctors, patients, and their relatives, so when arrests happen, you have to run to that one elevator and knock heavily shouting “arrest!” in order to get it as fast as possible. Meanwhile, the patient was still on the wheelchair, pulseless.

He got to the ER on the wheelchair, and CPR was started only when we moved him to a bed at the arrest room. I was afraid perhaps he would die because I was too slow, but then after all, I was on my own, and I did all it took to rush him there. Things get easier at the ER, at least there are residents with more experience than a lonely house officer.

“It’s too late, let him die in peace.” The resident said after multiple cycles of resuscitation.I froze.

“Wait, there’s pulse, he came back!” Said the nurse. He did come back, and I wanted to hug him for that. I think I was the only one in the room who was very thankful. To be honest, a part of me didn’t want him to die in my shift.

Then he had gone once again, we resuscitated. He came back again, but then he had gone for good.

And there I stood, facing a dead man in a room full of people who bore no emotion for him. I don’t know why I held his hand for a moment, but I kept staring at him, a part of me hoping for another comeback, and the other part relieved it was finally over. An eerie feeling. But then, this is life, and death happens.

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White-coated ramblings: (3) The resident/nurse superiority/inferiority complex!


Source: Google images.

– So what kind of doctors are you?

– A  house officer.

– What is a house officer?

– Basically the hybrid of a nurse and a porter!

Undeniably, we have a defective system, no I’m kidding, we have no system at all! If you’ve ever been to a hospital, you already know that a major part of a nurse’s job is giving injections, obtaining blood samples, blood transfusion, IV salines, inserting cannulae, and monitoring the patients vitals (blood pressure, temperature, etc.). 

Since the very first day as a house officer, I’ve been doing all of the above, and because there’s no such thing as porters, I’m also the one sent with patients’ files and blood samples to finish the paperwork. I haven’t done a single task that required any of the medical knowledge I earned in the past 7 years. I no longer even know what nurses are for, I mean beside mastering the art of  humiliating and delaying you!

  • Example: A patient is so feverish and needs an immediate IV antipyretic. I am the one responsible, so I go to the nurse and beg for the medication. She refuses, and demands the patient’s file first, which should’ve been with her in the first place. I don’t have the file, so I call the resident, and she tells me I should find it with the nurse. And the vicious cycle goes on until I find the file on the nurse’s desk! Meanwhile, the patient remains feverish!

While you try your best to get the above mentioned tasks attained, residents (who mostly have narcissistic issues) can do whatever it takes to abort them. I have to admit that my residents so far are kind enough to teach me and thank me for my efforts, but I get sent daily to other departments to request consultations and interventions, and I almost always get shooed like a cockroach or treated like I didn’t exist. It’s so pathetic that some residents are so delusional they believe they are the Gods of their specialty!

  • Example: A 3-month-old boy needs a urinary catheter. The pediatric resident doesn’t want to catheterize him, so she sends me to surgery hospital looking for a urinary tract resident. I request the procedure, but the resident ignores me as if I’m a mosquito buzzing around his head. When he finally responds, he tells me to wait. I wait for an hour, but he never shows up!

The only reason I put up with this crap, is because I once believed I could help make patients’ quality of life better, which right now sounds very naïve and ridiculous! Now one only gotta do this for the sake of God and nothing else!

 

 

 

24 things before turning 24!


Source: Google.com

So, after all,  last year’s list wasn’t quite a failure. With studying and exams being eliminated this year, I hope I’ll have the time and space to meet all my goals this time.

Let me start with some items I couldn’t tick off last year:

1. Finish my novel(s).

2. Win NaNoWriMo.

3. Scrub-in, preferably in an eye surgery.

4. Reach my ideal weight.

5. Finish “Insanity” workouts without twisting any joints.

6. Learn to dance.

7. Earn drivers’ license.

8. Read 20 100 books at least, including the Qur’an.

9. Speak French.

10. Play guitar.

11. Volunteer in a cause.

12. Fall in love.. or not.

And now with brand new goals:

13. Pick a specialty; I haven’t yet determined whether I should be an ophthalmologist or a psychiatrist.

14. Prepare for a fellowship in the picked specialty.

15. Save a life.

16. Run regularly for at least 3 months.

17. Run half a marathon.

18. Buy a heart rate monitor/fitness tracker.

19. Eat clean for at least a month without cheating.

20. Build abs.

21. Earn a belt in judo.

22. Go sky diving.

23. Attend a live concert.

24. Inspire more people.

What’s on your list this year??

White-coated ramblings: (2) Doctoring kids, AKA saving the planet!


Source: Google images.

First off, let’s just state the fact that crying kids are my least favorite creatures. Sick-screaming kids, on the other hand, are my personal imagination of an alien master plot to dominate earth.

So basically, my 12 hours at pediatric ER were witnessing vomiting, diarrhea, pneumonias, and the non-ceasing chorus of screeches mingled with the beeping of monitors. Such scenario would be somehow tolerable if it wasn’t in a governmental third-world hospital. Remember when I said it’s kind of like Grey’s Anatomy, except that it’s nothing like it?

Well, for starters, we deal with the lowest possible socioeconomic classes. Most of the patients are impecunious and ignorant (if not even illiterate), that never annoyed me; it’s not their fault and they deserve treatment. The disaster is that we, doctors, have to function with the least infection control measures (if not without any). The floor is dirty, and there are stray cats and cockroaches! I have seen a doctor collecting a blood sample without wearing gloves, the baby’s blood trickling all over her fingers, and when she was done and saw the shock on my face, she told me “don’t do what I just did!” There is a box of gloves sitting on the nurses desk, but few doctors care enough to use any. That sickens me!

Another emotionally devastating thing was how the bed sheets were blood-drenched, urine-stained, and needle-studded! I have been to governmental hospitals in UAE and seen how the sheets were disposable and consistently replaced. What I saw yesterday was just so wrong!

Back to kids, in such an overwhelmingly stressful situation, I tried not to get involved. How could I manage patients I have no sympathy for? The kids seemed like noisy things who needed to shut up! The only kid I sympathized with was 4-year-old who needed calcium gloconate injections to treat his hypocalcimic condition. He looked so harmless and terrified, he persistently begged to go home  and I found myself trying so hard to sooth and lull him to stop him from moving his hand and displacing his cannula. I have no idea how that boy managed to break my heart!

And there I survived my first night shift ever! I’m not looking forward to my next one!

White-coated ramblings: (1) ‘Cause bureaucracy sucks!


So today was my first day as an intern doctor. Let me tell you something about hospital internships in Egypt, you know, it’s kind of like Grey’s Anatomy, except that it’s nothing like Grey’s Anatomy! I’ll be thoroughly talking about this, but not today. Stay posted!

What happened today was a cycle of pleading and begging. Why? Because Egyptian “public servants” are heartless and always bad-tempered. Originally, I was listed in one of the ministry’s hospitals, but I filed a request to be moved to my med school’s educational hospital (not today’s story), let’s just focus on the fact that I DID hand the request to the woman in the corresponding office.

Consequently, I should’ve found my name automatically listed in the hospital’s schedules, which hasn’t happened! You don’t want  to know the details, because it’s so boring, but to cut the story short, they lost my request, and I had to spin around and get shooed from one office to another to file a new one, begging  the employees to just answer my Goddamned questions!

On the plus side, I finally have been listed in pediatrics with cool friends. But we have a night shift tomorrow! Yep, my first ER shift ever is tomorrow! Stay tuned!

iRun: (2) It gets better!


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You might already know that my last run was an utter failure. However, on the bright side, I’ve been running since then 2-3 times weekly. A friend recommended this “C 25K” app, and it helped a lot. So, last Friday was “Cairo Runners” wake-up run (a 8K route), and I needed to test my progress.

Well, last time I ran a Kilo and walked the rest, this time I ran around half the route. That’s something!

iRun: (1) Running 101: NEVER skip cardio!


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The accidental Blog.. © 2013

Save for today, I have never run further than few meters. In fact, I never was into running or any sort of cardio training, and perhaps that’s why I love lifting weights! So anyway, today was “Cairo Runners” season finale, and the shortest run was near 10 kilometers. I needed to prove I’m fit enough, so I gave it a go..

The run started at 7 am. At 7:05 am, I was panting. At 7:10 am, a simple realization hit me; I’m so incredibly unfit! Out of 10 kilometers, I walked around 9. To make things worse, I wore the wrong shoes (because my running sneakers didn’t match my clothes! Silly!); they were so un-comfy and kept making loud noises as I hit the road! Oh, did I ever mention how bumpy Cairo streets are??

Astonishingly, fifty-something men could swiftly sprint past me, when I was literally dragging myself and battling to catch my breath! My 14-year-old sister outran me, because I was just so turtle-ish!

I made the run (or technically the walk) within an hour and 44 minutes! So from this moment on, I’m obliged to:

  1. Run more regularly.
  2. Break the above “record”.
  3. Win a half marathon within the next year.

I’ll keep you posted!

iCook: (4) Improvising protein bars..


I was bored and hungry, and too lazy to dig the internet for a good protein bar recipe that I have all its ingredients, so I set my cooking instinct free. And it didn’t let me down! 😉

They don’t look beautiful, but they taste yummy! 😀

Chocolate granola protein bar*:

 Ingredients:

– 2 medium cups sugar-free musli.

– 3 egg whites.

– 3 tbsp. home-made almond butter (pure almond).

– 2 servings of your protein powder.

– 1 tsp. baking powder.

– 1 ordinary low fat yogurt (Greek would be better, but I had none).

– 16 pieces of galaxy milk chocolate (like 3 ordinary bars or one big bar)… You can use dark chocolate of course, but I can’t resist galaxy’s taste).

Mix all ingredients except chocolate. Spread on a tray. Cook in 180ْ C for 20-30 minutes. Then melt the chocolate and spread it over. Cool down, then enjoy!

*Makes around 12 bars. I think it has like 8 grams protein or maybe more. You can use my fitness pal to accurately calculate.

iCook: (3) Abracadabra! Now your pastry is lighter!


You  crave cupcakes? Waffles? Pancakes? Cookies?! What about the calories?? A bummer, right?!

I personally had hard time when I first started dieting. I love all sorts of pastries and have always cheated, and the calories have always hunted me down. So I started digging for alternatives. You might have already read dozens of articles about using lighter substitutes for baking, but this is a personal experience that worked pretty well!

  • Wheat bran!

Source: Google images.

I couldn’t find whole wheat flour in the nearby supermarket, so wheat bran was such a great alternative. Cutting down half the flour serving and replacing it by bran will do the trick. There are other flours, like coconut flour, but honestly, I haven’t used any.

  • Skimmed milk!

Source: Google images.

Well, less fat = less calories. You can use almond or soy milk of course, but I guess skimmed cow milk is less expensive and the most available.

  • Replacing the sugar!

Source: Google images.

I use my whey protein as the only source of sugar in the pastry, it gives me high protein plus a light sugary taste. If you don’t want to use protein powders, you may go for Stevia or any sugar replacement (I personally don’t prefer that option). If you’re making a salty recipe, then even better; you won’t need sugar at all! 😛

  • Tasteless, but healthy!

Source: Google images.

If you want to make your pastry healthier, you may add other protein sources, my favourite pick is flaxseed. It’s tasteless, but totally useful. You may use oats as well.

There you go, now go indulge yourself with a guiltless cookie! 😀

Beasting up!


On this date last year, I could never imagine that I’d look at the mirror to see myself in good shape or that bodybuilding would ever cross my mind! Let’s rewind a bit and go back to the very beginning…

Alright, I gained weight throughout the past 6 years of medschool, and since all diet plans failed because food was how I soothed my stress, working out seemed to be the last resort! 

I started with Insanity, but two weeks later I had to quit due to a knee injury; both knees actually! My senior year had started then and I got immersed in more stress and more calories. The thought of becoming diabetic haunted me, yet it wasn’t before accidentally stumbling upon My Fitness Pal when I got my second boost! I do owe that site! 

Source: Google images.

Recording your daily caloric intake as well as your exercises not only motivates you to stay on track, but also helps restrain your binge. Why? Because people are watching! Having friends in there who check out my daily progress helped me stay serious! 

So I gave Insanity another shot, three weeks later, I twisted my ankle! That was when I realized how vigorous workouts don’t suit me, and it was time for Turbo Jam to come in! It was a lot less intense and WAY more fun! I ended two rounds with good transformation, but still I craved more success.

Source: Google images.

A friend on My Fitness Pal suggested Body Beast, which is basically a 3-month weight lifting program. I was intimidated and had dozens of questions, so she sent me to this amazing Facebook group for women doing Body Beast, and I really have to say I owe these women big time! They were (and still are) incredibly supportive and encouraged me to JUST DO IT!

Source: Google images.

I never imagined I’d ever be able to lift 8 KG dumbbells, or that I’d ever be up at midnight doing squats and lunges, or that I’d push myself until the very end! And here I am, done with my 1st round and absolutely proud of the results! Oh God I can finally see some muscle definition, everybody tells me I have changed a lot, and you know what, I just feel like a champion! 

I’m starting my second round tomorrow, and will keep going on BEASTING UP! 😀