Wednesday, August 24, 2011

fall

when is the last time i fall down? as in walking and and trip and fall down.
i have forgotten the last time i fall, and today, i fall down.
stretched my hand and it's just a small scratch on it...
what happened to me in this week?

mermaid princess

people just leave, without reason...

i'm just like a mermaid, quietly stand by your side.... one day, i just disappear like bubble (if you ever read about mermaid princess)

Saturday, August 20, 2011

1st week in HPJ

I guess I am just a lucky girl!! I get to do venepuncture on the very first week of my first posting. I reach at HPJ quite early in the morning for ward work. It's not compulsory but by experience, usually there are a lot of procedures to be done in the morning. Although my class will only start at 10am, I was at HPJ before 8am.


So I saw Dr. Lee, who either a MO or HO is pushing the trolley around so I asked if I can follow her and see how she do the procedure. She just agree easily. So I watched her doing venepuncture, blood gases arterial puncture and so on. After a few patient, she asked if I want to try. I told her that I have not learn any of this before. She says it's ok and she just let me try.


The first patient that I took was a suspected TB patient. He was sitting in isolated room and after we wear glove and mask, we went in. He is a chinese old man and he is very kind. We let him know we are going to take his blood and he say: sure no problem! So I tied the tourniquet, locate and feel for the vein and then I just insert the needle and draw out the blood. This uncle vein is easily to be seen as all his vein around his arm is so obvious.


picture taken: http://www.sciencephoto.com/image/274694/530wm/M5320470-Gloved_hands_placing_a_syringe_in_a_vein-SPL.jpg


The second patient is an Indian, his vein is not easily to be seen. So after I tied the tourniquet I feel for the vein and confirm the place. This time, we use another method which is using vacuum tubes. Dr. Lee says vacuum tube usually is harder as we have to stabilized it before we fix the tube, she even says she actually failed in her OSCE as she is unable to stabilize the needle. And again, everything went smoothly as I am able to stabilize the needle and took the blood.


picture taken: http://ohceps.oxfordtextbookofmedicine.com/content/vol1/issue1/images/small/graphic131.gif


This patient was clerk by the Chinese HO doctor that I mention about the other day, who left me eat alone and he join his colleague. So he went into the room when I was trying to take the blood from the patient. The patient was sitting and this HO says: Usually for student who just started to take blood, we advise the patient to lie on bed. So I asked: Should I ask him to lie down? He answered: Nah... It's ok never mind. -_-!!! so what's the point you telling me all that?


After taking the blood, we went out from the room. I was talking with Dr Lee and this HO patted my shoulder and says: Now you know how to draw blood! Very good! . In my heart was like: wth?! Am I that close with you?? You actually patted my back?! Wow! What a surprise!! Not even Dr Lee did that to me. As in I am already very friend with him...


Well, just when I started to work/study in hospital, you can see lots of different type of people in the ward, including those doctors, HOs, MOs. Some HO seem like look down on us, they will have that kind of look when we were in the ward, as in they never be a medical student and walk like us. Some are very helpful, just like the one who gave us 'motivational talk' the other day, and especially Dr Lee who teach me and let me try to take venepuncture.


I actually also witnessed and assisted in CVP line insertion. There is an old patient who was admitted on Thursday night and he is Chinese. When Dr. Malik doing ward round, he asked me to help him translate to chinese and take some brief history from the old patient. He is 90 years old and Dr. Malik think he might not understand Malay or English well. I was unexpected and so not prepare for him to ask me to translate. But I still tried my best.


When a HO is doing the CVP line insertion, she can't speak chinese either. She trying to tell this patient to move more to the left side so she can insert it into his right arm, but she can't speak chinese so I helped her to tell the old uncle to move to the left. She actually thanked me! For the very first time, I feel it is not wasted for me to learn chinese. I can speak different languages and broken Hokkien which really helps me in my future. When inserting the CVP line, the patient complain of pain. I really feel helpless. The only thing I can tell him is we are going to be done very soon, please bare with us for a little while.


Are doctors helping the patients? I can hardly answer now......



For the first week in HPJ, I've

witnessed in Echocardiogram and Lung function test.
performed 2 venepuncture. 1 by needle, 1 by vacuum tube.
assisted in CVP line insertion and blood gases arterial puncture.


Looking forward to more procedure to be done!!!

Tuesday, August 16, 2011

why you become a doctor?

Don't tell me that you want to be a doctor is to help people in sick. It's all nonsense.


The second day in Putrajaya hospital, maybe I have gain more confident. A HO there actually give some 'motivational talk' to my group. Well, it wasn't a formal talk, it's like a discussion among the students and HO. He tell us his experience during his clinical years. I guess we all look so blur that's why he wanted to help us. Maybe he is trying to show his rank as HO compare to us medical student, but I want to think it in positive way. At least he is much more better than other HO and MO who look us with weird eyesight. As if they didn't went through the same route as us.


I actually approached a Chinese HO. End up he give me bad impression of him, and if he is really clever, I will not approach him anymore. We went down to cafeteria together as I am the only Chinese in my group and the Malays are fasting. So I thought I can have lunch with him and know more about the hospital and also clinical years. I actually eat alone at the table in cafeteria, as he went to join his 'own group' and leave me alone. I was like: wtf? you can at least introduce me to your friends or ask me to sit together with you guys to have lunch together. Fine. End of story about him. Really a bad impression.


Seen a lot of cases this 2 days as I tag along the doctor for ward rounds. I can actually learn a lot during the ward rounds and the doctor that ward round today really reach us a lot. Today ward round was done by Dr. Malik. He was funny and a little sarcastic but he is nice and funny. Very interesting during ward round and will not feel bored at all.


I was the only one following them for ward round as my group mates have gone nowhere. There is a Bangladeshis who admitted into the ward and was suspect of having dengue fever. But end up having another diagnosis which is Rheumatic heart disease, which is a very rare case in Malaysia. Even the doctors were so interested in the case. So after listening and discussion about this Bangladeshis illness, Dr. Malik was asking us what's the management for this patient. I didn't expect that he will as me as well. He asked my name, I answered. He say: my name is M and yours is M too! making everyone there laugh out loud. He also say this case is very good for us to learn, especially medical student, as it is rare.


First time ever I really heard a murmur. But there are still a lot of things I still not understand. What diastolic murmur, systolic murmur, S2 bla bla blaaaa... No idea how to differentiate it, even HO don't really know how to differentiate it. Cause it's rare!


The treatment for this patient is valve replacement. It is definitely a very expensive treatment. He has this disease maybe because he has previous history of Rheumatic disease but didn't get a proper treatment when he was young. Mainly because Bangladesh has poor health care system. He can't receive this treatment mainly because he is a Bangladeshi, and it's cost effective. When his employer know his illness, he will be sure to be send back to Bangladesh.


This is so sad. He can't get treatment and he has to live with it for the rest of his life, who don't know will last for how long. We trying to communicate with him, and Dr. Malik actually trying to explain to him about his illness by drawing the heart and valve. We doubted that he understand a single thing we are saying. His face is so clueless and he seem start to worry what's happening on him.


So, are you helping those in sick? No! Cause you can't give them treatment that they need because of so many other factors. He will never know how he died. He has family and children in Bangladesh waiting for him to go back. He come over here to work so hard just to earn a living, yet he is diagnose with this rare disease.



Fair? Totally not.
Help people in sick? Can't.
God? Seem has gone nowhere during this time.
Life? This is life.

Monday, August 15, 2011

1st day in Putrajaya Hospital

Went to Putrajaya Hospital can have CME session in the morning about dialysis. After that, we follow Dr. Shu to go ward around. It suppose to be Bedside Teaching (BST) but because she has work round to do, so we just follow her to go around the ward.

We have seen many cases in a day, in that particular ward. all type of disease that we have study last 2 years all appear right in front of us. Just that we doesn't need to present the case as the MO and HO will present it. But we still have to learn how to clerk a patient and present it to the doctors.

Haven't really clerk a patient yet as we don't know how we should do it. And we also don't have the courage and brave enough to do it without any guidance, since we are still new to clinical year. I was hoping any of our senior can teach us but can't see any of them. Guess that I have to ask help from the MO and HO.


And again, today, I still doubt if I really have prepare of all this. Not all question that ask by physician can be answer by us, including those MO and HO. Yet I feel I am not well prepared, including during task based learning (TBL).

Trying to study after class ended at 6 something in the evening, but was too tired. Had a little nap and yet it's so tiring... How to face the next 2 years if I am still like this?

Sunday, August 14, 2011

孤僻

孤僻到自己佩服自己的地步了!仿佛世界就只剩下我一个人。
快要有忧郁症了吧!情绪转变非常快。

生活里好像没剩下几个朋友了。有人问:为什么不去认识新的朋友?
老了,要认识新的朋友也很费神费力。
当然会有认识新的朋友,只是有时不会很投缘。

我把友情看得太重,最后只会把自己弄得伤痕累累。
也许是太在乎、太敏感了。

希望会有人来安慰我、开解我,盼呀盼也没有那个人的出现。
只有自己的多情。

电脑里的歌重复播着,来来去去就是那几首,听到闷了。
原来我就是这么闷的一个人。

几年前的我去了哪?找不回自己了。

写完了,心情也好一点了,至少恢复正常点。
心,还是闷闷的。

when?

maybe i am just too sensitive, maybe i ask too much in a relationship...
when only then i will find someone which will think of me and care of my feelings more than i do?

Saturday, August 13, 2011

tears stimulator

no idea why i feel like crying... maybe i am too stress? or maybe jay's songs is tears stimulator...
sometimes is good to admit that i am weak... but i don't want to be weak.
i guess age is just another cause of becoming weak... not only physically but also mentally...

i don't know why i feel like crying, don't know i cry for what... but it's the feeling for now.
i'm having this kind of feeling for this whole week...

Tuesday, August 9, 2011

大学第三年

大学第三年的第一天,好像蜜月期。十一点之前就上完课了。还以为会开始很忙碌的生活,可是第一个星期只是有关去医院的简介。


开始害怕也开始担心。好像前两年所读的全忘记了。不知道在医院时,不会回答教授的问题会不会被骂得狗血淋头。所以乘这个星期还没那么繁忙,我还是好好的复习最基本的知识。


学院还是还没安排我们的住宿。真得很笨!教授和学校管理员没有沟通好令到我们还是没有住宿,还好我可以住在我朋友的家,要不然真不知道要睡哪里。


未来的路好像很模糊。已经开始在害怕每一天的到来。
我......可以面对一切吗?

Friday, August 5, 2011

Oath taking ceremony




Today we had a Oath Taking Ceremony as we are going into clinical years, and we signed the oath.
Officially i am 3rd year medical student and I will be going to hospital soon.
The first posting I get is Internal Medicine. Well, seniors say Internal Med is hell, I should see if its really a hell.
There are also people saying after we finish our Pro-exam and start with Internal Med is an advantage for us. Because we get to revise back what we studied for pro-exam and its easier for us to remember back the knowledge.




Timetable has out but we don't even know where is our exactly posting. Even though I know I get Internal Med but I don't know if my subgroup is assigned to Terendak Hospital or Putrajaya Hospital.
Yes! This is the type of management of my college. They even didn't provide accommodation for us during orientation week and next week. how stupid!





Luckily I stayed with Ocean in her room where she is sharing with Sin Toun.
I think I am going to stay with her for next week again...


These few days lot of people saying I look different, as in my outer look.
Some say I am prettier and some say I look stunning.
Hopefully my result for this year will be STUNNING too!!

Thursday, August 4, 2011

routine

why i have to go through this routine everyday?!
wake up-self motivation-bad things happened-double standard-discrimination-unfairness-tired-demotivated-sad-emo-getting better-sleep
and then everything repeats

when

i want to be strong, and when i fall down, i'll try as hard as possible for me to stand up back.
yet everyday when i am trying to encourage myself to be stronger and be better, i am getting bad news and slap by reality and i fall again.
when? when everything of this will get over.
please be over as soon as possible, cause i don't know how far i can take it anymore... how much i can handle anymore......

我 要過多久 才能好呢

我 要過多久 才能好呢有好多辛苦路得走走到口渴 眼淚乾了 人會領悟些什麼
回憶是記者 它會挖出不為人知的寂寞每一個人的以前住在心裡 像事後的孤兒


so good in describing my feeling now. when only i will feel better?
life is so hard.
whenever i feel its getting better, it getting worst instead.
stop crying cause its helpless and useless.
but the heart sank really deep, and its heavy.

whenever i think of it, and i ask why
but there will never be answer.
how can you blame others when it is your own fault?
how can you not think of others when you took that action?
how can you not think of people's feeling when you say it out?
when only you will wake up and realize what you have done?

since when, you are not the person i look up anymore
cause you say: don't worry, i will take care of everything.
you are not doing as what you promised.
disappointed, yet i can't do anything.


journey of life is long yet short.