I'M OLD =(

So I did survive my bout of arthritis. The first time I realized I needed two hands to turn the shower knob because of my painful wrists, I laughed at myself. And then felt like crying. It was one of those moments you feel like crying and laughing at the same time.

It was absolutely pathetic.

Now that's almost over, my life has gone back to medical school. I'm currently doing Rheumatology/Orthopaedics module. It's a big difference from A&E where it was all action and drama. Rheum/Ortho is mostly sitting in clinic and theatre. By next week, you should expect me to draw some circles and funny drawings on the floor and chant for something good to happen. Letih laa doing nothing :(

While I love Rheum, I can't take in Ortho to save my life. Please la, Trendelenburg's sign pun tergagap-gagap lagi nak sebut. Ortho is very much like carpentry they say. There you go, that's another reason to hate carpentry.

And when it comes to examining a patient, kalau dapat yang gemuk, memang 'oh shit!' moment. Fine, I have to admit I can't always carry the weight of a patient's leg. And I'm tired of instructors giving me a funny look when I do chest compression. With my size, there's a limit to what I can do, and I'm tired of it.

I'm too busy for gym though :$

Ortho thinks they kick Rheum's ass. If a patient decides not to have surgery, they quickly bounce him/her back to Rheum. Like shoo, since we're not cutting you we're done here, off you go back to boring Rheumatology. I understand bouncing patients is like the fun game every doctor does, but c'mon, the majority of these patients are in chronic pain. I would imagine it being very frustrating getting bounced.

I'm not saying this because I've experienced arthritis. My arthritis did not make me a better person. I refuse to let it make me a better person.

Oh and I saw my first possible Munchausen's patient. This patient has a long history of complaining about her back and leg pain. She is the kind of patient who will scream her head off during straight leg raise test on lying down; but will then sit up effortlessly. There was one time during pre-op assessment she faked that she wasn't able to extend her feet. But when the surgeon came back to the ward to pick up a file that he forgot, he saw her walking to and from the toilet without aid.

Today she made an effort to show how she was struggling with her two crutches and the pain in the legs and back were killing her. The nurse pointed out her newly dyed hair which apparently was quite unusual since it's a pain getting hair dyed in shops. The way you have to sit back and relax your head during dyeing process would be impossible for someone with back pain of her supposed severity. And the doctor pointed out she was in high heels and why would any sane woman wear high heels if she was already having back pain?

I know why people lie, but still, WHY??

CHARGE

Have I told you medical students are pathetic? We are. We crave for action. After helping Henry aspirated 2.7L (yay banyak siut) from a pneumothorax, she had to leave because she was bleeped. She was like, "Okay both of you are in charge of resus now. If this man crashes, do something. Yell for help or get someone to come in."

Shin and I laughed that we felt important. Monday 08/10/07 at 1845 we were in charge of the whole resus area. For like half an hour. Sigh... sungguh pathetic.

But I got to steal a BNF from resus because nobody was watching... yay =P

A&E

Yes, it's true that recently my life revolves around what I do as a medical student. I have to admit I'm addicted to the A&E. It's my source of action and drama, lagi cool daripada tengok Grey's Anatomy. Oh btw, I've seen both episodes of the new season of House. Lega gile tak payah dengar Cameron membebel and Foreman being hostile. And that new unethical chick can so kick Cameron's ass. I hope she stays. The new people are a lot more fun than the old ducklings.

Back to A&E, I've seen quite a few things that I've classified as interesting. The other day my friend Shin and I were doing a night shift (saje nak kiasu), and a Chinese man happened to make his way to the A&E, crying and moaning in distress. Being the only person able to speak Chinese there, Shin became the translator.

Shin finally gathered that this man had been living in the UK for the last 6 years and had only worked for a year. He had 200 pounds which he was supposed to hand over to his niece who was coming from China as he owed his brother some money. But on that day he was walking around and found himself at a gambling centre. Being the idiot that he was he thought the numbers and odds looked great; and naturally (duh) he lost all his life savings in just one go.

Having to translate this story many times to various staffs of the A&E, Shin admitted, "Dia ni memalukan kaum aku je. And now he's asking for someone to give him 200 pounds. He's a big fucking idiot."

That man was later referred for psych review after they found a card saying he was a patient at a mental institute. But his story was still true, and pathetic.

Me: Can he not talk to his brother? Maybe...
Shin: Dia tak berani cakap. He got 17 miscalls already.
Me: Yea but you know, maybe the brother boleh faham ke. I mean, he's a mental...
Shin: He doesn't have a brother anymore.
Me: What? You just said...
Shin: No, he doesn't have any family anymore.
Me: *still blur lagi* What?
Shin: Mane ade dah.
Me: Wait.... Takkan kot.
Shin: Yea la, these things happen.
Me: Gile berkira orang Cina!
Shin: Eh you Melayu mane you faham. I Cina I tahu la...

Life's a bitch. Even though I know that man was an idiot, imagine losing all family because of one act of stupidity.

I met my first nurse who was really keen on getting rid of patients from the A&E. Apparently there's always one in every A&E. "If that Chinese man/lady on crack wants to leave AMA, let's not discourage him/her."

In some countries they won't treat alcoholics or drug addicts because they won't budget for such thing. In the UK, a proportion of people think they can always get treatment for every addiction that they have because the NHS is built for the people. It's hard to say what's the right answer to this issue.

On a lighter note, after I gave two sutures to this one young man, his father was trying to be nice to me (after grilling me dah berape banyak training I had on suturing - sorry la I was nervous at the beginning) that he offered the fish and chips he bought from the cafeteria earlier. I went back to the doctors' station and plopped down between Helen the SpR and Shin. I showed off my fish announcing, "He gave me fish!" Helen couldn't stop laughing and Shin asked, "So bila you nak kahwin dengan anak dia?" Shin thought it all seemed suspiciously like Malay culture, macam expert sangat la.

Maybe one day if I end up in A&E as a patient or a family member of a patient, I should try to be nice. Honestly, makes someone's day =)

BELASAH KANG

One of the things yang paling cepat I noticed about A&E is that senang gile terasa nak tumbuk muke patients. Or the family members. I know this doesn't sound very professional, heck I'm a medical student what do I care about professionalism yet. Tapi oh my god, tahu la A&E memang busy and hectic; and patients and family members are usually anxious and worried and pushy; but stop being so fucking annoying!

Nurse: Tell them there are 2 patients ahead in the list so the doctor will see their father in about 3 hours.
Me: But they'll kill me for that! *alarmed but sounding very pathetic*

Patient: 2 years ago I went to the hospital because of the same chest pain. They did a whatdoyoucallit a cardiogram and they told me I must've had heart attacks in the past. But how is that possible? I'm still alive. I'm still walking around. I didn't believe them so I just left. So the answer to your question I don't know if I've had previous heart attacks.
Me: ............ *hantuk kepala kat dinding*

Family member: Here, here. Use the one in the antecubital fossa. That's what I used to do when I was practising medicine 10 years ago.
Me: ............ *Sir you have to learn to be subtle, baru la cool*

If like Superman not having an alter ego, and just walks around wearing his ridiculous red underpants (hell, the whole outfit is ridiculous) on the outside, mane cool.

Wish I could hassle people like this 20-30 years from now.

Emergency Medicine is probably the easiest bit of medicine to read on. Because it's fun and challenging. What the books don't prepare you is dealing with all sorts of people you get to meet.