1st week in terendak

Lack of update lately. Mainly due to no internet connection in Terendak camp, secondly is due to my busy and hectic schedule in clinical years. Had a long weekend break but I wasted my Friday to work part time in Clinique. Then I was so regretted whole day there, so I decided to not work on Saturday and Sunday.

In Terendak Hospital was fun! The doctors there are so good, compared to those in Putrajaya. They really treat us like student and not HOs or MOs. The most important thing is, in Terendak Hospital, there aren't any Hos or Mos!!! haha! We are like the doctors there and no need to see those people faces like in Putrajaya. Some of the nurses there were helpful as well.


Do. Rosman and Dr. Ali are the doctors there. Dr. Rosman was kinda hot and he is chinese looking. When we saw him for the first time, I thought he was chinese, until he greet us in Islamic way wtf. He is quite funny as well. Dr. Ali is very very funny. He is not kiasu type unlike Dr. Rosman. So happy go lucky and during his class, it's fun and enjoying.


We actually act like a HO in hospital. Every morning we have to clerk the patient and give updates and progression to the doctor as we go for ward rounds. Some time we feel pity to both of the doctors cause they have to take history and do physical examination themselves unlike in HPJ there is HO and MO which had done the job.




On Tuesday, we have class in Putra Hospital. Not Putrajaya but Putra. The Melaka Southan hospital which later change its name to Putra Hospital. Dr Nor Izham, which is a cardiologist is teaching us once a week. So that day I drove my groupmate there as they are not familiar with the place. We hand lunch at mamak stall near Hang Tuah street. There is a disable boy selling tissue there. He is not only disable but also mentally retarded I think. No other words than retarded? sound so rude! And so we saw he is walking towards us, he was selling tissue and was saying Rm1 for 1 pack of tissue. Even though it's quite expensive, but we still bought it. He is much more better than those who are asking for money than really work hard to earn money. He is pity, but I doubt he want people to feel pity towards him.


After lunch we went to Putra hospital and Dr Izham bring us to a patient, as us to take his history and examine him. He had stroke few days ago and his signs and symptoms are obvious, but he is recovering as well. After that we have to present to Dr Izham and he will correct us if we were wrong. Then we encounter another patient in his clinic. She is a chinese lady who came to get medicine. Dr Izham out of sudden ask us to go into his clinic and ask us to examine this chinese lady. When his chest wall is exposed, the heart beat is so obvious. We can see the heart hitting the wall. When palpate 4 ares, there is apex beat, parasternal heave and palpable aortic and pulmunary area. When auscultate, there is mixture of murmur, S1 and S2 heart sound and it was so loud. This chinese lady has ventricular septal defect (VSD), probably for a very long time but didn't seek and treatment. But she still can live a very healthy normal life until recently she feel uncomfortable so she is seeking medical help. How often we can see a real life case of this? Even though VSD is very common, most of them will get surgical treatment when they were small, or after born, depends on the defect itself. I feel so lucky to have the chance to see and experience it.


At night, I join Jac and her group for Mid-Autumn celebration. We light lantern and also share a piece of mooncake among 10 people I guess.

There was a very funny incident when we had ward round on either Wednesday or Thursday. A patient had a crush on Dr Rosman! We were doing ward round in the female ward and there was this patient with right side eye defect. Dr Rosman was asking the patient to look his finger and follow the movement of the finger. In the same time we are suppose to hold the patient's chin so that she will not move around by turning her head. But when Dr Rosman want to hold her chin, she keep avoiding. Until Dr Rosman tell her: let me hold your chin. But the patient was soooo shy and she put down her head. It was so obvious and she say she is shy. My room mate clerk the patient and she told me the day before, the female patient say that Dr Rosman is handsome. hahahaha... and she actually only few years older than Dr Rosman but he call her Mak Cik!!! wtf!!! Of course it's because he didn't realize the age difference and he actually look a lot younger than his age. But still!!! This let me learn that don't simply call people uncle or aunty. It will be better if address people as Miss or Mr.


On Wednesday night we went out for dinner and also birthday celebration for Ehsan. We were actually split into 2 sub group in Terendak and most of them are from group B. My group was boring. I have to say that. When we already plan to go for dinner in Melaka town, I am the only girl from group A as the other 3 of them aren't joining. It was so disappointing. Why can't we go out as a group? Well, no comment. But I had fun with another group and guys from my group. The asam pedas claypot was awesome! Totally worth it as we don't know the way and was wrongly guided by Syue's friend. At last when we found it, it was around 8pm and all of us are starving! I feel hungry now when think about it. Should bring my friend there and try it one day. I actually pass by that area so many times but we never bother to go and try the food there. The stall is open by a chinese-muslim. He is so chinese look and we were all discussing about him after dinner. Cause he speak fluent Malay!!! and he understand chinese when a chinese customer talk to him in chinese. All of us get curious and test him. As in order plain water in chinese and my friend talk to him in chinese. At last all of us can't stand it anymore and Ehsan ask him if he is chinese or malay. Hahahahahaha... totally hilarious! He say he is chinese and has a 11 years old son. ok fine! haha...

Bought a cake along the way back from dinner when we suddenly realize nobody actually help Ehsan pay his dinner bill. Guys are so useless!! So we gave him a birthday surprise! He was in toilet when we were at his room. -____-!!!! All of us really enjoy so much!

痛

为什么需要有痛?


今天上完课就到医院去，当时已经是下午5点多了。去医院是为了准备明天的报告演示。
当时有几个实习医生还在轮班。跟他们了打个招呼，其中一个医生很友善的告诉我有几个不错的病列可以去看看。


另外一个实习医生说他们正要为一个病人输入中心静脉压(CVP)，问我要不要去看。既然有机会，当然要去观察他们如何输入CVP。


病人是一个末期肺癌患者，看起来大约60岁，很无助的躺在病床上。有好几位实习医生站在床边协助。实习医生小心翼翼的找病人右手边的静脉，找得并不容易。终于决定要输入中心静脉压，可是事了很多次都不成功。虽然已经在病人的手上注射了局部麻醉，病人还是觉得痛。虽然病人非常合作，可是就是可以很明显的听到他忍住痛楚的声音。


试了两次，终于放弃。实习医生决定用左手输入中心静脉压，还好一次就顺了输入。可是当他们要把病人躺下，取得中心静脉压的读数，病人一直说很痛。我们也不知道他那里痛。也许是他的癌细胞扩散到骨头所以觉得痛。要取得中心静脉压的读数需要一点时间。我们很努力劝病人在忍以下，再过一下子就好了。他也很合作的忍住痛楚。可是过了不久病人又喊痛，还说救命，求求我们赶快让他坐起来。


当时我很无助，不知道要怎样劝他，也不知道要怎样安慰他、帮助他。为什么要有癌症？难道就因为他抽烟，现在他所受的痛楚都是应该的？都是报应？我心里也有点挣扎，好像有两人在争论。一个天使，一个恶魔。一个在可怜他，另一个却说这是他应得的报应，为什么要可怜他？


其实这是我第二次见证中心静脉压的输入过程。第一次的老公公也是一直说痛，我也只好跟他说，一下子就好了，在一下子......


为什么过程一定要有痛？可以不可以是没有痛的？我真得很希望他们不会有痛的感受。


医生不是应该减轻病人的痛楚吗？为什么却好像在增加他们的痛楚呢？

Book Fest 2011- Dr. George Lee

Lets rewind back to last Saturday, which I really hope I have a doraemon to help me do it.


Went to Book Fest 2011 in KLCC together with Lee since he's going too. Not really confident to go by myself so I tag along with him. I want to see Dr. George Lee which is a urologist and is teaching in Monash now. I first read his article in Sinchiew newspaper and I really like it. It's sentimental and mostly about his own feeling towards his life, work, family and so on. He is launching his new book on that day. Last year he came out with his first book "make each day count", I didn't make it to his book launching event and didn't get to meet him and get his signature. But I am lucky enough to have my friend, Xiang to bought it and get his signature. His first book articles are mostly same in the newspaper, it's like a collection of his article.

So I went and see him in person. It's so fun to hear his talk and I actually recorded it. I just want to show it to my aunt because she likes him too! She also read his article in newspaper too. She actually in love with his words and become worst than me. She even phoned me and talk about his book!

I bought 4 books in total, all of his books. 1 was published last year which I helped my aunt to buy it, another 3 were for me, my aunt and Xiang. He bought for me last year and this year it's my turn to return to him. All with signature!

He has a huge amount of reader and fans, some is his patients and some is his student. The autograph session last for at least 1 hour. The queue was so long. He actually say 'sorry for waiting' to most of the people. Had photograph with him too! So excited!


While waiting for his signature, a guy call Frederick talk with me. Out of sudden he was behind me. It was a girl behind me when queuing. I have no idea when he appear behind me.
He says: you're so greedy, bought so many books.
I answered (out of surprise, cause a stranger talking to me): oh... I helped people to buy.

Then he continue the conversation asking my name and his name and if I were still studying or working and so on... Well, it's very weird and kind of awkward. I just can't keep quiet and don't talk to him, it's not polite. My friend wasn't beside me so I can't get out of it. He was actually the guy who give support to Dr. George Lee when it was open to the crowd to ask question. He says Dr. George life value is very good, as he still come back to Malaysia after so many years in oversea.... etc. I don't know why he talk to me, even ask me to talk photo of him with George Lee and ask me email him. He actually reply my email saying he will add me in fb and ask me to approve him. Too bad, so far I guess he still can't find me in fb. haha!

I was so happy last weekend! Meet him in person are great!


p/s: left out a small little part. I actually meet my online chat friend. practically doesn't count as 'meet' cause only i saw him. he didn't saw me. we never meet before, never have face to face interaction but i just know it's him for the very first sight. sms and ask if he was in KLCC and he was so surprise i know his location. he actually check if his phone got auto check-in in fb but not. HAHAHA!!! well. it's so funny, and surprising as well. this is what call fate.

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)

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!!!

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.

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?

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?

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...

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？

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!!

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......