Orthopaedics... What a blessing?

Hmm.. 2 weeks since my last blog. Sorry for the delay. I just came to realize that my parasitic faculty happened to tumpang guna Sibu Hospital's internet connection; as a result for that, the Hospital director was so pissed off that he severed the lines the following week.

Sigh. No more internet for me to abuse.

Things are going pretty fine. My surgical examination was pretty tough, but I think I'll pull through, I hope.

Long Case

This old ah-mu was lying comfortably on the bed, half dozing, before I ruined her morning. I shaked her a little and told her I would wanna clerk and examine her.

"Ah-mu, eh hiau tia hokkien bo? (Do you understand Hokkien?)" I asked politely.

She stared at me.

"Ah-mu, eh hiao tia hokkien bo?" I yelled, assuming she was partially deaf.

She shaked her head. "Wah see teochiew nang."

"WTF?!?" I had to agree since Teochiew was rather similar to Hokkien dialect. Sigh. Bad luck.

"Ah-mu... lee hamik beh? (Are you sick?)" I started asking, positiong my fingers into a tripod grip so as to jot down whatever she tried to say. Time is precious. 20 minutes clerking, maximum.

"Saya sihat." She answered in Malay. Saya tak sakit."

"WTF (x20) !?!?!?" I almost had a syncope. "Awak tak sakit? Kenapa masuk hospital?"

"Nadai. Akljdf&%(asi*og576hjig afnl*12^ksjasffg&5 ." She answered in Iban.

"Ya allah." I sped towards to the attending administrative staff, informing them that my patient is not fit for clerking because she is dementic. She answers me in Malay when I query her in Hokkien. Worst of all, she answers me in Iban when I used Malay instead! Then she claims that she has no sickness! What on earth is this?

Yet, they reassured me that just one someone had managed to clerk her with success.

"Shit." I whispered and trudged to her bed again. "Oh fuck me this time."

"Saya batuk sahaja." She answered to my questioning again.

"APA!?!? BATUK? Sik ada muntai darah ka? Sakit perut? Berak keluar darah? Kencing pedis? Kembang?" I yelled.

I think I had angina when I saw her atlanto-axial joint rotating. Why is a cough patient doing in a surgical ward?

"Ah-mu, kitak batuk darah ka?" I bombarded her again.

"Nadai." She answered again, in Iban. "Batuk mimek mimek."

"Holy shit." I gripped my knuckles and strived to restrict myself from strangling this poor old lady. Stop fooling around. You've wasted 10 minutes aldy! I think I'm dead. I almost dropped dead.

"Bukanlah. Dia masuk kerana malaena." Someone interrupted from nowhere.

I lifted my head, and saw a student nurse writing her clinical report near my patient. She heard me screeching at the patient, and I guess in her curiosity, came to find out what was the commotion about.

"Alhamdulilah". I exclaimed.

The student nurse went and grabbed the case notes and started to pouring me information about the patient.

Clarification: 4 reasons why it does not count as cheating.

1. I did not ask her to take the case notes.
2. I questioned the patients, but she replied instead.
3. I did not pay her anything.
4. I do not know her and am not related to her.

Thus, techinically, it does not count as CHEATING!

Aftermath: It ain't my fault! Haha. Don't blame me because I'm handsome!

*Anyway, I still screwed up my long case at the viva session. Sigh.

Stolen Undergarments

My girlfriends had their panties stolen on New Year's Eve. Happy New Year.

What some of the victims had to say.

Girlfriend #1 (Miss L**w)

Why must steal my bra? Cannot steal my panties? You know how expensive my bra is or not? My bra at least RM30, you know!

Girlfriend #2 (Miss L*h)

Chiak lat lo! All my panties kena stolen. Now have to buy new one liao! Eh, now supermarket still got offer ar?

Girlfriend #3 (Miss T*ng)

Yes har? Really har?

Girlfriend #4 (Miss T*oh)

Aiya. If next time he come and rape me how leh? Aiyo... Miss L**w, lucky you are more big sized that I am hor...

Girlfriend #5 (Miss N*g*r*ni)

Ommigod! Finally he steal my one. I'm so worried you know, if no people willing to steal my one.

Not-A-Girlfriend-and-Never-Will-Be-One (Madam Ch*n)

Hey how come he never steal my one? I am so beautiful leh? Aiyo... I think you all punya panties very nice ler... Miss L*h your one got many laces one.. Next time don't simply sidai your bendera la!

Pre-Exam Maniac Syndrome (PMS)

Exams in 5 days time. I think I am starting to have my PMS again. Yet, where's that rush of adrenaline? Geez, I think I have aged tremendously.

Having survived my previous medical posting EOP genocide, I am so grateful that I had made it with unexpected results. I had been thinking that I had flunked it, but then I passed. :) Splendid. Anyway, my theorectical part was ok since I had anticipated most of the questions (except for acromegaly). My clinical portion however was disasterous, except for the OSCE, and it still haunts my mind whenever I think of it. Sigh.

My long case was a tuberculosis patient, whom having completed his anti-TB regiment and came up for follow-up in the hospital, was unfortunately bribed with RM50 to become a subject of molest. Yet, it was not a tough task to manage him; garrulously cooperative, he began yakking about his disease -- how he came to it, how he got rid of it, how he felt about it, etc. -- and I miserably scribbled everything down. Not bad. Next was eliciting some physical signs. Hmm... wait a minute, there's nothing! Chest was totally normal. Then I came to realize that probably the history and examination were not really that crucial in this long case. Strategically I planned and prepared myself for the artillery bombardment... Lucky for me, I was the first candidate for my easily-irritated examiner (Dr. Annuar) and his autistic colleague (Prof. Jo); I did not aggravate him much and I could answer most of his questions, although I try to bear with him ridiculing with the answers I made. Phew, I think I had passed my long case.

Next was the short cases. Catastrophous. Sigh.

My first patient was a lady who presented with hypertension and hence I was requested to examine her abdomen. Hmm... HPT in a middle aged women eh? Mechanicaly, I started to run a few differentials in my mind.

• Renal Artery Stenosis (Middle aged woman. Ok. Most likely-lah)
• Conn's Syndrome, Phaechromocytoma and other disorders of the Adrenals (Probably?)

Ok. My guess was RAS. So I started my examination. Routine inspection revealed nothing. No clear obvious distension. Time for palpation then.

*Press Press* + *Squeeze Squeeze* + *Poke Poke*

Jesus christ. What is that big fat thing in the right side of the abdomen. Ok. Let's try more. Hmm.. moves with respiration eh? Oh. Dull on percussion. Affirmative for hepatomegaly. Let's see if there's anything else at the left side.

*Press Press* + *Squeeze Squeeze* + *Poke Poke*

Ok. Spleen is normal. Let's ballot the kidneys then. Oh... nothing extraordinary.

"WHAT! YOU CANNOT BALLOT THE KIDNEYS!?!?!?!" That was what my examiners responded, with a shocked facial expression and a widdened oral fissure.

"Yes. I cannot ballot the kidneys doctor." I replied firmly, thinking it was another trick to perplex me.

"COME. PUT YOUR HANDS HERE. OK, CAN YOU FEEL THE KIDNEY BALLOTING AGAINST YOUR HAND NOW?" Dr Anis put my hand on the left abdomen and his hands started poking posteroanteriorly at the renal angle. "Don't you know anything about Adult Polycystic Kidney Disease?"

OMG. SOB. PKM (Pukimak). CCB. etc. All of those sprouted out in my mind. That was the end of it... 1st short case: RcKs dead.

Ok. Cripply traumatized, I approached the second patient and Dr Mra started to pinpointed out her questions. Well, she led me throughout the entire course of action. Now I started to wonder if my exam then was another bed side teaching.

"Tell me what is this pulsation at the neck? Feel the pulse and tell me what you feel. Auscultate here and tell me what murmur is that? Feel the femoral artery and explain what sign is that? What is your diagnosis?" A series of questions leaked out from her and I answered them staggeringly. It was a case of Aortic Regurgitation.

She looked pleased. Alhamdulilah. Yet. 2nd short case: RcKs resurrected but still commatosed.

Defeated, I packed my things and miserably lamented for my imminent funeral. Yet, as I turned around and walked, I was recalled again.

"Last chance. Tell me what is that swelling is that patient." Dr Mra pointed at another male patient at another corner of the ward.

I knew it was my last chance of redemption. Firmly I cornered the swelling and scrutinized it with all my might and wisdom. Eureka, it is a splenomegaly. I answered her and justified my findings. Finally... I can see a smile at my examiners face... It was like a glaring ray of light, indicating dawn has arrived in a cold frosty winter night. My shoulders sank with relief and I almost passed out. 3rd case: RcKs is alive!

"OK. You can go now." My examiners waved me off. I trudged back to the waiting room; there was a feel of relief; sweet like morning dew in a dry spell. What can I say... I think I passed my clinical portion now.

Aftermath:

Many a people responded to my encounter as a sign of favorism from Dr Mra. Well, I can't agree more on that. Not all of my other colleagues who were stuck in that circumstances got a 3rd case (final chance) when they flunked the 1st case. Life is never fair. So why complain?

Nonetheless. Hey, should I be blamed because I am beautiful? Is it my fault that everybody likes me? Haha. Geez I am so vain! I love myself. :)

Friends, Fiends and Foes (A salute to my buddies)

Friends come and friends go, that's what I can say.

I remember growing up with different types of friends, and I believe they made me grew up a lot. Anyway, now I enjoy sitting down, observing people and drawing up conclusions on how ugly people's hearts can be. :)

Primary school

I don remember having much old friends here, except for those that I still tag along with in secondary school. What remains clearly imprinted in my mind are those imbecile classmates who are willing to do anything to make the teachers pleased. I am vocal since young, loud-mouthed to be honest, and I voice out whatever I am displeased with. This invites trouble. Anyway, I am not a well-liked kid then.

I blame my primary school teachers for making me a miserable kid. Anyway, I learn a lot then. What I realized is that when you are amidst people who dislikes you, the only people you can count on are people whom are being disliked as well. :) Anyway, my best-est of friends happen to be those that always end up in trouble with me. Sigh. I wonder where they have been?

Secondary school

Growing up in secondary school was better. I've got chances to meet all sorts of people; bullies, jerks, nerds, jocks, etc.. You name it. Gosh, I've got to say that I almost ended up being a gangster in school, if not for my lovable teacher who saved me from hell's grasp! Anyway, after form 2 I had found my group of buddies (and so-called ex-buddies).

It was during that rebellious epoch of my life that I started to cling even tighter with my friends, whom I've set as first in my list of priorities. I was a little bit different from them I guess and eventually I could not click on with them any further, and ended up being demarcated. Anyway, it was then that I realize what true friends are. Yung Khang, Shwu Yann, Hsiao Wen, Ming Yee, Hui Khoon and Simren, I thank you for sticking up with me through those bad times!

Pre-U

My Pre-U was nice and memorable. After most of the old school mates have gone, I found myself hanging with other friends whom I have not been that close with. Like I've said, new one comes and old one goes. I find myself even more detached with the old friends, except those buddies mentioned above! :) Life then was basically occupied with studies and assignments, as STPM was some tough shit. Anyway, luck was on my side, and now I ended up somewhere I wished to be.

What happened after Pre-U was a period of relaxation. Exam stress subsided and we got along even better. Outings and supper; those were fantastic. I still remember the night before STPM results were out; we refused to go back home and lazed at the beach till 3 a.m. because we are fucked up worrying of our results! LOL. However, eventually things went fine. We all got what we wanted. To all the best friends there: Kar Hoo, Ghee Seong, Jen Chun, King Hong, Chai Lee, Wang Shan, Chiew Yuen, Jee Yen, Heng Gee, Woon Li, Huey Yin and many more... Thanks a bunch!

University

When university starts, things become different. We end up in different places with different people. Hence, we adapt ourselves to our environments. Yet, the bond is there, still somehow strong, and I thank all of you for that! I do not know what lies ahead of us. Honestly. I wish we could still be friends, inspite of our differences. :)

This is dedicated to you all.

And I never thought I'd feel this way And as far as I'm concerned

I'm glad I got the chance to say That I do believe I love you

And if I should ever go away Well, then close your eyes and try to feel

The way we do today And then if you can remember

Keep smilin', keep shinin' Knowin' you can always count on me, for sure

That's what friends are for For good times and bad times

I'll be on your side forever more That's what friends are for

Well, you came and opened me And now there's so much more I see

And so by the way I thank you

Whoa, and then for the times when we're apart Well, then close your eyes and know

These words are comin' from my heart And then if you can remember, oh

Keep smiling, keep shining Knowing you can always count on me, for sure

That's what friends are forIn good times, in bad times I'll be on your side forever more

Oh, that's what friends are for

Varsity graduates into politics?

My faculty is in a mess; it always has been but lately it has been totally crippled by political bickerings since my Dean is retiring. Sigh. Hence, all the better lects are leaving, and the less contributing ones are staying to aggravate the condition. I'm sick of making complaints; nothing much can be done since we students are not the ones electing who's staying and who's going!

Anyway, a radio hostshow had a discussion made on varsity students and their political capabilities. I can deny no more that varsity students are a fearful force, although they only make up around ?15% of the entire population. (Can't remember the exact number, but I think it is not more than 20%!) Still, they are currently being dilapitated by the 1975 Varsity and Varsity College Act (AUKU), which directly prohibits local varsity students to participate in or openly support any political party or their activities!

Well, there are a few main reasons for this, in my humble opinion.

1. The government realises and is aware of the potential and capability of varsity students in altering the political trend of the country. Our own archives have told us that varsity students are usually the forerunner of revolutionary movements in the nation and the society. For instance, Dr Sun Yat Tsen was a young graduate when he sparked the Chinese Revolution in 1911. It is no longer a myth that varsities are the cradles of new ideas and thoughts, and that the varsity students are a young dynamic force capable of inflicting changes. Hence, they are a pain in the butt to the government.

2. The political and socioeconomial state of the country is itself unjust and inflammatory. Local graduates, especially non-bumis are aware of their own plight; they have to sweat harder to secure an entry to local varsities because the route of entry is usually and only STPM. (Compare STPM and Pre-Uni Matriculation) Besides that, it is clear enough that government scholarships is PARTICULARLY given to bumis. Hence, unsatisfaction generates new innovative revolutionary ideas which may strike an impact to the government's so called New Economy Policy designed to create just and fairness in the country's socioeconomic profile.

I can't really comment much on these inflammatory sentiments, as it would attract the wrath of the Internal Security Act against me. Thus, I would not delve further in these issues. (Honestly, what's the purpose of bragging on these issues as we are so aware that we cannot do a fucking thing about it? Hail to Malay supremacy!)

Well, let's say if varsity students are given a chance to make a change.... I would like to... get rid of the stupid UPU. It's a fucking stupid idea. I think it entirely goes against free our own right for educationl. Hello? We pay for our education. I would shut up if it were free. So, why can't we choose something that we pay for? Utterly rubbish! Then, it would definitely bring more improvements for the local varsities as they have to compete within themselves to innovate. Well, it is time those stupid people (Vice Chancellors and their administrative staffs) stop shaking their balls/tits and start to think and work!