Interesting Patients

#Patient 3

This elderly Indian man was looking at me when i was "supervising" Siew Li examined on a patient.

I didn't intend to start any conversation coz i was tired.

He seemed bored and wanted to talk. So he said to me:"Hi, where are you from?"

"I am from Kelantan."I said.

"oo...very rare.Not many Chinese in Kelantan?"

I've answered this Question more than 20 or 30 times in my life, so I gave him the same formulated answer.
Since he was so friendly so I began to "take advantage" by asking his permission to check his cardiovascular system.
While i was checking his chest, he demanded for my handphone number. I didn't know what to respond. I just smiled and ignored the request.
No abnormality was found except that his heart was beating very fast and his body was cold.
Before I ended my examination I stared at his leg while thinking what else to check since he was so co-operative.
"I have POLIO." He told me while pointing to
his leg.
Wow...1st Poliomyelitis in this ward.
"And my toe is bent due tight shoes I wore when
I was young."He pointed his left big toe.
I saw a hallux valgus.
Wow...1st hallux valgus that I saw.
Before I manage to examine his leg he requested for my phone number again...I got no choice. I gave him...For the sake that I could examine him.
Maybe because I felt guilty that i've checked him for a long time.
He said he'll send me a msg when he is free.Oh my god...I began to feel frightened...But I told myself it's ok as long as i don't reply him.
After examined his lower limb, we went back to hostel.
My friends told me not to give patient our phone number easily. It might be dangerous.
I did feel uneasy, but I thought he wont be able to find me.
After he was discharged, he sent me a message to wish me.
I think it would be cruel if I ignored him. Afterall, he is a nice and friendly guy who allowed me to examine him thoroughly. So I replied him saying thank you.
Even though he does not cause any harm to me(so far), I will be more careful next time.
Haha...

你什么第一名？

牡羊座.衝動第一名，做事後悔第一名，火氣大第一名，大膽第一名，敢愛敢恨第一名。
金牛座.穩重第一名，節儉第一名，貪財第一名，可靠第一名，吃苦耐勞第一名。
雙子座.八卦第一名，聰慧第一名， Crazy第一名，幽默第一名，多話第一名。
巨蟹座.體貼第一名，愛吃第一名，愛家第一名，孝順第一名，多愁善感第一名。
獅子座. 自信第一名，愛現第一名，要面子第一名，品味第一名，風度第一名。
處女座.細心第一名，挑剔第一名，愛乾淨第一名，小題大做第一名，吃醋第一名。
天秤座. 愛美第一名，猶豫第一名，懶惰第一名，善辯第一名，公正第一名。
天蠍座.癡情第一名，扮酷第一名，魅力第一名，冷冰冰第一名，理智第一名。
射手座. 貪玩第一名，糊塗第一名，可愛第一名，勇於嘗試第一名，心無城府第一名。
摩羯座.嚴肅第一名，鎮定第一名，忍耐第一名，認真第一名，保守第一名。
水瓶座. 好奇第一名，好學第一名，創意第一名，另類第一名，創造力第一名。
雙魚座. 心軟第一名，敏感第一名，多疑第一名，愛作夢第一名，胡思亂想第一名。

Interesting Patients

#Patient 2

I was wandering in the ward with Siew Li to find a patient for Dr. S.P Chan's long case.

Then I found this talkative man.

To avoid clerking patient with history not worth discussing, we usually flipped through the diagnosis 1st(DISAPPROVED by all doctors actually). His diagnosis was unclear-->COPD? His presenting complaint was progressive worsening of shortness of breath.And he had history of smoking for many years...

After clerking him, I was intended to advise him to quit smoking.

"Pak Cik, jangan hisap rokok lagi ya...nanti kesihatan Pak Cik jadi teruk..."I said.

"Pak Cik sudah lama tak merokok.Pak Cik akan berhenti."He replied.

"Ok, BAGUS Pak Cik!"I said.

"Tapi...Pak Cik hisap benda lain lah..."Said Pak Cik mischievously.

"Oh...Pak Cik hisap apa?"Curiously, I asked.

"Hehe...Pak Cik hisap puting..."OMG. Interprete yourself.

"Haha...bagus untuk kesihatan.Pak cik lebih gembira macam itu?" I continued stupidly.

He nodded.We chortled.

Crazy Human Doing Crazy Things

Read a ridiculous and absurd news in NST:
A cow, with 5 months of pregnancy, was thrown into the sea by the villagers because they believed the cow was impregnated by a villager.This happened somewhere in Jakarta.
That particular dude was caught having sexual intercourse with this animal. A ceremony was held to drag the pity cow into the sea as a way to discard his sins.
Shit, what law was that? To cover his shames by killing animal?
It was not the cow's fault. Moreover, pregnancy is imposible between animals and mankind due to differences in chromosomes and genetics.
It is the man who should be THROWN into the sea.

Interesting Patients

When I was in my 1st medicine posting at 7B&8B, I did encounter some funny patients.
They really cheered me up in the midst of boredom.
#Patient 1
This patient really impressed me. One day we noticed a Malay old man with hepatomegaly. Me, Siew Li and Chew Keat wanted to approach him. Chew Keat went and greeted him in Malay.

“Apa khabar Pak Cik….boleh tak kami periksa perut Pak Cik ….”

“可以可以。。。这边(in Hokkien)。”

To our surprise, he spoke Hokkien fluently to us. This was the 1st surprise he gave us.Oh my god, we guessed wrongly. Do not judge a book by its cover. Sometimes Chinese might look like Malay and vice versa. Don’t blame us. We tried not to express our astonishment, and continued to talk in Hokkien….

“这边痛吗？。。。”we asked.So we treated him as Chinese.

"一点痛咯。。。” （the exact conversation i ady forgotten)

After some time.....

“wa si hua na lang,bo si deng lang(我是马来人,不是华人)” He suddenly blurted out.

“哈，什么，我们以为你是华人，因为你福建说到很好！！”we said.

"wa si penang lang ma...Hokkien lang cheh..."( i m from penang, many hokkien ppl there)

"真的吗，别骗我们哦。。。”we said.(is it true,dont bluff us)

“是，我的名字叫Awang Bin xx,我有两位老婆，19个孩子。。。你看，他们都来了。”
Yes, i saw his wife with tudung and his children. So, he is a Malay. This was the 2nd surprise.

"我还会说很多语言，华语、潮州、印度话我都会讲，你可能都不会。” （i can speak multi language include Mandarin, Teo Chew, Tamil..you dont even know how to speak)

“是的，我不会。”we said.( yes, we dont know)
I thought he was just bluffing, so we continued to palpate his liver. He was in great pain. Yet he still allow us to palpate. He was a nice chap. We dare not palpate anymore.
After us, Chui Yee went to see him again. Before Chui yee left, the Pak Cik said something to her. She thought the uncle was conversing in Hokkien to her in a way that she didnt understand.She seeked help from me.So i went to him again.
To my surprise again, he spoke Tamil with me. I really didnt know what he meant but i think he was just showing off his ability, knowing that we would not understand at all...
I laughed out loud and answered him"AYA...ILEH ILEh..."
woah...impressed by his multi-language ability.

End of Medicine Posting

This morning just finished my 1st ever short case test.
Suppose this exam was held on 23 Oct afternoon. We were prepared for everything and on that day and went to ward 8 with excitment, not because of the test, but because I could go home on that night. But what came out from Dr Edmund really killed me,"Today afternoon short case is cancelled. Postpone to tomorrow morning.I have to go back to UMMC because my colleague is on leave and there's shortage of haematologist."Immediately I replied,"Sorry Doctor, i need to finish the short case by today......"Before i was able to complete my sentence, he interrupted,"U guys are suppose to stay until Friday. No one is allowed to go home. You guys are mature enough to think about it."I just couldn't control myself.Got so irritated.What about my ticket, what about my promises to my mom...Luckily Michelle wanted to go back Kelantan and I sell her the ticket.We went to buy waffer and eat to ease my anger.
No mood to study the whole night thinking that my plan was ruined.
Only manage to study NK Chew on Chronic Renal Failure coz heard that many ppl got that case...Didn't put a lot of effort on Respiratory System since so many ppl got that system.I thought i would get weird case like rheumato or CRF.or GI case.
These morning I was the 2nd candidate. I was quite nervous. Usually i am not that nervous during exam. For me nervousness is nothing but a killer. But this time i failed to persuade myself as I heard too many horrible stories encountered during short case exam.No matter how hard you prepared, sometimes the Question asked is beyond your expectation. OR even you're well prepared, you lost your word and mind due to anxiousness.
I saw the 1st candidate Hanani came out from 8B after a long wait. OK,it's my turn now.Be cool and confidence.No tremors are allowed.Dr Edmund brought me to a an Indian elderly male in 8A. Shit,Dr Edmun brought us to see this patient before...what was the diagnosis???I couldnt recall. Is it a Lung CA??
"I want you to examine this patient respiratory system".Dr Edmund.
Ok.I proceed with my own pace. I heard that his patient isn't co-operative.but weird he let me to examine.I check his peripheral signs and encountered some problem when i checked his posterior lung.
there was decrease in chest expansion and dullness noted in the middle zone...but no crackles...wait, i think i heard something...unfortunately, the patient started to call the nurse:"i want my medicine...i want my medicine....it's it xx...with xx colour...faster...i want my medicine...blah blah blah........."i couldnt spend much time on this auscultation any more since the time was limited. I presented the case as if it was pointing to lung consolidation.But i was wrong when Edmund gave me a 2nd chance to listen to the lung....shit,there's expiratory rhonchi...how could i missed that...this patient has COPD.(Chronic Obstuctive Pulmonary Disease)
Definitely, you can predict what he would ask me. It's all written in NK chew but i couldn't vomit out all.
"How do u differentiate between asthma and COPD clinically?"
"Tell me more about COPD and how do u diagnose it?"
"What do u mean by diurnal variation?can u elaborate further?"
"What will a severe asthmatic patient shows?"
These were the questions i was asked.
I tried my best to answer.
At the end of the test, he turned to me and said," Ong, theory wise not that good ah...."then i got what he meant.
I dont feel sad, instead i m happy because it's over. Afterall it costs less then 1% to our 3rd year final exam.
Lucky i didnt get any weird case.
Michelle was famous with her Rheumatology case.Winnie got Gout(again Edmund likes to ask about DNA,genetics and Biochemistry stuffs.be prepared with uric acid metabolism) and Shaun got Chronic Renal Failure.Rong Xiang's definitely not Marcus-Gunn Pupil.Tough.
Yay~!it's over~~~

笑死人的十二星座 .....

白羊座 :
妈妈经常叮嘱羊羊： ' 穿裙子时不可以荡秋千；不然，会被小男生看到? 面的小内裤哦！ ' 有一天，羊羊高兴地对妈妈说： ' 今天我和小明比赛荡秋千，我赢了！ ' 妈妈生气地说： ' 不是告诉过你吗？穿裙子时不要荡秋千！ ' 羊羊骄傲地说： ' 可是我好聪明哦！我把 ? 面的小内裤脱掉了，这样他就看不到我 的小内裤了！ '
(勇敢直率、敢做敢为的白羊）
金牛座 :
卖瓜小贩： ' 快来吃西瓜，不甜不要钱！ ' 饥渴的牛牛： ' 哇！太好了，老闆，来个不甜的！ （持家、想出轨又顾全自己的金牛）
双子座 :
妈妈叫双双起床： ' 快点起来！公鸡都叫好几遍了！ ' 双双说： ' 公鸡叫和我有什麼关系？我又不是母鸡！ '
（自我意识强烈、自行思维的双子）
巨蟹座 :
公车上，蟹蟹说： ' 今晚我要和妈妈睡！ ' 妈妈问道： ' 你将来娶了老婆也和妈妈睡阿？ ' 蟹蟹不假思索： ' 嗯！ ' 妈妈又问： ' 那你老婆怎麼办？ ' 蟹蟹想了半天，说： ' 好办，让她跟爸爸睡！ ' 妈妈： ' ！＠＃＄％︿＆＊（ …… -' 再看爸爸，已经热泪盈眶啦！ )
（恋母情结、依恋的巨蟹）
狮子座 :
狮狮去参加奶奶的寿宴。到了吃寿包的时 ? 狮狮问： ' 我们为什麼要吃这种像屁股的寿包？ ' 众人听了脸色大变。 接着狮狮拨开寿包，看看 ?面的豆沙，说： ' 奶奶，快看！ ? 面还有大便！ ' 众人晕的晕，吐的吐。
（以自我感受、不怕旁人眼光的骄傲的狮子）
处女座 :
处处对肚脐很好奇，就问爸爸。 爸爸把脐带连着胎儿与母体的道理简单地讲了一下，说： ' 婴儿离开母体之后，医生把脐带减断，并打了一个结，后来就成了肚脐。 ' 处处： ' 那医生为什麼不打个蝴蝶结？ '
（好奇心强又追求完美的处女）
天秤座 :
父亲对天天说： ' 今天不要上学了，昨晚．．．你妈给你生了两个弟弟。你给老师说一下就行了。 ' 天天却回答： ' 爸爸，我只说生了一个；另一个，我想留着下星期不想上时再 说！ '
（聪明、权衡利弊的天平）
天蠍座 :
蠍蠍刚睡着，就叫蚊子叮了一口。 他起来赶蚊子，却怎麼也赶不出去。没法，便指着蚊子说： ' 好吧，你不出去我 出去！ ' 边说边出了房间，把门使劲关严得意地说： ' 哼！我今晚不进屋，非把你饿死不 可！ '
（搞不懂、不按常理出牌的天蠍）
射手座 :
射射： ' 爸爸，为什麼你有那麼多白头发？ ' 爸爸： ' 因为你不乖，所以爸爸有好多白头发阿。 ' 射射： …… （疑惑中） 射射： ' 那为什麼爷爷全部都是白头发？ ' 爸爸：！＠＃＄％︿＆＊ ! …… （喜欢思考的射手）
摩羯座 :
一天，羯羯跟妈妈上街；走在路上，突然下起雨来。 妈妈拉过羯羯的小手，说： ' 下雨了，快往前跑阿！ ' 羯羯慢条斯理地问： ' 那前面就不下雨喽！？ '
（明白现实懒得改变的摩羯）
水瓶座 :
瓶瓶问妈妈： ' 为什麼称蒋先生为『先人』？ ' 妈妈说： ' 因为 ' 先人 ' ! 是对死去的人的称呼。 ' 瓶瓶说： ' 那去世的奶奶是不是要叫『鲜奶』？ '
（天生的另类、脑筋思考永远和常人不一样的水瓶）
双鱼座 :
爸爸给鱼鱼讲小时候经常挨饿的事。 听完后，鱼鱼两眼含泪，十分同情地问： ' 哦，爸爸，你是因为没饭吃才来我们 家的吗？ '
（富含丰富同情心、不分情况物件的双鱼）

Own World

Sometimes, I just want to be in my own world.
Why? Because sometimes the only and the one who understands me is MYSELF.
I like to be in my own world. No studies. No classes. No conversations. Maybe some musics. Book. Bed. Animals. Yes, they can make me smile.
In my own world, I listen to my own heart. It lets my mind feels depressed and body feels week. Thus, I can fall asleep easily. The moment before I loss my consciousness to sleeping, I think of many things. It seems like i always find an unknown answer in my sleep becoz when I wake up, I feel a lot better!

holiday going to end soon

Happy moments are always short-lasting!
So sad have to go back to the hectic life again.
Next break will be Chinese New Year next year!What a long long way to go...
Wait a moment...isn't there's public holiday for Deepavali on 27 Oct??Hmm...looking forward it...maybe i can go back home?By that time my 1st Medicine posting will be ended.Fabulous!ehehe...

My next posting will be Surgery posting.Heard my friend said this posting is quite free.Usually they just have one hour of class in the morning.Because the surgeons are always busy.And the physical examination and history taking is easier compared to Medicine posting because normally the patients are presented with lump ands bumps which are very prominent.Whether it is true or not i have to experience it myself later.

Talking about medicine posting, actually it is quite fun and interesting.
1st Doctor who brought us to ward round was Dr Sasheela. Even though her voice was so soft and we always thought that we had auditory problem, I appreciate the thorough history taking and PE than she taught us. Even though she didn't spoon feed us always, she's still a dedicated,patient,diligent Doctor and teacher.

Currently our class is taken by Dr Edmund,a haematologist who i think is a funny guy. He got so excited when he successfully made a spot diagnosis of achondroplasia(what's that?)Once,his hobby was observing the crowd and make a spot diagnosis.I believe he has the ability since he seems able to spot Thalassaemia trait in Siew Li.
Hm, waiting forward for this coming week. Because Edmund promised to teach us many things include ECG,CXR,examination of the joints...etc...cant recall.

Exam falls on 20.10.08.Haven't touch all the SPM notes yet...
Had a nightmare yesterday. Again, unable to finish the Questions given n was so panic! this is the evidence that i don't study enough!!