I will be sitting for what will be at this point, the biggest exam of my life.

Funny I am allowing myself to be scared, because exams are no stranger to me. There was school. Then college. Then university. The last one being the most gruelling.  

I should be used to this by now. After all, in this line I’m pursuing, exams will be part and parcel. Lifelong.

My prayer: That I will do the best I can and pass deservedly, only for HIS sake. It would be great if you could pray with me.

Back to books!

Coutesy of friends who play with my phone

p.s. Someone told me yesterday that they found my old blogs. I devided to pay them a visit today, and I just CRINGED! I was SO young! Definitely time to redirect them here.

Me: Selamat pagi, Pak Cik, _____________________(Insert obligatory introduction, medical-student style). Apa terjadi, ya? Points at leg.

Pak Cik: Oh, Accident.

Me: Accident ya? Macam mana? Pak cik naik motor ke, kereta ke, basikal?

Pak Cik: Naik motor.

(And wait for it, you will be doubled over laughing, rolling all over the floor)

LANGGAR KAMBING.

I snorted, but managed to contain my laughter. How la? This comes close to the “Langgar lembu” episode, does it not?

Today, I’m thinking of….

-The woman who teared telling me about her financial difficulties, multiple health problems, and her children. She was close to losing her job as her ill health imposes many restrictions physically in the rubber estate, and was having difficulties with the kebajikan department in settling the hospital bill.

-The refugee, hand-cuffed to the hospital bed who eventually succumbed to an incurable illness. He was caught a few years back, and was supposed to be deported back after being discharged from the hospital. Needless to say, he never made it out. But I wonder if it could have been better for him and his family this way.

-The uncle with a disease that hardens the spine and makes it super brittle. He fell off his bike and suffered a fracture in his neck. Doctors cannot decide if they should operate on him, as given his present spine condition, the procedure would pose a much, much, much more higher risk to him. And he does not understand why the doctors are not doing what they have to do to cure him; to him, they’re stalling and unsure.

-The young man who suffered multiple fractures in an accident and will not regain the function of his legs.

-The uncle who has end-stage renal failure, diabetes, and suffered a stroke. He goes for dialysis 3 times a week.

-The teenager who contracted an incurable sexually transmitted disease and does not know how it was so. He does not know where his father is.

-The aunty who had to lose a breast due to a detrimental 2cm diameter lump.

The list could go on.

Such life-changing events that are merely a part of what I have to ask in order to obtain a full medical history.

Each person with a story, yet, sometimes they are reduced to facts that point me towards their diagnosis.

I, on the other hand, have lived a comfortable, selfish, pampered life.

My main worries revolve around myself. What are they, compared to those of the patients whom I meet daily in the hospital?

What right do I have to complain/rant about anything at all, really?

And so I remind myself: The Lord is my SHEPHERD. I shall NOT want.

The doctor explained to him that he’ll be given a sedative (he’ll still be conscious) for the procedure, and he will feel like sleeping.

“Dik, sekarang doktor nak bagi ubat pelali, cucuk kat tangan , ya? “, says doc.

“Ha, kenapa kat tangan? Ubat buat tidur bukan bagi kat mata bagi saya tutup mata ka?”, is the lil’ boy’s reply.

Stole all our hearts la.

Today’s was especially brutal. Holding him down as the medical assistants and doctor manipulated away, I heard a *SNAP* as they pushed the bone back in its rightful place.

*shudders*

But he was all fine and cheeky again after that. Imitating the doctor and all.

Thought for the day: Even though medical textbooks have systematically outlined the clinical features, investigations, management plan, possible outcomes, etc of almost every disease imaginable for us to pore through, I realized that when it comes to real life, no two patients with the same illness would have the same presentation. Nor would their mode of treatment be the same, even though it’s the same condition. Each patient has his or her own treatment lined up for them; tailored to suit them and them alone, each susceptible to different factors. It simply wouldn’t work if the management plan for Patient A were to be applied to Patient B who has the same diagnosis and vice versa. Quite like the nature of our Maker too, isn’t it?

For the first time in my entire medical school life, I was grossed out to the point I had to look away.

I was not grossed out when I saw my first episode of massive bleeding.

I was not grossed out when I witnessed my first open abdominal surgery.

I was not grossed out when I had to help clean poop (not like I do it a lot).

I was not grossed out when I saw brutal wounds being stitched up or cleaned.

I was not grossed out when I saw drilling and screwing of screws in bones, coupled with the scraping and…erm..well, stuff (bone? blood?) flying everywhere, and I had to duck and move time to time to avoid.

Well, I might have winced a little, but still, I was able to stay to see the patient through.

So what finally got to me?

Answer 1: CMR – Closed Manual Reduction.

What is that, you might ask. Well, let me tell you, it involved no surgical procedures, no needles, no blood, nothing. Just brute force. CMR is akin to what you see on TV (for once, they aren’t dramatizing things). To put it simply, it’s to pull, push, and pull again the broken parts to realign them as they were before fracture. So yeah, you see the arm or leg being contorted into positions so unnatural, you probably would have trouble sleeping. And so at one point, I couldn’t look. I salute the medical assistants doing it, because they know they have to inflict such force and pain unto someone, yet, they do it with all gusto because they know that if they don’t, that limb will not be well-aligned. I walked away promising myself if I somehow end up with a fracture and will have to undergo CMR, I will, at all costs, demand to be knocked out first.

Answer 2: Smells

This is something I am still not able to take. Smells of necrotic flesh, infected wounds with pus ….you get the picture. It’s weird, because I’m not grossed out, but I just. cannot. take. the. smell. Worst part is, I know it can’t be helped. And I want so much to not be affected by it. This is one instance I do not appreciate my hyper-active sense of smell.

Of all things to get to me, it has to be unconventional things like that. *smacks forehead*

So this is 3rd week of Orthopaedics (and Year 4) for ya. I started off not really liking orthopaedics, thinking it to be one of the most crude disciplines (oh, the horror at the surgeries and procedures done). But funnily enough, I have grown (so far la) to have quite a liking for it and I find myself being more excited at teaching sessions and classes. Even though I swore (hypothetically, because I can’t swear) that I would NEVER do orthopaedics after I witnessed my first CMR, I think, perhaps, I would not discard the thought of doing orthopaedics entirely, and maybe toy around with it for a while. But we shall see, since I still enjoy going to the paeds ward whenever time allows me – makes my entire week.

P.S. I got my arm plastered today. Just to get a feel of what my patients go through. If I already felt restless after an hour, what more my patients who have to be in it for weeks.

Pardon the lack of clarity of the picture. Please pay attention to the bottom most line. If you find difficulty in making out the words, here’s what it says:

Impacted Anus – DENTAL

Students of my learning institution have always been chastised for our deficiencies in our knowledge of Anatomy, but this…this further echoes the sentiments of my lecturers for I have never known the anus to be even remotely associated with the dental regions anatomically.

Don’t I have a lot of brushing up to do. Someone please hand me the latest edition of Gray’s Anatomy.

Not the one that is not meant for medical education purposes, of course.

How can I not be amused yet angered at the blatant ignorance of those running our health care system? This is only one of many blunders that only takes willingness to step out of that “Tidak Apa” mentality for a brief moment to correct. Nobody is talking about harsh labour or using up 1/10th of brain cells.

I can only hope and fight against all reasons that I do not walk into that trap.

Lecturer: Hey. Do you have haemorrhoids?

Medical student: Looks completely puzzled. Shifts uncomfortably. Uhhhh..No??

Lecturer: Because you walk like you have ‘em.

Medical Student: ?!?!?!?!?!?!

(He recovers himself in a split second)

Medical Student: Oh…uh…Football injury la doctor?

Lecturer: Huh. Walks away to do whatever he was about to do.

Classic man. Ask me again why I love Med School.

1. All my Case Summaries and Case Reports are done for this posting. No more crazy all-nighters.

2. I am done with exams for this semester. I’ve just come out of sitting for the last paper – Surgery, and I’m glad it did not feel like a game halfway.” Game” because I’m not able to think anymore because it’s just too darn difficult and crazy convoluted, and I resort to blind guessing. Well, not really – I still have to pick the one that sounds the smartest.

A huge load has been taken off my back. I’ve never felt lighter. Or better.

This week will be my last week in Surgery. And as a third-year student.

Bye bye Year Three.

Hello holidays.

Three weeks without “I can’t believe you passed your pre-clinical phase not knowing this..”, ” You’re supposed to know this by now! “, “Is that how you’ve been examining the [insert any body part you wish] all this while?!”.

Three weeks without going to the hospitals and coming back at unearthly hours, without forcing myself to approach (unfriendly) patients, without pms-sy nurses…

Three weeks without going to the hospital.

Hmmm.

If I have anything due – reports, summaries, anything at all, I’d make sure I save 3 copies – 1 in the laptop, 1 on my thumbdrive, and 1 will be emailed to myself. At least 2-3 times in the course of writing.

I had 2 reports due today, 2pm. To avoid having to rush to finish them, I made sure I started on them earlier in the week, refining them every now and then, and had planned on putting the finishing touches yesterday night before finally printing them.

So of all things that had to happen, my lap top screen went blank spontaneously as I was typing halfway at night. Blank, you know, like how it would look when not turned on. My housemates were already asleep. Poor things they are, doing their surgery rotation. But I should not be so quick to speak as that will be my next and last rotation for this semester- I can only imagine it to be a notch less hectic than the Medicine rotation was. In deciding to be a considerate housemate, I decided not to wake them up. Considering the hour the Lappie (this is what it shall be called from now, hopefully with more affection projected to it, it would not play up so often. Especially not in crucial times such as this) decided to go blank on me, I decided not to bug fellow mates living nearby to lend me theirs.

After the clinic session today (very interesting and enriching one, I must say) I skipped lunch and headed straight to the library to add a few more lines and get it printed. Because when Lappie blanked, I hadn’t managed to save the many copies of what I typed. I was midway through typing, remember?

The library printer, too, decided that it wanted to be cheeky today.

I ran to the IT department (because that’s where I got my stuff printed the last time the library printer didn’t work) only to discover that they were still on lunch break. At 1.55 pm.

Class started at 2pm, and reports were due 4.30pm, after class. Just before it ended, I ran to the IT department again, only to be told to go to the library. Who said it was not working? IT man said, after making a call to the library.

So classmate and I ran to the library. True enough, as expected, library printer decided to hiccup on us a few times while printing. But we managed to get it to cough up our reports anyway. That’s all that matters.

The reports were handed up just in the nick of time, albeit the lecturer grumbling to the whole class about our “terrible learning attitudes”, my colleague and I. Oh wait, more like only MY “terrible learning attitude”, and not my colleague. Although both of us were the ones with the printer issues. People say that nowadays when you go for interviews, your potential employer actually checks out your Facebook profile. And blogs, if you have one. So in my efforts to stay tactful and to avoid any unexpected repercussions that will jeopardize yet-to-be-known future opportunities just because I see too many inconsistencies, I shall stop here at describing the scene. You do the math. =)

Am I looking forward to Melaka tomorrow. I shall eat my frustrations away.

A quick, pleasant tidbit for today: When a footballer of a guy, well built, sturdy and strong was asked in return when HE asked me if I’d entrust my mother to the care of another person, he whispered (because that’s how we talk to each other in clinic) indignantly “NO!! I will NOT!!” Even if you have to leave your job? “Yes! Even if I have to leave my job. I’ll never leave my mother to someone else’s care. Die die also I want to be with my mother“. All that with a straight face without any thought given. Haha. Like M&M? Seemingly hard on the outside, but soft on the inside? Shall leave you with that. =)

And don’t worry mom, I won’t either!

No, I’m not a big fan of the colour pink, so needless to say, I was not too happy.

To describe my own eye in medical terms, there was unilateral, diffuse swelling of the right eye with discharge, itchiness and slight discomfort. There was no pain, photosensitivity, or lacrimation.

Yes, I have got conjunctivits. In one eye. (It’s not common to have it in one eye)

I was diagnosed with one look from the Family Medicine Professor, who, after exclaiming that I had conjunctivitis in front of the whole class said: “I tell you all ah, this is an ethical issue. Conjunctivits is so infectious, people around you will be in danger of getting it. This has to do with ethics wan, all these infectious things – Influenza, TB, Conjunctivitis. You (referring to me) should have stayed at home, rather than put all of us at risk. I’m staying far far away from you errr. This has to do with ethics.”

Oh! Woe to unethical me who put all my dear, dear colleagues and friends at risk.

But I cannot argue for he is right. I may have downplayed the contagious-ness of my barely noticeable eye infection. I just hope he will not be mad at me for turning up for his class tomorrow. Fingers crossed that swelling will be less noticeable than it is now.