Tuesday, April 29, 2008

A Little More Life, Please

"The patients with primary toxic goitre may be psychic."

A Manual on Clinical Surgery, by Dr Somen Das

Medical textbooks need more typos like this.

I have this post titled 'The Importance of Failure' and it was basically a really, really lengthy essay explaining why I need to fail the Second Year of medical school. I half-finished it a couple of weeks before the actual exam but I made no attempts to complete it because... well... because I bloody passed, actually.

No one had any doubt of that eventuality; not my colleagues, not my parents and not even Phoebe, who witnessed how I executed my absolutely ridiculous study plan all through the month-long study break (and it's only ridiculous 'cause it's the only study plan in the world that does not contain a single hour of studying in it). I spent each and every day either watching movies, reading novels or goofing off on the interweb - while at the same time, I kept overhearing complaints during mealtimes from my batchmates about how there was no way they could finish the syllabus on time. There were at least 6 telephone directory-sized textbooks along with 6 notebooks filled with lecture notes I was suppose to swot from for 4 different subjects - that's medical school for ya, kiddo. The only effort I cashed in for my ludicrously unjustified pass was sitting down and reading all through the night before each paper. Somehow, during those nights I frantically crammed for Pathology, Pharmacology, Microbiology and Forensic Medicine, I also managed to finish reading the awesome 1000-paged first book of the A Song of Ice and Fire high fantasy series as well. I, in all seriousness, don't think deserve to pass at all.

I have this reckless streak when it comes to exams, and the most effort I've ever invested into any one subject of any one exam is the hours of the night before. Even that, I'd only read enough for myself to feel confident enough to get the grades I want. For example, if I allot myself 8 hours to finish reading for a paper, and if I feel confident that I know enough to pass by the 4th hour, I'd just chuck the book away and go to sleep. It's just who I am - I can't change that.

What I did for my Second Year exam is something entirely new. While I've paid a lot of attention in class for my First Year exam, I spent my entire Second Year with my head up in an apathetic cloud. I was grossly unfamiliar with all my subject matters and had a thoroughly incompetent understanding of the stuff I was suppose to know intimately. While all through the history of my academic career I have at least felt dutiful enough to ensure a passing grade for myself, I simply don't freaking care if I would actually fail Second Year.

I was tired of Medicine. To be really frank, I was quite prepared to flunk. In fact, I was so prepared that I have already made up my mind to quit med school when I flunk, and go for another career - rather than spend half a year in the refresher course and retaking the Second Year exam later. I like writing, I'd like to learn how to do it properly. I like graphic design too. And law is not too shabby either, considering that most of the career aptitude tests I took pointed that-a-way. I really ought to get out of Medicine before I am in too deep.

But thanks to some disembodied (and twisted) cosmic sense of humour, I somehow passed.

I don't have as much time as I did last year t this stupid blog of mine. I've started my clinical postings and have begun doing some vaguely doctor-ish stuff like taking patients' history, tapping on them with my fingers and listening in on their innards with a steth.

The buses which are suppose to take us to our respective hospitals everyday.

This phase of my medical school life can actually be fun, really - beneath all this apathy, I can still see that much. But still, it's pretty hard to enjoy myself when the most of the people I have to deal with don't speak English beyond "Hello", "Goodbye" and "Fuck Off" "Okay". My only means of communicating with them is sign language (have you ever tried asking someone the consistency of their shit that way?) and a English-Kannada phrase book. Imagine flipping through your phrase book frantically for about 5 minutes trying to frame your question, and having the patient answer in rapid-fire Kannada while you stand there smiling and nodding as if you bloody understand a single word what he or she is saying. Not fun. Thoroughly pointless. The school board seriously needs to know that only about 1% of Malaysians know that Kannada isn't a misspelling of that snowy country north of the USA.

On our first day in Medicine posting, there was this dude in his late forties that apparently spoke English rather acceptably, and everyone crowded around him, firing him with questions and poking examining him everywhere. I later found out that I was assigned to his case and when I visited him the day after, he had quite forgotten how to speak English ("No Ingris! No No Ingris!"). I remember asking him permission to perform a general and abdominal examination on him, but he put his palms together and quite literally begged me not to bug him. So, I had to go hunt for his file and copied a second-hand history. I kind of understand how he feel really - if you're sick and needs rest, would you like people bugging you with stupid questions? How willing are you to be cooperative if you know that the moron interviewing you isn't a doctor but just some stupid med school student? How about a stupid med school student that don't speak your language? Yeah, I thought so. Basically, I just go look for Mr Pancreatitis - that's what I call him, which the rest of my group mates took to referring to him too - to say 'Hi' to him everyday, ask him if he's feeling okay, and leave him at that. He was discharged today.

There was another incidence when I had to extract the history from another patient - an amiable and cooperative fellow - for a case presentation I had to do. I asked him if he consumes alcohol using hand signs. He answered in the negative but when I checked his case file afterwards, I discovered that he's a "chronic alcoholic". I have a feeling that he thought I was asking him if he wants a drink of water.

I have to examine a possibly HIV positive patient tomorrow - who has cough. Pray for me. Pray that she don't cough some blood into my eye or something.

During lectures, which are performed in the terribly humid wards over a patient while all of us are stand by, I find that my mind tends to wander. Everything the lecturer says become a sort of unintelligible buzzing to me. I can spend the entire time just standing there with my eyes going completely out of focus. My Body's saying, "Can't move, mate. Got to stay here," and my Mind's all, "But I don't have to."

Maybe it's just that I have never had a thoroughly realistic view on life. I read mostly fiction with a high preference for fantasy, and watches more movies than any medical student with no time ought to - and that possibly made me a little ill-equipped to swim in the real world. There's this constant yearning to fill up my life, as if it is half-empty and whatever I have in it is sloshing about restlessly; desperately even for something other than this. My Mind's wandering for that purpose, I think, searching and probing what I could have done and what could have been if I did, or just whir about at top speed for no particular end. That explains why I come home every night with my brain feeling more exhausted than the rest of me.

There's got to be more to life. I can't see the point of living if there isn't. I had a precious, minute-long phone conversation with Phoebe yesterday night, and I don't get quite enough of that (her mom's deadly inquisitorial when it comes to boys and dating). It's almost like hearing her voice anew again - that same sweet, almost cartoon voice I fell in love with the first time heard it when I called her to ask her out for a date; I have never even met her face to face yet, then.

Yeah, I need a lot more of these sort of stuff in my life.

Fed up,
k0k s3n w4i


pinksterz said...

haha i think it is normal for every medic student to think of stop doing the course.

i did (and still do). few times. per week.

and i think its healthy.

Michelle Chin said...


phoebe said...

i'd give up everything i have in a heartbeat, just to be in your position. its only when you lose something, that you realize how precious it is to you..

k0k s3n w4i said...

pinksterz: it's healthy to resent our livelihood? did you actually try hard not to pass then? :P

michelle chin: OI back!

phoebe: u'll give me up to be where I'm at? xD
in a heartbeat, no less xD
sigh, didn't know you'd give me up to undergo the tortures of a medical education. I got so lousy mer T_T ?

michelleg said...

haha sometimes they wont admit that they are alcoholics.. ;) *referring to ur chronic alcoholic patient*

pnee said...

real patients we see in wards are always different from those in books...but they r warmer than those in books,thy haf feelings....
language...might be a real challenge for u cause u're unable to clerk them...but rest assure,use those common terms in their language which u cant express thru hand signs...thru thr u will pick up wat thy're trying to tell u:) tat's how i communicate with indian pts,whr thy can only speak tamil:(
for hiv pts...hmmm...i've met a few,practice ur standard precautions in a proper way is wat i will tell u:)
well,update more on ur clinical phase...wana noe more:)

k0k s3n w4i said...

michelleg: true. I wanted to ask the HIV patient (who is single) whether she works in "service" industry. but thought better of it...

pnee: I got a smattering of Kannada I can use to get a general idea, but it's just not enough to get a proper description of the patients' problems. I'm just counting down the days till I go back to Malacca and talk to people who can... y'know, speak in a language I can understand. Oh don't worry bout me :) I know them pesky precautions front and back and front again, but thanks for the pointers :D. Anyhow, I doubt u'll hear very much about my clinical phase (or much about school, in general) because I srsly mislike talking about stuff like that.

phoebe said...

sho silly T^T not givin u up also. hmpf