The first time...

The first time of everything is always the most exciting one and you will always remember your 'first time' in doing something. 

I was watching an emergency LSCS yesterday and a senior MO was teaching a junior MO on how to perform the surgery. It was her first time in performing a surgery. To her, it may be an exciting experience that she cant wait to share with her loved ones but to the senior MO, it may be just like any other day that he scrubs in and performs a surgery. As I was standing aside and observing, suddenly the thought of doing something for the first time came flooding into my mind. I remember the first time when I learned to swim, the first time when I learned to speak in public, the first time I clerked a patient, the first time I did venepuncture on a patient, and the list goes on. There is a lot of excitement loaded in those events, but there is also fear in doing something for the first time. When trying something for the first time, you may be doubting yourself, whether or not you are able or capable to perform well enough, or what would other person think of you if you fail and the consequences when you fail. Often, these thoughts of negativism and fear would limit someone from doing what they think they cant do but in fact, they can. The feeling of insecurity often kicks in without you knowing and when that happens, you stop trying for the first time. Instead of having thoughts like that, what if you turned the first time into something exciting and positive?

Our days are built so routinely consisting of endless cycle of breakfasts, lunches, dinners, house chores, work and building relationships. It has been designed in such a way that there are days when you wake up, you just dont feel like doing anything at all. You will find yourself hard to get motivated. In order to make life a bit more exciting, a bit more meaningful, and to feel the thrills again, one need to come out of this routine and do something out of the box, for instance, go on a travel alone for the first time.

It doesnt matter how old you are, how mature you are and how experienced you can be, doing something for the first time in life could be sometimes exciting, unique and extraordinary. And to some, doing something for the second time may be boring or dull, however, if you could recall the mixed feelings you had when doing it for the first time, you may find the second time as exciting as the first time. And remember, you will never be fully prepared for the first time at everything and second experience may not be as smoother as you thought. 

So, when was the last time you did something for the first time?

-Pei Li-

The Etiqutte of A Doctor

If you ask anyone who is not in a medical profession on their perception of doctor, words that can be predicted such as, they are very noble, smart, patient, rich.. etc and the list goes on. However, things seem to change a little lately. And, I was wondering why such a change. 

Is there any problem with the competency of doctors? communication skills? or just attitude problem of medical professionals?

I believe most of the graduates have a certain level of competency and we have keep ourselves updated with the latest guideline provided to maintain optimal patient care. There are much emphasis on patient care, but has anyone thought that the relationship between medical professionals play an important role in a health constitution?

In my point of view, a doctor's behaviour is very important in many aspects and I believe not many doctors are aware of it. How does the doctor treat his patients, his communication with their subordinates or even someone who is very junior matters a lot. 

As a final year medical student who is going to graduate in few months time, I am learning how to be a good doctor. And being a good doctor encompasses many good criterias. One of it is being kind and humble. It may seem like a common sense, but many doctors have failed to do so. 

Doctors who are arrogant and inconsiderate to their juniors will cause unnecessary emotional disturbance and it will indirectly affect the performance of the junior. Of course this does not include reasonable criticism by a senior doctor. 

I always believe doctors should speak and act in a proper manner. If you think bullying/stepping on juniors makes you feel greater? THINK AGAIN! It just kills the interest of the junior in being part of the team. 

In other way, if a doctor who is very encouraging and kind, juniors will start to develop interest in learning and it will make a very friendly learning environment. 

Sandra Liew

Right or Wrong?

During our Sem 9 surgical posting in HTJ Seremban, there was a patient wrote to the star newspaper, filing his complain named "Why rob patients of their sleep and rest?"
http://www.thestar.com.my/Opinion/Letters/2015/01/19/Why-rob-patients-of-their-sleep-and-rest/
The patient complaint that the patients were waken up as early as 4.30 - 5am by the doctors for history taking and physical examination, robbing the time for their sleep and rest. However, I noticed some of the housemen nowadays are actually copying the files from the previous entry, some even just sit at the counter and copy the files without even talk to the patient or examine the patient. Hence, if the doctor is waking the patient up to talk to them and examine them, at least we know the houseman are really doing their job. However, from patient's point of view, it is true that they do need rest. As consultant round starts at 7.30am, so the MO round usually starts around 6am+, it is understandable the houseman have to start reviewing the patients as early as 5am since they have about 6 to 9 patients to cover.
Is the houseman wrong for waking the patient up early in the morning to take history & examine patients? I don't think there's right or wrong here. Perhaps it's just different point of view. 

- l.a.u -

If you could...

I have come across this video few years ago. This video left an impact on me and I believe if you watch it, you will experience the same way as i do.

Everyone has a story to tell. He or she may be the person standing right next to you, a patient that you attend to or even just a passerby. They do not carry an expression that is easy for you to read. The thing is, how many of us are willing to search for the story of what lies behind. Often, we are confined to the mindset of "getting work done" and we tend to ignore their feelings. When you diagnose a patient with terminal cancer and then you just sleep through the night without having to worry about it. That patient whom you just diagnosed, may have a sleepless night, perhaps countless sleepless nights with the fear of death or even persistently worrying about how to break the news to his/her family or what they gonna do when he/she is gone. But, do you know all these? Do you care how they feel? When a blind man sitting right infront of you, do you know how he pictures you or what lies in his imagination? Empathy is a gift and it is accessible to all of us, but we have to find ourselves the opportunity to explore, to identify. Sometimes, a question as simple as "how are you?" would make someone's day. We may not be able to cure every sickness but listening is often the only thing needed to help someone and to discover great stories.

Take a step back, think it through, and reflect on what you have done for someone today.

"If you could stand in someone else's shoes, hear what they hear, see what they see, feel what they feel, would you treat them differently?"

-Pei Li-

Mistakes

It has been five weeks since we stepped into the last 6 months of medical school. As being a medical student, we can still afford to do mistakes and learn from them. We were told to do as many mistakes as we can as a student before we directly dealing with patient’s live as a doctor. And I told myself, it is okay to make mistakes now.

When we told the patients and families that we are final year medical students which meaning that we are going to be a real doctor in less than a year time, they put trust on us. They will be willing to listen to our advice. The truth is, we are indirectly and actively participating in managing a patient. For instance, we give appropriate advice to patients regarding their lifestyle modification, diet control, handling of medication and illnesses. However, before we could give a good advice to patient, we should really equipped ourselves with knowledge because wrong information can be life threatening to a patient. 

I had made a huge mistake that day because I gave wrong information to a patient which can lead to life threatening consequences in her illness. I felt so awful and even hard for me to forgive myself in doing such a mistake which I should not. For the first time, I felt the responsible of being a healthcare professional in directly dealing with one’s live. When we carrying our lab coat which represent our profession, we should give our best in everything we do, be it prescribing medication or just talking to a patient. This can create a “butterfly effect” which lead to serious consequences later.

Yes, I told myself to do as many mistakes as I can in these 6 months before I become a real doctor. But, I really find it so difficult to accept the mistake that I have done. Even if the patient did not affect by the mistake, the thought of me almost caused life threatening situation to the patient is horrible. However, to admit, apologize and correct the mistake that one have done as soon as possible are equally important too. For this instance, I am glad that I was still able to amend the mistake that I have done before it is too late. This mistake had really gave me a huge lesson to learn.

So now, try to do as many mistakes as you can? 

No, think twice before you let anything slip out of your mouth. It’s more than pain to do mistakes. 

-K-

The reality

Originally posted on Kazayo

Have you ever wondered why the patient rather lie to you than being honest about their medical condition?

Yesterday, a patient was scolded so badly by the Medical Officer, because she defaulted the computed tomography (CT) appointment given to her due to her malignant status. She was in very bad shape, having really bad pain, sobbing away. Having surrounded by 5 fellas at once in a small room,  having to bear with the pain while these people do an ultrasound scan. She was left all alone in the room while the rest just walked away, discussing about her case. The poor thing was shouting for pain more than half an hour ago, no one bother to relieve the pain before doing the scan.
Then, the Medical Officer came in and started asking her why she defaulted the appointment, and refused medical treatment previously. My point of view, that MO was directing her frustration of having to do more work just because she wouldn't have to make another appointment for the imaging if the patient had turned up for the previous appointment.

Did anyone take a chair, sit beside her bed and ask her why she refused the medical treatment at the first place but rather turned towards some traditional treatment which made her condition worse?

I can totally understand why the patient refused treatment. There's no surprise if she is doing the same thing again for this recurrent thing, if she is treated like this.

This morning, I went to the hospital right after my Sahur, it was 6++. A patient stopped me at the first cubicle and told me there's one patient in deep pain, curling on the bed. I asked that patient if she was given any pain medication and when was the last dose. Then I attended to the HO at the nursing counter.

"Dr. the patient at bed x is having very bad abdominal pain, pain medication was last given at 3 in the morning. She came in because of dysmenorrhoea, and diagnosed with.......bla bla bla"

"It was written on the drug chart a BD dose right? At 8 in the morning and 8 at night"

"Yea, but she is in a bad shape now, you might wanna give her something to ease the pain?"

"You saw the drug chart right? It is a BD DOSE", he stared at me.

"Anyway, you might wanna have a look at her", I tried to hold on not to explode.

He walked off so unwillingly.

I almost whacked him with my messily-filled logbook - Eh harlo bro, you have a damn MBBS with you and you can't prescribe a damn pain killer for that poor patient who is curling into a ball because of the pain?! Damn you......
*spit on the basin*

Now I see why the Old Man is so upset.

For the first two weeks, I was really upset about the posting. We have different professors in charging for different wards and taking us for different topics on bed-side teaching. Each of them have different preference, each of them see things from a totally different point of view and of course have different expectation.
These people never came into consensus, but rather expect us to fulfill what they expect us to do. This is very unfair.

Covering all the beds in the wards, crowd around in the clinics, follow patients to the OT for surgery, having to complete the clinical skills assessment, speak up during classes or teaching sessions. We rarely have time to eat or shit, not to say extra time to mug up our medical facts. Then, during bed-side teaching, we screwed it up.
At times, we sneaked back to the school to be assessed by our Sister regarding the clinical skills, which is compulsory, then the Professor in the ward is making noise, saying why aren't we in the ward. When we went to the clinic following one of the professors, another Professor blamed us for wasting time in the clinic where we don't know what we are learning. One said go ahead to get some experience and observe different operations being done in the theater, the other one said there's no point going into the theater. Worst thing, when our logbook looks pretty empty on the procedure page, another one make noise.

We, the vulnerable one, always keep quiet, taking in every blame.

But hey, that's the reality isn't it? In the real world, that's what exactly happening. 
There is never a consensus being made.
You mold yourself according to different situations, and try to survive between the gaps. 
Now that's reality!
Stop complaining and find your way out!
"Be the change you want to see"

You are not here to learn the right things, you are here to learn things right - Prof. S.

-FiShe-

Introduction to Med Tutee.

In conjunction to MedTutor, a group of final year medical students have been inspired to create a platform to share their thoughts and dreams.

In this blog, we would like to share our views and perspectives beyond sickness, suffering and death.

Through each footstep, it helps us in understanding the core of humanity and brings us closer to what is beyond.

In the end, it is not how much you know about the medical world, but what you have gained from it.

How far we've come, and how far to go......

-Med Tutee-