I was once asked to recount the funniest moment I could recall from my Houseman year.

One morning during clinical rounds, a new patient stated quite seriously, "I can't take Panadol. I'm allergic to it."
The Registrar promptly asked, "So what do you take for a fever, sir?"
"Paracetamol!" the patient replied.
Pause.
The Registrar kept his cool and assured the patient that he would only be given Paracetamol in view of his Panadol allergy.

Another time, a nurse phoned me and asked: "Is this Dr Tina?"
"Yes, what is it?", I replied.
"Doctor, my patient's backside is itchy."
Longer pause.
I was very tempted to tell my caller that I would prescribe the remedy of "Scratch TDS". However, I bit my tongue and instead clarified the issue with the nurse before prescribing an appropriate medication.

I could catalogue whole journals of every funny or heart-breaking moment in my short medical journey so far. But for now, here is my list of four guiding principles if I had to go through the terrors of starting out as a House Officer or Junior Resident all over again:

1. Be Prepared for Anything

My first call happened on my second day of work. No tag-on calls or settling-down period. The clock struck 5pm, and the lives of several hundred patients weighed heavily on my inexperienced shoulders. Yet, I somehow survived the night, as did the patients. My MO tried to make a tutorial out of every new admission (thoughtful, but untimely, since it was 3am). My Registrar sat with me during a patient's MRI scan, giving me advice and reassurances (I called him out on it. Before 5pm, he'd told me, "Anything, just call. Anything." Famous last words!). I wrangled 50 minutes of sleep, survived post-call rounds with much yawning, and collapsed back home in my bed.

From sudden disappointments (your patient unable to go home because he spiked a fever), to pleasant surprises (a nursing friend offering chocolate eclairs to eat during your call), and anything else (being scolded by seniors from other departments, scolded by patients' relatives or scolded by nursing officers). The list goes on and on. Medicine is unpredictable because people are unpredictable. So be prepared for anything and everything to happen.

2. Diplomacy (and Having a Thick Skin) Never Fails. If It Does, Just Bite Your Tongue.

Much of the practice of medicine involves talking. If you aren't spending time explaining things to patients or their relatives, then you're glued to the phone speaking to the microbiology lab, the radiologist, the surgeon, or the medical sub-specialist. On some days, it seems all I ever did was sit by a phone and make countless calls. Otherwise, I would be sitting by a phone waiting to make calls.

What I still dread is making urgent calls to surgeons or radiologists in the night. Or having to beg the specialist to pretty-please-come-see-my-patient-because-my-consultant-said-so-and-I-don't-really-know-why. I've learned to start off these tough conversations with the most humble and sincere apologies and prepare myself to be yelled at anyway simply because the person at the other end can, given that s/he is more senior than me. My job is to sweet-talk my target specialist into doing something for me (sorry, I mean for my patient, of course). If this doesn't work, no sweat. I simply move on to the next phone call and the next unsuspecting specialist.

3. Do Your Best for Your Patients. But Sometimes, It Just Ain't Enough.

No matter how jaded or exhausted you feel, human lives are in your hands. An MO once told me: "We are Internal Medicine. We take care of everything; we coordinate everything." From the specialist consult to the allied health referral. Who can forget filling out AIC forms? The moment that patient becomes yours, it is your job to sort out their medical problems, social issues and post-discharge plans.

Yet, sometimes, no matter how hard you try, things just don't work out. Some patients die despite your valiant efforts. Some become worse after admission. Some never seem to leave the hospital because the nursing homes or community hospitals are choked to the brim. The blame doesn't rest with any one party, yet you feel somehow responsible. Don't despair, Junior Resident, because of number 4.

4. No Matter How Hard it Gets, Eat Well, Have a Good Laugh. Be Thankful for the Little Things. And Don't Forget to Shower.

Sleep will be elusive, especially when you're on call. But this doesn't mean you can't do other things in life. All of us are called on to care for people who have entrusted their lives to us. It is an incredible responsibility. But I think what really gets us through the blood, sweat and tears are the things that make us human. Laugh over funny moments, discuss wedding plans, take on home renovations, talk about our kids' schools, compare car prices, argue over politics, bond over meals. Ordinary things can help us forget the difficulty of battling diseases, limited resources, and "the system". It reminds us why we've chosen this path in medicine. It makes us smile when we see the gratitude in our patient's eyes, or when the consultant compliments you, or when your colleagues tell you, "you'll be missed".

I rounded off my housemanship with the horror of all postings: General Surgery. Please don't tell the surgeons I said so; they seem to love it with a passion that is beyond me. My personal experiences there warrant a whole article on its own. When that was finally over, I heaved a gigantic sigh of relief and started my Psychiatry postings proper. Amid studying for exams (and flying overseas to take them), running clinics, and learning new skills designed to help me in my chosen specialty, I've realized that the things I told myself about housemanship still apply as a Medical Officer / Resident. These probably will apply long after I've finished my training.

A consultant once told me that things don't get "easier" after housemanship. Sure, you have less scud work to do, you don't have to take that patient's GXM or give first-dose antibiotics anymore. But the responsibilities pile up as your knowledge and experience increase. Yet, some things do remain the same: anything can happen, diplomatic communications work (but not all the time), do your best for your patients, and please, do take a shower.