Medicine ---> Surgery

End of medicine.
Beginning of Surgery.

Unforgettable T.Intan.

Just came back from Teluk Intan, Perak. Spent a week, doing my Medical posting in Hospital Teluk Intan. A peaceful town, cheap food, nice hospital, co-operative patients, great housemates, not-too-bad cinema.... everything is just nice....

But damn, My car wasn't in good mood. He had a very, very HOT-tempered. Perhaps, he refused to leave KL. I had to stop several times along the way to deal with his tantrum... cool him down, pampered him before I continued my journey. It took me a hectic 4 hours to reach Teluk Intan because of him. =(

He is old but he is well-behaved all this while. So, I sent him for check-up. As expected, he was sick, Diagnosed with 'severe dehydration (shock) with multi-organ failure'. Fortunately, he was salvaged after a major operation with one-day of hospitalization.

Few days of rehabilitation was done in Teluk Intan. He was well and fully functioning.

And today, he successfully brought me back to KL in just 2 hours. =)

Teluk Intan

Final week in Paediatrics

Last week in paediatrics never stops me from learning. Previously, towards the end of the posting, I will be staying in my room, lazying around and waiting for the day to end. This is a good start at the very beginning of the year, a change which is good for me.

Saw numerous cases of cerebral palsy these few days. Was sad to see them completely bed-bound and unable to express their thought, if any. Really feel lucky for myself for being healthy.

Performed my very first autopsy as well. A truly unforgettable experience, especially so for a decomposed body. I can never forget the hyper strong odour, which still managed to penetrate my triple layers of face masks (a 4th facemask could have suffocated me). Never appreciate the odourless fresh air as much as now.

Final week is gonna end, exam is around the corner. Time is flying.

Hiro Nakamura, I wish I have your power.

Orthopaedics

My final week in Orthopaedics posting.

These are what I've done,

I attended 8am daily ward round for more than 36 times, skipped for less than 4 times.

I attended clinic for more than 15 times ( not including additional attendance to other teams' clinics), skipped 1.

I attended 5 seminars, missed 1.

I attended 1 lecture, 1 yet to be given by the lecturer, skipped 1.

I attended 2 workshops, another one not yet been given (but definitely, I'm gonna attend), missed 1.


Believe it or not, it's still my best record ever. = )

Not Too Sure

Looking at a patient with swelling at the back of his knee,

Prof: What's your differential?
Registrar a: Baker's cyst....semimembranosus bursa.... synovial sarcoma....popliteal artery aneurysm....etc.

Turn to another registrar,

Prof: Whatelse?
Registrar b: Not Too Sure
Prof: Nitrogen sulphide?
All: ( Huh??)
Prof: N 2 S = nitrogen sulphide

(--')

Case Study

This Case is Fictional. Any similarity with actual facts or cases is purely coincidental. It is merely for educational purpose.

Case:

Mr. Mohd. Being Sudumi, a 22 years old Malay gentleman was presented with tenesmus and pain on passing motion for 1 week duration. He claimed that he was allegedly assaulted by introducing a plastic item into his anus and he wanted to lodge a police report. On physical examination, he was alert and conscious. There was no palor, no cyanosis and he was afebrile. On Per rectal examination, there was no active bleeding, no ulcer or pus, no tear and no other injury.

Click the photos to enlarge

If u can't read the doctor's writing,
CLICK ME
for full translation

Okay, the questions are:

a)What is the provisional diagnosis?

b)What is/are the differential diagnosis?

c)What investigation do you need to do to rule out (tro) assault or sodomise?

d)What is the medico-legal issue associated with this case and how do you, as a doctor, deal with it?

Special Study Module

Why complain about this Super Superb Module?

Do you get any benefit by complaining?

DON'T COMPLAIN, don't be so selfish, let's share Good thing with our beloved juniors.

We DO love our juniors . . . . . don't we?

Why do you want to become a doctor?

"Why do you want to be a doctor?"

This is the most frequently asked question when we were the junior medical students.

"I want to help others."

This is the most common answer given by us. Gold standard answer.
But most of the time, most of us are bullshitting.

"I want to help the poor, they deserve better treatment."

Sounds familiar? It is a standard answer from medical students. A good way to help the poor is to remain in the government service as they simply cannot afford to go to the money-sucking private hospitals. Unfortunately, when they are asked about the reason to reject JPA scholarship......

" Ishhh (walaoeh), need to bond to the government for 10 years, so long, dont want lah. Wanna be free."

or, when they are asked whether to remain in the government service......

"Government? Cannot stand the workload lah, so many on-calls some more, I want to sleep lah, wanna cabut to private after the compulsory service."

or, when ask to go to the ulu-ulu(rural) area to help the poor.............

"Ha?? NO cinema, NO McD, NO Shopping malls, NO entertainment, can bored to death, u know....dont want lah!"

Another standard answer given by medical student is:

"My family member had cancer and I couldn't do anything at that time, so, I want to be a doctor so that I can prevent this. "

Does this sound familiar to you? If that is your answer and yet you are so obsessed with clinical practice and show very little interest towards medical research, you are going to the wrong direction. When facing some terminal or serious diseases, it depends on the researchers who work behind the scene to develop the new treatments. Doctors? They only prolong the patient's life, and the result is still the same, death.

Another answer:

"It's my ambition since I was a kid."

Come on, how on earth can you decide that when you are still very much dependent on your parents for most of the decision. Obviously, you get the idea from the sample essay in which you need to memorize when you were in primary school. "Apakah cita-cita kamu?" "Cita-cita saya adalah menjadi seorang doktor yang berjaya." Get it?

Another answer....

"Parents force me to study medicine."

Your parents might force you, yet, you still come to the medical school with happy face and very motivated, kiasu some more. Yea, when there is no good answer, just blame the parents lah, very easy answer.

..................................................................................................................................................................

Okay, why is it so hard to tell the truth?

" I want to be rich!"

" I want the title, DR. , glamour lah!"

"Doctor has higher status, people respect me!"

"Doctor syok, easy to tackle pretty chicks!"

Some doctors told us that becoming a doctor is not the way to be rich. After office hour, they were spotted sitting comfortably in BMW, Mercedes... (--III)
Yea, of course not rich lah, they are comparing themselves to Robert Kuok.

Some of you might say, "I can still help others by working in private hospital ma." Yea right, they pay a huge amount for your service, basically, you are just selling your skill to them. They pay for what they deserve but not at the mercy of your kindness. Some more, they can sue you if you don't give a good service. Have you ever heard that a kind Samaritan get sued because he/she is not giving a 'good enough' help?
"I sincerely want to help you, yet you sue me because my help is lousy? walaoeh!"

I don't doubt that, indeed, there are some students who really have the heart to help others and also to improve the medical services in our country, good for them and I salute them. But, how many of us are actually one of them? Are you?

Well, after almost 4 years in medical school, try to ask yourself the same old question again,

"Why do you want to become a doctor?"

Instant doctor

There are a lot of human beings in my hospital who like to hang their stethoscope around their neck, office hour...lunch break...after office hour, the stethoscopes are always in the right position. They do carry bags, some of them do wear white coats with big pockets....but why do they want to position their tools around their neck?

The answer is easy. What comes into your mind when a human being hang a stethoscope around his/her neck?

DOCTOR!

Yes, the formula is easy: HUman being + stethoscope (+/- white coat) = Doctor

They want to tell others that, " HEy! ! All of YOU! Look at me! I'm a doctor! I'm Syok! "

So, why do you need to waste your 5 precious years in a medical school?

Try out this "Instant Doctor" !!!

Human + stethoscope (+/- white coat) = Doctor

YOU CAN BE A DOCTOR IN JUST 3 MINUTES!