Hmm, another terrible and busy posting.
Basically it was all about ward round, classes, and study study study. We actually needed to follow the ward round every morning but it was really time-wasting for me. I really hate the ward round as the doctors were so busy with their routines and didn't really teach us or guide us anything unless we asked question. Being proactive was really a good way (perhaps the only way) if you really want to learn something from them, but i am not that type of person obviously. For the first two weeks, i didn't hear any word from the registrar talking to us.
Tuesday, April 24, 2012
Saturday, March 10, 2012
ORL-HNS posting
Another 3 weeks has passed. Quite a short posting.
ORL-HNS = Otorhinolaryngology - Head And Neck Surgery
Not to say it was an interesting posting, but not really boring either. As usual, it was packed with clinics and classes but without any oncall. People usually will say that it's a honeymoon posting, but for me, hmm, not really. We got to study quite a lot of anatomy and diseases in merely 3 weeks,
ORL-HNS = Otorhinolaryngology - Head And Neck Surgery
Not to say it was an interesting posting, but not really boring either. As usual, it was packed with clinics and classes but without any oncall. People usually will say that it's a honeymoon posting, but for me, hmm, not really. We got to study quite a lot of anatomy and diseases in merely 3 weeks,
Friday, February 17, 2012
ophthalmology posting + community eye service
It's was only a 3 weeks posting, but we learned a lot from it. As this posting was quite organized, we really could benefit a lot from it even though sometimes it was quite hectic. Doctors here was super nice. I could see they really put efforts in teaching us.
Tuesday, January 24, 2012
Orthopaedic Posting
Honestly, i don't really like orthopaedic stuffs. The feeling is like when i was studying physic in secondary school. (i don't like physic either).
Well, orthopedic was a totally different posting compared to surgery posting. I meant the the way how it was organized. Unlike surgery, everything has been arranged & scheduled nicely. Just that you got to wake up early to sign to your attendance before the clerk take away the attendance sheet. Next, you go for ward rounds, clinics, seminars and clinical teachings as scheduled, and also depending on which team you are in. After around 5pm, you will be allowed to go back and study at your room. I was in the spine team. The doctors were damn nice. They spoon-fed everything to us. The only drawback was i had to stick with spine things for 6 weeks, where i could hardly study stuffs from other teams. And i really hoped that my CT could be better. Almost every time doctor would be kept commenting on our history and after that, time was already spent up and he couldn't teach us much about PE. Till now, my PE still sucks!
Moreover, you may have to go for on-call occasionally if your team is in charged on that night. Luckily, i didn't have much on-calls, where i could have more free time for my study (or more time to waste?). Anyway, you can still learn a lot through on-call. you can see "fresh" cases like those mva cases in emergency ward, do dressing on those "fresh" wounds and learn the way how doctor manage the casualties there.
Hmm, not much 'great' procedures i have done in this posting. One STO, some dressings and assisted in some POPs. That's all. I knew that i should be more aggressive and asking more questions but honestly, i was quite tired with the log book requirements already and i chose not to chase blindly after signatures in log book. It was stupid attitude. And my reading was clearly not enough, most of the time i didn't really know what to ask and didn't even know what the doctors were talking about. Haiz. What a bad attitude!
My supervisor? Dr Halim, head of department! Omg! Till now, i am still scared of him. He scolded me few times during ward rounds as i couldn't cover my cases well. If i am smart enough to cover all cases fully and yet, manage to study well, i will definitely do it. But obviously i couldn't make it. I am so sorry to my doctors, and also my teammates, especially Prof Chong. My examiner? Dr Mohammad! Another scary doctor! Thanks god he was free finally after delaying for 3 times. I managed to answer those questions asked by him, even though i knew that my performance was just mediocre. Hopefully i was good enough to pass the posting.
Eventually, my turn to go home! My mood was so badly affected in the last week of orthopedic. I didn't really have the 'mood' to study for exam already. I missed my home sooooo much because i has been away from home for almost 5 months already. I felt so guilty for not studying well enough even though it was already the final week but i just couldn't control my mind. I needed a getaway and a nice rest after a long run in 4th year.
Therefore, as usual, i still couldn't manage to finish studying what i planned initially. Haiz. I knew i was quite lazy throughout this posting. Aargh! Got to be more hard-working next time!
Happy Chinese New Year and Happy Holiday to everyone! :D
Well, orthopedic was a totally different posting compared to surgery posting. I meant the the way how it was organized. Unlike surgery, everything has been arranged & scheduled nicely. Just that you got to wake up early to sign to your attendance before the clerk take away the attendance sheet. Next, you go for ward rounds, clinics, seminars and clinical teachings as scheduled, and also depending on which team you are in. After around 5pm, you will be allowed to go back and study at your room. I was in the spine team. The doctors were damn nice. They spoon-fed everything to us. The only drawback was i had to stick with spine things for 6 weeks, where i could hardly study stuffs from other teams. And i really hoped that my CT could be better. Almost every time doctor would be kept commenting on our history and after that, time was already spent up and he couldn't teach us much about PE. Till now, my PE still sucks!
Moreover, you may have to go for on-call occasionally if your team is in charged on that night. Luckily, i didn't have much on-calls, where i could have more free time for my study (or more time to waste?). Anyway, you can still learn a lot through on-call. you can see "fresh" cases like those mva cases in emergency ward, do dressing on those "fresh" wounds and learn the way how doctor manage the casualties there.
Hmm, not much 'great' procedures i have done in this posting. One STO, some dressings and assisted in some POPs. That's all. I knew that i should be more aggressive and asking more questions but honestly, i was quite tired with the log book requirements already and i chose not to chase blindly after signatures in log book. It was stupid attitude. And my reading was clearly not enough, most of the time i didn't really know what to ask and didn't even know what the doctors were talking about. Haiz. What a bad attitude!
My supervisor? Dr Halim, head of department! Omg! Till now, i am still scared of him. He scolded me few times during ward rounds as i couldn't cover my cases well. If i am smart enough to cover all cases fully and yet, manage to study well, i will definitely do it. But obviously i couldn't make it. I am so sorry to my doctors, and also my teammates, especially Prof Chong. My examiner? Dr Mohammad! Another scary doctor! Thanks god he was free finally after delaying for 3 times. I managed to answer those questions asked by him, even though i knew that my performance was just mediocre. Hopefully i was good enough to pass the posting.
Eventually, my turn to go home! My mood was so badly affected in the last week of orthopedic. I didn't really have the 'mood' to study for exam already. I missed my home sooooo much because i has been away from home for almost 5 months already. I felt so guilty for not studying well enough even though it was already the final week but i just couldn't control my mind. I needed a getaway and a nice rest after a long run in 4th year.
Therefore, as usual, i still couldn't manage to finish studying what i planned initially. Haiz. I knew i was quite lazy throughout this posting. Aargh! Got to be more hard-working next time!
Happy Chinese New Year and Happy Holiday to everyone! :D
Thursday, January 05, 2012
BKA
BKA aka below knee amputation, is a surgery which cut off
your leg at a measured level below knee.
This is the operation I saw during my second orthopaedic oncall
during last Monday night. The patient was the one I clerked before for case
report last month. He was actually admitted once last month due to diabetic
foot. Ray’s amputation was done before he was discharged. And I thought that he
would be okay after that. However, after another 10 days , he revisited our
ward again due to the spreading of gangrene again in his left foot.
He said when he was in clinic, the doctor cut through his
foot and found a lot of pus inside his foot. It’s a sad thing when you thought
that you are already recovered after removing part of your foot, and now the
doctor tells you that you have to remove another bigger piece of your leg. His
wife once told me before that they were actually having some financial
restraints. Even with the help from government’s welfare, it was just enough to
drive through their routines. All his children but the eldest one are still
schooling. He can no longer work as he feel tired most of the time. ( fatigue
is one of presentation for diabetic patients, not that they are lazy. ) His
wife can only earn a few hundred bucks by working in a school canteen.
During morning round, our doctor told him that BKA needed to
be done on him as the foot was already not viable and also to prevent the
colonization of microorganism there. He agreed without thinking too much. He
understood. Just that I could not understand why he could be so calm when
someone told him that his foot needed to be removed? I guess if I am him, I am
gonna cry a whole day long.
Sometimes, it might be just an ordinary operation for us as
medical students or doctors, but it plays a huge part for patient’s life. It might
be vital for survival but it does affect a lot on patient. I just feel like the
psychosocial part is a important part also in managing patient. They are human
being, their hearts are still pumping, they still have their feelings which we
can never ignore it. Don’t blame them if they are reluctant to accept your
decision of management, especially the more invasive one, but try to understand
why they feel that way. It does not always appear to be the good choice. It
might treat the disease but not necessarily the patient himself.
Appreciate your patients as they are helping you in becoming
a doctor. Without them, you can never be a doctor. That’s what I feel and learn
from him.
Thursday, December 29, 2011
Surgery Posting
Honestly it’s really a harsh time I have been through.
I love reading stuffs in surgery. But somehow, the system,
especially the requirement in logbook, dragged me away from the interest.
In surgery, you will get to see how doctors manage the
patients not merely through medications, but also surgical intervention. I went
into OT (operation theatre) few times, watching doctors doing surgery on
patients. I had studied anatomy on books, and now I got to see the real
structures in front of me. I could see how careful the surgeons were when cutting
the neck and trying to reach for the thyroid with all the great vessels beside
it. One of the best surgeries I saw throughout the posting. It was really an
amazing experience that made me felt like wanna to be one of them one day
later.
Apart from that, we had more chances to perform some procedures
compared to paediatrics. It’s so important for us to develop a good skill. Just
a bit disappointed for not having any chance to perform some procedures. A good
doctor should have a good knowledge, skill, and attitude right?
In the middle of the posting, I guessed most of us were so
depressed. The routine was so hectic till we didn’t really have time for study.
But, it’s still a great experience. It taught us how to appreciate the time we
have for study. It reminded me that having enough time for study is really a
blessing. And I feel so grateful for having some good friends in my group teaching
me stuffs along the way.
Nevertheless, nothing is perfect. And logbook is really the
killing and most stupid part of surgery posting. Logbook was meant to be
guiding us in learning the topics that we should learn, but it was obviously not
applicable here. Everyone, including me, was rushing for short cases and
signatures somehow blindly. When the atmosphere became so tense just because of
the stupid logbook, anger and frustration came behind. I knew it.
Anyway, I felt so relieved after finishing surgery posting.
I guess everyone felt the same too. It’s over man!
Currently I am in the halfway of orthopaedic posting. Hmm, I
am trying hard to hypnotize myself to love it.Aargh! :P I got a great quote
from my supervisor, Dr. Halim,
“if your future job is
something you like to do, then you will be like having holiday everyday and just
doing something you like to do.”
It’s so true. Hope that I will love doing the thing I am
gonna to do in the future. :D
Thursday, December 01, 2011
《不生病的生活 實踐篇》 新谷弘實
「希望你成為像野口英世一般了不起的醫生，為人群服務！」
這是我小的時候，母親經常叮嚀我的話。
我出生於一九三五年，當時，野口英世在日本已成為國民的典範，刻印在人們的心中。
他生於貧窮的農家，少年時左手曾遭受嚴重灼傷，後來苦讀成為醫生。他建立起歐美人也難以匹敵的成績，但可惜在研究中因黃熱病而去世。在我幼年時，母親就反覆向我敘述野口英世的故事，而且最後一定不忘叮嚀：「你以後也要做一個像野口英世般的醫生，為人群服務。」
一直接受這種教誨的我，上了小學時就立志成為醫生以幫助大眾。
但現在回想起來，卻有些不可思議。因為，我的老家是在九州的柳川經營棉被買賣的商家，身為長男的我，繼承家業原本是理所當然的事。
我的家庭不像野口英世那樣貧窮，對我的未來也沒有非常高的期待。我也不是因為在學校的成績特別優秀，被認為當一位醫生比繼承家業更為適合。但是母親卻在我尚未就讀小學的三、四歲時，就不斷勉勵我長大以後要「成為了不起的醫生」。
赴美初期，一美元兌換三六○日圓的高匯率，加上繁重的工作與低廉的收入不成比例，生活並不輕鬆，而且還時時感受到種族的歧視。當時，支持我的最大力量就是母親的那句話「成為像野口英世般了不起的醫生」。
美國社會雖然有些地方存在著種族和階級差別，但相對的，也有公平的一面，不論任何人，只要在工作上有傑出表現，都能獲得應有的評價。
赴美八年後的一九七一年，我深刻感受到這種精神。
我經過不斷的研究和嘗試錯誤學習，於一九六九年使用勒除器和內視鏡，成功完成世界首次的內視鏡息肉切除術。一九七一年，我在美國胃腸內視鏡學會中發表這項成果。
成果發表結束，我獲得滿場起立鼓掌的最高規格讚許。所謂「內視鏡外科」的新外科領域也於焉誕生。我聽到久久不歇的掌聲，覺得自己向崇拜已久的野口 英世又接近一步。
我的技術受到肯定後，接觸醫學界各領域名人的機會也大幅增加。其中有一位老醫師，在交談中得知，他在年輕時曾經見過野口英世。
野口英世是我自幼崇拜的人物，我期待從這位老醫師的口中聽到對他的誇獎，因此問了不少有關野口英世的事情。但是得到的回答卻沒有任何稱讚的話。
老醫師說：「野口醫師的成績，老實說，只是沒有人願意做而已，並沒有非他 不可的東西。我倒是覺得你的內視鏡息肉切除術才是偉大的貢獻。」
老醫師的話令我驚訝。為什麼身為諾貝爾獎候選人的野口英世，成績卻沒有受到太高的評價？原來，野口英世的研究領域是誰也不願意接觸的危險工作。
野口英世在美國首先從事的，是蛇毒的研究。蛇毒研究是他唯一得到的工作，於是將自己的命運孤注一擲在此危險的工作上。
他在此賭注上大獲成功。他博得極高的評價，但也使他之後接觸的工作幾乎都帶著危險。他後來相繼從事梅毒螺旋體（Spirochaeta Pallida）、奧羅耶熱（Oroya Fever）、沙眼等研究，最後終於在研究黃熱病時，不幸罹患黃熱病而去世。
以醫學家而言，野口英世的成績可說非常輝煌。不過我了解他的真實情況後，有一件事令我感到相當遺憾。那就是他雖然身為醫師，卻不太照顧自己的身體。野口英世的生活態度並不好。一方面，他廢寢忘食的專心研究，另一方面，他也經常爛醉如泥，大吵大鬧，過著沒有節制的生活。
來到美國，了解了偶像野口英世的真實生活後，我下定一個決心，即「我要成為像野口英世般的傑出醫師，但是決不要仿效他那種會縮短自己生命的放蕩生活」。
我在年輕時，也像野口英世同樣廢寢忘食的努力工作，但因為這個決心，我想出了能夠在短時間內讓身體休息，並恢復體力的方法，得以一直維持健康。
對我而言，野口英世不但是我自小崇拜的人，同時也是一位錯誤示範的醫師，從他身上，我了解到身為醫師必須比一般人更注重健康，以做為病人的模範。
野口英世去世時年僅五一歲，可說是「充實而短暫的人生」。不過，相信他也希望活的更久，以幫助更多的人。他未能實現的「充實而長久的人生」，正是同樣身為醫師的我現在追求的目標。
《不生病的生活 實踐篇》 新谷弘實
這是我小的時候，母親經常叮嚀我的話。
我出生於一九三五年，當時，野口英世在日本已成為國民的典範，刻印在人們的心中。
他生於貧窮的農家，少年時左手曾遭受嚴重灼傷，後來苦讀成為醫生。他建立起歐美人也難以匹敵的成績，但可惜在研究中因黃熱病而去世。在我幼年時，母親就反覆向我敘述野口英世的故事，而且最後一定不忘叮嚀：「你以後也要做一個像野口英世般的醫生，為人群服務。」
一直接受這種教誨的我，上了小學時就立志成為醫生以幫助大眾。
但現在回想起來，卻有些不可思議。因為，我的老家是在九州的柳川經營棉被買賣的商家，身為長男的我，繼承家業原本是理所當然的事。
我的家庭不像野口英世那樣貧窮，對我的未來也沒有非常高的期待。我也不是因為在學校的成績特別優秀，被認為當一位醫生比繼承家業更為適合。但是母親卻在我尚未就讀小學的三、四歲時，就不斷勉勵我長大以後要「成為了不起的醫生」。
赴美初期，一美元兌換三六○日圓的高匯率，加上繁重的工作與低廉的收入不成比例，生活並不輕鬆，而且還時時感受到種族的歧視。當時，支持我的最大力量就是母親的那句話「成為像野口英世般了不起的醫生」。
美國社會雖然有些地方存在著種族和階級差別，但相對的，也有公平的一面，不論任何人，只要在工作上有傑出表現，都能獲得應有的評價。
赴美八年後的一九七一年，我深刻感受到這種精神。
我經過不斷的研究和嘗試錯誤學習，於一九六九年使用勒除器和內視鏡，成功完成世界首次的內視鏡息肉切除術。一九七一年，我在美國胃腸內視鏡學會中發表這項成果。
成果發表結束，我獲得滿場起立鼓掌的最高規格讚許。所謂「內視鏡外科」的新外科領域也於焉誕生。我聽到久久不歇的掌聲，覺得自己向崇拜已久的野口 英世又接近一步。
我的技術受到肯定後，接觸醫學界各領域名人的機會也大幅增加。其中有一位老醫師，在交談中得知，他在年輕時曾經見過野口英世。
野口英世是我自幼崇拜的人物，我期待從這位老醫師的口中聽到對他的誇獎，因此問了不少有關野口英世的事情。但是得到的回答卻沒有任何稱讚的話。
老醫師說：「野口醫師的成績，老實說，只是沒有人願意做而已，並沒有非他 不可的東西。我倒是覺得你的內視鏡息肉切除術才是偉大的貢獻。」
老醫師的話令我驚訝。為什麼身為諾貝爾獎候選人的野口英世，成績卻沒有受到太高的評價？原來，野口英世的研究領域是誰也不願意接觸的危險工作。
野口英世在美國首先從事的，是蛇毒的研究。蛇毒研究是他唯一得到的工作，於是將自己的命運孤注一擲在此危險的工作上。
他在此賭注上大獲成功。他博得極高的評價，但也使他之後接觸的工作幾乎都帶著危險。他後來相繼從事梅毒螺旋體（Spirochaeta Pallida）、奧羅耶熱（Oroya Fever）、沙眼等研究，最後終於在研究黃熱病時，不幸罹患黃熱病而去世。
以醫學家而言，野口英世的成績可說非常輝煌。不過我了解他的真實情況後，有一件事令我感到相當遺憾。那就是他雖然身為醫師，卻不太照顧自己的身體。野口英世的生活態度並不好。一方面，他廢寢忘食的專心研究，另一方面，他也經常爛醉如泥，大吵大鬧，過著沒有節制的生活。
來到美國，了解了偶像野口英世的真實生活後，我下定一個決心，即「我要成為像野口英世般的傑出醫師，但是決不要仿效他那種會縮短自己生命的放蕩生活」。
我在年輕時，也像野口英世同樣廢寢忘食的努力工作，但因為這個決心，我想出了能夠在短時間內讓身體休息，並恢復體力的方法，得以一直維持健康。
對我而言，野口英世不但是我自小崇拜的人，同時也是一位錯誤示範的醫師，從他身上，我了解到身為醫師必須比一般人更注重健康，以做為病人的模範。
野口英世去世時年僅五一歲，可說是「充實而短暫的人生」。不過，相信他也希望活的更久，以幫助更多的人。他未能實現的「充實而長久的人生」，正是同樣身為醫師的我現在追求的目標。
《不生病的生活 實踐篇》 新谷弘實
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