med school mumblings...

Monday, April 30, 2007

Weekend Fun...and Pain

i met up with my chp research paper peeps at vivocity sushi tei last saturday. it's really such a blessing that although this chp grouping was randomly assigned we all somehow managed to work so well together. food wasn't fantastic but the company was smashing, not to mention the exciting conversations that sprung up around the table. i think ours was the noisiest table in the restaurant that night! those conversations carried on after dinner when we moved to the promenade on the third floor. we talked till past midnight, about ambulance calls to an infamous chain of hotels, secondary school life, and throwing grenades in the army. the gathering brought back memories of those crazy chp days with the door-to-door surveys, revision upon revision of the paper, and the many dinners which we had. the next outing is being planned, and i can't wait.

sprained my left thumb during dance on saturday morning. was pushing off from the floor during recital rehearsal when i felt a searing pain in my carpometacarpal joint. my first thought was that i had sustained a gamekeeper's thumb, but it's not swollen and only moderately tender, so i self-medicated with ice packs and ketotop. it got better over the weekend but i aggravated it while attempting to perform an anterior drawer and lachman's today. argh. it's quite delibitating to have a less-than-functional thumb -- i can't tie up my hair, can't open bottles and can't flip through my textbooks the usual way. it's something like a taste of my own medicine since i end up wincing in pain whenever i overextend the joint. the irony is that now i'm supposed to do all these stress tests to diagnose another person's injury and at the same time aggravate my own. fantastic.

spiderman on thursday after osces. yes! and to all the seniors who start their housemanship this week -- jia you!

Thursday, April 26, 2007

Second Ortho Night Duty

i've changed my layout because some people had problems viewing my previous one. picked an orange-brown prefab from blogger but the code was all wonky so had to settle for this grey, windswept look.

had my second night duty yesterday. bad night for me, good for the team. it was a trickle of admissions and we even had the opportunity to go for dinner with the team on call. interesting conversation i must say, though we never strayed far from medical talk.

case in point: 68 year old man with parkinson's who tripped and fell and ended up with a neck of femur fracture. his wife has been taking care of him all these while, and now, he'll be wheelchair bound for the rest of his life. she kept saying to us, "he's taking up all my energy!" and one can't help but feel sorry for the both of them. i'm sure her husband did not want to be in this stiff and helpless state, but his current condition is sorely testing her patience. she felt that an operation would be a "cure" for his state, and was dismayed to hear that the surgeons were not keen to operate. his pd isn't very well controlled because he gets these weird hallucinations when the methyldopa is increased, so to prevent that, he's being put on a lower dose of the drug. it is unlikely that he'll be operated on, so i'm not sure how the family will cope with the turn of events.

am wondering how different night duty at the western hospital will be like.

Sunday, April 22, 2007

two weeks in ortho has more or less strengthened my opinion that ortho is a sad discipline. two cases in point - the 90/c/f diabetic stroke patient with gangrene on two toes who had to undergo an aka (above knee amputation) and the middle aged, diabetic security guard who's had three previous ray amputations (2001, 2002, 2005) who now has gangrenous toes bilaterally. he has extensive lower limb dermopathy creeping to mid-shin level (i have not seen something so bad before) and the pus was just oozing from his toes when the dressing was removed, not to mention the smell from the gangrenous parts. he was offered a bka but refused. not surprisingly he was very angry at the surgeons for offering an amputation and insisted that he could feel his own feet. he's most likely to get himself discharged, although i'm not sure what will happen when he goes home. it's hard to say you want to cut off a person's leg, but what else can we do in cases like this?

i'm getting to know the team better, and they're pretty nice doctors to hang around with. night call was excellent since houseman, medical officer and registrar were all trying to teach us something. even my consultant, who was quiet in the first week, sprang a brief but excellent tutorial on the management of osteoarthritis on us. fantastic. i always love night duties because i seem to learn twice as much in half the time spent in the wards, not to mention the little nuggets and stories the doctors like to tell at night. heh.

my computer has finally arrived, as has my printer. compy is a dell e520, running on windows vista home premium, and the printer is a basic epson print+scan+copier. can't seem to find the drivers for the printer online, so there's a bit of a dent in my celebrations. i've had my previous comp for seven years, and the printer for even longer (it's a canon bubblejet - don't laugh), so this brand new set of gadgets is pretty exciting, not to mention getting my first subwoofer and 19" lcd screen. woohoo. was so happy that i dug out my sims3000 and began to build. i enjoyed playing it so much that i scarcely noticed that it was way past midnight, and then only regretted it at service this morning. haha.

Sunday, April 15, 2007

it's been quite a relaxing first week in orthopaedics - the usual lectures, tutorials and clinic sessions. my team's reg has been taking us through the ward rounds and i appreciate his practical approach to teaching us ("no didactic teaching, just tell me what causes confusion in a patient and how you would manage it as a HO"). saw a couple of familiar faces from my medicine rotation at the western hospital (including dr funny!) and a medical officer from chalet hospital's urology department. i couldn't help but think after meeting the uro MO that the world is getting smaller as i climb up the medical ladder.

and how fast time flies. when i first met dr funny he had just started his first internship rotation and was being hurled the most vulgar hokkien curses by a confused renal patient while attempting to take an abg. in few weeks' time, he'll be an MO. that uro MO from chalet hospital will be mopexed back to chalet hospital in a few days, which makes 3 postings since the time i last saw him. and me? one year ago i was a confused, disoriented youngling wandering around central hospital asking the ward clerks for good cases. now that i'm wiser i'm hoping that i'll be able to help the incoming second years as much as my seniors have helped me.

oh wells. it's time to get back to my mcrae, or as one lecturer said, "murk-ray". heh.

Thursday, April 12, 2007

communication.

we learnt all about ideas, concerns and expectations of patients in family medicine. that patients see things very differently from doctors and therefore expect something else. how true it is in our personal lives too. we involve our prejudices, desires and beliefs into our dealings with people and often get ourselves entangled in a sticky web of emotions. trying to extricate oneself from that mess is like trying to get out of a peat bog because it's got so much to do with your heart and not your mind.

[cryptic] i need to learn how to let go, and not to hold on to things that i've got no control over. don't think i can keep this up forever. [/cryptic]

Monday, April 09, 2007

managed to catch mr bean's holiday on saturday. it was a little painful in the beginning, like when mr bean got his tie caught in the vending machine. but as the film picked up pace, the jokes and gags got better and better. midway through the show, the whole cinema was laughing and thoroughly enjoying it. i won't blog much about it since there isn't much of a plot, but if you're looking for a brainless movie for your fried cranium, this is the movie for you.

had my first day of orthopaedics today. as the head of ortho said, orthopaedics is spelt with an 'a' and it means 'to straighten the child'. compare this to the american spelling, which in latin would mean 'to straighten the foot'! never knew that. heh. have been posted to the central and western hospitals for these two months. i seriously think it's a conspiracy to get me to work at the western hospital since this is the fourth posting out of eight that i've been posted there. well, at least the teaching is supposedly good. heh.

during my lunch break i got the chance to catch up with my anatomy group mates. the last time i had seen some of them was probably three months ago, so it was great to meet up and swap stories about our previous postings. i miss the friendly ribbing that has always featured constantly during our outings. it's been three years now; how much we've grown. what will the next 2 years bring?

and it's back to mugging anat again. latin, latin, and more latin. here's to a good ortho posting!

Friday, April 06, 2007

family medicine has been quite a relaxing posting. no night calls, only night clinics with a handful of patients. i got the chance to practise taking blood again, watch my first pap smear and do my first wound dressing.

i have to admit that i was pleasantly surprised that the teaching has been good. i wonder if the mmed in family medicine includes a module on teaching medical students, because everything has been explained to us very systematically. not only that, the tutors are very nice. just had a tutorial on community geriatrics this morning, and it was a hoot. lively and interactive and very practical. got a chance to take a spin on a wheelchair and at least for that short distance, it wasn't as hard as i thought it was. of course to wheel oneself everywhere is probably very tiring, but i always thought i would have trouble even getting myself to move or turn around, which i found out to be on the contrary.

so it was that the posting ended off well (ie test wasn't a killer) and we managed to have a wonderful night out. watched the number 23, starring jim carrey. it's a psychological thriller, and tells the story of a man who finds a book entitled the number 23, and finds that the events in the book seem to parallel his life. it's not just the description of his childhood, but also how the number 23 figures in his life - his birthday, wedding day, the day he met his wife, his name, etc. he gets drawn into this world where 23 controls and threatens to destroy him, just as it did to the characters in the book. it leads him to a murder which took place 15 years before, and he believes that the author of the book is the perpetrator. he makes it a personal mission to find out who the killer is, only to discover the shocking truth about the case, and himself.

jim carrey is fantastic as the protagonist walter sparrow, just like how will smith surprised me with his depth of acting in the pursuit of happyness. the movie is riveting and disturbing in the opening scenes, because the story is about an ordinary man in an ordinary town encountering extraordinary events with the introduction of the number 23. however, the story never quite reaches its climax. there is a shocking revelation at the end, but i was left asking, you mean that's all there is to it? there was so much potential to have it end the way the sixth sense did, where you walk out of the cinema with your mind in a whirl. the plot flatlines in the final half hour, which is a real pity. i'll give it 3.5 stars. heh.

after the show, some of us met up at acid bar for some chilling out. it really felt good to be sitting around, listening to the three piece band, and talking about things which we probably would not have discussed anywhere else. my only complaint would be that the songs were quite depressing, songs like foolish games and chasing cars. what i needed then was a couple of cheerful, upbeat songs, but i never got them. sigh.

we gotta do things like that more often. stuff seem to be piling up. the dean's office has finally revealed to some of our classmates the details of the electives (the way we're waiting is like how harry potter fans await the last installment), and we're now to do a one month project and come up with a report and poster. this will make our m5 year the busiest school year ever, since we'll have the ethics essay to hand in, two months of sub-internship to go through, and be the guinea pig batch of the medical science exam. exciting isn't it.

at least there's a sentosa jazz chill out tomorrow evening with the girls to look forward to. home made shepherd's pie and heart-to-heart girl talk, coming right up.