Friday, April 10, 2009

A Letter for My Professor

"Hey you with the pretty face,
Welcome to the human race"

Mr. Blue Sky by Electric Blue Light

I like Lily Allen's cover version better - especially when she sings the lines above.

Yesterday, I got sent out of the Surgery wards for doing something really inane by a the head of department of Surgery in my college - I will not disclose his name here but it suffice you to know that he is the Father of Modern Terrorism. What I did was this; I looked at a patient's lab report before completing her general physical and systemic examination. Still, the stupid thing is that he wouldn't have found that out if I didn't tell him myself. He was perusing the patient's file and I thought that he might be interested in knowing the highlights.

My colleague who was clerking the case with me did the same thing I did but he got off, of course, because I didn't sell him out. The reason Prof. Abject Terror got so uptight over my apparently harmless action was that he did not want our impression (as medical students) of a patient to be coloured by whatever other findings or diagnoses the ward's doctors have uncovered.

What he forgot was that we are also tasked with writing two cases every week (and lengthy discussion notes on them) and that we must not have duplicates, cases with the same diagnoses. And also, there is a list given to us enumerating certain types of diseases we must see and write about before the end of our Surgical posting. The only way we can achieve that two conditions is that we find out the patients' diagnoses - or at the very least, the pertinent findings in the history and examination - before deciding to invest the paltry 30 minutes allotted to us to finish taking a complete history and examine the patient thoroughly. Remember, we are only in the Surgery ward 3 mornings a week, so we have to select the two best out of three.

Never mind that the lecturer who want us to present these cases at the end of the 30 minutes would scold us if we select cases with no physical findings (which is more common than you think in the Surgery ward, I can tell you). So, how would we know if a patient have physical findings or not if WE DID NOT LOOK AT THE DAMN FILE? Now, suppose I follow the correct procedure - suppose I spend 20 minutes taking a complete history before proceeding to examine the patient - what if I discover at the 25th minute that the patient has no physical findings? Do I start all over with another patient who may or may not be a case I can write in my portfolio, and who may or may not have physical signs on examination?

Unless the Surgery department tells us which bed we must go to in the morning clinical session, I will continue to do what I have always done; look at every patient's file in the entire ward before deciding which case I want to clerk. In fact, I went to the wards half an hour earlier yesterday so I can have first pick of the cases before the college bus arrive with the throng I have to fight with everyday for the best patients. I did this because I want to learn, to see cases I haven't seen. I am in med school to get an education - not perform miracles.

Anyway, I didn't actually feel any anger when Satan, I mean, the Professor berated me loudly in the ward and sent me out. If any other lecturer did the same, I'd have flip out. The thing is, I consider him to be some sort of unpredictable force of nature in my mind - like a hurricane or a tsunami or underfoot dog-shit. He can happen to anyone at anytime without any warning. Plus, he sent so many thousands of students out of the wards over the years that the punishment no longer seem like such a big deal anymore. This is the first time I was sent out of a class by him though. Now, all I need is a T-shirt saying that I have passed my rites of passage in my college.

Oh yeah, he told me to write a letter explaining why I erred. I wanted to simply leave him a note saying "to err is human" but thought better of it after the alcohol wore off. Here's a transcript of that letter; which I spent a pretty enjoyable half hour writing (I'm pretty sure I wasn't suppose to enjoy it, though). Keep in mind that he likes to call people "incompetent fools",

Dear Sir,

This letter concerns my banishment from the Surgical Ward of the Malacca General Hospital for the day by your authority with the stipulation that an explanation must be put in writing regarding the circumstances which precipitated said penalty.

The patient which my colleagues and I were clerking presented with pain in the upper midline for 3 days with a history of one episode of vomiting and yellowing of the sclera of her eyes. After eliciting the relevant history of her current illness, I have, in a moment of extremely poor judgment and foresight, stole a look at the results of the patient's liver function test before the completion of the patient's general physical and systemic examination. You, sir, were informed of my indiscretions by my own candid and voluntary disclosure without any prompting from your party - another lapse of judgment on my part.

My reason for acting thus is because I had the gall to assume with a possibly misplaced certainty that the patient has a hepatobiliary condition from her history alone. I took further liberty by hypothesizing that the patient's liver profile would show abnormalities in her bilirubin levels, and made the terrible, terrible mistake of trying to test my hypothesis. I apologize for my over-enthusiasm.

My colleague, who was completing his questioning of the patient, left me with little to do till he is done, so I took a peek at the liver funtion report in the interest of saving time - as I would later be required to reproduce the findings in either the case presentation session (which, as of yesterday, is at 8:30 am instead of 9:00 am - making time economy more important than ever) or in my portfolio. Again, this is absolutely no excuse, and my stupidity and incompetence is indefensible.

Your judicious decision in sending me out of the ward and denying me my attendance in the records for the day, sir, is absolutely necessary because I need to see the errors of my ways and repent. After all, how else will I learn?

Once more, I apologize for my stupidity and incompetence. Thank you for sending me out of the ward, kind sir.

Your incompetent student,
Kok Sen Wai

I will get right back at you with a couple of real posts this weekend. But then again, I got a feeling that even my filler posts contain more contents (or at least, word count) than the average regular post most blogs display. Where the hell do I even get the time to write so much crap?

Joined the club,
k0k s3n w4i


nuraainaa said...

whoaa, ur good.

but u probably know that already.


~*caryn*~ said...

whoa. your surgery posting is really tough. compared to yours, mine sounded like a honeymoon.

senorita.. said...

wah, damn stress

pamsong said...

Eh, your letter to the Sir got typo lah. There's a double 'the' in para 2.

Love the sly sarcasm though. Haha. Give it to him lah!

k0k s3n w4i said...

nuraainaa: good as in 'virtuous' or good as in 'has mad skillz'?

caryn: rumour has it that when we start working, it's going to be tougher. waaay tougher.

senorita: this is why you should never let ur kids go to med school. if u send him or her there, it's child abuse. if ur child wants to go, he or she is a masochist.

pamsong: there's no mistake in the original written letter - which I handed in a day before i wrote this post. t'was a typo when i reproduced it here. what sarcasm? no sarcasm la *innocent*

Anonymous said...

ahah. He sure will like you, after this.

Zzzyun said...

haha ur letter is fantastic, man!

he will be seething in anger after reading it but cant do anything coz it's all up to one own's interpretation hahaha!

Anonymous said...

lol, no comments frm ur fellow college-mates...

i shall remain as anonymous

k0k s3n w4i said...

Anonymous: very likely. I'm so deferring, right?

Zzzyun: well, he didn't look as if he was seething when he read it. I'm actually pretty meek in front of my lecturers.

Anonymous: why?

Kok Wai said...

That's a nice posting u have there. Im sure the lecturer in question here will enjoy your letter. He will not fume, in fact he will probably muse over it. I was taught by him about 6 yrs ago. It's nice to know he is still as feisty. Trust me, when u start work, his scoldings will come in handy. Everything else u hear will pale in comparison.
In time, I have grown to respect him rather, as opposed to complete angst and anxiety when he took our class.
Btw, slow down on ure negative energy:) All the best in Melaka...

k0k s3n w4i said...

Kok Wai: contrary to what this post sounds like, I actually have great respect for the man. He's one of the few lecturers who gives me the sense that he's actually telling me things which would be immensely useful someday. I feel that way right after my first class with him. anyway, i wrote this post to let off some steam. I'm only sleeping 4-5 nights a week (4-5 hours each time), trying to make the best of this posting, so I might come off as a bit irritable at times. COntrary to my tone, i'm actually enjoying this posting. And thanks for the pep talk, o similarly named senior :)

kok wai said...

Why is there so little sleep? It can't be good if the body is deprived of sleep. trust me. If anything, the irritability is an indication:) the same cant be said of my surgical posting in college as I never did enjoy it. Ironically though I'm in a surgical based dept now, and soon I'll be starting my postgrad study the same in Penang. I'm glad u enjoy the posting in any sense:) Which batch are u in now?