May 18, 2008

Double Dose of Surgery

Fridays for us are normally non-hectic days, sometimes we won't even have any classes on Fridays. But this week is a totally different story altogether. I had a double dose of surgical rounds; cardiac surgery and also general surgery. Go figure I was zonked out by the time I reached home later in the night...

First up; cardiac surgery. It's actually a part of the general surgery cycle, like thoracic surgery that we had that day. As we were only given only 2 weeks for each of these minor subjects, there wasn't much to see. But we have seen is enough. I mean, I have seen enough to say that no way I'm gonna be a surgeon of any sorts. I mean, I love surgery, but to do it day in day out, having the patients lives in your hands literally, would just be too much for me I guess. But then again, maybe it's too soon to tell. I might have a change of heart once I'm done here, and then again, maybe not. Oh well, we'll see...

The cardiac surgery department is in the same building as the urology and nephrology departments. We were shown the OTs (operating theaters) and the ICU (intensive care unit) wards, where some post-op patients were hooked up to several machines to monitor their vitals. The day before, we've had a lecture about valvular diseases and valve replacements. And so when our assistants showed us the tools and equipments that they are using for the surgeries it made perfect sense for us. I can now say that I've held a biological porcine valve in my hands! (Ok ok, it was in a bottle, so no need to samak or anything like that alright!)

At the end of the show and tell rounds, our doctor assigned one patient each for us, and we have to talk to the patient, do a physical examination and stuff, and she expects us to present our cases next week. I was lucky that my patient was very obliging and he was in a stable condition. He had a coronary bypass and was in his 10th post-op day with no other complications apart from fluid in his pleura which I had the chance to see it myself while he was doing his ecocardiography. At first he was quite hesitant to answer my questions, but after talking to him patiently he began to open up and was being very sweet indeed. You know what I've long since realized eversince we started our clinical rounds; that patients respond to you more if you could relate to them, treat them like their human not just a nameless patient, and have tons of patience especially if they were a bit grumpy in the beginning. Sometimes they are lonely, and sad and depressed, so they would be unwilling to talk to people especially to those nosy know-it-all medical students. Eventhough for me here language is a barrier, but with my level of competency I am still able to get enough information from my patients. Most of the time I would beg their pardon for my paltry command of their language, but almost all of them just shrug it off and said that it didn't matter, as long as we can get the message across with basic words. See? Sweet aren't they?

Next up; general surgery. Well, actually this was optional. But I had the chance to do oncalls with our main prof, so why waste it right. One thing that I love going on rounds with her is that she'll show us some interesting cases and let us see and talk to the patients as we please, just as long as the patients are not complaining of course. By the by, even met my doc-in-charge of our group for normal surgical rounds and he asked me about my friend. Before you jump into conclusions, this was what had happened:

Last week, a friend called and asked for the procedure to see a doctor here, because one of her friends is experiencing pain that was ulcer-like and it's getting worse by the day. You see, he has been having this pain for almost a month now, but he was too scared to g to the hospital to seek medical consult until he couldn't stand the pain anymore. So, I told my friend that I would talk to my doc, and when I talked to my doc he told me to bring the friend over so that he could have a check up. And when he came, my doc said that he needed to have an abdominal x-ray done to check for the cause of the pain upon physical examination that was not indicative ulcer. And after the results were in, he told us the news; the friend's x-ray showed 3 possible differential diagnosis; Appendicitis (which the doc didn't think so), Meckel's diverticulitis, or Crohn's disease which is in the acute phase (this was what he suspected). And as his white cell count was elevated, the doc suggested that he be admitted to the hospital for further investigations and monitorization. At first he said okay, but later on he freaked out and refused to go back to the hospital, and last I heard he's already flown back home to get medical treatment there. The doc had actually advised him against it because the friend was in a critical acute state, but like how they say doctors are the worse patients, it's also true that medical students are the worse patients too. He refused to believe that he was that sick, so he wanted to go back home and confirmed it. Tough. I've nothing to say anymore. It's his decision at his own risk. But I feel that that was a really unwise decision. Thing is, having had classes with my doc-in-charge, I could really say that he is a really good doctor and surgeon and knows what he's doing. He has a fellowship from UK, for goodness sake. And he never made us feel like we were some low life students, in fact he made us feel that we were a part of the team (but only if we made an effort to show that we're interested in medicine, that is). So, imagine how I felt when he said that maybe the friend didn't feel that they were good enough for him. Malu giler, siot...

Well, after the interesting rounds, our prof told us that if we were interested there was going to be an open appendicectomy operation for one of her patients conducted by her resident surgeon. I jumped on the chance and so stayed on to watch the surgery. Real cool. But I was more impressed by the anaesthesiologist actually. She was so calm, cool and collected even when the patient had some complications and they were unable to intubate him because he has respiratory problems. Hmmm...interesting prospect. Another choice for me; anaesthesia perhaps? Pros and cons from you is highly appreciated :) ...

So, when I got home I was so hungry but was too tired to cook anything. Imagine my surprise when Pinky was in my place and suggested we go to McD for dinner/supper. I thot, whaddahek, haven't had a proper meal for the past one week now. It was kinda nice walking around town at night in the cooling spring breeze. I wish that the weather would be as beautiful as this; not too cold and not too warm, but I have a feeling this summer is gonna be the hottest ever. I just hope that they won't have floods this year, not like last 2 years where the floods had practically closed off the roads and train tracks to the capital. The reason for the panic? We had to take the flight back home from the capital, so to miss the flight home is a suppposed nightmare for us here.....tak kira, nak balik jugak! At the time, some were even considering hiring boats to cross that part of the country that was flooded so that they could get to the airport on time, hehehe.... Oh well, luckily the flood subsided and all of us managed to catch our flights and arrived home in one piece....



Oh, and in McD, this was what I had:

and for dessert, this was my obvious choice...


"It ain't heavy, it's my dinner..." Abis ler keras arteri koronari ku....

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