from pekan

i'm writing this from Pekan, a town about 45 minutes from Kuantan. my friends' get wireless connection here.

for these first 4 weeks of community medicine, my group has to do primary care. we have to stay at the nurses hostel while we're here because it is directly opposite to the Pejabat Kesihatan Daerah (PKD) which is where we are assigned to.

huhu macam2 kat sini. panjang lebar kalau nak cite. the best thing is my group got to a eat a loooooot of delicious durian today. two days ago we had a rambutan feast.

but we have water problems besides hostel probs.

can't wait to go back to kuantan tomorrow.

ayah's change of post

i called home yesterday.

as of yesterday, ayah is no longer the Dean of SPACE UTM but is now the Dean of Reseach and Post Grad studies. the ironic thing is, now there are 2 deans there. sian ayah. he's no longer the autocratic leader. he says susah nak buat decision if u keep having to discuss with others on every minor issue.

my lecturer, dr jamal said that the leaders who perform and deliver results are the autocratic ones rather than the democratic ones. i guess that's true. people tend to follow orders better when their boss issues a directive confidently.

its all becoz ayah's boss thinks he's a threat to his administrative career. tu la. bagus sgt pun org tak puas hati. tak pe. what comes around goes around, ayah said.

whenever i feel tired doing SRC work, then we have a meeting and i see that others are working 5 times more harder than me, so i forget about all my tiredness and try to focus on the task at hand.

i think i should write about my humble experience being in the SRC one day. 3 more months to go. i'll have to add that to my not-so-urgent to-do-list.

some rules for docs

Last year, I found an interesting book at the library titled ‘A Little Book of Doctors’ Rules’ compiled by Clifton K. Meador, M.D and I photocopied it.

There are 425 rules in it. Some are logical rules and some are quite funny.

Here are some of my favourites:

If you do not know what is wrong after you have taken a history, then take another history. If you still do not know, take a third history. If you do not know then, you probably never will.

In medicine, anything that can happen will happen.

About the time you think you have seen it all, you will encounter some new unbelievable

behaviour. There is no limit to the strangeness of human behaviour.

The mind readily sees and hears differences. It takes concentration and effort to see or hear similarities.

The appendix is where the surgeon finds it

Many patients do not change. They just change doctors

Use it or lose it. This rule applies to all parts of the body.

Never ignore an experienced nurse’s observation

Masses are either palpable or not. There is no such thing as a ‘suggestion of a mass’.

Only the patient knows how he or she feels. No one else does.

A physician who treats himself has a fool for a patient and a bigger fool for a physician
The physician’s belief determines the patient’s belief

Never wake a patient to give a sedative or a laxative.

Confusion is an essential phase of learning

No organ system fails in isolation

Weight gain or loss within 10 days is all water

Be very kind to nurses, they will be kind to you. Be unkind to nurses, they will make your life miserable

Do know harm. Do no harm

A hospital is a dangerous place. Use it wisely and briefly as possible

When you don’t know what to do, do nothing!

Speak so you can be heard

Write so others can read it

Doctors wives CAN have medical diseases

Wash your hands. Do it in front of your patients.

Be careful with labels. They can be hard to remove.

Much disease is self-inflicted, wittingly or not.

There is time for action. There is time for no action.

Use laboratory tests like a rifle not a shotgun… once shot at a time and with precision

When caring for a very sick patient, doubt all results of all tests

The pathophysiology of the diagnosed disease should explain the patient’s symptoms. If it doesn’t, you either have the wrong diagnoses or you are missing the 2nd disease that could explain the symptoms.

You cannot diagnose what is not in your differential diagnosis.

When a man seeks medical care, there is usually a woman urging him to do it. Talk with her

Most patients are women. (Do men worry them sick?)

Never take away hope

Stop all drugs if possible. If impossible, stop as many as possible.

You cannot be everybody’s physician

The interview is the beginning of treatment

Tell the patient to remove the foil from a suppository before insertion

Try to leave every patient smiling, no matter how grim the circumstances

Never order a test unless the result will help you direct the treatment or make a difference in what you tell the patient

Never appear shocked by anything the patient tells you

Listen for what the patient is NOT telling you

If you catch yourself thinking whether a patient might have either hyperthyroidism or hypothyroidism, then the patient does not have either.

if you need time to think, ask older patients to describe their bowel habits

Do not refer to patients as diseases.

No matter how much time you have spent in a patient’s waiting room explaining the condition, as you start to leave the family will ask one more question

Never tell a symptomatic patient, “Don’t worry. It’s all in your head”.

When you do not know what a patient has, do not say, “I don’t know what you have.” Say, “I don’t know what you have… YET.”

an update

i'm in community medicine now.

this is a picture of my class trip to the kuantan sea port. we had to learn on the preventive measures and safety precautions taken there since it is a port of entry into Malaysia.

my days and nights are full.

i guess that's a good thing.

i miss my family.

Girls’ day out

smiling faces...

all the girls that went not including the camera girl...
in the background are the array of cars we convoyed in

at marni's mak angkat's house

Last Saturday, we had a rehlah exclusively for the sisters of my batch. This was the first of its kind for us. Previously, the brothers have had their own rehlahs and other batches too. We’ve never really had the opportunity (read: we’ve never really made time for it).

Well, it was a last minute decision. Since half of the sisters didn’t go back home during the weekend, might as well go on an outing and strengthen our ukhuwwah amongst ourselves. Sebelum ni banyak aktiviti nafsi nafsi or the outings were in small groups.

We were supposed to depart at 6.30 am but hmm, since sume girls la kan, we only managed to do so at 7.15am. We convoyed to Balok beach in 8 cars. The beach was not very properly looked after and was filthy but it was too late to go to another place. The beach aside, we had a wonderful time there. Despite everyone being very hungry, we started the day with aerobics. I was in charge of that :P Everyone had ravenous appetites after that. The egg and sardines sandwiches with baked beans tasted heavenly. Then some of the girls went for a swim whilst the rest who were forbidden by FAMA to go near the waters or were allowed but refused to get wet, played on the safe, dry sand ‘teng teng’ and a few other non-wet games.

Then Jack and the gang brought mee hoon goreng and we filled up our stomachs with delicious and glorious food. In the afternoon, everyone was exhausted but satisfied and the group split into two. One group went back to the hostel because they had another fun activity planned whilst the other group (which I joined) went to Marni’s mak angkat’s house nearby for lunch.

We went back to the hostel with our stomachs filled up to the esophageal hiatus and our hearts contented, alhamdulillah.