The Entity

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Kajang, Selangor, Malaysia
Assalamualaikum. Writing all the way from Belgaum, Karnataka, India. Missing Malaysia so much. But everything is just perfectly fine here. India makes people not just live, but SURVIVE. :)

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Monday, 24 November 2014

second last


it's already 11 past something PM here in Belagavi where I currently live, not sleepy but feel this urge to blog. It has been quite a while.

whether you vivid readers of mine realize it or not, this author is already in her forth year. but no YEYY yet, as this is just the 2nd last year of medical school. And trust me, as you approach the end of medical school, you feel the urge to just stick to become a student. Being a student, gives so many benefits and you do not have to be responsible to the patients you are seeing. Plus, you can make mistakes as many as possible because you are still holding that student title.

And so, that's why life as a student is a bliss. For me, as a medical student, one cannot deny by how far his or her life is living in blissfulness. We are generally been exposed to the wonders of Allah's wonderful creation; the human body every single day.

We learn the normalcy, we later learn the diseased state and try to look for measures in a way that to prevent the disease from worsening or maybe just to stop the symptoms or the features the disease is presenting with. Even the drugs prescribed to the patients are actually us, the future doctors' responsibility to get it right. We can get sued for messing with the diagnosis and the therapy we decided on the patients. That is how insecure and risky our job is.

So now that I have another 2 years to be in calm state of mind, not having to put myself at that risky shoe as a doctor in practice, I must enjoy this life to the fullest! At the same time, must work really really hard not to miss anything out. Because, you can easily missed out now that you in forth year especially here in my University. You see your friends already capable to withdraw blood, so you were like, "Why she can get the chance but not me?!" then you see your other friend who was capable to wake up as early as 7 am just to catch an insulin injection and you say, "OMG...! I should wake up earlier. Damn you alarm clock!". The cycle continues. This second last year in medical school, the school will let you be an adult. You have to decide whether to attend a seminar, a lecture, a clinical ward work (ward round) or clinical presentation. It's all up to you! Hard working is what now matters most!

I was first posted in medicine. Internal medicine that was, for approximately 6 weeks. The duration is quite short compared to usual medical schools which had it for at least 2 months. Still it was an amazing posting. I admit I have learnt so many things. And I also admit during this posting, I had basically improved in history taking and case presentation as well as the physical examination, alhamdulillah! Medicine is again covered the whole thing. It's like you are dealing with things under the sun. Or the pandora box some will say it. Like always, as the first group of posting, there was some problem in between. We didn't manage to complete our logbook like a professional. It was rather sad because you know when you have to do things just as what you can do to get it finish rather than doing something really good because you really wanna impressed the examiners; these two actions are different. We were supposedly to be assigned to different patient each and made a follow-up for each patient. But we didn't do it because it was a last minute call. Later, we just made it finish by whatever wits we have. I myself typed 10 case reports in a week! That's considered a new record! And kids, trust me! Case reports can make you die! Like literally! I am grateful I didn't phew! Only is do not procrastinate in medicine! There's certainly no time to lingering around because every minute now counts!

Now, basically I am in the forth week, finale week of psychiatric. Psychiatric has been the most sporting post so far. Our lecturers are cool and they can totally understand how we work. They didn't just push us to the extra limits which was good. The only main problem came to the time of presenting a case. The problem is once again the language. Dealing with mentally disorder patients are somewhat fun, exciting but then again will just make you disappointed in the end. The disappointment appeared when you tried so hard talking like a chicken speaking to duck, yet you came to nothing. In psychiatry, history is more likely to be his story. His or her kind of story you need to know. What problem he or she had, cannot be asked by simply a question of "What problem are you having?" They would just say mental problem. Or "pagal" which means crazy or lunatic in Hindi. That is certainly not enough to write in our case sheet. To go deeper in knowing what made them come to the hospital is by reaching a good rapport; which needs an art. But rapport alone will not be maintained because they (the patients) see you as an idiotic doctor who comes to bother them in language they cannot understand. I have encountered one patient, an old lady having obsessive-compulsive disorder. She was fine at first, after an hour speaking to her, both in my broken Hindi and English, she got irritated. She asked me for an advice on how to make her get rid off the obsessive thoughts she was having.

 Her problem was that she continued being worried that she's being contaminated with her own urine after having that nature calls. She wasted pails of water just to make sure her bathroom is clean after using it. It was so severe that her family members started to notice. She also had this weird feelings that a well (a perigi) inside her room was going to pull her inside. As in to let her drown. She thus cannot sleep in her own room and felt so scared when ever she walked passed the room. She also thinks her hands were dirty - contaminated with urine, so she did not want to cook. The whole family needed to eat at restaurants each day. It was an interesting case of severe OCD. But when my professor took her version of history, the story was different. Well, actually half of the story I got was correct only that perhaps the patient got irritated because she was wanting to tell me about her other problems which was she heard voices of her sister in law who's already dead, but I couldn't understand. I started to give her advice on keep on praying to God, which I know silly but it's the best I can tell her that time. I didn't realize it was a wrong advice until I read her file which wrote she had troubles in praying because she was feeling rather unhygienic for such holy rituals. Bummer!

And on last monday, I actually volunteered myself to have an examination earlier than scheduled. Dr Antonio was rather spontaneous when he said examination was going to held that afternoon rather on the next Tuesday. Because I already pumped with two cases in my head, I quickly raised my hand in order to volunteer; and so I did. To my surprise the fifth year also had their exams on that afternoon, and they wanted to present the SAME cases I wanted to present. It was such an annoyance. I went to the ward an hour earlier to clerk a new patient. Like always, it was Monday, thus there were only like 10 beds full of patients. The male nurse then told me to clerk a patient named Rajkumar because the first on my list was rather mute. Yeah! in Psychiatry you will come across a mental disorder whereby the sufferers will be mute and rather not talk to you!

Rajkumar was a bank accountant, knew a little English but thought he was rather superior than me. I thought he was going to be cooperative so it'd be easy to clerk him. I was totally wrong. Because he was manic he seemed to be smiling but rather deep down inside, he was actually quite irritable. To attain rapport was hard enough. I called a male nurse to help me with history taking. He then said it was hard to take from Rajkumar as he said I was giving him tension headache. I was probably the 10th student who came up to him to clerk him hence he was irritated. The only thing I got was his 5years history of bipolar disorder. Details of each I was not able to get and clarify, I was absolutely a dead meat by then. 

At 3 pm that afternoon, I was rather scared because I did not complete my history of presenting illness. I cannot get the true chronology of what was happening to Rajkumar in exact. Most of the details I simply 'goreng'. Despite the things that gone wrong, Allah had definitely gave me the strength to overcome that useless fright of having to present a case in front of the other members of the posting group. Can't thank Allah enough. Alhamdulillah:) it's already the third posting. Neuromedicine starting tomorrow. Then obstetrics and gynaecology where the true stress and hectic will emerge ahahahhaha! Upon all, I am enjoying the starting of clinical years. My posting members are great, they are all tolerable and kind. I enjoyed having kak amalia, che mas, athira mazli, ryan, nadia, marlyana, een and everyone in the posting though. Hope we can survive till the end without conflicts. InshaAllah:)

>>p/s: posting this down because Nik Syakirah ahahaha. She asked how come I haven't blog anything in these past moments. Well yeah, things changed. But I think I'll restart blogging for now. I've always love to blog<<