Somewhere In the middle

i wrote this for the medical students' association yearbook. i think it's a mundane simplified version of my journey through clinical year.

read on and tell me what u think.

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The lyrics of Britney Spears’ song, I’m not a girl… not yet a woman plays in my head. Well that’s all I can remember of the song. It somehow describes the current phase I am in during these 3 years of clinical practice at medical school. I have survived the anxious and clueless process of my first clinical year and have yet to enter the ever challenging and fast-paced final year. With 2 fourth year postings down, and one more to pass, I feel very contented with where I am at present.

I remember clearly the day I entered the 3^rd year of medical school. I was happy to meet up with my friends after the longest break that one gets while doing a medical course at IIUM. Two of my batch mates took the opportunity to get married during that period.

I was excited to start my clinical year and encounter patients at the hospital. Happily equipped with my brand new white coat, stethoscope, tendon hammer and pen torch, I was anxious and nervous to begin learning the clinical stuff. The one-month long introduction to the major clinical year postings and impartment of basic examination skills were quite helpful. However, expecting the students to remember a one-hour lesson which is to be practiced a year later is something rather extraordinary for example the musculoskeletal examination which is to be practiced in 4^th year orthopaedics posting.

My very first posting was surgery. It was a blur of filling in the logbook, attending ward rounds, presenting cases and clinic sessions. When the time for end-of-posting examination came, I was a nervous-wreck and far from prepared. I remember Mr Faidzal saying that for undergraduates, everyone passes until proven otherwise. That helped decrease my anxiety level by a notch. My examiners were nice and guided me through my examination. Alhamdulillah I passed.

My next three postings were internal medicine, obstetrics and gynaecology and paediatrics respectively. There was plenty to learn in internal medicine. Despite being overwhelmed with the abundance of knowledge to be internalized, I actually managed another pass. Obstetrics and gynaecology was a very interesting posting. Conducting 10 deliveries was a wonderful new experience while presenting 10 cases to the specialists was a challenging feat with the limited specialists available at that time. Having gotten the hang of the clinical year after 3 postings, doing paediatrics in Temerloh was extremely exciting. The beautiful and new hospital, spacious wards, a different environment and living in a house with friends were fascinating.

I was very thankful to have been able to proceed to the fourth year. (One more batch mate got married during the holidays, alhamdulillah.) The initial 2 week long forensic lectures were intriguing and gruesome. The best part was that there was no examination at the end of it. The following 2 weeks of introductory psychiatry lectures were enlightening though I did catch a few winks or more during the sessions. To my surprise, I got the highest mark for the MCQs. The first time ever I got the highest mark for anything, and it had to be psychiatry!

Public health and family medicine was my first fourth year posting. It was full of exciting trips to the sea port, factories, rural areas, old folks home, mental rehabilitation centre and much more. The method of learning was a refreshing change from the usual wardworks, bedside teachings and mundane lectures. The trip to Ulu Tembeling was indeed one of the most memorable part of the posting. I enjoyed the 4 hour boat ride to the village and also going to the riverside village clinics by smaller boats. The delivery of riverine health care to the village folks was something new to me. For the family medicine part, attending the community clinic was a novel experience. The 1:5 lecturer-student ratio was great and more focused compared to the 1:12-20 during the bedside teachings. After completing the posting, I have a newfound deep respect for the gatekeepers of medicine and also the medical personnel working on the preventive side. I also learned that doing a research is hard. Period.

In between the 2-week break, I did my 1-week forensics posting in Hospital Tengku Ampuan Rahimah in Klang. Seeing the post-mortem being done was enriching. It was a reminder of how death could occur anywhere and anytime. Thus, we should always be prepared and live life to the fullest.

My second posting, orthopaedics, trauma and rehabilitation was a bitter-sweet experience. The mentorship system practiced in the department was very helpful especially since I got the best supervisor ever, the very funny Mr Shukrimi. Most of the experience and knowledge gained through this posting can not be found in any other posting for example the 1-week attachment to the Emergency Department, 6-12pm oncalls 2-3 times a week, the triple I course, hands-on workshop , rehabilitation lectures, different operation theatre and much more. We had to submit a case-write up every 2 weeks, the highest amount among all postings. It was an exhausting but interesting period to go through. I had several episodes of public meltdowns and moments of excessive lacrimal secretion however, I made it through.

I’m now at the beginning of my last posting, the specialized posting. Prof Dr Ariff reminded us that this posting does not aim to make us into specialists. Instead, it is to equip us with sufficient basic knowledge of special 2-weekly postings necessary to make us safe doctors. I’ve already fallen in love with the ear, nose and throat department and look forward to the other 4 postings ahead.

The elective posting is something I have always been excited about and looked forward to since the beginning of year 3. After that comes the dreaded final year. On one hand, it means full steam ahead and the end of honeymoon year while on the other hand it is one step further to graduation and work. A senior IIUM medical graduate once said that the view is much better from that side. Although she may be right, I think I want to take my time on this side and gain as much invaluable experience while I can in this wondrous ground of IIUM Kuantan.

Throughout this fourth year, one friend delivered a healthy baby girl, another two of my friends have gotten married to each other and several more have gotten engaged. Enduring the ups and downs of each posting together with my friends has definitely strengthened our friendship. The many high-spirited juniors and extraordinary seniors here also make life more colourful. Fourth year is indeed a wonderful year to be in.

11.55pm, 28^th January 2008

prof muhaya's talk

last saturday, the renonwned opthalmologist, Prof Dr Muhaya came to give us year 4 a talk on diabetic retinopathy and diagnosis of visual loss. as interesting as it was, i was somehow clueless as i have not undergone opthalmology yet. next week inshaAllah.

in the evening, she gave an inspiring and refreshing talk on how to enjoy the clinical years. i was so attentive, tak tido or ngantuk langsung sepanjang her 2-hour talk. that's a rare achievement i tell ya. i jadi mc yg tah pape. nasib baik majoriti girls yg dtg. i bebel sorang2 kat dpn, hehe.

there was so many interesting points i tak larat nak tulis semua. later inshaAllah.

ENT-related pics

here are some of the pictures i took during the ENT (ear, nose and throat) clinic and at the operation theatre.

the cool, handsome and macho ENT specialists doing a laryngotracheal reconstruction, the first ever attempted in Malaysia.

my group tengah observe the operation. i berusaha nak tengok tapi tak nampak sangat pun. nazhan and arep ketawakan je tengok i terjengket2. i like it when they project the picture on the tv screen. nampaklah sikit the surgical field and what the surgeons are actually doing.

this boy had a bilateral seroma of the ear pinnas.
the serous fluid inside was aspirated and they sutured a 2 buttons on the site to compress it to prevent any recurrence. at first, i didn't think they'd use a real button. seeing was believing. klaka je. surgeons pun kene tau jahit butang, hehe.

this is a palatine tonsil.
tonsillectomies are part and parcel of ENT.

this tiny bug (kutu babi) is a cause of misery and pain for many children. banyak gak kanak2 datang to have ticks removed from their ears.

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ENT is really cool. the work is during office hours and it isn't very busy. the surgeries are elective and not emergencies. my lecturers sume boleh je balik umah tengahari amek anak masing2. my lecturers are all very nice and handsome. the job must be very satisfying.

i so love the head gear they use to tengok telinga, hidung, dan tekak orang.

i'd definitely go for this specialization if i'm interested in a surgical-based field.

specialized posting

I’ve already finished an interesting week of ear, nose and throat (ENT) and look forward to another exciting week.

After listening to my roommate going on and on about how wonderful her previous ENT posting was plus i already had an interest in the field, i was biased for the posting.

i'll write more on specialized later.

p.s. thanx ramzi for helping me out with my computer. i appreciate ur help.

Monkey business

I’m not monkeying around.

I had a very close encounter with a monkey. Since my hostel is built on what used to be a jungle, the monkeys have come out of their homes to find easy food. Garbage is plentiful here and the supply is perennial. They can be seen having a feast around the rubbish dumping area and making a terrible mess with the help of the stray dogs. Some of our simian friends have been as brave as to scout around the hostel buildings and steal food from the unsuspecting rooms with open windows.

This has been happening for a long time but it has not disturbed me much. However, yesterday, I had a very close call with one necessitating this entry. It was in the evening, when I had just returned to my room and opened the window panes, but leaving the blinds closed. As I was doing some light reading, there was a shadow at the window. I thought it was a cat. I shouted at it and it jumped off the window sill onto a nearby tree branch. Imagine my surprise to see a monkey, looking back at me preparing to jump onto the window. I immediately closed the window and called my roommate to come and see the little fellow. Suddenly the monkey leaped onto the window sill which made both of us scream very loudly, hehe. Thank god it was closed. I nearly had a heart attack. Good thing my heart is still in good condition.

So now, I dare not open my window panes any more. I don’t want any hairy thieves rummaging in my room. It’s messy enough as it is.

it has been a really relaxing break. i've been doing nothing much. just the routine sidai kain, angkat kain and kemas rumah. there's no one at home most of the time. mak and ayah work. hammad goes to school, not that it makes a big difference whether he's around or not. only when i have to separate him from the computer to use the internet do our paths cross.

today i went out with uswah and amirah. we went to jusco tebrau. i had a wonderful time catching up and updating each other on the recent gossips.

i hope to do a reunion of the girls in my batch. been a long time since i've seen most of them.

a unisex name?

before i forget, i just have to write about this one incident.

it occurred just before my long case during the ortho exams.

i was anxiously awaiting my turn to be called to start the long case, pacing about while trying my best to read whatever notes was in my hand thus annoying my friends with my active movements.

after a while, finally the lady called our names and gave us our boards with the paper to write our notes on. i stood beside her as i waited for her to call my name. mine was the last name called. then she looked at the only male student around for a response. there was none.

realizing what was happening, i told her that it was my name. she turned red and gave me the board, apologizing for the mistake.

no worries sister, i'm kinda getting used to the mistaken identity.

the 'binti' thing does actually help ppl differentiate between genders.

the health camp (cont'd)

hidden in the bushes is a house. it has no proper toilet
BUT...
they have a tv with a cd player.
indeed everyone has their own priorities.
entertainment definitely comes first before hygiene for these peeps.

a baby beruk, freshly found in the jungle, a day before we arrived.

the cultural nite was a blast.
this kid may seem all nice and innocent but do not be fooled for a second, a lot of mischief lies underneath.

this is a picture that i shall remember the most.
to a most dear and kind friend, i'm sorry for going against ur back.
my impulsiveness and reckless behaviour does not deserve to be forgiven.
insyaAllah, i will think more carefully in future before i act.

if u've never seen one, that my dear friends, is a pokok kekabu.
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life is a journey.
along the way we make many mistakes.

its' not how many the mistakes
or how terrible the mistakes are,
what's important is that u learn from them.

the health camp

last friday and saturday, i joined a health camp at kg sg tiang and kg gol in jerantut, pahang (extremely near to taman negara).

the clear blue sky, welcoming us to the kampung. too clear in fact it was scorching hot that day. we were quite dehydrated.

after lunch, we went to visit the neighbouring orang asli village. we distributed food and soap to them and tried to promote hygienic practice (setakat mane yg mampu). it was quite awkward. didn't know how to go about it.

at the tok batin's house; with his 2 sons and 3rd daughter in law and grandson.
the kid at the far left is 2 yrs old while the kid next to it is about 4. they seem nearly the same size. that's becoz before age 2, they are fed with milk, after that, they eat adult food and start to become malnourished.

while visiting one of the houses, 2 dogs suddenly got into a fight and a bunch of dogs came to cheer them on. the noised they made was quite scary. its a good thing the tok batin was around to dismiss the dogs or i doubt we would have stepped outside the house.

this lady sells basic grocery stuff to the villagers. she's a muslim alhamdulillah and has the awareness to do dakwah. may Allah help her and reward her accordingly.

just another entry

makyang, not so close lah!

ppl can see all ur spots n blemishes unlike my soft n smooth baby skin

went to bersihkan surau yg kene banjir. full of selut. half day je coz ramai orang dtg tolong masetuh.

it's that time again.

another round of exams.



dah takde perasaan dah



berusaha je.