COAMS #38 - My first post-mortem forensic experience...

The Professor made us went down, One by one, we stood in a line, ‘warm’ he said, smiling at me, as if reading the fear written all over my face, as he took my hand and held it longer against it. I guess pretending to touch it didn’t work, and I totally lacked the enthusiasm my coursemates had, and the fear, I wasn’t faking it. I was so obsessed and compulsive, I washed my hands over 10 times that day…

The Professor took a knife and made an incision across the scalp. Then, he pulled the skin outwards and downwards, until the skin of the forehead touches the nose, like peeling a coconut husk. The mini electronic saw made an eerie ‘eeeeee…’ sound as it cut through the skull. The skull pulled apart, the brain removed. ‘No hemorrhages’ my friend whispered, but I was so shocked to actually rationalize anything, anything…

My friend, reading my fear, warned me, this part is even worse, she said, ‘the chest would open like a pod, and every internal organ removed’…The Professor, ignoring my fear, continue his carpentry work through the ribcage. I appreciated the emotional preparation, but somehow, I was still stunned.

Come on, you have seen numerous of cadavers(corpse) before at anatomy dissection, my inner voice tried to rationalize,.. ‘but this is fresh, it’s less than 4 hours!’ another voice argued.. and I wondered whether they were just thoughts or hallucinations…

‘Pop’, the chest cracked open and the mini saw stopped. In silence, he went through the intestines, as if searching for something. He tied one end of the gut, and later extract the whole gastrointestinal tract, from the tongue all the way to the colon, the lungs, the heart, the liver as well.

Then, they moved to another table. The brain was inspected and weight. Then the cerebellum divorced from the cerebrum. He sliced through the cerebellum. ‘Ouch!’ I shouted inside me… Although I understood well that the central nervous system has no nocicepters (pain receptors), and on top of that, it is already dead, I just couldn’t help feeling the pain… Then he sliced the cerebrum(forebrain), 1.5-2.0cm apart, sharply, skillfully and steadily,… spreading each out for signs of stroke, hemorrhages or infections. ‘Clean’, he said. At this point, I have a sense of déjà vu, as if this was a scene from a horror movie,.. I was already peeping through the narrow slits of my eyes.

Later, he started weighting the other organs, one by one, slicing them, analyzing them, like as if it’s the most interesting thing to do in the world – The tongue, the lung, the heart, the liver, etc..

He commented, ‘You should get used to the smell, no covering your nose and mouth with your hands’. He looked up at me, followed by another 30 pairs of eyes (of which belonged to my coursemates). I swallowed a gulp, it regurgitated back. It wasn’t just the smell, this, this was entirely gross… yet, I could tell no one… I cannot imagine me being on the table, and I vowed never to let it happen, and was already making plans to clearly state it in my will… I guess I was shallow, despite my profession background. But hey, I bet you would have thought the same back then if you were in my shoes.

Then, they sew up the body, halfway up the chest, shoved everything back into the body, including the brain and sew it tight. The head was filled with cotton and sutured.

And I, I could not eat any meat that day.

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I stared down from above. A group of curious students looked at me, with cruel glances and disapproving expressions. I was not sure whether this should be done, I am not capable of stopping them anyway; I just had to get through with it.

The doctor recorded the bruise marks on my body, the cigarette marks and the multiple old scars from the slashing of my father’s belt.

I was hurt before. And so, I fled to Malaysia for employment, or rather, for new hopes, for a better future. My new employee was very nice to me. Despite not having any blood relationship, they treated me like a relative. I taught their children to read, played, and raised them as if they were my siblings… Here, I found home.

Then one day, my chest hurt so much, I could not breathe… and that was the last thing I could remember.

I feel guilty having my employees now being suspected for abusing me, for my death. How can I tell them, they were kinder to me than my very own flesh and blood? Would anyone believe it?

The doctor sliced through me. Funny, I felt no pain at all. Yet, I felt like I have lost something. That is me, or rather, that was me… Seeing this only restrengthen the fact that I can never return to it. So, that’s it, that’s the end.

As he sliced through the heart, he nods affirmatively, as if he found eureka. ‘Fibrosis- the scar tissue’, he explained to the students, ‘Look, the left ventricular wall is much thicker than the right, left ventricular hypertrophy’. The students nodded in unison while I understood nothing at all. ‘Here, another strip of fibrose tissue’ he continued speaking Latin and pointed to some grayish-white section of my heart. ‘The cardiac enzyme stain confirmed it. She had a heart attack’

I had a heart attack.

Finally, that answered everything. I died from a heart attack, like my mother, which left me to my cruel abusive father. My employees were free of charges.

And I, I was free too…



(Note: all identities are confidential)

Written on September 02, 2007 at 12:51 PM

AMSC SEOUL 2007 - Cancer In Asia : Incident, Suffering and Prevention

AMSC SEOUL 2007!

My last conference of medical school was at AMSC SEOUL 2007… It’s sad having to say goodbye and not having to say ‘See you in next EAMSC, Thailand’ or ‘see you next summer in Japan’… I totally understood why Ryan attended so many conference, even after graduation, but considering my final year schedule,.. I knew pretty well that it is not possible…

Nevertheless, AMSC Seoul 2007 was certainly an unforgettable experience. Group 5 was the most happening group, still is… With our really nice GMs – the Pretty Vivian Park Young Jean, Cute Kate Choi Ye Ra, Cool June Park Jong Jun, Beautiful Kathy Kwon Su Hyon, Nice Robin Kim Seung Bin, Talented Edwin Shin Jung Hyun and the awesome members, Adorable Mary Toumura Misato, Wonderfully Happening Angela Chang Chih Hui, Sleeping Beauty Joanne Chan Pui Kwan, Magical Hamilton Chan Ho, Funny Xiang Salim, Crazy Yoshi Muto Yoshinori, Friendly Yessica Stefanie, Always-smiling Ooi(Ayui) Singsumpun Nontouch, Sweet Nic Thongdeethae Areeya, Stylish Ava Lee Sou Wing, Adventuress Daniel Su Chiung Jui, Musical Damarkusuma Arditya and of course my good-old-buddy-Aland Shum Koin Lon… Group 5 ROCKS!! ^_^

PreConference: Upon arrival at the airport, I met Hyerim. She cut her hair, but she’s still as sweet as ever… so nice meeting old friends again.. We checked in at Olympic ‘Parketel’.. The weather was great,.. summer felt cooling, unlike Malaysia. I went to Lotte World that day… it was AWESOME!! The rides were so scary, even watching it alone was scary.. I wished we had more time there… Visited
DeokDuGung Palace the next day...

DAY 1: Welcoming Party- To think that AMSC Korea 2007 welcoming party was at a pub,.. we had too much expectations… free flow of alcohol? You wished!! There were free flow of soft drinks and we had lotsa fun playing games…. And modifying games… ;)

DAY 2: Paper Presentation, Opening dinner.
Paper Presentation- With this year’s theme, Cancer in Asia, Incident, Suffering and Prevention, it’s really interesting to learnt about how each fellow countries struggle through in overcoming leading cancers in their country… This year’s paper presentation past unusually quick… I guess being in 4th year, I could follow the presentation and discussion easily… but i'll cut the academic-related-part off the blog so not to bore you ^_^

Opening dinner- Hmm.. delicious!! Performance by Arcadia was cool!! And the musical performance was impressive…. I never knew music instruments can be played in such a way…

DAY 3:Poster Presentation, Cultural Experience, Bimbimbap, Clubbing
Poster Presentation - it’s fun hopping around and looking at each country’s poster.. I still remember clearly of Hong Kong’s colon…

Cultural Experience- The organizing committee arranged this session so well, we got to play most of the Korean games… hopping on seesaw(Nolttwigi) was scary, I thought, nearly got off balance, played Yut-nori(with enormous dice), Kulrongshoe(hoop rolling), T’uho (arrow throwing), P’aengi Ch’igi (spinning top), Chegi ch’agi(kicking shuttlecock, similar to sepak takraw)… we drew Tal (Korean mask), Takbon (tapping patterns on paper with an ink pad), and making Deok(Korean rice cakes) the traditional way!! I thought Poong-mool, Sah-mool-nori Percussion best! I enjoyed playing the Jang-gu very much!!

Bimbimbap party in the rain… - Honestly, I was a little kimchi-phobia,.. but bimbimbap is a must experience,.. the rice design was rather impressive…

Clubbing- yeay! The Korean style!!

DAY 4: Hospital Visit, The Blue House, City Tour, Insadong
Hospital Visit- Interesting to visit and learn about Korean’s paperfree hospital...
Seoul National University Hospital, one of the most distinguished hospitals of the country!

The Blue House – Thanks to Kathy, we got to visit the President’s house!! It’s a very calm, serine’s place… but we could only take limited pictures though… national security… it’s okay,.. coz we even had souvenirs! From the President!! Yeay!!!

Insadong – Beautiful street famous for its many street performance and souvenirs…

DAY 5:Lecture at Seoul University, GyeongBokGung, Cheong Gek Chung River, Seoul Towel

GyeongBokGung- A Magnificent Palace!!

Cheong Gek Chung River- cooling river…

Seoul Towel – yeah, the one from My Girl,.. couldn’t find Lee Dong Wouk there though… ^_^

DAY 6:Closing Ceremony, Take off to Soong Woo resort…, AMSA Exhibition, AMSA Quiz

DAY 7: Rafting, Sauna, Cultural Night
Rafting was FUN!!
Cultural Night, was like always, the best event of the conference!!

PostConference: NamDaeMun, SinChon

Last minute shopping and good food…

Words are getting restricted towards the end, as i get sleepier...

...to be continue...

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I do crazy things in Korea

… I can’t believe I ran on stage and sang with an awful sore trout in front of over 300 audiences… WHAT WAS I THINKING?? And the weirdest thing was I actually got shortlisted, C-R-A-Z-Y!! My group people, especially Angela shouted like mad,.. May Luu and Queck was yelling down there too.. CheeYong commented, ‘Don’t do anything stupid again, you made me shout like mad!!’ and I was sorry for the other girl who obviously sang better, but I was just fishing votes from The Malaysians, the Indonesians and my group people… Aland managed to get thru while forgetting his lyrics despite having his cellphone playing the song on one hand, haha! poor Ricky… I still blame Aland for bursting my adrenaline and preventing me from chicken-ing-out,.. people think I was brave, I thought I was just stupid and crazy… arGhhh… thank God no picture was taken and I shall repress it for the rest of my life!!

The Sauna experience with Vivian, Kate, Kathy and Mary was another CRAZY one I find it hard to repress,.. but I shall not elaborate further on it…

Reuniting with old friends, way back from AMSC Kuala Lumpur 2005,.. friends from AMSC Hong Kong 2006, EAMSC Taiwan 2007 (Group 9 yeah!) all the way to AMSC Seoul 2007… it has been one HELL of an experience, I shall not exchange for any other…

(written on September 02, 2007 at 11:45 AM)

COAMS #37- so sick of being sick

it's been a week already,.. i suspect that i am resistant to the antibiotic prescribed... or perhaps there's just too much allergens... i suppose i am allergic to classes altogether... and i mean it quite literally... every morning, i have to attend ENT classes in this air-conditioned room with thick curtains infested with God knows how many zillions of dust mites and dirt... not to forget the tick carpets... the dark environment... my condition never recovers... having nasal congestion can be very torturing... BELIEVE me... especially when it start blocking your nose bilaterally, and you have to breathe through your mouth, your throut gets dry.. you get sore throut... URTI(upper respiratory tract infection) only worsen the condition... the the mucus start moving into your airway... the allergic reaction worsen.. the next thing you know, YOU CANNOT BREATHE!! terrible, terrible,terrible... cocaine spray and ventolin nebuliser only gives temporary relief... (just in case you were wondering, no, that does not make me a cocaine addict) Mr Megat adviced exercise to stimulate adrenalines,... is there any easier way? siGh.......... maybe when i get better...

i am so sick of being sick... the world keeps on spinning without sympathy... i feel terrible,.. physically and emotionally... and i start suspecting i might have Munchausen syndrome (falling sick to gain attention).. then again, this may not be the kind of attention one would like to seek... you have your coursemates subconsciously taking a 'FULL HISTORY' of you... impressive nodding their heads when you happen to be a VERY TYPICAL HYPERSENSITIVE TYPE 1... siGh...

sometimes, i just wished to escape... it's hard even to fish the 3 magic words [GET-WELL-SOON...]... really, instead, i have people around me 'taking history' and asking what medications i am taking... i suspect the 3 magic words doesn't exist in the chinese and malay dictionary... hmm... [semoga cepat sembuh]... sounds weird isn't it? xi wang ni hau yi dian? haha, yup, my chinese sucks...

oh well.. got to continue eating porridge.... why being sick have to eat porridge? i wonder whether who create the condept, whether it really works... all i know is i can't risk it cause i'm losing my voice, (correction: i lost my voice) and i am having shortcase (oral clinical) exams soon... i don't think my examiner will postpone the exam for me or excuse me for being sick... and hey, i don't know sign language, neither does he... siGh...


(Written on June 28, 2007 at 06:10 AM)

p/s: Later on, in Family Medicine Posting in 4th year(8th Sem), i learnt that:
1. URTI, in my case, is viral in origin,... so it's only normal that it last over a week
2. Viral URTI is self-limiting and does not requires antibiotic... it only needs adequate rest and symptomatic relief
3. i was abusing antibiotics
4. No wonder my body is more and more resistant to antibiotics!!

COAMS #36 - falling SICK... feeling SICK....

i hate falling sick, terrible running nose with post-nasal-drip, blocked nose with the ENT lecturer taking you as a good example of 'hyponasal' speech and hypertrophic inferior turbenates, and having temporary relief from the nebuliser and DAMN i wished i could just buy my own nebuliser and keep it in my room... the air is getting tense... i suspect the world's air concentration is depleting its source,.. either i am very sensitive or it's just me... and worst of all not having to take my medication because of the sedative effect when i have a case presentation tomorrow, tons of procrasinated homework and an exam coming up in one and a half week time....

learning points:

1. i hope people do not have to fall sick
2. if there is no sick people, there will be no need for doctors
3. if there is no need to for doctors, i will not be trapped here with assignments, case-write-ups and exams despite being sick
4. there's how much my life can suck sometimes...
5.because, noone is immune to disease
6. therefore, there will always be sick people
7. and therefore, i will always be trapped here with assignments, case-write-ups and exams despite being sick
8. and HELL, my life SUCKS

(Written on June 25, 2007 at 06:07 AM)

COAMS #35 - A World without light, colors, dimensions... Are we too blind to care for the blind?

( pic: the picture on the right is the mould while the picture on the left is the embossed tactile diagram of the inner structure of a car. This is found in the form 4 physic textbook)

What is a world without light? An empty world without colors? A world without dimensions?

Last week, I visited the MAB, Malaysia Association of the Blind at Jalan Tun Sambanthan.

It is amazing how much the visually disabled can do. Braille is not an easy language to be learnt. I tried closing my eyes and reading with my fingers, and hell, it was tough… The dotted characters seemed the same, more like tiny sands. Kar Yuen, the 6-year-old kid I met there, was able to tactilely read all the alphabets and numbers as fast as I read with my eyes. Braille is based on only 6 dots, yet it is possible to emboss characters A-Z, 0-9, in codes to be read by touch. Reading Braille is difficult let alone typing it. The Brailler (a Braille typewriter) has only 9 keys. Nevertheless, I had my name embossed in Braille ^_^ (just in case you were wondering, no, I did not typed it, too challenging for me, hehe..)

What impressed me most is that MAB transcribes text print to Braille. Text from novels, to Reader Digest and even school textbooks! An average Reader Digest book, after transcription, would be 3 books thick, each about the size of a box file! With that, the blind or low vision students are able to attend school, both primary and secondary school, together with other ordinary students. Yes, they would be able to sit for UPSR, PMR, SPM, etc… Diagrams (as above) are embossed so that they too can learn. Embossing diagrams is a very tedious task. Reading it is equally difficult. Yet, these special people have a great sense of touch and imaginations, putting together the puzzles into a picture. Really, really impressive.

And there was this guy playing Pachabel Canon in D. He had a diploma in piano. And to think that passing piano exams was a struggle even for people with good vision. Well, at least I struggled, and hell, I don’t even have a diploma! And there was this girl who passed her SPM with flying colors and was awarded ‘Anugerah pelajar istimewa cemerlang’ by the Melacca government. She aspires to be a teacher however her application to a teaching school has been rejected. The world today is too blind to see how much these less fortunate people need our support.

Lastly, I suppose we should count our blessings… (yeah, all of you who are lucky enough to be able to read this)… sometimes, we don’t realize how lucky we are, having one of the God’s greatest gifts. Ophthalmology is a very important branch of medicine, aiming to prevent visual loss and blindness. MAB on the other hand, helps people to cope with visual loss. Education and rehabilation is important...

Can we make a difference? Certainly! It can be as simple as helping a blind people to cross the street or to find a shop. Let him hold your arm and walk slightly in front of them, not behind. If you are helping a blind into a car, tell him which way it is facing, and place his hand on the car roof over the open door. If you are eating with a blind, take the courtesy to tell them what food is served. Debone the fish, if any and never fill up drinks up to the brim to avoid spillage. If you are working, you may pledge to donate a portion of your monthly salary or even provide employment to the blind. Don’t be surprised that the blind is capable to use the computer. They have ‘talking computers’ and manage with hotkeys. They use windows and other special software. Visit www.mab.org.my for more information.

(Written on June 09, 2007 at 09:05 AM)

COAMS #34 - Opthalmology

The fundus, it is perhaps, the most beautiful thing i've ever seen on earth. I think i am falling in love with it, almost.

I can’t believe I am actually enjoying my ophthalmology posting!!  Maybe it is because it’s not exam week yet, and basically the lecturers at this department are very very nice… The fundoscope, is a very amazing tool. You can tell so much just by looking at the fundus, it’s like looking into another world, peeking into one’s secret chamber. (ps: a fundoscope is a mobile hand tool used to view the eye structure, basically looking at the retina for signs of bleeding, leakage, occlusion etc) I have to admit had that the first few days was a struggled, where I could only see the vessels, a glimpse of the optic disc and nothing more… it was depressing at first… I strained my eyes so much that the patient commented that I looked as if I was more in pain that she was, haha! When I first saw the optic disc,i was so excited i was like 'yeay!'.., silly me.. Ophthalmology is fun, really, when you start appreciating more and more findings.. but I shall not elaborate on them here as i do not want to bore you off with terms… I think I am starting to like this posting, I hope I will… ^_^

(Written on June 01, 2007 at 10:35 AM)