taste of clinical year

it took just 3 hours for me to stumble over my block of will power.

i realised i cant study continuously for 1 whole day.

hmmm... shouldnt i have known that by now? like by at least 5 years ago??

what a naive idealist. -_-

a little drop of ink on how i fared the 1st week of clinical year.

thr is certainly no doubt, No doubt at all that clinical year is 100x more interesting than preclinical years. real life situations at last!

however, u get swamped with the ugliness of reality. interesting, but a little tough.

problems i am currently facing:

1. i have not finished reading the basics of surgery related diseases, so am perpetually blur when a patient tells me she has err.. lets say an enlarged thyroid. questions that pop up in my head were: main symptoms of thyroid disease, differential diagnosis for that chief complaint, questions to ask to exclude the differentials and come up w a provisional. then, physical examination to confirm the provisional. then what investigations to be done to further confirm and what management should be done.

n then b4 i finish reading up on how to answer all the questions above, the next day i clerk another patient, and its a totally different scope of disease, say.. hernia. n i go back n put hernia on my list of 'things to be read' and still stuck reading on thyroid bcz i was too tired the last night n fell asleep instead of studying.

so the aim now is to faster finish studying all those stuffs! easier said than done. argh. takes me hours n hours to finish 1 topic. n thr're at least 15 topics to cover.

2. if the supervisor says we should focus on a certain topic this week, so its another different topic to cover altogether.

3. n if i'm scheduled to enter clinic for say.. hepatobiliary that week, then its different again. (diff type of clinics everyday)

i tink the baseline for now is to finish studying the basics as soon as possible.

n finding out how to stay awake at nights to study instead of perpetually collapsing/fainting on my book at my study table. hehz.

ok gotta hit the books!

*on top of everything is finding out how to be nice to patients so that they let u interview them even tho u might be like the 5th person who has interviewed him for that day. n for them to let u examine them even tho u're like the 10th person to ask.

poor patients. imagine staying in the wards for 2 weeks.

1 day = minimum 5 interviews/examination by medical students.

multiply this with 14 days.

the patient would have repeated his history of illness and was examined at least 70 times by the time he gets discharged from the hospital. hehe. got 2 really thank them. some patients are reli nice. some pretend to be asleep when they see u walking twds them from far. i dun blame them. heh.

Sleeping at my own risk

1st shout out on the start of my clinical yr:

i need tips on

How to not fall asleep while studying at night.

Feed me with tips on how to stay awake ppl!! thank you!

emotions, communication, where they come together.

i came across this template n voila! decided it was nice n used it. :)

just back from ppd camp in neg sembilan at a btn camp area. the food was spicy aggravating my sorethroat, but much better than ppd camp 1 in 1st year. other than that, everything else was good.

i learnt thr's more to medical ethics than 1 side of the story.

i learnt thr isnt a clear cut yes no solution in being ethical.

i learnt to humble myself, even at times when i feel i'm not wrong.

and the importance of give and take bcz no one is perfect. i am not perfect. we gotta give space to ppl to make mistakes and look forward from thr.

its about getting through and around the system, while earning respect and respecting others.

I say this, because i am touched that a person forgave me for a huge mistake. to me it was a huge huge blunder. but there was no 'HARRR HOW can you do thisss??' or 'Crap.. now i have to do this / that bcz of ur mistake' or 'WHy din u realise earlier??' and not even an 'OH Noooooo....'.

just a simple reply of 'Its ok. no problem. dun worry bout it. it can be settled.'

This reply not only reassures me and takes away my guilt, but makes me feel a lot better knowing i hav not angered / troubled sum1 else bcz of my mistake.

i truly respect this person, and it was a solemn reminder to me to practise this sort of courtesy to others as well in future.

speaking of medical ethics, a few scenarios in the grp discussion session in the ppd camp spurred me to think further and look at both sides of things b4 making accusations or forming my opinion on 1 side.

When a doctor is charged or accused for negligence, ie. not attending to the patient properly/timely, patient getting contradicting explanations about the cause of a complication that arose in the ward, we need to consider both sides of the story. from the medical staff or system point of view, as well as that of the patient.

there are loopholes in the healthcare system. bcz no system is perfect, and in reality Msian gov hospitals still lack staff. the unfortunate thing is when the loophole compromises a patient's life, resulting in unneccessary deaths at times. its sad. but it happens. doctors missing out on significant vital signs of a post op patient such as severe hypotension, an alarm indicating a flaw (such as inserting a branula into an artery instead of a vein) that goes unnoticed, the exhausted houseman making a mistake in administering medicine in the middle of the night etc.

while the system constantly being improved in order to reduce mistakes by doctors or patch up loopholes in the system, the danger of being that victim plunging into that dark abyss is stil present. in certain countries, pharmacists accompany doctors in ward rounds to reduce mistakes done in the administration of drugs. it brings up the issue of credibility of doctors being questioned (which could injure some pride), conflict of interest, burden on healthcare system. but it's been proven to be successful.

another issue is about communication. its probably something that's still lacking in our healthcare system. patients feel uncared for bcz the doctor doesnt explain to him/her about his/her condition and management. the patient has actually been managed, but bcz he/she was not informed by medical staff about it and given adequate explanation, therefore they feel like they're neglected. communication is important. it prevents lawsuits. according to my Dr. facilitator. true. its a patient's right to noe what's happening to their body and what u're doing to their body.

another area is language barrier. they're lots of cases in gov hosps esp whr the patient has no idea what illness he has been diagnosed with and what or why he is taking this drug bcz the Chinese elderly cannot speak Malay or English and the doctor is unable to converse in Mandarin or Cantonese. i therefore, have to BUck up to improve my Mandarin. like seriously... ! gosh.

in the end its about every member of the healthcare team working TOgether to ensure the well being of patients.

i believe no doctor wants a patient to suffer. no normal person for that matter, wants anyone to suffer. but for now everyone has just got to play their part in trying their best to meet the needs of patients and learn to communicate effectively, in assuring him / her that he/she is in good hands.

town around town

at the end of 6 weeks, i'm going to look back and wonder whr the 6 weeks went to.

but let's just say its been a break that was pretty well spent. :)

1. see the good in people

- we all have a problem in judging others, in gossiping about who did what and how disapproving what they did was, criticizing behind backs esp when, when we have too much time. lol. its an ongoing cycle and sort of human nature. that everything outside the limit of our norms (at least what is normal in our dictionary) is unacceptable. a sentence at the back of a bus caught my eye. it says, If a man has 9 bad attributes but 1 good attribute, look at that 1 good attribute. We constantly need quotes like these at the back of buses lol to remind ourselves and slap ourselves out of that judgmental box.

- as the monkeys say it, See no evil, Hear no evil. sometimes being cautious, but ignorant is good.

2. pour in constructive words rather than then lashing out malice

There's one more to it. See no evil, Hear no evil, Speak no evil. 1 of the videos among the 15 Malaysia video release was about this harmonious community whr no 1 speaks, but ev1 is happy, all families are multi racial, ev1 can do any sort of job, take up any role in society and ev1 is happy. the catch is, NO talking. not even a cry for help. its wrong to say 'thr's a problem with the system'. well yeah its not exactly parallel cz we do need a platform to voice out concerns and discuss problems in the open. but when we face problems, we need to train ourselves to think. to think of HOw to solve the problem instead of pouring out venom and looking for a target to blame and complaining about what ifs and what not.

good leadership comes with good problem solving skills. Good followers stand on their own feet to think of solutions without waiting for the leader to solve every single problem that comes up. we need a balance. its a challenge to our minds.

3. seek God

While we can think that we are self supporting, able to depend on ourselves alone forever, or at least gauge support from the closest friends and ur family, there will be points where we stil need God. if you have experienced God's work in ur life, u'll noe what i'm talking about. u'll understand how God not only supports His children, but make them whole and steer them into a life direction that is meaningful and parallel to His greatness.

That spiritual filling in your life brings so much more meaning to life and makes life comprehensive. God is a living stream that never runs out.

Year 3 into clinical year.

seems daunting but exciting s well.

Heave ho! Pull up the anchor and let's set sail for the seas beyond. :)

owh! a few more things i discovered while taking Seng Wee ard Kch with my friends.

1. Ikan bakar at central park is heavenly.

2. teh si peng at 7th mile is original.

3. 5 layered teh si peng only looks good b4 u mix everything up.

before:

after:

4. the best belacan bihun stall at Song Kheng Hai is the one on the left corner from the front entrance.

5. Bako National Park isnt as far as i thought. :P

6. jungle trekking with an umbrella is quite possible.

thr's a pedestal shaped rock on the far right

the boat that took us to and fro from the jetty. at 1st we were wondering how come so damn cheap only RM5 for students like its the cheapest trip ever. until later only we realised the boat rent was RM94. Lol.

i still need to improve my parking skills... :S

popped into UNIMAS's medical faculty. :)

since thr's time to waste, i mean spare, here's a peek into kuching food variety.

1. foo chow large bee hoon - they cook it with some sourish veg that i dunno the name.

2. foo chow kong pia - circular bread w sesame seeds with meat stuffing. u can get the kosong 1s in sibu at 7 pcs for RM2. its a Sibu must have.

3. Jalan Song's carrot cake / char kueh - they have it salty or sweet.

4. rolled up chicken floss pancake

5. Open Air market sio bee. its the chilli sauce thats reli good together.

7. jalan Song's tomato noodles. crispy noodles in tomato gravy.

8. kolo mee - the best 1 is at Green Road. its the 1 kok joo poured dark soy sauce into cz he didnt like the plain colour of the noodles -__-

9. foo chow ting pien hu - u gotta try it cz i dunno how to describe

10. bidin - its a paku pakis species but different from the conventional 1s u get in west msia.

11. ka cang ma - i'm not entirely sure if this is swakian but seng wee's nvr tasted it so. haha. its chicken cooked with some green leaves herbs thingee with white wine. alcohol! :P

12. teh si peng - 3 layered tea - this 1s from 7th mile.

13. 3rd mile kueh chap - pork lovers wil love this. but for some, the aroma can be too much to bear.

14. o chien - crunch into the crispy bater fried with oysters. it looks like a tumour here but it tastes way out of the world of tumours. nice with soy sauce and pepper.

15. White Lady - a milky concoction of citrus fruits. slurps.

16. Metahon - its refreshing with lychee, cincau, lemon, the green thingy, jelly, sarsi flavor.

17. laksa Swak

18. green spinach noodles with char siew

19. Open air Market beef noodles

u'll nvr go hungry in kuching. :P

and now?

things to be completed by the end of hols:

-i got 6 wks if i pass all papers. 4 weeks if i flunk that neuroscience paper. sigh. seriously considering that i might fail. but anwwww......

1. practise the guitar

2. finish collecting samples for BPH. catch like 100 more uncles.

3. get 200 elderly ppl to fill up the IRT questionnaire.

4. go to Seremban n get all the elderly ppl thr 2 fill up our quality of life questionnaire. about 300 of them.

5. complete lit review for elderly QoL.

6. read the bible.

7. read Talley O Connor

8. Genting Highlands!

9. Ipoh hopefully

10. help out with UKM IV

n hope i can complete all the above in 4 weeks. more or less. akks! (while going out for movies and shopping etc stashed in the middle hehe)

fruitful hols! here i come!

exam wows

after a series of unfortunate unexpected pprs, these are a few things i learnt this week.

1. God's grace is abundant. i managed to get at least 6 hours of sleep each day, despite hvg to finish cramming 30 lecture notes of cns stuff yesterday. God's work truly.

2. studying uses up glucose, in the brain, in your body and stimulates hunger pangs in the middle of the night. i was so damn hungry last night at 10pm in the middle of studying anatomy. was contemplating whether i shud grab food at cafe but the thought of cafe food turned off the whole idea. ahah.

woke up this morning earlier than my alarm, due to, HUNGER. gosh... maybe God stimulated the hunger pangs at 6am to force me to wake up.

3. coffee, still works :P
had 1 b4 i started yesterday's cns marathon and had 1 this aftern after the ppr and am stil able to keep awake with brain functioning to be able to compose bm formal letters.

4. u can never study enough. never!
no matter how much u think there, i've studied it. i shud be able to do this paper.
u're going 2 be proven wrong the moment u flip open the 1st page of the anatomy objective questions. n to the very last page of the essay questions.

5. the feat of getting 4.00 in 2nd year 2nd sem is inhumanely possible. making some of my seniors, err... hrm. dun dream of it unless u have read AND remembered every single detail of not just the lec notes but every book ur lecturer recommends. n the 1s they dont. lol. at 1 point u're even thinking, can i pass this paper n u try to convince urself u can.

6. u start writing blog entries about ur exam papers sumwhr at a point of time in ur uni years. nvr dreamt i'd do this b4 this.

7. u complain about how tough the ppr was and scream and complain again to at least 10 different people u meet throughout the day. that's pretty definite for girls at least.

8. u cant sleep even AFTER the exam due to post exam excitement. reality takes time to sink in and normal body physiological responses take time to resume.

aaaahhhhhhhhh.......................... sighh.............. relief.........................................


*will be complaining again soon when i start studying for OSPE/OSCE (my practical n clinical exam due on coming tues)

owh n did i mention PIMPLES? *gaping horror*

of mid exams

hi there!

Miss Escape-from-reality-to-blog-surf speaking.

its the first time i'm publicly admitting to spoiling myself to a few moments of online surfing in the midst of critical exam period. hehe. the line in ktsn is so good so y not? :P

just so that i have something substantive to write about here, the GIT and endocrine pprs yesterday and today were how.should.i.put,it... full of unexpectations.

the git ppr was like

the beginning scared the wits out of me. :S thank goodness things got better in the middle.. then at the END... :S :S :S

todays endocrine paper was like

ok. back to reality. yargh.