Finals Fantasy - Amateur Transplants

End in sight

8 minutes. 8 ECGs. I was screwed for time. Ironically my heart was beating so fast at that moment. Where’s the ECG machine when you need one?

It was indeed a challenging (ie I might fail) OSCE set, 12 stations of totally random stuff. I guess since I’ve technically finished the ‘theory’ part of medicine, everything’s fair game.

“What advice do you have for me regarding contraception,” the young lady asked.

“As you are well aware, there are a huge range of methods available nowadays,” I started my typical opening schpeel.

In truth, there were a few good stations and a few calamitous ones. All in all I hoped I did enough to warrant at least a credible pass. At this point I couldn’t care less about my grades.

A certain friend described my current situation perfectly.

Burnout.

Idiocy

“Doctor, I’ve been having hallucinations, of a woman in my room. I know she’s not real though,” said one of the actors in my OSCE station

Great. Just great

“Err, tell me more,” I stalled. I had no clue what was going on.

“I think you have schizophrenia,” I blurted out for some reason.

The invigilator groaned. So did I.

I rambled on.

“Yeah, and my wife says the memory ain’t too good nowadays,”

That was the clue. Memory. Hallucinations.

LEWY BODY DEMENTIA.

“Ok ignore my initial diagnosis. You don’t have schizophrenia. I was being daft. I would like to do further investigations in order to confirm my suspicion of dementia,”

Good save. Good save.

True-flu-blues

With exams starting Monday, this weekend was reserved for the last minute cramming that so often gets me through these dreaded exams.

Instead I spent both days under the covers of my duvet, trying to keep warm as the flu hit at an opportune time.

“Bedrest and fluids and vitamin C!”, says mom. Who am I to disobey?

Have faith.

Advice for our aspiring doctors

"Abang dah final year. Ada apa-apa tips tak untuk kami yang baru-baru ni,"

I looked at their faces. Eager, so full of hope. I couldn't let them down.

" I have one tip for all of you. Get out while you still can,"

I turned away from their stunned faces feeling pretty proud of myself.

Messed Up

Empathy.

As medical students, one is taught to be empathic towards patients. In OSCEs, it is common to hear phrases such as, “that must be really hard for you,”, “I’m so sorry to hear that”, “You’re so brave,”, yada yada yada.

To be given the “empathy” mark, all you have to do is find the right time, the exact moment to use these classic phrases.

Then there’s real life.

If GP has taught me anything, it’s the reality that comes when a patient genuinely suffers from pain, anxiety and even low mood.

No matter how good the OSCE actors are, one can never substitute what happens to real people with real problems.

“That’s just so messed up,” I kept saying to my newfound friend, a fourth year medical student studying in Galway.

It seemed that every other patient that came in had some sort of darkness that was just…messed up.

Independent Medical Checkup

Ireland has one of the highest rates of litigation in the world per capita (population: 5million people ++).

One of the most frequent claims made is the right for compensation due to road traffic accidents.

Insurance companies are obliged to send their clients to get expert, unbiased medical opinions from GPs such as Tony. He’ll assess the medical side of things, getting a thorough history on the mechanism of injury, the degree of disability and the impact it has on the quality of life.

After examining Mrs PD, a 25-year-old housewife with three kids, Tony looked at me and sighed. (She had of course at that time left the room)

“Bloody cheat,” he exclaimed

“I don’t mean to be racist, but their kinds have been at it for so long. It’s the same modus operandi each time. They purposely slow down their car, brake suddenly and “bang”,” he was referring to the traveller community (wiki says) in Ireland.

A clinical examination of the purported “pain and stiffness” had so many inconsistencies that it just didn’t make sense.

“If it’s so obvious that they’re lying, why do they keep doing it? ” I asked, empathetically (snicker).

“Well it costs more to go to court, so most of the time the settlement is paid before it goes to a judge,” he said.

Wedding Bells

My aforementioned Iranian-Pakistani Galway-born medical student friend was extremely warm, courteous and kind. I felt that we connected a lot and shared many things in common.

Within an hour, we were already discussing the concept of marriage.

He had just got out of a 2-week marriage with an Iranian girl he hadn’t met before. His parents set him up to deter him from mixing with the wrong crowd, as he already had an Irish girlfriend.

Citing “cultural difference” as the main reason behind the divorce, I could understand how someone brought up in a western environment would struggle to adapt to the very rigid and authoritarian-like principles imposed by the girl’s family.

I'll spare ye the details.

“Marrying a girl also means “marrying” her family” he said with a distinctive Galway (Galwaegian?) accent.

Well said, my friend.

Moral of the story :

Life’s messed up. People have problems. You’re not the only one. Deal with it.

Believe

When you're searching for the light, and you see no hope in sight

Be sure and have no doubt, he's always close to you....

Just what the doctor ordered

I had high hopes for the GP rotation.

Meeting “Tony”, my designated GP for the week was indeed interesting. The man is passionate about his profession. He also earns my respect for having strong morals that stem from a belief that there is a higher power that will hold you accountable for your own actions.

“Now, I do not care what you believe in, as long as you believe in something, because God, whatever you call him, gave us this opportunity to do good to people. So you should be thankful.”

His relationship with his patients extends further than the formal clinical appointments. Everyone goes to him for everything.

After all, studies have shown that medical doctors are the ones most trusted compared to other professions. Lawyers lie at the bottom. I’m just saying.

Then there was drama…

“My husband is having an affair,” then she cried.

It turned out that he often hit their children, especially when drunk. He watches porn on his son’s computer. Their daughter is graduating on Friday. She doesn’t want her to know about the affairs. He openly admits to “f***ing tramps” when intoxicated. He bullies his wife.

Bastard.

The lady didn’t need any medication. She needed someone to listen.

Tony was the man she sought.

Anger, anxiety, agitation

Reading about anger, agitation and anxiety can never prepare you for the horror show of what it really is.

The man was a garda officer who had depression, Whoopadidooda.

Ironically his wife was a psychotherapist.

“I feel unsafe around him. He talks of harming the children with a knife” she said.

The alarm bells rang at once. This guy needed to be admitted immediately.

He had tipped over for the worse. Earlier he tried to poison himself with carbon monoxide. He couldn’t go through with it and came in to seek help.

Tony was the man he sought.

In grave danger

Next up is an engineer who works in a cemetery. He was depressed. He needed time off work due to “work related stress” He basically had to tell grieving families that there was no more space. Their loved ones would have to make way for “fresher” bodies. He couldn’t handle the pressure.

Tony was the man he sought.

The opposite side of the table

Then there was a medical student who sat in the corner, listening to it all. He had his own problems to deal with, yet he masked it ever so expertly. He took notes when he had to; he even made eye contact when prompted. He kept quiet most of the time. He knew that his life was nowhere near as screwed up as theirs. He had no reason to complain. Yet deep down inside, he felt like he could easily be the one sitting on the opposite side of the table.

Brain Waves

After three weeks being constantly updated on the latest celebrity gossip (bieber oh baby), I needed an outlet to boost my dwindling testosterone levels. Something manly. Something, macho….

Meh, I went shopping instead. Burton had a 50% sale on shirts. Add 10% if you show your student card. Need I say more.

Galway Trip

My peripheral GP placement has brought me to county Galway, a place of significance due to the fact that I once asked the interviewer to send me to Galway instead of Dublin. Let’s not go there. Some other time, maybe.

Eidul-Adha

Free food never fails to gather a crowd. A feast to commemorate Eid, organized by the Malaysian Embassy gave me an opportunity to meet up with many of my long lost friends/fiends.

I don’t know what to make of this, but I found myself congratulating quite a few colleagues who either got new wives or new babies. Speaking of babies, there were so many!

The cuter ones were being passed around, all getting their cuddle time as well pictures taken, destined to end up on Facebook.

I can’t believe typing “facebook” in MS Word causes a spelling error. Get with the times Mr Gates!

Without being judgemental (not), here are a few speech bubbles of what might be going through people’s minds when they post pictures of them holding babies.

Look at me, I can carry a baby without dropping it.

Look at me, I’m parent material.

Look at me, this baby is so cute just like me.

Look at me, Look at me, no don’t look at the baby, Look at me(Ka-ching)

Look at me…… You fill in the blanksJ

If this blog went public I’d be in for some walloping. Hey, we’re human, I’ve posted my fair share of pictures with babies as well.

I might just do that again in the near future just to gauge people’s reactions

Jokes aside babies are just too cute. I felt like stealing one to bring home. (Dear future me, I hope you don’t get into trouble for this)

Disclaimer : I AM JOKING. (Just covering my bases)

Buzan you genius!

Imagine my hand dipping into a huge pail of really smelly but white MILK. (just go with it). It stays there for a whole minute, and I almost GAG because of the smell. My STOMACH growls in protest.

I finally take my hand out of the pail. To my shock, the hand turns purple, then blue, then red again, then back to its normal COLOUR.

I gasp. My fingers start to GROW right in front of my eyes. Blood vessels start to DILATE on the surface of my palms. My whole hand explodes.

The end

White MILK : Calcinosis

GAG & STOMACH : esophgeal and gut dysmotility

Change in COLOUR : Raynaud’s

Finger GROW : Sclerodactyly

Vessel DILATE : Telengectasia

There you have it my fellow nerds, CREST syndrome.

Two chapters into the MEMORY BOOK by Tony Buzan and I already feel the 20 Euros invested paying dividends. Whoopadidooda.