aRtoF ~ $ 0 F ! 3 ~

Today'S BitCh

2011-10-19T06:44:00.000-07:00

Dear Bloggie

Today's Bitch is not someone who've ive onli known today, but someone whose true colours were discovered today. A common saying was 'Look at the good things of a person, not the bad' and so i did for the last 3 months.

And for that, I had also become the 'cooler' girl, who tries to overthrow the boss ( in my dreams)

Bitch keeps on saying that the boss always picks on her cuz she wears nice clothes, branded shoes, expensive bags..which we all did agree ( and another friend). We had all reached to the conclusion that the boss is jealous of her hence the boss' multiple hints to show how much superior she is to Bitch. 'I got this for RM1000.. my husband got me this.. i have 20 bags'

Today the light bulb was turned on. Bitch actually has the same problem as Boss. She HAS to be the one on top always. No one else.. Like I even wanted to be. Ive never realised that I was a threat

** Some people just tell u a story with no intentions of bragging. Some people simply has to tell u a story to boast**

Here's a series of what had happened today

1. Had an offer frm the office to go for another course, its my 3rd course that has an accomodation provided. If I go for this, I would have completed my 7 days of courses for the year which is compulsory for every officer

- She reacted by taking it on me on why I keep getting courses and she does not, and why are my courses indirectly making me mingle with the who's who in the service

- Yesterday she called immediately to the office, demanding an explanation why her name is not up yet for more courses, when she is more senior to me

- Today she made a remark about why are they always sending me to courses that have important ppl in it

- How would i know, i dont choose what i want, there's an officer who does it, i dont even demand it, i dun even know how she looks like, Duhh!

2. Was preparing a powerpoint presentation, about making our clinic to be run by computers. I came across the idea about 3 weeks ago, but never completed it. Was asked about it by my boss and another colleague, and finally decided to complete it last night. Bitch was initially supportive of it until she found out i was doing something about it, and said she'd be happy to be included in the project if it works

- She overheard me talking to the boss and colleague, informing them that it is completed and makes a remark. TWICE today

-She had a glimpse of my presentation whn i showed to her and my friend proudly( then, i did not get the whole picture yet). This were her remarks. " Did ur father teach you how to do this? ". This remark to me was normal i get it all the time. One of the reasons y im not motivated to do things, cuz if i answer a question correctly or i do something great, ppl will never think that its because i worked my way through it. They will always think dad helped with it. There was no excitement anymore in doing greater things.I shortly replied "No, he doesnt even know im doing this"

-' I Dont understand why you guys would wanna do this when we do not even get enough budget for medicine' like HUH? Fuck u bitch

-All of a sudden a turn in her opinion

- To prove a point, ( i think), out of all the 3 months, she chose today... to show that Ooohh.. u can type a memo, instead of writing it. Oooh, u can type a referral letter into a paper with different headings and blanks to fill. " See..what do u think?" and smiles proudly

+ A hAppy WeeKend +

2008-12-10T03:47:00.000-08:00

~~Yes!! It's the weekend with an extended one day. Thanks to Eid ul Adha ~~

Friday
Reached Seremban at about 7 plus, had home made Bubur Lambur and Sup Daging . talked and talked and talked with parents and head ot bed

Saturday
Woke up at 815. Had breakfast. Got ready and left the house at 9am. Left for MidValley and was at the entrance of Metrojaya 5 mins to 10. Dad was not allowed to enter by the security guard because he wants it to be sharp 10 before he lets anyone in. Luckily he did not make a big fuss. Nana and i were looking for proper shoes to wear to the hospital. It was between HP, Clarks and Rotelli. back and forth back and forth. FInally didnt buy any shoes. Took pics near the christmas' decorations. Chose a handbag for Mom and bought it for her. Shopped with Nana. Had lunch in Burger King and as usual to the tit bits shop to munch.. and pack:)
Went to Klang. Had tea with Grandma and went back home by 730pm.
Uncle Dollah and family stopped by, had dinner in Curry Leaf and had coffee back at my place.

Sunday
Its Eid! woke up at 3am for tahajud prayers. Quickly climbed back into bed b4 Subuh. Mandi sunat raya. had ketupat and rendang and lemang plus coffee and went tohe mosque to pray. The imam misorganised his scripts that he was struggling to continue his sentences. He burped during the speech too YEs ON THE MIC!The usual makan makan and minum minum and tv watching . 12pm pack stuff. 3pm waiting to go.got an sms traffic is heavy might be delayed. 415pm christabel and poh tian arrived. Had tea and left . Reached BP at 730pm. On the way back, was alrd getting depressed.. why oh why...

~~Cant wait to go back to Seremban in 2 days!~~

~Endoscopy~

2008-12-03T07:08:00.000-08:00

When i was in Seremban Hospital in my surgical posting most of my frens (including me) would skip the Scope room session. Until our dean who is the also a surgeon took us for classes and had asked us how mnay procedures involving scopes that we hav observed
Our answer was NONE SIR. He became very upset and insisted that we spent more time ther
During my end of posting exams in Seremban he asked me again if i had gone for any observations and i said we did not go

That is how the scope is inserted from above. The purpose is to view the esophagus, stomach and a part of the duodenum for swelling in the wall, ulcers, bleeding walls or vessels, and also interventions and diagnosis

Yesterday..for the first time in our lives we had managed to see how banding of vessels in the esophagus was done.. from zero cases over the 5 years to 2 cases within half an hour. Not onli dat i managed to assist one banding using the scope. , so so happy even though it was just holding the mouth piece and comforting and reassuring the patient

This is how a stomach with a protusion from the wall looks like through the endoscope. fascinating huh?

Depressing Batu Pahat

2008-11-30T21:24:00.000-08:00

This is wher i have been for the past 3 months and this is wher im going to be for the nex 3 months.

Things havent been great. During the first month, i went back for 3 weekends couldnt stand the fact that im stranded in this town. And mind u i am not from the metropolitan city of kl, penang or jb.

Of course my fellow batchmates(60+ of us) decided then we shouldnt go home or head towards kl that often as we have so many portfolios to do.We have 4 main posting in this FINAL semester namely internal medicine, obgyn, surgery and peadiatrics.. In each posting we are required to do 2 - 3 portfolios.

What is a portfolio?
It is writing a case of a patient from the day admission throughout his hospital stay and until discharge. This include the interviews the examination the management plan. Then, we are expected to constructively criticise the inadequacy of the management and how we could make it better. At the same time, it has too also be supported with evidence base medicine-meaning going thru as many medical journals as possible. After that, we are required to come up with learning issues regarding to the patients and discuss it maturely.

On average each portfolio is 20-30 pages long, and during ourfinal exams with have oral exams regarding our portfolios

IN the mornings we are all at the wards, covering the beds assigned to us, trying to do as many procedures as possible, go thru ward rounds with the doctors here and assist or observe in the operating theatres. IN the afternoon, its either ward work again or classes in the campus. Then after 3 hours of break, we head back to the hospital for our night calls.

Symptoms of depression among us:

PT: had diarrhea on each and every day wher she is in Batu Pahat without fail. When she goes back to her hometown, her stools consistency reverted back to normal
FS, AK, JK, JY, CT: home sick.keep thinking of home. dont have the motivation ot study or do anything
AK, FS: Acne flare up.
AK: Heavy menstrual bleeding, assocaited with blood clots and dizziness
FS, CT, BM, AM: Worsening of the allergic rhinitis
Evrybdy: You tubing fever seen we r deprived of entertainment here
Evrybdy: During the obgyn posting, all 18 of us finally showed our true colours, We all broke down under the stress and the long 8 hours of nite call and coming to work again the next day.
50% of us: the backstabbing, the kiasu attitude, the wiping lecturer's ass attitude developed just to get good remarks in the logbooks

++Our motivation to pass our exams now is to get out of this place fast. Cant live another 6 months here. We do not wan to be on anti depressants!++

Semester 10 is not fair

2008-11-27T02:32:00.000-08:00

every 5 weeks we change postings and the lecturer is expected to write something in our logbook
and how many times does the lecturer sees us in a week and for how long. Most of the time we are on our own and doing our on calls on our own. How would day knw how we have performed in a clinical setting next to the patient. How genuine we are and not just acting in front of the lecturers when the lecturer is around next to the patient.How would they knw abt our people skills in the clinics because at that ime many student would wan to examine the patient. Wat about those who have empathy.not coming forward to examine and talk to the patient when evrybdy else hav because she thinks abt the patient. If she was in the patient's place she wouldnt wan to be harassed as such.

Some people shine in class because of their knowledge. some ppl just happen to be lucky to get easy questions. Some people are so kiasu that they wan to present their cases in every teachign session with lecturers. Just to give the impression that they are well read and good in their knowledge.

How are these lecturers gi vent he authority and right to jot down comments in our logbooks when they do not knw if they limited time he has with us potray the true person each student is or not.
Those who suck up get excellent-because they critic evrything evrybdy else does.and report to the lecturer about evrything ,even things which are not right and alrd corrected. wat the hell?
Those who are good-some do deserve it and some just dont
Those who get satisfactory- those who hav potential but because of this excellent ppl, they are just labelled as satisfactory.

Im so pissed off.this lecturers think they knw a lot abt us. Nobody can rate a potential clinician. Their work should onli be rated by the patients. A clinician's overall assessment should be longstanding in 20-30 years down the road.NOT NOW.

Dear lecturers..do u knw u have made many ppl here depressed..lost the interest in continuing studies and make us feel worthless, like we dont even need to attend our exams to knw that we have failed? The portfolios are killing us too.Why do u burden us so much?

Im Pissed OFf!

2008-04-18T03:41:00.000-07:00

My nasib is so so not nice.i Have a running CCTV evrywher i go. Guess where today? AT the hospital parking lot. What happened? Read further...

I came at 8 am. Parked my car like how ppl in One Utama park theirs eventhough there is no parking space. At 430pm i get a call from my mom,

mom: Wher did u park ur car? Ppl are getting angry, uncle *** called and he said ur car is parked n the middle of the road

Sofie: No its not. Its the normal place wher everybdy else parks the car

mom: Then why he said ppl are getting angry?He called the house. he called papa

SOfie: i dunno he is over reacting evrycar can come in and out. and they can take the corner too. Its normal to park there. NOthing wrong and definitely i made sure i didnt block traffic

mom: Ok go and move ur car now

Sofie: its ok im leaving for home now

when i reached home. THANK GOD he didnt get thru to my DAD. COme on Small things and they r making it big. They think they have the right to do this jus bcuz they know they house number and my dad's mobile number and the carnumber plate
Im so pissed off. He made a small thing big. I got scared i thought when i reached the parking space i would havwe gotten cursed and bashed up. Turned out nobody was waiting for me. Parking spaces were half empty. COme on! why make my life miserable! Just mind ur own business. If u dont have one FIND ONE of ur own. DONT MIND MINE!

i had another person telling my dad i was cutting into the lane while waiting for the traffic light.
this happened to be a doctor

Dr +++: Plz tell ur daughter nex time try not to cut into other people's lane while trying t make a turn at the traffic light. Its dangerous and she might irritate another person and cang et into an accident

dad: Oh dat was me. It wasnt her

Dr +++: no no she was wearing a scarf.. im very sure of that

dad: No that was me. i observed u wer always busydoing sumthing else when u wer driving. This time u were searching sumthing from ur glove compartment. so i thought y not. She was sitting next to me in the car

another occasion..and this time its the same doctor again and its regarding the same junction wher we turn off into the road that leadsto the hospital. ther was an alternative way ( making a uturn..go towards the back of the dialysis centre..then join into the same road that leads to the hospital). He saw me doing that and just had to inform my dad

Dr +++: plz tell ur daughter that it takes the same time to wait for the lights to turn green rather than to take the long way.

3rd occasion..this is a visitor coming to the house

Uncle +++: i saw ur proton car coming down the hill from the hospital. She was going pretty fast

( i was onli going at 60km/h..I KNOW ITS A HOSPITAL AREA!)

OH MY GAWD!! and recently my mom told me that i cant go watch a movie with ronald all by ourselves. people wioll talk and get the wrong message and all these stupid things will reach my dad in a wrong way...OH GROW UP SEREMBAN PPL!!! and so i couldnt go out for a movie on a frday evening bcz evrybdy is back in their hometown and nobody to chaperon me and ronald..PATHETIC!!

Medical Specialty Aptitude Test

2008-04-15T09:03:00.000-07:00

http://www.med-ed.virginia.edu/specialties/Home.cfm

This is a test containing 150 questions to determine which speciality is the best for u according to rankings..these were my results..

Rank	Specialty	Score
1	physical med & rehabilitation	43
2	gastroenterology	42
3	general internal med	42
4	family practice	41
5	dermatology	41
6	rheumatology	41
7	pediatrics	41
8	radiology	41
9	psychiatry	39
10	occupational med	39
11	nuclear med	39
12	infectious disease	39
13	hematology	39
14	cardiology	39
15	neurosurgery	38
16	anesthesiology	38
17	endocrinology	38
18	nephrology	38
19	colon & rectal surgery	37
20	emergency med	37
21	orthopaedic surgery	37
22	plastic surgery	37
23	thoracic surgery	37
24	general surgery	36
25	preventive med	36
26	ophthalmology	36
27	med oncology	36
28	radiation oncology	36
29	pulmonology	35
30	allergy & immunology	35
31	aerospace med	35
32	obstetrics/gynecology	34
33	pathology	34
34	otolaryngology	34
35	neurology	33
36	urology	32

Surprisingly what i plan to do came under top 10..hmmm.//interesting..will think about it..and now imconsidering rehab too:D

Why i Wanted to Become a Doctor

2008-04-08T23:24:00.000-07:00

This was written about 2 years ago when i first entered clinical school. I cant remember what triggered me to ut this down to paper.. but i think it must have been something the lecturer asked us in class

Before i enrolled into this course, i had a very clear picture on why i decided to become a doctor ( That was long before my accountant ambition was rejected although after gaining a scholarship for that). Reasons were too Euthopian..Saving lives, cure their ilnesses, prolong and give good quality of life. Too insensible when i think back. My first few weeks in clinical school made me realise that putting words into sentences is very different from learning through experience.

The main idea is to help people is still there but many challenges are now more eminent ..not as easy as i thought it would be. Especially when we are emotionally attached to the patient.
I realised a good performer in class will not be a good performer in hospital too. Clinical school definitely requires more than memorizing, mugging . It requires common sense, intuition, compassion to people and empathy. I am more human now

Pulmunologist - Specialist in Lungs

2008-04-08T22:33:00.000-07:00

Clinicians vs Academicians

Evrybody can become a doctor, it is one you become of after that, either a clinician or an academician..

How do u differentiate which type of doctor everyone is through observation in the wards

An academician..will do all sort of things which might worsen the patient's condition
Imagine reaching the emergency department feeling breathless, the doctor suspects the patient has asthma, then the doctor asks the patient to blow into a peak flow meter ( a cylindrical instrument to measure the lung capacity) and treats according to the reading on the peak flow.
Thats an academician. A clinician.. knows that there is no point in doing a peak flow. The patient is already breathless and asking him to do this and that can worsen his condition. Just treat according to experience. Academicians will follow the percentage of reduction in peak flow then give dosages of medication according to one is written in the book although what they giv might be inadequate for the patient. A clinician picks up the sign and knows how much to give in a snap

How we suddenly came to this discussion because when discussing on the scenario above, one colleague of mine suggested a peak flow and mode of treatment should depend on the deficit in the peak flow reading.

And he defended his stand by saying this was written in the book
Our professor's argument was, books are written by academicians, they do not know what is practical and what is not in a real setting. and you know why? because they have time to write books. which implies they do not spend enough time in the wards to see real patients

An academician can give beautiful talks in conferences but not be a good clinician
A clinician can be a a clinician and giv beautiful talks too because they relate to real life experiences and makes the talk more memorable.

Besides that, academicians will try to go for any possible conferences, talks, put up papers and publish books. They are hardly in the wards. Wherelse, a clinician is always in the wards, even not on his call days, on public holidays, taking care of the patients, they might not be as bright when it comes to the most uptodate news on medicine but the beauty is seen when they pick up signs in patients which many people can do. They can predict when something is gonna go wrong although patient looks well and nobody seems to be wrried about the patient. Subtle signs are their speciality, the slightest sign of breathlessness they can detect,that sort of thing

My professor told me too that even patients can distinguish a clinician from the academician
The academician comes to the ward talks to the patient and other doctors about the latest technology, the best treatment overseas, the statistics which they memorise, but when it comes to hands on in examining and treating the patient..they are not as confident

When all this patients fall sick, although the academician who claims to be still be practicing medicine has more titles than the clinician, they will still go to the clinician because they know clinician wont miss the most subtle sign and will manage them with care and appropriately

The more i heard his stories the more i felt clinical work is definitely for me. I love the challenge of picking up things whch other people forgot to or just couldnt pick up. I have done many regardless it was a counter check with my colleagues or even the house officers. Its like wow..endorphins released.. like im sherlock holmes, able to crack the case by myself. I felt that i was able to prolong somebody else's life.

My most memorable was i saved a baby who was not born yet from dying in his mom's womb, just by asking for a history which the house officers missed. i alerted the nurse and she was induced into labour and pushed into the labour room. If i was late that baby wont be around..such a cute baby!:)

Compulsive Pathological Liar

2008-04-02T06:27:00.000-07:00

A diagnosis made by our lecturer when one friend modified part of his history of presenting illness about a patient's loss of consciousness..just a minor detail..about

' Mdm R a 38 year old lady presented with history of not being able to be awakened from sleep after 4 hrs. This was discovered by her daughter who just came back from work.....

and around the end of the whole report

' Mdm R lives with her husband in a wooden house.All her children live in different states around Malaysia'

Our Lecturer: StOP!. are u lying?normally no child wouldbe outstation and comes back from work around evenign to their mother's house

Friend: Erk..sorry i lied. She didnt come back from work. she accidentally came back home that day

Our lecturer: Plz dont make it a habit. Your seniors failed his final exams because he lied. He didnt examine the patient and said he did and he created his own findings. We examine our patients first before letting you examine them. Ok tell me about the physical findings. Any relevant findings u would like to point out

Friend: Actually i didnt find anything relevant after examining her.. evrything is fine

OUr lecturer: Are you sure.. you are telling me she is diabetic and she does not have any signs of complications?

Friend: aaaa..ok..i lied again..i didnt examine her

Our lecturer: Please tell honestly if u didnt examine the patient. You are a danger to society!

While looking at the ECG of the patient, one person tried to interpret it and it was wrong.

Ourlecturer: Ahaa..lying again.what is it with you people and lying. Is this contagious?

CoMmunity CliNic

2008-03-30T22:25:00.000-07:00

since last friday was the national university day, my uni had also given us one day off thats when i decided to go to the dentist(government) punye.so i went as a patient..no lab coats..no official wear so i did scaling and onli paid RM4.

while waiting for my mom to come fetch me ,one rather old looking chinese man, shabbily dressed.. came out cursing..

Chi Man: Halor..saye jumpa itu doktor dia kata saye punye cermin(specs) sudah takda guna la
Sofie: oo ok
Chi Man: cilakak la itu doktor
then he began to take out his wallet..
Chi man: lu tengok ini
i got scared i tot he is gonna ask for money
Chi man: Ini dia tulis saya punya mata..lu tengok saya punya mata sekarang, sebelah ada kicik kah?
Sofie: Erm. Tak sure la uncle.Saye bukan doctor ( pretended to be a layman). Tapi ini power mata kanan lagi teruk dari kiri la ( contradicted my role)
Chi man: aiya ya ka.sikalang itu doktor cakap sama saya ini spec sudah tada guna la.mau buat balu.cilakak itu doctor
SOfie: o ok
Chi man: Ok aa..saya mau balik dulu
SOfie: ok Bye Uncle
then he walks abt 4 metres also then he turned back
Chi man: you mata ok a?spec ok a?
Sofie: Yes yes ok
Chi man: Oh..ada itu asam (wind) saja aa
Sofie: Itu pun tada la uncle.datang jumpe doktor gigi
Chi man: Aiyoo kasi cabut aa..jgn kasi cabut la
Sofie: Takde takde..bukan cabut tampal saja
Chi Man: Bagus bagus..jgn kasi cabut nanti masuk dalam badan manyak teruk..Ok aa saya mau balik

i Hope after talking to me he went back a bti calmer with less cursing on th way home
Of all ppl waiting outside he came to me.he mus have tot he could relate to me since we bth wer wearing specs..

SO cute that uncle..Hav u guys noticed older ppl are much more cuter..??

VOting Day

2008-03-29T00:55:00.000-07:00

Yeah this is long overdue!! cudnt connect to the internet for 2 weeks..had to go to starbucks to prepare my slides for class presentations.

Alrite..so this was the first time i was able to vote.Didnt want to waste it. Had so much confidence that i was going to vote for that side. I walked up to the sekolah agama with my parents. Sister who was back frm manipal stayed at home since she didnt register to vote. When we walked..there were BN cars every around and many outstation cars too. Suddenly cars u dun even c around the area during raya are now back in town. On the way to the sekolah agama..ther was a booth to check our names listed or not..then after checking then they'l allow us in further..then we walked up further..

Wah..got policeman also. Evrybdy lined up outside the gate and when the police said u can go now..then onli we moved in, checked again our names at another booth using a computer. then there were volunteers who direct us to different classes..My mom and dad apparently got the same aliran. but i had a different one. Being all nervous i waited outside the class and when he policeman gave me the nod, i entered the class.
There are saw 4 ppl sitting with papers clipped together with a ruler and a pencil, then one person read out my name and evrybdy looked at the same page. She couldnt finish my dad's name and sumbdy else had to..What a MALAYsia we are living in.

then they gave me my ballot paper and i stod at the booth..quite sure it was the initial decision i was going to do. but when putting the 'X', then i thought.hmm..nvm la..this one's my dad's friend let's 'X' him. then i'd do that side for the other ballot paper. THen again i contemplated and decided to g for the same 'SIDE'

when i finished i put my ballot paper into two different boxes and walked out.MEt up with m parents and happily went back home.When i got home..my dad asked me

Dad: Check if ur IC is with u
Sofie: Erm ok..(look thru my wallet) My ic's not here..Macam mane ni
Dad: Look Carefully
(went back to the car looked evrywher inside the car and even under the car..no IC)
Sofie: Its not there..Takde takde..Mesti kat tempat undi tadi
Dad: Hmm go and take back.what if they sell ur IC?giv it to illegal foreigners?

i went back..got stopped by the ppl in first booth
Lady: Pls check ur name before voting
Sofie: I alrd voted but i think i left my IC inside i need to go and check

Went to the first police officer
SOfie: Encik.saye tertinggal IC
Police 1: Ade lesen memandu tak
SOfie: Ade
Police 1: Ok boleh register gune lesen memandu
SOfie: Bukan bukan.Saye dah undi tadi. Tapi rasenye saye tinggal IC kat dalam

He called one of the volunteers brought me to the class and met up with the police officer outside the class

Sofie: Encik.. saye tinggal IC kat dalam rasenye Boleh tak kalau nak check
Police: aaa.. IC ye. Sekejap.

Then the guy inside the class recognise me
Guy: Datang untuk IC ye?Nasib baik saye simpan
SOfie: thnk u thank u..

wah Lau!! SO embarassing..

On the way out..one old lady was walking with me and we talked n the way to my car. She chatted a bit and she straight away guessed that i was a doctor..i told her im still a student and i asked how did she guessed ..cuz i tot she knew my parents.. then she said..no no its the way u carry urself..fulamak..i was wearing fitted clothes with jeans and 10 ringgit slippers and i look like a doctor..she doesnt knw my Skull is HolloW :D

F a t E d

2008-03-13T17:55:00.000-07:00

Faith are sometimes things that u dun expect of. Like when the person u least expected to spend the rest of your life with..might be the person u hated most or bullied and teased u most. I in particular did not despise my current fate. It was just of the unexpected..Mind the definition again...things that u dont expect of

My fate is not a person.I would like to share with you about my faith with and illness. On a drizzling evening my friends and i went to the cover the beds in the paediatrics ward..all of us were allocated beds indifferent cubicles, to make it fair and everyone can see an acute (something that just happen suddenly) case..a chronic (something that has been there for sometime..has remitted and now relapse..or now coming in with complications) case..a critical ( a matter of life and death for the poor child) case to get a range of illnesses.

there were 7 of us so each covered 3 or 4 beds.

A surprise to me..i had to cover 3 beds..located at different parts of the ward..and all were Febrile Fits ( This means the child is fitting because he is having very high fever usually among children of ages 3 months to 6 years). All of which were two year olds and weigh 10 kilos

It was fate..

a friend told me..' i think its your jodoh'

: if only febrile fits was a person..i would be married to him soon.
i now introduce u to Mr and Mrs F. Fits

: if only it was dowry.. i would be getting trays and trays of management of febrile fits

: if only i had a western wedding.. all my flower girls and ring bearer would have a history of febrile fits

: if only i wanted a new car.. the front rail of the bonet would be engraved with FF.The boot would be labelled as Fits 1.8

: if only it was a housing area.. it would be Fitting Gardens

ffff Farah Fated Febrile Fits ffff

.:My FutuRe ..My dad's Past:.

2008-03-07T05:42:00.000-08:00

rite now our starting pay as housemen have also increased..its now rm4500 inclusive of on calls

the star and NST yesterday announced that doctor's pay after housemanship of two years will be rm6000 inclusive of allowance
can u imagine how my jaw dropped..not just mind.in fact everbody.. the parents..the other students.. the current housemen..the current medical officers

first reason being that the current medical officers who have worked about 10 years in the government service are getting a pay of this much. and they cannot accept the fact that easily all this young pass outs are going to get this amount from the moment they become medical officers. One MO came to see my dad and complained that it is unfair that they are all getting so much without even climbing up the seniority ladder and all this juniors will be getting the same pay as those who have served for 10 years

the parents..are really happy bcz now they realise..its worth now being a doctor..despite the amount of money they had to spend to get their children thru medical school..despite all the exam stress that they also hav to deal with.. despite the non stop working hours that they hardly ever see their children..despite their regret to make their children suffer..mugging for 5 years..jus tobe underpaid and work like a dog..finally..IT IS WORTH being a docto

as for me..im jus too happy to be receiving this kind of pay!!i finally can start investing my money!!

Walking down memory lane...

when my dad first started becoming a houseman..the pay was less than rm1000.it was difficult enough to live.eventhough without kids.Hearing his stories about how he and my mom survived the hardship was unbelievable. imagine having to pay monthly to buy a fridge..
how they played 'kutu'
This 'main kutu' means they collect a pool of money among themselves, the doctors each month..all must contribute the same amount lets say rm50..so if there are 4 people main 'kutu' in the end of the month they will take turns to get rm200 a month. then when my dad wanted to go to sit for his MRCP again there was no money available. that time there was no masters program in the country. he had to put it on paper that he was selling his car to my aunt so that my aunt will receive a bank loan to 'buy' it. this money was used for air ticket..to support my dad's expenses in the UK for a month.. and also for exam fees. And at that time very few scholarships were available.JPA only sent malay students so they did their masters in the UK for a year or two.

AS for the non malays, it is all their own money.And because they went there purely for the exams, they did not have the privilege of having classes there. They hang aroud in the hospital just to familiarise with the cases (Western countries cases are different from tropical you see certain things are mroe common there and become more important in exams). Then they hang around in the university campus and try to see if there are many arabs around.WHY?
Because they are the ones with enough money to PAY an examiner to Teach them JUST FOR THE EXAMS.MY dad and his friends try to listen from outside the lecture hall or join in secretly.

Hardship was this back in the 70s for doctors even when they are medical officers

And unlike these days MRCP was very tough because there was no mock exams.no mcq books nothing..so many doctors do not pas for the first time.My dad thought he would fail too so he decided to head back to Malaysia without knowing his results.He thought he would just try again harder next year..means more Money! but to his surprise on his way back he was informed that he passed and is now a specialist.

With that title in hand..slowly promotions came in but definitely not as many as this. Thats why a lt of the doctors at that time decided it doesnt pay to be faithful to the government service. Most of my dad's friends resigned and opened up their own privae practice. Only those 'foolish' ones stayed on. Inspite of that..not all reached their full maximum promotion before retirement. My dad was one of the few lucky ones who reached the Super Scale A

Macam orang Melayu selalu cakap..ade hikmah di sebaliknye..Maybe this is it.He is a senior and quite prominent doctor now...Prominent bcz he is one of those old dogs who still want to work under the government even after retirement. Hehe..

~Spot Diagnoses..

2008-03-04T07:18:00.000-08:00

What it means here is diagnosing the patient's condition without asking questions to the patient or relative and not touching or examining him. It is done purely just by standing in front of the bed observe the patient and guess what he has. This comes from experience..

Personally for me, this comes with experience..intuition..and a queer eye

Today is my 2nd day in my last paediatrics posting. We did a lot of spot diagnoses by ourselves..And my friends had the tendency to check if my spot diagnoses will work since they already know the cases

The first case was baby boy who was on a nasogastric tube, wearing diapers, remained in full flxed position in all limbs, head was slightly enlarged and the most prominent feature was the feet all flexed and inverted and the whole body was stiff
My Guess: Cerebral Palsy
Answer: Correct
Then i was asked to tell the age of the boy, and my colleague said 'You will be surprised'
Since he was very looking like only a few months old, i guessed as 2 years old. My friend said wrong. Then i said 6 years old. And he said close..its 7 years old

The second case was a baby boy 1 year 4 months left all alone in the cot.Tongue protuding and other features which pointed out to Down's Syndrome
My guess: Down's Syndrome
Other people guess: Normal baby
Answer: Down's Syndrome

Third patient is a 3 year old girl looking rather obese with periorbital puffiness.Moody. Saw her on my way into the ward
My guess: Nephrotic syndrome.Not remitted--> mEans Steroid Resistant Nephrotic Syndrome
Answer: Steroid resistant nephrotic syndrome..Focal Segmented Glomerularnephritis

Fourth patient was a 5 year old boy with a chipmunk round face. Saw him on my way into the ward
Diagnosis: Thalassemia,
Answer: Thalassemia, came in for blood transfusion

My last patient..left me on cloud nine. A 6 month old baby girl was just admitted. Her bed was next to the cerebral palsy boy. The doctor who brought us for case presentation moved over to this bed and asked us to observe.'Tell me what's wrong with this patient'. All 7 of us were quiet.I observed
Diagnosis: She cant see, doctor
The doctor asked me how do you know?Your friends don't seem to know this
' Her eyes are moving around, not focusing to anything'
The doctor answered' Its called rotatory nystagmus'
Answer: Cortical Blindness

This is the most interesting day for me in the ward:) Cant wait for tomorrow

Multiple degenerative disc disease

2008-02-29T20:13:00.000-08:00

a very long diagnosis.. and someone dear to me has this

a common misdiagnosed conditions in older people
since more common ones include-
muscle spasm
spondylosis a.k.a uncomplicated osteoarthritis of the spine
disc prolapse(herniated disc)
spine compression fracture ( seen in patients with long standig osteoporosis)

Spinal radiographs ( X rays)shows only the bony tissues clearly while soft tissues such as organs and nerves are rarely seen
..MRI images are best when this condition is suspected.this is how an MRI image of this condition looks like

.:Each degenerated disc has a tendency of compressing onto the spinal cord, causing a sharp shooting pain or numbness, areas affected depends on the level of spinal cord which is involve.Most commonly is the lumbar area(the spine after the rib cage and before the hip bone).Sites supplied by the spinal cord n this area is the legs

There is no way to stop this.only delaying progression and relieving the symptoms are possible

Management:

First choice- analgesics. paracetamol and cox inhibitors
combined with physiotherapy
2nd choice- epidural steroidal injection (injecting into the space enclosing the spinal cord)
3rd choice- fusion of the vertebrae ( surgery to fuse the spine .limiting movement of the spine reduces the symptoms)

Choice of treatment are according to the order above, proceeding to the next only if that current treatment does not provide symptom relieve.

Guess which is the original size of the spine when seen from the side in an x-ray
(A) (B) (C)

Learning a New Language

2008-02-26T06:42:00.000-08:00

HOla again.. just to share with u an interesting site that teaches a foreign language for free. Its called www.livemocha.com . u can learn a lot of languages here.french, german, arab.indonesian, tamil, hindi. And the courses ranges from beginner, intermediate to expert level..its also sort of interactive means u can chat or mail the other ppl who are master of the language u r trying to learn to help u out..or u urself can b a tutor to help those who need to master a language which u alrd hav.

right now ive finshed lesson 101 of Hindi..i thought it would come in handy if i wan to work overseas as most people alrd speak english..if i do meet singaporeans or indonesians or malaysians..ther is Malay and indonesian language..both which im comfrotable in. as of clinical school ive started catching up withmy cantonese.i can now understand a patient's history whenever my fren interviews one.and for tamil..im still shaky..need an interpreter.

the reason why i chose hindi was because there was no urdu(hindi is 90% like urdu). Urdu if u guys do not know is actually the official language of india and pakistan. because they have so many dialects and languages due to it multiethnicity, urdu is the lingua franca.IN fact it is also spoken by 50% of the ppl living in the UNited Arab Emirates.oh and not to forget..a minority of ppl living in Uk and USA are indian or pakistanis or afghanis:D

This i thought would really come in handy since being a doctor requires me to interact with evrbdy and knowing the language will help my patients to be more comfortable interacting and expressing themselves, thus making my job easy too. I do not need an interpretor, i do not have to worry if my interpretor is not translating the right word, i do not have to worry about the interpretor not knowing the medical jargons that he needs to use, and i can build trust with my patient through mastering their mother tongue:)

Besides, the more accurate the history.. the more accurate the differential diagnosis is, the provisional diagnosis,the physical examination, the investigations that are essential, and most definitely the treatment prescribed. This is doing justice to the patients who do not converse well in English. Doesnt mean if they are 'handicapped' in language, they are denied equal treatment compared to the rest..Thats how i feel about being a good doctor

now i realise why my 13 year old cousin brother who is residing in the US..a talented musician..ambitious to be a neurosurgeon since he was 3..has started learning mandarin, tamil and malay everytime he comes down to malaysia since he was 8. His parents were thinking far ahead for him. Multilingual ppl are always assets..anywher..

hOlaaa peepz!

2008-02-23T21:52:00.000-08:00

Heylow ppl. Its me with my countless attempts of trying to keep a blog but it's the first for this blogsite:) Ive jus been sitting at home doing countless art projects for myself. Cant wait to go back to uni and the hospital..but of course the final exams can wait.

these are wat ive been doing:

a rack out of a mandarin orange box all itemised for my things (its to be put in my rented place)

a desk organizer out of a shoe box ( poorly
constructed though hehee)

origami bookmarks put inside and origami envelope---made tonnes of them to distribute to frens and appointment orgainzer collage:) sister..the spirit of giving got to me

This final year of my studies ill be dealing with two major exams one in august and the other in february. in september..ill be moving to batu pahat for me studies..6 months only..nothing permanent i hope. ANother hassle of finding a place to stay..Maybe Edwin can help me on that(its his hometown)

As for my current status for this 2008. im back to being single. ill save u all the drama on wat happened. Not looking for love yet and hopefully will find contentment in that.