Saturday, July 3, 2010

Unintentional harm

Ppl were born with the natural instinct to do wrong. If u realized, we weren't taught to carry out actions that are by society's standards or universally accepted as immoral i.e. lying, hurting others but these were inherent, as if a human nature. No one taught the 3 year old child to lie but he did so to save himself from perhaps punishment or repercussions of his actions. Sensing danger, he by all means tries to run away. Another illustration. The 4 year old boy refuses to admit he scribbled the wall because he was afraid of being scolded. Obviously no one taught him 'to lie to get away' prior to that. He did it by human instinct. You get what I mean. (if u beg to differ u're welcome to share ur opinion of course) but that isn't my main point here today anw.


 

When we do something that has unintentionally hurt others, we hope to clarify things, clear doubts and make amends to the person, to let him/her know that it was unintentional and we're sorry. Of course this doesn't give us the right to continue being ignorant n to hope for mercy each time we unintentionally hurt others. Bcz when it happens too often and repeatedly, ppl get tired of it and you know sth isn't right (with the way u're handling things). Whnever we're given the benefit of the doubt or are spared of our mistakes (or not), we take a lesson out of it, make a mental note and continue to mature and learn to be more and more tactful. In that process, we continue to salvage on open and forgiving hearts of ppl ard us to look past our misgivings.


 

Becz the point here is: None of us (well most of us anw) inherently wish to hurt others.

In whatever aspects and by whatever way.


 

So that brings me to the main point lol. Sorry for being sooo long winded.

Ppl around us (our friends / associates / family mbrs) who have caused hurt to us / our loved 1s / our friends / others could have done it unintentionally. Certain actions that we think are unacceptable by Our standards, may be acceptable by another person's standards. It differs bcz we were brought up in diff fam backgrds, a layout of society with diff expectations n needs and diff levels of tolerance.


 

The individual, did not realize he/she has caused hurt to another fella bcz:

  1. If he/she were to be placed in that situation / commented w the use of certain words, he/she feels its alright n wouldn't be offended bcz he/she has a higher threshold level in accepting criticism.
  2. He/she feels it's alright to be messy / borrow things without permission / leave things around etc. bcz he/she wouldn't mind for others to do likewise to his/her room or things.
  3. There was a communication breakdown whr sth said meant a different thing/ Is interpreted differently by two diff individuals.
  4. His/her standards of 'normal' differs from everyone else in our clique.

Brain jam. There are a 101 reasons that can be listed out.


 

Therefore, before we start judging / condemning / labeling a person for an action we disapprove of, we need to remind ourselves that:

  1. No1 likes hurting others. (the definition of none is of course not absolute, well you know what I mean cz I'm lazy to list out exclusion criterias lol) It could most likely be unintentional.
  2. Humans inherently have a tendency to do wrong, but as we mature and bcum educated, the norms of society/our surroundings and our conscience determines to what extent we inhibit sinful tendencies and do the 'right' things.


 

In order to evaluate that person, we have to rightfully

  • Clarify matters, find out reason he/she did that blah
  • Find out if it was intentional or otherwise
  • Let the person know how and why his/her actions were hurtful or deemed to be wrong by others.
  • And of course doing all the above in a very very tactful manner at a correct time.


 

If I had hurt sum1 unintentionally and did not realize it even til much later, I would appreciate it very much for ppl to tell me that and how was I wrong by the 'standards'. Not to be spoken of behind my back and deemed to be horrible by everyone else.


 

Well yeah, most ppl in society however prefer to take the shortcut and skip right to spreading juicy gossips about others. I dun deny this shortcut is easy and tempting to take (by inherently sinful nature hehe).


 

I therefore stil need to continuously remind myself to walk the longer road, take that extra mile of reflection and at the same time, try reduce unintentional harms towards others. J


 

We don't just need communication. we need effective communication.


 

*this post was written by random thought and is not linked to any specific personal encounter/experience.

Wednesday, June 30, 2010

filling the air

i realized fresh bloody images were a test for me when

we were shown pictures of a brain tumour removal surgery this morning. i cringed at 1st at the sight of the crimson red bloody face, could still take it, and as the day passed, it was forgotten.

later on this evening, i spent 1.5 hours observing a wound dressing being done for a patient with a severe pressure sore at the sacral area.

it was a super huge wound of 10cm x 10 cm x 4 cm. with 4 more smaller wounds beside it, some of which connects to the huge wound in the centre via a tunnel.

as i walked back from the wards to my room, i could still smell and see the image of the wound in front of me. the image isnt so bad. it's the putrid smell that filled the air the moment the wound was exposed. (wore a mask but it didnt help)

at that very moment, my mind was filled with amazement, wonder and awe for all eternity for all nurses in this country, who spend their days in wards through all stench, blood, pus, ammonia etc. to tend to the needs of esp frail patients.

i will never ever in future question the intensity of the job of a nurse, and the passion she/he has for patients! not that i have ever been questioning it before this. lol.

n i brace myself for tougher moments in houseman years as i watched a brannula being inserted relentlessly into the femoral artery of a patient with more than 10 tries and still not succeeding, n few more attempts to draw blood from that area which also failed. (the patient is paralyzed from the umbilical level thankfully, thus not feeling any pain)

wow.

Wednesday, June 23, 2010

GIT

i need more


Indigestion, colicky thoughts, constipated ideas, altered actions that differ from the heart.

there is no way, no way at all (in my opinion lar i think i could be simply exaggerating) any medical student can excel without
-the guts to ask what they think are stupid questions
-the guts to overcome inferiority complex
-the guts to appear dumb
-the guts to persist even though u noe u're gonna face rejection
-the guts to call doctors even though u anticipate being yelled at or getting a reli annoyed answer
-the guts to try out new things even though it means being ridiculed when making mistakes and looking reli bad in front of patients

becz everyone starts out from somewhere. n we need an essense of humility to overcome that pride in us that doesnt want to face embarrassment or humiliation or unpleasantness.

i need an extra dose of guts. i'm not there yet. i stil hesitate when i contemplate the chances of looking bad in front of others. but then again. its a personal feeling of insecurity. come to think of it, no one is going to rmb your mistake or your face for that matter. patients come in n out of wards all the time. they're like hundreds of students n nurses dun bother rmbering ur names or how u look like. its a place whr ppl are stil forgiving when u make mistakes n ask dumb questions. n yeah. thr's an advantage of being a student who is still learning.

'it may be my fault but pls forgive me bcz i'm still learning *kesian look*' n u kinda get away w it. if not for that day, the next day is a brand new day.

hrm yeah. i guess.

How far can your guts take you?

How far u want ur guts to take you.

*rats what am i doing here??? i'm suppose to be studying!! *groans

Saturday, June 19, 2010

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.


Wednesday, June 16, 2010

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!

Friday, June 11, 2010

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.



Tuesday, May 18, 2010

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