Saturday, September 5, 2009

Back to the ward.

Feels good to be back in the ward again. I went back to medical ward yesterday after being asked by my friends . I will be quite free and relaxing during this semester. Their emotion and facial expression reminded me during the time when I was semester 7. Those feelings when all of us feel lost and dont know what we will be facing in few months time. "This is just the begining......."this words keep flashing through my mind during that period of time.

Well, no harm for me to learn more. I agree to go back to the ward and try to elicit clinical signs from the patient with them. I was glad that I have group of seniors who taught me a lot since I came to clinical school. I believe that without them, I won't have passed the exam. I think this is the time I should help the others, those who will be sitting exam this semester. A part-time lecturer told us in the clinic :" In medicine, you must always have mentor or senior around during your clinical practise, it is impossible for you to know all and you should keep asking and most of the time you need help from others."

The wards still looked the same as last time when I was semester 6. The only thing different was the doctors and nurses. Now it is a compulsory from Ministry of Health for all the hospital staffs to wear surgical mask as long as they are in the hospital, because H1N1 is on the heat now, sometimes you wont realise that you just walk passed a H1N1 patient who is waiting for registration.

Since we were banned from entering hospital a week before exam, I've never been in the ward until yesterday. The feeling was kind of weird :" I am back....." all the doctors and nurses with familiar faces, busy working on the Friday night, I saw a group of doctors and nurses resuscitating a patient on the bed. Although they were all wearing mask, but I still can recognized some of them. I really miss this place man.....As a small kid 20 years back, I remember I always get excited to be in the hospital, whenever my parents went to hospital for health screening, I always wanted to follow. I like the smell of the hospital, I like to work in the hospital. Crazy guy.......lucikly I dont have Malingering or Maunchaussen syndrome.

I miss talking to the patients.
"Pak cik rasa macam mana sekarang?"
"Pak cik sudah masuk ward berapa lama?."
" Aunty, can I check your stomach for a while?"
" Pak cik tinggal mana, dengan siapa?"
" Oh pak cik dulu kerja Army kah?? Air force army!!!! sekarang pencen enjoy life lar...haha"
" Adik, awak ada rasa muka atau badan warna kuning kuning?"
" So uncle, how long have you stopped taking TB medicine?"

I saw an elderly patient with CML (Chronic Myeloid Leukemia) with skin metastasis, which I think is quite rare to find someone with skin metastasis. He looked confuse, his eyes can barely opened. He can hardly speak clearly which I think is because of the obstruction from lymph nodes around the neck. My friends and I examined him. He has massive hepatomegaly and massive splenomegaly. I never felt such a big spleen before in clinical school. Yesterday was the first time and also the first time I saw a skin metastasis. I dont know whether I will see this patient again or not, and I not sure how many time left for him, but for sure I will remember him.

Another case I saw was a patient which I guess has infective endocarditis. Yesterday was the first time I able to appreciate 2 different murmurs from same patient, and another patient diagnosed with Gonorrhea infection with Reactive arthritis aka Reiter Syndrome.
Helping juniors = helping myself. If not because that I followed them back to the ward, I wont be able to see the 3 cases above.

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