做一天的人类灵魂工程师

大家好，真的是好久没更新我的部落格了。不是很忙，只是很懒。 =P

这次想跟大家分享我在四月份医学实习时的乡下服务。

这次乡下服务的地点位于 Kerambitan，Bali. 我们的目标是 --> Sekolah Dasar Timpag ( Timpag 小学）

我这次的任务就是教导这般小学同学关于急救的基本常识。

首先，我和我的一组朋友一起制作了一些关于急救的 小册子, 原来制作一本小册子是那么艰难的，而且我们也需要确定所记载在这本小册子的咨询时正确的，以便可以传授正确的知识给这些小朋友们。

我们用 slide show 的方式先解释一遍给小朋友们听。

 

然后，我们还出了考试题测试小朋友们的了解能力

如果他们有疑问，还可以上前来问我哦！！ 

我们还为了奖励这些小朋友们，自讨腰包准备了一些小礼物。

经过了slide show presentation 以及简单的测试题，当然是开始实习啦！！

这些小朋友们都纷纷举手抢先学习的机会，让我真的很开心！！！

大约中午十二时，终于完成了历时三个小时的教书过程。

当然要来一张大合照 以做纪念，这是我第一次担当人类灵魂工程师的角色，而且又是在岜离岛，这样的经验是第一次，也有可能是最后一次，所以我觉得特别有意思。

最让人又气又好笑的就是小朋友们的调皮，看看以上的照片就知道了！！

除此之外，我们也在这乡村里提供老人家一些简单的医疗服务，测量他们的血压以及提供一些医药的知识以及供应。其实很同情这些乡村里的住户，由于他们的住处离城市遥远，加上没有交通工具，很多乡里的人就这样离开了这个世界。他们就是被医药服务忽略的一群，我觉得那天过得分外有意义。

回家的路途中，不忘了在沿路上留影。。。蓝蓝的天空，绿油油的稻田。。。这就是大自然最棒的风景了！

后记：

第一次担任人类灵魂工程师，还蛮好玩的！也开始了解为何老师们可以那么的伟大，还有老师们那么热忱于教育界。就比如说我的妈妈好了，她是一名教师，自小我都不明白为何她总是为小学同学们大动肝火，原来是真的是在乎他们在学业上的进步才如此懊恼，我时常都觉得她自找的辛苦，呵呵。。。 虽然如此，她还是时常鼓励我长大后选择做老师，她一直都跟我说做老师多好多好，我都不以为然，最后选择了做医生。

直到这次的乡下服务，我终于尝试到做老师的成就感，尤其是当你解说后，看到他们有明显的进步，那种成就感不会在医治好病人的成就感之下！！！妈妈，以及各位老师们，我敬佩您们！

最近看到报纸说大马要大量栽培新一代的人类灵魂工程师，希望不是空穴之谈。希望真的可以好好造就下一代，懂得欣赏以及珍惜人才，这样国家才会进步。（这是我在印尼就读后，深深体会的。。不是践踏这国家，只是这里好的教授实在少之又少。。。不好的老师，真的会教导出不好的学生，不好的学生又怎么能使国家进步呢？） 所以老师真的扮演这举足轻重的角色。

人们都说，当你越老了就会越像你们的父母亲，我开始慢慢体会到了，我对这般学生们还蛮苛刻地（就像我的妈妈一样 =P)，尤其是在实习的时候，当小朋友们做得差不多“有模有样”了，我的朋友就“放过"了他们，而我就是那个反对放过他们的讨厌鬼。。哈哈。。。我会要求他们重来直到他们真正的了解后，我才肯放过他们。那些小同学都说我很 "galak" （凶的意思），当然之后我还是会与他们打成一片以避免他们真的“讨厌”我。。。 =）

有时候，真的觉得 Everything happen for a reason, 如果不是老天爷的安排，让政府派我到这里求学，我就无法体会乡下如此的生活，一开始真的很不习惯这里的一切，看到这里落伍的一切真的很令人沮丧。。日子久了，就会觉得 Everything happen for a reason..没有这些苦日子，我就不会珍惜现在所拥有的一切。

最痛的心－母亲是伟大的

昨天刚从小儿科部门站岗回来，真的把我累坏了。。。
不想多说，只想分享我此刻的心情。

还记得，以前一开始迈入医学生实习生涯时，常常会把私人感情放在病人身上，久而久之，再遇见更多病人之后慢慢地都变麻木了。 但是在这里很想跟大家分享我在小儿科病房站岗的心情，突然间觉得自己是幸福的，是幸运的，虽然做医生让我牺牲了不少自己的时间，为病人而活，但是昨天看了那些小孩后，忽然间很开心 觉得自己很幸运成为医生，有机会看到人生百态，即使牺牲了青春但真的不会白费了人生。

病人一
他患了 duodenal atresia 小肠锁闭症，刚刚施完手术，消瘦得不行，已经三个月大了，才三公斤而已，他的母亲也辞了工作，天天留在医院照顾他。他母亲告诉我，自从进院以来，她自己也瘦了8kg.　由于这婴儿需要根据医生安排的 nutrition 时间表定时喂奶，有时是每两个小时，有时每三个小时喂一次。就像昨天，是我负责这婴儿的饮食时间表，除了白天之外，凌晨的一点，三点，五点都要叫醒他的母亲泡奶喂这婴儿。我只不过每三天站岗一次，晚间没得睡，但是这母亲呢？天天都要这样的过生活。，

病人二
他患了一个罕见的病，名为 Pierre-Robin Syndrome , 三个月大，病情危在旦夕，更可怜的是原来他们的第一个孩子也是患有先天疾病而离世的，万万没想到第二个孩子也是那么的不幸。听护士们说原本这夫妻家境还不错的，但是之前为了救第一个孩子的生命已把屋子卖掉，孩子还是救不回来。现在他们都把所有希望寄予这第二个孩子，夫妻也没什么工作了，天天２４小时不眠不休地留在加护病房陪伴这孩子，希望奇迹可以出现，孩子可以活下去。

病人三
他患了Burkitt's Lymphoma, 伯基特淋巴瘤，才两岁的小孩就得忍受化疗的痛苦，而且在颈项的肿瘤把他压得喘不过气来，时常面临呼吸困难的危机。站岗到了今天早上，以是我第三十个局钟的工作时间，精力也消耗得七七八八了。。。在写报告时，竟然在报告上“鬼画符”，沉重的眼皮不听使唤地压下来，忽然间听到走廊传来一阵婴儿哭闹声，把我从“神智不清”的情况下唤醒了，好奇心的驱使下，去看看到底是哪家的婴儿在哭泣？原来是他。他的母亲楼着他在怀里，不停地想办法让他忘记肿瘤带给他的痛楚，忘记哭泣，但都徒劳无功。过了两个小时，那孩子还是哭泣着，我看到了一幕让我很辛酸的画面，那母亲一只手抱着还在哭泣着的孩子，也许看到我走进病房，另一只手就不好意思地默默地拟去自己脸上不停流下来的泪水！！！我看到了，眼睛也湿了。

是，那些不幸的孩子是很痛苦，
但是身为父母亲看见自己的孩子那么痛苦但又无能为力时，
心更痛！
试问世上还有谁的心能比那默默拟去自己泪水的母亲更痛呢？

Say bye to Forensic & Hello, Sweet HOME !

REUNION DINNER 02.02.2011

This is the 1st time i had my reunion dinner in Bali. We ( As usual, the same gang of people ) went to Dynasty Lotus Restaurant for dinner, it cost Rp 140,000 ( RM 50 ) per person. Not really nice though, but the most important is the atmosphere. We did really enjoyed it ! Can see from the photo below... we ordered the "yu shang" , and we just found out Bali Chinese, they don't mix by them self but the chef mixed for them. Immediately we stopped the chef from doing this... and all of us stand up , pick up our chopsticks and shout "Fat arr... Fat arr.....!!!!" while we mixing the "yu shang" ! and of course, we became the focus of the restaurant !!! everyone looked at us.. yet we not felt any embarrassment.. =P

STUDY DAY 03.02.2011

although is the 1st day of CNY where i supposed to enjoy the day to the max, sadly i had my exam on the next day... so what to do ? stay at my dorm and study...but the progress of study was darn slow as my heart already on the way fly back home. LOL

EXAM AND ON-CALL DAY 04.02.2011

Having my exam in the morning. Right after the exam, my last on-call in forensic department started. On-call in forensic divided into two part --> Forensic Pathology and Forensic Clinic.

• Forensic Pathology - Stay at the forensic building , stay with the "corpse". If there are any case of unnatural death eg. traffic accident, we have to perform the external examination on the dead bodies.
• Forensic Clinic - Stay at the Emergency Room, record all the cases which have the potential bringing to court, deal with the police man and the client/victim, about insurance etc. Besides, we also play the role as the 1st-line practitioner who handle all the rape cases, sexual harassment, criminal cases, disputed paternity, persecution, etc.. before consult to forensic specialist.
  

The following picture --> when i had my last on-call in Forensic Clinic.
Again, i would like to sound out forensic is really an interesting department.. I learned a lot throughout the lab, about the mechanism of death in cases of strangulation, hanging, gun shot wound, stab wound, suicide , sexual abuse or rape, sudden death, electrical injury, burn injury, infanticide, etc etc....

Out of surprise, someone bought me a drink at 2am when i almost fall asleep during on-call, feel warm and touched. You know who you are... Thanks a lot.. =)


CASE PRESENTATION AND GO HOME 05.02.2011

Hoorayyyyyyyyyyyy^^^^^^^!!!!!
Hopefully it is not too late to collect ang pao ,agree ?
kekekekeke,.....

Forensic Expert !!! 法政先锋

It's been sometimes since last i uploaded about my medical life in Bali..
Time flies, I had finished my 1st part of clinical years ( "surgery cycle" ) and now it comes to the 2nd part of clinical years which we called it as "medical cycle".
Well, for your information, Surgery Cycle is more about skills and "action", meanwhile Medical Cycle is more about study and knowledge, which include the following :

1. Radiology
2. Forensic
3. Pediatrics
4. Internal Medicine
5. Public Health
6. Ophthalmology
7. Psychiatry

I have 4 weeks time in Forensic department, had been gone through the 1st week and now comes to the 2nd week. I wanna write a lil bit about what happened for the past 1st week.

• had been went through two autopsy : Neonatal Cases which suspect infanticide. Another one is homicide of an adult. It's really interesting when doctor was explaining about what we discovered and deduced the time of death, the way the corpse might killed, and revealed the cause of death throughout the process of autopsy. In the same time, it only the smell of corpse which we really need to endure. The culture over here, we are not allowed ( hmm... not to say not allow, but it is "better not" ) to wear face mask, the reason given is by not wearing face mask is a way of respect the dead bodies. Thus, there are NO one wearing masks during the autopsy, so if you insist to wear, you looked VERY WEIRD among the people !!! so what i did was using my fingers and pinched my nose when i really couldn't stand with the smell. But most of the time, no much people pinch their nose too.. so i am one of the weirdooooo...!!! Gimme sometime, I will learn to be immune to the smell !

• Two times of experience in performing External examination ( 验尸) : One was died on traffic accident, and he only 18 years old. So please everyone, ride / drive carefully ! Don't lose your life because of traffic accident, It really heartbroken to see the parents cried bitterly upon their death children. Another cases was about sudden cardiac arrest of a young army , 22years old, experienced convulsion and died when he received punishment in the military forces of nation. Me and my friends , total of four, went to the military camp.. and what happened was we were well greeted by the captain and naval officers and crowded by over hundreds of soldiers. We went inside the center of the camp and saw a coffin covered by the flag of Indonesia. A good experience thou, something like what happened in the movie.

• Duty in forensic department include standby at the emergency room, recorded all the cases, assess the wound how it got hurt, handle all kind of cases include sexual assault, murder, suicide etc. I love the morning report, everyday each group will present the cases they encounter during their duty and we will discuss about the wound investigation, for the murder cases or if the corpse come with putrefaction, we learn to find out the identification of the corpse, investigation of death, their post-mortem changes, the blood stain, the mode of being killed and provide our findings or useful information and cooperate with the police.
  We have a meeting room for us to analyze the cases like what happened in the movie, and i really really salute the forensic doctors the way they analyze and explain the cases !

• Really gain a lot of interesting knowledge in this lab, especially how the killer would do on the corpse trying to mask up the real setting of the case. haha..!!! By studying forensic pathology, each case will reveal the truth !!! Sadly, there are still lack of forensic doctors in Indonesia. ( i not really know the condition in Malaysia ). There are only 3 forensic doctors in Bali, so everyday we can see the 3 doctors work like the mad ones but they still looked so happy.. Actually I really so curious the reason they choose to specialize in forensic. In Indonesia it is FREE OF CHARGE to specialize in Forensic because they wanna encourage more doctors to involve in this field. Although F.O.C. but from what i noticed, it is still not successful to attract doctors to specialize in this field.

This is the Forensic Canteen which located beside the forensic department, provided food and drinks for those unfortunate family... of course, doctors are welcome too.. haha...

This is the TWO LARGE CONTAINERS which people always talk about... it contained all the victim who are undetermined identity, or those who are not collected by their family. What i heard from my friends, it still contain the full body or part of body of the victims during the Bali BOM 2002.

DISASTER VICTIM IDENTIFICATION - the DVI TEAM which is really well developed in Bali especially after the incident of Bali Bom in year 2002.

During our 30 hours duty in forensic department which happened once in 3 days, you will see the offering or worships goods placed on the floor of each corner and in front of EACH room. From what my friend told me, by offering these to prevent "them" to "disturb" us during the night.

the ambulances which transporting the dead bodies to the hospital...

What we afraid the most during the duty is the sound of the corpse trolley coming to our way, which mean some one had died and we need to handle the dead bodies by performing external examination.

In all, case discussion and investigation is undeniably interesting, but frankly speaking, i still feel very scare in handling dead bodies or staying up at night in the forensic department.


*Rest In Peace*
*Treasure your life*
*Finger-crossed*
*Amen*

Satellite Trip II & III : Singaraja & Wangaya Hospital

Since i started Surgery Department 3 weeks ago, it was freaking busy and tired. Sorry bloggie, been ignoring you for so long...

Well, I would like to continue the blog post about my satellite trip in Obstetrics and Gynecology. After the 1st Satellite hospital trip , here we go to the 2nd and 3rd satellite trip..!

Satellite Trip II : Singaraja Hospital

The following picture shows how's the delivery room looked like over there.. quite spacious.. and they have room for USG scanning, VIP patient delivery room, Economic delivery room, and Gynecology Room. Few shots which i took with the midwife over there... =)

** Felt myself so clumsy while cuddling a baby in arms...**

The picture of the hostel condition which located just behind the hospital...

To me, Satellite hospital trip is FUN and GOOD in the sense of u can handle the patient fully by your own.. In the contrary which SERIOUSLY tortured me alot is the condition of the hostel provided by the hospital.... it's not "super" dirty but still i had to take a deep breath and tolerate the cleanliness over there especially the toilet and the bed...

Here's the front door of the Emergency room of Obstetrics and Gynecology which stated there --> 24 Hours !!! Not really 24 hours thou, because i will sleep at the front door counter at night when there is no new patient... hehehe..... I'm only human man... =P

Satellite Trip III : Wangaya Hospital

Some snap shots with the friends , midwife and nurses over there...
Note that I took a nurse cap and put on my head... Does it looked weird ???? Guess so....

Some babies photo which i would like to share with you all...

Upper left pic : A premature baby which is too Small
Lower left pic : A Macrosomic ( when the birth weight is > 4.0kg - 4.5kg ) Baby
Lower right pic : Anencephaly --->> Infant born without a forebrain, the largest part of the brain consisting mainly of the cerebral hemispheres (which include the neocortex, which is responsible for higher-level cognition, i.e., thinking). The remaining brain tissue is often exposed—not covered by bone or skin.

In Obgyn department, of course not only about handling a labour, but also the pathological cases for instances abortion, ectopic pregnancy, dysfunctional uterine bleeding and many more...
Another interesting point is you will learn a lot of moral values indirectly when go through these department..

For example, a 16 years old girl come to the emergency room with her boyfriend and complain about profuse menstrual bleeding, after physical examination , you found there are flesh in the blood....and so what do u think ??? After the incident, she cried over spill milk because the feeling of guiltiness towards her parents... it really otiose... Don't do something which make yourself regret.

and trust me, you will definitely love your mum even more after witnessing by naked eyes on the process of mother giving birth...

In a nutshell, I really MISS OBGYN now.... !!!

Miss the feeling of handling a delivery by my own and u heard the baby crying out loud...
Miss the feeling of when you helping out the mother, thy will scold you or even pinch you because of the intolerable pain but after giving birth to a child, they will step forward to apologize upon their ragged attitude and thank you with a grateful heart.

The feeling of satisfaction within is really really Meriting !!!!

Satellite Trip I : Karangasem HospitaL

Time flies... I have completed the 1st series of the Obgyn Satellite hospital trip. Here i post some photos narrated about the things that i had experienced for the past 2 weeks in this hospital. In short, is tiring but really nice !!!! I really learned a lot throughout this 2 weeks in the aspect of skill. Theory ? uh hum... i had no much time to study...I just couldn't wait to get into the dream world after the 30hours oncall..and by the time i woke up, another 30 hours oncall repeat again... excuses ??? =P

This is how i fitted out myself when i was going to handle a labor. Oopss.. forgot the cap. don't imitate yeah, this is not hygienic =P

Does it look funny to wear the apron + boots ?? at the 1st place, I really felt it looked funny..as if like working in a kitchen instead of a labor room. hahaha... but it's really important to get rid from the blood / amniotic fluid splashing on your clothes. And the boots served the same function as well... it made me think about .... phua chu kang ...!!! haha...

* Enjoying photo shooting in the Labor room *

The following picture is the very memorizing one, my ever 1st experience in handle a delivery. and the few other babies which i handled their birth as well. It was really touched to see mother so hard and suffer in giving us birth...


Some view about the hostel of this hospital... far better than what i imagined ! It was like heaven and hell difference with what i had experienced in Negara Hospital when i was in Neurology Department.

* the most important --> Air-conditioner !!! *
* We all sleep like a pig each time after the 30hours working *

Snap-shot session with the doctors here.. Thousand of thanks to dr.Suci ( lower left picture : right beside me ) who guided and taught me patiently the technique and skill of how to handle a delivery.

One thing very important i have learned over here is ---> my right hand is "functioning" !! FYI, I'm left-handed. Before coming here, I was quite nervous and lack of confidence in handling baby delivery / stitching the laceration of the perineum on the mother. I always doubt myself in doing intricate work like cutting or stitching by using right hand. But after few trials and without giving up, I can make it now ~!!!!! This was really inciting and convinced me that "aeris boleh" !

Learned a lesson behind :
"Everything is POSSIBLE if you dare to try ,
Everything would be IMPOSSIBLE if you hold back, and refrain from doing it !"

In a nut shell, felt myself still quite clumsy at times, but Thank God i didn't made any trouble or putting the mother/baby in risk...and of course, my skill still yet to be improved.. Gimme some time.. I believed i can do better.. hehe..

The final photo session of my last oncall in this hospital on this sunday morning. Yes, we are clad in Pink Uniform during oncall.. looked like patient more than doctor ,isn't it ? haha... They said pink color is more patient-friendly... and patient won't have the so-called "white coat" phenomenon on us...

Packing up my luggage, moving to the next satellite destination in this arvo --> Buleleng Hospital !!! Here I come ^^

Again, FINGER-CROSSED... may i handle every delivery safely and do no harm to both mother and baby. Amen.

Obstetrics & Gynecology - Finger Crossed

I would be in ONG / Obgyn ( Obstetrics & Gynecology ) department for a period of 10 weeks.

1st n 2nd week - Quarantine week in the main hospital of Bali.

From the 3rd - 8th week, i will be traveling around 3 different satellite hospitals of Bali.

3rd-4th week ( which means NOW ) - Karangasem Hospital
5th-6th week - Buleleng Hospital
7th-8th week - Wangaya Hospital

and the 9th and 10th week back to the Main Hospital and sit for the final exam.

Thus, I would be away from my comfort zone ( my room ) for 6weeks... I miss my room especially my "beddie" so much.... actually is really good to serve the community in the satellite hospital where i would have the chance to handle the laboring mother thoroughly by my own. Yesterday learned to deliver the placenta under supervision of doctor, indeed a nice experience..! Will have more chances to do so in the coming weeks and handle the whole delivering process from 'A' to "z" ... *Finger-Crossed*

After witnessing the whole process of delivering and how much the mothers suffering from the pain of delivering, i really getting more and more appreciate my mum and Love her even more ^^

Bitter Sweet of Anesthesiology ! Loved it !

Time flies, fingers counted.. wow..! I had been went through quite a number of labs - 1st, ENT . 2nd, Neurology . 3rd, Dermatology. 4th, Anesthesiology. And Now ---> Obstetrics and Gynecology. Been busy for this whole 1st week because this is the week of quarantine where all of us have to stay in hospital and standby 24hours.

Finally it came to the last day of quarantine and i squeeze out a lil bit of my time during dinner break to write a post about my story in Anesthesiology department.

Well, as usual, not much writing.. just wish to share with you all my latest photos which i taken during these lab.


1st, entering anesthesiology department is just about grabbing the chance of doing this ( the following picture ) at the summative examination . ( oopss...i mean doing on the real patient instead of this mannequin.. 0.o ---->>>>>>

ENDOTRACHEAL INTUBATION !!

( a cool one ! haha !!! )
one of the reason i love this department

2nd, you got the chance of doing induction ( means hypnotize a patient and take care of them during the operation ) In this picture, GUESS what i was holding ????

This is the drug which Michael Jackson Kill himself !
named,
PROPOFOL !!!!

so when you are insomnia or agitated, NEVER EVER PLAY FOOL with those drug before understanding the toxicity or the risk overdosage of the drug
because It might cause you FALL ASLEEP FOREVER.... juz like michael

3rd, throughout the lab, i have the chance to see all sorts of surgery.

4th, each time i entered operating theater's changing room, i just couldn't get myself from ignoring the FUNNY TRANSLATION below.

"Ruang Ganti Dokter Spesialis Pria"
( Pria - Male )
translated to
"Changing Room of the Doctor Specialist of Man"

So funny !!!

why not just
"Male Specialist Changing Room" ?

I really so interested to know what the Caucasian students' thinking every time thy read these...
I'm so bad huh... Yes, I admit ! haha... ( just joking.. Just trying to make my life more laughter while working in hospital ... anything which can create some sparkles throughout my dull routine life, i would just love it ! haha ! psycho >.<"" )

Another picture - All the "smelly" shoes parading themself infront the entrance of operating theater

5th, when it comes to the end, of course, photo session !. I would never forget to grab photos.. haha... because it might be the last time...no no no, i think it was really the 1st and the last time ( the only one chance) practicing anesthesiolgy in Bali...
Guess i would miss it when i back to Malaysia... Full of bitter and sweet MEMORY !!!!

6th, why i love anesthesiolgy ?? when there's no patient, no operation... I can just dancing in the operating theater !! haha... Just Joke ! ok! Actually I was so scared to let doctor saw I so daring to dance with the infuse stand. LOL

All of us make chaos in the Operating Theater In the very final on-call of Anesthesia ! Interesting !

Don't misunderstand, we were very serious when the operation was carrying on , ok ?? =P

That's all for my anesthesiology department ! It's full of ADVENTUROUS, Challenges, FUN and of course, some troubles which i stated in the previous post...! After entering obstetrics and gynecology, i really really miss anesthesiolgy at the moment !!!!!!!

and I wanna said, I REALLY REALLY SO ADMIRED ALL THE ANESTHESIOLOGIST. Genius above all the genius !!!!!

遇上大怪物。倒霉

1。大怪物发威：
一如往常的早上七点，Resident Doctor 及 Junior Doctor 陆陆续续的走进麻醉部门的 Meeting Hall。知道今天是“大怪物”医生主持的 Morning Report，每个人都绷紧了神经。终于，大怪物出现了，一进门就爆轰医生们。他说，“昨天我发现这个 Hall 有不少垃圾以及手术的 Mask。为何会这样？不是你们这班人，还会有谁呢？我现在命令你们，立刻把你们身边大大小小的包包，所有东西搬离这个Hall,不要污染我的 Hall, 我的生命会受到威胁!!!"

（这样生命也能受到威胁？大怪物的免疫系统及生命还蛮脆弱的吧？^%$&*@# ）

2。无辜的我遇上了大怪物：
我们所有大小医生只好把身边的书包全部丢进图书馆。然后，Morning Report 就这样继续。不到十五分钟，大怪物忽然间手指指向我，说，“You... Out !!!" 我心里顿时下了一大跳，我没讲话，也没打瞌睡啊，而且这还是我第一次那么的全神贯注去听 Morning report. 我错愕了一下，他又再说，“Is You..! You don't understand English ? I said.. OUT !!!!" 就这样，很丢脸的，在众目睽睽之下 （那边总共有六十几个医生）被赶了出去。我只能傻傻地坐在等候厅，等着被审判。Morning Report 完毕，我就硬着头皮去见他，他说，“你知道你犯错了什么吗？”，我摇头。他说，“刚才的morning report,为何你翘脚的姿势坐着？你知道这样是不对的吗？我不知道你们大马是不是有这样的习俗，但是在这里 is a different culture. 如果你要翘脚 ，回去你的国家才这样做。在这里是不准的。”

（ wth ? 我只不过是女生姿势的翘脚坐姿，这样也踩到了怪物的尾巴？之后，我询问了这里的 Locals, 他们都说这里并没有说翘脚是不礼貌的啊。。。他们也叫我"santai.." ( 安慰我，叫我relax..cool down.)

3。Literature Writing 被退回：
见完大怪物后，匆匆忙忙地赶去 print 文章，然后去 ICU 会见另一个医生, Dr. A.
Dr.A 才翻了几页，就说，“ I told you the topic is - Electrolyte Management in post cardiac Arrest care ,right ? why you wrote all the normal physiology of electrolyte? "
我急忙解释，“ No..doctor, because i'm thinking to introduce the basic of electrolyte first ,then only talk about how's the electrolyte can influence the post cardiac arrest..."
他即说，“这你给谁看？我是博士了，我不需懂这些basic, 而你呢，你也是junior doctor 了，不是也懂 basic 了吗？为何在 literature writing 还要介绍 basic？ 如果你要 basic, 那么你回去读 semester 2 吧！！”
乓！乓！乓！我又中抢了。而且，ICU 是很安静的，他的volume 又那么高，我又再次“成功”的吸引全场的目光，所有 Specialist, Resident Doctor, Junior Doctor及nurse,还有病人家属全部看过来。。。我真的是很想挖个老鼠坑让我钻进去。

（只有谁没看过来呢？病人咯。。因为他们都昏迷着。。&^@&^$*）

然后，他又说，“你回去改过给我。。我没那么有空去看你那长的文章”
我低着头，背部弯着的," Yes, doctor. Sorry for troubling you, Doctor."

( 天啊，我真的是要崩溃了！要成为医生的道路真的那么难？越来越觉得自己怎么那么的渺小，那么的不被重视，那么的不被珍惜，那么的微不足道。。。觉得自己像只老鼠。。过街老鼠，人人喊打）

4。怪物又发作了：
我垂头丧气地走出 ICU, 就立刻受到朋友的简讯，“wei...aeris..where are you ? why are you not in operating theater ? Dr. XXX (那只大怪物）was checking our attendance here and he found that you are missing ..he is looking for you...faster come ... faster come.." 就这样我又气喘呼呼地赶到手术室。然后向他解释我的“失踪”。。。当然的，又是被喷到一脸臭屁。

5．我红了！
然后，我就被派入 Follow 其中一个 Operation.我是戴着 Mask and Cap的。怎么知道，这样也被其它麻醉医生认了出来。。他们就开我的玩笑说，“ Out...!!! hahaha......" 然后，外科医生看不懂他们的玩笑，这麻醉医生就帮我“发扬光大”说，“他就是刚才被赶出去的咯。。haha.... ”虽是开玩笑，但我的心情又是怎样呢？

天啊。。！！！我终于红了也！！But In the Bad Way.. =(

6. 就这样，搞了整天。。。发现刚才赶着去Print 的时候，把 Pendrive 遗留在那儿。。幸好情形还没糟透，放工后去领回幸好还在那儿。
但是，回到家后，却发现。。。。。。。。。。书包也不知怎样。。破了！！！

写到这儿，发泄够了，时间也浪费够了。。。是时候纠正我的文章，还有读书。。。 oh my gosh, 考试又接近了。。但天天都很忙，怎么有时间读书啊？
待会儿晚上九点又要去站岗了。。。希望站岗时，那只大怪物不要出现。。
晚上了也，怪物应该去休息了吧？只有我们这些小卒需要站在前线“防卫”，对吧？

希望待会儿顺顺利利。。不要再惹麻烦了，我已是一身蚁了！！！
>.<"""""

I have had enough

麻醉学第二周的日记

12.07.2010
起死回生的感动

在麻醉学部门里时常都会遇到各种病情极为严重的病人，无论是在手术室或是加护病房（ICU）。在手术室站岗的我，到了临晨一点钟还以为没有病人将要准备入睡，忽然间被叫醒。。有个男患者，30岁，交通意外，头壳都裂开了，左边及右边的脑部都积血需立刻动手术 - Trepanation ( 环锯术 ) . 身为麻醉师的医生们全部都神经绷紧起来，丝毫不敢放松，身为菜鸟的我们也跟着不敢怠慢，赶忙帮头帮尾以及每五分钟就得纪录病人的心跳及血压。还记得我记录病人的血压最低竟是 40/20 （正常：120/80),真的太可怕了。。。好不容易麻醉剂立可纠正病人的心跳及血压，手术只进行了一半 （只不过完成了左边的 trepanation ) , 当外科医生正为病人的右边头壳开始“钻洞”，病人的血压又再狂跌。。失血的程度高达 1.5Liter.　原本正打瞌睡的我们无不打起精神。到最后病人的情况越来越不乐观，麻醉师们便展开了抢救工作。。眼见医生们打了数不尽的“心跳加强药”及提高血压的药物。。朋友告诉我说，如果没错的话，打了上百支的药物！！！ 有些医生就做CPR。。抢救了半句钟后，终于这病人的心跳及血压恢复了（虽然还是很低 。。）第一次看到那么惊险的场面，真的让我觉得麻醉师－－－简直酷毙了！

14.07.2010
第一次的 外部心脏压缩（External Cardiac/Heart Compression ), CPR


白天，被派到加护治疗病房里工作及观察病人。加护病房里的病人有的是产后失血过多加上子宫切除手术，有的是中风病人，有的是交通意外的病人，还有各种肿瘤切除后的病人等等。突然间，有个病人陷入危机状态，医生赶忙展开抢救工作。。。经过critical 的十五分钟抢救工作后，医生就说，“谁要学习 CPR 的同学，现在可以赶快穿上手套抢救了。。” 当然，我们每个赶紧穿上手套，然后轮流给于病人外部心脏压缩 。。。这也是我第一次真正在一个将离世的病人施展急救的工作。原来那种感觉真的是好像在戏里面般，我的心里直叫呼，“心跳恢复吧。。。求求你，心跳快点跟我恢复。。。！！”当我正为病人外部胸部压缩时，monitoring 着的电脑心跳有所起伏，但是当我们一停下来，就恢复了平线。。。最后，宣布死亡。

P/s : 第一和第二个case 都是因交通意外导致头壳爆裂，脑部积血。。。还记得小时候，政府常常在电视上打广告 ：没戴上头盔的西瓜被撞成西瓜浆。。。戴上头盔的西瓜就没事，不知你们还记得吗？这两个case，麻醉师医生真的尽了最大的能力了，最后病人还是离世．．．而且，他们都只介于２５－３０岁，英年早逝。。。生命真的没 Take Two 的．记得驾驶小心，还有一定要带头盔！！我很感谢上天的保佑，在中学时期的我，也曾经很爱飚摩多，觉得很威风，很刺激。真的很感谢主我现在还是好好的。也要向一直很担心我的父母亲道歉，让您们操心了。忽然间，觉得当医生是很好的，在很多别人的故事中领悟了很多，成长了很多，也把很多事情看开了。。

15.07.2010
婴儿出世的兴奋

就在今天刚从站岗回家，就马不停蹄地很想写部落格（虽然还有更多更重要的 Journal Writing及书本等着我）还是改不了的坏性格．．明明就很忙还是忍不住要花一些时间做一些 secondary important 的事情．=.=""""
这两个星期在手术里，看过了大大小小的手术，偏偏就是没看过剖腹產．．今天终于让我打开眼界了！（觉得自己好三八哦！呵呵）原来看着婴儿出世是那么另人振奋的！！！真的超开心的！当医生很快的一手把婴儿从肚子里＂抓＂了出来．．．然后听到“哇哇哇”的叫声．．好开心哦！刚好做完这case又是回家的时间，简直开心极了！！！难怪Senior们都告诉我进妇产科部门是最好玩的部门．我的下一个部门就是妇产科了．．呵呵．．．期待中．．．　＝）

值得一提的是，这孕妇是３８岁高龄产妇，第三胎，距离第二个孩子的生产竟是１８年之多！！！令人难过的是。。。她的丈夫在她怀着这胎儿的第四个月就去世了。。。　

人生，真的是变化无常。。。。　

麻醉学之至理名言

在新的部门-麻醉学部门，实习了一个星期。结论是：很Blur！
这部门其实真的是一个又新鲜（因为这部门的知识是在theory year时没接触过的）又充满挑战性（因为这部门的有关知识真的难）又会让人觉得很Amazing 的部门。。。因为人类头脑的厉害，我们可以把病人“毒”至不清醒的状态以便手术可以顺利进行，然后手术之后又可以帮病人“清”毒以让病人清醒过来。

第一天到了 Anesthesiology Department Meeting Room, 就被这张“超级”人类的图片给吸引住了。这张图片解释着要成为一个麻醉师，就要有超凡人能力，因为真的不简单。

在手术里，动手术的外科医生固然厉害，但是对我而言，手术室里真正的 HERO 是麻醉师。因为麻醉师须确保病人的一切安全，就比如说麻醉师需控制氧气的供应，病人的血压，心跳，呼吸都是麻醉师一手包办，如果手术中失血过多或忽然心跳跌得很快，麻醉师就得立刻纠正，不然病人的生命就危在旦夕了。

One of the criteria of　“ The Ideal Anesthesiologist　” - Store of Jokes and Witty Comments.
所以才来到这部门一个星期就听到了许多麻醉师的“至理名言”　：

医生一号：
要相信自己－医生通常医治病人是让病人神志清醒，但是身为麻醉师的我是要给病人“毒药”以让病人昏迷。（听起来好恐怖哦？）要知道麻醉药是Narcotics（毒品）的一部分，所以要分外的小心。在这世界上我只相信我自己，即使护士或其它医生告诉我以测量药物的安全性，我还是会亲自检查多一次。

医生二号：
有一天，有位朋友在做 Presentation, 医生发现她的 Presentation 出现了一个错字就立可轰咆她，吓得在台上的她直飚冷汗。然后那位医生忽然间１８０度的转变，立刻好声好气地说：我们是人类，人类只不过是凡人一定会犯错，但是我们能做的就是把错误的几率降至最低平线。（麻醉师的脾气，真的好难捉摸哦！上一秒把你骂得狗血淋头，下一秒却好好地跟你说道理）

医生三号：
这世界上没有危险的毒品，也没有危险的手术，只不过呢，这世界上医生有分为两种：一种就是危险的医生，另一种就是安全的医生。毒品本深不危险啊？手术，也不危险啊？危险的是医生，因为医生是负责控制这些毒药或手术的人。很可悲的是，我目前看到的是，危险的医生多过安全的医生。所以，想清楚，你要成为危险的医生？还是安全的医生？

医生四号：
Put Yourself In Other People Shoes,想象如果你的亲戚在手术病房里，你希望一个有经验的专科医生帮你的亲戚施药动手术，或是一个医学生呢？在坐的我们，每个都选择有经验的专科医生。所以这医生警惕我们在手术里实习时不准擅自对病人胡来。

医生五号：
如果你们有兴趣以后专攻麻醉学，奉劝你们要找一个了解你们的另一半，最好找回医生成为你的伴侣，因为医生比较了解医生的生活。别像我当年那样，我的另一半时常认为我在外有别的女人，因为我天天需迟回家，然后有时候三更半夜有跑出去。。其实全部都是奉献给医院啊。。我们烦恼及压力够多了，别让感情事增添我们的压力与烦恼，这样会活得很痛苦。

这些“至理名言”你又有什么感想呢？

在麻醉学部门有趣的部分就是我们有机会学习 Emergency Medicine ,以上的模型就是让我们学习 CPR 的模型。有趣吧？医生再三叮咛我们要好好照顾这模型，因为真的很贵。

忙了整个星期，刚过去的星期五才有时间“进货”。。。我的“货”全都是------ 咖啡因
Nescafe - addiction, Teh-O, Teh Tarik, Cocoa etc
我已是想尽办法让自己清醒
>.<"""

如果这地球就像个时钟，可否把电池暂时拿出，让地球时间停止转动？
我真的很想“Ｐａｕｓｅ”一下，但是　不能。

明天是星期天却得去医院站岗，在这部门的站岗地点是手术室里
手术室里的冷气真的好冷，又不准穿Jacket,
身穿单薄的手术袍在手术室里过夜
想到这里，心情就一直往下掉。。。
才不过是个开始，却已真的很累，也很phobia了。。。
时常在我的部落格出现的一句话－－－－我很想家。

I'm Done with Dermatology !

After a freaking hectic 1 month "compact" version of Dermatology ( skin disorders ), I'm here to announce that I'm DONE with Dermatology and Venereal disease.

First and foremost, infinity thanks to the Father In Heaven, who blessed me all the way throughout the whole process, including the time where i need to travel for 1 hour journey back and fro to the satellite hospital everyday for the one whole week, having extra-lecture until 10pm everyday... Thank you !

Well, i passed the exam ( without flying colors thou.. ) but I'm happy and satisfied with the results because i know i didn't study for exam.. some of them might think I'm stupid just because i didn't score well, so what ? I'm glad that i was doing good in the verbal examination which i can express my own point of view, stand on my point, deliberate the cases for the correct diagnosis, and i have good marks on that... I'm satisfied ! I think this would be more important for my future ,nope ? I do not wish back to the old times where i always just memorize and memorize and score in the routine dull paper exam. I really enjoy the verbal exam because it's more lively and i gain satisfaction from that ! Yoohoo !!!^^^

So here I show you guyz snippet of the whole dermatology which i had learned for the past 1 month.

One of the above picture - which i took with my patient's family. I visited their housing area and find out the cause which related to the disease, imparting them some advice how to prevent the disease recurrence.The diagnosis was Scabies , in which that a hygienic environment play a vital role on the disease.

p/s : as usual, my face always looked pale... haha... and thanks to Shiela, who accompanied me finding the way to the patient's house.

YaY !!!! I finished my 3rd lab - dermatology...!!!
Tomorrow , i am entering Anesthesiology Department !!! (麻醉学) Guess it would be tough yet interesting department ! Anesthesiologist is always my idol !!!!

P/s : thanks to Gordon, who bought me the mask, which shield my "sensitive" face from the sun everyday riding to hospital. You always request me to post up the photo of wearing mask, Voila !
but i don't think i looked cute on that.. >.<""""

After the exam which held on Tuesday, this whole week i was occupied with a lot of things which I loved to... for example SLEEP !!! ( the very most important )
Others ? hmm... watching movie, keep in touch with friends, reading friend's blog, surfing net..
Sports ? Certainly my favorite ! The above photo which i captured when i was playing tennis...
the blue blue sky...!!! hehe... of course, body combat, swimming, dancing would never drop out from my list...

Ok, back to the sentiment part...
I really don't like myself being fickle-minded very often and balked at many decisions or idea.
I'm not genius and I always confuse i should study for knowledge or study for exam ? because i couldn't hump over both stuff at once. At last, i choose to be myself, I study what ever i want to.. After noticing some of my friends or doctors, I think if you want to be successful in any field, a lil bit of ego is needed.. i mean a decent one, NOT to much until splurge over presumptuously ( which i noticed in some of thm =P ).
what do you think den ?

Well, i am still finding the zeal which keep me moving on in this field... and i need u guyz encouragement...Thanks you all always keep me in trail wherever i almost fall out of the track !

Have a blissful Sunday !!!!

白袍下的辛酸

以前总是很羡慕那些天天可以穿着白袍的医生们，希望有朝一日可以好像他们般地，感觉很风光。。。

进入实习后，才发现其实白袍下隐藏着很多不为人知的辛苦。。。
就比如说像我们这些新菜鸟，天天穿这白袍又如何？
有时候，在医院的地位连一个倒垃圾工人都不如，
我很清楚凡是要成功都要由底做起，
但是有时候可否给我们一丝丝的尊重？

在医院里，
新菜鸟就像是个廉价工人，
从最简单的入院手续及注册工作
从最肮脏的倒粪倒尿工作到推病人照 X-光，
有时候还得帮忙推那些不幸逝世的病人到验尸房。

庆幸的，
有时会获得病人的尊敬及爱戴，
尤其是当他们看到这些新菜鸟那么辛苦的帮忙救人
有一天站岗时遇到了一个生命危险的病人，
需要展开急救工作，
我做了足足六个小时的 "Jaw thrust" (颚推力)
站了整个晚上，手指也接近瘫痪阶段，痛到不行，睏得我眼睛都张不开。。。
当手指痛到无法忍受时，就会想偷懒不用全力去施展颚推动作，
一旦“随便”做这颚推动作，monitor 显示的氧气水平就会下降，
所以无论如何，
这是人命，多累多痛也好还是需咬紧牙根撑下去，
劳累了整个晚上，到了白天病人还是支撑不住离开了。。。
虽然如此，病人的家人还是会很感激这班菜鸟医生。。。
“谢谢你，医生。。。谢谢你整晚没休息一直帮我的老婆撑到最后一秒。。。已经足够了。。”
这就是目前我所见到菜鸟在医院扮演的角色。。。
其实菜鸟也很重要啊。。。别总是呼呼赫赫或是丑脸对待
没有我们这般任劳任怨的“廉价工人”
那些工作谁会要做呢？

过去的一个星期，
感觉自己在过着非人的生活，
天天从早上 7时到晚上11时工作及上课，
回到家都瘫痪了，加上有时还得站岗晚班呢？哪来时间读书啊？
天天到了医院都要心惊胆跳，
天天等待着专科医生会派给我怎样的病人来做我的考试，
因为病疾太广，坦白说我真的来不及读完所有课程，
我能做的只是尽力做到最好，
希望医生派给我的是我所熟悉的病疾。
我从星期一等到星期四才等到我的turn,
真的精神上好折磨。。。感觉自己频临疯掉，尤其是当看到身边的朋友都考完了的时候
今天也完成了我在“皮肤部门”的第二部分考试
下星期还有总考，帮帮我祈祷吧。。。。
进了皮肤科部门才知道原来不简单，
真的是不可以看小皮肤专科医生。。。
也许我对皮肤病没什么兴趣吧，读起来很吃力
我都告诉朋友们，我还是 enjoy 脑科部门多一些。。。呵呵。。。

现在一个人坐在医院的 International wing 咖啡厅上网，
刚刚看见一个让我很动人的情景很想与你们分享，
一个中年男子抱着婴儿及一位年迈老太太走近来，
不久我就看到一个穿这站岗制服的女医生跑了进来，
坐在他们隔壁的我都能强烈的感觉到她是多么想念自己的婴儿，
短短的半小时，她就是一直紧抱着自己的婴儿猛亲，
嘴巴喃喃说道，“你知道妈妈很想你吗。。宝贝。。。"
然后那老太太端上那热捧捧的家菜给那位女医生，
说道，“你怎么老是在医院？真的有那么忙吗？你很久没来看我了。。。”
然后，一家四口坐在医院里的咖啡厅吃晚餐。之后那位女医生依依不舍的亲吻自己的婴儿后，又得回去站岗了。
看到这样的情景，
我心情百感交集。

坦白说，我真的不希望以后我的父母亲或老公孩子得来到医院见我才能一家“齐聚一堂”。

让你们看看我最 Latest 的“累”样。。。哈哈哈。。。

脑科部门之小镇故事

在脑科部门时，被派到 NEGARA ，这小镇服务长达两个星期。
FYI, Negara 距离我住的城市三小时，NEGARA GENERAL HOSPITAL 是我们其中一间 Satellite Hospital.


路上的风景是 很迷人的。。。赶路中还是忍不住停了一会儿欣赏这宜人的风景。







一路上感觉还不错，但是。。。 当我走进 NEGARA HOSPITAL 的宿舍时，就好比噩梦开始一样。。。只有一个字可以形容宿舍的情形－“糟”！！！加上我这个有洁癖又爱挑剔的人，简直就是“不可能任务”。。。。>.<""" 挑战不可能任务　：

１。天天需用这肮脏的水洗澡
２。洗手盆被那些不用的syringe诸塞着，大家都是Junior Doctor, 应该要保持清洁啊。。。都不知哪个家伙竟然把syringe 和食物渣滓丢在洗手盆，真的让我很生气～！
３。宿舍里没有风扇，谢谢那些好心的Senior 捐出这些小型风扇。看看那风扇的大小，再跟那椅子比较。。。你就知道这风扇是有多小型，而且是我们８个人一起共用这两把迷你风扇。所以，很多时候，身体都是汗流浃背，粘粘的。
４。我们八个一起共用那唯一的桌子，读书，做报告，吃饭都在这儿。
５。睡房，天天需在蜘蛛网的“笼罩”之下睡觉。。。有时房间也有一种潮湿的味道。。要怎么入睡呢？　我天天都特地把自己搞到很累，或是拼命读书，让自己读到累了，就不会过度的醒觉四周肮脏情形


以下图片是与那边的护士与医生合影　：
（左上）：在 Polyclinic of Neurology 外与护士合影。一开始她们还以为我是日本人。哈哈。。。
（右上及左下）：在polyclinic 前的小池塘
（右下）：与那边唯一一个脑科专科医生合影



充满岜厘岛风味的 NEGARA GENERAL HOSPITAL
在这里，他们都称“hospital" 为“Rumah Sakit"...


终于熬过了这两个星期，独自一人骑着摩多，三个小时的路程回到我的 Comfort Zone - 我在岜厘岛的房间。
在那儿的两个星期，我真的很想念，很想念我的房间。。。那干净又舒适的房间。
也是第一次，我体验到有一个舒适的房间，我，真的知足了。。。也不会埋怨说没假期，没得回真正的家。在那儿，我的感觉是只要能回到岜厘岛的房间已经是很开心的一件事，根本不敢奢求有假期能回大马。

心里真的开始崇拜那些无国际医生，站在最前线帮助那些穷人，宁可抛弃舒适生活而选择天天在潦倒的环境下生存。

骑着摩多车，心里默默祷告保佑我平安回到宿舍。只不过，回到宿舍，我的四肢都麻痹到不行，真的越来越佩服自己，简直像个女战士 （哈哈。。。忍不住自夸起来），因为目前只有男生而没有女生像我这样发神经骑摩多到 Negara. 三个小时，真的不是开玩笑！ 原本我其实也蛮担心自己是否做得到，真的很感谢上帝聆听我的祈祷，保佑我沿途中平平安安的。


沿海公路是蛮崎岖的。。。感觉真的很棒！起着摩多看着海，偶然之下，让我发现有一条直路是直开到海边。。。好奇心的驱使下，忍不住驶进这条直路，简直太棒了。。。 因为。。。。

直路的末端就是一望无际的海边。。。。天空与海洋的地平线。。。。。。
而且是没人的。。。。整片蓝蓝的海洋一览无遗的呈现在我的眼前。。。。。。
好棒好棒 ！！！！！！！！！！