of ditziness and med school!

moving on!

2009-05-01T11:39:00.000-07:00

goodbye and hello!

moved over to www.ditzydoctor.blogspot.com :)

see you there!

not studying

2009-04-28T08:54:00.000-07:00

i have an ACLS test tomorrow and i'm not studying, instead i'm surfing blogs. oops!!!

on the bright side, today was my first day shadowing! delivery suite is interesting.
my intern is a generally nice guy, not particularly warm or welcoming but i'll take a person like him over others i could mention any day!
he taught me a fair bit of stuff, reassured me that i wouldn't need much OB/GYN knowledge to survive this posting (hahahahaha), told me which attendings to call and which to avoid, and how to listen to the nurses (esp the senior midwives!).

i got to see an episiotomy (OMG, i think i need to start wearing my specs, i couldn't see a thing amidst all the blood and i was terrified of getting blood into my eyes. specs from now on!) and well, i hope i learn pretty quick so i can do a neat one instead of a messy one - v impt for women!!!

there's a lot to learn, but basically we're glorified clerks and must learn all the paperwork and form-filling.
other advice was to read up on medicine and surgery during this time so as not to forget! v impt, i say! :D

short work days, 5 day work weeks :) i'm happy!

i start with day surgery - meaning i admit all patients for elective surgery, more glorified form filling and blood drawing. hmmmm. but work should be pretty easy, i just need to get my forms straight.

and my first call is on a public holiday :\ rather depressed but hopefully i'll have a day off in lieu of this :D

i feel rather bad for the residents, because of our "newness" and lack of everything, they're forced to do step down calls to fill our shoes and to help us out, esp in the delivery suite! :\ seniors, your help is really really deeply appreciated.

on your marks!

2009-04-27T08:22:00.000-07:00

uhhhh i feel so unprepared! :(

in theory i should know how to manage a pre-eclampsia, and GDM patients, how to safely deliver a normal baby, how to manage PPH and do an episiotomy. at the very least!

but the truth is, i DON"T KNOW A THING in clinical!!!!!

OH MY GOODNESS.

first day of job shadowing starts tomorrow, here's hoping i learn something and don't die in the process!

new new!

2009-04-23T08:13:00.000-07:00

frontier psychiatrist is a "newcomer" to the blog scene (meaning i haven't read his blog before this).

his site is pretty interesting - read the parts on "things that have given psychiatry a bad name"!

the part that freaked me out the most was the one on lobotomy:
(http://frontierpsychiatrist.co.uk/things-that-have-given-psychiatry-a-bad-name-1-lobotomy/) <--- i need help on how to hide this link please please?
and it's accompanying article. so brutal!

anyhow just helping to drum up support, and no, i'm not getting paid. hahaha!

internship coming up

2009-04-20T08:10:00.001-07:00

posting results are out today! i have gotten one of the postings of my choice, and i'm right pleased with it :)

OB/GYN, coming right up my way! :) 4 months of women and babies, i think i'm going to love it to bits.

the people posted there with me are mostly nice, all aquaintences (but then again, given my reputation for being gossip girl, i think there's hardly anyone in medical school whom i don't at least say hi to), well, minus ONE person who has an incredibly bad rep.

let's call this ONE person Prawn. he's arrogant, pushes people around, and doesn't ask for things nicely. he takes on responsibility and runs from it at the last minute. he has grandiose ideas and comes across as really impressive but in reality, he can't carry them out.
but he also has some good points, like being generous, i have to admit.

we'll see how it goes, hopefully he'll have turned over a new leaf!
but i'm not going to let that spoil my enthusiasm for OB/GYN. it's time to dig out the books for some refresher courses on how to read a CTG and what to do if there's primary PPH etc.

EXCITING! :)

ps. i'll be moving over to ditzydoctor.blogspot.com soon :)

i passed! :)

2009-04-18T09:50:00.000-07:00

title says it all - i'm super relieved and happy given that an unexpectedly large amount of my classmates failed this round. shockingly large amount, in fact, and amongst them many whom we thought were far from failing!

i guess i'm a doctor now, and i'm torn between being extremely happy and being terrified of having patients lives in my hands. but it's what i've always wanted, so here's to more medical education! :)

just back from grad trip, had a blast! :) hope you all are well!

surgery clinicals

2009-03-25T09:37:00.000-07:00

surgery clinicals today, hopefully i'm a clear pass!
couldn't have asked for nicer examiners (well, except one).

tired, more to come but thanks a million for all the good wishes!!!! :D

final clinicals on sat and sun. 4 more days!

week 2

2009-03-20T09:05:00.000-07:00

week 2 is down, we've trolled our way through another 3 horrifying papers plus a communications skills OSCE of 10 stations worth.

medicine essays were alright for me, but mcqs were again another horror. this time, i fell asleep despite during the paper despite drinking coffee in the middle of it and 3 toilet breaks to wash my face :\
plus i'm pretty sure i got a lot of questions wrong so that was even more :(
eg: young girl who is febrile, signs of SLE, renal punch +. what is your first step in mx?
others: RESUS
me: give iv ABx. :( OMG! :(

but at least i made one lucky guess - entacapone turns your urine ORANGE :D
go me, i am the queen of ridiculous answers.

modified essays were a HORROR. it's an evolving scenario but you just can't be sure of what they're asking for.
plus the questions were really really BAD.
eg: using a bone marrow aspirate to diagnose TB
eg: managing a patient with status epilepticus complicated by anaphylactic shock to phenytoin
eg: reaching a diagnosis of an elderly man who has just travelled overseas to a rural place infamous for having CSWs (commercial sex workers) with his family, and is now feeling malaise and has a fever, and you get ONE investigation. lovely.

and you know the best thing? our "lovely" prof even commented on someone's facebook note: i think all the papers to date have been fair.
FAIR???? far from fair if you ask me. give ANY ONE, including profs some of the questions we had and see how they do before you tell me it's fair.

osces was like a game, i zoomed in and out of stations and talked alot of rubbish, thankfully mock patients were nice. my hands shook so badly when i was suturing that the examiner laughed at me!
and i've never removed staples before so my prof even showed me how to do it in the middle of the station whilst saying:"girlie, it's obvious you've never done this before yah."
to which my meek reply was: " err, not really prof". duh.
at least osces was alot better!

clinicals are coming up - rumours abound about weird cases aplenty eg. von Hippel Lindau syndrome, charcot marie tooth (HSMN1), osteogenesis imperfecta etc.
i have no clue what to expect, but hopefully i'll recover from this beating by the medicine theory papers to face the clinicals with my head held high!

mbbs, 1

2009-03-12T10:07:00.001-07:00

day 3 of exams has ended, and i'm exhausted. i've averaged 4 hours of sleep a night (my usual is 7! AHHHHH). my skin is sallow and my eye bags are HUGE. a friend who doesn't study with me had a big shock on seeing me today in the exam hall and said i looked terrible.
i then got a further shock on looking at myself in the mirror. OH MY GOODNESS :(

the things stress does to you - i forgot to eat breakfast before my exam today! :\ thankfully i was saved from hypoglycaemia by the sweets i sneaked into my pencilcase throughout the 3 hours. gracious.

exams so far have only been surgical theory papers, but oh my goodness they seem to be going from bad to worse.
doing 180 multiple choice questions with tricky tricky wordings and double negatives made my head spin. people tossed coins, fell asleep during the paper, and headed for plentiful toilet breaks. MY GOODNESS.

and me? i had diarrhoea through all my papers. WHY IS THIS HAPPENING TO ME????
thank goodness i sit in front of the toilet in the exam hall!!!!

2 more weeks!

minutes to midnight

2009-03-07T08:57:00.000-08:00

2 days to doomsday!

sorry for lack of updates, been sitting in school attempting to squash stuff into puny little brain (seems to have gotten smaller, much).

lots of discussion going around school - realised that if i had gone to states instead i would have had an easier time facing boards rather than being at the mercy of examiner's questions and unfair distribution of cases etc etc but that is another story for another time. first to pass my MBBS and then i'll talk about USMLE and heading to states to train!

2 days to go, 2 days to go. brain is shrinking by the day, tiredness is increasing exponentially. many of us are all bemoaning this, and wondering how we will ever pass with our current little knowledge (of course, typical med school "snipers" kick in - lots of moaning and groaning and wailing about being stupid and daft, and then owning all our arses with their immense knowledge and making the rest of us feel like dirt - i have plenty of friends like that. HMPH).

but i am also going to miss this last round of studying together, we will never do such things again and have such great company! :(

the long unrelenting AHHHHHHHHHHHH

2009-02-13T08:16:00.000-08:00

there is that long, unrelenting "AHHHHHHHHHHHHHHHHH" in the background noise of my head every minute of every day, a clue to the underlying stress.

final year is really a cycle of ups and downs - stresses and boredom. you keep looking at the same material, thinking you know it already, only to be shocked into stress when some doctor pops you a question on basic stuff on to find you've already forgotten it/ don't know it quite as well as you thought/ totally clueless.
(FYI, i am usually in the last catergory :( how daft)

my stress levels have been rapid cycling several times in a day, up down up down up down up down. something to that extent, maybe more!
it's enough to drive a person mad. plus i get resting tachycardias and sometimes i wake up at night with palpitations and drenched in cold sweat from an exam nightmare. AWFUL :(
worst of all is not being able to sleep because of the stress induced palpitations! :(
i should really start taking a beta blocker soon or i'm going to fall to pieces before the exams even start.

i'm manifesting my stress externally by having pain in every single place you can think of. my orthopod tutor was laughing at me for having more pain than an old granny.
i have chronic back pain, knee pain (from chondromalacia), shoulder pain (from impingement), thumb pain (from cheerleading, zookeeper's thumb), a mucinous cyst on my finger and toes, hyperlaxity causing flat feet and lax ankles.
and oh, neck pain from not sleeping well and headache from all the pain :\
no wonder he was lauging at me as he went through my list one by one! but he was very nice about it and offered to prescribe me beta blockers if i needed them. i think i'll take him up on his offer soon!

the long unrelenting AHHHHHHHHHHHHH? i have to learn to deal with it (no, i am not hearing voices yet. just one voice!) and hopefully it will spur me to actually studying instead of sitting in front of my books and mountains of papers pretending to study so my parents won't nag at me. :\

2 good things about this week:
1) ortho is FULL OF EYE CANDY :D my favourite tutor has a lovely sexy baritone and is really hot, to boot. he radiates charisma and i've obviously been swooning over him and my friends are so exasperated with me they roll their eyes at me every time he walks by. haha.
2) i saw cute medic boy (now a doctor!) and he remembers me! :D oh, joy!

happy valentines, you all! :D

countdown: 2 weeks

2009-02-08T08:24:00.000-08:00

infectious diseases is over, and i have failed the test miserably. i'm a little shocked and dismayed (alright, make that quite, it's been quite some time since i was failing mathematics regularly). but i suppose i deserve it, having not studied as hard as i should have!

anyway. there is this new thing on facebook, a meme called "25 random things" (which reminds me, i haven't done dragonfly's old toy meme yet! oops i'm so sorry!).
and to my ultimate shock and horror, i realised that so very many of my classmates have put down: i don't know what i'm doing in medical school/i think medical school is the wrong choice for me/i shouldn't have chosen medical school etc.

it breaks my heart to read that. i know of so many others who would have given an arm and a leg to get in but couldn't because these people have taken up their places (not undeservingly though).

coupled with the facts that:
1) medicine is no longer thought of as a "noble" profession - litigation rates are up, patients are becoming more and more non-compliant
2) complaints against medical personnel are on the rise
3) burnout rates among doctors are higher
4) slipshod work is also higher

stuff like that gets you down.
i was really depressed for quite a bit to learn that so many people thought that way.

i was one of those people who decided that i wanted to be a doctor when i was young (i really enjoyed bandaging my sister and jabbing her to make her feel "better", all in the name of play, of course!), and i firmly made my choice when i was 14. nothing has changed my mind since then (except for a short period of time when i really felt that i should have done nursing instead, but i'm over that now. more on that some other time).

but such is medicine, such is the job and the demands on you.
i never expected to make such a huge lifestyle change, to have almost no "university life" to speak of, to be totally out of the loop with the rest of my friends in other faculties, to wake up early early early and go home late late late. so many things, so many things.

but it has never changed my desire to be a doctor, as much sadness and ugliness and frustration i have experienced (there has been a good deal more than most people, i am sure! largely due in part to my hearing problem and others). i still hold onto my idealism, and i can only hope it won't fade that much 20, 40 years down the road.

i still want to hold a granny's hand and tell her it'll be alright, we are here to take care of her; to tell a pregnant lady to keep pushing, her beautiful baby is coming out soon; to play with a kiddo and watch his smile (which will make my day); to tell jokes to an elderly gent and see his eye crinkle. people make my life, and my life is medicine. there isn't any other way.

guitar hero

2009-01-30T08:13:00.000-08:00

i received a bit of a shock over the week, not sure whether the news is good or bad but i'm choosing to look on the bright side for now! :)

lately my group of friends and i (and almost everyone i know) seems to be addicted to wii's guitar heroes! :) most fabulous. except that being ditzy (by name and nature) me, i am constantly making a fool of myself on the songs :\ doesn't help that i'm tone deaf as well!
but it's great fun to sit around and watch as people get disinhibited and start yowling and wailing over songs such as livin' on prayer (my favourite!), complete with hitting the high notes ;)

i introduced my parents to wii - and my mother promptly whupped my dad in wii tennis almost effortlessly! that left my dad grumbling lots (i guess men's egos are big huh) and being rather unhappy - until he thrashed my mum at wii golf. hahahaha. boys will be boys i suppose.

on the medical side, we've started infectious diseases and it's only the 2nd posting that i really quite dislike :(
i don't quite mind the HIV patients, the STDs etc. it's really the whole infection control thing that gets me - it's so super inconvenient and scary - i detest the thought of carrying MRSA or VRE. as a result, i'm obsessive-compulsive about washing my hands and cleaning my stethoscope between patients and it's so time consuming cos i really really wash them :\

ID physicians are incredibly and their knowledge of lab results - after all, their diagnoses depend almost solely on lab results sometimes!
but i have to admit i was stunned when an attending lecturing us managed to give percentages of symptoms of how patients might present.
for example: nausea is present in 50%, and vomiting and diarrhoea in 30%.
he went on to do this for each and every symptom!!!!
granted, it's only rough percentages, but me, i have problem remembering all the symptoms, let alone the percentages!!! gracious.

today, attending (same as above) asked me, " so what are the causes of malignancy responsible for pyrexia of unknown origin that are not blood cancers?"
all i could stupidly say was, "ummm, solid organ tumours?"
i think he wasn't happy with my dumbness and gave me a scathing look. oops.
and sadly, there is no happy ending to this story - i didn't get a chance to redeem myself. it feels like geriatrics all over again (except there was a happy ending in that one!) :(

3 weeks left in clinicals, 2 weeks of study break and the BIG ONE arriveth :(
just as well i guess, rather than being in a state of eternal limbo!

weeeeee areeeee the CHAMPIONS :D

2009-01-26T05:51:00.000-08:00

so we won the softball tourney! :) despite me playing terribly and my old injury flaring up and having to sit out most of the last few games, (all the medics on the team have diagnosed me as having supraspinatus impingement, probably with rotator cuff strain and early osteoarthritis - ahhh, the perks of having eager medics as friends), WE ARE THE CHAMPIONS!

only now do i know what certain death means, we really came back from the dead!
each of our final 3 games was won in the bottom 5th innning (we play a modified version of 5 innings) when we were up to bat, and won each game by ONE measly run. that's really cutting it close!
but we won! and i've never been so elated in my life. my team spent a good few minutes just hugging each other and screaming our heads off, showering kisses all round. heh.

alright on to medicine stuff:
the new internship employment packets have been given out, and we've been asked to list our matches and selections for the upcoming intern year. problem is, they've changed the system completely from our seniors time, due to a new employer (some shuffling around, i'm clueless), so that means most of us a clutching wildly in the dark at our decisions, except for the very brilliant and brainy top few who are assured of getting what they want.

for me, it's a gamble. should i go with medicine, surgery and OB/GYN or should it be medicine, ortho, OB/GYN?
what if i don't get OB/GYN??? (besides throwing a fit and sinking into depression and crying all day, i mean) what would be a better choice? medicine, surgery, ortho?

coupled with all my friends choosing different things and all of us being on different areas of the results spectrum, (i believe i'm somewhere in the bottom half, sadly), it's a whole new confusing world.

clearly, i'm going to have to put in some hard thinking on this one. and i need to get myself a decent passport photo when i'm not half asleep or with hair that sticks out all over :\

ahhh, the perils of growing up! :(

anyway!
it's the first day of lunar new year so HAPPY NEW YEAR (again) one and all! :)

blisters, warts and all

2009-01-15T07:50:00.000-08:00

i have multiple blisters on my hands right now from softball trainings, as well as corns/callosities and warts (for which i blame the boys, i have not had warts since before this year, before this team!).

the whiner in me wants to shove my hands into the face of everyone whom i meet and gain some sympathy (pathetic of me). and the masochist in me somehow tells me to appreciate the blisters, warts and all, because i'll never get them again. not from softball anyway.

i know it's my final and last last last season, but something tells me i'll have a hard time giving it up.

come sunday night, it's time to hang up my boots, keep my glove and bat and helmet.

wish me luck for sunday's matches! :)

bring in 2009!

2009-01-04T07:22:00.000-08:00

so we've reached 2009 (and i have shamefully fallen far far short of my 2008 resolutions!)

HAPPY BELATED NEW YEAR EVERYONE! :D

this year, my resolutions are simpler (and in no order of importnance):
1) to keep off coffee (i'm pretty sure i will go right back on it once i'm post-call)
2) to pass my finals (either 1st or 2nd try, hopefully not longer! :\)
3) to work out/exercise more (my increasing weight is reason for worry. uh oh) - should i go with a gym membership or gymnastics classes?
4) to spend more time with my loved ones (super impt)
5) to spend less in light of the economic crisis - really time to rein in my spendthrift ways!
6) to get on the right path to learning to be a good doctor - in terms of attitude, teamwork, compassion, conscientiousness etc, not just in pure knowledge.
7) to devote more time to church, i have been MIA muchly this year
8) to organise my room (uhhh, this is hard. i am probably one of the messiest people on this planet)
9) not to complain and whine so much!
10) to blog more regularly and not be so boring (heh)

much love to all of you! :)

the one about shoulders

2008-12-26T09:13:00.000-08:00

is shoulder crepitus normal? because i don't think so :( and i have really bad shoulder crepitus in my right arm and none in my left :(

i think i'm a prime candidate for osteoarthritis of my shoulder! :( this is worrying. maybe i should give up softball, it's straining my shoulder far too much anyway. but after this season!

or maybe it's the hypermobility (i can bend my little fingers backwards to touch the dorsum of my hands!) that's causing the crepitus?

uhhhh. this is freaky.

(this all came about in playing the game rayman's rabid rabbids on wii!!! and guitar hero. i do declare i must be the shittiest player on wii alive, i have no sense of rhythm and i keep fingering all the wrong notes and pressing the wrong things. ARGHHHHHHH)

2008-12-25T05:44:00.000-08:00

merry christmas one and all! :)

here's hoping you all have lots of love laughter and fun this season! :D

test!

2008-12-20T04:10:00.000-08:00

i had my end-of-medicine-posting-test on monday this week, which was rather nothing short of traumatic.

first of, i had a funky hot russian lady as my tester (who looks fabulous and oozes fabulousness out of every pore! even her clogs were so funky i wanted to faint at her feet), but sadly, i had a hard time understanding her accent. uh oh :(

next thing - she's a gastro attending, so i thought gastro would be alright, given that it's my pet topic! sadly, it wasn't to be :(

my patient was a previous healthy young gentleman, who's a permanent resident in my country, working for the railway system.
he presents with:
1. fever of 1 week, 40 deg. worse at night and spiking
2. diarrhoea of 1 week, 5 times a day, watery and of normal colour
3. vomiting of 5 days, non-bilious non-bloody. unable to keep food down. up to 11 times a day
4. jaundice of unknown length, recognised by his wife on the 3rd day of fever "eyes turning yellow"

past history of pulmonary TB, treated for 6 months and deemed cleared. nil other history of note. no previous surgeries or blood transfusions.

family history of diabetes mellitus (type 2) and hypertension on his mother's side. father has a prosthetic valve inserted (unknown reason). uncle had liver cancer.

not currently on any meds, no recent illness, no known drug allergies.

has been residing in my country for past 4 years, wife and child came over 2 months ago.
not stressed about work in any form over last 2 months.
previous sexual history except for ex-wife (now divorced), and she is well.
no contact or travel history, colleagues are all fine.
no recent ingestion of seafood.

so there i was, heading happily to a diagnosis of hepatitis A (most common and transmitted faecal-orally), with differentials of cholangitis and other forms of hepatitis.

and stupid me, only notices the PICC line in the last minute, and upon asking about it - it is revealed he had a liver abscess, went for I&D and is now on iv antibiotics.

ARGHHHHHHHH!!!!!!!!!!!!!!!!
and all this was revealed in the last minute of my test - my whole test is now changed from a diagnostic problem to a management one. and i know shat about liver abscesses because they're usually managed surgically where i come from (and surgery is my next posting so obviously i haven't read up on liver abscesses AT ALL).

and of course, i got royally screwed over by my funky fabulous examiner, who must have thought i was an idiot for not knowing a thing, plus my friend (who took the test with me), managed to get an easy case of painless jaundice (diagnostic problem - the actual answer was a cholangiocarcinoma! goodness). :(
strike one :(

strike 2 came when my friend had a 6th nerve palsy with some conductive hearing loss in a young lady, and she was unable to even come up with a proper list of differentials for the causes of an abducens palsy. i was biting my tongue so hard i thought it would bleed, and i felt like the small kid in class who desperately wants to answer questions! :(

and my case? an elderly man with:
1. diffuse large B cell gastric lymphoma (cachexic looking)
2. pulmonary fibrosis (but not cushingoid in appearance thanks to his cancer)
3. infective exacerbation of his pulm fibrosis (there's consolidation, coarse crackles)
4. bilateral pleural effusions
5. a secondary spontaneous pneumothorax (so it's now a hydropneumothorax on one side)
6. a chest tube with fluid inside

so my diagnosis was:
pulmonary fibrosis with superimpose infection, and bilateral pleural effusions.

she was so pissed/miffed/angry/etc that i missed the pneumothorax, and she said she'd initially rejected this case for exam because she thought it was too easy with the chest tube.
i don't think she for one moment remembered that chest tubes drain BOTH effusions and pneumothoraces, and if she'd bothered looking at the chest drain - she'd have noticed BOTH air and fluid inside.
instead, all i got was her ranting about how pneumothoraces are a medical emergency etc etc etc and how i could have missed that is beyond her and i would make a totally unsafe intern. :(

then she marched me over to the x-rays to have a look, and when i pointed out that it wasn't a tension pneumothorax (no tracheal deviation, no mediastinal shift, no diaphragm depression), she got all huffy and pissed off with me even more and said all pneumothoraces were medical emergencies regardless of whether they were tension or not. (is she right?)
so, strike 2 :(

my second short case was a man with cervical myelopathy, presenting with frequent falls.
he had spastic weakness of both lower limbs, hyper-reflexia and ?upgoing plantars (couldn't tell because he was really ticklish and kept withdrawing).
upper limbs - slight hypertonia, brisk triceps, normal supinator and biceps reflexes.
so i thus presented him as having cervical myelopathy at the level of C7 due to normal biceps reflex and exaggerated triceps.
she wasn't happy about my ?plantars, saying that it was obviously upgoing (but the guy kept retracting his foot! so how can you really be sure?), and she said that the upper limb reflexes were brisk as well, and that i didn't do it correctly. oh well. but i did manage to answer all her questions on cord compression etc (all thanks to ortho!!!! :) so it wasn't a complete waste of time! after all!) and spinal shock and bulbocavernosus reflex. YAY! :)
she did concede that my neuro is far better than my respi exam. :\ but at least i gave her a decent impression. whew :)
(so, NO strike 3!)

my friend's last case was a dead easy bronchiectasis, coarse crackles heard all over the lungs, marked clubbing, chesty cough and purulent sputum.

after the test was over, she did admit that i'd gotten much harder cases than she did. but i cant' help feeling it wasn't so fair :(

oh well i hope the real exams won't be this hard! :(

my 100th post!!! :)

2008-12-11T08:05:00.000-08:00

time flies and it's my 100th post! :)
and sadly, it isn't anything deeply meaningful etc, instead, it's my usual whines and moans. uhhhh sorry.

i managed to kill some fat juicy caterpillars in my hostel room! they exploded with green blood. disgusting.
my room is now a lizard haunt, a caterpillar nest and an attracter of all sorts of insects. freaky.
I WANT TO MOVE OUT!!!!!

i donated a pint of blood 2 days after my run, and promptly developed symptomatic anaemia for 3 days- giddiness, tachycardia, palpitations, presyncope, exertional dyspnoea etc. NO MORE DONATING BLOOD TILL I"M FITTER!
thankfully i'm better now :D

clinical test will be next week - i'm keeping my fingers crossed that i get awfully fierce and killer examiners so i won't be so scared in the finals! rather odd maybe, but better to get slaughtered now than in the finals right? :)

must really stop making up signs in my head, i keep seeing raised jugular venous pressures when there are none, hearing murmurs when there are none, feeling hepatosplenomegaly when there is none! UH OH.
missing signs is even worse. i have missed EVERYTHING in any system you care to name. UHHHHH.

doesn't look too good now! :(
and it's only 89 days. ARGH i need a white knight in shining armour please! :(

2008-12-07T04:36:00.000-08:00

10 k run today!

shitty awful, am so unfit, timing was way bad, route was way worse, number of people was over the top and it wasn't the best organisation, for sure.

but all that aside! :) i completed the run in a 5 minutes past my original time, not bad for a final year medical student with not much time to train :)

which reminds me that i really really have gotten superbly unfit, must exercise more after this!

92 days to finals!!!

and it's down to...

2008-11-30T09:15:00.001-08:00

99 days left!!!!!

-cue panic attacks-

AHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH!!!!!!!!!!!!!!!!!!

clinical confidence

2008-11-27T06:00:00.000-08:00

today, a nice intern told us to have a look at a patient, and perform a neuro exam of her lower limbs.

now, neuro, is certainly not one of my best topics in internal medicine (gastro is, by far). in fact, i used to have ZERO confidence in it at all, thankfully, 1 month of subinternship in neuro (and seeing nothing but neuro) did give me a fair bit of confidence.

however, in this dear old lady (who happily chatted with us the whole way through and really made us laugh! :) i hope i'm like that when i'm old too!), her constellation of signs was puzzling.
- slight hypertonia of the Right LL, normal on the Left
- no reflexes at all bilaterally
- upgoing plantar on the Left, equivocal on the Right.
- normal power on the Right, weak on the Left.
- sensory loss in a stocking fashion

so the overall picture is that of a mixed pattern, with peripheral neuropathy thrown into the picture.
she told us that she had an old stroke, which explains the weakness and upgoing plantar on the Left.
the peripheral neuropathy explains the missing ankle jerks bilaterally.
so how does that explain away the Right hypertonia and the missing knee jerks?

her upper limbs were fine, no cerebellar signs or cranial nerve signs. she was admitted for a fall (her Left sided weakness), and there was a bruise over her left knee.

i then started questioning myself- were my signs correct? did i do the right thing? did i examine correctly? am i thinking straight? maybe this is ALS or SACDC instead?

so, unsure, i went off to ask the intern - who happily assured me all my signs were correct and it was due to many pathologies!
(the absent knee jerks were due degenerative disc disease/PID that was large, and the hypertonia was due to a new stroke, albeit a small one).

in short? clinical confidence is very important. you've really got to know what you're doing!

another 2 friends of mine were told by the resident to examine the cardivascular system of a patient - both could not hear heart sounds and were depressed and anxious.
the resident proceeded to tell them," that is exactly what i wanted you to hear!"
it turns out the patient had a pericardial effusion (with bulging neck veins) so therefore the heart sounds were muffled!

medicine revision, 1

2008-11-20T08:51:00.000-08:00

2nd week of medicine revision posting now (out of 6), and the countdown begins in earnest. there's 12.5 weeks of school left, 2 weeks study break, and then the end of the beginning is here. medical school is a long road (compared to other degrees), but we've only just begun!

i can most safely say i will be extremely sad and sorry to see my undergraduate days behind me.

12.5 weeks. and then it's make or break.

i have only 12.5 weeks to brush up on clinical skills, to perfect my examinations and differentials and presentations to a level for passing (hey, i'm not aiming for distinctions here!). i want to be a safe doctor, a good doctor. so i'll work hard. but i think that half the stuff we're tested on is pointless and useless.

i'm still getting scolded left right and centre for my gross lack of knowledge and ineptitude. sigh :(
take today for a case in point - the opening stem was "this man complains of intermittent joint pain. please examine his legs"
i just went ?????!!!!!! in my brain and proceeded to try to wing it with an ortho exam, trying to incorporate what little of rheumato i remembered. and was told by my tutor - " you'll fail if this is MBBS" :(
to think my group mates got easy stuff like hand and neuro exams :( oh well but at least i'll have a better idea of what to do now, i guess.

8 minutes for examining and presenting sounds like a mighty short time, i have no idea how we're going to do it, but like generations before us, we'll survive somehow :\

may more mid-diastolic murmurs come my way! (although i did hear plenty in india, i can't really hear them anyway) and may all the patients for MBBS please be admitted in the remaning 4 weeks so they'll be called back for exams well :P

12.5 weeks!!!!

angry, it's good to hear from you that you're alive! :) hope you're enjoying clinics!

and dearest dragonfly, i hope you're safe in whereever you were going to from rurality :)

geriatrics

2008-11-11T06:34:00.000-08:00

2 weeks of geriatrics has ended and i must say it's been an eye opener. geriatricians are truly the best clinicians around, they manage patients holistically and genuinely seem to care for them. on top of that, their medicine knowledge by no means pales in comparison with those doing internal medicine!
some of the hardest MBBS examiners around are also geriatricians. hmmm.

i've learnt about polypharmacy (so common!!!!), falls, incontinence, dementia etc. and it's startling to know just how many of these we attribute to "aging" and write off as being normal when they could be treated!

and another scary thing is how fast my parents are heading into the geriatrics age bracket (alright it's a good few years but still), they're no longer as young as i thought they were. and it's never something easy to understand, your parents growing old. somehow i always thought they'd always be there! :\ i can't imagine life without my mum and dad (i mean, even when i was overseas/staying in hostel, they're still there.)
but all things must come to pass. i just hope i don't get there too soon!

seeing all the elderly folk every morning on rounds makes me sad. most of them have social issues and no caregivers, and the wait for nursing home places is miles long. as a result, the doctors are frantically trying to get them out of hospital to make way for more acute patients, and it seems that no one wants them. must feel terrible, to be so old and to have lived so long and done so much (i'm assuming) and to be so unwanted in the end.

geriatrics breaks my heart, and it reminds me too much of my gram. but i do think that it's an incredibly worthwhile specialty to go into if you're looking for all-rounded care of patients.

we were scolded really badly on rounds, for our gross lack of knowledge and finals being only 4 months away. basic interpretation of ECGs, BP taking (i didn't know that you can't take BP from a hemiplegic side!), feeling of cervical lymph nodes, my groupmates and i have failed miserably.
it's a call to wake up and start studying, we obviously didn't know as much as we thought we did. but at least there's 4 months to go which hopefully should be enough time!

now we're into the final stretch, 14 weeks to go to finals. 6 weeks of medicine and 4 weeks of surgery, with 4 other weeks in between on minor postings. it's the home stretch, so wish me luck!

2008-10-23T09:06:00.000-07:00

i'm back! all browned and peeling from bali :)

fabulous waves, beautiful people (sadly, i'm not included in this description), cheap food, and gorgeous scenery. it was a blast!

now it's time to hit the books again for the paediatrics test on saturday. sigh.

holidaying!

2008-10-16T04:16:00.000-07:00

i'll be off for a couple of days for my annual beach holiday (a new destination this time round!).

it's time for sun, surf, sand and sea! :D
i can't wait till i fly off.

watching mamma mia made me desperately want to visit greece! it was a fabulous show, loved the songs and singing. tanya (christine baranski) has got to be my favourite character! bring on the fake boobs and the 3 ex husbands ;) nah, just kidding. but really, she's great! :D
pls watch it if you haven't already!

meantime have fun, everyone!

it's over!

2008-10-11T05:28:00.000-07:00

and it's over! :)

my sub internships are over :D

i was helping my intern to run his part of the ward which includes 4 6-bed cubicles, 1 high dependency area and 2 isolation high-d rooms.

NOT EASY :(

i have even more respect for interns now esp seeing them manage all the medical conditions of the patients almost single-handedly without any help or input from the attendings whatsoever, such is the sad state of ortho.

of course, the anaesthetists, geriatricians and various medical disciplines help greatly greatly greatly. i can't even count the amount of times i've had to call renal physicians, cardiologists, pulmonologists, haematologists etc to beg for help, after which they will usually help after hearing," i'm the ortho sub-intern". such is the notoriety!

we ended our last day by going out with the interns to celebrate at a nearby pub (this isn't us though, it's some other people who were there but i took this photo of the pretty lights!), and they treated us, being such lovely people they are! :D i love doctors. hehe.

we'd a smashing good time, and i'm thankful that we have seniors such as these to help us out in the future :)

more on ortho subinternship some other time! :)

ortho internship, 3

2008-09-30T21:48:00.001-07:00

thus began the 3rd week of my internship, wherein my previous intern left to become a resident, and i got shunted to the infection side of the ward (see previous post) to help for a few days before the new rotations take place.

the past 2 days have been a whirlwind, i somehow made it through chaotic morning rounds (there aren't proper rounds in ortho, apparently. the attendings just come one by one and you grab the case notes and run after them madly and try to scribble down their orders desperately whilst hoping that someone else is with whatever other consultant may come along).

tuesday was especially bad because i'd woken up at 440 am, checked my clock, realised i had to wake up at 530 am instead and fell back to sleep - and i MISSED MY ALARM COMPLETELY. omg. thankfully my hall master gave us a lift down to hospital! i have never loved staying in hall so much, ever. :)

and just on time too, i reach the ward station just as the 1st consultant (one of my favourite too!) has finished the first file. i managed to catch the rest of his orders :)

rest of the day is pretty uneventful. i've grown to love the long-stayers, they're like my own!

there's this old man with MRSA in a ward cubicle by himself (he has to be isolated), and his 2 grown daughters (old enough to be my grandmas!) hover by his bedside protectively all day. if i should even approach his bedside with a kidney dish for blood taking, they jump up protectively and start giving me the evil eye, and demanding to know exactly what i am doing and why so. whilst i do appreciate their concern, i don't exactly speak their language and i can't explain myself very well.
i understand that their father has been in hospital for over 2 months now after a fall, resulting in an NOF #. shortly after hip replacement, he managed to dislocate his prosthesis in hospital and developed MRSA and has been bed-bound since. the infection isn't clearing up (we've been doing vanco troughs and infection markers religiously, hence the blood taking). in a bid of desperation (perhaps out of seeing the patient everyday), the attending decides to schedule a "closed KIV open reduction of Left hip posterior dislocation" in the OR that day, and leaves it up to me to tell the family. i break the news none too gently (i'm really crap at this) and the daughter bursts into tears promptly.
it's pretty sad, isn't it? i really do feel sad that their dad has to be in hospital for so long and has so many bad things happen to him.
on the other hand, i wish they would just let me get on with my work and stop unloading all their emotions on me. it's very frustrating, and it makes me hate them unintentionally.
just yesterday, i was ordered to do another septic workup on him and bemoaned the fact endlessly. as i walked into the cubicle, i was super pleased not to see any of his relatives around, and managed to do my work fairly quickly. i was feeling really pleased with myself then, but also guilty.

it's not like we're subjecting him to extra tests that needn't be done, we do need to track the decreasing trend of infective/inflammatory markers and the vanco levels to ensure he's getting proper treatment. but as an sub-intern/intern, there's nothing much we can do other than that. the attendings have no clue about medical management, they refer widely and loosely. i have written some of the shortest and crappiest referral letters ever (read: dear colleague, thank you for seeing this patient. pls refer to attached summary and advise. thank you). sad to say, this is the standard in ortho. i initially tried to write decent letters with a short summary and relevant points and investigations but gave up after my intern told me to forget it as the medical people reviewing the letter usually just ignore the summary because it's so poorly written.

it's quite appalling, the general lack of care. the attendings only seem to want to get into the OR, they dont' really seem to notice the patients

just the other day, i was confronted by a very angry Infectious Diseases (ID) attending, demanding me to go through the file with him. i cringed as he pointed out each and every mistake in documentation - chief ones being:
1. "wound is clean and dry" - attending
this was followed by "wound is oozing haemoserous discharge" - intern
and "milking of wound soaked 3 gamgees and gauze pads" - nurse clinicians

2. "pls review for possible infection" - attending
and no labs for blood/fluid/tissue cultures or septic workup of any sort was initiated.

3. days worth of not seeing the patient yet documentation shows that the patient is unwell

etc etc

i couldn't help by cringe as he berated the surgeons. he ended it off by saying, "even if you beat me to death, i won't come here if i need ortho surgery!" and "don't EVER be like them if you want to be a surgeon in the future!"

quite mortifying. i'm seriously thinking harder now.

and of course, how can i end a post without talking about the resident drug addict?
he's been admitted in and out of hospital, has had 20 over operations in ortho, has lodged more than 20 complaint letters against interns, residents, nurses, cleaners etc.
and has been walking up and down the wards demanding for morphine injections and raising a hell lot of noise in general, being rude to everyone.
the irony of it all? in his complaint letters, he calls everyone rude, and himself a defender of the wrongs, the righter of injustices etc etc. quite ironic that he mentioned sueing his own brothers in the same letter.

on the bright side? (there's always a bright side). i had to set a plug on an 85 year old gent with a shoulder carbuncle, and he entertained me lots, kept quiet whilst i set the plug, joked with me afterwards and generally made me feel lots better :) when doing his post-op review, he was still cheery although in lots of pain, and politely asked for a jab to stop the pain. what a gentleman! :)

patients. love them? hate them? you decide.
but like i said, i still love my job. :)

ortho internship 2

2008-09-24T03:08:00.000-07:00

this week has so far been a mixture - there was a tonne to do on monday!

my overflow ward actually had many things to do - my intern was actually happy that he could pass his time usefully instead of bumming away in the lounge reading the papers. and we finished everything in our usual slow and languid fashion by 1245, just on time for him to go post-call at 1 pm. :)

after a long slow lunch (everything is long and slow in ortho, i have realised), i head over to the infection side (septic arthritis, MRSA, osteomyelitis etc) to help my friend with some bloods.
after we get yelled at by the ID consultant ("don't let the files touch the table! don't touch the curtains! wash your hands! blah blah blah"), and realise just how unsterile and unclean we are and feel ashamed, we balk in horror at the amount of blood tests he has ordered - 4 culture bottles (2 sets) and 4 tubes (including a coag studies and a cross match) = more than 20 mls of blood in all.

and this patient has cardiac and renal failure (really really oedamatous hands) and is BMI +++ (obese is right) and has MRSA pneumonia and really really really small tiny bad veins.
:( :( :( :(

so we prep culture sets and sterile gloves and mournfully head to her bedside and beg her into letting us do our work. to our great surprise, she hardly flinches when my friend does an arterial puncture (we thought it'd be kinder than waiting for her small tiny veins to drip 25 mls of blood slowly), and i try to rouse her to ensure she's not coded on us!!! so scary.

and the arterial puncture doesn't work - we try on both radial arteries and still NO BLOOD. dang.
so we look for femorals but with BMI +++ it's a little hard to feel (since we are so inexperienced and new) so i suggest to my friend we use the PICC line instead (peripherally inserted central catheter - for long term iv abx use, costs about $700 to insert. ack). after getting permission from the nurse, we try our hardest to draw blood, but NOTHING COMES OUT!!!! :(

i run to the nurse and tell her we can't get anything from the PICC line, and she freaks out and comes with saline to flush the line. and whilst she does it, i watch and realise that : you have to UNCLIP the PICC line to give the saline flush.

after the nurse leaves, i quietly tell my friend that "hey, we didn't unclip the line!"
and he is right in the middle of a 3rd radial puncture.
and both of us look at each other and burst into hysterical laughter, right in the middle of the ward, right in the middle of the procedure.
we can't help ourselves, we've just spent 1 hour trying desperately to draw enough blood!
i think everyone thought we were mad but really, we were so suepr relieved when we used it and it worked. THANK GOD!!!! :D

after this, when i stood up from the patient's bedside, i was whoozy! goodness me.
so i thought we could go home - it was 5.20 pm and our day ends at 5 pm!
but no, the intern says to clerk a new case (with active pulm TB!) and the 2 of us are ready to faint. hahaha.

well, all is said and done, but i still love my job. i walk the hallways knowing that there are crappy days and there are good days, but i still love my job :)

on the bright side, yesterday and today was bliss!!!
i took off at 1pm yesterday and went to watch mamma mia (fabulous!!!) with my friend who was post-call (i wasn't post-call but my intern said i could leave) and we didn't even need coffee to stay awake! :D
SO WATCH MAMMA MIA!!!!!

and today my precious stethoscope died on me :( there goes $700 :( i hope it's under warranty!!!!
but we ended real early too and i'm back here typing this at 530 pm :D

bliss :)

ortho internship

2008-09-19T06:22:00.000-07:00

ortho internship has started!
and it's not quite like medicine internship.
it's another month of pretending to be a doctor and trying to learn how to be a proper intern.

on the bright side, it's been fun :) i've gotten to do backslabs and casts! i'm learning post-op reviews and what drugs to order.

on the dark side - it's really quite boring. there is NOTHING TO DO because i'm handling overflow patients (those not in the ortho wards) and they're all long-stayers and very stable. so my intern and i will see them every morning on our rounds (no attendings or residents, just us both. horrifying) and chart up whatever we think. i'm learning just how different ortho charting is from medicine (think very very short and to the point), and i guess that's the attraction of it to some people.

i've already found a patient i adore :) she's smiley, never refuses my blood taking skills, always has a cheerful word for me despite my pathetic-ness about knowning, um, nothing. she really really brightens up my day every morning on rounds!
sadly, she also has an iatrogenic epidural abscess (from a lumbar laminectomy) that's been evacuated, but her wound isn't taking well. when i did the wound inspection today, the edges weren't apposed or granulating, the only thing holding both sides together was the stitches. :( v sad. my intern said to leave it for a few more days, we'd check again on monday and pray for the best over the weekend. i hope so too!

so far calls have been a farce - i've gotten to go home at 830 pm the night i was on take :) in part, this is due to there not being any rooms for us to sleep in, as well as having no new cases come in.
however, i stayed back to wait for my friend to travel back together one night this week, and ended up helping her with her ward call (meaning that you see all cases in the ward - such as low/high hypocounts, giving 1st dose antibiotics, doing procedures etc) which was SO BUSY. omg. thankfully between us both we managed to help the intern out a fair bit and we left at 11 pm, utterly shagged out. whew.

still, i'm thankful for being free as compared to being horrendously busy (like some of my classmates on the colorectal team) where they go home at 10 pm on a daily basis. NO THANKS.
i would like to work hard, but this is also my final year and i want to rest and study as well - i'll work hard when i need to (like on call) and when i should (as an intern). but for now, i'll enjoy my time off and use this time to study for the fast approaching finals! :)

2008-09-12T09:44:00.000-07:00

derm is finally finally finally OVER.

all the cramming and studying desperately for a short 5 minute exam at the end of 2 weeks. it feels a little anti-climatic.

and it was a total letdown.

right now i'm just too tired to say much, but as most of my class, it's unlikely i'm going to pass. i still love dermatology very much, but really, today's test was AWFUL.

of rashes and itches

2008-09-01T01:02:00.000-07:00

ear candy: the ting tings! :)

we've started a 2 week rotation in dermatology. it's only the first day today!

so far, i've sat in a psoriasis clinic (oh those poor patients!) and seen numerous viral warts being removed. ouch.

i've also learnt that to do derm, you need to do an MRCP, which kind of puts paid to all my hopes and dreams of doing derm!

i used to think that derm was for the lazy and weak (please shoot me), being influenced by general surgeons (i was young and impressionable back then!) in the early days of medical school, who had no qualms slagging off dermatologists as being lazy and headed for a good life, where money and time were in abundance. little did i realise i would fall in love with the visual nature of the "spot" diagnoses of dermatology, the quick consultations, the ability to impact patients's lives so greatly (even if the conditions aren't life threatening).

i regret dismissing it so lightly before! derm has had me enthralled with rashes, bullae, scales, warts and more. (i still have to admit i like OB/GYN more though)
but it's a highly competitive specialty and i, being closer to the bottom of my class rather than the top, am not likely to get in, even more with the need for an MRCP (my medicine is in a highly woeful state).

so i guess i'll just enjoy derm whilst it lasts and look back on it with fondness :)

withdrawal symptoms

2008-08-27T05:03:00.000-07:00

withdrawal symptoms: depression, anxiety and craving (from wikipedia)

i've been having typical classical withdrawal symptoms, much like alcohol and benzo withdrawal (in a mild form of course!) - the olympics is over! :(

i wailed to my sister: what are we going to do with our lives now????

no more rushing home from hospital, plonking myself in front of the tv and squinting really really really hard at michael phelp's abs (yes, i ogle shamelessly) and the divers too (thomas daley is the cutest thing ever! plus they have super abs.)

no more gymnastics and synchronised swimming, no more of usain bolt's showboating, no more tears and smiles and celebrations and sadness.

i'm sad :( why is it only once in 4 years!!! :(

to end this sad woeful (and highly pathetic) entry, i leave you with :

appreciate, people, appreciate! guys don't come hotter than this :)

and it really doesn't hurt that i can re-learn all my surface markings for anatomy from these photos. i should blow them up and imprint them onto my puny brain ;)

i think i love pyschiatry!

2008-08-21T03:45:00.000-07:00

as it has, so often, i'm falling in love with my rotation.

i'm pretty certain that i don't want to be a psychiatrist in the future, but in the meantime i do love my tutors at my current hospital to bits.
we've had so much fun despite it being JCI acredition week (which means we're kept out of wards and clinics in a bid to improve said hospital's chances of being JCI acredited so we won't screw up in front of the auditing big shots), it's meant half days, long lunches and lots of laughter as the doctors feel bad for us and give us long but super interesting tutorials.
i've never laughed so much in my life!

we've acted all types of patients, from the usual depressed/schizophrenic to the adjustment disorders/OCD/ hypochondriacs. i adore the tutors, they manage to make a 3 hour tutorial on alcohol dependence super interesting. i haven't fallen asleep once yet and that's without coffee! (granted, i'm drinking tea now in a bid to cut down my unhealthy amount of caffeine, but still!)

my favourite doctor so far has been the one who's encouraged us to act, who tells us funny anecdotes about his past patients, who's always approachable with a ready smile, who realises that most of us won't become psychiatrists but still tries his darndest to make us fall in love with psychiatry anyway, against all odds :)
he's even counselled my groupmate for free (she's got a chronic adjustment disorder and is currently depressed) and has been sensitive to her moods, asking whether she's alright enough to participate in the acting sessions.
when we finished our tutorial, i turned to another groupmate and said: i sure as hell hope he's married, cos if he isn't married, i'm sure he's gay! (my point being all the good men in the world are married or gay. hehe i'm just joking)

psych has really been so much fun! i've never looked forward to going to hospital so much in my life, and never with such a smile. :)

only thing is, we haven't once been in the wards or clinics, i'm not very sure if i'll like it then - this hospital is famous for nurses hating medical students. urlp.

but so far, it's been a blast! :)

and Shrink, i do imagine that you're like my favourite tutor! :)

2008-08-13T09:48:00.000-07:00

so my postcards have reached some of you? :)
that's lovely! :)

right now i'm finishing up my 2 week rotation in paediatrics at the same place where i'd just finished my internship, it's nice bumping into the doctors as i walk around! :)

paediatrics, though, is a completely different story.
i'm totally not cut out for this.

our first tutorial was on a small boy with down syndrome. as expected, he'd the usual cardiac defects and we were expected to pick that out.
me, all i could think of was "this is such a small boy, and that's such a big scar"
i know i tend to let my emotions get the better of me, but really, this has got to stop. i'm terrified of kids because i'm scared i'll make them cry. i'm scared of making them sadder, of putting them through more inconvenience, of making them more uncomfortable.
it's really saddening to see a small kid burst into tears when the 100th medical student of the day has percussed his chest and he's just to tired and sad.
it breaks my heart, honestly.

on the other end of the spectrum, i feel like slapping bratty kids who run in and out of clinics shouting and throwing temper tantrums. i have little patience and i think lowly of kids with bad behaviour (they're usually just plain spoilt by their parents, not ADHD or autism, usually), which makes me supremely pissed off.

so i spend time swinging wildly between being pissed off and being sad.
clearly, paediatrics is really really NOT for me.

pyschiatry's up next!

internship, 4

2008-08-02T02:54:00.000-07:00

so it's over!
and it feels like it's barely begun. i've loved my student internship to bits, although somedays i remember feeling like i need to cry from the sheer amount of work.

but i've loved it all. from talking to patients, to rounds, to morning team breakfasts, to talking with the nurses, accompanying patients down for scans, doing calls and being sleep deprived etc. i feel like i'm more prepared for internship in 9 months time although i'm sure i still have lots to learn.

maybe i'll even do medicine in the future, it's not too bad although i'm still far too impatient for my own good, and i hate that i can't DO anything to make them better. i hate waiting for them to get well, i hate sitting by helplessly. my tutors have said i'm surgeon material through and through, but i don't really know. but this posting has shown me that medicine does help, just in different ways :)

it was my last day yesterday, and by right, i should have been out of the hospital by noon since i was post-call. but being an appreciative, sentimental lot, our team residents brought the 3 of us out to a 2 hour long lunch where we had such fun! i love my neuro team :) after that, it was a whirlwind of running around the hospital looking for doctors to give chocolate to and answering pages from the nurses about my overflow patients before i finally was free at 430 pm.

so i decided to go have a look at one of patients i admitted on call the night before, a grouchy nursing home resident with cellulitis. he was still grumbling about wanting to eat a certain type of food, so i hoofed it down to the canteen to see if i could help. he was so absolutely delighted when i carted up the food for him! that made staying back so late post-call absolutely worth it. sometimes, going out of your way for a patient isn't for them, it's for you.

i have to admit my resolve for making him happy was strengthened by a code blue that i saw whilst waiting for the lift. as my friends and seniors came running with the crash cart, i saw the relatives crumple up outside the ward and start crying. it wasn't just any cry, it was a bone-chilling wail of total and absolute sadness. i wanted to reach over and tell them something, but i didn't know what. i didn't have anything at all that would ease their pain slightly, and words of comfort seemed so trite.

i saw one of my seniors (usually the jovial, flirty type), kneel down next to the relative and say something. which turned the cries even louder. thankfully, the lift came and i escaped, biting back my own tears.

this scene cuts only too close to my heart, when my gram died some years ago. it's hard to be on the other side of the fence. i feel nothing much for the dead person, but once the relatives start crying, i find it hard to keep from crying as well. i've been there, and there's nothing much that can be said or done. sorrow is for you to deal with alone.

that said, after being sad all of yesterday, 14 hours of sleep made me feel better and i'm now resolving to be nicer to my patients while i can. after all, it's no point being nice to them when they're dead. (forgive my bluntness)

so bring on paediatrics! 8 more months to the start of finals!

internship, 3

2008-07-27T05:31:00.000-07:00

andddd the postcards have been dispatched! :D

many thanks to those of you who replied :) hopefully nothing gets lost in the mail, and no worries, everything will stay with me and only me (except the postman who sees it!).

week wise, i've done 2 calls, the 2nd of which was a total and complete farce. i had 6 hours of sleep (from 1am to 7 am, undisturbed! amazing) and my intern slept 5 hours from 1+ to 6+. really amazing call. there was nothing to do! and she could even teach me!
which was kind of good because i was so tired already. but my first call was hectic, i was running around trying to do blood cultures. who knew so many people would spike fevers on a monday night?
and i had to sweet-talk this poor old lady into letting me set a plug into her tiny non-existent veins, and with my lousy luck, all the teensy yellow plugs (26 G) were ALL GONE :( so i used a 23 G plug and had to jab her 3 times before i finally stuck a vein. WHEW. i was all ready to run out to my intern screaming at 3 am in the morning if i couldn't do it, but thankfully, it went in.
i did have to run out crying for help when i walked into the room of a young teenaged girl with ulcerative colitis who was crying piteously, and her mum was standing there giving me the evil eye and i just felt SO SMALL AND TINY AND UNSURE :( thankfully my intern was super understanding and nice, and charmed his way into letting the poor girl be jabbed. whew.

strokes are getting familiar to me, although i still can't localise for bloddy 2 cents worth. but at least i can tell you if it's cortical or subcortical so that's an improvement i guess! :)

i did weekend rounds alone with my attending, FRIGHTFUL. i had no idea what i was doing half the time, i didn't know scat about my patients cos i was post-call and highly sleepy, and i'd totally forgotten my orthopaedics and couldn't present the pelvic x ray he asked me too, after which i got totally owned by him despite him not having done ortho in 10 years. UH UH :( not good!

i'm sad to be leaving, i've only got 1 week left! :( my ward intern is really sweet and nice, the residents are helpful and teach loads too. things are good :D

best to make the most of this last week! :)

postcards!

2008-07-20T05:15:00.001-07:00

does anyone want to know where i'm from? :D my lovely government has created a series of medical postcards to increase medical tourism so i'm going to send them since they're free (and of course unbelievably corny).
if you'd like one, email me!!! :D
ditzydoctor@gmail.com :)

internship, 2

2008-07-19T07:47:00.000-07:00

this week has been a combination of good and bad days.
the bad days were really awful. so much so i wanted to come home and cry.

for example: no lunch, endless discharges and new patients, have to do blood cultures on a renal failure patient with practically no veins to be seen/felt due to massive odema, having hypoglycaemic symptoms (meaning hands shaking v badly) whilst trying to do said blood culture, only to have blood clot when i finally draw enough blood to put into tubes, and spending next 1.5 hours trying to find more veins on the poor old guy to poke and then attempting an arterial puncture only to fail miserably. NOT A GOOD DAY. :(

but yesterday was awesome comparatively- nothing to do! i even had time to take a nap and go to the staff sale on the top floor and buy oodles of cheap yummy chocolates from one of my favourite brands! lovely. even had time to drop by and say hullo to some of my favourite patients (dear me, i'm so biased) in other wards. LOVELY :D

but this student internship is good, and i'm learning lots. i can do a preround by myself now, i can do discharge summaries relatively quickly, i can refer patients and call for help (only thing is, i can't use the phone so usually i grab someone and beg for help with calling)

i know that i'm probably not getting the "full" experience, some of my friends are so super busy they leave at 930 pm, but i can't complain, it's the luck of the draw where you get posted to. at least my neuro exam has improved by leaps and bounds and i can roughly gauge power and reflexes now. so i'll be grateful for what i get! :)

i'm learning, slowly. i won't exactly survive as a REAL intern yet, but i'm getting there, i hope!

this only makes me want to study harder so i can pass my finals and get to work. somedays, i love my job! (on others, i just want to hurl blood and faint). i remember on monday, after i spoke to 2 of my favourite happifying patients and told them they could go home, their faces lit up instantly, and i was thinking: oh God, i really love this job! (this was all offset by the amazingly horrendous blood culture the next day)

but more and more, i realise that as much as i sometimes think i'm in the wrong profession (i should have been a nurse!), i think i'll survive :) we're stronger than we think we are!

internship, day 1

2008-07-07T07:51:00.000-07:00

it's so bloody tiring. it's 1030 pm here, and i'm going to sleep.
i have to wake up at 5 (freaking) am to take public transport down the hospital which is all they way across the city, damnit.

internship is not hectic, for me at least. but it's so tiring because i'm still in the holiday mood. make that very much in the holiday mood! i kept nodding off today in the teaching session, and when the resident was giving us instructions.
what a way to make a good impression, huh.

i'm on the neuro stroke team, and our patients are located all over the hospitals, and there are so many many patients!!!! goodness me. the attendings lead the charge and it's like being on a surgical team all over again, they walk so fast, they write so fast, and they talk so fast! amazing. so much for medical rounds being relaxed affairs.

i haven't learnt much today except that there ARE reversible cause of dementia - to which my reaction was: is there such a thing? my attending promptly glared at me. NOT GOOD.

and i've done my first ever discharge summary! which took me a painstakingly slow hour. but my intern said it was not bad! :D so i'll be happy with small things :)

i'm not looking forward to tomorrow, least of all thurday, when i go on call for the first time. someone save me!!!!

and so internship beckons!

2008-07-04T11:03:00.000-07:00

we've just received emails from our hospitals, it's official. the student internship training (1 month in medicine, one in surgery/ortho) will start for me come monday with 4 weeks of medicine in a tertiary hospital with loads of profs.

i quaked with fear through the briefing, it was all the usual stuff about responsibility and punctuality and professionalism, all the stuff you hear and you think will be you someday but just NOT NOW.

well, my now is here, and i'm scared shitless, to be honest. i'm the sort who needs loads of sleep, who does things slowly, who likes to take her time. to be honest, this all sounds frightfully demanding and i'm not quite sure if i'll come out alive, let alone unscathed!

but i'm also looking forward to it in a way, because whilst my friends and classmates have come toting home bagloads of stories of how they treated and managed patients ALL BY THEMSELVES in electives, how they were really doctoring instead of just observing, whilst i was stuck being a passive observer (although i did have loads of fun in india, nevertheless). i'm itching to DO something, to be useful, to learn something practical. i learn better by doing than by observing, i have realised.

and this is my chance. to BE someone, to DO something. nothing irks medical students more than to stand around more and be useless, we want to do stuff, to be part of stuff. and i'm determined to make full use of my 4 weeks in internal medicine, including my 4 calls.

it's a lightweight thing compared to what interns actually do go through (i've heard of 15 calls a month!) but it's something totally new to me given the fact that i am in a traditional system (read: spoonfeeding abounds). i hope to learn oodles and to prove to myself that i can do it despite my many misgivings, and to find out just how much my childhood dreams of helping people translates into reality.

i've been rostered to neurology (oh the utmost horrors, i detest neuro with a passion that equals my love for wentworth miller and james mcavoy - did anyone watch Wanted? smoking hot!), and the associate dean happens to be the consultant in charge of me. yes. small, insignificant, tiny, me. i am horrified at how badly my lack of knowledge and my detest of neuro is going to show up badly on the first day! which means i have to go mug up on strokes and epilepsy and headaches and cranial nerve palsies all of today and tomorrow.

and when all else fails, i only have to think of my first ever exam case -
a sweet old man who had colorectal cancer with liver mets at time of presentation. his prognosis was awful. i clerked him after 2999999999 (you get my point) eager medical students had approached him, and he cheerfully agreed on hearing that i had an exam. he recited his history with practice and a smile, asking me whether it was sufficient information to pass and didn't bat an eyelid when i had to return to ask him some more questions that i'd previously missed.
i passed the exam in the end (just barely), and full of gratitude, went back and sat with him for a good 2 hours, just talking about his homeland and his youth. it was a good 2 hours of learning for me, and not in medical terms. about life, love and loss.
before i left the hospital for my next rotation, i ran back into the ward to say goodbye to him, telling him i was leaving. as he wished me luck, and i the same, neither one of our eyes were dry.
i never found out what happened to him (partly because i didn't want to) and i've forgotten his name by now. but i won't forget his kindness and his smile.

i haven't come across many patients like him since then. but i guess your first patient is always the most memorable. i don't expect to have the time to do that for all my patients, but if i can even do that for one, i'll be more than satisfied.

a death in the medical family

2008-06-25T08:58:00.001-07:00

today, there was sad news.

a fellow doctor from my tiny little island has died, from massive haemetemesis, postulated to be due to intractable ITP. much else is unknown.

i didn't know him well, but i do remember the few kind words he had for a despondent medical student struggling through her OB/GYN posting, convinced she was never going to make it.

he wasn't the most stellar of characters, granted, all of my countryment probably knew him by name due to his notoriety and the circumstances in which he achieved it. but he struck me as a good person, innately. i could have been wrong, of course, and biased.

but i will remember those kind words, and how they pulled me through a horrible day.

he may be gone, but the kindness i received will long stay with me.

may you rest in peace.

2008-06-22T09:35:00.001-07:00

awww shucks.
i have just realised that when i wake up in the morning, i will be a final year student. SO NOT LOVELY.

i should be in a blind panic, but thankfully, i'm not. all thanks to the lovely dean's office, which has decided to start my one-third of the class with a 2 week study break! which equates to extended vacation so now i have time to meet my friends who've just flown home from all over the world where they're studying. how lovely :D

then again, you have to wonder just what the administration is thinking when we've just had 4 months of lovely slow-paced electives, coupled with 3 weeks of holidays, who the heck needs to start with a 2 week study break?

but i'll rant about that when i start sub-internship in 2 weeks time!

ahhhh, procrastination ;)

PHOTOS! :D (part 1)

2008-06-17T09:28:00.000-07:00

from top (left to right): our train compartment (and yes, that's my pink bag there, the bagpack is under the seats);

the train station at 4 am in the morning with people sleeping on the floor;

one of the lovely nurses showing us the way to our rooms (check out the white cap!);

the gen med consultation room at night (it has 4 or 5 tables inside and 2 examining beds);

mine and my friend's room;

and cupboards (v messy argh);

the main street in town;

one of the sari shops where i bought punjabi suits/salwaars;

during a political rally!

1. goat!

2. buffaloes

3. sunset over the main road

4. gloves washed and hung out to dry before repowdering outside the ICU

5. the ICU

6. view of the hill from our hospital

7. the circus we visited (the outside) at night

8. nurses hostel with their laundry hung out to dry (things keep getting blown off!)

9. medical library :D

1. during a typical gen surg outpatient clinic (4 doctors around 1 table)

2. the most adorable little boy who sells mangoes outside the hospital - i gave him quite good business i'll bet

3. medical library!

4. relatives sleeping outside the wards

5. in the OT (2 beds in 1 theatre, and there are power cuts. HORRORS)

6. outside the outpatient dept

7. where we were :D

8. main town at night (an hour away from the hospital)

9. our train!

(on our weekend escapade from the hospital)

1. a pretty hotel (sadly, we could only afford to eat there, not stay there :( poor!)

2. chocolate! :D not as good as it looks though :(

3. pretty scenery that we had to inch our way down a slope to get to - the boys went but we girls stayed higher up

4. suicide point!

5. a cow that decided to lie down right in front of our parked car

6. horses for riding! (no, we didn't go)

7. a lake where we went paddle boating

8. a pretty church (why is my photo cut off at the top???) where we went for sunday service

9. a family that miraculously appeared when i whipped out my camera to take a photo of their cute youngest son (half hidden behind his sister) - they're definitely not camera shy!

more will be up later! :D

2008-06-13T20:52:00.000-07:00

anndddddddd i'm homeeeee!!!!!! :D
on my sunny little island after 2 months of nomadic wandering and living out of a suitcase.
i've plenty of stories to tell, and i've really discovered my love for this profession i've chosen. :D i couldn't ask for more! :D

it's not a life changing experience, but it's definitely something for the memories.
photos will be up (after i've blurred my face out of them hahaha) soon hopefully!
and i will blog. but for now - time to sort out my shopping (i managed to shop 20kg worth of stuff from india, don't ask me how!) and my books (they're super cheap over there, i must have bought a tonne - maybe that's how i hit 20 kg worth of shopping! oops)

in the meantime, here's 7 songs i've been listening to this week!

1. no one but you - queen
2. i hate myself for loving you - joan jett
3. always - bon jovi
4. i want to break free - queen
5. chasing cars - snow patrol
6. 100 years - 5 for fighting
7. kokomo - beach boys

2008-05-12T08:05:00.000-07:00

we're in bangalore now! it's the total opposite of the rural hospital we were first in, it's v clean and modern, but somehow all of us prefer the rural hospital better - medicine there is somehow more pure?
our new hospital is also a mission hospital, but it feels bigger and less personal, people are less friendly and welcoming. the food is alot better though!

hopefully things turn out well - i want to type more but the computers here are so so old and outmoded that it's hard to get much done online!

2008-04-23T03:29:00.000-07:00

so i'm in india right now!!!!!

many thanks for all the comments - i'll post up photos when i get back! nothing much yet, sadly.

we're in a small rural hospital that has 75 doctors. it's a non teaching hospital but there's a tonne of nursing students cos it has a nursing school. the nurses here actually wear white caps and it's just adorable! the students wear short white coats and white punjabi suits, the staff nurses wear white saris and generally look gorgeously dignified. their saris never seem to stain or get dirty!

the heat is amazing and i'm suffocating, it's about 38 degrees C here and only bound to get hotter as the days pass. the fan in my room isn't much use, it beats hot air around the place. yikes. mosquitoes and flies abound in plenty! i keep swatting flies in hope they'll stop coming near me, but i guess i should give up soon. heh.

the outpatient load is incredible. there's people queuing up at 7 am in the morning!
i'm doing O&G right now and it's pretty much the same as back home, but my friends doing paeds and medicine have been wowed by the spectrum of patients they've seen! most of them present in the late stages so it's usually florid presentations.
rheumatic heart disease is prevalent - all sorts of murmurs come into play
dysmorphic syndromes is another one

the list goes on - there is much to be said for the lack of sterility here, but they manage.
gloves are rewashed, masks are washable, not disposable, they dont' wash their hands with chlorhex/alcohol handrubs!
i'm getting pretty good at eating with my hands though! :D the canteen ladies have been so super sweet, they ply us with extra stuff cos they know we're foreign.
i've taken to wearing the punjabi suits as it's so super hot!
alright back to the labour ward!

2008-04-17T08:28:00.000-07:00

i'm leaving for india in less than 24 hours!

will blog if i get the chance to :D

meantime, stay safe and have lots of love! :D

tlm - all the bestest with your finals!
jess - see your email :)
xavier - all the bestest for your exams!
harry - continue enjoying yourself in clinicals :)
ms-ellisa - hope that ankle gets better soon, poor girl
cal - i hope your Bsc is wonderful!
dragonfly - enjoy your gyming! :D

shrink - keep smiling, i love your blog!
liana - you're almost an attending! so exciting :)

2008-04-15T08:32:00.000-07:00

oops i guess i'd better explain myself about my career choice!

after re-reading what i wrote, i guess it really does sound like i want to do paeds or neonatology. but the reality is, i hate paediatrics because i'm totally useless when kids cry (i only feel like slapping them to make them shut up - i have not a single patient bone in my body when faced with a crying/screaming/temper tantrummed/etc. kid, and will make an awful parent, i know). plus, paeds makes my brain hurt. i went home with headaches everyday from my paeds posting. there is SO MUCH TO KNOW, and there is so much at stake.
i must admit, a part of it comes from spending time in the hospital as a kid. i detested hospitals and doctors for a long long time. so doing paeds was facing up to all these hidden/repressed memories!

and as for neonatology, i actually did consider it, but i always feel massive twinges in the neonatal wards - the babies are so tiny, and all fighting for their lives. i feel even more helpless, and i really can't bear that they're so helpless and i can't help them.

i have way too much respect for paediatricians and neonatologists to even consider going into their field. it requires far more brain power, patiences and loving kindness than i ever could possess.

i know i also waxed lyrically about ENT/otorhinolaryngology some time back, but thinking hard about it, i realised as fun as it is, i really can't see myself doing it everyday for the rest of my life. i like it very much, but i'm not as passionate about it as i am about OB/GYN. it's interesting, sure, i like it and i enjoy it extremely. but it doesn't get me going first thing in the morning, it doesn't get my adrenaline pumping and my heart racing. it feels exciting, but safe at the same time. and i'm the kid who usually rides the biggest rollercoaster in the amusement park! but ENT is a close choice behind OB/GYN and urology.

urology is much fun! :D that can't be denied. i have lots of fun seeing patients, in the OT and out, i like clinics and it's pretty simple yet you get lots of hands on fun. but it's also a male discipline, for a large part. and i still prefer women's problems to men's problems because i can relate.

whereas, in OB/GYN, i'm dealing with (mostly) motivated patients, who know what they're in for, who are coherent, who are adults and (usually) sensible. the big difference between kids and adults. i love doing deliveries, i love the way the father steals up to the baby after the delivery and ogles over it, the way he kisses and thanks the mother after the delivery, the way they both cry (mother openly, father secretly) whilst looking at the baby, the way the mother eagerly reaches out for the baby and holds it so tight. i love that.
i love picking up the newly bundled baby and looking at it in awe and amazement. and the way the parents show the baby unconditional love.

i love gynae, and how cervical cancer is the most treatable cancer in the world, there's even a vaccine for it! gynae surgeries are simple and understandable, the anatomy is clear and usually a joy to behold.

there is much i love about OB/GYN! :D

so the part about the grasp reflex being the best thing in the world? it's true. but i was thinking more in terms of delivering the baby rather than taking care of the baby. that's all. :)

2008-04-11T10:41:00.000-07:00

and right after i put my big, fat foot down and decide, once and for all which specialty i'm interested in, today, i encounter something that just about cements it :)

i was in the ex-premmie clinic today at the big city hospital, because my tutor runs clinics both there and at the women/baby hospital. so she kindly treated us to lunch and gave us a lift there! how lovely she is, really :D i adore her to bits!

and whilst she was talking to the parents, my friend, P, and i will interest ourselves by playing with the babies and doing a developmental assessment as best as we can on them :)

and today, whilst we were seeing a pair of twins, i was happily playing with the younger one, when she just reached out and grabbed my little finger tightly and refused to let go. there is seriously no better feeling on this earth than having your hand held by a little one. such is the power of unconditional love! :D

OB/GYN, i say :)

2008-04-10T08:29:00.000-07:00

today i watched an episode of house that made me put my foot down and decide to stop waffling on my specialty choice :)

OB/GYN it is, i hope! :D

2008-04-08T08:28:00.000-07:00

i'm so super sleepy, having just watched "oliver twist". that is one mighty cute boy! i'd love to kidnap him home - the eyes alone would do me in.

that aside, the last of my internal medicine remedial is safely over, with an mcq test (in which they repeated more than half the questions!).

so now, i only have 2 weeks of child development left to get through before i fly off! :D i can't begin to tell you how excited i am about flying off!!!

child development has been boring - because i'm not learning anything. we spend most of our time sitting by a small computer screen straining to hear what's going on in the room (we're watching through a camera on the ceiling in the next room) whilst the pyschologist asks questions.

forgive me, but honestly, i didn't ask for this elective to learn pyschology, i took it to learn about ADHD, ASD, CP etc. behavioural paediatrics.
thankfully, we're going into the real clinic tomorrow to play with the kids (and hopefully brush up on our developmental assessments as well!) and that should be alot more interesting.
note to self: BRING COFFEE

i went back to my last hospital on friday to attend grand rounds, it proved mighty fascinating (we saw a video of a laparoscopic AAA repair, congenital malrotation of the gut and others!). and then, my MO stepped up to present a case, and it sounded familiar - i realised it was the poor guy who came in with a perforated viscus and was throwing up blood that i saw in the A&E!

as my MO said the words,"inserted a foley", he turned to me and WINKED. omg i could have died on the spot. how lovely. but it was good to know the poor guy was alright! :D

2008-04-01T03:08:00.000-07:00

it's been a week since i've returned from mountain climbing!

it was, truthfully, the scariest experience of my life. but also one of the best!

i can't say i've managed to overcome my fear of heights, but i know i can push it aside somewhat, and that's a step along the road of recovery? :)

making our way to the summit in the pitch blackness of the night, with only moonlight to guide us, was terrifying once we reached the rock face and had only the rope for safety. i didn't dare to look back at all until i was safely seated on a rock (jumped on it to test if it was steady!) and the view just blew me away. :)

but for now, it's back to hospital! and i'm starting a 3 week elective in child development. it's not as interesting as it sounds, because so far it's been very very boring. hopefully things will perk up after a bit!

doing surgery calls was really interesting. this elderly gent came in complaining of massive abdo pain and constipation, the medical officer was all ready to write him off as having intestinal obstruction until he started vomiting coffee grounds right in front of us. the chest X Ray showed no free gas, puzzlingly, and the vomiting became really really really bad.

they tried to put in NG tubes but somehow it kept lodging against the wall so it couldn't suction anything. and the poor guy was just moaning in pain. poor thing!
in the midst of all that, the MO yelled at me to catherise the guy, so i tried. i honestly, honestly, tried. now guys, please don't kill me.
the first thing i said after cleaning and draping was," where's the hole! omg!"
to which the MO replied," there! SO BIG"
uh-oh.
so i looked. and i looked. and i stared. and i FINALLY found it.
try as i might, i just couldn't catheterise him. after i injected the lignocaine, i couldn't stuff the catheter in!
in the end, the MO put on gloves and showed me how to do it properly. sigh.
well, it was my first catherisation after all!
after this whole debacle, he turned to me and said,"missy, NOT GOOD. you better learn to catheterise male patients soon! and FAST. go get some experience! i can't believe you didn't even know where's the hole!!! tskkk."

uh-oh.

right now, i'm missing surgery muchly, i really don't quite like paediatrics. hmmmmmm

2008-03-29T01:21:00.000-07:00

i'm back from mountain climbing! with aching legs and a sunburn to show for it. but it was well worth it and a much needed break from hospital life! :D

2008-03-12T05:42:00.000-07:00

so england has lost the 6 nations title, jonny wilkinson has been given the boot, anddddd, iain balshaw has been reinstated! :D no prizes for guessing which of the 3 make me the happiest.

it was a totally crap game that was a massive waste of my time. WHAT IS HAPPENING TO ENGLAND!!!! pathetic, really. i think jonny wilkinson, much as i adore him, is past his prime :(

anyway! on the medical front. i've started my electives proper and i must say i'm very happy with my current 3 week elective of surgery/A&E. we get to do both at one shot and that makes ditzy a very happy medical student, which means that i spend more time doing things instead of just sitting around waiting for things to happen :)

it really helps that the doctors i've sought out for this elective are massively nice and dedicated to teaching, i truly do adore them. we're going on call with the surgeon tomorrow and it promises to be interesting, given his penchant for yelling loudly at all times (he just speaks like that! but that's really good for me though, so i'm not complaining!). hopefully we'll get to do procedures and see some cases! :)

rounds have been hectic. surgeons walk so fast! i need more comfortable shoes, i was used to trolling slowly from bed to bed in medicine rounds, and spacing out in between get pimped. now, i can't! we're expected to run ahead of the surgeons, to get the files, to wake the patients etc. this, according to my tutor, is what we MUST do if we don't want to get kicked off rounds. (we got kicked off rounds on monday because he was sick and wasn't there to defend us, and there were 8 students in total on the team, making for a very pissed consultant who ordered us off for breakfast!) so by making ourselves useful, the consultant doesn't mind having us there :)

it's the upper GIT team we're on, and i've been seeing stomch and oesophageal cancers aplenty. makes me sad, thinking about the way they have difficulty eating. eating is one of life's pleasures! and also, given my medical history, i'm more likely than not to get oesophageal cancer. it hits very close to home.

today we clerked a patient who had metastatic oesophageal cancer. he was very nice about it, and didn't mind us taking up his time. a rather handsome gentleman, to be honest! i suspect he has hypopituitarism, he looked rather young for his age. he must have gone through radiotherapy.

it was rather sad. he's been healthy all his life. only thing was, he smoked 20 sticks a day, and drank loads of beer daily. now he's seeing the results of that (it's linked to oesophageal cancer). really sad. but he's lived long enough to see his daughters all married and his grandchildren come into this world, so i guess he hasn't really any regrets. he was sad, but rather jovial throughout the interview, saying that he had a duty to teach us. such patients make my day. funny, it's always on surgery rotations that i meet my favourite patients. somehow, patients in the medicine wards aren't really happy to talk to us. i think it's because they're alot more sick.

admittedly, i didn't ask many questions. instead, i left that to my friends and just looked at him this whole interview. i saw myself lying there, in that bed, in some 40 years. it's awfully scary, and i really should be prepared.

that aside, we went down to the ED later, and i clerked a lady with chest pain. my history was all garbled and i'd forgotten how to ask the right questions by now. my tutor was rather unhappy with that!

a while later, a collapse case came in. a tiny old lady with eyes opened, pupils blown. she'd had metastatic lung cancer and you could actually see the cancer on her skin in the supraclavicular fossa. it was quite terrible. i tried doing CPR, but i'm just hopeless and totally ineffective at it. my compressions didn't so much as register a spike on the ECG, sadly. everyone tried, but as it turns out, she'd probably been dead for 3 days before that until her family found her. loads of aspiration secretions found in her lungs.

it was very sad, really. i was disoriented for a bit after that. i mean, i should be used to deaths by now, shouldn't i? then again, it's a marvel how easily we lose our lives too. nothing is ever for sure.

it's been a long day, i've got loads more to read up on for surgery. i hope you all are well.

2008-03-08T08:02:00.000-08:00

i'm watching 6 nations now!

scotland vs england: the scotland jerseys are sooooo much nicer and more manly looking than the england jerseys (if you aren't fit, white only makes you look fatter).

then again, i shall be absolutely gutted if england loses! especially since toby flood is playing! :) total eye candy for me :)

2008-03-05T07:27:00.000-08:00

my clinical test is tomorrow!!!
and i must confess i'm rather scared stiff.

i managed to miss a whopping big pleural effusion a few days ago, and fabricated up another consolidation. respiratory medicine is obviously not my strong suit. then again, with the ears i have, neither cardio or respi is cut out for me, and rather obviously so!

but the be-all-and-end-all of this medicine remedial (barring the MCQs a month later) is tomorrow. i've scurried around and called my tutor about who my tester is, and apparently he's the youngest and newest registrar and he's super nice. so there's hope yet for me! :D

and the 3 boys that i'm doing this remedial with have finished their tests today and have told me that it's passable, their standards aren't too high and the cases are nothing out of the ordinary. :D in short, i can do it! :D my lovely partner has offered to go on rounds tomorrow (and at an unearthly hour, no less!), even though his test is over, to see what new admissions there are and what patients i'm likely to get for the test. thank God for nice people! :)

but i really do want to pass on my own merit as well, as much as knowing the cases would help, i would also like to pass on my own, just like the final exams next year. i won't be having any sort of help at all then!

then again, i have improved markedly this posting, it's really just respi which is killing me. so maybe there's hope yet!

i hope you all are well! :D when i next blog hopefully it'll be about my lovely tester. haha

2008-02-26T05:36:00.000-08:00

i'm such a scaredy-cat i disgust myself.

for every single tutorial we've had so far where we've done short cases, where we take turns to examine patients.

now, i'm the type who believes in going on a rotatory basis. but the rest of them, apparently, don't.

so that means for every single tutorial so far, i have NOT examined patients, i have NOT presented. in short, i have kept my big mouth shut and stood quietly at the side and tried to be a sponge to absorb. i hope i'm learning that way, because, as far as i remember, i didn't use to learn that way! hopefully our learning habits change as we age :D

but that aside, i really need to pluck up my courage and step forward to volunteer myself. so far it's been nothing but a vicious cycle, where i tell myself to be brave and stupid and volunteer for the tutorial, and then i get cowardly and chicken out. afterwhich, i get frustrated with myself for not being brave and beat myself up emotionally and tell myself to be braver at the next tutorial. it's really a vicious cycle and i get more and more stressed each time. it's not doing me any good at all!

but talking to my sister helped! and now i shall chant the mantra that it's ok to be stupid and to volunteer. i hope it works, we've a tutorial tomorrow again! :) wish me luck yes :)

and dear Shrink - your comment on listening to lungs was incredibly helpful! :)

2008-02-17T02:48:00.000-08:00

i passed! with a B in pathology :) am incredibly happy and thankful on this score!

now, with the ghost of pathology safely behind me (but please don't let me forget too much!) i can safely concentrate on my internal medicine reposting. whew.

i managed to completely fabricate a pneumonia case yesterday - meaning, i knew the diagnosis but couldn't find any signs except shallow breathing, so i made up my own signs of dullness, crackles and increased vocal resonance. i managed to fool my tutor rather well, i must say. he was quite pleased!
unfortunately, this cannot continue if i'm to have any hope of passing my final exams. it simply won't do.

i'm going to be more hardworking and look for people to examine and clerk (a little hard when i don't speak the same language!), and stop going home so early. granted, reading is good, and it IS what my tutor is telling us to do, but at the same time, clinical skills cannot be totally neglected, yes? :)

hope all of you had a brilliant valentine's! :)

2008-02-13T01:45:00.001-08:00

the results will be out on friday! but if you've overdue library fines, amongst other things, you can't check your results online. i sure hope i've paid my dues!

the tiny hospital (or rather, the geriatric hospital) is simply lovely. there are gardens EVERYWHERE. in fact, it seems as though the whole place is a garden, and the hospital happens to be smack right in the middle of it by chance. there's even a soccer court! i guess they're really trying to encourage everyone to be healthy, doctors included. unfortunately, i suck at all types of soccer, table football included. :(

my friend and i have been assigned to a geriatrics ward! which isn't good for me because i can't for the life of me speak dialects, which means that history taking is completely out for me :( thankfully my friend can manage a little and is a really good-looking boy so all the elderly ladies in the ward enjoy pinching his cheeks and cooing over him whilst i stand to the side and try not to laugh in between asking him to translate my questions.

unfortunately, he has had enough of all this and is determined to avoid getting pinched or patted anymore (i stay wisely further away) so we are going to the male wards to find patients after ward rounds for the next few days. i only hope the elderly men are not as affectionate. or else, i hope they're all gay!

and there's an army ward here too! to my vivid imagination, it's full of hunky soldiers with rippling muscles and 6 packs, all ready to be loved back to health. to my friend, i am simply deluded and he insists its full of malingerers and daft guys who're simply unlucky. either way, maybe we'll venture in there soon! ;)

we've been having such early days! as in, i get to go home for LUNCH. my consultant usually dismisses us after ward rounds, which end at 11 latest (there's only about 12 patients) and we usually hunt around for a bit to see if there's any nice patients who'll talk to us or let us examine them, then we head home for lunch. and this despite my staying almost 2 hours away! i get to eat lunch at 2 plus latest, which is great because i usually hate hospital food. :D
and speaking of which, the canteen here doesn't look too bad, but it's really small. not much choice! so i'm happy to go home for lunch, as you can tell.

there's so so much to read up on, i feel as though i've forgotten ALL my medicine stuff. it seemed much easier 1 year ago! then again, memory erases the bad and keeps the good. anyhow, it's a good reality check as to how much there is to re-learn, or rather, learn, because i'm really doing somethings for the first time.

neuro is terrible as usual, i cannot elicit the right signs, let alone localise the signs or remember the 6 syndromes of 3rd nerve palsy etc etc. neurologists must be an incredibly brilliant bunch! i've a good mind to practice the cranial nerves on my parents everyday, though i don't know how much they'd stand for it. hmmm. but something has got to be done, i really really don't want to risk looking like the stupidest pea in the can when the prof takes us for a neuro tutorial tomorrow.

meanwhile, thanks for all the kind words and encouragement :) it's been a lot of help! :D

2008-02-10T02:00:00.000-08:00

i'm back! :D

we've been busy celebrating a traditional festival and thankfully i've been spared from the usual cheek-pinching by relatives i've not seen in yonks because we've been hermit-ing at home this year. whew.

anyway in other news i've been posted to a small hospital rather far from where i live for my general medicine remedial. it's the smallest major hospital where i live, and is renown for its long-stayers and sizeable geriatric population. not much general medicine there, apparently! but i've heard the doctors are amongst the nicest to be found so hopefully that'll save our sorry arses from a second failure!
to be honest, i'm rather looking forward to it. big hospitals feel rather impersonal sometimes. on the other plus side, there's good food around this small hospital! :D food is always always a plus point - hospital canteen food is usually not much fit for eating. :\

so i'm off to go study a little on neuro exam so i won't look like a total airhead in front of the doctors tomorrow if we are so lucky enough to get a tutorial on the first day! :)

2008-02-03T09:31:00.001-08:00

THE LIST IS OUT!

that was the title of the email i received from the department, announcing the do-or-die list's arrival.

if your name is on the list - good luck to you. you are now called to sit for an oral exam in front of the WHO'S WHO of the department setting the paper, which means ALL the profs and emeritus profs and profs-who-love-to-fail-students. yikes!

however, if your name isn't on the list - then it's WHOOP-DEE-DOO!!!

and so, the email read:
"if your name is on the list, you would have been called by the department to notify you of your time slot for the oral exam" (or something like that!)

and so, i rush to check my phone! (which happens to be charging! damnit that's half the house away!)

and to my horror, bright and clear on the screen: "1 MISSED CALL"

cue canons and earthquakes and utter despair! (yes, i am such a drama queen). after staring at my phone's screen in shock and horror and alternating between "omg wtf, this can't be true" and "omg omg i so knew it! i'm doomed to fail!" for what seems like an eternity, i finally pluck up what little is left of my courage and call my class head, who's checked out the list himself.

to my sheer relief (this sounds wayy too tame for the internal combustion i went through - isn't there a more dramatic word!), i am OFF the list.

and so i thank God and all the wonderful angels above who watch over me daily despite having no time to study and going on vacation just before the papers, i have, for want of a better word, PASSED.

the rest is totally inconsequential, because PASS = MD.

i'm not on the smarties oral exam list either, but that doesn't matter, because i am totally OFF the do or die list. so there.

i'm not the smartest pea in the can, but i'm fairly competent and that's enough! :D i've given my best, and i'm going to be happy with it. (well, until the results come out and i get the lowest possible grade alive - then cue more drama queen antics!)

meantime, time to polish up on internal medicine! i've got 4 weeks of remedial to make good on myself (angry medic, i totally hear you right now) and i'm determined to pass this and clear my name. no more slacking off, no more fooling around. it's serious business! ;)

2008-01-30T08:00:00.000-08:00

IT'S OVERRRRRRRRRR!!!! -flings papers in the air merrily and prances around-

YAY!!!

admittedly, it wasn't a perfect paper (in my dreams only!) but heck, i'm hoping that it was enough to pass!

now i'm off to enjoy myself, head to the beach for a tan and some sand, sun, sky and (pseudo) surf! the 4 "S"s stand for 4 of my most favourite things in the world :D

there's a little black cloud on the horizon, that is, the pass-fail results on monday which determines whether i'll need to sit for an oral exam, but right now, i'm just going to take it easy and worry about it then! :)

2008-01-26T08:27:00.000-08:00

it's do or die!

1 more day to the beginning of the end, and then hopefully i'll be free and escape the re-paper.

nothing is staying in my head at the moment, it's a "i vaguely know the answers, but i don't know the answers" kind of feeling.

it's quite terrible, and I HATE PATHOLOGY.

then again, maybe positive feedback and positive pyschology does wonders, so I LOVE PATHOLOGY! I LOVE PATHOLOGY! I LOVE PATHOLOGY!

to stave off boredom and stress, i watched chariots of fire tonight, and ohmygosh, the boys are so young and handsome and the show is so totally inspiring! no prizes for guessing my favourite - lord andrew lindsay! i'm a sucker for bright smiles and bright eyes :D

cute medic boy made a reappearance today (if only for a few seconds!), smiled at me, and then promptly disappeared back into the bowels of the hospitals for his examination prepations. the seniors sure have it much harder - the final FINALS are coming up! :( and that's going to be me all too soon.
(tlm - just how do you stand it!)

and heath ledger is dead! OMG how did that happen! according to the reports it seems that the anti-insomniac drug he took had a bad side effect? maybe it was the synergism of all the pyschiatric drugs he's been taking. :( still, it's a great loss! :(

alright, it's back to pathology. slides and histology, cytology and gross specimens, my brain is exploding and cumulating in a liquefactive mess of necrosis and inflammatory infiltrates of predominantly neutrophilic nature!
yes, being nerdy helps i hope! :)

ps: THANKS JESS! :)

2008-01-19T04:26:00.000-08:00

just a quick update - i'm alive!

barely, but alive. i'm drowning under mountains of paper and books that i haven't seen since we ended year 2, of which they're only examining us on right now.

i've skimmed through the syllabus once through but i can't remember anything, unfortunately :( hopefully it'll come back to me when i start doing the questions! have been camping in my friend's room for the past few days and i'm finally home for the weekend (internet access, hooray!) and it's really good to see my parents again :)

no signs of cute medic boy though! :(

the stress has permeated every corner of the library and school, and it's KILLING ME :(

hopefully it'll all come together in the next week! ONE MORE WEEK to exams!

may you all keep safe and enjoy yourselves! :)

2008-01-12T06:14:00.000-08:00

today was another happy day! :D

1. my college softball team won the tourney! :D with me as honourary coach and cheerleader. if only i was staying in college this term i'd be eligible to play! darn it, the 1 year i don't stay and play, they win. murphy's law :( but i'm still so happy! :D

2. cute medic boy was studying at the next table all of today! when i left to go watch the match, he was there, and when i came back, he was still there! and he said hi and bye to me as i left. YAY! :D

studying is coming along, but painfully slowly. :( am desperately worried i won't even complete one round of reading, but i'm going to do the best i can.

it's a ban on computers for the next 2 weeks! :( wish me luck please!

2008-01-11T05:53:00.000-08:00

i'm back! :) and it's really lovely to be home. i cried the minute i stepped out of the plane into the familiar airport. my goodness.

but it's so good to be home! good golly, i sound like a real homebody. i guess i must be! i have no idea how i'm going to manage to endure 10 weeks away from home during my electives!

many thanks for all the well-wishes and calming comments! i did manage to make it for my lecture (which proved useless) and submit the online forms. and wrangle an extension from the admin staff for the submission of the other forms.

but OH MY GOODNESS i totally miscounted the days to my exams! and now i have 2 weeks left instead of 3. OMG. i am SO SO SO DEAD. i really have to work much much harder now and my hopes of passing have just about gone downhill drastically, but hopefully it's still do-able somehow.

2 weeks left to exams! which means i will wake up in the wee hours of the morning, stumble blearily to school and attempt to study, take lots of breaks in between and gossip and play games, and study till late at night before my kind parents decide to take pity on me and fetch me home (i still haven't passed my driving!) or i crash at a friend's dorm (why didn't i chose to stay on college! why! why! why!)

only 2 weeks left!!!!! GAH.

but here's wishing you all a very belated happy new year! hope your christmases were all lovely :)

new year resolutions are:

1. stop procrastinating and actually do some work - i really need this. finals are only a year away and i'm still half-arsed about all the stuff i'm supposed to know, meaning i know nought. nothing.

2. put more effort into what i do - if it's worth doing, it's worth doing well! so there.

3. stop eating so much sweets and drinking so much caffeine - my caffeine addiction was so bad at one point i had to excuse myself from tutorials to run to the vending machine for a quick cup of coffee because i couldn't concentrate. oh dear. and i have got to stop eating sweets. my group mates pinch them off me all the time as they know i always carry sweets, and thus i am perpetually buying sweets for my group. SAVE MONEY!

4. which brings us to this: STOP SHOPPING RECKLESSLY. save money. nuff said.

5. exercise more - i'm not about to let last year's half-marathon go to waste! aim is to run 5 k at least once week and lift weights once a week. sounds miserable? well, i'm a medical student. we have no lives, remember?

6. spend more time with those who really matter. i'm sort of learning how to do this, it's a matter of spending more time with my family now :)

7. be neater. oh jess, i totally agree with the paper avalanche bit. my room is a disaster area and i can NEVER find anything when i want it. it's terrible. i have to shift stuff around to sit down or sleep. awful!

8. to be a nicer/meaner person. say it like you mean it - no more hiding behind things and pretending to care when i don't, and actually trying to be nice. paradoxical maybe, but i know what it means :)

9. to speak up more. i tend to be timid and hide behind my groupmates in hospitals because i'm never sure of myself. NO MORE BEING COWARDLY!

10. lastly, to devote more time to God and prayer. i really need this.

alright, 10 resolutions, made late! hopefully they stick for a bit. i'm not too sure about the coffee one though, with exams looming drastically near! :(

but may this year ahead be a good one, you all! :)

2008-01-07T13:26:00.000-08:00

apparently, medical students don't go on vacation?

i've just gotten ahold of internet access after trudging through italy (gorgeous place, gorgeous people!) and i've found my email account inundated with all sorts of school-associated stuff, from updates about the upcoming exam schedule to tips and revision lectures and to arranging electives - all of which are going to be OVER BY TIME I RETURN HOME!!!!!!!!!!!!!!

i'm burning up with stress right now, i don't know what to think or do. all i can think of in my blind panic is how much i am in the deepest of shit (and yes, i haven't started my studying for the exams either, and they're major ones!!!)

oh woe. maybe medical students don't go on vacation after all. lesson learnt? take shorter holidays with internet access. :(

i'm sorry this 1st post of the year is so negative! but arghhh, the stress is killing me. a happier post soon i promise!

2007-12-28T13:41:00.000-08:00

this post is coming to you from europe!

hope you had a lovely christmas everyone! :)

i have shopped and shopped at the boxing day sales - crowds are CRAZY. they throw clothes etc on the floor and think nothing of pushing you out of the way to grab a bargain. humans are really animals, to think of it.

couldn't resist a bit of dorkiness when i passed by the Guy's Hospital - had to take a photo of it! (not with it, mind. am not that dorky yet!)
didn't spot any medical students (no white coats!) so too bad.

and have heard stories of how awfully screwed up NHS is. yikes!

alright time is out! i don't want this holiday to end - i have exams right after this and should be studying :( but i'm on holiday! :(

2007-12-19T08:34:00.000-08:00

and so man u won!! a scrappy terrible game, but the luck was with the winner and that's all that matters - the 3 points!

enough of prattling on about soccer now, let's talk about something else!

there have been christmas decorations aplenty in the hospitals, mostly along the offices. NONE in the wards, where i would assume the people who need them the most would want them?

so much for spreading goodwill and cheer this season eh. apparently office staff can be bothered to pretty up their offices (is there some competition?) but not the wards. the sick and ill don't need cheering, i guess.

but the good thing is that volunteers have been popping by to say hi and sing, and it makes me happy to see small kids smiling toothily away!

a fact: i love kids too much to do paeds. and also: i don't possess enough brains to do paeds.

anaesthesia's coming to an end, can't say i've enjoyed it much. but it's been lovely sitting in the ORs - i love nothing more than seeing surgeries! scrubbing in is even better - but my complete lack of anatomy gives me away. ORs are FREEZING, by the way - are surgeons all very fat and thus well-insulated? NO. so why so cold? i have no idea, honestly. i spend the last 2 weeks freezing my arse off!

am still trying to write my report, but keep getting distracted! urghh facebook i blame you!

we had a patient stimulation earlier this week, in which we were individually brought to a dummy and given an emergency scenario where we had to rescue the patient - i managed to rescue mine! although, on hind sight, i should have done alot more things, but at least i managed to keep him alive till the end of the scenario. i have to admit, i spent more time staring at the monitor chewing my nails and wondering what the hell i should be doing next to increase his blood pressure and slow his heart rate! basic physiology - ALL forgotten. sigh.

well, a blog post very much about nothing.

2007-12-16T04:47:00.000-08:00

it's here it's here!!!

THE day of the season when man u play liverpool. and more than that - chelsea plays arsenal!

YIPPEEEEE!!!!

this day will probably never be repeated in history, so to commerate it, let's indulge in some eye candy!

1st match: man u vs liverpool

fernando torres from liverpool

and cristiano ronado from man u! (there is only ONE red team)

2nd match: arsenal vs chelsea

and now, before any detractors cry out that i am just another air-head watching for the good-looking guys, let me assure you that they're simply a bonus.

hey, i started watching soccer before i hit my teens! i can most certainly assure you that i wasn't interested in guys at all then ;)

i can most certainly hold my own with discussing with the guys about football players and game plans, although i'm not an expert (i am undoubtedly the expert on good-lookers) and i didn't finish last in the fantasy football league. so there!

and i am most certainly a man u supporter! stand up proud and say it loud: MAN U!!!
(have to admit i fancy the pants of torres though - man u is suffering from SUCH a dismal lack of eye candy! of course, i'd have to say kaka thrashes them all hands down - a good looking lad if i ever saw one!)

so there - may man u thrash liverpool's arses and wipe them clean off the field, and may chelsea and arsenal have a lovely goalless draw littered with the red cards that arsenal is known for. how lovely! :D

most sorry if i've offended any barking mad arsenal, chelsea, or liverpool fans out there - you know how it is in football team rivalries so please forgive my own barking madness!

enough of fan-girlyness - on to the matches!

2007-12-14T07:03:00.000-08:00

because i am tired, and sometimes you just need hope that there'll be a better tomorrow.

met a lovely ENT prof in the OR whilst pottering around waiting for things to happen. managed to ask him a few questions regarding my pawp's friend - who happened to be treated by him! i had no idea, and neither had he. i guess it's one too many patients!

but it's always lovely when profs make time to answer your questions, so you don't feel like the lowly medical student aka dirt-on-the-bottom-of-the-shoe or MRSA-in-the-OR. yay for good profs! and he wasn't even in charge of me - i'm doing anaesthesia now!

anaesthesia, on the other hand, is a whole different story. far be it from me to enthuse about anaesthesia, and far be it from me to say i have the brains needed to do anaesthesia. i have been routinely amazed at how much information the anaesthetists/anaesthesiologists (whichever they choose to call themselves - i'm clueless in this aspect) have at their fingertips, and their calm and serenity in handling all sorts of situations is nothing sort of breath-taking. i freaked out when i saw i grade 3 larynx - no glottis in sight at all!!! and yet, the anaesthetist calmly looked and asked for another blade and just intubated the patient. like that! snap fingers!

2007-12-12T01:13:00.000-08:00

i managed to successfully intubate my first patient today! on my first try! :D

granted, my tutor was holding my hand with the laryngoscope. but still! yay! :D

although, being in the OR made me wish terribly that i was on the other side of the curtain observing the surgery instead. thankfully, my tutor was fairly understanding, and after yakking a fair bit about anaesthetic drugs, allowed me to scoot to the other side of the curtain to witness the surgery. pretty cool surgery too, a Le Fort I.

i actually couldn't see the cords when i first slid in the laryngoscope, but a little gentle traction does wonders - the posterior end was revealed immediately, and cricoid pressure allowed me to see the glottis. WAY COOL. so sliding in the tube was definitely easy.

i'm looking forward to doing more procedures, hopefully i'll get to do them in the ENT OR where there's higher turnovers compared to the spine ORs (one spine op can take 6 hours! even worse are the cardiothoracic ops) it's just too bad i'm not rostered to a GS or OB/GYN OR - life would be so much more interesting (surgery wise i mean).

my tutor seems like a pretty nice guy, he speaks with a Queen's English accent. very clipped and precise! and he reminds me terribly of my previous ortho tutor, i really have to keep reminding myself to call him by the right name!

all in all - a good day :D

hope you lot are gearing up happily for christmas! :D

2007-12-07T07:02:00.001-08:00

having been tagged by xavier (someone please teach me how to insert links???), here goes a meme with 7 random facts!

1. i'm not from europe (sorry jess!), but i'm going to visit europe soon though!

2. i have many, many, MANY eye candies. so much so that my friends roll their eyes when i point out a cute actor/sportsmen/doctor/medic/random person.

3. when i was young, i wanted to do medicine because i thought white coats were the coolest thing alive! really. (of course it's not the only reason now!)

4. and i said so in my medical entrance interview. which got the professor snorting with laughter, and he remembers me to this date. apparently humour gets you places! little did he know i was being serious.

5. my caffeine addiction only started in medical school. or rather, when clinical rotations started. sigh

6. i am not a well person. as in, i have diseases that are considered serious by any standards, but more on that another day. (no, it was not a motivating factor for entering med school - see point 3!)

7. i used to love christmas, but since something happened it hasn't quite been the same, but it's still my all time favourite season of the year :)

and i have to cheat and agree with medstudenitis that i cannot wear high heels. sigh no pretty feet and shoes for me!

2007-12-05T05:59:00.000-08:00

i did something stupid. uh-oh.

we were sent back to hospital where i first started clinical rotations in, and by pure chance, i saw... my very first tutor!

who, erm, coincidentally happens to be major eye candy for me. (no one else seems to think so! POOH. he's young, cute, has a great smile and great spectacles, and is always friendly! not to mention highly talented!)

and so, i saw him, turned and almost swooned, then fell right on top of my friend and gave an undignified sqwauk.

very very brilliant, ditzy. sigh. :(

thank God, being the busy surgeon that he was, he was rushing off someplace and didn't witness the entire incident. whew. thank God for small favours!

2007-12-02T02:26:00.000-08:00

it's done it's done! i'm suffering from aches and pains and lethargy right now, but ohhhh, it feels good having crossed the finish line after the half-marathon!

it was so hard to keep going at some points though, when your spirit is telling to give up because really, it seems as though the end's no where in sight.

but along the way, there were great motivating factors :) seeing the sunrise (well, a part of it!) was really inspiring, and needless to say, crossing the finish line was the most inspiring of all!

what really struck me were the supporters though, they were so tireless in yelling and cheering and waving balloons. briliant, really. must have been tiring to keep shouting like that! and their unflagging cheer was contagious, i found myself breaking into a smile when running past them.

ahhh. life is good.

now, if only i could walk properly, then life would be perfect.

note to self: must not overdo this aging body next time!

2007-12-01T05:07:00.000-08:00

after 6 months of on-off training and several runs in between them, tomorrow is THE big-day!

the half-marathon beckons.

i don't expect to be able to run all the way to the finish, but running most of it would be ideal. sadly, my fitness is still not up to par!

but oh well, nothing left that i can do between today and tomorrow except sleep early!

hopefully i'll still be alive when i stagger across the finish line. crikey!

2007-11-26T05:24:00.000-08:00

i'm still really upset that my paeds elective has "poofed" into thin air. ARGH.

but a kind friend has offered to let me do an ortho elective with him so that's alright now! :D ortho is way more fun than paeds and it's important for exams too so that should be fine.

but what i don't get is:
WHY TELL US SO LATE!!!!

yes, this is a rant against the administration.
they jolly well knew that they were taking year 3s for that period in which we'd applied for electives so they'd be unable to handle us at that time as well.
and i'm sure they had all this planned long ago too.
so why tell us only now???

i'd already planned and settled all my elective slots, only to have it ruined by a cursory late announcement like that. why not tell us right from the start when announcing elective choices?

it irks me that students are taken so lightly. it's as if we don't matter at all, we're an afterthought.

they can't even be bothered to tell us properly, just a short email with 3 lines to it.
not even any apologies. and my elective supervisor didn't even know! good golly.

i know students aren't that important, but for goodness sakes, would it kill you to have released that announcement 3 months earlier or something once you knew?

it's not just me who's affected, it's a whole bunch of us.

it smacks of high-handedness and uppityness. don't look down on us please. we're humans too!

now i've to find something to do in that one week between surgery and ortho. ARGH.

(here's an explanation for jess!)
where i come from, we have an elective period of several months after completing most of our core curriculum at the end of year 4. so we get to do stuff we want to during this period, or we have to do remedial postings if we've done badly in any of our current postings - i'm scheduled for one boooo.
anyway, we have finals at the end of year 5, which is why the elective period is so important because it affords you: 1) the chance to brush on your weak subjects before heading into the "death" year, so to speak; and 2) the chance to do something you really like that you haven't gotten enough of in the core curriculum!

hope that explains it sufficiently! :D

and thanks a million xavi and jess!

2007-11-22T07:20:00.001-08:00

my paeds elective just got cancelled! :(

and i have and ENT test tomorrow that i haven't studied for yet. :(

can my life get any worse?

pardon the melodrama but oh, i really did need that paeds elective to have a chance in hope of passing my finals, having done paeds so very very very long ago!

WOE. am most definitely NOT HAPPY.

all the love in the world for ENT isn't really helping right now. arghhh

2007-11-16T09:05:00.000-08:00

I PASSED OB/GYN!!!!!

thank the sweet Lord above for merciful grace!

although i didn't quite do as well as i'd hoped (i'm in the bottom half of the class), and this quite puts a rethink to my OB/GYN dreams, i'm happy :)

passing was what i asked for, and passing is what i have received :) shouldn't be greedy!

next time, i will work harder. but then, what's the point in burning out so early?

my mantra has always been:

PASS=M.D.

and i'll keep it that way :)

FOR NOW: OB/GYN is over!!!!! but i'm still applying for a rotation in it no matter what - delivering babies is truly thrilling, and i can't get enough!

2007-11-14T07:10:00.000-08:00

I LOVE OTOLARYNGOLOGY !!!!!!

(or ear, nose throat - ENT for the uninitiated)

i have been standing in clinics for the past 2 days, non-stop. ordinarily, i would be complaining about backache and how boring it has gotten. but strangely, i am energetic and well, my back doesn't ache as much as it should!

it might be the lovely doctors who're ever so willing to teach, or the interesting cases i see.

then again, it might entirely be the free drinks machine. coffee anyone? i have been max-ing out on my caffeine. OOPS.

but seriously, although i hate hate hate looking down microscopes, ENT has been fascinating. i actually want to read up on it to know more. i want to peer down the endoscope and see vocal cords and other things.

whoohoo!!!

i actually felt an enlarged lymph node today. amazing. usually i'm the one who'll completely miss it, but today, i actually got to feel it. and a thyroglossal cyst!
but on a more sombre note, thankfully both conditions were benign.

i went up to the wards, and spoke to a patient's mother. it made me greatly upset. but more details another time.

for now, i have to present the case at grand ward rounds to the prof tomorrow. i'm trying not to quake in my shoes about my lack of knowledge about quinsy, so i'm off to read up and try not to get royally owned! ;)

2007-11-10T08:03:00.000-08:00

thanks for all the comments on ENT! i haven't decided if i'm going to do it, but it's definitely one of my top few choices. :)

after being assured by the rest of my cohort who had already sat for the opthalmology posting exams that it was as easy as pie, i went into the exam room, well, not very prepared. a gross understatement.

as it stands, i managed to completely fluff 2 slides out of 10, and mess up quite a bit of the rest. hopefully i'll scrape a pass!

this is a severe reminder that "easy as pie" is only true IF you have studied. i really really do need to remind myself that not everyone takes things so lightly. and i neither should i, really.

i realise that eye surgery freaks me out. as in, REALLY freaks me out. i can't stand the thought of anything touching my eye besides my contact lens!

i don't know how the glaucoma patients do it, when they have their IOP measured with applanation tonometry. how can they sit there passively and let the probe touch their eye? me, i'd bolt.

we had our IOPs measured, and it took me 8 tries to finally open my left eye enough as they fired air jets into it. OWWWW. that was freaky enough!!!! thankfully, i don't have glaucoma.

and eye surgery is way cool, but also way freaky. the thought of cutting an eyeball? just a NO-NO. cutting some's abdomen, yes. cutting someone's head, yes. nose, yes, throat yes, legs and hands, yes. basically, anywhere besides the eye = yes.

to be awake as the surgeon gives a retro-bulbar anaesthetic to numb your eye? OWWWW. i almost freaked out.

and worst: to be able to see the scalpel coming to your eye whilst you have stitches removed in clinics on follow-up? MAJORLY FREAKY.

patients definitely have more courage than me. i guess if you really need to, you summon up the courage from somewhere. but oh please, dear God, don't let me be the one needing eye surgery now. call me a wuss, but oh, really! i can't stand anything touching my eye!

corneal transplant

then again, being me, i still do want to have LASIK. ahhhh, the price of being vain!

but opthalmology is OVER! and now, for ENT!

2007-11-03T23:56:00.001-07:00

am back! and most sadly, have started school :(

HOLIDAYS ARE NEVER ENOUGH :(

but i've had good trips so i'm happy! can't ask for too much eh.

i managed to catch the rugby world cup finals (albeit a delayed telecast!) and was HORRENDOUSLY DISAPPOINTED.

ENGLAND HOW COULD YOU DO THIS!!!!!

ok, i know it's not their fault, but arghhh. i was so rooting for england to win!

alright enough of that!

like i said, i'm back in the hospital now, and am looking into the windows of people's souls.

so opthalmology isn't that boring after all! unfortunately, am as blind as bat. whilst everyone else seems to have no problem using a fundoscope to see lovely beautiful optic discs that are hyperaemic/cupped/elevated margins/pale etc etc, i have problem even seeing the blood vessels of the eyes. :( am a complete utter failure at this. i can't even tell if the blood vessels lead to optic discs, and have blinded several patients with my (borrowed) fundoscope by now, i'm sure, with the blindingly bright light i use.

fortunately, a nice resident told me to steal some pupil dilators (short acting) from the clinics, and to go home and dilate my family member's pupils before bed and to see their eyes. teehee. will be trying that out soon, and i'm keeping my fingers crossed in hope that i finally do succeed! :)

going to the OR and being allowed to look down the zeiss microscope during a cataract surgery (a phacoemulsification) was THE BEST THING EVER! i can see just why people fall in love with opthalmology. the clarity of the images, the delicacy of the surgeries, and the feeling of satisfaction when the lens slides in place; you just know that you've done something incredible and helped this man/woman get sight back.

AHHHHH. the miracles of modern medicine! incredible.

also saw a botox jab to relieve a facial spasm. also incredible.

but botox is so freaking expensive! 300 for unilateral crow's feet, and 400 for unilat upper eyelid jabs. eeks. plus you've to redo them every 6 months or so.

eye candy abounds in this department, no doubt. the guys have been trying their darndest not to drool at all the lovely females around, most of whom would be considered v pretty by most standards.

in the male eye candy department, it is rather lacking, sadly! but i've found one who more than makes up for it. he's earnest, kind, and willing to sign my attendance so i can go off early. OOPS. and he's so geeky cute! i'm such a sucker for geeky guys who're cute. suffice to say he's the reason i drag myself to early morning clinics when i'd otherwise be at home sleeping. and meeting him in the OR was the best thing ever! :)

oh dear. i realise how pathetic that sounds. but it'll be over soon, we're moving on!

all in all, i don't think i'm going to do opthalmology though, it's too narrowed and sub-specialised for me. i think i'd lose interest quickly.

one more week! and then i move to another glamourous specialty. but tests and reports await first :(

i can safely say that otolaryngology interests me far far FAR more than opthalmology. bring on the scopes and hearing devices!

2007-10-19T08:39:00.000-07:00

horror upon horrors! have realised am going to miss the rugby world cup finals because will travelling :( oh sadness. my heart is breaking! i can only pray where i'm traipsing to has cable. if not, i will be one heartbroken girl.

and yes cal, jonny wilkinson TOTALLY wins! :)

but holidays have been fabulous. even if i only have a 1 day break in between trips - i would much rather do this than go to clinics ANYDAY. am so terrible! definitely not your typical med student!

where i just came from :)

am looking forward to my next holiday tomorrow, hopefully it'll be as fabulous as the 1st! :)

meantime, please keep safe and enjoy yourselves! :) if you're jealous, just think, in 1 week's time, i will be back slogging away in the wards again. so there ;)

2007-10-10T07:12:00.000-07:00

instead of studying for my upcoming OB/GYN exams like the good girl i should be, all i am doing is watching rugby.

yes, rugby. world cup fever has hit where i live!

in particular, england.
no, not because they play well, or because i like jonny wilkinson's butt everytime he lines up for a kick (suggested by a guy friend as a reason for my deep undying love for england), but just because.

and also, they have the best looking player in the game! which accounts for a very very teensy, tiny part of why i support england. (really!!)

altogether now: awwwwww.

i heart you toby flood! may you make more tries and convert more kicks for england!

then again, if new zealand was still in the world cup, i doubt i'd very much notice toby flood at all. anyone thinks much of dan carter? ;)

right. back to OB/GYN stuff

2007-10-06T05:35:00.000-07:00

OSCES for OB/GYN were today, and suffice to say i bungled it up miserably. most miserably. it was my own fault for snuffing those stations which i prepared for (and well-prepared at that), and not preparing those that were strongly hinted at which to come out.

it was 10 min per station, and i got chased out of 3 stations early with a disappointed look on the examiner's face. rather ghastly. i couldn't answer questions like: so what is the cause of the foetal distress? can't you pick it up from the history? to which my only answer was: am very sorry, i really don't know.

that went on. and on and on and on. which left me feeling utterly demoralised and broken after the exams, so much so i had to run to the toilet and cry. not a good thing, considering i have never ever done that before.

but i'm home now, away from that stress. 1 more week till some much needed rest! theory papers await. one more week!

2007-09-22T05:51:00.000-07:00

this is what babies really truly look like when they've just been delivered. all icky, screaming, crying and definitely not cute at all.

and yes, we really do check the genitals 1st thing once the baby is born!
very important ;)

and after that, once they're big enough, they can be dressed up like this!

everyone, altogether now, awwwwwww.

delivering my 1st baby was an experience. or maybe lack thereof. i did basically nothing but put my hands on the baby's head, and the midwife did the rest. but still! it was one of my lifetime experiences. i mean, how many people get to help out?

but before we get to the delivering babies part, let's deal with the observing deliveries part.

where i come from, we have a falling birth rate. and that thus equates to less deliveries to do. and that thus means many many medical students fighting for few patients. so you have to wait till you go on call to try your luck!

and when we were on call, it just so happened that a senior i knew was on call and very willingly showed us the ropes despite being a busy sleep deprived intern himself. thank you very much! that, in essence, is exactly the type of doctor i want to be. never too busy to teach.

and so, i got to observe a birth first. the mother was a young skinny girl, she looked almost too small to be carrying a baby! her husband to be was 8 years older than her. very tall and skinny. and they're getting married shortly. she was in labour for real long, and vomiting and screaming and crying in pain. and through it all, he held her hand, wiped her vomit, and cleaned her up. wow.

and the birth itself took more than 2 hours. geeee. she had no strength left to help push, and couldn't put herself properly in the crunching position, so i ended up helping to hold her leg for 2 hours. my hands almost fell off after that.

andddddd. she made progress of 0.5 inches (descent of baby's head) in 1.5 hours. geeee. but shortly after that, she really picked up and the baby was born within the next hour! :D everyone was so relieved. me, i was just grateful i didn't have to hold her legs anymore, my arms were so tired.

but ohhhh, the baby was so so so cute! big big eyes and chubby cheeks. :)

and scarily enough, she had extensive perineal damage and the repair took an hour. and she couldn't stop bleeding out. thankfully it stopped after a whole lot of rubbing.

and now mother and baby are fine :) thank God! :D

it was the first time a patient ever thanked me. even though i didn't do much. but i really was so thankful that they were both alright.

and so after that much drama, i went to sleep. only to be woken up by the intern yelling that a delivery was in. for me!

and that proved pretty uneventful as the mother already had 2 children prior to this :) very easy and fast delivery, over within 20 minutes with minimal perineal damage. although i did nothing, it's definitely something to remember :)

i think i'm in love with OB/GYN!

2007-09-09T07:37:00.000-07:00

long time no update!
am sorry :( hope this post finds you well!

have started OB/GYN rotation. is hell on earth.

actually, i do love OB/GYN. it's really really fun and interesting to boot. however, the early hours and the countless tests are driving me up the wall, coupled with the huge amount to study and the fact that in 4 weeks time, i'm going to be sitting for a BAO (bachelor of obstetrics) instead of the usual end of rotation test. it's a degree!

and that is enough to freak me out.

BUT i love what i'm doing, i love seeing patients, i love the surgeries despite how bloody the c-secs are, i love deliveries, i love gyn onco, i love urogyn. everything else is passable.

in short, i'm having the time of my life. except for the studying. ah.

2007-08-05T02:45:00.000-07:00

i faced the dreaded OSCEs!

hopefully i'll wrangle a pass somehow. over here i'm not quite sure if failing one station means an overall fail even if we pass the rest but i'm really quite hopeful i'll make it. failing this means failing this rotation in ortho and means having to forgo my electives next year so i'll really be quite devastated!

i'm pretty certain i passed 4 out of 5 stations, the 2nd station being a very big dubious question mark. our OSCEs this time round concentrated on clinical examination in ortho, namely the knee, hip, spine, hand and shoulder exams.

spine station was easy, PID/DDD no questions asked. patient (all patients are actors by the way) was perfect, giving positive signs and cues without my even asking at points. but managed to piss examiner off with my bowstringing test, apparently the examiners don't quite concur?

hip station was horrible. the patient complained on hip pain. and i have not a clue on how to do a hip exam. thank goodness my tutor was in the room and greeted me cheerily when i entered. as usual, i managed to bumble the exam by starting on the pathological side first (a BIG no no - always examine the normal side first!). patient wasn't as helpful, but very obliging. tutor even went," oh just skip that part" when i was spouting my usual drivel about wanting to fully expose the patient, saving me time. BUT i forgot Thomas' test (which is very very VERY impt in hip exam) and i almost forgot to measure limb lengths until my tutor pointedly asked," ditzy, are there any more tests you wish to perform?" TWICE. and he had to discreetly point at the measuring tape too. OMG. if he wasn't my tutor, i think i wouldn't have half a hope in hell of passing this station. this is definitely one dubious station. i hurriedly diagnosed the patient as having secondary osteoarthritis likely due to his fall on his buttocks many many years ago. geee.

shoulder exam was mostly alright, except i misdiagnosed the patient as having an impingement syndrome rather than a partial rotator cuff tear. hope that didn't count too substantially!

hand station was fine, carpal tunnel syndrome with split sign on ring finger. positive tinel's easily faked by patient, but she gave positive phalen's in BOTH hands. eh? nevermind. the prof was super sweet and let me off real quick after i cursorily tested for intact radial and ulnar nerves. i quite adore her!

knee exam is usually my best station, but this time, i bungled it up. didn't test range of motion, didn't test fixed flexion, forgot my sequence, didn't test fot collateral ligaments. luckily tester was a fairly nice and jovial prof who hinted broadly at my missing tests, but i didn't have time to complete the examination.

sigh.

well, 4 out of 5 isn't too bad! hopefully my overall score will pull me through.

it's really funny. i usually have no love for ortho, but when i was studying for this OSCEs, the unbridled thought of : oh, i LOVE ortho! came to mind, for no rhyme or reason. strange. maybe i really do love ortho after all!

it'll be sad to leave this posting, i had fun for the most part. but there's still more OSCEs to come at the whopping end of rotation test in 2 weeks time with long and short cases to go. hmmmmm.

2007-08-02T08:20:00.000-07:00

i'm nearing the end of orthopaedics! it's been surprising, but i do appreciate the straightforward nature of it all.

the standing in clinics though, is wreaking havoc on my poor back. i have paravertebral muscle spasms! i really need to learn to change my horrible posture.

meantime, tomorrow we're off to the cerebral palsy association. it makes me sad to see CP kids. they're really, awfully, terribly sad, especially the quadriplegic ones. there was this quadriplegic CP kid i remember seeing in paeds who was abandoned by his family. no one even came to visit him. i remember standing by his bed watching him and trying not to cry whilst he rasped for breath, his stridor audible through the ward.

CP. so important to know to pass paediatrics and MBBS, so devastating to the kids and family (depending on which type it is - some are near normal!)

but i believe all these children are in God's hands, as am i.

2007-07-02T08:44:00.000-07:00

trying a random test online from xavier's blog! :)

so which specialty am i most suited to?

1 urology
2 radiology 41
3 pediatrics
4 obstetrics/gynecology
5 gastroenterology
6 colon & rectal surgery
7 ophthalmology
8 general surgery
9 dermatology
10 med oncology
11 radiation oncology
12 orthopaedic surgery
13 plastic surgery
14 hematology
15 emergency med
16 anesthesiology
17 physical med & rehabilitation
18 otolaryngology
19 family practice
20 infectious disease
21 neurosurgery
22 rheumatology
23 endocrinology
24 cardiology
25 nuclear med
26 thoracic surgery
27 aerospace med
28 pulmonology
29 nephrology
30 general internal med
31 allergy & immunology
32 neurology
33 psychiatry
34 occupational med
35 pathology
36 preventive med

hoho how interesting! those in bold are those i'm interested in. rather odd! but it's only a test after all.

and i'm highly please that GS has made it into the top 10. but as much as i know i love surgery, i know that the lifestyle is crazily crazy, and it's not for me. so for a while now, my top choice has been urology, and i think the test all but confirms it. :)
suffice to say, i'm very happy! but that doesn't mean i'm discounting other choices as well, of course :)

2007-07-01T08:12:00.000-07:00

so school starts again, back to the wards we are!

and i'm doing orthopaedics now. grumble grumble grumble. (instead of OB/GYN as orignially planned due to a stupid mix up in the admin department) i should really have lifted weights over the holidays in preparation for gruelling exams on knees on guys twice my size.

and i can forget about wearing dresses and heels this rotation because orthopaedics requires sheer brute force :\
at least i still get to wear make-up! unfortunately the early mornings have all but killed my affinity for my make-up bag, and as a result, i look hideous. i'm too lazy to even wear my contact lenses!

it's the first week into my rotation, and i have already:

- cursed my medical school for mixing up my rotations

- been scolded for not knowing anything (many many times)

- impressed the prof by knowing what "orthopaedics" means ("straight child")

- diagnosed a ganglion (purely by hearing what it is from my friends and having no prior knowledge)

- been labelled an airhead by 2 tutors at least (not a good sign obviously)

- fallen asleepy in a tutorial (of which i thought i was doing a good job hiding it, until my tutor pointed out that i was very obvious, much to my mortification)

- sat through a sodding boring lecture that was accompanied by a wonderful free lunch (thank you drug companies!)

- been coolly backstabbed by my best friend of 9 years, who feigns ignorance

- managed to perform knee examinations 3 times, all of them wrong ("you're not giving him a skin massage!!!! grab his tibia!")

- become utterly dependent on coffee for rounds at 730 am. (sigh eyebags)

- memorised my way around the hospital (go me!)

as you can see, i'm the proudest of the last point.

but still, it's great to be back in the OT. i live for the OT, i love scrubbing in, i love breathing the sterile air. first OT day is tomorrow and i'm really really pysched up! :D

which reminds me that i need to buy OT footwear. the present ones in the hospital are really disgusting and smelly, i doubt they've been washed in yonks. ewwww.

now, to learn fractures and knee/hip replacements!

ortho is wayyyy harder than i thought it would be. sigh.

2007-06-10T08:24:00.000-07:00

so the much awaited holidays are finally finally finally here! (and did i mention FINALLY)

and against my better judgement, i gave in and went for hip-hop class. thank goodness i did, i never enjoyed it as much as i have that night. some play music, others play computer games, some sing, some run, some dance. we all de-stress in our own ways :)

and realising that i'm one of the best in the class made me so high (ego trip! ego trip!) that it even spurred me to open my big fat mouth and shove my 2 big feet right in by offering to teach them jazz as well, to widen their dance perspective. now, i do NOT do jazz well. i do NOT do jazz! so why am i offering. the only thing i can do is cheerleading, which is NOT jazz, it's not even dance! cripes :( but i've made my bed and i'll have to lie in it, so i'd better quickly go grab one of my jazz-dancing maniac friends and learn something more substanstial. oh dear.

going to the home to teach the residents dance woke me up from my priviledged life, if only a little, but i can safely say that i'd like to continue. and now i'm shopping for a street jazz class :)

and boy, have i indulged myself. gym sessions, waking up late, massages, endless chocolate and non-stop playing of csi, house, greys and ER. this is life!!!

so as i'm off to camp (groan groan groan) with a bunch of kiddos in a futile attempt to play mentor to them, i wish you all fun too! :)

2007-05-28T07:11:00.001-07:00

it's just one more week to my end-of-posting test and it'll be term-break! i can't wait. it's been wayyyyyyyy too long since i've had a proper break! :)

my friend has asked me to join her in her hip-hop class, it's something i'd love to do. especially since they're combining it with charity work, by performing for homes and stuff. it's killing 2 birds with one stone! i get to feel good about doing charity work and i get to dance. how wonderful!

(not that i ever took ballet, i was horrendous at it - even managed to get myeslf kicked out from class says alot about my standards, doesn't it?)

i never knew how good i was at dance till i joined cheerleading. i always figured that i definitely wasn't amongst the best few, but i sure hoped i wasn't among the last few. somewhere in between cut it just nice. but in cheerleading, under the tutelage of the more accomplished dancers, i suddenly realised how much i've improved. i could handle virtually any dance steps you throw at me, despite how little time i had to prepare compared to the rest of the squad.

and i became good enough to even correct them and show them how it should be done. i never knew. the things you can do, if you have people who're willing to take a chance on you! such people are heaven-sent. truly.

i'd like to say it opened my eyes to a whole new world of dance, and of course that i took up the offer to dance in the hiphop group.

but that's not the way life works, and too many things conspire to keep me from dancing.

first of which would be my next rotation of OB/GYN. =( of which i am most definitely NOT looking forward to. where i'm headed is notorious for tutors who hate teaching, anal-retentive professors, nurses who routinely shove medical students out of the way for their own nursing students to do deliveries instead, fussy patients and basically, being treated like scum of the earth.
but i've always loved OB/GYN, and despite all that, i'm going to try and make it work. after all, if i haven't experienced it for myself, i'm not going to know, am i? so here's to catching as many sweet babies as possible and entering the OT as much as i can! :)

and there's still the next bunch of cheerleaders to deal with. squad politics are never nice. always nasty. and not easily resolved. i'm not sure if i'm committing to Nationals next year, i don't know if i have the time and energy to coach and train at the same time, and still deal with politics.

maybe if i quit cheerleading i'll have time for dance. then again, there's so many other sports i could do!

meantime, it'll just have to wait. first, the test, then term break here i come! :)

2007-05-25T07:36:00.000-07:00

i can feel myself suffering from "medstudentitis", otherwise known as medical student syndrome.

was almost half in depression today despite an easy rotation to a clinic near my house. reason being the sun was shining so brightly and school holidays are beginning for the rest of the world. plus we've gone without a break for so long i can't even remember when was the last time i've had a holiday.

although i pretty much do enjoy this rotation of family medicine, i really really need a break. i need a holiday.

but my depression was semi-lifted by meeting a good friend for dinner! over 2 1/2 hours, we talked, gossiped, whined, and bemoaned the much-hated internal politics that inevitably develops amongst our classmates. and why some people just cannot get along. it makes life tiring for us all.

i hate internal politics! people, please get along and be friends. so i don't have to deal with all your crap. life as the peace-maker (not by choice but because it's my duty as group leader) is AWFUL. have some consideration please

2007-05-24T06:04:00.000-07:00

it's been so long since i've had any measure of fun that i've been procrastinating in blogging. so.

today, i walked past a mum, with 2 young kids in tow, one in each hand. when i walked past them, the kid nearer to me reached out, saliva-covered hand removed from mouth, and gave my hand a punch.

my instant reaction?

"OMG I HOPE HE DOESN'T HAVE ANY CONTAGIOUS DISEASE!"

before medical school, it would have been:
"oh man, what a spoilt (insert swear word of choice here) brat!!"

how much medical school changes you. who were you before medical school? that's a very good question i need to remind myself of, every now and then.

i mean, i know you aren't a fixed personality, you grow and change with time. your personality, (and you, for that matter,) changes as you grow older (and wiser - hopefully. or grow more mature, to put it euphemistically), and you find your tastes changing, your values changing, your priorities changing.

but that aside, it's different from how medical school changes you. is cramming all you're interested in now? is the library the first place you head to in the morning upon waking up and the last place you see before you sleep? EVERYDAY?

i don't think we need robot doctors. we need human doctors. who know how to relate to patients, who know how to communicate. to empathise, to heal.
so it's really important to me not to lose myself in the heady world that is medical school, but to look at it in the grand scheme of things and to keep a part of myself human, someone you might actually want to know better.

ps. yes, i did swab my hand vigorously with an alcohol swab after being punched by the saliva-covered fist.

pps. don't you lot carry alcohol swabs with you too? ok, fine, i'm a dork. i know it. but i'm a clean dork!

2007-04-29T08:04:00.000-07:00

am sad! wrote a whole post on A&E rotation and it poofed into thin air. rubbish!

anyway will attempt to recap what has undoubtedly been the learning experience of my whole rotation.

was happily clerking and examining patient in resus room during a lull in the evening on wednesday, when we were yelled for to standby for a collapsed case.

by "we", i mean the rest of the very well-prepared team. i stood in a corner and freaked out, not quite breathing, and trying to make myself as invisible as possible. if you've figured out that i'm quite useless at cpr, you're definitely right. the life saving course we took has left me scared of performing cpr, especially with the admonitions about how i would cause the patient to have massive fractures and liver lacerations.

thank God my seniors, x and y, were around. they were so excited, yet so calm about it. it wasn't their first cardiac arrest case, but they were by no means experienced either. they noticed me quaking pathetically in a corner, and y came over to ask how i was doing, and tried to help me overcome my fear.

the patient was rushed in with EMTs in tow, he was an old man who was roughly, oh, twice my size. and i'm not anything like those skinny waifs you see on the runways, to put it nicely.

he was asystolic, and the team instantly bagged him and intubated him, pumped him with drugs. it was so fast i barely noticed anything, they did it with such confidence and experience.

x heroically performed compressions whilst y tried his best to allay my fears, talking me through each one of them. after succeeding in calming me down and telling me it'd be best if i tried sooner rather than later, i stepped up to take x's place. the poor guy was sweat soaked and exhausted, yet still managed to yell encouragement to me.

y located the spot for me and cheered me on as i started compressions, telling me to look at the defib monitor to see how i was doing. x felt the femoral pulse and nodded his affirmation that i was doing right.

and boy, it was surreal. the feeling of pumping someone else's heart, of holding someone's life in your hands, it's incredibly surreal. everything kind of faded away, nothing mattered but the monitor and the compressions. it was as if i no longer had any fear, i was born to do this. i was calm and composed and knew what i was doing. it must have been the change that everyone talks about but you never think will happen to you.

y took over when he saw my rhythm was faltering, and between the 3 of us, we must have kept it up for about 20 minutes. each time we stopped to check the rhythm, we were full of hope that we might bring him back. but each time, it picked up hopefully, only to slow down into a flat line.

the decision was made to stop him after the 8th time he flat-lined.

i was rather disconsolate, to say the least. yet x and y took the time to comfort me, to tell me that we'd done all we could for him. it takes a miracle to bring a patient back usually, they said. he just wasn't meant to have a miracle maybe. plus he was really old.

the doctors even came over and told us we did well, and thanked us for helping.

only later did we find out that he had been unconscious for nearly an hour before he was rushed in. his family had thought he was sleeping as usual. so our efforts were as good as no efforts, we couldn't have done anything to save him, it seems.

that went a long way towards making me feel better, and i could see the relief on x and y's faces. so they too, felt some measure of relief.

sometimes, you do everything you can, but it's not enough. God gives and God takes. and who are we to fight that? it doesn't mean that i feel no sorrow, that i'm dehumanised. it just means that i choose to accept what happens. i do feel sad, i wonder how his family feels. it's the most terrible thing in the world to lose someone you love. i know how that feels, personally, and wouldn't wish it on anyone, ever.

but i'm really thankful for the 2 wonderful seniors who were so concerned about me. these are people i know i can trust in the future, they'll make wonderful doctors no matter which field they choose. these are people whom i respect.

and i've realised cpr isn't that hard after all, it's actually manageable on a real patient :)

as for the patient, may he rest in peace. at least he felt no pain. thank you.

2007-04-12T07:48:00.001-07:00

am on A&E/ emergent rotation right now. it's helluva tiring and i need sleep! =( i miss psych already!

but emed is wayyyyyyy fun and i'm loving it. i'm awake when i'm on the floor and i just have such a good time! my iv setting skills are better than my groupmates (despite me having the least practice in surgery posting - that's what you get for being a type b person - you get shoved aside easily by the many hungry types As lurking by your side) and i can't help but feel a little smug over that. i even feel like shouting:" HERE"S TO YOU SUCKERS!!!!" when they can't get an iv in even though it's mean, i know. but having been shoved aside perpetually, it's just a rush of repression! heh.

but that aside, i love emed. so far i haven't learnt much, but it's been alot of fun. suturing, blood drawing, setting ivs, reading ECGs.

and soon, you begin to think: hey, this is the life i could lead!

for now, posts will be slow and trickling, depending on how much sleep i get on the floor.

and to angry medic: i passed my test!!!! hooray! i really thought i would fail. how's your exams!

2007-04-04T04:03:00.000-07:00

and so, i bid adieu to psych med with a sham of a test to be held tomorrow. (which i will still study for anyway even if it's only 20 minutes long - because i love psych!)

(and that is exactly what i feel like doing to myself right now)

it's simply too bad i lost my head in the clinical test today and yabbered on ditzily in front of my examiners. i knew the answers, damnit! i studied and clerked and i knew what i was doing. but why why why do i always fail at the final hurdle? i have no problems doing calls, my interns say they're always glad to have me around because i'm actually of some help. but why why why do i always freeze up and flunk my way through the test? in a tutorial i'm fine, i can handle most things. but why ONLY in a clinical test do i screw up? and royally at that.

i really have got to learn to keep a handle on my anxiety and keep a cool head. no one wants a doctor who loses her head ever so easily. but it's galling, especially when i see my colleagues, who worked half as hard as i have, sail through the test with ease and flirting with the testers (no i'm not joking!) at the same time. ok maybe it's just being subjective, where i come from, students are renowned for claiming not to work hard but rushing right home after school to start hitting the books. so maybe i'm wrong.

but enough of all this negativity!

i had a real sweet lady for my psych test today. the most hilarious thing was: i met her right outside the door whilst waiting for my friend in front of me to be done with her test. she was happily chowing down her snack and looked pretty happy. and of course, me, being the clueless medical student (i should really change my blog to cluelessmedicalstudent.blogspot.com shouldn't i) happily smiled at her and made small talk. i had no idea she was my case!!! so imagine my surprise when i sat down and she was led into the room. GOODNESS. apparently one of my other friends was so smart he clerked the patient outside the door and used the time in the test to arrange his answers. pfwahhhh i say. be honest boy!!!!

but it's so scary. i couldn't tell what in the world she had, in that short time i had. it could have been anything, i had 4 differentials but didn't know which one i should have said. schizophrenia, bipolar, depression with psychotic features or ptsd. it's freaky, what she says. i only hope it's not true, i felt so sorry for her, if what she says is true and not some sort of a delusion. i mean, attempted rape repeatedly? i shudder to ponder that. i mean seriously, how wrong can that get. women suffer in silence, and only 25% report sexual abuse. it's still a huge taboo.

i don't know what to do or say. i could only stare at her and throw out another question, i don't know what iwas asking. i don't know what i was doing. i kind of blanked out after trying eliminate my differentials and trying to decide whether what she told me was really true. i think i'll make one helluva lousy psychiatrist!