The Pearls & Pitfalls of Medicine


My Medicine lecturer / Cardiologist, Dr Punit Bedi, asked us to write about the pearls and pitfalls we've encountered during our time in Medicine posting, would just like to share some of mine.

To be perfectly honest, Medicine and I did not get along well when we first met back in 5th semester in Manipal. At that time, the pitfalls were many and the pearls came few and far in between.
I was very excited to have finally met with patients but the excitement was soon replaced with frustration as the language barrier and sheer volume of medical knowledge to be gained before any encounter with patients became meaningful. This continued well into my 6th semester as the random elderly Chinese gentleman with minimal command of Bahasa Melayu still posed the same challenges in language barrier.‘What’s your differential diagnosis?’ became the most dreaded question to be posed, especially so when my group mates had already rattled off the few diagnoses that was kind enough to pop into my head.
Came 7th semester however, things gradually but noticeably changed as the myriad pieces started to fall into place and history taking and examination became smoother. It was the change in attitude towards learning and more independent ward work sessions that allowed me the time to catch up. I loved the challenge posed by each case as not everything is straightforward but almost everything had a pattern; the beauty of medicine was that you have to really look and listen before you can purposefully act. One of the pearls came to me when my lecturer said the following words of wisdom,
 “The aim of history taking is not to come to a diagnosis, but to formulate the management for the patient; diagnosis may come at a premium and sometimes may not even come at all! But, the patient regardless, still requires treatment; that is the function and duty of a doctor”
It was also at this time I found the human heart intriguing with its various presentations screaming for attention when something’s not right. I sometimes do however feel guilty when a murmur is detected as the joy of detecting a finding but at the expense of a pathology borne by the patient conflicts emotionally and morally; how can the patient share my joy of finding a clinically significant pathology which is in his own body?
While clerking a leukemia patient, I too became aware of the dangers of radiation and was dismayed by my own country’s eagerness to delve into the radioactive rare-earths industry in the pursuit of monetary gains; no amount of money can blur the image of the elderly Chinese gentleman while he struggled to explain to me his condition through shallow labored breaths and fighting back nausea.
I loved my time in Medicine posting, as it was when things made sense and the time spent with people made it worthwhile. This is why I decided to become a doctor, to help people.

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Doctor by profession, but generally very lazy in real life. Hailing from Kuala Lumpur, and with the exception of a few years, I'm mostly made in Malaysia. Currently serving in Kota Kinabalu, Sabah (Malaysia) as a Neurosurgery Medical Officer, discovering and enjoying this blessed 'Land Below the Wind' since 2012. Let's talk shop.