Temptations... and Ambitions...

Psychiatry Day 3

2009-07-09T01:57:00.002+08:00

Somehow, being in the Psychiatry wards brings no further emotions apart from that of uneasiness. Not from the patient, but rather from the environment, as mentioned previously. Till now, I've been flouting the pages in hope to finish in time. And the more I read, the more I'm confused.

A 3 days' perspective tells me that Psychiatry is more of a blame game of mental illness. Yes, you may deny it, but look at it this way. It is more of a retrospective view of an illness, pointing fingers at all sorts of possibilities. Notice that you've been under assisted delivery (forceps, vacuum delivery, etc)? Then you could have been at risk of mental illness. Have you ever thrown tantrum when you were a kid? That could be a risk as well. Such subtle and insignificant risks are generally blown up into a full blown issue the day your mental illness arrives. They(Psychiatrists) start pointing fingers at the past, and fortell what could have happen to arrive to such illness. They say that it is not your fault, but it was perpetually pointed at the past at what you've done to experience this. Isn't this a subtle way to tell that "It's all your fault" in your face?

Generally speaking, there is no clear cut borderline which separates the issue of psychiatric illness from normal behavioural issues. In fact, given the tenacity of the psychiatrist, one would expect that everyone would be having psychiatric disorder one way or another! The only thing which prevents them from intervening in everyone's life would be the guideline of the existence of social norms.

And the more time I spend in this posting, the more confused or absurd I can get. Let's hope I'll be surviving the 2 months as a student and not as a patient! :P

A Disillusioned Doctor

2009-07-07T20:16:00.003+08:00

Recently, I've sent an article to The Star. While it was being published, the main content wasn't. Here's how it sounded like: (Link to article)

"I REFER to “Cheers replace tears for SPM top achiever” (The Star, July 4), and would like to congratulate Mo Ye Vonn for her PSD scholarship to AIMST.

However, there are things I would like to clarify to doctor wannabes.

One should know that a doctor is relatively underpaid. An office worker is paid RM2,000 on average for 40 hours of work a week, with overtime allowances beyond that.

A houseman earns up to RM4,000 a month for more than 100 hours of work a week. For that amount, the doctor is valued as much as a clerk.

Besides, most hospitals are understaffed. Certain hospitals do away with the one day off per week for housemen. Forget the one day off post 36-hours call. It’s just a myth.

In short, consider us more like Filipina maids, without any day off, and confined to the hospital most of the time."

And so it was, left with a question mark. I was relinquishing the thoughts of money in this article, which was supposed to be like the one below:

Letters to The Editor,
More Tears to Come

Refering to the article “Cheers replace tears for SPM top achiever”, I would like to congratulate Mo Ye Vonn for her PSD scholarship into AIMST. However, to our amusement among medical students, we find that the tears shed was out of no reason, for life still goes on, without the need to be depressed. Perhaps it was an exaggeration, along with the loss of appetite to eat anymore, but if it is true, I’d promised that there are soon to be more tears to come post-graduation.

Perhaps, there are things I should really clarify to potential doctors wannabe’s. One should know that a doctor is relatively underpaid. General office work pays RM2, 000 on average for 40 hours worth of work a week, with overtime allowances beyond that. A houseman, meanwhile, earns up to RM4, 000 a month for more than 100 hours worth of work a week. For that amount, the doctor’s value is worth a clerk’s job afterall. Besides, most hospitals are understaffed. Certain hospitals do away with the one day off per week for houseman. Forget even the one day off post 36-hours call. It’s just a myth to appease the public of the housemen’s working conditions. In short, consider us more like Filipino maids, without any day off, and confined to the hospitals most of the time. With that in mind, I can assure you that housemen will get rich in no time, earning all the money and nowhere to spend it.

Many a times, the public and the government had been focusing on the doctors as the main primary health caregiver. We talk about improving doctor’s standards, or their pay and working conditions so that doctors could be more efficient. We even thought of producing more doctors that one day, there would be more doctors than accountants and lawyers! Have we ever thought of the health organization and system? Better trained nurses (with better pay, of course) could relieve the burden of doctors in the healthcare service. In the overseas, the nurses are definitely knowledgeable and well-trained, and are given the ability to make decisions. Imagine the housemen in Malaysia who still have to take blood from the patients when these are done by the nurses overseas! That’s why housemanship period would be the time when time management is utterly valued, for most housemen preferring quickbites as substitutes on the go, or sometimes skipped a lot of meals. It’s true that this gives better training to the doctors, but this is just one of the many examples where delegation would free up the doctor’s time to tend to more patients at one time. Therefore, the ministry and the public should be reminded that doctors are not the only ones involved in the healthcare services, but rather the medical team as a whole, from doctors, nurses, attendants to the janitors! Focusing only on the doctors would not do much to improve our country’s healthcare services.

Another main concern in mind would be the filing system in the hospitals. While teaching hospitals are equipped with computer systems in the storage of patient’s data, some government hospitals (if not all) are still in the stone age of keeping data records! Imagine this, computer systems makes information accesible to doctor with a click of the mouse. Results are available instantenously via the system, saving the doctor’s time from running around the hospital blocks to retrieve reports, and the office job of stapling the results to the patient’s file. These tasks can take up to an hour or more each. Imagine the time running here and there frantically, especially in the middle of the night!

And all the housemen can do is to stay strong, for housemen had no voice over such matter, for fear of their career being in jeopardy. They fear that the 5-years worth of studies would go in the dumps just for the sake of opinion. Or they had tring to swallow it out of the name of passion and joy. But, should this really be taken advantage of? Such silence would be the ironic aspect of a the profession, for we are on equal grounds with the maids, that is, being underpaid and overworked (and potential abuse from superiors as well). That’s why, if you’re crying out of rejection of PSD scholarship, I wonder how much more tears would be shed through this ordeal?

--The End--

It was a post of doubts, thinking of what a career would we be into. Since it was somehow distorted, a reply came through:

Don’t be fooled by TV medical series

WITH reference to the letter by YM “Housemen are more like Filipina maids,” (The Star, July 6), I wish to advise those who wish to pursue a career in medicine to acknowledge that it is a noble profession.

It is not about money and a lavish lifestyle as portrayed by the American TV medical series.

It will involve stressful long hours of hard work to serve your fellow mankind.

Only your passion towards your profession will be able to carry you through during your two years of housemanship.

If one thinks that house officers are just like Filipina maids, then I am sorry to conclude that he has probably chosen the wrong career. The writer is obviously only motivated by the monetary reward and not by his passion and interest towards his profession.

A doctor’s work cannot be valued with ringgit and sen. We need to serve our patients with compassion with or without money.

POOR DOCTOR, KL

--------------------------------

Maybe his ideas were distorted due to the the limits of article space, but here I am, telling him that he's crap anyway. ( I'm free to retort anyway.) As someone who would enter this profession, I say that doctors are mostly liars. They may seem all-knowing, but of course, they are humans too. The public overvalued doctors as saints, and perhaps that's why they think saints can work super extra long hours. The old doctors are worse, thinking that "Last time we did the same training, so why can't they?" But expired doctors they are, things are always different every generation. If we would like to compare, doctors last time have to plant their very own paddy to eat. Such nonsense can only be churned out by such extra-ice-age people. Don't make me laugh at his very own delusion that doctor's a noble profession. This just meant that all he wanted was fame, even if he does not admit it. :P

Besides, passion and interest gets you nowhere. Millions of people with overzealed passion were vying but could not get into this "noble" field, so why do you think yours can? Does passion really matter? Or was it the pride that made him think that it was all passion? Life is not about early passion (much more of delusional, if you'd asked me). In fact, there is no single factor which defines what should we do, but we should ought to do with our concience right. He could be one of those who learned to adapt and never complains, but sometimes, such challenges are what that requires us to improve. So, we, the newer generation should actually strive to improve, lest we get such third world doctors who, well, work well in the 3rd world, but not in consistence with Malaysia's strive to be a developed nation. Perhaps it is time we let go of such super doctors, and learn to delegate instead. We may not be super doctors in the future who-knows-it-all, but at least, we will be having a more efficient medical team and a proper organization and system for the benefit of all.

The conclusion is, one man can't save the world. A man learns to delegate, so he can save more. Many a times, doctors misunderstood the meaning, as they thought that the phrase applies to fellow doctors only. And many a times, doctors refused to delegate for fear of loss of indispensibility. But here, I'll say, work and share with everyone, be it your nurse, your attendant, or your patient. With that, you may not be the superhero doctor who save the world or the one people idolizes, but at least, the job gets done easier.

All Psyched Up

2009-07-06T11:58:00.002+08:00

Today has been the 1st day of Psychiatry posting. Of expecting one to have more freedom out of an 8-weeks posting, it would rather seem to be of a cluttered one. The timetable clashes here and there, no thanks to its 20-pages long booklet catered for the students, with our names repeating over and over again. Such disarray can only be seen in Psychiatry maybe. Or just my hospital.

Anyway, back with the place, at least I've finally got to the wards, and it was quite deep in the territory. Grill bars can be seen at the entrance of the male and female wards, reminiscing of what may be seen from the papers of the Taman Sinar Harapan commotion. Well, of course, the patients were well-dressed (fortunately) rather than being in the nude. But generally, I would say that the wards seemed more dilapidated than other wards, being in a world of their own. (Including the students, nurses and doctors). I wonder if I could remain sane after 8 weeks there, not due to the patient factor, but rather the environment. One thing for sure, psychiatry wards could be one of the least conducive place. As far as I am concerned, a proper asylum hospital would be a better environment, with the outdoors welcoming them with open arms. But here? It seems more like we're trying to hide them from vicinity. It's just rather depressing, from what I can see.

And why I'm so free here? It's all because the professors have a meeting for the semester exam papers. Being treated like patients ourselves, we're not allowed to have our supervisor's phone number. Authopsies are generally unwelcomed on the 1st day of posting, so naturally, we'll skip it. Let's just hope some reading for tomorrow's lecture helps. :P

The Cusp of Oscillation

2009-07-01T23:30:00.006+08:00

The worst thing is to see that your horoscope talks rather true about you. At least when more than 50%. So here's for those who wants to know more about me. :P

LEO

Persons born "on the line" between two Zodiac Signs partake of qualities found in both Signs or, more strictly speaking, have a blend of traits that may compose an individual nature. Due to variations in astrological calendars, this may became apparent during the last few days of a departing Sign, but the "cusp" (as it is termed) pertains chiefly to the first week of the incoming Sign. While the new Sign is gaining its ascendancy, the influences of the old will persist but gradually loses its hold day-by-day until, by the seventh day, the new Sign is in complete control.

Individuals born on the cusp of Cancer (the fourth Sign of the Zodiac) and Leo (the fifth Sign of the Zodiac) are ruled by both the Sun and the Moon. These cuspians are witty, ambitious and sometimes, extremely unscrupulous. Indeed, this particular cusp combination frequently produces the most corrupt of politicians who attain eminence. These natives are experts at appealing to the various vulnerable points of their associates and the inherent daring ambition provides the power of securing for themselves the preferment and advancement to which they aspire, even though better individuals may, of necessity, be sacrificed to their progress. Nonetheless, Cancer/Leo subjects will nurture the family group and take pride in the warm hospitality they invariably provide.

The Cancer/Leo cusp combination, also known as the Cusp of Oscillation, corresponds symbolically to the period of human life at around the age of twenty-eight. Of all twelve cusps, these natives most clearly display the split influences of two adjacent Signs almost opposite in their orientations. Here, traditionally feminine orientations (associated with the Moon) and traditionally masculine orientations (associated with the Sun) are combined equally in one single personality. Thus, Cancer/Leo males are likely to possess strong feminine sensibilities and Cancer/Leo females display an accentuated masculine side. Integrated in such a manner, these contrasting characteristics can result in a highly-balanced and healthy personality. However, when there is a tendency to vie for ascendancy, this cusp combination often produces wide mood swings which can cause immense psychic stress. It may be hard for others to know exactly how to approach these cuspians and those who know them well will frequently ease slowly into conversations, sitting quietly until the mood becomes apparent. Generally, it is difficult (if not impossible) to push Cancer/Leo subjects from one psychological state into another due to the fact that they are resistant to emotional manipulation. The water element of Cancer results in these natives tending to respond through emotion, while the fire element of Leo provides a more physical aspect to the character, coupled with a tendency to respond to the world by way of action. Thus, these cuspians are normally quite intuitive and will leap headfirst into life, refusing to fret over whether their latest goal is realistic or practical. However, should the situation happen to require drama or courage, then these subjects most certainly possess both...in great abundance.

Cancer/Leo cuspians love being on the "cutting edge" of innovative projects and activities, possessing the vitality and ambition to be successful in creative endeavors. Indeed, "creativity" is one of the keywords attributed to these subjects and their caring nature ensures that the benefits of their imaginative powers will help others. Although they may not necessarily be suited to the position of leadership, they are efficient and their application to the task at hand is admirable. These natives also know how to delegate authority and work within a team environment. They usually prefer to be in the "thick of battle" rather than be found "sitting on the sidelines," and those who can work with these natives as true associates and partners are often able to share in such experiences, thus penetrating deeply into this cuspian's heart and mind. Cancer/Leo natives set high goals for themselves. They are great thinkers and possess magnificent memories. By nature, these are immensely sympathetic souls...particularly to those in distress and will contribute freely and lavishly toward relief. Loyalty to friends is yet another admirable trait associated with this cusp combination. Indeed, there is no trouble or disgrace sufficient to cause these natives to forsake those to whom they have given friendship. Females governed by this cusp combination are frequently among the best wives and mothers to be found in the entire Zodiac. They are good housekeepers and excellent cooks, with a pronounced desire for "pleasures of the table." Indeed, all these cuspians (regardless of gender) have a strong association with food.

Cancer/Leo natives are both emotional and traditional, often very interested in their heredity and ancestors. They are frequently prominent in the theatrical arena since their inherent flamboyance and love of attention make them natural candidates for fame. There is a tendency here for these natives to perceive themselves as the "center of the universe" and, sometimes, they are absolutely correct. However, often fascinated by their own brilliance and eloquence, Cancer/Leo cuspians may become self-hypnotized to the point where they consider themselves to be masters or mistresses of right or wrong. From high-minded reformers, they can turn into unscrupulous spellbinders and their self-confidence could cause them to ridicule their own conservatism. Once the Leo mind drops its idealism and falls prey to indolence or deceit, then the lunar forces of Cancer will take control in the worse possible way and stir the restless mind with jealousy. However, this may all be avoided by fostering the natural exuberance afforded by Leo and turning it to progressive channels. True Leo individuals born born during the early period of this particular cusp combination frequently rise high in such professions as medicine(swt???) and law, as well as becoming fine educators. The reason for this is due to their human sympathies, which are strongly furthered by the lunar undercurrent supplied by the Cancer influence. Cancer/Leo cuspians often make excellent amateur chefs and some go on to make a career out of cooking. Since pleasure is paramount to this cusp combination, its natives are prone to sepnd money in order to feel good. Cancer/Leo cuspians enjoy physical exercise (which can aid to counter the stress inherent in the emotional nature of this blend) and there is a decided preference here to play team sports or participate in group exercise rather than any solo activity. In short, these natives are far too sociable to truly enjoy solitary running or any other form of individual activity.

Here, the powerful governing influence of the Sun (which governs Leo), assumes almost total control over uncertain Cancer (governed by the flickery and fickle Moon). Nonetheless, this lesser force is present and can evidence itself, much like the Moon will occasionally eclipse the Sun. Individuals born on this cusp combination should basically consider themselves to be the subjects of Leo and strive to shake off any lunar weaknesses that could prove to be their undoing. If such natives become retrospective, then they should consider the past and its traditions to be nothing more than a guide toward a much greater future. Should the Cancer/Leo cuspian become moody, then he or she needs to "snap out of it" and think in terms of ambition. When this combination becomes sympathetic to suffering, it is important that immediate steps be taken to improve the condition or the brilliant and intellectual qualities given to this cusp by Leo may easily become warped or even dissipated. Cancer/Leo cuspians tend to go through life with a strong shell around them...one that is not easily broken. However, such individuals are the first to express emotion in any given situation...the first to laugh and the first to shed tears. There is also a strong ability to see projects through to completion. Thus, they are good organizers and tend to be very popular or even inspiring individuals. These cuspians are prone to be more sensitive to the movement of the Moon through the Zodiac than are other cuspians and their mood frequently changes in tune with the Moon's passage. In essence, these are by nature normally gregarious, social, self-assured and fun-loving characters who live life with much enthusiasm. Usually domestic and peaceful souls, they possess strong emotional drives and refuse to sit still when loved ones are threatened. There is also a tendency in the character of this cusp combination to live in something of a fantasy world.

With regard to relationships, Cancer/Leo cuspians rank high in almost every area...the gambit from devotion to romance. In dealings with business partners and friends, these natives tend to fare better with individuals who are even in terms of disposition...ones who are able to promote a peaceful and constant environment in day-to-day activities. Steady jobs, well-founded relationships and a dependable mate are vital to these natives in order to even out their constrasting moods. Nonetheless, they will most likely remain happy (to some degree at least) so long as someone is paying attention to them.

The greatest strength of Cancer/Leo cuspians is to be found in their creativity and in their generosity toward others. Sometimes, these qualities will combine and result in an individual who provides thoughtful gifts or unique solutions to problems. In addition, blessed with an emotional orientation to life which makes them aware of the difficulties their loved ones must work through, this cusp is counted among the most understanding characters of the Zodiac.

The most important lesson to be learned by Cancer/Leo natives is that they need to work with people who are not only highly competent and can carry their own share of the load, but that such people are able to understand these cuspians on a personal level. It is also necessary for them to learn self-discipline and try not to concentrate overly much on the past...instead, living for the present. Additionally, these natives should note that it is essential for their blood and digestive organs to be well-toned. As with all cusp individuals, these cuspians tend to be attracted to others born on the cusp...particularly those who fall within the Libra/Scorpio and Capricorn/Aquarius combinations.

-- Possess the inward and sensitive traits inherent in Cancer --
-- Possess the outward and fiery traits inherent in Leo --
-- Tend to have rather volatile personalities --
-- Prone to movement...both physically and emotionally --
-- Life is prone to be focused on strength and grace --
-- Often lacking in self-discipline --
-- Apt to dwell on the past --
-- Need to learn to live for the moment --
-- Vibrant and energetic --

Notable Cancer/Leo Cuspians Include:
Sir Edmund Hilary; Ernest Hemingway; Alexander the Great; Amelia Earhart; and Walter Payton

A Second Life

2009-07-01T00:25:00.004+08:00

I was an aspiring guitarist. I started a new life in a town called Sunnydale. Being a young single chap, I was enthusiastic in a new town. I bought a small house with my lifetime savings and began my career right away. I practised guitar, perform in the park for some meager tips, and came home everyday just in time for some own home-cooked meal. Career seem important that I hanged out with fellow musicians as I work myself from a backstage boy to the lead guitarist. The life was nothing but routine, apart from hitting out at fellow colleagues who bore my child(ren) out of wedlock. Not one, not two, but 3 children in total. If I kept matters as it was, soon I'll be fathering the whole population of Sunnydale!!!

Blame it on my charismatic and lucky soul, but I never got to know my very own children and talk to them. Life is all about fame and the sex game, and nothing else. I never got to explore the small town, or did any of the fishing, reading or a massage from the spa. If I'd earned that much, why would I not be enjoying them? At the rate I was going, I would reach my lifetime aspiration to be the celebrity musician that I dreamed of. At the price of life itself.

And that is where Sims 3 strikes reality. You can't have everything in life.

In short, I figured that this game is the best way to invoke your curiosities of "what if's". What if I'd worked hard to achieve my career? What if I'd been promiscuous? What if I had chosen another path, the road not taken?

The up side was, Sims 3 is a totally new dynamic game. The Sims world were no longer compartmentalized in squares. It's an open field (requiring much more of graphics rendering, of course) where the world is your imagination. Roam the world, smell the fresh air, bump into a fellow Sim by the road, or go for some hobbies. The tomatoes outdoors are harvestable, the fish are there for your fish and chips menu(provided you knew how to fish and cook). You walk your date from house to the fine dining, or visit the theatre on a date.

Eat more, and you'll see your sim gradually grow fat. Exercise more and starve yourself, maybe you'll get slim. And of course, your sim(s) have moods, or characters which clearly defines human. And your sim ages (provided you did not switched off aging in the options) gracefully till the day they die.

Then again, there are limitations. Despite my many attempts to flirt with many females, and lots of woo hoo-ing (sex in Sims term), there wasn't any repercussions. No sexually transmitted diseases, no AID's (Sims citizens are free from infectious disease). Well, you may expect drama when you were caught red-handed when your lover B bumps into you while you were having intimate moments with Lover A. The dramas that ensues was the reason I started this side-story to fill in my curiosity.

Apart from that, my sim was just a workaholic. A bachelor who lives a free but lonely life. Life started as he steps out of the house, but back home, he is just a lonely chap. Towards the end, he'd realised his problem, but it was too late. It was just a matter of days before he aged and turn into an old lonely geezer. A man with career and fame, but without a resting place to retire. It must have been depressing to learn this.

From what I've learnt from here, celebrities live a lonely life. They might have millions of fans and friends, but there was never a true friend. It's such a irony that perhaps, MJ might have played this game before deciding that it's better to die young and be famous than age but soon forgotten. This is just a theory postulated out of fiction, but nevertheless proves that only celebrities who died young are remembered better, be it Bruce Lee, Elvis Presley, etc. That is when all your belongings become freakingly expensive at auctions, but well, you never get to enjoy the wealth of it.

Maybe it's time to take life easy. I'm not sure if I'm ready to slog myself through that much of work for life. Maybe the balancing act, done right, ought to make life easier.

Or maybe I should doze off right now. Nitez!

The Tracheotomy Assistant

2009-06-29T17:43:00.004+08:00

A tracheotomy can be done in 1 minute time. Particularly for emergency.

That was what Dr Ee mentioned merrily while whisking away from the changing room, towards the operating theatre. Crap, the last one I saw took at least half an hour from scalpel to needle. Wondering if he's just joking.

Well, I tagged along, because the patient was one of the many rare cases of trachetomy done under local anesthetic. And also because, the patient was my grandma. I did not tell Dr Ee (not intentionally) for fear of disrupting his focus. Well, you know, having a family member around can be intimidating for some doctors. I'm not a fussy one anyway, and what happens in the OT stays in the OT, with me well aware of all the potential risks and complications.

After a while there, Dr Ee was there giving instructions to the nurses and anesthetics. Lignocaine, size 8 tracheostomy tube, no sedation, etc. I was listening casually for I was just observing. No stress, no tension. It was another freezing evening in the OT.

"You can scrub in if you want to," Dr Ee gestured to me, giving the green light.

But crap, I wasn't prepared. I haven't scrubbed in for an OT procedure before. Call me a noob. I know some of my coursemates would be dying for this opportunity, but I wasn't one of them. I'm always the laidback, because there's plenty of chances when you're a houseman and I believed that opportunity presents itself (which is untrue, of course, I know). But today was one of the days when Mr Opportunity really presents itself right at the doorstep. Was I in the position to refuse?

Soon I was in the gown attire. The nurses and the attendant were helpful in aiding me scrubbing in. Gosh how funny can I look when no one could recognized me when I'm wearing a mask? And there I was, holding the retractor ala "pokok" style. Glad he gave instructions because O&G phobia of having to help without being told made me think twice before offering to assist. Plus O&G nurses can be mean. Very mean.

The whole process from scalpel to needle took just 10 minutes. The added time, he said was due to the fibrosis around the trachea as a result of post-thyroidectomy some 20 years ago. The incision was "minute" according to him, approximately 3-4 cm on the neck. I saw some incisions were done 2-3 inches, so I knew it's an exceptional case. Hope there's no problem with such a small incision such as stenosis! :P

Well, I must admit it was kind of fast overall. He has 8 years of experience, what else to say (Not to mention the ability to brag with pride-but willing to teach nevertheless). Grannie's stable now, waiting for the pneumonia to subside. It's a tiring day with another fateful event in ENT. I'm not sure if this is really called fate, or just another series of coincidental events. Or maybe it acts as a reminder of the purpose and meaning of being in this field. And the very sole reason why I'd preferred to study in UKM(despite its many dumb protocols and imperfections - guess humans need to adapt to imperfections after all).

Somehow, if the fateful encounters with ENT continues, perhaps it's a sign of fate. Should I heed the call or should I not?

I'll just worry of the present then. Until then... until then...

A Short Ending

2009-06-25T14:40:00.004+08:00

After what seemed to be a clinical hoo-haa for the past 2 months, a beam of excitement surfaced from the magentic horizon. It's the end of one posting, which meant, the mid-sem break is here. Somehow, it was quite a relief that I'd shrugged myself through. Time flies in the Triad posting, and the moment you could pause for your 1st gasp of air, it is already the end of the posting. Blame it on the 9 weeks holiday, the comfort zone which I needed to be pulled out of.

Looking back at it again, it didn't look that shabby after all. Maybe it was the "getting used to it" part that was hard. Having a 3-weeks encounter with the supervisor of each posting almost seem inadequate. Eating an exotic meal was challenging enough, what else it's like having 3 different meals one after another. (Authentic Sze Chuan Curry, Vietnam cold food and Thai's fried crickets, etc) But, if there's so many students who went through the same journey and survived, why not me? Maybe there's gonna be hiccups here and there, or possible diarrhea, but I guess I'll be able to vomit back a substantial amount for the exams. :P

Next, I'll be having my 8 weeks Psychiatry posting after the 1 week break. People told me its going to be an easy time there, so I'll just see how it goes. Seems that this year around, everyone is trying to compare who has the easiest posting of all. If I am to believe all the feedback, I'll be disillusioned that Year 4 is a stroll in the park. Compared to last year, there are always claim that the posting they are in are the hardest of all. Or maybe it's just that same few who made the noises all the time. It so happen that I haven't met them all. Yet.

And so, here it is, time for my Special Study Module meeting. Maybe I'll post more updates and thoughts during the holidays. I'll be having all the time in the world. So, whats the rush? :P

A Frozen Skill

2009-06-22T23:00:00.003+08:00

Just got my certificate that would maybe last 2 years in the freezer. The Basic Life Support skills, which are slightly more advanced than the layman's ones, would be put into waste. When would we really be helping a victim? With the rampant HIV/ Hep B viral spread, no one's gonna take the risk unless you have the face mask kit. And are we going to carry it 24/7?

I'd rather freeze the skill for 2 years and wasted it down. Muahaha.. End of story.

The Bean Series

2009-06-20T17:24:00.003+08:00

Introducing the new family member, Chocobean(Right) :P

Brain Dead

2009-06-18T20:55:00.005+08:00

I guess among all the patients, brain death is a rare case scenario in the hospital. I happened to be there, in the ICU, by chance. All these while, I've only heard of it in the movies, Hong Kong TVB drama series (making it looked very common), and any novel stories of the fiction side. Never would I thought that I'll be encountering one yesterday.

Brain death may sometimes, be the most traumatic death one could ever imagine. With a mechanical ventilator along with other life support, the patient seems to be lying peacefully on the bed. Close family members would of course, wish that the patient was just in deep sleep, waking anytime soon. But all lies is but just a human body in a vegetative state, incapable of human function. A living corpse, as one would name it (perhaps that was what that gave ideas to the creation of zombies anyway).

The patient was in her 30's. Late thirties. A young one for that reason. After somewhat of her state, her family members were told of the outcome. A bleak one. The father had accepted it, but the mother was in denial. Sometimes, it is hard to swallow the fact that your beloved ones are gone, what else when you can see them unstiffed as one would expect a dead could be, with what seem to be chest movement with every breath of the ventilator.

We were taught on the brain death certification prior to the test. The widespan ethics enclosing the brain death matter can be a flinching idea for any doctors. To certify was rather easy, but to break the bad news to the family members was the hardest of all. On the moment of truth (brain death certification), she was still. No response. Her chest was moving up and down as a sign of surviving act, but the tests of the brain stem (Cranial nerves tests) indicated otherwise. Absent pupillary reflex, absent gag reflex, and absence of natural breathing exasperation when the ventilator was removed temporarily (apnea test). The eye balls were held in a fixed gaze despite turning her head left and right, although there were some wobbly motions of the eyeballs in the transition.

We've watched a lot of movies and series to tell us that miracles do happen. Comatosed patients waking after 5-10 years, or even 20-30 years, with no signs of aging nor muscle wasting. Not even any malnutrition was noted despite the long comatosed duration (And we audience believed the TV back then, even till now). But the cold hard truth was, no one would wait that long. No one could ever last that long.

There are reasons why brain death certification is more important in government hospitals. The Intensive Care Unit (ICU) houses limited beds, and each one is a rare commodity with a price tag numbered with the number of human lives which can be saved. The life support machine could be needed elsewhere, for those who would be able to benefit more than the sole one which had an extremely dimmed chance of living. Besides, the organ donation team would also benefit from salvageable parts, and saved the lives of many other patients. Some may think that it is a form of "harvesting the living being", but rather than allowing it to rot in years. Even if that patient manages to wake in 10 years time, the body function would be worse than an 80 years old man. Physiotherapy would not be able to substitute the "exercise" of our normal body function and activities, at least for that long period of duration. There are many more ethics and issues involved, but I guess it'll never end if allowed to continue. But, not all hope is lost. If you're as rich as Lee Kuan Yew, you'll be able to sustain a continued support of ICU maintenance with the life support in private hospitals. Mind you, the cost is no laughing matter. A few days' stay in ICU in private hospital can cost up to 5 figures, what else a year's worth!

In the end, it's all up to weighing the pros and cons. "Sacrificing" a life to save more lives may seem justifiable. But then again, who would do so if it happens to themselves?

This is the dilemma where even Big Bro would need some head cracking.

Anesthesiology

2009-06-16T19:30:00.005+08:00

2nd day of Anesthesiology. Ophthalmology has been the past tense, with much sweat wiped off. This time? It's been a whole long day of standing. Walking and standing in the labor room OT in hunt for log book procedures and gobbling down the Anesthesiology book as soon as possible. Each book ought to be finished in the 1st 3 days by right, so I'm sure taking my effort in finishing it.

The labor room OT sure brought back some nostalgic memories. And of course, some attitude. Imagine when you greet two doctors and there wasn't any acknowledgment. You thought they didn't hear you, so you practically raise your voice to greet them. But all you get was some stare with the intent "Nonsense medical students, shoo away!", and you knew that they weren't exactly ENT's candidates of sensorineural deafness. They wouldn't need cochlear implants either, but perhaps some EQ implants. And mind you, they weren't the merely housemen or registrars, but prominent figures in the department.

And then, some doctors just never change . The hormonal level in O&G has always been a lingering high even in the bloodstream of some doctors. Mood swings, and disregard for others when it comes to petty quarrels. Our Anesthesiology professor was being pursued from 1 OT to the other just for the extension of time and the long-winded argument ala housewife from the O&G doctor who was of the same rank. Well, the anesthesiologists were right on one thing, they were treated just like nurses by the surgeons. Whether the surgeons respect you or not, depends on their very own personalities.

And the nurses? As usual, barking up on every tree they could scramble on. The superiority complex just never ceased to amaze me, for no other nurses act like those in the O&G department. Saving lives is one thing, keeping your head sane is another. If only they could realize that, I'm sure they'll be great doctors and nurses if not fantastic. But I guess they are humans after all, fallible to mistakes. Perhaps, it'll take some time before the realization sank, which by the time, I hope it wouldn't be too late as to see the freefall of the department.

On the bright note, I'm sure there are equally as many good doctors in the department. The doctors who are always involved in the Personal and Professional Development has always been the doctors with a respectable integrity. I wonder if the PPD gave them a good perspective or the nice doctors and PPD has always been having good affinity with each other. It's just that sometimes, it's rather frustrating when there are so many "bad apples" in a department that they influence the registrars and housemen. And this can give a hard time for us medical students.

I"ll just dread my return to O&G next year should I able to proceed to 5th year. It could be a torture if I got some "hawks" (as described by Prof Oteh), or it could be some paradise if I had one of the "doves". Anyway, lets just see how it goes for Anesthesiology for this 2 weeks, and we'll worry about the future, in the future instead.

An Eye for a Nose

2009-06-08T20:20:00.006+08:00

I have been having allergic rhinitis from young. Just pick me up and I'll be a decent ENT "specimen" for nasal speculum. Engorged inferior turbinates, deviated nasal septum, etc. Plus, you can just diagnose me from many of my symptoms, from coughing, stuffy nose, sleep apnea to heartburns. The spectrum of complications would never seize in fact, and might worsen any day possible.

All I can say is that perhaps none of the ENT doctors would have notice it. Or it was too minor that it escaped attention. So common to them that no one really bothers about it. It's either I'm being compliant or non-compliant to medications (which I am definitely not a good one).

And then, there was 3 weeks in Ophthalmology, my supervisor would have notice it from my constant rubbing of nose. A prominent sign of "itchiness" for allergic rhinitis. Never mind that she might have missed some of my symptoms. But at least, she could know what I'm having. Seems like it takes an ophthalmologist to diagnose a nose problem.

I'm not saying that the ENT doctors are no good, but most likely it was overlooked and ignored. Seeing the same cases everyday, everything in your field becomes a routine that the minor signs can be ignored completely. Doctors are humans too. Most of the time, we even overlooked our very own health when we as doctors should be the most concern of ourselves. Have you heard of the case of a Cardiologist dying of myocardial infarction, or the doctor in the public health advising the public on healthy lifestyle when they can be obese themselves. Luckily, the male obstetricians would not have the chance to suffer from postpartum complications!

I'm heading towards the last week of Ophthalmology posting as well. Be it a pass or fail in the mini-CEx, I think I've learn a lot, especially from the fundoscopy. At least UKM's new must-buy-ophthalmoscope policy ensure that we would be knowing how to use the fundoscope properly. :P And coupled with a strict supervisor? Well, at least we're learning something.

Note: Case-write up is almost finish with the PPD component remaining and some amendments. Anesthesiology posting would start the following week.

MAB Revisit

2009-06-04T00:45:00.005+08:00

Ophthalmology posting sent me back the memory lane: MAB. It was a surprise for me to be there for the 3rd time, and I'm going to know the place inside out soon.

It wasn't really a pleasant visit as I could say. We could make use of some punctuality as MAB people have to wait for 1 and half hour for us. Mind us for not even having any gifts or souvenirs of appreciation, but we were the ones begging them to show us around in the first place. Plus, 57 of us was way too much for them to handle since tours are done in 20 persons max (forcefully). I really felt shameful for how we are doing things in UKM. Everywhere we go, we bring such "fame" along. Not to be reminded that Dr Sheik Muzaphar did carry the same burdens and acts too, where more and more blogs are reporting on his infamy acts in schools and much much more, which might qualify me into trouble if I spilled out anymore. Until when will we be able to apply our PPD skills thoughfully?

Nevertheless, here's a brief summary of events with photos:

New kid on the block (Right) joining MAB :P

Just kidding, it was just a demonstration of a blind leading a blind.

ABC center

Medical students cramming the place

New kid in MAB fitting in. :P

Are they sleep-walking (standing) or just trying to empathizing?

Low Vision Center

And the KFC for lunch. Wedges were twice the size once upon a time, not long ago.

That's all for now, before signing off and off to bed.

The Ticking Time Bomb

2009-06-01T22:45:00.005+08:00

Tik..Tok.... The time bomb ticks every second. No one knows when it's going to explode. The legs had been shaking, and I'm sure I'd swallowed a thousand liters of saliva. The heart almost went still the moment the brain freezes. In countless situations, I was walking on a tight rope, and never failed to be amazed that I'm still balancing still fine. Still fine for the moment.

And that is what I felt like facing in the Ophthalmology posting. Somehow, it reminded me of O&G. Perhaps the similarity of the initials (O) played a part in the bad luck. Bad in the sense that, I'm forced to work the extra mile to survive. Maybe it's good for me that I'm working my a$$ off the calories, but it sure ain't good for the heart.

This would be the first posting where I'm having to do a case write up without the patient's notes, and seeing the patient once in the clinic. ONLY. My supervisor said it's going to be too bad for me because what I see would be what I get. And that was my 3rd day in posting, 2nd day in clinic, and 1st day with my supervisor in clinic. I'm not even sure what was I seeing, and there it goes. She promised that our mini-CEx would solely depend on our skills in fundoscopy, which a lack of skills which guarantee a failure. Hmmph.. I'm not sure if I should be grateful or fretful over such "good treatement". The thought of resitting a minor posting did occur now that I've seen my chances to pass as a glimpse of hope. God knows how long will it take for me to learn to appreciate the fundoscopic findings. My eyes are squinting towards the end, and I'm not even sure of the results of such hard work.

Where is the bed of roses in the Triad posting? I've had 2 supervisors who are enthuasistic to teach and drill us and made sure it's no honeymoon, while the rest seem to be having joy through their Triad. Is Triad really a minor posting? It felt like a super major posting after all.

Signing off

Reading Manners

2009-05-31T12:24:00.002+08:00

I'm sure at some point of time, most of us became avid readers. Such popularity was the book that we sat day and night to finish the book, or bringing it along everywhere we go. During meal time, in the toilet, on the train, walking back from the mall, or perhaps, while driving in a traffic jam.

But, sometimes, have we forgotten about mannerism? If there is such a rule, I would call it the book etiquette. While some may seem harmless, what we actually did was to deprive ourselves from the joy in life. Can you imagine yourself reading during meal time? I've seen many grownups father figures (not mine though) reading the newspaper while waiting for the wife to feed their children. If and only if the father would have put it down and talk and interact with is children, I'm sure he'll be able to see the joy of the family bond, and not by regretting having to miss it. Nowadays, even school children read their school books while eating with their family, whether inside or out of the house. Such is the kiasuness that most of them had, which does not even guarantee better results.

And sure, this had gave birth to a younger generation who wouldn't even look up as they gaze intensely at the book while talking to you. Is there any manners if you are at the receiving end?

Or in the toilet. Do you have any idea that many claimed reading while sitting in the toilet creates more constipation problem than you would have thought? But that's not my argument, but I just think that reading memory should be associated with better smell memory. Plus, I've seen many eating Nasi Lemak in the toilet in my secondary school. Maybe the extra "flavor" tasted good after all!!

Reading on a public transport may be a good idea if it's too long a journey. But this should be limited to light materials such as magazines. However, being one of those with motion sickness, I am not in favor of such habit. Unless you are sitting down, you should be aware of your surroundings while taking public transport, as pickpockets are always on the loose, regardless of where you are. The same goes for those who read while walking. You might be knocked down by any vehicles as you cross the road, or the foul victims of snatch thefts and robbery. These acts are done preferentially on those who are less alert, mind you. The robbers and thieves aren't exactly that stupid to not notice. So, don't blame anyone but yourself when you became such a victim. And reading while driving? That's even worse than drink and drive or on the phone while driving.

Reading should be done in proper places, where comfort lies, as it is of pure enjoyment. Reading in malls may seem somewhat attractive as claimed by Abby Wong in her article in The Star, but her somewhat weird fetish for "Guys who read in public" is a baseless recommendation. Instead of helping out with groceries, the guy may choose to read instead. Such typical male act would not be tolerated if found to be true, as it is just a method of escapism from duty.

What in the end, I am not discouraging people from reading. Read all you want, even porns if you fancy them, and I don't mind a little, but please be reminded of your book etiquette.

A Rant of 2 weeks

2009-05-30T18:03:00.004+08:00

Found these few pictures, so I'd figured updating it would be nice.

The final week of ENT posting where there are more registrars (Masters student) in the wards due to their impending exam.

As a matter of fact, I went Jogoya last week with my parents and my dear. A combined father-mother day celebration, and everything's on me including the twin seats in Pavillion for Anghels and Demons later. But truth to be said, after so many thumbs up from blogs and friends, I'd a hard time swallowing it down. A big letdown, probably due to its quality.

Perhaps Jogoya was at its prime, years back, but definitely not now. Firstly, there are VIP counters with food reserved, which made it a no-no in customer service. Secondly, I would say Jogoya would have been a fine display of decent food for its price. It's definitelt not fine cuisine as mentioned by many others. Maybe it's due to the fact there many have not really tried what is FINE afterall. Among many choices, I would have said that only a few made to the passing list, the baked tomato seafood cheese, potato wedges (which KFC would have done a much better job), the coconut juices with their recycled shells, and the other beverage section. The satay was way off with normal Maggi Mee curry sauce, and any Station One cafe can outperform Jogoya in terms of steaks and meat. in short, none of it was outstanding, which I have to give credit Saisaki which would have done a better job with half the price. the list of dissatisfaction grew so much, and I figured even a meal in Smokehouse would have been a much better choice, a small but enjoyable quantity.

And none of the meat were fresh.

Jogoya won in terms of ambience and space.

Fine display of plastic "shark fins" and fake abalones which taste normal that even "Lala" would taste better.

A bunch of "freshly" stir-fried golden needle mushrooms lumped with too much flavoring and tasted terrible.

A generally 3/10 for Jogoya. Or perhaps my expectations were really too high.

Nevertheless, Angels and Demons was a fine movie with spectacular scenery. It's better than Da Vinci Code movie in terms of storyflow despite its rushing ending. But none should expect more for a 2 hour movie. I'll recommend those who would prefer a better story, to read the book. Movies are after all, just a snipped version of the novel.

All in all, spent Rm400 on that day, so at least the movie was a redemption of the previous not-so-fortunate incident. Well, at least my parents were happy, and it has been really some time since they'd entered a cinema. So, I guess that's worth it. :P

Eye is Not Just Eye Afterall

2009-05-25T17:38:00.004+08:00

It was my first day in Ophthalmology posting today. For the first 10 minutes into briefing, I was almost very sure that I hated this posting. Eyes, are just eyes, it seems. The coordinator did not make it welcoming for us to be there. It promised misery so true that we'll wish we would not be there. And the rules and regulations? Crappy.

But soon, I was proven to be wrong after all (Glad it was). In the clinics, the doctors were friendly and willing to teach to us. Never mind our supervisor wasn't there, but we learned what we came to learn. Too bad that I could not appreciate any, and blind as a bat we could be as. There were many findings, enough to fill in a third of my 20 requirements of fundoscopy findings, if and only if we knew how to appreciate them. But that's besides the point.

There was this elderly man who came for follow up. All I knew was there was something wrong wit his lens, I guess. Something ICOL or like that, perhaps spelled backwards or anything. He was asking for guidance on cleaning his wife's eyes. There, the doctor was correcting him for he caused pain to his wife, which lead to a much more heated argument, as he claimed. Despite being taught the proper way, he was reluctant to help his wife, for admiting a mistake took a lot from his ego.

And there the doctor had to do a counselling job. Marriage counselling it seems. Ways to "tackle" the issue so the husband would help his wife. Ways such as explaining to the wife that it was an "alternative" method to clean his wife's eyes which was taught by the doctor. And ways to fish out his love for his wife from the sea of egoism. It wasn't an easy persuasion, but it sure was cute looking at a 60+ years old man acting like a kid when it comes to ego.

And there was this case of a 12 year old child coming for a followup. Her left eye was injured. Child abuse. The dad and her step mum did the unthinkable. And there I was disgusted at the thought of the father who was heartless. Until I heard that it was a doing from a hammer by her father. That is just way beyond the soul of a living being. Poor daughter who had almost been blinded by the hammer of the father's doings. What was he thinking?

There were many more interesting cases which can be seen in the clinic. One thing for sure, I was glad I was there. In the clinic, we "see" the world through the eyes of the patients. And we, became the eyes of the society, to observe and watch the flow of time. It sure does look interesting, but I'll have to make sure I'm finished with the requirements of the posting. Otherwise, I'll be "able" to come here AGAIN. (Note: There's no ophthalmology posting in 5th year)

Making A Difference, Not the Numbers

2009-05-24T14:40:00.003+08:00

Life is all about making a difference. A difference with a sense of satisfaction when you knew that you were a part of it.

And that's what I think my life should be about.

Back in my secondary school, I believed that not all national schools are crappy. Despite others saying that a better future and results are ensured in prestigious schools such as VI (Very Idiot) or St John, etc, I enrolled in one. The school was on the down side with its poor performance, and I got a decent good results in SPM with 10A1s. It (and also better results from juniors) was enough to motivate the school to perform better, and to believe that it is not impossible after all. The teachers were happy since then, and students flocked to enroll in our secondary school. Of course, I was happy for 2 reasons: I got Rm200 from a decent results (while prestigious schools in KL would only award you a cert/trophy/plaque), and I got to make a difference. The sense of satisfaction that follow through was sweet back then. And that was the tiny little difference I was happy to make.

Well, that didn't end there as I continued the deed in college for STPM. I wasn't the first, but it gave hope to the teachers that their efforts were not in vain. Still, it was another sweet moment back then, where I had made a difference still, and not just filling in the numbers.

Until now, I still had the same feeling for where I lived. Not in academic sense now that it's not of a major relevance. I'd felt the duty to serve (but not blindly) the country I lived in, despite many of its major flaws. True, discrimination happens at times, but it happens everywhere in the world. Why would that stop us from being indifferent? Despite all the racism chants that were hurled almost everyday, deep down inside, we are all Malaysians. That would not change a single fact about it. Malaysia, afterall, is a multicultural country with a diversified population apart from its diverse flora and fauna.

If our country is weak and flawed, it is us who should work hard to improve it. Each country had its stages of development and go through the changes and growth. So, why are we running away to neigboring countries to enjoy their "development"? Can't we help out in our very own country? Can't each and every one of us make a difference here, instead of making the numbers in neighboring countries?

Help our own people. Rally for a change if we had to.

But I can't force everyone to accept my views.

Afterall, the grass is always greener on the other side...
Because we were too busy looking instead of tending the grass on our side.

The Beautifully Imperfect Mind

2009-05-22T17:31:00.003+08:00

Sometimes, the mind can be deceptive. Sometimes, it tells a tale far from the truth. And sometimes, it rather believe in outrageous lies rather than the cold hard truth. And let me share with you a recent encounter of mine.

I was on my way back from Laman Midah to hostel. With some "heavy" footwork which leaves more carbon footprint. As usual, the traffic was slow, and the eye wanders off somewhere over the horizon.

Then there was this car in front of me. It was shaking furiously from side to side while it was on the go. As it stopped at the junction, it was basically "bouncing" up and down, straining its suspension. And there I was, puzzled by the incident. What the hell was going on?

There was a guy at the back seat. He was facing me, the driver behind the car. I guess he was the one causing the lateral and vertical movement of the car. even through the window, I can see the man in specs nodding his head up and down, and then trying some manouever up and down, from slow and steady, building up a momentum which seems to be more furious as he continued. Not long after, another man sat up at the same level. He was in a messy state as well, the hair was rather messy from all the God-knows-what-they-were-doing stuff.

And there were so many questions running through my mind.

If you'd ask me, my first impression wasn't that clean, I gotta admit. What can 2 men be doing in the back seat bouncing up and down and in a messy state?

Well, it went on for quite a few minutes as I followed the car. I guess no one can be that athletic for such a long time non-stop. It looked more like an act of desperation. An act where it seems life and death seems of the main concern.

Till then was when it struck my mind. They came from Laman Midah. And the car seems to be going in the same direction as mine.

The hospital.

I guess after all, it was a resuscitation effort. CPR. Laman Midah apartments meant one thing: They are medical personnel at least, a place where UKMMC personnel and students hog a major part of the place. Maybe there was someone who needs resuscitation. I saw them heading towards A&E, but my curiosity did not seem to get the better of me. I've been traumatized by my initial thoughts, and I'd rather let it have a rest. And that was the case of a misunderstanding.

So next time, do not believe what you see. Things may not always be what they seem to be.
I may look fat, but to be honest, I am lean and muscular. :P

The Liar Game

2009-05-19T22:33:00.002+08:00

I've been living in the heart of KL for my whole 23 years all this while. I should have known the liar game inside out all this while. But sometimes, I proved myself human. I fell for the smallest tricks at times, when I begin to give the benefit of the doubt. To what extent? I thought I should let down my guard and to start to accept. But all I knew was sometimes, human are fallible creatures. The gullible side in every human would always coexist with their "innocence", as day and night would. So, why am I still so liable to believe such things at times?

Perhaps, it is the feel good factor, not to question, but to have faith in your friends. It is always tempting to believe each and every single word from pleasant looking strangers. It is always better to believe that a friend who pretended to be sick, rather than trying to question the motive of last minute ditching in the mind. And it is easy to believe a friend who claimed to be a genius and rich, to be rejected from an organization just because he/she was overqualified or due to reasons such as racism. It is easier to believe the claim of a housemate that he got 3.71 for his CGPA, when he had only 3.20, going great lengths to lie for the sake of nothing but a pinch of self-satisfaction.

And yet, these malingering happens all the time. Well, on one side, one would felt anger. But on the other side, they claimed that they had done no harm. However it may seem, if we look from a perspective, no one really does something for the sake of harming someone else. Each and every one of us, in our lifetime, did some harm to someone else, because of our selfishness and for self-perseverance. Hypocrites we are, but Hippocrates we aren't.

Politicians never tried to ruin the country on purpose, all they did was for their own benefits, in monetary gains, fame, and power. The same goes for the government as well as the opposition. The welfare of the citizens? They might be there, but it could be the 2nd, or 3rd, or 4th, or the last priority to the sake of non-existence. Pastors preach for they love God and wanted to be loved by God. And all religions preach the benefit for doing good for the sake of heaven. Wouldn't that be a form of materialistic gain? Can't we just help the others because we wanted to? Or arguably by some psychologists, we do good so that we would feel good, which could also be a motive in the first place. To what extent, I do not wish to explore, but all I can say that, it all lies in the gray area. Faith and lies would stay as in Yin and Yang, never to overpower each other.

The liar game, is after all, a test of faith. What is faith if there are no liars?
And what's a lie if there's no faith?

HOT!!!!!!!!!!

2009-05-13T00:20:00.003+08:00

The weather is hot!!!

The OT

2009-05-10T18:08:00.005+08:00

It's been almost a year since I last set foot in the 18-operating theatre center of UKMMC. It was during Surgery posting last year. Nothing much of a memorabilia in a place where there's everything and you gain nothing most of the time. But this time, I set my foot again, as a 4th year medical student. ENT posting.

And it was eight in the evening.

The on-call doctor had called us to look at an emergency tracheostomy(creating an external opening at the throat to ease breathing) under local anesthesia, a rare case when usually it's being done under general anesthesia. So there we were, our group standing in the OT, with soft music in the background. At least not some hard rock music preferred by some surgeons.

The old patient was anxious, but he soon calmed down after attempts to put him down on the "stage". His laryngeal cancer grwoth was too large that it almost obstruct the whole airway. Being too old, he can't stand GA for too long, so it was reserved for the later biopsy procedure.

The cold air in the OT invoke some nostalgia. Partially Surgery, partially O&G. Was it that long ago? I'd remember that I understand nothing of surgery, being a clown bystander most of the time in hope for a signature. At least this time, I get to understand how it's being done. Surprisingly, the "cutthroat" was not that grueling as it seems. At least not like those cricothyroidectomy done in the movies which looked dramatic and the impending threat of death loomed. Done proper, it finished in no time. The environment began to stir some feelings of the past.

Once I'd thought of being an ENT specialist. Well, perhaps that was one of the many reasons that tipped me in here. My own conditions which had not improved after a long time made me even more determined to find the answer myself instead of being conned by those private ENT docs. Now that I'm here, I'm beginning to seek for the anwers that I had been looking for. Allergic rhinitis, laryngopharyngeal reflux, chronic cough, nasal septal deviation, polyps, some minor obstructive sleep apnea, lack of focus most of the time, mood swings faster than PMS at times, they all fell into pieces. What there may be missing some pieces of the puzzles, at least I got the general picture.

The X-files are not that "X" anymore.

The interest in ENT would grow better if not for the rush of a short posting, and what now lies ahead is a long journey. Would I really want to be an ENT specialist? The thought lingers, but the pre-requisite of a being a Surgeon prior to that is not a welcoming thought. Isn't there an Internal Medicine masters instead? Or dermatologist? One thing for sure, the future is undetermined, and who knows, I might not even be in this field after a long practice? Again and again, only time shall tell.

Have you McValue LUNCH-ed this week?

2009-05-09T08:38:00.004+08:00

A year ago, McD jacked up their menu prices. There were many complaints about it, coupled with the diminishing services and deteriorating food quality. Being a rather frequent customer especially when Wahid Cafe became dog food, I was one of the many who e-mailed to McD, and they had turned a deaf ear on it.

Nothing was been done, for Burger King, their once strongest competitor had now been nothing more of a shrimp. I remember the last time McD lowered their prices was not long when Burger King hit the market with style, threatening to displace McD out of the Malaysian food ecosystem. So, there was nothing much that can be done for this.

But now, everything's not the same anymore. The price increase turn down many potential customers, and the rumored McD supporting Israel had caused an uproar that everyone loves to see: Pushing the price further down. I wouldn't know if it's true of the support, but I am sure grateful for the action. A national boycott is what it takes to push the price down, a move really welcomed by McD's customers. Instead of having once every month due to the expensive tag, we had twice a week at a slightly cheaper bill. How's that going to sound?

Well, some may argue that it is affordable even at a skyrocketing price, but please look at the whole picture of affordability. Plus, you may not even be the one earning to pay for it. Not that it matters, you can even bring your own tupperware or your reusable McD wrappers and paper bags for takeaways if that pleases you to leave lesser carbon footprint, but McD ain't gonna bother about it.

Now that the McValue lunch promotion is running so smoothly, nothing can stop the customers from coming back, unless there's a new McD pandemic H1N1 flu. The success of it had made McD extending their promotions from only 4 basic meals at RM5.95 on weekdays to extended higher range menu at discounted prices available Large Add-on even on weekends. That means everyday!

Of course, nothing would stop us from having McD when we had the time. McD is the most convenient fastfood where there's 7 spots I've frequented, particularly when McD is "active" along MRR2. Even in ENT posting.

Now, how's that? McD meal is fully inspected. Safe and clean.. :P

How bout you?

Murderer-in-Training

2009-05-06T21:55:00.003+08:00

I thought Med School is supposed to turn our hands into healing hands. I thought cadaver was the last dead thing we had to touch.

But I guess the movie Pathology might have been inspired by the Forensic Pathology posting. Cadaver was one thing, fresh bodies is another. Cadaver feels fake afterall. But fresh bodies? I had no idea. I wonder how many would just faint at the sight. I wonder if I would be one of them.

Surgeries are just incisions, but post-mortem felt more like decapitation and mince meat. And I wonder if it would be something like this below:

(Click to enlarge: 18SG)

Let's just hope my 10 observations and 2 post mortem would flow smoothly. 4th year is already so foreign. :P

Random Pics update

2009-05-04T16:00:00.006+08:00

Holidays had been non-productive in a sense, but still managed to grab a whole lot of my time. So here's some updates of at least what I have done some purposeful stuff in my life:

1.On the track

2.Gerai Klinikal at SMK Lembah Keramat: Hadi the patient

3.Gerai Klinikal at SMK Lembah Keramat: Blood test

4.Gerai Klinikal at SMK Lembah Keramat: The feast for us

5.The Ipoh view

6.The plastic trees in Ipoh that cost millions when you can get cheap palm trees

7.How I wish to learn, but till now, the only word I knew was: YAMATE!!!

8.A view from Suria KLCC

9.Outside KLCC

10.The twin corns

11.Su Yan gobbling the sushi all by herself on Sushi King Bonanza.On Friday, Saturday and Sunday.

12.My dear's new hostel room in Laman Midah: Bed and the table that I'd built with sweat enough to flood KL. :P

13.My dear's new hostel room in Laman Midah: The other corner

14.My dear's new hostel room in Laman Midah: Cupboard corner

15.And KLCC again in another occasion. I wonder why's with the fetish on KLCC. Perhaps it's the longest, the hardest, and it's twin power, well, u get what I mean..

16.And the paper waste left by just 1 senior in a matter of a year or two. Imagine how much paper thrash we produce every year. Perhaps he might have thought it might be useful for us, and left it there, but we'd decided otherwise and sent it to the recycle pile. Save the environment.

17. 1st day in ENT, and the scary tools for you ears, nose and throat. Even the circus' sword eater might freak out at the sight of this.