Realism Abounded.

Currently, I'm suffering from a lower back pain. At the level of L4, L5, S1, 2 parallel to iliac crest. Worsened on exertion. Sounds fancy. But trust me it hurts. Shallow down to my poor medical knowledge, i begin putting up certain diagnosis together see if it fits. But of course nothing fits. My mind wonder off to MRI examination, up to multiple myeloma with rare sudden onset of lower back pain.

You see, as a medical student we can awe you guys with a very fine-sounding fancy medical terms. Because that's preety much what we are doing. We play pretend. Nicely wrapped in a warm cocoon of a protective layer of subcutaneous fat. With exception in exams, no one will scold us when we make a bad judgment, so-far-off differential diagnosis or wrong lists of treatment plan. We got scold at at times. But no consequences to be shoulder upon.

I went back home, for 3 long weeks of practical training in paediatric ward back in my home town hospital. I did the practical alone, and by some strike of fate, no other students were having classes there as well. Apart from the other HO's there i was, alone. I gathered up all courage that i had, went and introduced myself to the specialist there, asking for permission to follow them for the whole 3 weeks while I was there. The first day wasn't so bad, I must say. I was greeted by a super-nice senior nurse we all call Sister who later during her free time will call me to show her expensive cats collection on her Fb page. Optimist with the warmth countenance, I was optimist with the days ahead.

How i was wrong.

Did i mention, I was trying to postpone my practical in Malaysian hospital for as long as i can, or better off, not ending up doing it at all? I was running away for as long as I can, from the system because of all the scary stories i heard from friends studying medicine in Malaysia. You see, we can choose ,really, whether to do it here or back home. People in Malaysia called us the 'elective students' so we are free to do anything we want, come or went back to hospital as we pleased as no one is monitoring or having direct supervisions on us.

Since that was the first time walking in Malaysian ward as a student and what more not yet learning Paeds, you can imagine how stressful it was for me. I was scared too, whether things that have been taught here were sufficient enough or are we going to be labelled in the same categories as other incompetent-overseas students that seems to be the way of Malaysian doctor's classification on the fresh graduates, if you know what i mean.

A lot of things humbled me during the day to day practical. It seems to prove the common theory for all jobs, that practical is different from nicely-written textbooks theory. How to put them in order of adequate history taking, proper physical examinations, to come up with differential diagnosis, various applicable clinical technique, quick judgement in emergency cases, are some of many that we are expected to master by the time we hold that magical scroll while smiling to the camera on the graduation stage.

All the HO's, senior or fresh on first posting without getting tired, advice me to polish up on how to read X rays, reading ECGs, interpreting complete blood counts, distinguish different types of murmur, chest sounds, basically all the things we often omit in medical school and not to forget start to get familiar with Malaysian enormous short forms. That will, at least help you to lessened the pressure of seeing more patient in less time, they say.

It was then too, I saw a lot of rape cases, child-abused, school teenagers pre-maritial conceptions (in between really close family relatives) that end up with endless list of congenital defects of the new born baby, poverty, poor sanitation, even poorer knowledge and interest towards health in general, and any other rural problems you can imagine. That being said, I'm sure urban hospital has its own perks to deal with.

I saw too, how poor communications among doctors, too much social/hierarchical barriers can lead to jeopardizing patients' safety. That i think, we all need to work on. We too can have a day to day learning process without compromising a senior-junior doctor's respect. At some point we all need to look back and realize that everybody begins at the exact same starting point. Being all-senior and putting up a stern-faced of mentor-ship doesn't get us anywhere, for sure not gaining any respects from people working under and around you. Well, at least not that i can think of.

In the end i guess, it's our coping mechanism that hold us through. A senseless form of endurance. To hold back tears and stays emotionally detached when we're yelled at in front of patients and their whole family members. To be pre-vaccinated with some sort of emotional anesthesia. Both in facing patients and impossible working environment.

You do know that this post purely intended as my tool of nurturing personal reflections, exploring new experience, dealing with them on higher ground and starts seeing things beyond my own narrow perspective, right?

Till then!

>.<