The following is an interesting case history which I heard from my father two days ago:

"A 9-year old girl from Temerloh (in Pahang, I think) was brought into my clinic on Saturday morning. Her worried parents (who accompanied her) claimed that she had this abdominal pain in the last eight days. It was initially around the epigastrium, then it radiated to the suprapubic region. The pain was intermittent and became progressively worse as the days went by. The girl also complained of anorexia, nausea and loose stools. She did not have any problems urinating...."

"Her parents added that they had been to numerous doctors in their hometown. All diagnosed their child as 'having wind', and advised them to use medicated oil to alleviate her symptoms..."

"On general inspection, she was in obvious pain. Her temperature was slightly raised (low-grade fever), and on palpation of the abdomen, the suprapubic region was tender...."

"The two differential diagnosis I could think of at that time were: 1. acute appendicitis, of which the inflammed appendix is behind the rectum (retro-rectal appendix); 2. urinary tract infection (UTI)..."

"I requested a urine sample. Her urine was clear and later found to be normal (through the dipstick test). UTI has been ruled out, and that left us with the first diagnosis, which is a serious matter if no immediate action is taken..."

"Without further ado, I informed her parents about my findings and diagnosis, wrote a referral letter, and advised them to send her to the hospital immediately. There was not much time left, as the surgeon I referred her to might not be around by noon...."

"The trio left for the hospital...."

"It was a while before I received a call from the surgeon. The man said that the girl had been operated on, and true enough, it was acute appendicitis (retro-rectal). He went on saying that her appendix had in fact burst, but the contents (fortunately) did not spill into her peritoneum. Rather, the inflammed structure collapsed, forming a localized abcess. If it were not for my immediate referral, further complications might ensue, and the young girl could have died..."

I was naturally struck with awe. 'How did you know it was appendicitis, when this was an atypical case?', I asked him. He just shrugged it off, and answered that he had only seen about 3-4 such cases in the last 30 years of his medical career. Working experience, he said, taught him a great deal of things, and went on emphasizing that doctors make mistakes at times - "the one thing that really counts in medicine is LEARNING from one's past, and not repeating them tomorrow...."

Exceedingly proud as I am of him, this story nevertheless worries me a little. I am now in my third year, and there is still so much more to learn (in med. school) before I graduate. Burning questions remain:

What have I learnt so far in IMU? Where do I stand? Am I "people-person" enough (I highly doubt this one lor) to be what it takes? Can I cope with the load? Is everything I do now worthwhile? And can I adapt accordingly when situation calls for it....like water can?

More importantly - Is medicine my true calling??

Though I have always dreamt of following my father's footsteps, and yes, I am aware that there is always room for self-doubts, these uncertainties are now taking a strong hold. And judging from the way conditions are at the moment, they are here to stay....

...for a while. There is still hope now, isn't there? And I'd very much like to believe that. =p

Meanwhile, I shall anticipate THE day when muddy waters become clear and self-doubts dissipate; when I can stand tall once again, able to look at the Past straight in its face and declare, "You know what? After all the blood, sweat and tears...IT'S WORTH IT!!"

That day WILL definitely come. I know it. T'is' only a matter of time. And heart. *grins*