Psychiatry

This year is a psych year...ever!
I've been doing psych attachment for more than 2 months!
Even longer than O&G, Medicine and Surgery!
Yet, I still be in this blankness and perplexity.

Funny how people afraid to judge others when they've been asked to but willfully judge people in subconscious state.

In judging others, we expend energy to no purpose...But if we judge ourselves, our labour is always to our profit.

Thomas a Kemphis

Ya Rabb, grant me the strengths!

KAMI

To Mahasiswa Biasa,
Anda telah membuatkan saya malas nak balik ke Malaysia.
Terbayang apa akan jadi kalau saya bekerja di sana nanti.
Saya takut kalau semua orang berfikiran seperti saudara.
Kami akui kami kurang pengalaman, kurang praktikal.
Tak sudikah saudara dan kawan-kawan mengajar kami?
Buruk sangatkah perangai kami terhadap pesakit, sampai golongan kami dipanggil golongan kurang ajar?
Kalau kami kekurangan ajaran, tak mahukah saudara dan rakan-rakan mengajar kami?
Soalan saya; mengapa saudara menggunakan nama Mahasiswa biasa? Kami luar biasakah?
Takpalah, itu pendapat saudara.
Kami janji, kami pulang nanti, harap-harap apa yang saudara jangkakan tu, tak menjadi realiti.
Kita jumpa nanti.


(maaf kalau ada yang terasa dengan entri ini, saya terkecil hati sahaja selepas terbaca email kawan kita ni.kejap lagi besarlah balik hati saya eh =p )

courtesy from http://nonowrites.wordpress.com/

The End of Fifth Year

(from previous entry)

4th station
You are a TI in one of the GP practice.A mother concerns about her son who has poorly controlled eczema.

GP station.Fuh,tough.But I should be able to do this.Eczema.Pretty random!Come on,Huda.You have been to eczema clinic with awesome Debbie,the eczema nurse.Argh, kenapalah saat2 begini tak berfungsi minda ni?Tarik nafas.Fuh!

5th station
Alamak! Dr.Stace is here~He is my guru!Salute him!Dr.Rajapakse is here too,accompanying Dr.Stace.Gabra2!Relax Huda!

This gentleman comes in as he complains of being fat.Attached is the lab results for him.Take a focused history and you will be asked few questions after 8 minutes.

I have to admit, I could have done this better.Way better.Sigh~

6th station
"Ok Huda.You are meant to take history from this gentleman who complains of pain around his abdomen started 2days ago.But, he is gone to the loo.Shall we wait for him?We will give you extra time,okay?"

What?Extra time?That isn't possible!The timer is outside,Sandra, she will never know that I start late.When it's 10 minute, I have to get out from this room and move to the next one.How can I get extra time?Impossible, Dr.Larsen!Argh~~~
Alhamdulillah,as I grumbling about, the patient came in.Really, wasnt his fault at all.Nature calls.

OK,you have to take a focused history and perform the abdomen examination.You have 8 minutes.

Huh,as I thought!No extra time.Takpalah.

7th station
Oh,My God! Dr. Elder and Dr. Whiltshire.Peads!Fuh!Nasib baik bukan Dr.Stanley.

This mother comes in as her daughter,Hayley aged 18 months does not gain any weight since 6 months ago. Address her concern and you will be asked to give the summary of your findings and provide a diagnosis.

Very vague.My history taking was crap!Padahal,baru saja lepas peadiatrik modul.Bagaimanakah???

8th station
Dr. Wong and Dr.Raymond were there in the room.OK,must be general med station.Eh,wait, I know this patient.I had him during my General Med OSCE.Bad history I would say~Heh!

Examine this patient's cranial nerves 2,3,4 and 6.Report the findings as you proceed.You will be asked few questions at the end.

Good Lord!I just practiced this with Ana and Mel.Alhamdulillah.Just remember not to confuse Right and Left.

"I would test his visual equity using the Snellen Chart but Im not going to do this now." "Oh,wait.There's a Snellen Chart here.Probably I need to test your vision then."
What the heck!You should check the box first,Huda. Alamak, macam mana nak guna hand Snellen Chart ni?Adoi.Tulah,dulu asyik mention jek,tak nak buat betul2.

9th station
Yeay!Finally!Oh Allah! Tak sabar ni.

Erk! Dr.Maharaj~~~Orang kata dia adalah garang.Intimidating!

This lady presents with 10 years history of incontinence.You have 8 minutes to take history and you will be asked about the management.

Lovely lady,I would say.Alhamdulillah.

"OK, Huda.Tell the patient how would you manage her?"

"....and also we could offer you some medication,Im not quite sure how we give it to you but it will help you overreactive bladder."

"What medication you you give her?"

"Oxybutanin."

"What?How do you know about this?Where you read this from?"

"..err...err...err..."

"This is pretty new.You could get distinction,huh!"

In my mind: "Dia ni perli aku ke apa?Keep the straight face,Huda.Persetankan dia."

"OK, for long term management,what would you do?"

"We could offer you operation..." tetiba kena potong.

"What?Operation?Who are you to perform the surgery?You are a TI.Not a surgeon.Come on, How would you manage her in long term?Come on,come on."

"..err..admit her to the hospital...?"

"No, no,no!"

"..err...err...refer or discuss with my consultant???..."

"No,no,no!Come on, You have ruled out this from your history just now!U know this"

"..err..."

"Time's up!You may leave now!" I can see the frustation in his face.

"Wait, I would refer her to the urology department." and he didnt bother to listen~~~Afterall, my time is up!


----> The end of OSCE.I looked around, searching for a shoulder to cry on.I saw Dylan.Perfect!Would borrow his shoulder.Oh,No!Bukan muhrim.Owh,How I wish Ana or Mel were here to hug me.To comfort me!

"Huda, are you alrite?"

"Noela, thank God you are here.Can you hug me.please?Really need it."

"Sure,Hon"

..and I cried!

(Syukur pada Illahi)

The End of Fifth Year

5 years being here in NZ;3 years down in Dunedin, 2 years up here in windy city of Wellington.

27th October 2007 - Saturday
Huda Zakari - Student number 10, in Group 1 (purple). Starting point will be rest station.

Lengkap tertulis pada slip peperiksaan yang kami terima 2 minggu sebelum.
First group, start with rest station,which means I will not have any rest station while doing this OSCE exams.9 stations without a break.Would be tough!And it was!!!

Ini lakaran yang berlaku pada hari Sabtu,27 Oct 2007:

1st station
You are a TI working here today, this lady comes in to have a discussion about her Fluoxetine medication.She is planning to have a children of her own.Attached is the information sheet for SSRI usage in pregnancy and breastfeeding mother.Address her concern.

Well, at first,I thought this station was a GP station.Sweet!I can nail this!Owh,wait.I didnt know about SSRI in pregnancy.Alamak!Im screwed!OK,Huda.Ini untuk masa depan.Berusahalah!Ya Allah, tolonglah hambaMu ini.OK Huda.Baca je apa yang dia tulis tu.
"Hi there.My name is Huda and I am a trainee intern working here today.Is it okay with you to spend sometime taliking to me?" My opening for every station we had that day,or every time I did my OSCE practices. =) TYPICAL. Ayat hafal! =p
Nasib baik the lady is very nice.
It turned out that station was a psych station! Oh, Lord!

2nd station
You are a TI in surgical outpatient clinic and Mr. X comes in after being referred by his GP. He has been noticing blood from her back passage. Take a focused history and you will be stopped at 6 minutes.

Sweet!Surgery station.You can do this Huda.You just revise this with Ana n Mel yesterday evening.You were the patient.You know what to do.Shine Huda, shine! Mr.Keating was in the room with his registrar. He was the one who responsible to my palpitation.No kidding! He was!
Alhamdulillah, the history part was great.

Next task:Please explain to Mr.X that he needs to have a colonoscopy.

Isk, tetiba mindaku dikatup. Blank! I was stucked at the complication part.And, most important thing,I forgot to say about the biopsy part.Alahai,dah sah2lah kalau masukkan endoscope tu akan dibuat sekali biopsy.Huda,Huda. Mr.Keating said,"Well,there's a lot of things you can do while doing the colonoscopy,you know.Especially in patient that we suspect to have cancer.You may leave now." DUSH!Aku diperli oleh Mr.Keating.

3rd station
Aku berlari ke station 3.Punyalah jauh jaraknya dari station 2.Isk.Dahaga sungguh. Aha,ada sterile gell di luar pintu.Examination station.Apa agaknya menanti di dalam.

Mr.K presents with painful left knee.Perform the knee examination in 5 minutes.After that you will be asked to explain something to Mr.K.

I didn't recognise the examiners.Very unfamiliar faces.No written vignette.And, did I hear left knee?not right?How am I going to do the left side examination when the bed is stuck on the wall?Ok, better ask again."Sir, your left knee is sore,is it right?" "emm,yes.The left one."
Okay,Huda.Put up with it.Look confident! Sigh, of all examinations, why knee? I prefer shoulder over knee.Oh,my Lord.This is my weakest examination.Help me,Allah! Personally, I think I did badly.I could see the examiners looked so angry.Nevermind,Huda.Just proceed to the next task.

Explain what is wrong with the Xray result and address his concern.
Fuh,I'm done with the 2surgery stations.Move on,Huda!


....to be continued (too long to put under 1 entry)

My heart~~~

LUBB DUBB

Sadness is beautiful,

Loneliness is tragical.

So help me!I can't win this war.

Touch me now don't bother.

If every second it makes me weaker.

You can save me from the man I've become.

Looking back on the things I've done.

I was trying to be someone.

Play my part.Kept you in the dark.

Now let me show the SHAPE OF MY HEART.

Really,what is the shape of your heart?What is the shape of my heart?Does the heart have a shape?How many heart shapes are there?

Can't help but to hear this song playing over and over again when Dr.Aitken lectured us on Heart problems in Paediatrics thus afternoon.My mind switched on it's radio when he mentioned "Kids with Tetralogy of Fallot (pronounced as fallo)will have boot-shaped heart.The apex sort of turn upward.I know it's hard to see a boot here, but you have to take my words for this".Then, this BSB old song keep on playing in my head until now.

I still remember last year,when we had a session with Dr.O'meghan from Hutt Hospital, he asked what a heart is?All boys (I mean it,not exagerating) and minority of XX answered "heart is a muscular structure,pumping blood to the whole body,supplying oxygen, blablabla...". And, not surprise, majority of the girls answered heart as an organ that tells you the feelings.

Anyway, this entry is about SHAPE of the heart.Nothing else.Iskiskisk, we can talk about this tiny little organ forever.MasyaAllah~~~ (ia kecil, ia gagah!).


Apa lagi bentuk yang ada untuk si hati (atau si jantung?)

Egg-shaped heart is for Transposition of the great arteries.
Real egg heart =)

Snowman heart is for Total anomalous Pulmonary venous return.

Ok, lepas ini,pakat ramai-ramai tengok chest x-ray dekat cardiology department or paediatric ward, look for these shapes of heart,aye!

Study time!