Thursday, March 25, 2010

Program Pendedahan Kerjaya Doktor (Day 4 = O&G)

Day 4....We went to the oncology and gynaecology department. There were 3 wards, ward for Sakit Puan, Maternity Ward I and Maternity Ward II. There were only 1 specialist, Dr Ranjit here today and another who was on leave was too kind to come to work also. We have met Dr. Lau, Dr Lim and other HO also. They are all very friendly to us. I super like the maternity ward…haha many pregnant mother and babies!!! We get to chat with those mother who had just gone through labour and look at the little babies…Never saw babies as tiny as this before. Many of them were born last night. There was also a baby as huge as 5kg!!! (Looks like baby of a few months old)

The HO talked to us. He was also a scholarship recipient who studied in Russia. 6 years there. He told us about life there. He said it was ok, studying was fine and the allowance given was really huge amount that he got to travel around the world during winter breaks. And only then I knew the tuition fee in Rusia medical school was much cheaper than Australia! It was approximately RM150,000 only compared to the almost 1mil fee in Australia. My my…But the living expenses there were huge too but please prepare about RM300,000 for that six years if you have the intention to study Medicine there.

Then we went into Labour Room!! Haha. Surprisingly, there were quite a number of mothers there waiting for deliverance and many had just finished. So when we reach there, no screaming was going on but we heard sound of heartbeat of babies in the air.

~Skip the cleaning placenta part ~

(The most interesting part but terrifying normal souls like us. Too much blood.)

When we put on the gloves and mask, we got scolded by a nurse. Well, we deserved it. Because we didn’t know how to put on it properly and didn’t ask for instruction also. So…haha. Fortunately, the scolding was worthy because after that, we were taught in detailed about the way to wash hands, wear and remove gloves and mask. (What we normally do are all wrong!) NEW THING! :D

Then, we spend the whole afternoon in O&G clinic to observe the way of doctors communicating with patients. Soft, tender, not harsh yet professional. Do not get carried away emotionally by patient. Remain calm at all times.

Tomorrow: Specialist Clinic and Closing Ceremony!

p/s: Help..dont want go back KL already. My homework hasn’t touch while most people already finish…!@#$!!!!!!

Program Pendedahan Kerjaya Seorang Doktor (Day 3 = Orthopaedic)

Today went to orthopedic...means...about bones. Anything ortho is bone (i presumed).
Went to the orthopedic ward today. 7 doctors including housemen, medical officer and specialist. In this ward, you can see lots of metal frames and heavy loads around. We went for a round and saw
  • a guy who was just admitted had his hand (behind thumb) slashed open. Tendon cut. Yikes....seems really really painful. Flesh and blood stuck on the dressings.

  • A guy with amputated mother toe. The amputated foot wasnt stitch Flesh and blood again. Plus, bone. This is the first time I saw real bone exposed like that. Because last time when people keep telling me they cut until can see bone inside, i dont get it. Now i do, and it is not a pretty sight, believe me.

  • Woman with amputated leg. I didn't know what her story was but the nurse just told me that when her leg become black, it means it is "dead" already. No oxygen to that part. It had to be amputated as soon as possible, if not, the germs there will spread to other parts of the body and amputated area has to be wider and wider...pity her. But luckily hers is still below knee level. And i learned that we can take off the stitching thread on day 14.

  • Another thing is that, we must not lie on the same position with the same pose for too long time. It will cause the skin on your back to become like rot. A big hole filled with pus will form…partly cause by heat.

  • Today is “soft tissue day”. Most new cases and related to soft tissues (means not bones)

  • We went to the children ward too!!! Saw kids there but pity them also. Sick children.

Oh ya, michelle from chung hua also joined us today. She didn’t notice the letter until yesterday. Well, thank God that I went to check on Sunday. (I think God suddenly told me to go to the website and check… :D)

After ward round, we went to the houseman’s case presentation. :D This is my note which…form less than 1% of what he said, because we do not understand what he was talking about most of the time:
Bone and Joint Infection
Osteomyelitis . TB.

Osteo = Bone. Mye=Marrow. –itis = inflammation
So osteomyelitis is Bone Marrow Inflammation.

It normally occur in thoracalumbar spine in adults. Common in infants born with difficulties. Epiphysis is expanding part of new bone.

Treatment: Dehydration, antibiotic, surgical drainage.

*the houseman was asked to draw lots of diagrams too. So, brush up your arts future doctors!

Then I went back to the ward while my group mates went to have lunch. While waiting for my stomach to become hungry, suddenly the Dr Denny and a HO wanted to do bone traction. (what?? Nevermind, you’ll see later). So, I decided to stay back even though I was hungry already…haha There was a guy with bone fracture at thigh. To make the 2 parts of fractured ferum into a straight line, a metal rod is to be inserted through the tibia and a heavy load is hanged on the metal rod.

The 10 kg is…exaggerating. Don’t know the real weight. But during the operation, the doctor first make a small cut on the skin, blood gushes out and while the rod was bring hammered hardly (literally) into the tibia and out on the other side through the skin, the patient was like “aduh aduh! SAKIT!!! KEJAP!! SAKIT!” (local anaesthetic injected only)…I feel like fainting. Not sure if it is because I was really too hungry or it is too hot there or this is just bloody terrible. Maybe all..haha I decided to walk away and take a breath then go back in again. The doctor ask, “So, you still want medicine?” Lols…I’m not afraid of blood!

After that…I had my lunch straight away. Cannot stand the hunger anymore, how did the doctors starve whole day??
It was more or less like this today. Afternoon we did not do anything… :P

Tomorrow: O&G!!!!!

Tuesday, March 23, 2010

Program Pendedahan Kerjaya Seorang Doktor (Day 2 Surgical)

Surgical Department today! Was late by 1 minute today because I went to the school before going to hospital. :P 3 of us spent some time looking for where for we should go but barged into the Operation Theater door instead. But at last found Sister Wong at the Male Surgical Ward.

She gave some briefing and let us follow the Dr Wong, Dr Suraj, Dr Tarek, Dr Kenneth and Dr Chong(houseman) round the ward. We walked from one cubicle to another. The environment in the ward is much calmer than E&T yesterday and most patients there are waiting for surgery or had done it. What the doctors did was to attend to each patient check on their condition upon referring to the previous diagnosis or reports from tests. We were quite confused with the doctors’ conversation actually but made an effort to listen anyway. (all those “terms” =.=”)

Then we went to the Female Surgical Ward. There were fewer patients there. Some with jaundice, gastritis, goitre and finally cancer. We witnessed how the surgeons told the patient that she had tumor. It was hard, you have to be diplomatic, be gentle yet firm at the same time. The patient and her family member started to cry, they keep asking, is there any hope? What if the tumor is removed? Any hope? The surgeon can only tell them, it can be removed but total remove or not, it is not guaranteed but do not give up, there is hope. Yeap, the tender loving side of a doctor. We all have to understand how big the pressure is to tell someone that he/she has cancer or cannot live any longer or things like that. But that’s how a doctor’s career is, a doctor is not a god, a doctor can only do his very best to save a person who depend on him to stay alive.

Then, we went to the Palliative Care Unit. The patients sent to this unit are those like with last stage cancer. The tubes connected are significantly less and the doctors told us this is a unit to let them relieve their pain before they “depart”. The family members of patients here should be prepared but that doesn’t mean give up hope. The doctors still do whatever they can to save the patient. We saw them; some looked ok while 1 was suffering. He was gasping for air literally.

We went to another ward and came back. The one gasping for air had passed away. Shocked. This is the first time whereby 5 minutes ago, he was still alive then the next, gone. The family members all gather around discussed about the funeral. The body was covered by white linen. Then attendant from bilik mayat came and took the body away. We looked at the doctors but they can only continue with what they are doing. Maybe, they are used to it already. As what we have been told, there are 2 things in life that is for sure: 1. Taxes. 2. Death. So, we should accept it as it is.

We also went to Intensive Care Unit (ICU). Yea, saw many complicated machines and tubes inside. The aircond broke down so it was a bit warm inside. The funny thing is, one of the patients inside use magazine to fan herself. Haha…ICU patient fanning herself with magazine, believe me, you can’t imagine how was it. The nurses tried to help her, but she insisted to DIY. But I believe she was quite ok one already, moving to normal ward soon I guess. :D

Afternoon, the doctors are busy doing their paperwork and nothing much happened in the ward. After talking to some of the patients which was really awkward because I don’t know what diseases they had, no knowledge about their diseases and some don’t even know what disease they had. So just a mild chat and I decided to go to the pantry and chat with Sister Wong. Well, I found out she is Sharon Wong’s aunt. Haha. My group mates were at somewhere else chatting with their friends. So I tried to glance through my homework but the weather was too warm and I became so sleepy…At last, I napped in the pantry. Haha… Only after my group mates came by to wake me up only I go walk around the wards again. The ward seems to stink in the afternoon but tolerate with it please.

There was also another family crying and mourning later in the afternoon. Another death case. They follow the attendant who was pushing the body to the bilik mayat while calling out the deceased’s name loudly along the corridor. Sad.

Whole afternoon of walking around the wards then chatting with candidates from O&G and orthopedic department, it’s finally 4pm. Doctor Tarek finally came back and with 3 housemen, he went to round the FMW again. I met Lynn Wei!( Or should I refer her as Dr Wong here. Hehe. ) And 5pm, go home!!!

Today, I had learnt to: communicate with patients, Life and Death.

Tomorrow: Orthopedic Department!!!

Monday, March 22, 2010

Program Pendedahan Kerjaya Seorang Doktor (Day 1 = E&T)

I only knew I had to attend this program yesterday afternoon. Thank God for suddenly letting me have the urge to open the JPA website. Actually I was posted to Hospital Kuala Lumpur because I thought I would be in KL during the time of program. Who knows…it will be this soon and I am back in Miri already. So had this tedious process of calling HKL, JPA and then Hospital Miri to let me transfer here.

So, 9.00 am sharp, reached Hospital Miri main entrance. I think the last time I came here was during primary school because of asthmatic attacks last time. Since it healed, I had never stepped into this placed hence no whatsoever memories. It was a bit dark but peaceful. Typical hospital but with no medication smell. We registered ourselves and sat down in Niah Room. There were 14 of us and luckily, Kevin, Clement, Choon Vui and Tze Kiong were there too. There were student posted from Limbang, Marudi, Lawas and Bintulu too. Ms.Yusliha (if not spelled wrongly) briefed us first. She was very outgoing and friendly that made the whole situation goes from super tense to fun. She told us about the rules and regulations and all sorts of stuff. Then the Ketua Pengarah came and said a few words too. (Mostly about being a doctor not very glamorous and all) Then a senior MO came and advised us to remember to come back to serve Sarawak after graduation if we really DID medicine. Then Dr. Wong, a surgeon came and talked about surgery, not much about that but more on a doctor’s life again. About how we have to sacrifice everything, to help people, no like what shown in TV, have to be really determine to finish medical school and everything. We had a good long talk then.

Enough with that, then we are divided into groups. Was happy because I was assigned to a group with 2 other students from SM Sains. I mean, MEETING NEW FRIENDS AGAIN, yeah!! Haha. They are Charlie and Nur Sharyn. 2 very polite future-doctors-to-be. :D For the first day, our group went to the E&T dept (Emergency and Trauma). Woohoo…was so so excited, because I believe this is the most nervous and busy dept…(I guess only ok, I don’t really know how a hospital operate now) When there and wow, packed with patients. I never knew Hospital Miri would be so busy, patients keep coming in non stop, some urgent, some not, but all “not in a good mood”. I mean of course, who would? They are sick what… We met our first MO, Dr Priscilla Joseph. She’s nice though really really busy (Bear in mind, the ratio of doctor to patient in Malaysia is about 1:300 as told by the senior MO, 300 MAN!!!!!!!) She looked very professional. We also met a medical student posted here from England.

E&T have 3 zone, Green, Yellow and Red. Green is for normal patient. Yellow is where most emergency cases enter after the primary triage. We saw a lot of people there and it stinks at first, but we got used to it after that. We also visit the Bilik Pemerhatian for stable patients under observation.

I saw:

  • How they take blood sample (looks like a painful process, I don’t know…) Even baby had to do so and he cried like no tomorrow. But we have to be careful not to touch the blood with bare hands because blood is very dangerous.
  • People having sodium chloride and dextrose infusion. Helped a patient to carry her infusion pack while she goes to toilet…lols..
  • Patient with swollen eyes (Something opaque blocked the whole eye ball which reminds me of Saul. Haha)
  • Patient with heart problem (The nurses measure the heart electric impulse by sticking some suction clips with gel onto the chest...k la, i'm sakai, never saw it before k...)
  • Patient with ehem…genital part problem. What should I say, this is the first time I look at people’s genital part. I mean, directly. It was a bit awkward at first, but the med. Student say we should just get use to it. K fine. We actually saw a few more patient with this type of problem after that
  • Patient who was unconscious being sent here and the MA (Medical assistant) keep pumping air into him.
  • People who was sent in due to car and domestic accidents. Saw the MAs help them clean and sew up the wound.

I can’t sit still the whole day. Charlie and Sharyn were already tired and sitting there but I keep running around…look here look there… :p

The ambulance from Berkenu, Limbang and Miri were coming in non stop. I did make an effort to ask an ambulance driver if i could have a ride in the ambulance but...who knows, asked the wrong driver, he was the Limbang Ambulance driver. Haha....

And lastly, this is really due to my ignorance. There was a guy sent in with breathing difficulties. So I was standing right beside his bed. He was unconscious. Then a MA came in, he pointed ILI with his fingers to me. What? What ILI? Then he went away. I continue looking that guy. Dr Michael, another MO came in and told me, “He got ILI o..” I was like “What?” “You don’t know what is ILI?” “No” I replied, still smiling… “We suspect he got H1N1.” AAAA, I ran away immediately. Lols. I know if I really want to be a doctor, no matter what type of disease it is, I should face it. But man, I have no mental preparation at all for this… (haha and no mask) So I quickly grabbed a mask from sister and put on after that…gosh…haha…

DEFEATED? No!!!! Instead, this made me even more interested about this whole career. Back to medicine field? Erm...let's talk about that after this 5 days program.

Tomorrow: Surgery Department!!!