Friday, October 10, 2008

On Going Speechless

We were scheduled to have our long case today. As before mentioned, Dr. C wanted us to cover the ward, in a way that, all the patients admitted to the hospital are to be clerked by us. And so, in doing that, we have our own log book on the admissions to the ward.

He was looking at the notebook and asked some questions about some of the patients my assigned to my colleague when suddenly he asked, "Who's patient is this? Number 3."

I'm no.3. I'm the third in the group list. And so, reluctantly I went out and presented the case.

Good morning. My patient, xxx is a 67 Chinese lady, came to the hospital to obtain her medical report, but sub...

Stop stop stop. How can a patient be admitted to the hospital for medical report?

But that's what she told me. She said she didn't expect to be admitted as well.

Well, if a patient is to come and get her medical report, she would just get the report and leave right?


And I'm sure you won't believe 100% what the patient told you. Don't be so naive, you're what? 23?? Tell me what's wrong with her.

Okay... She has had shortness of breath for the past half a year with productive cough. Yada yada yada...

I presented the case in less than 10 minutes. I think. He asked a lot of questions throughout the long case presentation. I know it's normal. It always do look so when we're watching the colleagues being asked in front. But it's just soooo not right when you're the one presenting in front.

Bong, so? What's else do you think you should have asked?

I shrugged.

The rest? He asked the colleagues sitting in front of me. What do you find insufficient in his history?

The class was quiet. I honestly do think I have presented all the neccessary. Maybe not that thorough. Indeed we're not that pro in history taking just yet. But I went according to the textbook. So logically, everything is there. It's just up to us how we're intrepreting it.

Was the SOB and coughin progressive?

It was intermittent.

No no. I mean was it progressive over the last 6 months?

I looked blank.

Do you know what I mean by progressive?

Err... Nope...

It was disastrous so to speak. I'm utterly disappointed with myself. Urgh!

And to have our end-of-posting exam coming up the week after next, with him as our short case examiner, I don't know how bad it's going to be... I'm scared...

To make it worse, while we were at the bedside showing him my findings of pleural effusion in my patient, I asked a stupid question. "Should I expose her back?"

What do you think? Don't ask such stupid question.

Everyone else in the group was taken aback. Dr. C was definitely not in a good mood today.

I managed to at least show that I did my chest examination, from the back, correctly. And the one thing that was positive I heard from him was, Okay, you know how to appreciate what's stony dullness.

I feel so miserable...

He's such a nice guy, and I feel so bad disappointing him...

After the session ended, my group members joked that I have recovered from my fever instantly.



5 Jujus:

H.a.M.s.A.p said...

OH OH! The back is very important when examining the lungs! Thats where the big proportion of the lungs ar! Nvr mind la, learn from ur mistake! Jia You!

Ah-Bong said...

of course i know the back is important. that's why i demonstrated the findings on the back. just wasn't sure i should lift up her shirt since it was in the open ward. :P

raeshad said...

i've always wondered about the teaching system back in malaysia, esp in teaching hospitals.

anyhoo, as hamsap said, learn from one's mistakes.

i know i would be terrified if i were to be called out, and singled out in a conference type setting, with all your colleagues around.

raeshad said...

and p/s: even if it's an open ward, don't u have curtains that you can close for the physical exams? as for me, once i step into their bed, to take their history, i immediately close the curtain for the patient's and my privacy :D

Ah-Bong said...

haha reashad, maybe you should come visit the ward someday. it's like, very crowded, the curtains are drawing in to the beds. if u get what i mean. lol