Gerak Khas Attachment: Day 3

So everyone, how do you all start your day? I start my day with the biggest embarrassment of the year. I WRONGLY ENTERED LADIES ROOM! I just noticed that after I came out from the toilet cubicle while washing my hand, I see from the mirror a female staff nurse fixing her pants. I foolishly asked, 'ni tandas perempuan ke?". She replied, "saya rasa ya!" which I replied "takpe, jangan bising-bising, saya salah masuk tandas ni!".

On my way to the ward I can't stop LOL-ing! I entered the ward and pretend to be professional, wearing my white coat, stethoscope and books heading to first cubicle. Meet one of HO there, ask if I can join him clerking and thank God he allowed me to. Basically, our cases today is MVA infarct with U/L HPT, SVT with HAP, first fitting episode in 26 yo patient and some other more complicated cases. Alhamdulillah, experience of clerking a patient yesterday gives me some confidence in approaching a patient. Even that kind HO told me to do PE on the SVT patient which have bibasal crepts (because she had HAP). Also he showed me the very much patchy X-Ray. Alhamdulillah, HO of this particular ward are very much cooperative.

Also, after a MO came and ask me a few question and reminding me about GCS and suggesting MacLeod's book to learn clinical examination. Then I saw the specialist came in. I joined her round and seeing lots of new case since yesterday is active day (Ward have three different days in one cycle namely active, post-active and passive, where active day is for active admission and passive means no new admission).

The specialist also tell us about some clinical classification of hypertension and DDx for secondary hypertension. After that, there is this Down Syndrome with failing kidney. She was not suitable for PD because of non-compliance and easy irritability. But she can't undergo HD due to central line stricture. Then, sadly the specialist told the parents that she is departing. The patient didn't say anything, but I can see the gloominess of her mother's eye. Her mother almost cried when she was informed that her 26yo daughter is departing. I am not very good at translating what I saw today but who can? Only her mother know the feeling of knowing your 26 years raised daughter is departing. So, that's the drama for today (Dramatic rounds started to show EOD pattern).

Then, after rounds I came down to library and have a nap (one hour and half sleep is considered nap, kan?). I came up to the ward at 4pm and the HO that I joined this morning asked me, "Eh, kenapa tak pergi CME?". I said I was in library. Hahah..pretty good excuse, right? So in this department/ward, CME is on Wednesday. Then, I excuse myself to go back early. Tired meh...see you again soon!

Glossary:

HO- house officer (pegawai perubatan latihan siswazah)

MCA infarct- middle cerebral artery infarct

U/L- underlying

HPT- hypertension

SVT- supra-ventricular tachycardia

HAP- hospital acquired pneumonia

PE- physical examination

MO- medical officer (pegawai perubatan, basically those who finished their housemanship)

GCS- Glasgow Coma Scale

DDx-Differential diagnosis

PD- peritoneal dialysis

HD- hemodialysis

EOD- every other day (alternat day pattern of events)

CME- continuous medical education (sort of seminar where HOs present about pre-assigned topics of clinical subject)