Temptations & Ambitions

If you'd asked me, urban city favors a sedentary lifestyle, in the physical manner. Your muscles go to waste, and your adipose tissue multiply exponentially, just like cancer cells.

Ask me again, I say a rural town also favors a sedentary lifestyle, for the mind instead. Your brain matter go to waste, and tissue fibrosis replace whatever empty space in your skull has left, along with water, or perhaps free air.


I think I need a life. I mean, out of Slim River. I guess I'm too much of an urban guy, and I can't live in too much peace, until perhaps when I'm a retired 70 years old man waiting for the time to come. Otherwise, I'm just not meant for rural area. I may die a brain death.


Until then, I'll just bear with Pediatrics posting here for 2 weeks. Suffering in the agony of boredom, and brain atrophy. Do remind me if I forgot who you are. Do understand my condition. Until then....

Big Cinema in Teluk Intan. VERY BIG......

Library in Hospital Teluk Intan (HTI).. a moment of silence..and also a form of "Sleep Study"... zzzzz

Another moment please...

The famous chicken in Gulam Rasul, Teluk Intan

Not to be missed.

Dishes in Sze Chuan Restaraunt.. This looks good, but it wasn't

The other dishes

The building I've contributed RM10 to, by forgetting to put up the parking coupon.

The interior of the building. They have one of the most advanced facilities and best services, mainly because those who came are those who contributed towards the comfort of this place.

"Sleep Study" being done in the staff room in Surgical ward

"Sam Siu Ye" (3rd Young Master). The alternative for Jalan Hill's mediocre chee cheong fun. If you'd asked me, the chee cheong fun here are "must try" because they are famous here, not because they are very delicious.

"Muka Stress" trying to study... so "yeng".. :P

Posingly stress??

This guy trying to practice some guitar to entertain his gf. n_n"

The secret of Sam Jo Ee's study regime. Must study like this only can be successful. :P I know, it looks gay.. -.-"

Another day of presentation for bedside teaching. No one says the bed must have patient. :P

The taller he gets, the more "torticollis" neck the rest have..

Eager minds trying to be 100% attentive

Concentration drifting into the horizon

Drifting...

All down the drain.. Note: The doctor is just sitting in front of Sharen.

Roasted pigeons would have tasted nice...yummm....

It has somewhat come to an end, my surgery posting. All in all, I've been through 15 weeks of Surgery, if I am to count from Year 3. There are of course, ups and downs, some hardworking moments, some lazy moments, but I'd pulled through the 1st posting of Year 5. In one piece. I thought I would have developed some form of avulsion towards Surgery, but it seems kinda okay now and not that horrible. Perhaps I had to go through Pediatrics and Orthopedics to understand how interesting Surgery is (In relative sense). Now, I find the core postings rather interesting, from Internal Medicine, Surgery to (the most fearful) Obs and Gynecology. 


Clinical proficiency test (CPT) was done 2 days ago. We came all the way from Teluk Intan for it and had to return to Teluk Intan on the same day itself. Of course, I drove myself there, so I had an extra day off for myself before coming back to TI yesterday. That's how useful a car can be especially in final year. CPT was only 20 minutes, and it was somewhat not worth the journey to and fro. We were given 20 minutes to take history and do physical examination. The usual in the professionals for long case would be 45 minutes, and an extra 15 minutes of preparation (Or so I heard). So the time given was rather short for us. Of course, some may argue that targeted history taking and PE would only take 15 minutes for example in Family Medicine, but there's no referral to higher center, and you'll be the "final destination" for the patient. Plus, the spectrum of diseases may vary from center to center.


I started as one of the first few early candidates. After given the bed number, we were to rush to the beds to start our allocated 20 minutes session. I was having bad luck with Prof Ramdzi messing with me, with his usually undecipherable one-word conversation and also to ask me to present to him after that. Then, I arrived at Bed 15, with no patient. It was an empty bed. Cursing my luck, I panicked for perhaps, a few seconds and hasten my way to the invigilator to inform about my situation. I was directed to another bed, which had the case notes on the table. I flipped it over to avoid having a peep on it, and started my "mission". Throughout the session, there were at least 2 interuptions from the female house officer and a staff nurse for me to assist them in their ward work. Never mind the staff nurse who got the hint and walked off quietly, the new house officer was being rather rude in her approach. She demanded me to follow her to another bed, and I told her in a nice way that I a test was undergoing. Refusing to listen (maybe she had impaired hearing), she demanded again in a harsher tone. That was the last straw where I told her sternly that I was having an exam now, while giving a glare that I could eat her up if she kept insisting. The glare must have worked before she realized what was going on and she apologetically walked off. 

The 20 minutes session was not really well spent. It took around 10 minutes for my history of presenting illness before I realized that I was running out of time. Finished history taking in 17 minutes (I think), before proceeding to one of the most modified physical examination of the abdomen which would have gained at least a yellow card. Examining the hands while taking the pulse rate and breath rate, and a rapid palpation of the post-surgical site abdomen (after a proper quick glance of the whole abdomen, of course) while standing, before I realised my mistake and did it while kneeling down. It wasn't really a complete one, but I did what I could before Mr Christopher Ho entered. I knew I was lucky because Prof Ramdzi was not my examiner. All I knew next was I was presenting and answering questions in almost one breath. There were flaws in my presentation, of course, especially when I was not reading from my clerking sheet, using it only for occasional reference (A bold move when this was the first time of me doing it). Maybe the "no pause" moments gave way plus, Mr Christopher Ho was a nice and kind examiner. Hence it went rather well as compared to some of my colleagues who had examiners who are more malignant.  


Whatever it is, I'm just glad that it's over. What I'm looking forward to is Pediatrics, where I'd flunked last semester along with Orthopedics. It took much more courage to go over something you would dread to do, so I'm trying to be all optimistic. The next 2 weeks, I'll be in Slim River, so I'll be having a total of 5 weeks of nomading. Driving is really tiring at times, but I guess home is a place you can truly rest. Until then, I'm looking forward for a nice break this weekend.


P.S: I'll post some pics in the next post. :)

This blog, perhaps had evolved into another stage ala "Confessions of a Medical Student" by Shin Yin. Or perhaps a transient one, maybe "Confession of a Laidback Medical Student". Funny how we'd used to take a peep into the lives of final year medical students, their endeavour, their joy and pride. Funny how it felt that no matter how you prepare your mind for this day to come, taking that single leap is still as terrifying as it could be.

3rd week into Surgery, and somehow it did not felt as bad as it was in Year 3. Perhaps I was as lost as I could get, which is why I would empathize the juniors more. They may be our juniors in just these 2 years, but who knows they may even be your superiors, or seniors when you take your Masters program? I truly believe in the law of present karma, so be nice to everyone, or at least I tried to. 


Being a 5th year is different from a 3rd year. The consultants and specialists pay extra attention to you, because you are having the professionals exams soon, and any screw ups would spell trouble for their part. When would you get 6 consultants + specialists for a group of 5 students? Back when I was in Year 3, it was 2 specialists to a group of 8 students. Plus, as a 5th year, you get to do more procedures in the wards. You tend to be more proficient in the clinical procedures (or so we thought, or we'd master the art of pretense) and even the registrars acknowledge your presence. Even now, we get to scrub in to assist the doctors in the operation, although it's still not as much as doing the thing itself(not my cup of tea though). At least there was a purpose going to the OT, as well as Prof Rohaizak's teaching in the OT. Back in Year 3, operating theaters were strictly nono for me, because we as 3rd years were just like the neon lights on the Christmas tree. Nice, shiny, and yet insignificant. Or maybe white elephant. Or sometimes, we became the annoying flies being swatted off right from the start. Ignored most of the time, and learnt nothing, apart from desperate attempts to get signatures for the logbook for observing OT procedures.


As one of us did noticed that the house officer posted to UKMMC were getting younger and younger. Little did we realised that it wasn't them. It was us getting older and older. The house officer may even be of the same age as us, hence the decrease in the age gap between us and the house officers. Can't really believe that we're now 24 (alright, some may be 23, fellow rabbits)! We were so young and naive, and knew nothing much of the postings. The current revision did stir up some nostalgic memories and how we'd felt so old. The memories of the past seem so distant and yet the time ahead of us seem short and insufficient. 


Prof Rohaizak gave one of his teachings in the OT today. Again, he mentioned something and asked us to refer to page 400+ Forsythe. His trademark trick. Alex was quick to point out that he was lying, and Prof was laughing, because he knew each and every one of us back then in Year 3 would have believed everything that he said and even jotted it down (I didn't back then, FYI).

Now is the time for us to brush up our knowledge in history taking and physical examination. I thought I'd done it well, but yesterday proved me wrong. I wasn't able to do much with a lateral neck swelling(multiple) which proved to be cervical lymphadenopathy in a short case teaching with Miss Nani. That shows how much I'd not covered yet. And today, the diabetic foot patient, I could only stare for some time, and the sequence of order for the examination was rather awry. There's a lot more to learn, but I do know that this time, I am rather well-equipped with the knowledge compared to the me 2 years ago. Let's hope the spirit and zest shall prevail over a year's time at the very least.

Last week was full of theory. Seminars. Lectures. My head was filled up to the brim as I could recall. Although I did doze off some of the time, I admit that I had been awake for most of the seminars. Especially the doctor was giving pointers and not the students. Some students just gave the longest classification ever in medical history, reading every fine print in it. Hey, we're in med school, and you're supposed to present, not to recite every single words in the classification. we can leave that to our own reading time. I'm not that into audio books afterall.

This week? It's officially the start of the clinicals of Surgery posting. Ward rounds, colonoscope, OGDS (again and again for the scopes!) and presentation rounds (screwed left right up down for my own mistakes anyway) again in the evening. It's been a long time since I've been up from 7am to 5.30pm. Prolong standing is the torture. Tommorrow's going to be OT day as well as pre-op ward rounds for Wednesday. And also on-call shift. How on earth am I going to slug through this?

Oh well, I know I may not be the worst off. There's still peeps in the Pediatrics and O&G having worse days than me. This would just be a warm up for the preparations for final year (hopefully final as in FINAL). Well, that's some consolation. But I'm to know that my next posting is Pediatrics followed by O&G (then Family Medicine and lastly Internal Medicine). This is the final push. Sorry for the long rant. I know this may be the last hiatus or another rant coming up. This way or another, this is going to be the start of a series of ranting posting for the whole year. Because happy moments are to be enjoyed and I'll forget to write about it anyway. *sigh* Timne to start my revision and brush up my history taking and physical examination.