我是用还在颤抖的手在键盘上打下这篇文章。
我到现在还不敢相信30分钟前我干下的事...
这件事开始于我在Facebook发现有位coursemate的shouout:
"I passed the exam!"
下了一跳！难道考试成绩出了？！
第一个念头就是发sms问一问...
结果，很不幸得，果真如我所料。
在只剩我一人的空荡荡apartment里走来走去，坐立不安...
时间已经是晚上2330了。
我突然念头一闪，换了衣服，拿了钥匙和学生证就往门外走。
对了！我就是要到campus看成绩！
Campus的距离离我的住处只有5分钟的行走距离。
了解我的人都知道我是的没耐心的人。
若等到明天再到campus，我今晚一定是睡不着的。
不管成绩如何，好歹也让我今晚或安心或伤心地入睡吧！
问题就是campus在2000时后就不再让人进入。
要知道这里国大医学院的academic office还是传统地把牺牲树木把成绩登在布告栏纸上。
上网我都试过了，结果是（意料中网站画面）masalah sistem无法查询。
所以，夜闯campus并不能完全是我的错咯！
一面走在暗昏昏的街上，我就一面让自己呼吸急促，
心跳加速...
加快速度让自己流多点汗...
到了campus的 guard house，我出示我的学生证，
一副焦虑的样子，说：
saya nak masuk dalam cari dompet saya yang hilang
不用费多少功夫，自以为自己高高在上的guard很容易的就相信了。
（这就是典型UKM guards）
他用对讲机说了一些话后就让我一人在空无一人的campus里“找我遗失的钱包”。
有时候，最烂的借口也许就是最好的借口。
再加上我那天衣无缝的演技....
我果然是犯罪的料啊！
我用随身带的handtorch照亮前路在漆黑黑的Block E里找到我要的布告栏。
这并不是一件简单的事，因为全Block E 里有三个布告栏在不同的两曾楼。
而且要避开随时巡查的警卫。
（因为我应该在“遗失钱包的图书馆locker"找着）
这可不是简单的任务啊！
犯罪天才的我找到了我夜闯UKM campus的目的...呼了口气...
我还是及格了。
我不敢相信...我看了三次然后匆匆转身就走。
我离开那布告栏2米后，我再转身看了布告栏，
看了三次后才决定我的眼睛没问题后，
才转身匆匆一副赶到图书馆前（两栋建筑物的距离）的样子。
还好到这时候才碰到警卫。
他那关心的样子让我觉得...
唉~如果我真的是个小偷的话，实验室里的东西就完蛋了。
最后我装着一副快哭出来的样子到 guard house 拿回我的学生证，
那个自以为很了不起的 guard 还劝不懂处理状况的我到警察局报案。（当老子白痴啊！）
只好对道德说对不起啦！
我对这里的警卫本来就没有好感...
尤其上次出纸罚我50块的那只。（因为我没把学生证套在颈上）
说起来我为什么那么在意这次的成绩...
因为我在温习周里颓废崩溃了一个星期。（50%的温习周时间）
每次进考场前我都在忧郁地听着耳机，
甚至在考 urinary system 的前一天到 Time Square 的 Arcade drift 到过瘾了一个下午，
回到房间后随手翻了Anatomy 20分钟就躺在床上死到第二天的天亮
-- 我可是睡了12个小时哦！
在我考一张我之前完全没有温习过的 paper 前...
更屌的是我在考试时间结束的25分钟前就离开考场了。
我真的只用了20%的力气来考这次的final，
我及格了...?!
这是什么道理啊？！
说真的，我对自己的能力感到....
害怕？
不管是我在学业上的能力，还是我那与天俱来的犯罪智慧。
我真的那么令我自己都害怕吗？
Showing posts with label Doc's magoo. Show all posts
Showing posts with label Doc's magoo. Show all posts
Saturday, November 15, 2008
Sunday, October 5, 2008
Clincal Skill - relfection
This is an assignment I was required to do for my Clinical Science Learning (CSL) module. Well, I prereleased it here, before I hand in to my mentor tomorrow.
Ooi Zhi Hao A116684
Clinical Skills Learning 5 (CVS3) Reflective writing
On the 5th session of Clinical Skill Learning, I, as with my other colleagues, were required to perform skills that we learned from 2nd till 4th session, which including general and cardiovascular system examination on a standard patient. We were informed that the particular session was going to be a mock OSCE, just like what is going to be in our real final examination. As differ from 1st year standard patient session, this time, we were not only be tested our clinical examination skill, but we are also going to the particular cubicle in order and solo, without other colleagues watching what we were going to do. During that session, I offered to be the second person to be tested.
When it was my turn, I walked towards the cubicle and was told to read the question. During reading the question, I committed my first mistake as I was spending too much time to organize chain of question I was going to ask about history of presenting illness. Till my examiner / mentor reminded me of the limited allocated time, then I started to panic and began my history taking by greeting the standard patient. During the first question of taking history of presenting illness, I ended my question 2 minutes before time up. My examiner broke the silence by reminding me about asking patient’s symptoms at night. Before I could asked further question about patient’s paroxysmal nocturnal dyspnea, it was time up and I had to present my history taking. After my history taking presentation, my mentor told me that my history taking wasn’t impressive as the biggest flaw in my HPI was the lacking of any childhood disease that would suggest rheumatic heart disease.
Next, I was required to perform a cardiovascular examination on the same standard patient. This time, I couldn’t stop myself by thinking my mistake during history taking. This distraction caused my performance worse than I used to be during usual session. Couple of things I missed during my CVS examination, included radio-radial pulse, collapsing pulse, carotid pulse etc. With this poor performance, my mentor finally pointed out in her feedback that I was behaving nervous during the whole mock OSCE, and I will need a lot of practices to be more professional next time, which I couldn’t agree more with that.
As my reflection on my mistake during history taking, I realize how important it is for a medical student / doctors to be well prepared anytime with any situation of how the patient might be. Organizing chain of though when the patient is in front of me is surely not an impression I want to be in front of a sick person who might need emergency medical treatment. Patients seeking our help because of trust, hence, any delay in approaching to patient is not a good thing to do, but in fact, causing patient to doubt our professionalism. In more serious level, delay in approaching a patient because of “organizing chain of though” is not an excuse, as time is very precious especially patient attend to us with a serious medical problem which might be life threatening. A fast response and well-react to a patient’s medical problem can sometimes mean saving a life. Be well-prepared anytime is the first lesson I learn in this session.
In order to improve my approach of history taking, I realize that I was missing the part of nocturnal symptoms and childhood history is because I wasn’t formulating differential diagnosis in the process of asking history form the patient. Making use of clinical manifestations of various diseases I learned from books, I should be able to form a provisional diagnosis after knowing chief complaint of the patient. Based on this case, patient was young and presented with shortness of breath. I should have suspected rheumatic heart disease, on the ground of its prevalence among young population, and hence it would lead me into probing any history of rheumatic fever during childhood. From here, I learned that conversation with the patient and simultaneously making provisional diagnosis in my mind is a multi-task ability I should practice a lot. This is a big step from history taking in 1st year when there weren’t many diseases that we learned which limited our differential diagnosis in first year, but it shouldn’t be in second year right now. With our maturation during this year, it’s time for us to make differential diagnosis during history taking, and not after.
In the physical examination part of this mock OSCE, I should learn to overcome my distraction next time as it would influence my performance. From here, I realize that steadiness is very crucial when we are going to approach a patient physically. Steadiness would mean making sure oneself is not influenced by distraction, no matter what. With a clear thought, we will be able to complete all things that we need to do when we were examining particular system of a patient. Lacking any step would sometimes result in missing a sign that might suggest a particular disease. Furthermore, steadiness also enables us to appreciate some clinical signs even more, e.g. heart murmurs, apex beat etc., which is very fundamental to make every our action merely action, but an investigation.
Lastly, I should keeps reminding my weakness always, but not allowing them to influence me when attending a patient. I should also keep my mentor’s advice in mind, which the only way to perfectionism is through practices, and lots of practices.
Ooi Zhi Hao A116684
Clinical Skills Learning 5 (CVS3) Reflective writing
On the 5th session of Clinical Skill Learning, I, as with my other colleagues, were required to perform skills that we learned from 2nd till 4th session, which including general and cardiovascular system examination on a standard patient. We were informed that the particular session was going to be a mock OSCE, just like what is going to be in our real final examination. As differ from 1st year standard patient session, this time, we were not only be tested our clinical examination skill, but we are also going to the particular cubicle in order and solo, without other colleagues watching what we were going to do. During that session, I offered to be the second person to be tested.
When it was my turn, I walked towards the cubicle and was told to read the question. During reading the question, I committed my first mistake as I was spending too much time to organize chain of question I was going to ask about history of presenting illness. Till my examiner / mentor reminded me of the limited allocated time, then I started to panic and began my history taking by greeting the standard patient. During the first question of taking history of presenting illness, I ended my question 2 minutes before time up. My examiner broke the silence by reminding me about asking patient’s symptoms at night. Before I could asked further question about patient’s paroxysmal nocturnal dyspnea, it was time up and I had to present my history taking. After my history taking presentation, my mentor told me that my history taking wasn’t impressive as the biggest flaw in my HPI was the lacking of any childhood disease that would suggest rheumatic heart disease.
Next, I was required to perform a cardiovascular examination on the same standard patient. This time, I couldn’t stop myself by thinking my mistake during history taking. This distraction caused my performance worse than I used to be during usual session. Couple of things I missed during my CVS examination, included radio-radial pulse, collapsing pulse, carotid pulse etc. With this poor performance, my mentor finally pointed out in her feedback that I was behaving nervous during the whole mock OSCE, and I will need a lot of practices to be more professional next time, which I couldn’t agree more with that.
As my reflection on my mistake during history taking, I realize how important it is for a medical student / doctors to be well prepared anytime with any situation of how the patient might be. Organizing chain of though when the patient is in front of me is surely not an impression I want to be in front of a sick person who might need emergency medical treatment. Patients seeking our help because of trust, hence, any delay in approaching to patient is not a good thing to do, but in fact, causing patient to doubt our professionalism. In more serious level, delay in approaching a patient because of “organizing chain of though” is not an excuse, as time is very precious especially patient attend to us with a serious medical problem which might be life threatening. A fast response and well-react to a patient’s medical problem can sometimes mean saving a life. Be well-prepared anytime is the first lesson I learn in this session.
In order to improve my approach of history taking, I realize that I was missing the part of nocturnal symptoms and childhood history is because I wasn’t formulating differential diagnosis in the process of asking history form the patient. Making use of clinical manifestations of various diseases I learned from books, I should be able to form a provisional diagnosis after knowing chief complaint of the patient. Based on this case, patient was young and presented with shortness of breath. I should have suspected rheumatic heart disease, on the ground of its prevalence among young population, and hence it would lead me into probing any history of rheumatic fever during childhood. From here, I learned that conversation with the patient and simultaneously making provisional diagnosis in my mind is a multi-task ability I should practice a lot. This is a big step from history taking in 1st year when there weren’t many diseases that we learned which limited our differential diagnosis in first year, but it shouldn’t be in second year right now. With our maturation during this year, it’s time for us to make differential diagnosis during history taking, and not after.
In the physical examination part of this mock OSCE, I should learn to overcome my distraction next time as it would influence my performance. From here, I realize that steadiness is very crucial when we are going to approach a patient physically. Steadiness would mean making sure oneself is not influenced by distraction, no matter what. With a clear thought, we will be able to complete all things that we need to do when we were examining particular system of a patient. Lacking any step would sometimes result in missing a sign that might suggest a particular disease. Furthermore, steadiness also enables us to appreciate some clinical signs even more, e.g. heart murmurs, apex beat etc., which is very fundamental to make every our action merely action, but an investigation.
Lastly, I should keeps reminding my weakness always, but not allowing them to influence me when attending a patient. I should also keep my mentor’s advice in mind, which the only way to perfectionism is through practices, and lots of practices.
Saturday, August 2, 2008
The cardio-genre of the art of medicine
Many people draw paralel between medicine with art.
"Medicine is an art." That's what my clinical mentor told us, "you are now learning not only medicine, but also the greatest art of human inteligence"
Recently, without much realizing, I found myself drown in one of the medicine art -- the music of heart. Here, I give you electrocardiogram (ECG / EKG).
Before I come to the chapter of ECG, the name of ECG/EKG was not stranger to me. Well, you can hear the word being mentioned every now and then in medical dramas. Most situation would be...
"v-tach...no! v-fib! Charge pedal to 200! ... clear! (everyone step away from the bed, and the doc is shocking the patient)"
or...
"asystole...push another gram of epi! Now, charge pedal to 200...clear!"
so, ECG was not a stranger...
But, the first time when I was staring on the P, QRS, and T waves...they are strangers. I though it's easier to be intepreted like other lab results...but, hell! It's like some foreign / outerspace language to me!
So, I went to librabry, trying to search for a book called "ECG made easy"... but there's a name of a book in the cardio shelf that caught my attention "The only ECG book you would ever need". Because of the boasting and ego of the name, I chose it.
"By the end of this book, you will be able to read ECG just like how the musician read the notes..."
Wow! That was...the book is making a promise!
And now, on 30% of the book, I found myself fonding in reading the ECG... I'm like, kinda appreciating how the ECG is presented in this way... it's like learning a new language, a new art... although I'm still being far from intepreting ECG in glanace, but I hope that one day, I can reach the standard of telling what's wrong with the ECG with only one glance...it's cool!
If medicine is an art, then ECG would be the music of the art, which specifically, in the cardio-genre. I like it! =)
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