A Walk in the Park

I have been taking a walk in the park the past 5 years.

5 years?!?!

Where exactly have I been?

Did I get lost in a labyrinth? Well, I don’t remember meeting Minotaur.

Did I prick my finger and fall into a deep slumber? I guess not, as I do not recall a prince who kissed me out of the grasp of the sandman.

Did I step into a crack in the fabric of time and was teleported into the future? I don’t think so. Most definitely did not jump off the Brooklyn Bridge.

I would like to think that I took an extremely long path. It was the path that was ahead of me 5 years ago, welcoming and bright, inviting, promising.

My walk for the past 5 years had been very interesting. There were times where I walked through the most beautiful paths, with lush greeneries and beautiful blossoms, bursting with life at every step that I took. Sometimes I had to climb endless flights of steps, every step an agonizing effort. I slipped many times, especially in the dark when there was no one around.

Oh yes, I had company. There were those who always remained acquaintances, hence our cordial relationship. There were some who called themselves friends, yet would abandon me when I had my knees deep in mud. Few stayed by me, pulled me out and kept me going.

I saw the exit sign some weeks ago, and knowing that I would reach the last mile by this time, I was gearing myself for this last league. The final mile is an uphill ascend. Sometimes I fear that I am not strong enough to make the climb. But I know it is silly thinking, knowing that I have wonderful support from people who are really true to me, and would be by my side at every step I take.

Revision Blues

Today is the 5th day of Chinese New Year.
It is also pre-exams day.
This is our exams week for the Orthosurgery posting. I have Surgery clinicals tomorrow, Orthopaedics clinicals on Thursday and theory paper on Friday.
Feels horrible to have a holiday turn into study leave.
15 days of Chinese New Year might seem like an over-indulgent affair but like most Chinese, I celebrate any cause to makan :)
My brains are in a state of denial! I've been staring at my books for hours and yet there were no synapses at my amygdala. Don't even talk about my amygdala....I wonder if my Wernicke's is fully functioning at the moment.
What is this?

Where I am sitting, this looks so much more tempting.

*Sigh*

I am a month away from my finals. Haven't really had the time to reflect back on my 5 years of med school. Sometimes I wonder what is my most important lesson in med school.

As a med student, the doctors and lecturers keep telling us that most of what we learn in med schools will not be what we see in future as doctors. We are now at the textbook level, and we do not always find textbook patients. The practical aspects of being a doctor has to be experienced and learned that way.

For now, a med student has to sit for her exams in the midst of Chinese New Year and Valentine's Day (not that I have a date anyway).

"Medical practice is not knitting and weaving and the labour of the hands, but it must be inspired with soul and be filled with understanding and equipped with the gift of keen observation; these together with accurate scientific knowledge are the indispensable requisites for proficient medical practice."

~Mosos ben Maimon (1135-1204)

The Finer Points of Learning

I attended my team's clinic yesterday. As our team specialise in colorectal surgery, a majority of our cases seen were bum cases.

I arrived early and managed to clerk a new case which had to be presented to my specialist later on. A colleague of mine was already tagging the specialist in his clinic when I arrived. They were seeing this patient with haemorrhoids, and was already examining the patient behind the screen. I joined them after obtaining permission, and the scene that greeted me was really quite hilarious.

The patient was on the examination couch, lying on his left, legs bent to allow optimum exposure of his rear end.
My specialist had already inserted the proctoscope, but very strangely, he was looking away from the patient and looked as if he just licked bile.
My colleague was standing at the foot of the couch, giggling silently.
There was a strange smell within the cubicle.

I think my specialist took a blow in his face. (LOLOLOL)

I took a peek into the proctoscope, and saw some faecal material within the proctoscope. Looked like the patient did not answer nature's call that morning.

To cut a long story short, the patient underwent a rubber banding for his haemorrhoids.

I learned that we cannot be too enthusiastic when doing a proctoscopy... Do not stand so close when removing the probe, and be careful of noxious gases.

To all those who will not be peeking into other's bums in future, remember to empty your bowels before seeing a bum doctor.

Learning the ropes

Surgery is not my favourite division of medicine. In fact, it is probably my least liked subject. And it is not because I am haemophobic.

There is just something about surgery that gives me the chills. Personally I find surgery relatively messy, dealing with abscesses, intestines, infected wounds, hernias, cancers... The list goes on.

When I was in my 3rd year of studies, I did a 10-week rotation in surgery. Needless to say, I wasn't the most enthusiastic student and only spent enough time to learn the basics, whatever was necessary to pass the exams.

Now that I am in my final year, and in my final months of studies, I find myself going through this rotation again, this time for a much shorter period, only 4 weeks.

I am taking more interest in surgery now that I am almost completing my training, voluntarily doing or assisting in procedures.

After a whole morning in the clinic yesterday, I realized that there is more to examining a patient than what medical school can teach.

I've already been reminded of the importance of wearing gloves in a previous post.

Yesterday I remembered to wear the latex fingers before performing a rectal examination... But I only wore it on my right hand. I thought that since I was only going to use my right index finger, what's the point of wasting another glove for my left hand?

I only saw the point after applying KY jelly on my finger. I needed my left hand to part the err... you know what I mean. So there, bitten by my stupidity again.

That was for the rectal examination. I was observing the house officer inspect another case, this time a fistula in ano. I could never forget how bad the smell was... It reminded me of smelly salted-fish with belacan. Ughh....

So lessons from clinic :
Always wear gloves on both hands. You never know when you might need your hands or what you will touch.
Always wear a mask when examining a fistula in ano.

I am wiser now.

My Hands

I did something quite dumb today. I examined an inguinal hernia without wearing gloves!

No, it's not a deadly sin, but would have been better had I donned the gloves. The purpose of the gloves is mainly for hygiene sake, protection for my own good against body fluids of a patient.

I only thought of those darn latex after I started my palpation, when I felt that something was not quite right. Everything felt so....distinct! Only then was my mind flooded with the same message,

"Bare hands! Bare hands! Bare hands! Bare hands!"

The joke is on me, really. Moral lesson of the day : Don't forget your rubber.

I won't, hopefully :P
Thankfully there were no secretions or discharge. Phew!