On The Shrink

I've always been interested in psychiatry.

I think it's very sad.

On Clearing the Debts

With the ease of technology nowadays, we can actually check our debt with the university via the student portal online. I knew that I'm owing the university some big sum of money, but I never really go into details what am I paying for, I assumed that I'm paying for the tuition fees and hostel accommodation.

But since a year back, there were some hoo-ha from some coursemates about certain stuff that we were charged despite we do not use the facility... For instance sports equipment and such.

What really get some party unhappy was the fact that we still have to pay for microscope fee even though we don't even enter the laboratory anymore...

So with that... I think I'm gonna be so much poorer after the transaction. Meh.~ I'm in debt!

On the Oath Taking Ceremony

The Hippocratic Oath (orkos) is an oath historically taken by doctors swearing to practice medicine ethically. It is widely believed to have been written by Hippocrates, often regarded as the father of western medicine. In the past, it requires a new physician to swear upon a number of healing gods that he will uphold a number of professional ethical standards. But of course, over time, the oath had been modified.

So, generally, freshly graduated medical students will go through such ceremony where certification of practice would also be issued. I think. Or at least I thought we had that in our school; where we would be reciting the Declaration of Geneva.

Had ours on a Monday December the 14th. Would've liked it if Dad could be here too; but due to unavoidable event, only Mum and Sis made it to the hall. It was definitely one of Mum's proudest moment. Sis told me later that, Mum was holding her tears back when the new Dean was giving her speech.

Apart from the 3 main things that she asked us to carry back that morning, remember what we've learned, know our limits and humility; the only quote that I remembered was about the parents sending us to the faculty 5 years back as medical student and we're returned now to the parents as doctors. LOL.

All the graduates were then asked to stand on the stage in front of the parents and the few staffs of the faculty to recite the oath. Soon after, we received our temporary certificate of approval for work from the Dean.

Took some photos after that, and headed to the multipurpose hall for some light refreshment. While queuing to get some food, the faculty admission registrar ushered us to go join the Dean. I was like, WHAT? She insisted that we join the Dean and 2 other families. Mum and I was trying so hard to resist; we just felt it was all too awkward. I mean... The Dean is like.. up there... and I'm like... of a different status. There was no way I'd want to sit with her.. But in the end, we went in anyways. We didn't want to create a scene. LOL. But seriously, it was super a.w.k.w.a.r.d. Created some small talks alright, but still, it was pretty uneasy.

Once the Dean stood up to take photo with some other students, we headed out straight away. And if you're wondering where Sis was, she waited far away from the room when she saw us sitting down at the Dean's table. LMAO! There was definitely a line, we were brought up "Asians", we just don't mingle with authorities. LOL!

It was all well, short and simple, and a huge milestone for all of our lives.

On the Dream Came True

Prologue

I had been angry for so long. For the past 6 months, I was holding grudges against everybody. I was pissed, I was tired, and I wanted to give up. My Dad lost his cool on my once; because he heard some stupid rumors. And I, many times with my Mum and my sister; because I felt controlled..

So the final exam came and ended. 5 days. Over 2 weeks. With breaks in between. It was finally over. The exam tension and stress...

I was relieved it was over. But I couldn't stop imagining that I MIGHT have to go through all this shit for another half a year. I was scared and on many occasions, I could actually heard my heart pounding. I tried to keep myself occupied with movies and drama series. I went online and tried to play games, and I went through some old photos and did a lot of photo editing. Yet I didn't dare to touch any of my books or clear my study table, having delusions that if I cleared them too soon, bad things might happen...

Result day.

Friday the 4th of November. 2 days the exam ended on November the 1st.

It was drizzling that morning. Traffic was slow. And the road was jammed up. For a distance I took only 10 minutes on normal days, that stretch of road dragged for a whole long hour. I was headed back to school, in case I had to attend the special viva session. But I dreaded it. On many occasions, I was so scared that I shouted my lungs out inside the car. My hands were trembling. My legs were shaking. Pairing that with the jam where I had to step on the brake and clutch and accelerator, I was amazed I didn't get involved in any accident.

The viva list was scheduled to be released at 9am. I checked my phone again and again, praying that I wouldn't receive any messages from the Dean's office about getting called for the viva session. Every other 5 minutes I checked my watch and my phone. 30 minutes after 9, while I was still stuck in the jam, Mum called. And I jumped. Literally. "Gosh you scared me!"- was the first words I said to her.

15 minutes after that, while I was still trembling inside the car, I jumped at another text message. A colleague sent a text to inform me that there were 6 people in the list, and the official result due at 3pm. I was partially relieved, but not entirely. After all, I needed to be on the passing list. I had to.

I finally arrived at school 1.5 hours after I left home. But I didn't know what to do. I didn't want to clean my room. Neither do I want to go to the ward or stay in the library. So I went for lunch. And fought for seats with all the other office workers in some newly opened business center.

By 3pm, I was back in front of the Dean's office. The crowd was already gathered there. Everyone was nervous. And whenever there was anyone coming out from the Dean's office, everyone looked at him/her. My heart was pounding harder and harder as time passed. And when the secretary of the office finally came out holding a piece of paper, everyone crowded upon her.

She gave a speech. About something. I couldn't remember, I wasn't paying any attention at all.

I was chanting under my breath. And I was sure she saw my lips moving non-stop.

GOSH! POST THE RESULT UP ALREADY!

The tension that she built was beyond what words can describe.

And when she finally ended her speech, she headed to the board.

"I shall post this one up first." She said.

"Oath taking ceremony will be on the 14th. Bring your parents along. And boys, wear coat."

After that, she turned around, "Ready? Everyone ready?"

I stared at her. My heart was beating twice every single second she was delaying. For a moment it was beating so hard I actually felt pain. And when she finally posted it up...

My heart stopped beating.

Someone shouted "Alhamdulillah..." Followed by some screams...

And then I saw it.

I walked away, trying to hide my tears.



The first thing I did was calling my Mum... But she didn't answer the phone.


So I dialed my Dad's number instead.

"Pa, result's out."

"How is it?"

"OK lo..."

"OK means what?"

"Pass lo!"

"Oh.... Congratulations!"

And he continued with his speech. Something about not stopping there, and lots of things to do right after, about housemanship placing and the hostel fees and tuition fees and such... I didn't get everything he said though. LOL.

I was too happy for words. And was thinking on how to tease my mum. LMAO.

As I headed back towards the car, Mum replied my call earlier.

"So how so how???"

The impatience in her voice was very obvious. I believed her heart stopped pounding for a minute as well.

The thought of teasing her didn't materialize in the end. I couldn't come to do it.

"Oh! Finally! Oh my God... I'm so happy. Oh! I wanna cry now! Oh God... Your hard work finally paid off! Oh... I feel like hugging you now! I'm so happy!!! Oh..."

And the so many "oh"s after that. LMAO!



Everything else was history after that.

I informed the brother in Prague and the Sister who was then holidaying in Krabi.

Then, I informed some good friends. Headed out to Puchong for dinner with these close friends.

And went on to do some other things the following few days.




Epilogue

Entering medical school used to be a dream. It came true.

But, finishing it was one hell of a tough job.

And when I mean tough, I doubt any of you would understand. It was a torture of emotions and mentally draining, of which I wasn't really prepared for.

After 5.5 years of medical school, I'm finally unemployed. For some reason, I'm so happy that I'm finally unemployed. And for once, I feel liberation; from anger, hatred, worries, fear and of course, University of Malaya.

On the Whole Series of Medical Books

Cousin gave me his stack of textbooks 4 years ago when he graduated from his medical school, I was just in my first year then. Or somewhere there. I thought I'd actually use his book, but alas, all those books remained unopened in the box until I was halfway through my clinical years where I have already gotten my set of textbooks.

So... since we actually came across this months ago, and that they accept books for recycling, plus the fact that these books are already a decade old... so... yea... you know...

I suppose I prefer to have my shelves cleared for other stuff rather than over 10kgs of unused and untouched books.

On Being Fashionable

Attachment in the clinic a couple months back. Was with this young metrosexual doc in specs. Wait, a Burburry specs. Not that I was checking him out, I just happen to see the word as I was close enough. And then halfway through the clinic session, oooh wait, what's that?

Nice shoes!

I'm so gonna get something like that next time. You just wait. LOL

No seriously, I wasn't checking him out. Though he does look good in a way, nice dimples.

On the Mask-like Face

It's deja vu all over again.

Lecturer: Medie, are you okay? You looked, erm.... worried.

Medie: I'm fine.

Lecturer: Are you sure you're not down or anything? You're so quiet.

Medie: No no. I'm fine.

The God-knows-how-many-th lecturer to comment something like that in the past 4 months. So I'm beginning to wonder, my keeping quiet gives people the impression that I'm what, depressed, sad and worried?

Well... My facial muscles want to relax and I just let them. Boo~~
Plus. I don't like to talk.

Any problem with that?

On Medical Pronunciation

Pronouncing medical terms sometimes are a bit of a headache. We Malaysians, it seemed, since we learnt Malay language since kindy and with all this 'baku' learning, it might've been quite easy if English could be pronounced in similar way. But sometimes, they just don't. Silent K. Silent T. Silent L. G as J-ay... If you know what I mean. Read this. I was amazed I spent so much time in my blog 3 years back. No wonder I was so lousy now, didn't study enough... Grrr...

Anyways. Came across this during my revision.

Ay-mo-ro-sis... Erm... Fu'j'ax? Fu'g'ax?

On the Depressed Look

Lecturer: Medie... You're so quiet. You look so depressed. Are you?

Medie: No... I'm fine.

Lecturer: Are you sure? Cuz if you are, you need counselling.

Medie: Yeah. I'm fine...

It wasn't the first time someone mentioned that. First the professor who scolded me for not knowing the grades of pressure sores last year. Second the one who failed me in my surgery end of posting this year. Third the primary care professor who was so ever kind. And now, the other lecturer who lost her husband to a cancer. And that hasn't include all the other peers and medical officers...

What, so I can't keep a poker face now without appearing depressed?

I'm just... euthymic.

On the Detailed Sexual History

During sexual history taking today, we were advised to be detail in enquiring about a male patient's practices he's involved in any sexual inter-courses with another man, especially when the patient comes to you with discharge from his private part!

So... we needed to be as detailed in this thing called 'risk assessment'... i.e. their risk of getting HIV or hepatitis, the spread of latent infections to other people and so forth... And one particular point that is to be addressed, would be the person's position in the intercourse. The passive one, or the active one. The giver or the receiver...

And the first thing that came into my mind, before the professor mentioned the word 'active' and 'passive'...

Was...

'Top' or 'Bottom'.



Now.

Shhh.

Thou shall not speak. About. The. Vocabs. That. Came. Into. My. Mind.
I guess I just got familiarized with these terms at one point when I befriended some friends.

On OCD versus OCPD

Obsessive compulsive disorder versus obsessive compulsive personality disorder. Which one do you have?

Like what I've posted yesterday, I have hypochondriasis that is not severe enough to be diagnosed. So yeah today, I think I might tell you I have obsessive compulsive disorder that is not severe enough to be diagnosed. In another word, I'm being hypochondriatic, somewhat.

I used to have this habit that, the outdoors is full of germ, and when you're indoor, you should shower, change and you're only allowed to sit in certain area, and definitely not the bedroom. But if you accidentally sit on the bed, I'd change the bedsheet. Or if you've touched the door knob, I'd wipe it with antiseptic. And you're only allowed to walk in a certain area that is already contaminated, and is kept that way so you have a space to walk on without contaminating the rest of the space.

I definitely know it's wrong. Ego-dystonic, what they say.

But I just couldn't help it.

And I don't think it's my personality disorder. Where the patients usually are ego-syntonic.

So it's definitely obsessive compulsive.

Still, not bad enough to get me diagnosed.

So... It's definitely the hypochondriasis.


I hope there's no psychiatrist reading this. By all means, this is not educational. This is just pure crap.

On the Medical Student Disease

Medical students have a common problem, especially the first years and the second years when they first get exposed to medical illnesses. Any simple single symptoms they'd start think about all the possible diagnosis. A cough is pulmonary tuberculosis. A rash is herpes. Smegma is some sexual transmitted disease. Diarrhoea is seroconversion of HIV. They think of the worse, and they freak themselves out. They are hypochondriac. They have... hypochondriasis.

I think I've grown out of my hypochondriac obsession. Somewhat rather. Minus the over-analysing sometimes, but I don't think I have hypochondriasis.

But of course, I think certain mommies have hypochondriasis as well. Their kid didn't recover from a cough despite taking 3 days of medication, and they start seeking treatment in another clinic, and believe it's something more serious that the earlier doctor has missed. Something like that.

But yeah. Hypochondriasis. I certainly think I've grown out of it. Although the psychiatrist said it's a medical student disease. I think I might have systemic lupus erythematosus. This rash on my face, they never heal!

But of course, it's just impossible. I don't fulfill 4 of the 11 criterias to be diagnosed to have SLE. So yeah. I'm crapping again.

On the Grandiose Delusion

Grandiose Delusionsv(GD) are characterized by fantastical beliefs that one is famous, omnipotent, wealthy, or otherwise very powerful. The delusions are generally fantastic and typically have a supernatural, science-fictional, or religious theme. There is a relative lack of research into GD, in comparison to persecutory delusions and auditory hallucinations. About 10% of healthy people experience grandiose thoughts but do not meet full criteria for a diagnosis of GD.

It's a psychiatric problem by the way.

Certain patients claim they talk to God. Or they claimed God came to them and giving them clues what to do. Or they dreamt about God telling them they should save as much people as possible, and build an Arc, before the big flood come. Hmmm come to think about it, just like the movie Evan Almighty.

So more often than not, when religion comes into play, we are inclined to think about bipolar disorder in manic phase, or maybe just schizophrenia. But of course, it could be some other more complex psychiatric disease, which are pretty much unknown to my limited knowledge.

Sometimes I wonder, those who claims they are messenger of God, or they communicate with God, or some Deity enter their body and they have the power of the Deity; who, really are able to tell you what you haven't mentioned precisely...

How do you explain that as compared to Grandiose Delusion?

On Vocalizing

It wasn't the first time that I got told off for being too quiet. Many a time, newly met people would be thinking I'm too arrogant to say hi. I for one, find it hard to say more than just hi when I have no idea who the person is, until I warm up and know more about him/her. So... yeah. Perhaps, just like a 8 to 9 month old toddler, when they were hold by strangers, they would start crying because of the stranger anxiety; instead of crying, maybe I too, developed stranger anxiety and became mute.

Professor asked about the development of human speech. It was interesting in a way. Have you ever look at it?

A baby first starts with crying (which, well, isn't really considered speech)..

But when they first start off, they vocalize. Ooooo Aaaaaa oooooo aaaaa ooooo aaaa

And then, only they learnt how to babble. They learnt how to pursed their lips for a while. So you start to hear baaaaaaaaaaa maaaaaaaa baaaaaaaaa

By the time they're 8 to 9 month old, they start to put the syllable together. Baabaaaaaa Maaamaaaaa... And that's where all the new parents got all excited thinking their child calling out for them. For all we know, baby didn't actually call out "Mama" specifically...

Not until they're 1 year old. Or somewhere there. They finally meant it.

Slowly, they learned to pick up more words. After 1 year old, they learned more nouns. Eat! Poopoo! Gaigai! Iu! And God knows what sort of neologism they have. I know I called water "IU" when I was young. It's actually French!

So when the baby turns 2, they join the words. Want eat! Want Iu! Want pee!

And there'd be 3 words after another year.

And so on...

And progresses...

And when they're 24 like me, they talk crap like me. Or write crap like me now.


ps: Is it just me or everyone thought that the toddler in the pic I attached looked... old... LOL

On the Knee Chest Position

There are certain heart conditions where the patient would turn blue, what we call cyanotic heart disease. But of course, the mainstay treatment would be surgery. But there are also simple measures where the patient are asked to squat down or maybe curl up in lying position as long as the flex their hips and knees and keep their knees to their chest, what was called as the 'knee chest position.'

But if you askED me, I would have told you I have no idea why. For all I know, I may actually answer that they are asked to do so to lower their centre of gravity perhaps, reduce the work of the heart pumping enough blood to the rest of the body, and hence less blue. Lucky me I didn't tell the professor what was in my mind that day, or else I'd be screwed upside down.

Only came to know the reason why when another colleague explained about it.

Apparently when they are asked to hold their knees close to their chest, they are (1) constricting the femoral artery, and hence (2) increasing the peripheral resistence, and hence (3) increasing the workload of the left ventricle, (4) reversing the right to left shunt, so there would be more blood pumped into the pulmonary circulation rather than straight into the systemic circulation, and hence... less cyanotic.

Eureka!

Don't get me?

Nehmind. I'm just mumbling....

On the Trouble with White Coats

My white coat is a pain in the ass. I know a lot of people wash them weekly for hygiene purpose. I used to just keep them for one whole posting before sending them to the laundry (at home). But since a few months ago that Mum's more often coming over, we saw the more often that the white coat is in the laundry.

Initially, I thought getting the white coat soaked in Clorox would get rid of all the stains, dirt and whatever stuff that's stained on the white cloth. I let it soaked overnight, and the next day, to my horror... It turned yellow! It wasn't pale cream coloured yellow, but it's YELLOW!

I had to use the other white coat I had from pre-clinical years because the one I wear all the time, was too yellow to meet the public.

Days later, Sis got the blue stain thingy to make the white coat the tinge of bluish colour most white cloths do. But guess what, the white coat came out RED!!!

I almost got a heart attack really. Mum came in a week later, and help out with the Clorox-ing again. And she found that if we don't soak the cloth too long, the whites won't go yellow. Or TOO yellow. It's still got a tinge of yellow cream on it, but at least it's wearable.

We even tried out some stain remover. God knows where these red-pinkish stain came from. Looked like blood or something. But to have those stain as big as that, I would've been wearing the white coat into the operation theatre and got the blood splashed on me!

But still, the coat still has a tinge of yellow cream on it. Even with the blue dye, it doesn't come out the bluish tinge as how we used to have in our primary school uniform.

One fine day, Mum brought home bleach. And after reading the instruction and being careful not to soak the coat too long, Mum finally was leaping in joy. She was literally yay-yay-ing! Finally it's white again!

But as the yellow coating on the white coat were bleached, the 'blood stain' became more obvious! We tried to wash them off with the stain remover, and finally, the final product, we're hoping it'll be white again.

Like white... WHITE...

Sometimes, white cloths aren't that easy after all.

On the Premarital Conceive

One day in the Antenatal Clinic, I was talking to a young couple. First visit to the hospital, 30 weeks, for antenatal booking. Cheerful lady, supporting husband equally. Then halfway through, the husband excused himself to the washroom.

Then I asked how long have they been married. Just half a year ago.

I stared at her. Half a year. That would probably make her baby in her tummy just 26 weeks old. So I tried to clarify again, when was her last menses.

Then she started to panic and was asking is there going to be a problem. I looked at her, I also started to panic. "This baby is your husband's? Or..."

"Yes it's his. But is there going to be a problem?"

I looked at her. What kind of problem?

"I mean, I conceive before we got married... And I'm a government servant... Will the hospital like, report this to the government or anything?"

I looked at her in disbelief. Speechless. Then suddenly, "Of course not! Hahahahaha."

She also cracked a smile.

Like, seriously, who would be so busybody? Even if I'm the hospital director, you think I give a damn if you conceive your husband's baby before you guys got married? Unless you were raped, then maybe I'd suggest a police report. But then again, our law is kinda... hmmm... I thought I read somewhere that, even if the husband is forcing him onto his wife, that wasn't considered rape, because they're bound by the holy matrimony. But yeah, whatever.

So... yeah... of course not!

For one, I'm not with the JAKIM.

On Conveniently Forget

So the Gynecologist asked me to clerk a patient before presenting the patient to her. Normal pregnancy, 20 weeks, coming for a booking at the hospital. No past medical illness or surgeries. First baby. Husband sitting at the side seems happy and all. Not on any medications and completely healthy. Seems normal right?

But as I was filling out her first visit form in her folder, I accidentally flipped through her notes and guess what... she was actually admitted before. Psychiatric ward in fact. I looked at it, curious. But it was 3 years ago. As long as it's not any mental illness like schizophrenia or bipolar disorder I'm sure it won't be a big deal right? Some more, it's just... parasuicide!

In another word. Not a real suicide. Just some impulsive wanting to end her life because her husband too ego and boss her around. So she swallowed 3 strips of panadol.

But as undergrad, I figured I shouldn't be missing anything out in my history. So I consulted her again. Her husband was beside her, talking on the phone. I tried to be as sensitive as I could, speaking in a very low tone, "I accidentally saw your file, you had problems with your husband before?"

"Oh... no... no no no.. That was no... no no...." She panicked.

And I also panicked.

For all that matters, some people might not want their spouse to know their past right?

Then I quickly, "Okay okay, let's not talk about it... Never mind. I won't bring it up later. No worries."


Later on in the consultation room, everything went on normally. In fact, I thought I just totally forgot about her parasuicide history. Speaking about doctor-patient confidentiality. Where does medical students come into? Hmmm...

On the Thick Lips

Was talking to a pregnant lady in the clinic one day about her pregnancy and some other things. I thought she looked pretty, somewhat. Big eyes, thick lips, nice body. Just that... maybe the lips was a bit... thick. It looked as though it was swollen. There were no curves, they just look, huge and swollen...

When my fellow colleagues saw her, she whispered to me.

Colleague: "Do you noticed something wrong about her? Particularly the lips?"

Me: "It looked swollen alright. What, you think it's some allergic reaction?"

"No no... actually it's artificial. My sister has clients doing that also. Painful you know."

"What, so they inject something inside their lips is it?"

"Yea, something la..."

"But well, thick lips are sexy. Like Angelina Jolie."

"Painful la wei..."

Well, beauty has a price.

On the Bag of Fruits

My supervisor is a Burmese who has been working in Malaysia for a decade or maybe even longer. So naturally, many of the Burmese patients would be referred to her for the ease of language barrier.

One day, this whole big family came in and they were talking in Burmese excitedly. It was as though they haven't seen each other for ages. Probably it was that. It wasn't before long that they settled down to business and consultation ensued, in Burmese.

Finally, as they stood up to leave, husband held up a bag of fruits and handed it over to the doctor.

"Oh oh, there's no need for this!" "Need, just take it, you've take care of us all this while." "Awww... okay okay, thanks a lot!" I could almost write out their script even though I know nuts about Burmese language.

But looking at that bag of fruits on the table after that, I felt warmth. I was touched. I felt... appreciation.

Where can I have this kind of patients?
I wanna receive gifts too! LOL LOL LOL!