Showing posts with label Hospital. Show all posts
Showing posts with label Hospital. Show all posts
There are often instances when realizations hit you with a BAM and you wonder just what the hell are you doing here and now?

Paeds has made me realize how awfully skilled are paediatricians. Truly, they must be one of the most innovative people on earth. And yours truly would happen to be on the other end of the spectrum. It's probably not very smart to be saying how poor is my interaction with children, but yes.. this morning I made an infant cry and this random uncle walking by was like 'horrrr you ahh... make other people's children cry'. And it wasn't because I examined her, the only thing I did was carry her!

They say that children can tell beautiful people apart... I agree. They say that children can read vibes better than any other... I agree as well. They say that children.. and to a certain extent, pets; can tell if you're a good person or not.... I agree.


So does that mean that I've become so filled with hate that intrinsically I'm gone....




Fall seven times, stand up eight.
~Japanese proverb
It is said to be the most common cause of heritable mental retardation second only to Downs.

It is caused by a distruption in the expression by either an nucleotide expansion or deletions of FMR1. A dominant X-Linked gene (FMR-1; familial mentral retardation 1) *trying to type the longest sentence ever expressed in a single breath*

Loss of the FMR1 expression results in Fragile X.

Clinically they will present with;
Pre-pubertal; Normal growth but a large head, Delayed developmental milestones, an association with autism, ADHD, tantrums.

Post-puberty; Long face, low IQ, Macroorchidism

other opthalmo, orthopaedic, dermato and cardiac anomalies.


Reason for nerding today?
I saw a 5 year old boy suspected for Fragile X in the clinic today. He came in due to a refusal to eat food other than kwey teow soup and drinks milk every 2 hourly. Outward appearance appeared normal, none of what has been described above; plus his mother mentioned that she was also slow to walk when she was younger. Eye contact was surprisingly- still held, but otherwise he would definitely have struck me as an autistic child.

I also met a child who was then diagnosed with spastic hemiplegia CP. Such an adorable 16 month old, who smiles incessantly and active as ever. Yet his mother cried when the doctor confirmed her worst fears -- that her baby wasn't normal. Cried even more when he advised her to apply for the OKU card actually.

Hmm. makes me wonder if there could be something between me and paeds. as much as its painful to go through the milestone examinations I'm starting to feel how Bern could be so attached to the little darlings. CP's are generally quite common but I think that encountering a Fragile X for the first time was quite.... mentionable. (there is no such english word)
Guess they aren't only found in textbooks under 'rare'.

Oh yeah talking about rare; there was a Henoch schonlein purpura case in the wards today.

YUP. you could see the 'WHAT?!' s on top of all our heads when the specialist came up with the diagnosis. Upon inspection I thought it was a freaking healing chicken pox (but i did reason out that if it was he would have probably been isolated) !!

Anyways paeds has been quite eventful thus far.


No quote today but I'll show u a picca

:)



STOLEN

Sometimes it unbelievable when I think about just how long ago was it that I was filling in that JPA application form and ticked the 'Perubatan' box.

Medicine has taught me so so so many things.

People misunderstand what the commitment really means. The box doesn't tell you of the nights you have to go without sleep, or the days you have to with coffee to stay awake in class. They don't tell you of the number of patients you have to clerk and remember how to present to your superiors. They don't tell you either about how you have to work for 24+12 hours straight if you actually want to get work done and not just pass it on to the next colleague. Nobody tells you how after a whole day of learning you come home and the first thing you need to do is study again, because tomorrow is a brand new day and brand new questions awaits you. If you don't keep up, so would mistakes. Nobody tells you how many systems you have to read and remember in order to be holistic, and no one would surely tell you the number sacrifices or how far you need to plan ahead to beat your own due dates.
Nobody tells you how horrible you feel when you cannot answer a question, and you think about what would have happened to the patient if you had been this careless when treating them next time. Nothing compares to the tears of a mother of an inevitable miscarriage and definitely not one of an oncologist who lost her husband to cancer. Nobody tells of the politics that goes on behind the scenes in the places you work, you study and the people who suffer because of that. None can describe the frustration felt when you stop and question, why in the world are these people here if they when it seems like that's the last thing they want.

No one tells about how much the specialists slog and the housemen scrape to get through each day with limited resources and energy. Nobody tells you how little hours a MO on call spends with her infant daughter at home and they definitely keep the angst of reading yet another wrongly prescribed medicine in the books from you. No one tells you how many relationships are broken up due to scarcity of contact. No one tells you how limited your options are after you graduate. Ironically the security that all parents thought medicine could provide for their children would present itself from the opposite direction. No one told you that the way the country is going now by 2020 you may be jobless as a houseman. No one told you that by the end of 5 years you'd most likely have to leave the country to specialize elsewhere. No one told you that not everyone is as lucky as that, to be given a chance to leave.

But let me tell you about the most important people in a medical field. The Patients. They don't tell you how painful it is when you poke and prod in a case of perforated acute appendicitis. They tell you it's okay when you fail your fourth attempted cannulation on their arms. They laugh as they thank you and try to match make you with their nephew before they leave the a&e. A mother cries as she tells you that there is really nothing wrong with her son.. he's only autistic. They share how it's always been difficult to open up to people around them, how much they've wanted to die, and some even how they've even planned and attempted suicide; but here they are talking to you. They don't say how it feels to live everyday at the mercy of strangers, strangers who look tireder than themselves and snap at any persons nearby. The mother of 2 doesn't tell you how embarrassing it is to give birth to her set of twins in a room filled with people lining up to the doors. A father carries his daughter with hydrocephalus out the door amidst the stares of people around him. The lives of PPKP's who work over time and risk their health fogging in an outbreak area without proper equipment and supervision. The uncle with bladder CA who longs to go home but cannot as his relatives refuse to accept the responsibility to look after him. A hospital security guard who so obviously have the facies of a trisomy 21 and yet there you see her, everyday on the ground floor in the hospital. The fruit uncle who stays and sells his jambu come rain or shine. Uncle RawT who's fed generations after generations of surgeons. It never fails to amaze me how despite all the pitfalls that becomes of their lives, there they are, day by day, incessantly.just. there.. And nothing so wrong with us could warrant enough to turn them away.


Medicine.


You have stolen my heart.
So don't give it back to me, not yet.

I submit to you that if a man has not discovered something that he will die for, he isn't fit to live.
~Martin Luther King Jr
There was a certain particular point just now around 2345 hours that I suddenly realized how important it was to have a pair of good good shoes. By good i mean comfortable. Its amazing that the Medical students MA's SN's and HO's don't get varicose veins from all the standing. When i sat down just now after the hours and hours of standing.. i actually felt. old.

ANYWAYS

37 yo female lady comes in with acute shortness of breath. I find out that she has bone mets 2' to Br CA. and she's even had a mastectomy. At the age of 37! It must have been at least 1-2 years before her ca was dx'ed. all at the age of 37. According to her there is no fmhx. but i never got to ask more about her risk factors, because she was so worried she had lung mets. She kept wanting to meet the oncologist, she's just had a metal plate inserted into her femur for a pathological fracture, she was accompanied by her bro and uncle, she's not married, i wonder if she's ever had the chance to experience losing her virginity, she was really really pale, she has nice veins for cannulization, she has pretty eyebrows too aside from being pretty in general, She told me she lost alot of weight, and that the disease was a very morbid one, she .... is only 37.

Indian uncle comes in due to a fall from an acute giddy episode. Had a bypass 10 years ago and a hx of DM which he takes both OHA and subcut insulin. Memang got hx of IHD one lah, so this time he says he felt giddy - Malignant htn? But he says he's compliant?!?!?! A few hours, 2 tired relatives, 2 failed brannulas and a chest xray later, he's obviously feeling alot better and says that - actually my scrape on my knee was the only reason i came in lah. Nicely missing out the SOB part. lol i talked to his wife and she confirmed the SOB, she was like 'dei, u HAD sob ok' lol so cute.

Today it was probably field day for neuro. I even saw our senior Nigel there. There was an 18 yo kid with a  (big!) EDH, but question- do lucid intervals last for a whole week!??! that's how long that's passed since his fall. The only thing he has is probably a fractured clavicle and bleeding into the sclera. Symptom wise he's been unable to tolerate loud noises and been having headaches that are non progressive. 18 yo kid with a motor lah, who flew superman style when he drove into a pothole.

Next to him was an uncle in his 50's who came in from an alleged MVA. He's alert and everything but ha ha here's the catch- he's so darn confused. If you didn't actually understand what he was saying you'd think that he's totally fine. Until you realize that he's answering 'depends on what they find' about 10 times to 12 questions. When Nigel asked him to remember 3 things - car, window, house (I cant rembr if it was window)... and then asked him to repeat it about 8 seconds, later he said 'car, brother'. Full stop. A few mins later i asked him a few other questions and i thought he was a little less confused when he was able to tell me he worked in penang and had no medical illnesses.... Untile I asked him if he knows where he was now and he goes Johor. MRI brain showed a small SDH.

The last bed in the yellow bay housed an auntie who had a long hx of htn and known to be non compliant. Earlier in the day she told her husband she had a bit of headache, and after passing motion she said it got worse. Next thing you know she's warded, unconscious and sweating profusely. Dx? Haemorrhage stroke. MRI brain showed Basal ganglia bleeding that drained into the ventricles but thankfully with no midline shift. Even when they wheeled her to the ICU her GCS was probably still <10.

78 year old chinese auntie came in feverish, unconscious, obviously cachexic with a BKA of the Left limb. Our very very nice MO who decided to gave us a teaching in the end used her as the bedside case. Okay so apparently from that first sentence itself we're already supposed to kinda guess what's the dx. Let me just tell you what was done; Resuscitation with NS improved her condition tremedously as she gained consciousness; CBD showed concentrated urine; Vitals monitored; Reflo done there was no hypo/hyper; ECG showed no ischaemic changes, blood Ix's taken- takes damn long to get back so don't know what yet; The last i saw her CXR hadn't come back yet. Talking to the relatives revealed that she just had a stroke 2 months ago and her BKA was done in May this year. Provisional dx? :D

Thin, cachexic, jail inmate comes in with acute SOB. Unable to finish a sentence, very obviously tachypnoiec. p02 was around 90 i think. Can't remember his vitals but anyways. Hx of IVDU and goodness knows what else that goes on behind prison walls. I was unable to clerk him fully, to even get more details on his presenting complain as he was in so bad shape but what we found out later was that it was a full blown TB attack. Every body wore masks after that for the rest of the night. haha.

Middle aged uncle comes in with R hypochondriac pain, feverish and jaundiced. Dx?
PS he's a walking biohazard, and i spilled his blood! DENG!!
*Thank goodness for H202*

In cubicle 3 there was this  man who came in after he got stung by an ant. Black fire ant (at least that was what i got from his translation lah) there are black fire ants one meh? he came in to yellow zone sweaty, reddish and very very obviously distressed. We were all like omg omg omg where pain where pain where pain. Then he went 'behind, my back'. I was like what happened?` who bang you? or if it radiated anywhere kinda abdominal pain like. Then he went 'no nonono, ant bite'. For a while there i was stunned, lol. like ,what? then it finally hit me - anaphylaxis! The yellow zone was very busy at that time, i think that was also the arrival of all the unconscious ones, so somehow or rather his HO beckons me to wheel him to the green zone. Which, btw, was more or less in a chaos as well (that's an oxymoron because it's always in a chaos!) and he told me that (in a very direct translation) - the ant bit him and he lost his sight. Now everthing's black and he's finding it very uncomfortable both generally systemically and progressively getting harder to breath. As he sits in the green zone he asked me if it was possible for him to lie down somewhere - cus he was still on a wheelchair! I reallllly wanted to take him to a bed, take his vitals and insert a line cus i could see that he was getting redder and sweatier. but i couldn't. needed the doctor's consent first. haiz. So i kept watching him and finally lah this HO came over, took one look at him and went 'shit he's going into anaphylactic shock'. What happened afterwards was definitely one worthy of the ER scenes. This was the first time i saw Hartmann's being used. Im glad that at least he's stabilized now. his friend also very funny lah 'hey just an ant bite right? Just one injection then ok dy right? then he can go home already?' I could see the HO roll her eyes like dude, he's going into respiratory distress you think one injection can cure all ah?

and the misc's...
Teenager comes in with 2 sites of jelly fish sting with sand still found on her feet.
More of the usual trauma cases
Less of the kids today --- ie : less bawling
or maybe it was just because i was in the yellow zone majority of my time
There was also this auntie who wanted to introduce me to her husband's friends son who's a very nice guy cause i wheeled her to the toilet so she figured i must be just as nice. if not nicer :P
Everything else was more on the :| side. Not as funny as that one.
OH i also set my first 2 brannulas (FINALLY HALLELUJAH!) but i did fail like about 348274897256384 before that. My brannula's bleed.... alot. :(
The staff's were damn nice lah today!
and catheterized a lady as well.

I don't want to be a space occupying lesion.
Had a prep talk from Dr Jonathan. lol i didnt know the MRCS was useless.




*Day 4 has been left out consciously due to unforseen circumstances*  :D
Todays session wasnt as busy as yesterday. Hence, we were more in the way. Because we were less useful. Hence we were more in the way. Because the HO's were less friendly, trusting? Hence we were using up 02 there. I wonder if i can reiterate that enough

After yesterday, today we had an influx of kids. They seem to be getting knocked up by motorbikes alot.
And the asthma patients seem to flock in by families! For eg the mother will bring the daughter in, but in the end we'd find out that she'd  be needing it herself.
Twas a night for female catheterizations.
Today was the first time I kena tegur too. And was proven wrong? in a very simple finding. See this 78 yr old uncle comes in with progressive breathlessness that's been lasting for the whole day, wtih a hx of IHD, triple bypasses, and a pacemaker inserted this March. He also has a hx of asthma. So he comes in and sits at the neb area, and i see him gasping, so i tried to get a bit of hx out of him. And then I find out that he also has crepts in his left lower lobe as well as bilateral pitting oedema up to the shins. Obviously nebbing him isnt going to work anymore right. So i brought it up to this HO who was writing something down. I only got to '78 year old uncle' and she was went 'Dont bother about the asthma patients first!! I need to clear the people behind first!'
Hello! If this was mere asthma why would I be bothering you? Ish i'd just ask u if its ok to give neb cus i heard diffuse rhonchi throughout. Haiya but anyways. its a nother point in learning. I did all i could. and he wasnt exactly like - dying lah.
Then the same uncle, a few hrs later, a diff HO came over and listened to the chest. Then when she was done she looked up and asked who listened to his chests, whereby i raised my hand. She was like 'listen again' in that really smug tone. Lol. Yes, he has crepts. but oh-ho even after he coughs he still has crepts!
But haiz- the medical student is always wrong werd .... that's how it goes in the hospital hierarchy.

The bossy loud but very helpful nurse wasnt there today. Our nice MO wasn't there today either. I met mr American accent tho.
The cases seem to be repeating ler.
This auntie of about 70 comes in complaining of general weakness and an uncontrollable tremor of her right hand. Dx? STROKE. (seriously, like where in the world did that come from) Makes me realize that I have, indeed, a LOOOOOOOOOOONG way more to go.
Teenage girl comes in collapsed. Where I see them elliciting the pain reflex when charting the GCS. I also saw the vast improvement after they NS'ed her and gave her ammonium salt. From disorientated to orientated and a full 15.
Pregnant woman of 5 months comes in with a ?fractured small feet of the foot. The issue is not the fracture, but the fact that her leg was infected from a scrape a week ago. She went to a priv hospital but they didnt wanna take any risks so they gave her only painkillers and nothing else. The MO wanted to do an Xray- the fetus? And since it was infected, they had no choice but to give her antibiotics--- SO HOW? She was told to discuss the issue with her husband cus now even a small procedure like taking an xray needed a consent. She never came back after her discussion.
Guess who I also saw today. My fav surgeon and wife. His dad was involved in an MVA. Lets just summarize it - He came, he saw, he sutured and his dad left the hospital 2 hours later. everybody say NO FUSS!
He asked me how am i too, to which i could only reply .. 'I'm fine'

Ps - I have an absolute PHOBIA of setting lines now. Today I couldnt even draw blood! Dammit. Meh. To fail and fail again. :(
Had ENT (in the freeeezing ent room ffs) till about 12, walked over to PMC for tutorial at 1-2pm followed by CDC meeting until 4.45pm. Walked back to hospital for emergency med at 5pm. Is it weird that I'm still alive and standing? its 1.30am and I'm typing todays patients in because we just got back about an hour ago.

Today we went to the 'green' - not hot- zone.
YEAH RIGHT

Its like a freaking wet market. Today it was more of doing things rather than chatting one on one. But i definitely learned alot today - skillwise.
Saw my first ABG too.
The nurse is such a killer she laughs at us when she sees us so enthu
Then she raises her voice when we -almost- injected the patient with 100mg ranitidine
Laughes at us again when we couldnt set a line
OMG THE LINE SETTING IS SOOOO BAD!
I hate it when i find blood then when i fully insert the brannula it perforates the vein and a haematoma forms. Got me so excited too when i extract the needle halfway and see blood. Yes Im in lah!!! konon. Babeng!
IM's Subcuts
Hey you, can you do an ecg?
I want an ecg pls. now.
Get all the basics lah ok, fbc, lfts. ...

and the first time i heard that- i could literally feel my eyes go WOWZERS, are you asking MOI?!?!?
(Very few buse creats tho)
Then there was this uncle who haematemized... wanted to talk to him. they were pumping him with NS cus he was very weak. closer and closer and closer.. suddenly he coughs in our maskless faces. I could almost see all the SHITS! thought bubbles above our heads.
Auntie who squat down drying her hair and couldnt get up back. "Auntie why were u squatting down particularly?" Oh I do that always. Yeah, why? Oh I do that always.... Yeah lah WHY LAH???? Finally I found out that its cus the hairdryer is on the ground. Chewww
Kids who come in with lacerations on the scalps. Fell down in the car lah, the swing lah, cousin push lah.. etc.
Grandmother of an MO in the department came in with chest pains- Suspected unstable angina but shes so cute lah.
Another auntie with bilateral knee replacements came in septic, probably a septic haemarthrosis.But when the 2 surgical HO's aspirated it was clear (yellow?) joint fluid.
The first lady I tried to put in a line in failed miserably. TWICE. omg. She had rigors which made things even worse. The MA came over, picked up her tourniqueted hand, and went this is how u do it ZOOOP. masuk. walao.
Kid with brittle bone disease comes in after falling down while on crutches. Fracturing the other side of  his body. Some one labelled him 'stupid boy'. Manjaitis? With a voice like that he can be anything he wants lah.
Police officer comes in alledgedly with chest pains. Tapi energetic aje tgk die smsa ecg.
9 days old baby comes in with no BO for the past 5 days. Worry worry.
Indian auntie complains to the woonderful MO whotookusytd sumoreapologizedfornotbeingabletoteachustoday that her son has beenn there for the past 1.5 hrs and not been nebulized, instead was told to see the doctor and when this random elderly uncle comes in he gets the solution straight away--- Found out that BOTH her son and her were asthmatic. Funny fellas. not sure about the mum but the son had expiratory wheezes in the RLL.
+ Numerous numerous cases of uncontrolled hypertension.

I cannot possibly remember allthe other cases that came in today. Either too busy doing ECGs or  failing in  setting lines, drawing blood, bandaring diabetic ulcers, or some sort like that. I spent about 15 mins in the xray room too. Like some factory lah that place, there is no rest at all! It takes a longer time preparing the patient, whereas to take the xray you just adjust some numbers and press a main button. The red button like.
There were no major major cases lah like ytd's pneumo, but there were those people who came in dyspnoeic, BP's over 200 systolic, tachypnoic, and just bloody unconscious. Yup, those people whom you read about in text books.

Came back at half 12. in the rain. in the night.


feeling damn accomplished eventhough i know its far from accomplishing anything really that significant.


Emergency medicine? You are NOT in the way if you don't LET yourself be.
13/9/10

So starts day one of our emergency med posting. Today I saw:

1. This uncle with a suspected intracerebral bleed. Referred from SP with an ICB + secondary parotid tumour. So he's got this facial palsy that looks pretty chronic. Plus a stroke like presentation. Upgoing plantars unilaterally etc. MRI showed an active bleed but wait, do bleeds occur IN the ventricles?

2. This 11 yr old kid pushed the button to change the traffic lights and crossed without waiting for it to change. He was hit by a motorbike. Left side of the face badly lacerated with 2 open wounds seen. The ?plastic surgeons spent 2 intensive hours ONLY suturing up his face and cleaning up the debri. His 'sakit!s' still rings in my mind when they were trying to apply local anaes.

3. A lady with Down syndrome comes in due to an alleged fall, a scalp wound on the posterior aspect of the head. I really pitied her because it took a while for the MA to find a good vein. It took a few tries too. She couldn't really speak... or understand us, so I couldn't really get a good hx from her. But wait what is this- she can't walk.

4. This Indian uncle came in due to acute shortness of breath, his BP was 209/160 WHATT!?!? but clinically all he had was an 02 bag. Not even breathless. So when I talked to him I learned that he was dx'ed with DM 1 yr ago and is on combi OHA and subcut insulin. BUT THEN HOR he also has had 2 digital and one below knee amputations liao. So fast one? He asked me when was my exam, and i told him it wouldnt be until 2012 for my last last final one. Then he told me an unbelievable thing 'Hey, I'm usually one of your patients for the final exams lah!' hahahahah. Krs asked and he told us that usually he's put under nephro or opthal. Yay for Indian uncle! :)

5. Chinese lady who was admitted due to LoC. Provisional dx- symptomatic anemia. But I'm pretty sure she's having some bleeding somewhere. For once the term 'pallor of the palmar creases' could be used here. Her lower lids were damn white too. But she seems a little out of it lah, I mean it took the other 2 AGES to ask what CA did she have before and it wasnt until her relative arrived that we finally found out the tumour was -- - jeng jeng jeng. of the ovaries.

6. IVDU man comes in with LoC as well. Thin, emanciated with obvious temporal wasting... Heck his WHOLE body was wasting lah. The MO put in the CVP into the wrong vessel so they ended up using the femoral vein. When he pulled down his pants then we saw the highways. They were treating him for septic shock, (suspected mycotic aneurysm) so he also had to be catheterized. There was an... erm... foreign object embedded in his penis. 'Bereng'? The MA took alot of fun asking us med students about it. 'U sure tak tau apa ni?' ---  Entah. Bereng? Beads? Hmmm internet pun takde lah abang!

7. Elderly uncle comes in due to an alledged fall. Laceration wound right in the midline of the skull above his head. MA sutures him up. Everything's fine and dandy until he was suspected to have TB and has never had treatment. WHAT THE

8. Our hero for the day. 27 year old guy, tall and thin (well he wasnt really tall but he was dark. so kinda fulfilled the -dark and handsome part) :P comes in with 2 day hx of sob + pleuritic chest pain. Upon ex, a spontaneous pneumo was suspected. Wow his chest dam nicce to percuss lor. just tap a bit and it goes PONG! Anyways they did a chest drain on him and he's recovering well now. Nice uncomplicated hx and easy to follow up- i've got my emergency case down pat.

ps- today i saw a perforated eardrum as well as a normal one. The normal one was mine. ha ha. luckily no wax.
Today we met a very eccentric doctor
His name is Mr Lvln, and he's a consultant surgeon

He reminded us once again why were we studying medicine
 He showed us what it means to be 'dedicated'
If I can survive with 4 hours of sleep per day why cant you?
Sometimes it hits me how much we're getting pampered in this generation of ours
Ask Mr Mjt how nasty he was to his HOs and MOs in the past
I became a surgeon at the age of x5 and sat for x qualifications in 5 years

Back in Dublin we had a dentist-oringomaxillary surgeon who became the first years medicine coordinator
His name is Dr J Las. And boy he was young and charismatic :P
(But he's actually not that young - still charismatic), we found out
What he told us then, haunts us again today
When you study medicine, you need an anatomy, a physio, a biochem and a patho book in front of you


Today I found out how lacking I am
 And arrogant I have been
I know nothing
And yet I am so full of myself
My reasons for doing medicine.... remains mine to be judged
I wont deny that perhaps it's not what the philantrophists would like to hear
But they are mine and mine alone

I wouldnt mind doing surgery in Taiping tht's for sure (but I'll definitely need his prep talk alot!)

"Encik mane wad 18 ye?"
"Oh tepi wad gila..."

~The security guard who answered us this morning.
PRECIOUS.
 Mum decided I was a little too free dawdling around the house so she decided that I'd be interested in doing a short attachment in HSM. Yes the italics and the first person pov usage says alot. hahaha

Remind me again why am i doing medicine?

I got a good tongue-in-cheek answer tho;- " so that you'll have interesting things to talk about with me".
Right.

I used to think that those doctors I met during my first attachment, the very first ones, the one where JPA wanted us to have to put into our CV, the ones where you try to pretend like your doctors, hang around, do nothing, understand nothing and even take up patients beds on the pretense of being on-call.... I DIGRESS.
Yah, i used to think tht those doctors who asked me over and over and over and over again, if medicine was reallllllly what i wanted to do. Did I really know what i was getting myself into? I think I remember one of them even telling me that it wasn't worth it, it actually wasn't. hahaha. Wow, those were the days.

Only today, you're still taking up space and oxygen, but fortunately, at least you're giving back a little something in return. if only ~ really. Not that bad, a hand here, a cuff there, you make yourself useful... by staying out of their way. hehe. There are times where I wonder if it would be different overseas, I wonder if the doctors there face the same predicaments as the docs here. If they are overworked in overcrowded wards as well, or if they are ragged and irrationally berated by pmsy SHO's. (Tho i do know they get sued alot...lol)

Today I got tiao'ed in the hosp. The same someone also mentioned that I got affected emotionally by it. Yes meh?
I don't think so tho, cus if I did, i might have shouted back at her. Since technically I didn't have anything to lose; I wasn't her HO, i wasn't even a doc ffs, so i was in essence, nothing :)
Ah well, i hate doctors who pms in wards. meh. Dun wan shake hand mar dun wan shake hand lah.. ISH.

I suppose there are always the bright slides that you look for at the end of the day, things which are not essentially medicine (because I cannot prescribe or treat ppl, technically speaking, yet) but still such a vital part of it that you can't leave it out. I realize that I tend to so nicely ignore it because by omitting it, it makes me seem like I'm suffering so much for my life's cause. Things like having a 9 month old baby smiling and shaking hands with me, then having the grandmother say that he only does that to a very few handful of people, definitely not ppl he meets for the first time; Things like haggling with the MO to do suturing and realizing that it's not because he doesnt trust me but because he wants to do it himself... (he says as a student he never got to do it lol), Things like having 4 translators to get a question of 'do u have palpitations' across (like from english to chinese to hokkien, to half hokkien-thai to thai and back again) Things like having a nurse and the HO telling me that that person in mind memang damn pmsy one and that I dont have to worry too much.... things like that =)


not to mention, The special one is here~!!! It feels so surreal... :)
I like reaching out to grab a hand that is actually there.


Live as if you were to die tomorrow. Learn as if you were to live forever
~Mahatma Gandhi

I've found out that my mother doesn't agree with the quote ;)
  •  Spastic Children Association Penang.- It's unbelievable how normal they can look, (or even the fact that a 14 year old CP'ed boy can pwn you in maths, for the matter)  and yet have CP. How spastic their movements are, how some cannot even chew, how little Gab is so verbal in his communications and how little Jac goes into fits about thrice everyday, how strong their parents must be to not only be able to bring their children  in everyday, but to do those stretching exercise and be hit with the reality that their child will always be stigmatized, over and over and over again. How strong their will must be, those parents whose  first and only child is diagnosed with idiopathic cerebral palsy. How we take the ability to walk so sparingly and these kid's goals are to be able to walk properly one day.
  • A week into the KKIK's and I already want to be a permanent member there. All I want to do is sit in the clinic/ lab and draw blood everyday or do unlimited Reflo's or hear the familiar dub dub dub's from the sphygmomanometer. So much for aiming high and reaching for the stars. Heck, I just want to be an MO. hahahaha!
  • Hokkien! Dammit it took me more than 10 minutes and grossly exaggerated hand movements just to tell this standard 5 educated auntie to come back 2 days later and again next tuesday.  
  • And I quote; "No lor, my son don't have girlfriend yet. You interested or not? My son engineer leh!" It took me almost all my willpower just to not burst out laughing and look rude.
  • Conferences, conferences and more conferences. I've realized that the art of acquiring freebies from those big pharmaceutical companies is indeed a skill that needs to be learned. I noticed that some of my seniors are just so ....smooth. Haha. 
  • What happened to 'weekends'? I seem to be away every single weekend that there's absolutely no time to rest. :(
  • Today we looked for our 2nd Fam health project patient. Thank God we found a really cooperative and 'same frequency' one.That was where I realized that I am not looking forward to entering the hospitals 7/5 next week when we start the medicine rotation! I want to grow mushrooms in the KKIK!!! *rants*
  • Simon once jokingly said that I sweat like a guy; I'm beginning to think that he may actually be right. 
  • But basketball is just as awesome as ever! I still need new shoes tho.
  • Is it just me or has my irritability score gone off the scale again.
  • I think in this week I've prayed more than I did for the whole of last year. Starting to think about alot of things in more details.
  • I think the term ' understanding the opposite sex' is actually an oxymoron.
  • Psychoing and brainwashing myself using Chris Quilala's I Exalt Thee actually works. 
I think I need a break. stat.

Ships in harbours are safe, But that's not what ships are built for.
~John Shedd
It's unbelievable how much a language barrier can bring your day down. just like that.
It's unbelievable how frustrated I can get by a simple 'im tired, sorry'.
It's unbelievable how obvious race plays a part in getting a patient comfortable.
It's unbelievable how uninformed the patients in a third world country can get.
It's unbelievable how much of the education you gained 2.5 years in a western country is un-applicable here.
It's unbelievable how long it takes for a frickin MRI to be done. Long enough for the patient to have started treatment and be out on his feet well and alive in the west.
It's unbelievable how much it costs to have a patient be up and on his feet well and alive rather than waiting for his MRI.
It's unbelievable how hot it gets up here. It's unbelievable how we can claim patients are 'sitting comfortably' when it's a frickin oven in there.



It's  unbelievable how a simple and happy smile from your patients can brighten up your day. Just like that.

I would rather be ashes than dust! I would rather that my spark should burn out in a brilliant blaze than it should be stifled by dry rot. I would rather be a superb meteor, every atom of me in magnificent glow, than a sleepy and permanent planet. The proper function of man is to live, not to exist. I shall not waste my days in trying to prolong them. I shall use my time.
~ Jack London
Hey peeps! Been a while since the last update.

Anyway gonna keep it short and simple;

  •  Started the 2 weeks attachment in MMUH. So it's down to taking histories every single day, as many as possible, as efficient as possible, as fast as possible..  uuhhhhh okay, maybe fast isn't the right word to use lah, I'm pretty confused with what style/ template we're supposed to use. for eg: for our presentation, should our opening sentence use the patient's own words, or should it be in our own medical terms? All the interns/ sho/ reg's seem to be telling different things. heck, OHCM seem to be saying different things too! Everytime my partner and I present, we. get. grilled.  But looking on the brightside, we're getting better every. single. time. The only thing i guess i could really work on is the reading up part. (read: LAZY :P)
  • Malaysian Night was awesome. ESPECIALLY the chinese dance. Well, to be fair all  the dances were really good, but i guess the chinese one holds a special place in my heart ... i'm biased nyek nyek. Yeah as for the constant bugging reminders i get to upload it,... will do! once i;m done with this week's hosp. -which btw, would be tmrw... so PATIENCE!!!-
  • 4 weeks and 3 days more to the land of my spilled blood (literal translation lol)
  • Leading worship for the first time ever this sunday. Really appreciate Kells giving me this chance, but i have to keep reminding myself that its a team effort. There are only we's and not i's. In fact, i'd say there's only Him and not us. :)
  • Lost my phone. =( okay there goes my plan of bugging my dad saving up for an iphone. I think if i had lost that, i might actually have slit  my wrists!  Ps- msian hospitals have no wifi right?
  • If you google Hosea's Wife, you'd have found out that she was a paradox. Apart from being a song sung by Brooke Fraser, it also tells of how God used her as a symbol of a sinning nation. At the end of the day I dont know if she's the bad guy (definitely nothing like Rahab) or a significant bad guy. It also addresses... (not quite, but at least it tries) the issue of What do we live for? ...  (i got that from youtube lol) - Doesn't mean that i'm pondering over my life now either -  It's just a nice song, and a nice song at that. :)
  • Brooke Fraser is my new favourite artist! (altho some of her songs do actually suck :P)
  • On a more personal note, I find myself turning pretty emotionless come these few weeks. hmmmm ~.~ such a far cry from how emotional i used to be eh...  but it's good, at least i wont feel like the worst person on earth when you start taking histories from people with cancer. cough, not like i actually took hx from a guy with final stage tumor behind his eye and who was dam sulky and i felt dam bad cus he might just die anytime.. or something cough.
  • Oh i also got taken out on my very first date. ha ha ha h ah..  and and and...and lastly................
Life seems to have fallen right back into place. with the same actors, same stage and the same play. Yet it's so different now. (being poetic here lols) so very different. Different in a good way. :)

More appreciative, more cautious, an entire newness that I've never experienced before. I like it. =)
Happy Feb peeps!


The grand essentials to happiness in this life are something to do, something to love, and something to hope for.
~Joseph Addison