14th December 2006 - My attachment here at HKL ended on a "low" note. The 3rd posting was pretty disppointing, to say the least. Got posted to a surgical ward, as you might be aware by now....and frankly speaking, I did not learn much, as opposed to what I got from my first two postings. The number of cases at surgery weren't many, hence there wasn't much I could learn....apart from a couple of "lumps and bumps", acute abdomen (read: acute appendicitis) and peripheral vascular diseases. Ward rounds were much quicker as well; whilst rounds could last up to two hours at Paeds and Int. Med, the surgical rounds normally ended in 40 minutes. And as for the surgeons and MOs.... lets just say that they left a pretty bad impression (to me, at least) after "hanging out" with them for a week. ><"

Sigh.

However....

With the amount of "free" time I had while at surgery, I went back to Paeds and Int. Med. Departments whenever I could. Boy, was I glad I did...the environment was definitely a welcoming change from what I experienced at my designated ward. And yup, I saw a couple of interesting cases too, thanks to my UPM friends [especially Wing Nung who alerted me most of the time =D], which included Henoch-Schnolein purpura, pulmonary atrioventricular malformation, hepatoma secondary to hepatitis B, Corrigan's sign (I swear, the carotid pulse was visible even when I stood approx. six feet away from the patient!!!), cerebellar degeneration secondary to chronic alcoholism and hepatic encephalopathy. =) So hey, things weren't so bad after all!!! lol.

I'm not sure if I'd like to be a surgeon in the future though.... o_O

Alright, time for a quick update on my attachment (Pssst...sorry la, evie. Should be updating more often, considering the amount of free time I have atm. *blushed*) I'm currently on my third (and last) posting at HKL. A surgical ward, no less. Things are moving at a snail's pace for the time being, so there's nothing much to see yet. =( However, it's been only five days spent at surgery, so perhaps I'll see more cases in time to come. Err, hopefully. =P

"But what about the second posting, eh?" you might asked. Well, internal medicine was far more interesting than I thought it would be. For starters, the clinical setting was WAY different from what I have seen at the paediatric ward. While the paediatric department has a new block of its own [The paediatric department expanded so much that it was shifted out of HKL's main block to another building in the early 80s. It's about a five-minute walk from its original site, depending on the traffic and weather =P], the medical ward I got was a lonesome, one-storey block, with a clinic attached to it, and an old folks centre nearby.

One unusual thing I found about this ward is its location - it is secluded, and very much away from the main block. Strange, considering the Internal Medicine department (and all the other int. med wards) ARE in the main building. Not surprisingly, I got LOST on my first day.... so much so that by the time I got to my designated ward, it was almost 0940 (Note: Ward rounds begin at 0800), and I was perpetually drenched in sweat. Talk about "good" first impressions! o_O

Dad joked that the ward I got was probably an old one, with its four walls standing tall long before they decide to build the main block. He might be right. There were times when it was just like a (movie) scene of a WWII hospital: The vast (yet) crowded hall, the alarming number of beds strewn across the floor (not to mention the mounting number of sick patients as the day went by), the ever-so busy medical staff, scurrying across from one side of the hall to the other, treating the sick....*sweats* And no, I'm not kidding nor exagerrating at all. =P

Apart from the first day, my two-week attachment there was, overall, quite smooth-sailing.

I got to see:

1. lots of chronic cases you'd hardly (or rather never) find in kids, such as IHDs, MIs, CVAs, uncontrolled DM, COPDs, chronic liver diseases, Parkinsons, long-standing peptic ulcers and lung Ca
2. a whole new set of acute conditions like lung TB, chicken-pox pneumonia, septic arthritis, malaria, orchitis, AGNs, and various skin conditions
3. two HIV cases - one presented with diarrhoea and explosive psoriasis, another one with cerebral toxoplasmosis. [I managed to talk to the former. It's sad, really...listening to his fears and frustrations]
4. how to insert a branula and draw blood. And I managed to draw some blood too, under the watchful eye of a more experienced, 3rd year med. student. heheheh.

I made:

A whole new group of friends! 3rd year medical students from Universiti Putra Malaysia (UPM) this time around. And what good timing too! Was pretty afraid to be alone initially, especially so after Boon Hui completed his attachment. I cannot imagined what it would have been, were it not for them. It's certainly an honour getting to know them and all. =D

And I got to revise:

1. My clinical skills. *winks* The "3rd-years" I met are currently mugging for their upcoming 2nd professional examination, which consists of an MCQ (or is it SAQ?) paper and an OSCE examination ( which is subdivided even further to long-case and short-case presentations). So I happily joined them....with their consent, naturally. =P It's amazing, watching them at work. THEY'RE SO GOOD!!!! Made me pretty inferior at times. lol!

2. ECGs. At least I am (a little) more aware now of how a NORMAL ECG should look like! =P

3. Chest X-rays. There were simply so many respiratory/CVS cases in the ward that I had quite a lot of practice. =)

Man, this is one heck of an update! Will end here first la....hehehe. More updates later. =D