Medical Elective

March 2018 - March 2024
An open-ended adventure by Alice
Currently traveling
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  • 2countries
  • 2,204days
  • 164photos
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  • 4.9kkilometers
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  • Day 1

    Singapore

    March 17, 2018 in Singapore ⋅ ⛅ 32 °C

    Arrived at 7am, got a taxi (with a shouting lunatic) from the airport to Marina Bay Sands. Was completely gobsmacked by the sheer scale of the place!
    Went to the check in desk in tower 1 but my room wasn’t ready yet. Left my suitcase with the concierge and set off with my rucksack to Gardens by the bay.
    Went around the Skyway (suspension bridge type thing up in amongst the giant metal trees) which gave a great view of Marina Bay Sands and over the rest of the gardens.
    Then wandered round to the cloud forest and flower dome. Cloud forest is basically a massive indoor 7 story rainforest, complete with waterfall and atmospheric misting. Very beautiful! Flower dome was a bit overcrowded but has some very pretty flowers and trees non the less.
    I then got my email to say my room was ready and so I headed back to the hotel.
    The room was something to behold! On the 17th floor with a gorgeous view over the bay. Enough space for about 300 people... lovely bathroom with a freestanding massive bathtub and a massive king bed.
    I dropped my stuff off, donned my swimsuit, bathrobe and slippers and headed to the infinity pool!
    WHAT A PLACE
    The views are stunning, people bring you drinks to your sun-lounger, there are palm trees and a pool that was just the perfect temperature to go with the 30 degree heat.
    I chilled there for a good couple of hours, complete with prosecco and sushi (and a distinct lack of sun cream so I got pretty burnt).
    I then got a message from Krystle who I know from dancing at Warwick. She lives in Singapore and offered to show me round.
    We went to go get some bubble tea because apparently that’s what the locals do. I had lychee flavour with black pearls, so delicious!
    Then we went for a wander around the bay to see the sights. Ended up being quite a walk, did 18km altogether.
    After our walk we went back to the infinity pool so Krystle could try it out. We took lots of pictures and enjoyed watching the sunset.
    We wandered in to town and stumbled across a light show in the bay. Using a combination of laser lights and fountains in the water they created a magical display.
    We then went to go have some dinner at a hawker centre which is apparently the best place to get local food. It’s basically a massive hall with lots of different food stalls in it. Here we tried bbq sting ray and fried carrot cake (not actually carrot cake at all, basically a rice flour thing in some kind of sauce, very tasty!)
    I was then getting sleepy as I had only had 6 hours sleep in 3 days so I headed back to the hotel, with one last view over the bay with all the lights on.
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  • Day 2

    Travel day

    March 18, 2018 on the Philippines ⋅ ☀️ 33 °C

    Up at 6.30am to head to the airport. Had less of a lunatic driver this time!
    After I had checked in, grabbed some pancakes and coffee and settled in for a bit of a wait.
    Set off on time for Manila, arrived half an hour early.
    Got through the transfer surprisingly quickly and found myself at the gate crazy early.
    The flight ended up being an hour late so I had a long wait.
    Eventually landed in Iloilo at about 8.30pm so was about 9.30 by the time I got to the house. Had some food waiting for me and had a quick tour of the house.
    Shown to my room where I am staying with Kirsty and Claire who are both nice nursing students but only here until Saturday so then I will have the place to myself!
    Pretty much went straight to bed as I had an early start the next day.
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  • Day 3

    Intro day

    March 19, 2018 on the Philippines ⋅ ⛅ 15 °C

    Woke up at 6.30am to have some breakfast, nice selection of tasty snacks!
    Then met Joy and Richard who showed us to a Jeepney, the main method of public transport in the Philippines (basically a stretched out version of a tuk tuk sort of van with a completely unfathomable route network and payment system).
    We made it to the hospital where we were shown into the student’s room. We were then informed that we had to attend the morning ceremony, where songs are sung, mission statements read and awards/intros done outside the front of the hospital. This also included us being announced and introduced to the team, having to stand at the front!
    We then did a tour of the hospital where we were shown all of the departments. It’s all very different to the uk (obviously) with lots of cramped beds, relatives helping with care and unbelievable heat!
    We then headed out to town for a city tour. First we went to Molo square which has a historical mansion where we tried Blue Ternate (flower) ice cream which tasted like vanilla and flowers. We then went to look at St Anne’s church before getting a jeepney into the city proper.
    From here we went to the city hall where we were made to watch some strange videos about various festivals and world record cycling events(?) that happen in Iloilo. After this we were able to try on some local performance costumes full of feathers and beads which was great fun!
    Next we went up on to the rooftop to get a view of the city. Not that attractive but there was a nice view of the ocean and the river that joins it.
    Then we headed for some lunch at an idilic little restaurant called Buto’t Balat. It was a little haven in amongst the city chaos with a pond and beach hut style straw huts. Had some delicious mango smoothies and a variety of Philippine food.
    We then went to a supermarket to get local SIM cards, adapters and crocs ready for placement tomorrow.
    Back to the house for my intro meeting and a local language lesson. Trying to learn Hiligaynon is very difficult as it turns out! Another one tomorrow to try and practice what we learnt. Then we had some dinner and a bit of chill time. I was also not so patiently waiting for my email to find out which hospital I was placed at. Off to bed for an early night ready for the first proper day tomorrow. Exciting stuff.
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  • Day 4

    Internal medicine day 1

    March 20, 2018 on the Philippines ⋅ ⛅ 7 °C

    Up at 6.20am for breakfast - hash browns and scrambled egg today.
    Got my scrubs and stethoscope on, packed all my gloves and masks and headed to the hospital via a jeepney (which I still don’t understand).
    Was shown to the internal medicine office where I observed handover. This was mainly done in English although I found a lot of it difficult to follow.
    It seems as though the system is that residents run the wards and text their seniors to keep them up to date. I have only spotted 1 consultant so far!
    I introduced myself to the consultant in Hiligaynon which he seemed very impressed with!
    After the handover I headed to the emergency room but was told there were no “toxic” patients and that I should go to one of the medical wards.
    I headed to MM1 which is a male medical ward. Here seemingly all medical specialties are covered under 1 roof. I found myself a resident to tag along with - Kevin, who was nice but not particularly talkative. Tried to ask questions where possible. Saw a few interesting cases. Also noticed a few things which stood out as different from how things are in the UK. For example, people intubated with no sedation, being bag valve ventilated by their relative (folks as they’re called here). No curtains to be seen for privacy. No hand washing or PPI. Every single patient on some description of drip regardless of why they were in. Also the ward was about 1008734 degrees and full of fans to waft all of the germs around!
    Headed back to the internal medicine office and found free lunch!
    Went back to the house and decided to go to a near by pool for a dip and a cocktail. 15 minute walk in the sweltering heat (apparently it’s 32 degrees, feels much hotter!).
    The pool was gorgeous, we had the place almost to ourselves with about 8 work the world girls there. Had a strawberry daiquiri and some calamari, played in the waterfall and generally had a nice time. On the walk back I got a matcha ice latte.
    We then had another language lesson which was much too fast and a bit pointless, but we did revise jeepney language so that we can all navigate by ourselves now (hmm).
    Had some dinner and then decided it was about time I got back into some form of workout routine. Made up a WOD, found a space in the house to do it in, got some speakers and a timer and even managed to rope Emma into doing it with me! It was very warm and sweaty but fun non the less.
    Sat and a tried to do a bit of research on places we wanted to visit before heading to bed.
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  • Day 5

    Internal medicine day 2

    March 21, 2018 on the Philippines ⋅ ⛅ 3 °C

    Up at 6.30 again, feeling much more tired today though!
    Got a jeepney which went down lots of little back roads so spent a long while thinking I was lost.
    Went to the internal medicine office for handover and a case presentation about normal pressure hydrocephalus. The poor resident got torn apart by the neuro consultant who insisted that NPH is a common presentation here.
    Then headed to the female medical ward to try and see some different stuff but no doctors to be found. I was directed back to the male medical unit. This time, I was introduced to cases much more readily and saw quite a few interesting ones.
    By 11.30 I was far too hot and had been abandoned by the doctor so decided to go meet the girls to get some lunch. Went to a nearby mall and had some prawn noodle thing which was very tasty, although I had no idea what I was actually eating! Also got dunkin donuts munchies!
    Headed back the hospital and gave ER another shot, still no joy! Decided to try the other female medical ward and found a really helpful resident who was actually willing to teach me some stuff, result. Saw a really tragic case that made me a bit upset, can’t help but think that if they were in the uk they might have been alright. Spent a bit of time with the resident but then she had finished her rounds so made an arrangement to go on her rounds with her tomorrow instead, fingers crossed!
    Headed back to the house with the girls. We then decided to go to a massive mall called SM city to get a few bits and bobs. Managed to get an Adidas peak cap, a play suit and a couple of vest tops, also some snacks for Friday when we are going on our first trip away.
    Spent a bit of time in the evening having a look at borocay and planning our trip there, then headed to bed.
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  • Day 6

    Internal medicine day 3

    March 22, 2018 on the Philippines ⋅ ☀️ -9 °C

    Up early again, back off to placement. Went to the female medical ward this time. Attached myself to the postgrad intern (kinda like an F1) and helped her do a few procedures which was cool. Even learned some tips from her for different things. Went with a patient who had a stroke to have an X-ray, which involved pushing her all the way to a separate building, still being ventilated by her relative, no portable X-rays here!
    Went back to the house and had a video call with Roger :) nice to have a catch up!
    We then had bbq and karaoke night. Gorgeous bbq food and mango pudding. Had a few drinks and then the karaoke began!
    Seemingly it’s tradition for newbies to sing. I was determined that I wasn’t going to do any, but eventually gave up and did a rap - numb/encore with Emma as my singer. It was actually kind of fun!
    Had a few more drinks and played some card games on the roof. Really fun evening and good chance to get to know people. Then to bed for an early start
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  • Day 7

    Isla Gigantes day 1

    March 23, 2018 on the Philippines ⋅ 🌙 19 °C

    Up at 4.30 which was painful! Got a van between 10 of us to drive us to the boat port. I slept for the whole way, so tired! People on the trip were: Emma, Hannah, Tegan, Sophie, Emma S, Keziah, Claudio, Laura and Anne.
    Lots of waiting around but eventually got shown to our boat. Had to walk across a dodgy looking gang plank and hope we didn’t drop our bags in the water!
    The boat resembled a spider with floats out on sticks at the side. Not particularly sea-worthy. We had an hour and a half journey where we thought we were going to capsize. Got completely soaked through to the point where I might as well have jumped into the sea.
    After a sketchy journey, we arrived at an incredibly beautiful island, with white sand and clear blue water. We were greeted with a fresh seafood lunch of clams, chicken stew and rice. The meal was made slightly uncomfortable by all of the stray dogs begging around us and red ants clinging everywhere. The rooms were cute wooden huts with 6 beds in each. Some electricity but no phone signal to be had.
    We then went for a dip in the sea which was heaven. Perfect temperature, just beautiful.
    Next we got changed and ready to go on a hike up to some caves on the island. It was a hard hour long hike, clambering over rocks with blistering heat and humidity.
    Eventually got to the top and found some pretty magnificent caves - Pawikan cave or sea turtle.
    Lots of interesting geological features and photo opportunities. 3 chambers with holes up at the top so you could see the sky. Stood on a precarious rock to get a great photo. Had to get help on the way down as there were some pretty tricky parts with big drops down the sides.
    Made it down and rewarded ourselves with another swim in the sea.
    Then had dinner, bbq pork and fish with more rice. Drinks and card games followed, which sort of escalated to the point of some people being completely smashed. Lots of fun and good to bond with everyone.
    Eventually all got to bed at about midnight.
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  • Day 8

    Isla Gigantes day 2

    March 24, 2018 on the Philippines ⋅ ☀️ -9 °C

    Today we got woken up at 6am by some random rave music being blared out from somewhere near our huts. Tried to sleep through it til 7am when we had to be up.
    Had breakfast of scallop adobo (local speciality), fried egg and... you guessed it, rice!
    Headed to get the boat, had to wade out to butt level and then fight our way up the plank from the water. Had a 20 min journey to get to the first island of our island hopping day.
    The first island was called Cabugao Gamay. Walked up to a viewing point where you could see a sandbar across the island. Took lots of photos but then it started chucking it down, and I mean like monsoon level rain! Took shelter in a little hut, although the rain was just blowing in sideways so we were all soaked anyway. We then tried to make our escape onto the boat. There was a problem getting the anchor back on board so we were floating around for quite a while whilst a poor guy was diving in trying to rescue the anchor. We eventually managed to set sail.
    The next island was called Sand Bar and was essentially a strip of sand in the sea with a few trees on it. We went for a swim here, although the currents were very strong and there was some pretty big waves! Our boat went to take some people somewhere else and so we had to wait for it to get back. While we were waiting we decided to take lots of photos, make pyramids, jump shots etc. The tour guide brought us over some freshly steamed scallops and oysters which were delicious. After what felt like forever, with no access to any of our stuff including suncream, the boat eventually came back.
    Next we headed to an island called Antonia. This was a bit more touristy than the others, but still pretty quiet. Here we went on banana boats and jet skis which were easily the most fun thing I’ve ever done! Didn’t fall off at any point either which I was quite pleased with as it looked painful! Managed to get the jet ski up to 52 mph (which is the top speed) which on water felt like about 100. At this point we all started to notice how sun burnt we were getting but by this point it was too late.
    We then headed to our last island - Tankie Lagoon. Here there was a beautiful little lagoon hidden behind the rocks. The water was super warm and clear so we had another swim. Then some people went off to do cliff jumping. I sat this one out because the route up looked pretty treacherous. Everyone made it ok and all did the jump which was probably about 5m. Few cuts and bruises though I think.
    After this, we headed back to our island. We had a bit of chill out time so some people had naps. I went and had a bucket shower to try and cool off and get rid of the sand that was everywhere. At this point the sunburn was really starting to set in. Burnt everywhere, very sore!
    We had some dinner and a couple of drinks and then I headed to bed as I was feeling pretty exhausted. Some of the others stayed up to do karaoke.
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  • Day 9

    Isla gigantes day 3

    March 25, 2018 on the Philippines ⋅ 🌙 10 °C

    Up at the crack of dawn again for more seafood breakfast. I actually couldn’t bring myself to eat any more so I had a cereal bar that I had brought with me.
    We were told the sea was likely to be rough due to high winds (great) so we needed to set off early as it would be a slow journey.
    Waded out to the boat again, this time a lot more sheepishly due to the sunburn and cold water mix being quite painful.
    The journey was quite rocky but not as bad as I expected from what they had warned us about. Got back to the mainland with enough time to spare to go buy tshirts from the tourist office and then back in the van for a 3 1/2 journey back to Iloilo. I napped most of the way, although the air con was freezing so I had to put all my layers on.
    When we arrived back I just chilled and did a bit of washing. Spent a while with my feet up to try and get rid of some of the swelling that was accumulating. Got my stuff sorted ready for the week ahead and went to bed.
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  • Day 10

    Medical ICU day 1

    March 26, 2018 on the Philippines ⋅ ☀️ 8 °C

    Up at the usual time. French toast, bacon and syrup for breakfast today, yaaass!
    Went to internal medicine handover as usual but this time was introduced by one of the residents who is in charge of work the world things. She showed me where MICU was and introduced me to the staff which was nice.
    MICU is air conditioned which is AMAZING! And there are only about 8 beds in there so it isn’t too busy. Most of the patients seem to be stroke patients (still can’t figure out why it’s so common here) who are intubated and have full monitoring. Saw an “emergency” re-intubation in a patient that desaturated to 50% as a blood clot was blocking her ET tube. The resident seemed very relaxed about this and didn’t particularly do it with much urgency! Read through some notes and saw a few patients then headed home.
    Once we were all back we headed to SM city mall again to grab a few bits ready for our upcoming weekend away. Got a new bikini, denim shorts and some products. Also treated myself to a frappe! We then headed back to the house to chill.
    As this week coming is Easter weekend (Holy Week here), it’s basically a massive national holiday from Thursday to Monday and so me, Emma and Hannah are planning to go to Borocay then. We spent a bit of time looking at hotels and eventually got one booked which has a pool and looks quite nice (decided to treat ourselves). Once we had done that, I chilled in my room for a bit and then video called Momma. Was really nice to catch up with her, even if the video did keep cutting out! After that I went to bed.
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