Jan 19, 2006

Curl Check War… (disappointed)

yes… disappointed with the dilemma that I am in now.. supposed to blog about the dinner MPIS that I recently had but couldn’t, reason being - there’s only 2 available pc in the library, one could not go online… another could not handle my pendrive being plugged into its multi-lubang backside…

so, my comment about dinner that day shall be postponed…

i’m disappointed by a tale about a patient in the ward, actually more of a disappointment about his children. the patient, X is a stroke patient and he is currently well and could go home with children. Isn’t it a good news? if I am the son, i would be jumping joyously and pack up to get back to HOME SWEET HOME… but before no, the children wanted to keep their father at hospital. excuse being, they don’t know how to take care of the father. What the f***? I’m really pissed at this situation. The rehabilitation doctor came and wanted to teach the children how to take care, and the children refused, YES, REFUSED to learn them, and wanted to wait for their newly hired maid to come in a month time to learn up the take-care-of-stroke-patient skills. this story can really be a sensational hit at Ripley’s believe it or not. the parents would hardly leave them over with a maid, and now they just wanted to leave the total responsibility on their father to a complete stranger.

if you remembered my previous blog entry, a nurse once said,"satu bapa boleh jaga sepuluh anak, sepuluh anak tak boleh jaga satu bapa"

then, there was this friend of mine, Y, that told me after graduating and working, she will repay her parents. I said,"money not important to them, it is more important to take care of them". She was taken aback,"no, i think i’ll just repay them back. I am too busy, besides I am not on good terms with them"

Nonetheless, there are still time to change her mind. I hope so.

Jan 16, 2006

the eyes that truly see

no class the whole day… initially.

have not confirmed any ward rounds last week.

anyway, started my own schedule today just to pad up the time

630am jogging

800am breakfast off to ward (haven’t decide what to do)

815am saw some dr doing rounds - follow them to get to know the patient

900am still following

1000am still following

1100am told by leader FishXar La Bull (not her real name), we’d a class with Dr. HT CHong… did some short cases… my examination sucks… big time… but got rather relatively good marks…

1215pm go to meet prof gracie because she wanted me to collect signatures for our previous anaesthetic class attendance… she’s so scared that she could not get our signature… yes, she used the exact word - scared

1230pm chow time

100pm went back to room. got a letter from college - sukacita, anda ialah finalis untuk Mr. Personaliti - ooooh great, i will be the target of pranks at this dinner… hope i can spread "joy" to everyone… and took some tense of all the pre-examination stress.

130pm went with the mamat to practice short cases in ward paed5. examined several babies. the first baby’s parents got so used to the examination, that they taught us what we miss… SUPERB…. BONUS

215pm joined clinic of Prof Adeeba… got questioned about various AIDS medication in a patient which is pregnant… really starting off in a rather complicated matters… why is the drug started, why it stopped, why start back again, why didn’t stop like the first time? start, stop, start, stop, start, stop… kepala pusing.

400pm really tired… went back to Ward 5U to see whether i can learn anything from patient. just too tired to really clerk a patient professionally, and so i sat down quietly and talked to a blind uncle. I sat down introduced myself as a medical student, but conversed as a friend. he is alone, and perhaps finding the all the sounds in the ward to be a drama to him. he doesn’t have anyone around him and no other audiovisual devices, too. he was glad i was there. he told me about the story how he got blind. how the incident striked in such a manner that everyone mistook it as a joke, he spoke about his previous striving in the society, he spoke about his adversity - wife leaving, lose jobs, selling houses, moving places, supporting children in studies, and not forgetting some darn hard, cold facts with the medical "professionals"**. he told me how he loved "er hu" (sort of chinese traditional violin), how he loved 935 FM from singapore because of all the stories how great people in the world had their own share of suffering ie deng xiao ping never had any children for 40 years since his wife last miscarriage, how he deals with his children’s education, how he learnt all his skills of using a walking sticks and how much fun he had in the Malaysian Association for the Blind, how he despise wearing sunglasses because he thought he look like an evil villain wearing one….

"Uncle, is there anything that the medical people should be more sensitive about?"

"Yes, something scary happened to me. It was my 3rd day in 6E, UMMC (the eye ward), and as i asked a doctor how’s my condition, he answered me slightly rude- uncle, your eyes is blind liao, cannot see, so, tomorrow, you can go back liao"

"Oh"

"But a nice doctor, soft spoken, later talk to me again. He told me - uncle, i did not know what you were previously told. but i just wanted to tell you the truth. Before i tell you, it is best that you prepare yourself mentally. This is something that could have happened to me, too. I want to tell you that the nerve for your eyes is completely spoilt, so resulting in blindness. You will be living in the world of blindness in your coming days. But medical field are advancing very fast nowadays. One could not predict the future. Who knows there will be a discovery anytime that could help you see again, by probably changing a new eye for you. In medicine, there is always a possibility"

"Yes, it is true, we are all human, one day, we will also becomes a patient ourselves eventually"

* piloism: professionalism is not in the name or honor people had given you. it is in the little things that you do that makes the whole lot of difference.

as what stephen chow sing-chi had said and portrayed in his movie: "keh leh feh, tou yiu zou ko, jun yip ke keh leh feh" (in cantonese: in acting, extras also have to be a professional extras)

by this time, you maybe thinking "what this fella so free ar? talk so much to patient, blog so much, siao ar" "ok… going to study liao.."

Dec 27, 2005

graffiti war, NOT only at theatres

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Disclaimers: Though all the words are meaningless fictional teasers meant for entertainment, not for otherwise, but the graffiti is real (made by white board marker buatan malaysia. Malaysia Boleh!!)

xmas down south

everyone loves Christmas (no offense, Muslims), even though you don’t know what the heck it is for (no offense, non-christians, most of you all really don’t).

The reason probably why xmas is so popular perhaps would be it is the only other season besides Chinese New Year that someone would have the privilege to wear red, or perhaps it is a time where somehow it seems like everyone is having a birthday. Everybody receiving gifts for everybody is always an unforgettable nice moment, unless of course, you find that

the process of thinking what to buy,

the process of going through shopping complexes to buy something,

or the process of forking out a great amount of money to buy so many gifts

is a truly agony too harsh to bear.

Anyway, xmas is xmas,

it is a season of green, white and red,

a season of xmas trees and santa clauses,

a season of snow,

a season of xmas carols,

a season of going places for holiday,

a season for wild shouting and countdown,

a season to count your blessings, etc…

my xmas was spent at orchard road, singapore. It was really a wild countdown and everyone was flocking around like there were gangfights all over orchard road. Everyone were there. The rich, the poor, the old, the children, the babies, the elated ones, the depressed ones, you name it, you got it.

this is my second time at singapore. my last time in singapore (>10years back) was also during xmas time, and was also at orchard road. At that time, the lightings were cool and great but the people were less wild. I remembered how my dad kept saying how wonderful to celebrate xmas at the orchard road, over and over and over and over again…. over and over again. Couldn’t recall how great it was back then, but the most significant thought about that trip was it was my first time on a plane, from Penang to Changi, Singapore.

This year, everything was wild and dangerous. Not snowing at the tropical country does not deter the ah bengs at singapore of mass importing the "snow in the can" and making the whole orchard road a war zone. It is actually looks like hairfoam in the aerosol can, going at the price of S$10 for 5 cans. People just blasted away the snow at one another like hong kong movies. One guy actually held the two cans as if he was holding 2 guns and as he shoots he SPINNED around. knuckle head. i suspect he was on pills on that night. Anyway, not just the youngsters were at it, even the middle aged (40-60years old) also bought several cans and shot around at everyone randomly enjoying the moment, perhaps de-stressing themselves from their everyday’s work. nice to see their participation. Foreigners got blasted like mad, and one actually turned into a walking snowman.

All this aerosol is from china, and they may be just some damn cheap stuff which is hazardous to health. i wonder whether any health or environmental officials care to check them out. no report about them so far. I googled about it.

Got lots of photos with some else’s camera, so will be uploaded later, much much later. wouldn’t risk bringing my palm camera into such a risky place.

The best thing about xmas this year was I celebrated it with someone special, and staying over at her sister’s place.

being a unpaid student, i made something special for her.

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white xmas in a can. (CFC-free) - copyrights not reserved -

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taking the train to Singapore

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Xmas eve travelling - chinatown complex

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Xmas night at my faculty - the most best that i had seen in 5 years. Cheers!!

Dec 23, 2005

bore and boar, part 2

reply aka comment from tauke:

So, let’s say the dozen of students who had been deeply encouraged by their enriching palliative experience in Taiwan deserved to ignore the lecturer, we still have more than 80% of the class. They chose to ignore this one simply because it is not coming out for the exam, and maybe most medical students care more about diagnosing rather than the totality of management itself, which palliative care is a part of.

I agree that I am being self-righteous when I label my coursemates as kiasu. But sincerely, the reason for my previous post is my utter disappointment with the shallowness of the future doctors who cannot even give one hour to listen a palliative care lecturer who came all the way to UMMC, probably with no pay, who is just interested to enlighten our darkened minds something about caring for the terminally ill.

So what if we can diagnose a 6th nerve palsy due to a cerebral abscess secondary to AIDS, if we know nothing about the palliative options of this AIDS patient?

Amongst those who stayed behind for the lecture, some were playing Bingo, some were reading their medical handbook, some were chit-chatting, some were sleeping, some have no idea what they are doing in medical school. Very few actually cared.

If this is the kind of attitude my future consultants have in the hospital, then I fear for the terminally ill patients of their time.

my reply:

shallowness is always there.
people are born shallow.
some actually grew to become more shallow unfortunately, fallen victim to their instinct to survive.

in the spirit of malaysia boleh,
palliative is part of management, who cares.
rehab is part of management, who cares.
lifestyle is part of management, who cares.
alternative medicine is part of management, who cares.

all ppl interested is in the advanced pharmacotherapy or surgical technique
at least, that is what our examiner would be interested to know, so they think.

i had the most disturbing experience in my recent rehab class about orthosis and prosthesis, one of my coursemates actually asked me to sit in front, so that i could answer any question from the rehab dr, dr rameezan. "y u can’t answer meh?" "no lar, i am not interested, not as interested as you do, i can’t be bothered" i gasped, nearly anoxic.

albeit, rehab dr, palliative team, primary care dr, is often being perceived as less important.

but in real fact, lots lots and i shall repeat again, lots have actually forgotten that the best part of medical management that really does matter which is preventive medicine, as the old saying goes "prevention is better than cure".

if the prevention is good,
we would have less cancer patient in palliative,
less MVA survivors in rehab,
etc etc etc…

but since we still in the "malaysia boleh*" state, hopefully we should still harp onto "to cure sometimes, to relieve often, to comfort always", hoping this will be better in the future, where doctors will be doctors, not "veterinarian"

transformation of heart largely is by self-effort and self-realization, living up to one’s principle and conscience despite pressure from peers and others.

kiasuism is always a relative thing.
self righteousness is always a relative thing.

prof philip poi once told me, "sometimes you all are just too relax, and not being kiasu enough"

* malaysia boleh ada orang merokok di tangga hospital dan tempat larangan merokok seperti universiti
malaysia boleh ada rekod terbaik dalam bilangan kemalangan jalan raya
malaysia boleh ada orang lepas sakit jantung masih hisap rokok bagaikan ubat
malaysia boleh banyak banyak lagi

lastly, in medicine, no one should be ignored, the most important person in the management is not the specialist nor the consultant, often forgotten, it is the PATIENT.

Dr. Liew "we must empower the patient and also give power to the patient"