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The Theoretical Doctor @[email protected] · 2026-01-13 · 01:00 UTC

Lazy Days As A Medical Officer

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Do lazy days make you feel rested or unproductive?

While I’m at work, I’d be looking forward to returning home or towards my off day. In contrary, while I’m at home or on my off day, I’d be thinking about returning to work.

Do you feel the same way?

Previously, as a House Officer, I’m used to the “one off day per week”. Whereas, as a Medical Officer, weekends and public holidays are granted off days, except if you’re well… oncall and that depends on your current department as well as some departments require you to put in a half day shift during weekends or public holidays.

I’d say for me, considering I live alone and I don’t even own a car here in Sarawak, I’m pretty much lazy and unproductive to the point I get restless sometimes.

That’s counter productive as rest days are meant to make you feel… rested, right?

Thus, on my off days, since I’m an early riser, I try not to disturb my circadian rhythm by getting up at the same time as usual every morning, partly because I forgot to off the alarm or somehow, my body clock just wakes me up every time.

To feel so-called “productive”, I’d do some studying with my morning coffee till I well, lose my focus, then I start wondering about lunch and start cooking, handwash my clothes because I’m too lazy to walk downstairs with a bag of clothes and finally doze off for my afternoon nap.

I’d then wake up in the evening to have dinner and pack my essentials and bag for work the following day before finally, retiring to bed early.

I really need to be more productive during my off days.

Even me writing this just sounds too depressing.

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The Theoretical Doctor @[email protected] · 2026-01-10 · 01:00 UTC

My FIRST SOLO Oncall Shift As A Floating Medical Officer

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My first solo oncall shift was on the 17th of August 2025 a few days after I have completed my tagging period.

I had a passive oncall on standby just in case things got out of hand, which is a good thing. However, I was adamant to try to survive on my own as if I only had myself and the specialist. Thankfully as well, it was on a weekday which meant I was able to reach out and ask for help if needed and the others would be able to assist if needed or advice me.

As usual, morning rounds, followed by peri rounds. The role as an oncall medical officer of the day is to update the progress of the patients in the specialist’s WhatsApp group as well as to upload any latest wound pictures, if any.

The day was rather busy with rounds and in between I would receive calls from Klinik Kesihatan (Community Clinics), usually requesting a clinic date. Thankfully, no referrals yet.

After rounds, I headed back to the ward to complete any pending joblists before heading into the operating theatre (OT) for a patient that was awaiting her call to OT.

During that operation, there was a referral from the Emergency and Trauma (ETD) Department, referring a case of laceration wound over the forehead for a 3 year old boy.

The medical officer at the ETD was kind enough to assist in taking the bloods as well as admitting the patient. My colleague on the other hand came to check in on me after her day in the clinic and attended to this kid.

After the first operation, the following case was called which was the 3-year-old kid. I have always enjoyed being in the operating theatre, or any hands on procedures.

Despite knowing that I should be conserving energy, instead, I proceeded to carry on and after the second op, I entered an ongoing flap operation next door to assist.

Another referral came for a laceration wound over the forehead for an Orthopaedic patient who was post-operative and transferred to ICU. Apparently, it was missed when the patient arrived at the Emergency Department as he suffered multiple opened fracture and was posted for operation immediately. Thankfully, he was intubated and sedated and I was able to perform a bedside toilet and suturing for him.

By the time I was done, it was midnight. I went back to the oncall room to shower and change for the night. I would usually change into scrubs again if I were to be oncall, just to be on standby in case I was needed immediately.

I did not sleep that night, it just felt wrong as the flap operation was still ongoing since 8am.

I went in again to check in on them, however, I was not needed at that time. Thus, I kept a fellow colleague company.

At 2am, I returned back to ward to complete the planned discharge of a patient and started my morning review. Thankfully, I did. In between, I was referred a new case of another kid who suffered another laceration wound at his right eyebrow. Thus, counselled the parents, obtained consent and admitted the patient.

After that, I was requested to collect bloods or bags packed cell for the patient who was still ongoing operation. When the commotion was done, I returned to continue my early morning reviews.

By 4am, I went back inside the operating theatre to check in on the ongoing operation. Technically, still far from done. Scrubbed in to assist with harvesting the skin for split thickness skin graft and refashioning of the affected limb.

At 8am, we were finally done. The operation officially lasted for 24 hours. All of us scrubbed out and I changed out of my attire to return to ward and follow rounds.

During peri rounds, a patient was called to OT and I entered organ as I dislike peri rounds. After the OT, all of us were just beyond tired and I went home for the day.

No doubt, it was my first “solo oncall”, it did not feel lonely at all as since there was an ongoing operation, physically, I felt comforted knowing that there were people nearby and felt more like a slumber party instead.

And the most important part… I survived it!

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The Theoretical Doctor @[email protected] · 2026-01-08 · 01:00 UTC

My First Tagging On-Call Shift As A Floating Medical Officer

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My first tagging oncall shift was on a Sunday with a fellow medical officer I knew when I was a House Officer in General Surgery. Back then, he was having his attachment in General Surgery.

Just like a House Officer, we had to undergo a period of “tagging“.

In the Department of Plastics and Reconstructive Surgery at Sarawak General Hospital, I had to undergo a tagging period of one month, every other day (EOD). This is because, I am a newborn medical officer with no previous experience in General Surgery (as a Medical Officer).

This is an advantage as I would be able to learn as much as I could within a span of 1 month. However, it was also a disadvantage as I’m afraid, I would be burnt out mentally and physically considering the on-calls were on every other day (EOD).

“I can do it. If others could, I could too.” , I repeated this mantra to myself but the learning curve is going to be an extremely steep one.

During my first tagging oncall, thankfully, it was with a fellow senior colleague who I was rather comfortable with.

We started with our morning ward rounds followed by passover and peri-rounds. After we were done, we went back to the ward to settle our pending job-lists followed by lunch.

As a tagging on-call medical officer, the first call would be to me for referrals. After which, I would discuss with my senior and proceed to see the referred patient together. After reviewing our newly electively admitted patients, pre-op rounds with surgeon and demarcating the op site and pre-op meeting, we went back home in the evening and returned at night together for our night reviews which we updated in the Department’s WhatsApp Group on the progress of certain patients. Incidentally, a patient whom we were awaiting for op was called into the operating theatre and the operation ended at 2am. Finally, we returned home for the night.

I was nervous of course as I usually get anxious easily. However, I took my shower and headed to bed.

My phone was kept beside me in case I were to receive calls or referrals. At 6am, I returned to the ward and started our morning reviews as well as prepared for our morning rounds.

Since, it was a Monday, it was morning ward rounds, handover and peri rounds as usual. However, since I was still tagging, I was expected to stay till 5pm or to join the ongoing surgeries.

Thus, my first postcall was spent in the operating theatre assisting till 6pm. However, despite the ongoing operation, I excused myself to return home and rest.

The following day will be another one, thankfully, not oncall but within office hours.

Thankfully, it was a good call with a fellow senior that I was comfortable with in terms of approaching in regards to my doubts which was undoubtedly, many.

I can only hope that I would be able to survive this whole month of tagging.

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The Theoretical Doctor @[email protected] · 2026-01-05 · 01:00 UTC

2026 – The Beginning

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First of all, Happy New Year! I hope you have had a great start to this year and if you have any New Year’s Resolutions planned, I hope that you will be able to stick throughout the year.

I did not have any New Year’s Resolutions planned as I usually did the previous years. Mainly because I have just moved to a new place, settling in with things still pending in Kuching, trying to adapt to my working environment as well as picking up on new skills.

Thus, New Year’s Resolution? It’ll come as the year progresses.

My New Year’s Eve was spent at work and mainly in the ambulance with a dear friend as well as work colleague, however, that is a separate post for another time.

As usual, since I’ve started working as a doctor in 2023, I’ve always made it a point to work on New Year’s Day, a habit which I’ve adapted from my dad ever since he has started working at the age of 18.

However, New Year’s Day is a public holiday here in Sarawak. Thus, I was allocated as the oncall medical officer on the 1st of January as well as on the 2nd of January. Per oncall shift is from 8am on that day till 8am the following day (which means, mine ended at 8am on the 3rd of January).

My first case began with a case of wound breakdown over the right wrist, which the patient chose not to seek hospital treatment followed by another case of upper gastrointestinal bleed which was sent to hospital. This was then followed by another case of possible acute appendicitis which the patient and family decided to “discharge against medical advice” because they wanted to seek treatment in their hometown considering they were travelling and happened to be in the same area.

Upon returning home, I was called back for a case of breakthrough seizure likely secondary to under-dosage of medications. The patient had three episodes of seizure that day followed by a regular 1-2 monthly episodes. Hence, referred and sent to hospital.

Finally, I can return home. Time to get some rest since I would be working the next day. Shortly after, I was called back, a patient sustained laceration wound over the medial aspect of his antecubital fossa. Mechanism of injury? Unknown and he was in an extremely drunken state.

Otherwise, he was stable. Sadly, my medical assistant at that time could not be contacted to escort the patient to hospital and the family members did not have their own transportation.

If only, he was fully awake, I would have triaged him to green zone. However, transportation issues… Thankfully, the patient’s family has an uncle who was willing to send. The only thing was he needed some time to arrive due to the heavy rain and slippery roads.

I didn’t feel good leaving the patient behind although he was stable. Thus, I stayed till 4am until his uncle came and the patient himself had woken up.

After that, I went back home and straight away gotten ready for work since it’s a working day and I am still oncall.

The following day on the 2nd of January, went by smoothly during office hours with referrals here and there but it was manageable.

In the afternoon, another patient came in for symptomatic anaemia secondary to abnormal uterine bleeding with newly diagnosed cervical carcinoma. Her haemoglobin level was 5, who again, refused hospital referral claiming she visited the clinic for fever and not for her anaemic symptoms. After much convincing and discussion with my specialist, the patient still opted to “discharge against medical advice”.

Which makes me wonder… Why in the world?…

This was followed by dinner with my friend. I remembered thinking to myself that evening that maybe… just maybe… I would have a cold night. Enough of referrals.

However, at 11:30pm on the 2nd of January 2026, I received a call from my medical assistant that a patient presented to the clinic breathless with an SpO2 of 50% under room air, started on high flow mask and at best, it is only 90%.

Sounds like an impending intubation and CPR case.

I called up my friend immediately as I rushed to the car as she lives closer to the clinic. I needed all the help I could get for this patient. The roads were slippery and it was a rainy night. Yet, I sped. Thankfully, my friend had already arrived before me.

The patient?

I remembered seeing this patient on the 23rd of December 2025. At that time, his lungs already had crepitations with reduced air entry over the right side and yet he chose to “discharge against medical advice”. I remembered telling him that he would collapse if he didn’t go and true enough, here he was… sitting up, gasping for air.

His vitals? Blood pressure was sky high, lungs filled with crepitations but no pedal oedema, lines were set, no ECG done but we didn’t have time to waste…

I called up the Emergency Physician in the nearest hospital (which is an hour away), presented shortly and informed that we had to proceed with intubation because he was too tachypnoeic.

We prepared for intubation, informed the family members as well as explained the risk of CPR and death. The family understood and agreed.

Intubation… This was a difficult intubation for the guy was a very large guy with hardly any neck visible.

But before we could start, his GCS dropped and so did his heart rate, I started CPR while my friend attempted to crash intubate. We attempted to crash intubate and both times, it failed… I called up the Emergency Physician again and told her that we were 30 minutes into the CPR, she told me to call off after the current cycle.

My first death at a new workplace and on the third day of the year at 0027H, 3rd of January 2026.

Then, I proceeded to complete my notes for the family members to bring to the police station to lodge a police report and broke the news to the family. I was calm and so were the patients’ family. After that, I called up the Emergency Physician to thank her and then, I broke down.

I broke down because had he gone on the 23rd itself, he wouldn’t have to gone through this.. He lives alone and his so-called family members aren’t even his biological family members but neighbours and friends… I broke down because I also felt defeated… We tried our best with such limited resources and manpower…

Yet, I couldn’t save him…

If you have YET to come up with a New Year’s Resolution… At least consider this, adhere to your regular check-ups if you have any… Stay compliant to your medications, diet restrictions or any fluid restrictions if you do have…

And if something is off or not right, please RUSH to the nearest clinic or better, the hospital… Because there is only so much that we can do with such limited resources in a community clinic.

Otherwise, I wish that you have a Blessed 2026 filled with love, beautiful memories and wonderful opportunities.

Remember to have fun and do enjoy it but please do so, responsibly.

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Inside the Red Head's Head @[email protected] · 2024-05-21 · 11:12 UTC

Daily writing prompt What is the legacy you want to leave behind? View all responses

100 years from now some archeologist who probably looks a little like Indiana Jones is going to stumble across my alonetone account, listen to all of the music I have posted there and decide that it is some of the greatest music created in the 21st century. My songs will be studied in universities, splashed across all social media (because there will still be social media 100 years from now), and deftly woven into the fabric of 22nd century society. You can bank on it, folks.

What legacy will I leave behind? A Legacy of Rock.*

Okay, now that you’ve stopped laughing…

I don’t know what my legacy should be. Hopefully it’s our kids, Harry and Bellana. Hopefully they continue to be good people who always chose to do the right thing. Hopefully having me around for most of their lives has had some small influence on them that helped lead them in that direction. Hopefully they will someday have kids of their own (no pressure though) and they are able to pass on whatever tiny influence I might have had on to the next generation.

That would be enough for me. I would be proud to leave a little legacy like that. Proud and honored.

*If I don’t use that as the title of my next album, Spinal Tap should.

https://robertjames1971.blog/2024/05/21/a-legacy-of-rock/

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