MD year 3

And year three of my MD programme just ended in the blink of eye. So, it's good to jot down all the funny and interesting incidences that happened during my first clinical year in hospital. Happiness, grievance, anxious, anticipation, disappointment, euphoric are the words that best describe the moments, either hard or sweet, that I've gone through during this period of life.

1. O&G
My first ever clinical posting begins with OG, which stands for Obstetrics and Gynaecology in full. This is indeed an awesome posting, which I got the chance to practice on my hands-on skills the most. In a week of five days excluding the weekends, we are allocated in few areas comprising of clinics, wards, OT room and labour room. In the wards there are a lot of cases in related to labour as well as prelabour eg pre-eclampsia, gestational diabetes, placenta previae, fibroids, hyperemesis gravidarum, PCOS etc. Through clerking (tho what we usually did was just chit chat with the patient) the details of the patients are soon revealed. Bedside teaching and self studies are the way I used to secure all the knowledge in my brain.

One thing that makes this posting unique is labour process. I bet this is the top eye-opener for a newbie in medical field. All we did in labour room was to observe, observe and observe. And sometimes, we need to survive through the grudges and even complaints from the fierce-looking 'mi si' aka nurse or the female doctor who was always in mood swing condition, and we nicknamed them PMS sufferers lol. Our relationship has been like Tom and Jerry, whereby we medical student as the mice, must always be smart enough so that no harm can be imposed by 'Tom'. Despite all these funny relationship, the most valuable moment one can observe in labour room is when you see the baby's head is crowning, few seconds later they arrived safely into the world, vowing their arrival with loud yet sonorous cry. Later on the father will hold his baby with his lips slightly vibrated, to which I believe it is the act of praying and chanting to the God who blessed their family with new life. Perhaps this is the first ever thing that a new daddy can practice on his fatherhood I guess? Well I shall learn it when the right moment befall.

2. Pediatrics
Well the moment I stepped in paeds ward, I was astonished and anxious. All I saw were baby crying, looking ill, or even with dismorphic features on their face or bodies. Parents, with majority mothers, hold their love on the lap with grievance and shedding tears of sadness. I'm the uncle to my two year old nephew, and all I want for him is to live happily and most importantly, free from any diseases and suffers. So, initially my heart can't take it when I see a Downs baby with parent worrying their child's future mental development; a nephrotic baby with gross swelling on face and genitals; a meningitis baby with frequent attacks of seizures and stiffness; or a congenital heart disease baby with cyanotic face that can't feed orally just like other normal child can do. Child are supposedly linked with positivity, vibrant, optimistic and whatever word that brings the good meaning, but this naive thought of mine just vanished and broken into pieces when I entered paeds posting. So, to the staffs that work in paeds department out there, I salute y'all! All are unnamed Heroes/heroins indeed.

Nine weeks of posting ended before I realized it, and there's one particular girl that I remembered vividly. She was a ten year old kid suffering from rheumatic fever. Thanks to her I auscultated murmurs for the very first time in my medical training. What makes she stands out from the masses? I noticed her hospitalization throughout my posting, until the last day she never been discharged. This  has triggered my curiosity to further discover her stories behind, and through questioning I found out that she was actually the sixth(?) siblings in her family, because of the big numbers of children, her parent seems didn't pay much attention on her. I hope they are just merely busy to earn a living that let their daughter laying in the wards for such a long periods, without visiting her even for one single time. All the times when I walked around her bed, her only companion was her elder sister that came to hospital after class. I pray in my heart, wishing her to get discharged as soon as possible with no recurrence and least complications from her diseases. Stay strong and healthy! To the girl with brave heart.

3. Internal medicine
If you have ever played some fighting/adventurous game, before you level up you must always beat the strongest enemy aka the big boss. To me, IM together with surgery, are among the two biggest big bosses that one can encounter. Unlike OG and paeds which you can focus on few diseases, there are basically no borders in learning the art of medicine. Despite the must-know diabetes, tuberculosis and hypertension, one has much more enormous knowledge  to be learnt and mastered on. Flicking through the thick textbooks, highlighting the important phrases, making own notes are the things we do everyday with tired mind and body after whole day of classes and hospital sessions. I had all these bad impressions on IM before I enter this posting. Ironically, things always turn up differently from what you aspect it to be. True that one must read a lot in this posting, but at the same time things that you can learnt from the IM wards are countless, indispensable for the rest of your lives as a doctor.

I have two tutors that evoke my desire to persue more knowledge in IM- Dr Zamri (who currently works in HSNZ as a specialist) and Dr Hashim (who owns a clinic). The former is a dedicated doctor that shows enthusiasm in teaching and nurturing young future doctors. He will grab you in the ward to examine patient with murmurs, hepatomegaly, or with finger clubbing during his ward round. This inevitably give you the chance to learn more clinical presentations and have them sealed in your mind. From him I know that patient is our biggest and most valuable textbooks. The latter, who was well known for his strictness, never fail to impress me with his vast knowledge in medical. Each time I fail to answer his questions, besides the word 'rubbish', I earned new things. And this will never ever be forgotten after being 'tortured' by him. My deepest and most sincere gratitude to both of you, Drs.

4. Surgery
Here comes my most favorite posting-surgery! TADAA! The one and only one reason for this, it is direct, direct and direct. You don't need to grill your brains to get the answer, just by observing the anatomical position, you can easily generate Ddx and even Pdx just on the spot. Acute appendicitis-you can know by just asking few questions and do some bedside test; hernia-you can know just from observation; obstructive jaundice/DVT/head trauma-you won't missed it unless you're blind. In OT session, we get more chance to revise on what we have read earlier on by seeing what the surgeons cut out and which layer they excised. Moreover, I'm blessed with many humble surgeons that let us to stand beside (ya literally besides) him during the operation. What else can you complaint of?

After finishing this posting I've finally get an epiphany on my future direction. I wish to become a surgeon that operates in the OT. There's no better curative measures for any diseases in the world other than surgical intervention (provided that they are excisable and operable). I will certainly work hard in this direction and may my dreams come true one day. Holding a forceps and scalpel, performing suture on the wounds and see patient recovering in a promising speed and condition will be my ultimate goal to be achieved in the future. Aren't they awesome? =)