On Special Syndrome

The thing about us, we feel a bit bored with the common cases in the ward. No doubt there's the normal common presentations, asthma, bronchiolitis, pneumonia, fever and what not... Tell me about it, coming to 7 weeks in the ward, how many patients with febrile fits were assigned to me? 14! Blardy freaking 14 febrile fits patients okay?! I can so call myself and the other 3 partners of mine to be the 'fits specialist' already. More often than not, we sighed whenever we found out that we've got cases of febrile fits.

And same goes to the other small groups. They grumbled with the common asthma cases. Or the prolonged fever. Or bronchiolitis. Or pneumonia. Okay, maybe pneumonia might not be that common in adults, and it triggered quite a lot of interests whenever there is a pneumonia case in the medicine ward, for the findings that we could get, but in paediatrics, pneumonia presents similarly to bronchilitis, and even showed some overlaping signs with asthma.

Therefore, once a while when special cases comes in, everyone would rush to the bed and explore the patients. Speaking about boy with Stevens-Johnson Syndromme a few weeks back. The little boy cried and threw tantrum whenever any of us walked closer to him.

Stevens Johnson Syndrome

And there was the few cardiac cases who were quite critical. Some tetralogy of fallot cases and quite a number of babies with ventricular septal defect as well. But cardiac cases were a bit difficult as their heart rate are indeed, pretty fast. Being us who took interest in special cases, I guessed we haven't really mastered how is pan-systolic murmur different from ejection systolic murmur even.

Then there were the nephrotic cases. There was one particular boy who was in the ward since the first day we got there, and have been there for a few weeks. We got quite close to the boy so to speak. So roughly, we've seen the signs as to how a nephrotic patients can present. Edema and what not. So subsequently when 3 more nephrotic patients came in, and coincidently assigned to the colleagues who got the first nephrotic patient, she sighed.

That was how easily bored human can be.

Eczema herpaticum

So when KW got a Minky Kinky Hair Syndomme that sparked LOTS of interests in everyone, we were let down by Prof One who told us not to even bother about it. Later on then we found out from Dr. Angie that, the little boy is the ONLY one who got the disease in the whole country. Imagine that! Hah.

During ward round today, we were once again told off by Dr. Chai for taking such huge interest in specific syndrommes when we should've gone and clerk and examine the common cases. Asthma or not, what we ought to do was to polish our skills and learn how to execute our technique correctly. Not to talk about some special syndrommes, Minky Kinky or Stickler or what not. Couldn't agree more.

And there's another type of special ones in the ward. Sickness like hydrocephalus or cerebral palsy. Neurological cases were hard to come by. And it was a few weeks ago since we got our last hydrocephalus patients. To which I was bombarded pretty badly by Prof One for not being able to do a proper head examination. (Like uh what?! Examine the HEAD??) So when there's a boy with cerebral palsy came in due to pneumonia, the news spread like wild-fire. Just one hour after he came in, there were already some medical students checking him out.

Hydrocephalus

So the whole morning, I pitied the boy for being the centre of attention. Being surrounded by some 10 medical students since 10a.m. till 12.30p.m. Examining the lower limb. The upper limb. The face. Maybe he didn't understand what we were doing. Perhaps that was for the better. But I suppose his mother got pretty fed up with us boys and girls.

If anything, I think I'm going to miss the ward. There were so many different attitudes shown. The kiasu-ism. The kiasi-ism. The dominating. The studious. The lazy ones... And I guess the thing I will miss the most, playing with cooperative kids who do not have stranger anxiety.

It's the end of Paediatrics posting. I mean, well, coming to it. Written exam on Monday, and bedside examination on Wednesday.

I know I am close to heave my relief soon enough.


ps: Photos taken out from Illustrated Textbook of Paediatrics.