A Tale of Fruits and Vegetables (and other Assorted Eat-ables)

Guys, i think de debate has gone long enuf, time to focus back on EOS-9. Haha, thank u for visiting my blog, sad huh, only when got big hoohaa den ppl wan2 read :o). I've deleted the previous comments (wow...67 comments...fell off my chair when i logged on last nite) cuz i think it only promotes disunity in our batch and hurts ppl's feelings.

Entertaining, and satisfying for some (ie. can take sniper-shots at each other without knowing who shot who), but to wat extent is it useful to our lives as future doctors?

I leave u with my last comment.

Thank u and no probz, enjoyed being ur batch rep, i untung from classes, u untung from classes.

I think unfair le to call ppl rotten eggs. Everyone got different way of living, different way of looking at life. Not fair to impose upon other ppl wat u think is right or wrong. Best thing is to work together no matter wat kinda fruit or vegetable u are.

Even better, use ppl's differences to untung together. Next time u might be the physician who has to work closely with de surgeon who u think is dem arrogant (who in turn thinks ur the arrogant guy from medicine). How then? Pt die on table cuz u both arguing whether to cut the blue or red vessel?

So why not turn de negative energy into something positive to benefit everyone? U happy, i happy. Let's develop dat attitude in sem10 ya!

Now, after sem9 (or sem10 if u want to be sure), do go say thank u and show gratitude to the teachers who've helped u.

Ppl make mistakes, most important they learn from it. Allow ppl to make mistakes, u get to learn along as well. Yikes, next time u get married and u find HUNDREDS of mistake with ur spouse, everyday throw eggs at each other ka?

Cheok, thank u for being so brave to make the public apology! Thats how a MAN shud be!

And a big thank u to all lecturers who've worked hard to help us, especially during our last days in sem9, de most crucial period. We will strive to become great doctors, and wont dissapoint u all!

Gambate C2/06 for EOS-9, we WILL all meet and suffer together in BP!

ps. My blog stubbornly appears on yahoo, altavista etc. Guys, wan to post comment, try not to use lecturers direct names or our uni's abbrevation, scard someone google hard enuf, and its the whole friendster blog issue again (sigh, dat wuz 91 posts and 80 comments down de drain...boohoo...).

Revision Classes, Generous Lecturers.

Few days ago we made a beloved lecturer angry. Very sad, after he has given us so much and asked for nothing in return, we caused him a lot of trouble. I agree, when he mentioned that we have trangressed his sincerity.

This has gotten me to realise something.

I think we, as a batch, have been quite unappreciative of a few lecturers who have given their time to give us these revision classes. Remember, they're not paid a single cent, they've used a lot of their time (in the above case, 2 hours each time le), and some have risked their position to access stuff. And a lot of big lecturers are not happy with these lecturers giving us the extra classes.

A word of thank you would be the bare minimum for them, but hell, sometimes its only 2 or 3 ppl in the front row who thank these lecturers when they go off. I feel very bad, having to arrange classes with these doctors cuz some of them get nothing in return, and yet are still eager to give us extra classes. I end up thanking them profusely to represent the whole batch (and sometimes make sure i say my thank u as loud as possible in hopes everyone gets the cue after a class). And some ppl think im sucking up to the lecturers, thats the worst part. Not easy being a batch rep huh, tryin to please everyone...

Its high time we showed our gratitude. A personal card, gift or maybe even a free lunch (a few have requested for that, and heck, a few had missed their lunch just to teach us). A doctor in the hospital offered to give my friends and me "tuition" for rm60 an hour. Our lecturers got nil. Please, do show these generous lecturers ur gratitude, no matter how big a doctor they are, they're still humans too.

Role-Models

I realised sometime ago that both lecturers and seniors serve as role-models for us to learn from.

During gynae, we went to PD and got SD for teaching. Well, from the start we got the shelling edi. As we were moving from one bed to the other, my friend asked me sumthin about the last pt. SD got really upset. "I am trying to teach here and this clowns are talking behind me," he told the accompanying MO. "Listen to me when I'm talking!" he screamed at us. "Observe how I interact with patients! How I give consultation, what mistakes ur seniors are making, how I comfort pt!"

Even though I didnt get to take down a shred of note dat day, I learnt alot of lessons about character. I realised that there is more to just tailing doctors while they do their ward rounds and waiting for them to directly teach us med students. I think we should take active steps to try and be inspired by them as they do their work. Watch how they talk to patients, try to follow their train of thoughts as they work out the management for a complex case.

I take my inspiration to be as hardworking as possible and to share what I have learnt with others (in contrast to ppl who are really kiasu and dont wan to share stuff) from the juniors one batch before ours. They are really an amazing batch, demonstrating hardworkingness and always helping each other out without having a sense of superiority over each other or fear of lookin stupid in front of the smarter students.

I was inspired to study out of topic for the sake of being a safe doctor by a really super senior, now workin in Sabah i think. He knew how to read ECGs long before others, and always organized things into categories and lists. He also said to not always trust textbooks, and to always see what was REALLY happening in the wards.

My inspiration to become a doctor with a sense of mission comes from 5 lecturers who really demonstrated sumthin far more than just a lecturer.

I found this quote while studyin for a Buddhist exam that I'd like to share with u all. Tsunesaburo Makiguchi, a Japanese teacher and founding father of SGI, writes:

"We learn how to live by imitating others. We observe what others do and copy what we see, trusting in their example. The same is true of flower arrangement, dance, kendo, judo or any other art or skill. We trust our teachers and do what they say. After mastering imitation, we move on to creativity. That is how one learns to live."

Ah, my last imitation was also during gynae, where i "imitated" one of our lecturers who kept sayin "give me 5 causes of recurrent miscarriage" or "tell me 10 causes of PPH". I find that assigning lists a set number or grouping things into categories make them easier to memorize. Another gynae lecturer told about how during his student days, med students had vivas, so the nite b4 exams they would be practicing non-stop. I tried that the other day, pretending i wuz at a viva, and found the learning experience to be quite fun (and u can ensure u know all ur stuff about a disease).

Our time here at uni is not all about memorizing stuff, but to also glean as much as possible from the characters of outstanding ppl around us. And that leads us to becoming great and competent doctors (and also give SD some peace of mind, now dat would be a great way to pay back for all the teachings he gave us). Gambateh for finalz!

Near-Fail Experience

Gynae clinical exam wuz quite bad on Thurs. Couldnt get a proper history from patient, confused her with too detailed questioning, but she had so many symptoms that i had to filter out the really significant ones. She was a 48 year-old who had a thyroid problem, a fibroid and presented with a mysterious cyclical bleeding with dysmenorrhea. Menses irregular, sumtimes 3 days, sumtimes 2 weeks, i suspected the 3 days wuz intermenstrual bleeding.

Spent alot of time clerking, abt 30mins, left onli 10mins to examine. No chaperone, everyone left for CME, super-panicked, luckily got juniorz next door safe us 3 guys. Now have to belanja them makan...

Dem shocked, last min Dr.Z couldnt make it, ended up having Dr.VS. From someone who gave quite good grades, to someone who failed u cuz u didnt palpate liver and spleen in obs case. Presented history dem kelam-kabut. I reported no findings on examination, he asked me to palpate the abdomen again, still i didnt feel anythin. He palpated, then took my hand and placed it on the suprapubic area. Crap, got mass....

I knew he wuz goin to fail me for missing de fibroid, but i kept my spirit up and din give up under the questionin. Later in the afternoon, i timidly asked him whether i had failed. He said he wuz goin to fail me for missin such an important finding, but reconsidered when he considered how complex the case wuz and i didnt miss the thyroid findings.

Dr.Vs then told me the 4 mistakes that lecturers will fail students for:

1. A student killed the patient bcuz of carelessness.

2. A student lied.

3. A student displayed an attitude problem (getting cocky with lecturers, or rude to patients).

4. A student kept talking nonsense.

Im sure we know friends and batchmates who've (perhaps unknowingly) commited these mistakes. Ah, now we now the 4 cardinal "sins" to avoid when goin for a viva or clinical exam!

Remaining Singletons, Desperate Times

Holy cow, a junior juz informed me dat we only had 7 single guys in our batch onli, our batch of 63 ppl. Crap, sum of us juz study, study, study...and 4got all about gettin a girl. Jeez, dats not a good thing! I thought damn hard of the guyz who were single just to dispute her, and i couldnt count up to 6! Now dats worryin...

J
Y2
TS
TL
ST
W

I cant think of the 7th fella, but heck, if u girls out there are lookin for handsome med students with charm and an attitude, plz come to IMU and study, we'll meet u when u get posted as a houseman (housegirl more like it) and we're already macho MO's throwin our weights around when the specialist is at home.

A Useless Lecturer...and a Great Teacher

Haha, time for me bitch abit, let off some steam after a tension-filled exam week.

Recently got told off for smiling and apparently "laughing" at a patient during class by one tight-ass of a lecturer. What more, in front of our fellow elective students, wah, dem freakin embarassing. Outta de blue he looked to me and said, "Why are u smiling? I've seen u smilling all this time. Do u know ur disturbing the class? Whats so funny about the patient?"

He then spent the next 3.5 hours calling authors of various books, "not clinicians, they never go to ward..all that is wrong..." and correcting the dosages of TB medications in the CPG. Wow, he's suddenly smarter that the whole MOH commitee who made that CPG. Ah, i could have been doing better things, like studying desperately for my exams, rather than listen to someone brag about how great his knowledge is that it surpasses all textbooks. I list 2 interesting points he insisted that he was right:

1. On percussion, pleural effusion is dull, while solid masses are stony dull.

2. An empyema is a pleural effusion.

Apparently, we also heard that he criticized one of our previous lecturer who we always looked up to. And using our lecturer's name as well, during class in front of students. Dats the biggest med ethics error to make: criticizing a fellow doctor (haha, that makes two of us!). Tsk tsk tsk, bad move, it may have been during just one class, but the whole uni knows about it edi. And of course, as with all rumors, it gets twisted up and added on to along the way, so it wasnt surprising how evil a picture was painted of him at the end of the receiving line.

Amazing, I've rarely met doctors who u can learn what NOT to be. What an arrogant tit. Ah, take ur damned degrees and shove it up ur stenosed butthole.

I believe every academic doctor has a heavy role to play. Not just to teach, but to inspire their students. Very hard to find such teachers, and I shall now give one of them their due appreciation here.

I still remember, back in sem6, i was walking up the stairs and bumped into this doctor with a waist pouch at level 4. Amusing to see doctors walking around with a waistpouch, reminded me of mum and dad. I always saw her eating at a place i eat across the street. Well, there was a piece of rubbish on the floor, and before I could pick it up, she bent down to pick it up and threw it into the bin. I was touched by such a simple and humble act. A doctor doing such thing in front of a medical student? Quite unheard of. Later, when I found out how big this "little" doctor was, i was even more touched. Funny, its the greatest teachers up there who are the humblest people of all.

True, she may have made many stinging comments, and we all fear her case presentation sessions (we'd stay up like mad trying to cover every patient in the whole ward), but every of her sessions was worth more than the RM31,000 we'd pump into every semester. Two things I gained during her sessions that have stayed with me till now.

1.
She inspired us on how to take an intelligent history, not just for the sake of presenting during class. How to carry out a very rigorous physical examination, and not having to take too much time. Practice, practice and practice. What you dont know, quickly go back to the textbook to reference, then return to the patient. Then, use ur history and PE to come to an intelligent diagnosis, not just shotgun ur way with a long mindless list of differentials. I found out that was a very effective way of studying medicine.

2.
And she demonstrated humility when in front of patients, treating them as true human beings, not some "case" for presentation. I was impressed by how she turned from a high-ranking doctor to a fellow human being when dealing with a patient (and how she turned back to being very, very sharp when turning back to us naive students :o).

I may have screwed up Paediatrics (i still hate it), but i think thats the most precious lessons i got from the posting, how to take a powerful history and do a thorough PE, and how to be humble. Everytime we met for class, she would always correct our techniques, trying to fine-tune our skills. Seldom have i bumped into a lecturer who would take great pains to raise us as future doctors.

Its rare to find such teachers. Best to learn as much as we can from them and be inspired. I'd bet 75% of all the knowledge we get here at med school we'd forget, but its the character that we've built thru being inspired by such great people that'd stay for the rest of our lives. Now dats worth all the RM270,000 our parents have invested for, to see their children grow up to become powerful characters.

I leave u with 2 of her quotes that have been my favorite:

"I fail u in exams for ur sake. I fail u in the finals for the public's sake."

"We as doctors are both scientists, and humanists."

And, yeah, examz are over, holz are here!

Tips: Pumping Petrol

I still remembered my SAM English teacher saying, "It's pump gas, not petrol." Ah, English.

Well, someone left an article about pumping gas on the desktop of the library computer. Here are the tips without the long-winded scientific explainations behind em:

1. Fill up in the morning when the ground temperature is cold (colder petrol, denser petrol, ur car takes in less air).
2. When filling up, do not squeeze too fast (pump handle has 3 modes, squeeze at fast mode, and petrol will turn to vapour on entering ur tank).
3. Fill up when ur tank is already half full (petrol station storage tanks have an internal floating roof to minimize evaporation).
4. Do not fill up when a fuel tanker is pumping into the petrol station storage tanks (the fuel underneath is being stirred around, most likely stirring up the debris and dirt at the bottom as well).

These tips were by a certain Ramesh Patel who works at a Durban pipeline. Haha, in this internet age where misinformation can spread damn right fast thru the entire world, we're not sure if this is for real or a hoax, but no harm in practicin em, eh?