Friday, April 21, 2006

Confession of a medic student #13 - Raymond's Philosophy

(April 21, 2006 at 12:02 PM)

You are a detective when seeing the patient,
You are a lawyer when presenting the case,
You are a doctor when rendering the treatment.
(Quoted from Prof Dr Raymond)

I attended Prof Raymond’s talk today. He’s one funny lecturer. He even has his very own philosophy! –he calls it the [Raymond’s Philosophy]… facing exams is one thing, treating and managing the patient is another, both equally important. "I never believe in saying [i want to be a good doctor], instead, say [i want to pass my exam] first. How can you be a good doctor when you fail and is NOT a doctor... pass your exam first then be a good doctor"he said. I didn't like the way he put that, i mean one can be a good medical student and still pass exams... be nice to the patients... but i guess he had his point...

I had a weird week… an exceptionally pleasantly weird week though… I met a number of ‘different’ people… and I wonder whether was it an omen… maybe, God was trying to say something… a language, I don’t quite understand yet… (then again, since when do I believe in omens?)

3 weeks had past… I’m getting used to going to the wards… the patients here are generally nice… sometimes I feel a little guilty when the patients thanked me for examining them… I mean, I should be thanking them for being my subjects… (no offence)... sometimes, knowing the problem but not being able to help much gave me a sense of helplessness...

the wards sometimes scares me… not that I’ve seen any ghost or spirits… it’s just that, seeing sick people made me treasure life even more… some diseases are very common… you may find half the patients in the wards having hypertension and diabetes mellitus! COPD, Myocardiac Infarction, Tumour – very commonly seen… there was once, i saw 5 Dengue cases in a ward!! before entering the wards, i had never anticipated these disaese to be that common... i mean sure, you know the statistic, but seeing them is another thing... and for your information, half the patients in the wards are smokers… (NEVER attempt smoking... it's bad for your lungs, vessels, heart, brain and can cause cancer in almost every part of one's body!!)

it hurts to admit that, sometimes, every doctor has his limits… you tried so hard, yet in the end, it’s all in God’s hands… then you start praying hard… last week, they had to discharge a hepatitis B patient, ‘there’s nothing else we can do’-the doctor said… and the family cried…

Sunday, April 16, 2006

COAMS #12- Bell's Palsy?

(April 16, 2006 at 10:57 PM)

Destiny is not a matter of chance,
It is a matter of choice,
It is not a thing to be waited for,
It is a thing to be achieved.
(W. Bryan)

My consultant, Dr Hamidon, said the line above. He’s a nice funny guy.

2 weeks of clinical studies have past. So, much had happened lately that I’m not sure what to blog. My ‘interesting’ wards meetings? How I met my previous boss at the orthopedic wards? How I had cramps on both legs and almost drowned? How we got miserably caught in the rain at pasar malam? What I bought at pc fair? Preparation for AMSC Hong Kong? etc… (that could take a few pages..)

ok, let me just share with you my clinical studies, you could skip the boring lines, of course ^_^. For the first month, we were divided to 4 different systems, one system each week- CNS(central nervous system), CVS(cardiovascular system), Respiratory system and the Abdomen. So, I had my CNS lessons on the 1st week, CVS on the second.

During my CNS posting, I met a patient who had Bell’s palsy, which was quite an interesting case. For the benefit of non-medical students, I’ll explain about Bell’s palsy. Bell’s palsy is a paralysis of the cranial nerve 7- the facial nerve, the essential nerve for facial expressions. Which means, to perform an examination on the 7th nerve, we need the patient to perform a series of ‘face exercise’(which was quite funny).
1. without moving your head, look upwards
2. screw or squint your eyes
3. puff your cheeks (the examiner, with his index fingers, will attempt to pop the air out of your cheeks)
4. show your teeth (grin)
Good job! I see you had excitedly examined yourself. Good, you have great facial muscles. Ok, let’s go back to the patient : Because the nerve is only effected on one side of the face, you would only see paralysis on one side of the face (eg:left side). You can obviously see the asymmetry- drooping of eyelids, drooping of the corner of the mouth, flattened nasolabial folds, smoothing of the wrinkled forehead… The patient is OK now, you can’t really see the weakness of facial muscles unless you observe carefully and perform the facial examination.

I was happily following my consultant on the wards one day when I heard someone calling my name from the back. When I turned my head, I was like –OH MY GOD! Remember I used to give tuition lessons in Rasah Jaya during my form6 break? Well, that was my boss, Mr Raj. He was admitted to the orthopedic department, MVA(motor vehicle accident) 6 years ago, now he’s back with complications-infection. He had 5 fractures and had a graft. Serious case, almost had his leg amputated, but the doctor managed to save his leg. The kid that ran into him only had a RM300 summon, while Mr Raj had suffered for years, and still is…it’s a sad world… It’s funny though that you can actually meet people you know at the hospital. It was fun chatting with him though… He was telling me how the consultant shouted at the students, and I can’t help thinking that I might be one of ‘the students’ some day … *siGh *…

Did I mention that there’s an Olympic size swimming pool at the stadium opposite my school? It’s something like the one in S2, only that it doesn’t have a deep and a shallow area. Yes, it’s deep all the way, but if I hop on my toes, I could almost emerge. Swimming was fun, it helps me think (the way writing helps me think).. except the part when I had cramps on the back of my calf, first on the right leg, then the other. The pain was so sharp, radiating upwards. I could not even bent my knees! The funny thing is, my friend, im sing who attempted to save me, grab my hand and I was like ‘let go, I can’t swim without my hands’ –haha! Oh boy, she was scared alright. CONCLUSION : 1.never forget to warm-up before swimming, 2. sexy, good-looking lifeguards are only found in Baywatch.

P/s: I was lucky I did not get admitted to the A&E department this time. Hopefully, when I left KL campus, I left the curse behind as well. The last thing I need is to be clerked by my own coursemates! *sigh *…

Friday, March 10, 2006

COAMS #10 - 1st Clinical Class

(March 10, 2006 at 08:38 AM)

I had my first clinical teaching today. I was wondering whether I should blog it, considering that it was one of the worst day of my life!! Not that I had been scolded by the consultant, somehow, they just have the ability to make one feel ant-small… perhaps even lower than an ant. And blogging this is obviously a humiliation…

I had second thoughts again, of being here. I didn’t allow those thoughts to penetrate me too deep though. Tried to dispose it at the back of my brain. Clinical years is like a huge gap, and I am certainly no Olympic champion. The fear of having to adapt has came back to haunt me. Only this time, in multiplied momentum. *sigh *…

You must be wondering, how terrible my first ward teaching turned out. Surely, it can’t be that bad. Well, it’s not that bad,.. just bad.

“Surely Wu, that’s a very weird thing to say”
“Don’t whisper. If you want to say something, just say it or else stay silent”
“You are on your own during exam. Don’t discuss”
“Not reading everything is equivalent of reading just one page”
“With this attitude, do you think I should give you any more lessons?”
blah, blah, blah….

I wanted to tell him that it wasn’t an exam. Express that if reading 90 pages out of 100 is equivalent to reading 1 page, I’ll gladly read 1 page. And to remind him that it IS part of HIS JOB to give us lessons… then again, my heart wasn’t beating at the moment, and I wasn’t strong enough to protest.

Boy, how I hate his sarcastism. His body language, the way he shake his head… Do you really have to be this tough on us? Come on, it is after all, our first day… couldn’t you be more encouraging? Then again, I tried to convince myself that perhaps, he had a bad day,.. or PMS/monopause or something…

Then again, my condition isn’t as bad as other groups. Just sad and depressing. But I’m not giving up, not yet.

Tuesday, January 10, 2006

COAMS #24- PMS

PMS (Pre Menstrual Syndrome)

Sometimes, I just don’t understand myself. I worry over petty little things, I act emotionally, then I blame it on menstruation, hormonal fluctuant and all.. Okay, let’s just say that I got all my priorities wrong! What are my priorities? What do I view important in life? Life over here is frustrating, really,.. sometimes, I just don’t get the people here, I can’t understand them.. I realized I live in a selfish world… and I can’t allow myself to be one of them, I can’t go against them, the worst thing is, I can’t talk to anyone about them… arGhhhh…. And it’s driving me mad…


The walls are getting closer, the knots are getting tighter, the air is getting denser…

I tried to look at the bigger picture, trying to understand to situation,..

Remember the time I was crazy over Ranger & The Georgian Magazine thingy? I didn’t regret over them,.. I mean The Georgian was a great success we can be proud of, but Rangers were stupid, but I did learnt a lot, experience wise… I guess at that point in time, those things were important to me.

OK, I know you are all lost, I’m like taking you on a journey that doesn’t make sense. I did have this weird dream last night though.. there was this helicopter which landed in HUKM (mind you, we actually do have a helicopter pad here)… and it (the helicopter) took me far, far away,.. and I see HUKM getting smaller and smaller from high above,.. as if the problem resolving,.. then, I woke up in my room, bummer! (imagine having the harsh reality suddenly hitting you)

My homework is piling up, running way back behind my study plan. My consultant, Mr Ismail insisted that we read 20pages a day, which at first, it seems really easy, but I am now about –200 (negative two hundred) pages behind time… *siGh *… The problem with me, I guess, is that I don’t put much priority on studies, but a hell lot on exams. That how I ended up so stressful are the exam days approaches… with the last-minute-studies and all… with the adrenaline shooting high, the endless cups of coffee and god knows how much ‘midnight oil’ I’ve burned…


Footnotes:


‘midnight oil’ – is referring to the proverb burning the midnight oil. And the sentence I used is grammatically wrong and merely for exaggeration purposes; therefore not advisable for students to follow. Ps: Hell, the whole article is grammatically wrong anyway! Thank God Pn Chu Lai Lin(my English teacher from high school) is not here with her red ink pen.

Sunday, November 27, 2005

COAMS #7- Visit to the Leprosy Centre

(November 27, 2005, Sunday, at 18:37)

I find it easier to blog than to express myself verbally. Today, I went to Rumah Harmoni, Kuala Kubu Bharu. It is a spastic home, about two hours bus ride from my campus. What I saw there was nothing like what I had expected…

The place was rather damp, with a foul-smelling odour. Beds were arranged in two rows, facing each other. The beds looked like enlarged metal cradles. In each of these ‘cradles’ was a child, a teen or an adult. I thought that is was almost cruel to put those people behind bars. Perhaps it was worse than staying in prison as they are confined to a 6 X 4 feet bed, where there, they eat, shit and play. Little did I know, they not only have difficulty in speech and movement, they also have mental disorders, almost like big babies who never grew up.
But that was not the worst thing. Some of the kids had their feet and arms tied to the corners of the bed, which was very scary. I realize this is done to protect them, to prevent them from injuring themselves or eating their diapers. Others, being physically disabled and paralysed, all they could do is stare at the ceiling all day.
There was one kid that really caught my attention. The kid had encephalitis. He’s head was huge, almost like the size of an oval-shape watermelon. His body was thin, cachectic, almost the same size as his head. When I was cutting his fingernails, I notice that the nails are long, soft, thickened and brittle. Its structure differs from ours that are collagenously hard. The poor kid couldn’t lift his head. He just stared back blankly.
In another isolated ward, the inhabitants here didn’t even have the luxury of a mattress. They had to sleep on hard icy metal cradles. According to the nurse, they have to tendency to eat the mattress. They weren’t even given diapers. So, the cleaners would clean the beds by just splashing water on them. Imagine how cold that is!
I tried to communicate with the people there. This, was the toughest part. They couldn’t express themselves and I wasn’t sure whether they understood me. Some managed to mumble a few words slowly; some replied in smiles, others just stared back. Later on, we found out that they actually loved music and dancing. So, we find ourselves laughing, singing and dancing with them. Perhaps this is one of those cases where - actions speak louder than words.
There was an aunty who happily added my bracelet to her collection. Yeah, I treasured that bracelet a lot, but to see her smiling, I guess it was worthwhile. If only we could be easily contented and rediscover with our innocence.
At the end of the day, I felt that I was not really to leave yet. Sure, I’ll go back to my everyday life, complaining about practically everything. Then, in time, I might even forget about what happened today. Therefore, I shall blog this down, to make sure I don’t.

I felt sad, I felt empathy for them, and above all, I felt hopeless.

So, I lived in a cruel world. I asked God, why do you allow this? Why can’t everyone be healthy? Then negative questions like, where are their friends? Where are their families? Do they even have families?
There are many people out there, lonely and in need. Yet, very often, we couldn’t find the time to lend a hand. Some of my friends, who initially planned to join us on this service, changed their minds to watch Jolin Chai in person. Some were busy preparing for minitest this week. Some were just too lazy to get up… I wouldn’t brag about myself, because, if Lee Hom was in KL this morning, I would probably not be writing this now. Then again, we, being luckier, should be thankful of what we have. We, being luckier, should help the less fortunate, making them feel cared, loved, ‘belonged’.

--------------------------------
Review on 2008:
reading back this post after 3 years, brings back all the old memories and feelings... the kid, by the way, had hydrocephalus..

Saturday, November 12, 2005

COAMS #6 - The CULTURAL SHOCK at Medical School

(November 12, 2005 at 11:52 AM )

Did I talked about the first time I entered medical school, I thought that EVERYONE HERE WAS MAD??? I cried on the first day of university. Yeah, hate to admit that. Laugh at me and I’ll delete this. I had been away from home for camps, visits, vacations, yet this was the first time I felt home-sick. And I didn’t know who to complain to, everyone was encouraging and perhaps more excited than me. So, I started writing my diary. Somehow, writing helps me think, writing calms and soothes the emotion.

To me, coming to university was a ‘culture shock’. The biggest obstacles, okay, maybe I should put it this way, MY biggest problem was - the language barrier. Noone told me that ALL Chinese in university communicate in Mandarin. Well, it’s not that I totally don’t know Mandarin, but it’s just that I didn’t thought I could survive Mandarin ALL DAY LONG. Of course the Malays talk in BM but there were only a handful of Indians. So, well, it’s just BM and Mandarin. Hmm… Welcome to the -WE-DON’T-SPEAK-ENGLISH- world. I don’t know how well I hid my hatred towards this place at that time. I did consider pretending that I don’t know Chinese or joining the Christian Fellowship (which is pointless as the Christians here uses Mandarin as well).‘Why must I adapt to them? Why couldn’t they adapt to me?’ I thought.

I remembered clearly, a senior paused and asked, ’Who doesn’t understand Mandarin here?’. Thankful, I raised my hand only to hear the reply ‘you can get your friend next to you to translate’. I really couldn’t blame him because there was like only 5 hands up and majority rules. But of course, at that time, I was disappointed and it only made me hated this place more. I made a point to try speaking in English to the juniors only to find that most of them were more comfortable with Mandarin. I wanted to help people like me, yet little did I know, I was simply torturing others, so I switched back to Mandarin.

I realised how naïve I used to be. Later, I found out from my friends that it wasn’t just UKM, the same condition is present in USM, UPM, UM… u name it. They complaint and recovered, I remained stubborn, refusing to adapt, until months later… Well, I should consider myself lucky that I didn’t have to communicate with my Chinese roommates in BM (like my friend, Boon Lee). I did wonder though what happened to all those people like me- the Georgians, Paulians, Convent Girls and ACS. They simply vanished into thin air and I had my entire life history wiped out. OK, they went to collages and only a handful studied form6. Oh well….

I’m OK with Mandarin now. In fact, sometimes I subconsciously speak Mandarin even to the Malays, which was kind of embarrassing.

Being already depressed during first semester, discovering that ALL MY COURSEMATES ARE MAD only make things worse. MAD as referring to the way they study -MAD. It was kind of scary, I have to admit. Some can just study for hours, like some machine programmed to work. Of course, at that time I didn’t realised that some people genuinely enjoy studying. And I really envy those people - people who possess the PASSION to be a doctor. What separates me from them, besides the language barrier is that PASSION.

Like I said before, DOCTOR to me at the beginning, was just a profession, interesting, secure, challenging and a little ‘cool.’ Well, if you can’t decide what course to take, might as well take something that would help the people. Hoping that the ‘satisfaction’ will drive me, I took the back seat.

Being welcomed by lecturers who made us felt that medicine is a nightmare itself was a nightmare. Medicine is a lifetime sacrifice, they said. I started to deceive myself that I’ll learn to like this course, like the way I was deceived by TV series that doctors in white coats are cool; and perhaps by Dominic, this UM medical student who gave us such a motivating speech during form6. Nevertheless, I forgotten that for those PASSIONATE ones, it was a whole different story. And no, I did not get to keep the eye from the dissection hall.

Later on, I realised that I’m not alone. Many of my course mates didn’t have this PASSION. Some wanted to be pharmacists, veterinarians, one of them wanted to be a pianist, another a ballet dancer. If I was bold enough to follow my dreams, I would probably be studying journalism instead. But, hey, I’m no Robert Frost. The Tertiary Education Ministry Board would probably commit suicide once they find out how many of us didn’t really wanted to study medicine THAT badly. I did felt a little guilty for those who wanted this place more than I do but did not get it. But of course there were those who REALLY wanted to be doctors. Yeah, I envied them.

Honestly, medicine is not such a bad course after all. Perhaps it was the way I hated UKM when I first arrived, the ‘cultural shock’ that made me bias towards the course. Everything was fine except for the exam part. Simply because I naturally hate exams (who doesn’t anyway? I blame our exam-oriented educational system).

I enjoyed the dissection sessions we had for anatomy, one of the few things I often looked forward to. I loved PBL (Problem-Based-Learning) sessions where we were given medical cases to solve, they made more sense to what we learnt in lectures. The Basic Clinical Skills were fun too, though we had like only 2 sessions. And I loved the anatomy tutorials. And I hated all the tests, regardless mini test or exams- all of them! Lectures? Some are interesting, some were just merely reading from the text, sometimes I wonder-hey, maybe I’ll take his job-. But no, I don’t sleep in lecture halls. I either pay attention or skip them.

Perhaps it is unfair to put the blame on TV, parents and friends. The year I had my STPM, Grandma had a fall. She could barely walk back then and had to use a wheelchair. My uncle and cousin tried traditional medicine, messaging oilments, bandaging herbs. My cousin, Kian Guan happens to be studying Chinese Medicine. It’s not that I don’t trust traditional healers, it’s just that we tried everything, even acupunctures, but the condition did not improve. I felt helpless. Finally, we brought Granny to the hospital, she had her femur fractured and had a minor surgery. I don’t know how she endured the pain. Granny is now on walkers but things were never quite the same. She lost the freedom of walking freely.

Let’s put it this way- yes, I’ve the interest, but not the passion, not yet I suppose. Hey, I have 3 years till I graduate. Perhaps time will tell.

Author's Note

Dear friends and readers, Thank you for dropping by and leaving comments/ shoutouts. More importantly, thank you for being there... please accept my apology that, lately, i may be busy with work and not have time to reply youir messages/comments, but rest assured, each and everyone is read, and highly appreciated :) have a nice day! ^^

of love

Today, i heard a story which was not a story of falling...
of living in the dark end of winter turmoil..
instead, it was a love story..
of a couple who did not live happily ever after...
but they live, loving each other..