Congratulations to Batch 22,

Through the hardship of the past month, you have emerged victorious and now have the right to call yourselves Final Year students.

To those who didn't make it, have faith that everything happens for a reason, sometimes you have to do things twice to get it right; but if something is worth doing, then it's worth doing it right.

To those who are going for supplementary, the thought of going through it all again is often the biggest burden, but to quote Winston Churchill:

                                                             "If you're going thru hell, just keep going!"
Take a few weeks off to recharge, come back & be better than you were; you didn't make it not because you're no good, it's because God decided that the challenge was too little for you the first time.

If He has brought you to it, then He will bring you through it. Don't give up.

Happy holidays & make the best of your electives!





On grace and manners;

To quote what was once said before,

Good manners are just a way of showing other people that we have respect for them. 
~Bill Kelly


Every once in a while there are days when we are faced with those with such poor manners, to such an extent that there is no other label to give but RUDE.


Often when it happens, we are taken aback as it's often unexpected. Then there's two immediate thoughts that will then cross our minds, the first one often being,


Was it something I did or said to make you act rudely?


Which is a valid enough of a thought for you to wonder, because you are concerned if it was your doing. But the problem starts when the second thought occurs,


"Setan goreng! If you are rude to me then why shouldn't I be rude to you? Fight fire with fire la friend!"

At which point you will be wielding something sharp out of anger, most probably your tongue.


They may say that the pen is mightier than the sword, but they forget that the tongue can cut so much deeper.


But again, as they say,


Anger is a wind which blows out the lamp of the mind
~Robert Green Ingersoll


Don't stoop down to their level, and never ever do anything foolish. As anger, to quote once again,


Anger is an acid that can do more harm to the vessel in which it is stored than to anything on which it is poured
~Mark Twain


To all those reading this,


I pray, that you may, keep your wits about you, and your grace and manners even closer. Never reciprocate that which is wrong, as two wrongs don't make a right.

Treat everyone with politeness, even those who are rude to you - not because they are nice, but because you are.
~Author Unknown


But if all else fails, always remember,


Treat people as you would like to be treated.  Karma's only a bitch if you are.
~Author Unknown


Sitting at the study table, reading my book became more and more difficult; my eyes started to sting and water.

"Bagus ni, study kuat sampai pedih mata, hebat hebat!"

*Pats self on the back with a smug smile*


Maybe I needed to take a break from studying I thought, since my eyes 'can't take it'.



So I went out of my room to take a breather, and I found my mom busy at work...


With a bag of onions...

Hypnotic!



Chet, patutla pedih, baru duduk menghadap buku 5 minit takkan mata nak pedih!



Hari Raya is close everyone!
Anyone else used to eat this when they were kids? 

Popcorn Perisa Durian
"Makanan Paling Istimewa"

Damn right it is!



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.
Love.

A word so familiar to many of us, experienced by most of us; it's the core of our emotions & is the double-edged sword that aspires us to greater & greater heights, or saps us into the ground & keeps us there.

Love.

I will not teach a bird how to fly, nor will I talk to you about love; It's an axiom that needs no further explanation.

However;

Love From  Above.
Now that's a different matter all together.


It doesn't matter what religion you profess or subscribe to; I'm no preacher & 'to each his own' as they say.

Today has been a day that seemed out of the ordinary; Manipal is not only known for its extreme faculty members & food (Mamak Mee Goreng is manis, Nasi Pattaya die tak berselimutkan telur goreng & here is the only place where you'll find soy sauce that's sour. I can continue this list but takut pitam pulak), Manipal is also known for its extreme weather.

"WHOTT yhu mhean bai y-extreeeme mhaaaan?"
*Use Indian accent liberally here for best effect*

Let's just say the only seasons experienced here is Summer & 'Super-Special-FanTAStic-Exclusive Summer'. Allow me to digress for a while: Indians are proficient in the use of expletives to convey their sentiments about how 'special' something is, regardless if the item in mention was 2 pats of cow dung which came from the same cow, but since we've added the prefix 'special' to one of it ; it has become super-special-magical cow dung. This play of words also applies to situations that involve bargaining & trade:

"Sarrr (Sir), that shoooe looks realllllyyy good on you; the blue & the orange colour give you a veeeery 'cool' look."

The moment a local Indian in a tight orange shirt with bell-bottomed dress pants & slippers tell you that you look cool in something, you KNOW you're in trouble!

"If you buy noooow *jiggles head on multiple axis to appear more convincing*, I'll give you SPECIAL price"

The moment he finishes that sentence you know that that's a huge load of bullshit. Even 2 pats of cow dung cant compare.

Anyways, Manipal is known for its extreme weather; if it rains it rains alot. Plan on getting soaked 6 days a week every morning on your way to & back from classes. Mouldy clothes & shoes are also thrown in as a complimentary gift to complete your rainy season experience. And if it's the dry season, expect zero rain for weeks on end & dust to decorate the interiors of your house & respiratory tract.

But today was an unusual day.

It's the dry season but rains have come as if the clouds are incontinent or suffering a bout of diarrhea & 'maut' winds 'blow like anything' (this is a local Indian proverb used to signify extreme action). Cyclone Phyan has landed on the shores of India from the Arabian Sea carrying with it water, wind & fury.

Basah lagi la aku pagi ni.

A freak wind storm caused quite a scare in Manipal tonight because usually the only potentially fatal wind at this hour are those released from the undisciplined anus of barbaric housemates.

Hehe.

Jokes aside, this cyclone is dangerous stuff. Facebook reports that several people almost met with an accident & trees dancing due to the might of the freak winds. You can find everything on Facebook nowadays; FB is the new CNN.

I guess the cyclone screwed up with my building & caused some structural damage too.

The clock pointed to 11 pm; singing practice was over & it was time to go home. Cheery mood & laughs all around, we bid our goodbyes & made our way back.

A nice slow drive home, raincoat flapping in the wind. Motorbike dies a few times due to the cold weather. I curse like a sailor in the hopes that it'll warm up the engine, but all it did is panaskan hati je.

Haha.

I reached home, avoiding the random cow attempting to cross the road, before entering my apartment's compound & gliding into a parking spot. By the sides of the generator I walk, turning right to reach the stairs & made my way up.

Barely 2 steps left before I reach the top of the stairs, a loud crash was heard below me.


"Aaaiyooooo..."
said the security guard.


A large circular piece of plaster ceiling was in pieces all over the floor that I was at barely 2 seconds ago.


Masyallah. Allah is Great.


I was speechless. I was astounded. Had I been 2 seconds late, or maneuvered around the crossing cow in a bit more complex & elaborate manner, I might have been in time & right on the 'X' where the plaster ceiling fell. Concussion, hemorrhaging, any number of CNS manifestations could have afflicted me. Heck, instead of being the one interviewing the patients of the Psychiatric Ward, I could have been easily the one answering those questions should the head trauma be so severe.

Masyallah.

Despite all my sins; Allah you still love me & I love you too. One can't help but to be thankful to the Creator, for He is the one whom has created us & decides our fate. We may sometimes turn our backs on Him, but never will He ever turn His back on us.



Love From Above.





Is what you've shown me tonight Allah.
Yes.

To the keen-eyed & the critical, the title should've read 'Psychiatry & I'.


But I figured a lil' rhyme at the expense of death by grammar is worth it if it'll make the title that bit more catchy. If it worked for Timbaland then it'll work for me;

After all it's just 'the way I are'.



Alhamdulillah, praise be to Allah the Merciful, I've made it to 3rd year. Congratulatory remarks & handshakes aside, I really am grateful tohave finally made it to my Clinical stage.


No more waking up to go for classes you dont believe in.

No more by-hearting things you cant even see.

No more discussions about fictional diseases.


Because now I am in the realm of reality; the substantial & the concrete.

Cold, hard medicine, at it's best.


It's one thing to read about ascites (collection of fluid in peritoneum/abdominal cavity), & another when you're face to face with a patient whose stomach is so distended insects may confuse it for an anthill, & at every turn of their body and gentle palpation of the abdomen will ellicit a wince of the face & a quiet whisper of pain to escape from their lips.


"Novu aagtade"

"I have pain."

http://tattoos.lovetoknow.com/images/Tattoos/6/60/Woman_pain.jpg

Here, pain has a face.

And she greets you 'Namaskara' every morning & hopes that the hand she's shaking is the same one that'll take away her pain.

Ascites is no longer a line in a textbook, or a picture on an OSCE slide; it's walking, talking, & eating. It may have 4 sons & 3 daughters, it may have a history of hypertension, it may also lie about its smoking habits only to be betrayed by their nicotine stained-smile.

Here, ascites is a person.

It feels good to finally put a name to a face. It starts to make sense when & what certain drugs are used for when you see their packaging strewn across the bedside table & hanging off the i.v. pole. You feel good when your finger throbs in pain from the percussion you performed on a patient.

I do feel bad for the patient at times; having to endure our constant prodding & enthusiasm for examining their bodies. I thank them for their patience in answering our repetitive questions when we're trying to document their history. For tolerating our broken Kannada; I know how hard it must be to not die from laughter at our grammatical mistakes (more like grammatical disasters).

This was one month ago, during my Medicine posting at rural Karkala hospital. Bitter-sweet times, I think I'll miss it the most. Though we lived in constant fear from being scolded in front of the patients, it was my initiation & transition into the Clinical world. And like all first loves, you never forget them.

I'm now posted to Psychiatry at KMC Hospital. A hospital so big & twisted I think it moonlights as a maze in its free time. Apart from learning the theoretical aspect in classrooms, we're also expected to do our rounds in the patient wards.

Ward D4. Famous for its residents. The mentally-ill reside & recieve treatment here.

There's only one way in & one way out; and that said portal is framed by a locked metal door. A security guard with a curly mustache holds the key; I am of the opinion that the mustache is the source of his strength. Windows are barred with a grill & no sharp objects are allowed inside.

On my first day to the ward, I knocked 3 times on the metal door. A mustache hovers into view in the door's porthole followed by a face & a critical eye looking me head to toe.

"Tak gila kut", he seems to think.

And I was granted entry.

On my left, an old lady with a green sari greeted me by rocking back & forth on a stool, all the while mumbling to herself & making facial expressions to go along with it. On the opposite wall a girl was giving me the eye as I passed her. A warm welcome indeed.

I walked on with the hope of finding my classroom, which I was told was at the end of the ward. Judging from the seniors' stories about this place, to get to the classroom was like going through a baptism of fire; sometimes you get stopped by the enthusiastic Aunty whom asks you if you're 'the teacher?'. It's also the same Aunty that insists you take her BP measurement just for fun. At other times you may get a man whom has a penchant for Chinese girls & will ask them out to watch Hindi movies together; reject him & you will earn the privilage of getting a banana thrown your way.

I passed a group of carrom players, all of whom stop & raise their heads to gift you a sweet & innocent smile as you approach them.

Just the other day, we were having a class in the classroom by the ward. Suddenly a loud banging & crash blew the thick old wooden doors wide open. Immediately 3 girls did an interpretive dance as a way of expressing their shock & fear (names witheld to protect the sanity of the dancers, nyuk3) at the intrusion. Some of the dancers stood up & did some fancy footwork while others even incorporated the chairs they were sitting on as part of their repetoire.

Hehe.

The 'gatecrasher' strolled in slowly into the small classroom, lending suspense to us sitting at the back of whom our view was obstructed by the old wooden doors until the gatecrasher strolled clear into view. He was of average built & nutrition, dressed in kain pelikat/sarong with a shirt, eyes half-open & with a drowsy look about him. A 3-second pause followed before he issued a very meek "sorry" before turning around & exiting the classroom.

Fuh, what a day.

It may be amusing to read & watch their antics, but never forget that they are still people. Your cynical smiles will still register with them & eat away at their being much like how you'll laugh at a child for his foolishness when he tells you it rains because the clouds are crying. In both situations you willl make the patient & the child cry, the only difference being that the patient cries on the inside.

Psychiatric patients are no less human than you or me, & that their quirks & oddities should be embraced & studied. These people need our help & the stigma attached to them should be abolished so that they may be one day treated & rehabilitated to restore them to the people they were pre-illness,

Or to the people they would have become have they not been born with their illness.

The Reading Habit

An Introuction

Hello & welcome, from me to you.

Talking Shop:
If you talk shop, you talk about work matters, especially if you do this outside work.

But anything goes really.

Hope it's as pleasing on your eyes as it was for me typing it out.

Thank you & enjoy.

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Shop Talker No.1

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Kuala Lumpur, Malaysia
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.

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About me

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.

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