Thoughts about internal medicine 1

I have re-discovered the evils of coffee -.-

Talk about luck 

Got an mrt seat after a hard day in the hospital. Old man walked in. 

Glanced around. Everyone was either sitting or sleeping. Gave up seat. 

Seats cleared. Sat down comfortably. Pregnant lady walked in. Glanced around. Everyone was still either sleeping or reading. 

I couldn't help it. I burst out laughing as I offered my seat. 

The funniest thing was, on the both times I gave up my seats, I was seated beside the same young lady, once on her left, and the second on her right. 

Seats cleared. I got smarter. I remained  standing. 

Finally, the young lady noticed that she was the only youngest one who remained sitting, and got up as well for an ah ma. 

Karma strikes:)

Thought on Orthopaedics 5

Talk about luck.

Today, I randomly selected a consultant, and randomly intruded upon his clinic session.

He was... odd, to say the least.

And I don't even mean his random face-booking in between sessions. Or his random flight booking between patients. Or the fact that he constantly tells patients- what i am doing is shou su (operation), not mo su (magic), of course there is pain.

All the above mention can be accepted as mildly eccentric.

This guy... is incapable of giving a straight answer to any question.

There was an strange X-ray of a humerus. And, in what is usually accepted as the norm, you asked what you are not certain of.

'Sir, what's wrong with that humerus.'

He paused in between his smsing and stares intently at the X-ray.

'What's wrong with the humerus... what an excellent question.'

Continued smsing away.

If he did not repeat my question back at me, I would have thought that he did not hear me. Maybe he is a five seconds amnesiac. I tried to put in a subtle reminder.

'It looks really odd.'

'Hmm,' he replied. 'This patient is called Sara Jane. In USA they will call her sara. In Singapore we will call her sa-rah'

I imagined my expression at the moment to be something between incredulity and confusion. Which translate into this ---> -.- (I told you this has become my permanent expression)

'Sir--'

'Sara Lee,' he interrupted suddenly. 'Isn't there a margarine called Sara Lee?'

'I believed it is a confectionery brand sir,' says his house officer helpfully.

I gave up waiting. 'Sir, what is wrong with the humerus?'

He remained perfectly unperturbed. 'What is wrong with the humerus. What a deep, thoughtful, well-structured question.' An anticipatory pause, and then--






'Xie Xie ni, Sara Lee! Xie Xie ni, Sara Lee. We have a lot to thank Sara Lee for eh? All the cardiac arrest and what not.'




-.-"




I gave up. I went to read the case files directly instead.

Thoughts on Orthopaedics 4

Another nonchalant mentor -.-

The first mentor, of course, was in General Surgery. Our first conversation went like this:

'Hello, is this doctor ____? My name is Chiawyee, and I am calling on behalf of group 39. We are attached to you for 4 weeks. Is it possible for us to meet you?'

'..... Why?' (by the way, this is expressed in a genuinely puzzled tone)

What a deep question. I fumbled clumsily over the other side of the line in sheer panic, but as these things often go, with practice, you get better.

Then, in ttsh:

'Hi, Mr____, I am chiawyee, a third year medical student attached to you for four weeks. I was just wondering if i could meet--'

'Call Dr ___. I'm on leave now.'

'Oh. Okay.'

*Flips through long contact list to hunt for said doctor.*

'Hi Dr ____, this is chiawyee, a third year medical student. I am attached to your team for three weeks, so I thought perhaps we could--'

'Oh. Have you called Dr _____?'

'Sorry? Dr _____?'

'Yes,' said the doctor on the other line patiently. 'Mr ____ is the consultant, I am the associate consultant, and Dr ____ is my registra.'

For those who are not aware of the hierarchy, it goes like this:

consultant > associate consultant> registra> Medical officer> house officer>>>> medical student.

I had a visual image of myself being thrown down the ladder.

'Actually, sir,' i said lightly. 'Mr ____ asked me to contact you.'

I sensed resignation over the other side of the line. Hierarchy triumphs all in Medicine. Even planktons can use it to their advantage sometimes.

'Oh.... okay.'

And, as I moved to SGH, i made the customary phone call one more time.

'Hi Dr _____, i am chiawyee, a third year medical student attached to you for four weeks.'

'....Oh.'

Three seconds passed. I started again.

'So.... I thought I should call you, you know, just in case you want to have a look at me?' If interested?, but I didn't say that aloud.

'Oh,' said the voice in realisation. 'Oh.' In resignation. 'Yea, sure, i have clinics now, so--'

'Excellent sir, I am free now, so I will there. See you in a while.'

My luck with tutors is phenomenal -.-

Thoughts on Orthopaedics 3

Sometimes, there are cute things too. General Surgery loves food: Red Currant Stools,Coffee Bean sign, etc and Orthopaedics love animals (and mnemonics and classifications, but that is besides the point)

Introducing the WINKING OWL SIGN:



Oh, I forgot to mention, but in medicine, intelligence is not the most important thing. Imagination is. So, with that in mind:

Introducing, the WINKING OWL SIGN:



Can you see it yet? Yes, I know it looks (and is)like the bloody spine of someone, and you don't see an owl flapping around winking at you. I didn't know there was an owl in our spine either. Until I saw this picture:



(Pls refer to the first picture: pedicle erosion)

CUTE RIGHT? CAN YOU SEE THE WINKING OWL NOW IN THE PREVIOUS PICTURE???

(P.S. Referring back to the picture, I wonder if picture C is called the Squashed Owl Sign)

Digressing a little- when I typed winking owl sign, for some strange reason, the following pictures popped up as well:



-.-




Anyway,now that we get the idea and essence of IMAGINATION, allow me to introduce the second animal: The SCOTTIE DOG SIGN!

(specifically, its the scottie dog with a collar sign, but let's spot the scottie dog first)



Can you spot it? :)

Here's the clue!




Tada!SO CUTE!

And here's the dog with the collar:



There you go! And this is what we do most of the time, be it X-ray or slides: Imagine things that are not there! That's why medicine is an ART!

The second thought about all these cute animals, of course, it that the conditions that they represent are not cute at all. The Winking Owl signifies an invasion of cancer into the bones (pedicles) and the dog with collar represents Spondylolithesis, which is basically a fracture of one part of the vertebrae.

P.P.S. I don't owe all the images. I got them for google image search. Please refer to the search results for their respective websites; aka I am too lazy :P)

Thought on orthopaedics 2

I really dislike ortho. 

After a period of time, I began to conclude that  orthopedics surgeons are either cursed with obsessive compulsive disorders, or they have a remarkable amount of free time on their hands, because they have classification for EVERYTHING. Every fracture in the body is graded to the point that it is almost disgusting. Why,why,why? 

But never mind that. It is also another world where new terms are abound, and we are expected to assimilate ourselves accordingly. In order to do this, students, have over the years, come up with mnemonics for EVERYTHING-.- (it is debatable which is present in a larger volume- the mnemonics, or the classifications). We have so many mnemonics, that they have effectively lost their function. (it is too much effort to remember them, and then remember what they stand for)

Unfortunately, somethings are not made for mnemonics. That is when desperate students come up with something else; in particular for these two terms: varus and valgus. 

'i can't remember.' I complained to my friend one day. 'which is which.'

My friend gave me an imperturbable expression. Then he pushed a book forward. 'read this passage.'

Eagerly, I glanced at it. 

'to remember varus and valgus, just imagine yourself looking for a walrus.'

I was filled with a subtle sense of doubt when I read the first line, but I carried on. 

'You say "varus ( where is) the walrus?" the walrus jumps between your legs, and your knees move apart. '

My expression, at this moment, is something approximating this --> -.-

'Thus, varus refers to a deviation away from the midline of the joint.'


"-.-

'how is it?' asked my friend casually. 

Well, thanks to this stupid tale, I now constantly visualize a walrus jumping in between the limbs when the word varus is uttered. 

At least I have no problems with remembering now-.-

Thoughts on Orthopaedic Surgery

It is sad, that I have reached a point, where the internet no longer understands what I am asking for.

Thoughts on surgery three

Now, in a curious, half obsessed, but perfectly innocent way, I was dying to do a circumcision. 

I just wanna see it. Snip something off. 

Anyway, I finally got the opportunity I wanted today. I even skipped tutorial for it. 

All went well, until it is time for a procedure known as the death grip. 

' What is the death grip?' I asked innocently. 

'it means exactly what it says.' was the cryptic answer given. 

'i can't wait to see cy do it,'said one of my sadistic cg mate. 'i hv been recipient of it for two operations.'

'You mean giver. You didn't receive it.'

'That doesn't make it sound better.'

Calmly, the surgeon trust me the penis. All students have been conditioned to accept whatever is offered to them with no questions whatsoever. I took the organ before I even knew what I was going to do.  

'Hold this until the tip turns purple for five mins.'

My hand subconsciously squeeze something. 

'Good,' said the surgeon sagaciously. ' I got a meeting to go to.'

And with that signal, everyone scattered off to their various duties, with me in the centre, beneath the operation lights, holding a penis in a death grip. 

I felt just a little stupid. For one thing, where exactly should I be looking? (I spent the first two mins watching the nurse pack the instruments.)

Three minutes into my task, I thought i should make some intelligent comment. 'Exactly how purple is purple?'

Unsurprisingly, no one answered me. The comment, however, did give me an excuse to look at my working hands. I thought it look more grey than purple. 

What if I killed the penis? 

Then this circumcision would turn into a castration. 

Come to think of it, just how much force am I suppose to exert?

Thankfully, the nurse saved me from further thinking a minute later.