"He wondered, as he had many times wondered before, whether he himself was a lunatic. Perhaps a lunatic was simply a minority of one."Nineteen Eighty-Four (1949) by George Orwell
This has been a proper busy week so far and the weekends would be upon us before I can devote some time to penning another opinion piece. So in the meantime, here's the report I was forced to write for my college's academic office detailing my experiences in the elective program I followed during my recent 5 weeks vacation; which just happens to be a thoroughly honest account of events, by the way, or I would not deign to publish it in my blog.
I typed the whole thing in just one hour to meet the deadline while having to meet the stipulated 1000 to 1500 word count. If you know me, you'd know that I generally don't react well to coercion, particularly when it comes to writing. My Ex-Grrrfriend™ can tell you just how difficult it was to persuade me to participate in my college's annual creative writing contest in my 1st Year, just so I can prove to everyone that I'm not a complete good-for-nothing (she likes a boyfriend she can boast about, you see). After we split in the following year, my class rep assumed her mantle and went through the quite troublesome process of getting me to cooperate and win the contest for my batch again - which I did, awesome, handsome and winsome creature that I am. I was also told to contribute articles to my college's newsletter and magazine, but I don't think the editorial body of these publications can stomach my fondness for profanities, my propensity to be brutally honest and my controversial scope of interests anyway so I didn't even bother. I write what I want, when I want, however I want to. An editor, in my humble (haha) opinion, should serve only to streamline my penwork and correct my grammar - not dictate my content.
So yeah, you can read for yourself how gosh darn seriously I took the academic office's instructions. Sic semper tyrannis, biatch,
The following is the report of my four weeks long elective posting in the Orthopaedic Department of the Seberang Jaya Hospital in Seberang Jaya, Seberang Perai (also known as Province Wellesley, which, along with the far more famous and tastier Penang Island, forms the state of Pulau Pinang). This report was written on the order of my college's academic office, the non-compliance of which voids my entire elective posting like it never happened; voids it like how the Ministry of Truth in George Orwell’s haunting political fiction, Nineteen Eighty-Four, operates in censoring the existence of any event which throws the totalitarian governing Party in a bad light. Remember, Big Brother is Always Watching.
The posting spanned a not insubstantial period between the 19th of April and the 14th of May – though arguably, many other medical college prescribe far longer tenures in order to allow their students achieve a much firmer grounding in the inner workings of the hospitals they choose to be posted in. Four weeks only permit a thorough elective experience in a single department – or two at most. I respectfully suggest that our college's administration review this policy and make attempts to extend the allotted elective time-frame for future batches of our student body. On second thought, I think I’ll retract my criticism above. The college’s administrative prerogatives are never wrong. Please remember my constant and unwavering support for the ruling regime if my exam results and academic record ever come under scrutiny.
I reported on a Monday on the 19th, a week later than I hoped to due in part to the incompetence of the clerical staff of the state’s Health Department in handling my application. I left Malacca for Pulau Pinang on the 14th of the same month, and even at that point in time, I have yet to receive the confirmation and approval letter the desk jockey coordinating the state's elective program promised me in one of the numerous phone calls I’ve made to him to hasten the process. A representative of my interests (which is a fancy way of saying 'my dad') had to mail said letter back to Penang to me when it arrived days after my departure. I was quite prepared to march into the Health Department’s office in KOMTAR to retrieve the letter in person and offer the clerk a piece of my mind.
To get back to the fabric of my report; I was given a yellow name tag which identified me as a 'pemerhati' (the Malay word for 'observer') and I despaired because I thought it meant that I would not be allowed to perform or assist in any medical procedures and as a result, accumulate no practical experience from my time in the department - so I pragmatically dropped the tag in my pocket where it did not see daylight till my last day at the hospital. I was also told by the Seberang Jaya Hospital’s administration to report to a medical assistant rather than to a supervising physician – not that I’m implying anything here, no sirree. Medical assistants are as indispensable as doctors in the smooth running of the healthcare machine. And so are nurses. Great people, the lot of them. I positively love them to smithereens. These are my official, on-the-record opinions of these wonderful, wonderful professionals. Anyone who claims otherwise is a dirty liar.
Fortunately, my worst fears came to bear no fruits as I was quickly took under the wings of one of the specialists of the department, an orthopaedic surgeon by the name of Mr Ruban (he hopes to super-specialise in hand surgeries, by the way). He orientated me on the department's schedule and advised me not to come for electives everyday as I might 'burn out', to borrow his vernacular. Naturally, I put his counsel under serious consideration. The many house officers manning the department – spent, dried out husks of former human beings they are – echoed the sentiment and told me that I should spend my one last lengthy holiday in medical academia outside of a hospital. In that first day, I remained unfazed in my flaming and radiant determination to attend almost daily. In that first day.
The department’s timetable – and henceforth, mine – ruled Mondays and Thursdays as clinic days when they attend to outpatients and follow up on previously admitted cases. On Wednesdays and Fridays, the department performs orthopaedic surgeries in one of the hospital’s operating theatres. I said 'one' because it was not a very big hospital and does not have the overwhelming workload of a larger centre. Tuesdays belong to the Bukit Mertajam outpatient clinic and operating theatre, and as my permission letter from the Health Department only covered Seberang Jaya Hospital, I thought it was sensible to sit that day out.
On one of my first days in the outpatient clinic, the Head of Department, Mr Abdul Aziz B. Yahaya M.D. (USM), M.Med. Ortho (USM) sat me in his chair and room, handed me his official rubber stamp, a book of medical certificates for sick leaves, and a prescription book; and told me to see patients in his stead while he make his rounds through all the rooms in the outpatient clinic to better supervise his house and medical officers. Needless to say, it was a prospect both daunting and exciting at the same time. A house officer was assigned to make sure I do not bungle up the case sheet write-ups, the referral forms to physiotherapy, the prescriptions and the radiological orders – but I was pretty much left to sink or swim on my own when it comes to taking a patient’s history and performing physical examinations. Luckily, I was fresh out of passing my Phase 2 Stage 1 Examination and much of my theoretical and practical knowledge in the discipline of Orthopaedics was still retained in my memory – and any case which was too complicated or advanced for me to handle, I consulted Mr Aziz, who was more than happy to guide me.
I was told by the house officers that the Head of Department spoke favourably of me in one of their meetings, saying that I was an exemplary medical student. I doubt I deserve such a high praise but nevertheless, it encouraged me to help staff the outpatient clinics on most subsequent clinic days - particularly on the days the Head of Department is present to maintain his excellent impression of me. I strongly believe that our college's curriculum can benefit greatly from adopting a similar strategy in our training program. It is a very expedient method in forcing medical students to quickly learn their subjects while cultivating an enthusiastic attitude towards performing the duties expected of a house officer, which they will all assume in due time - lest they drop out of med school and become pharmacological company representatives instead, of course.
I was also taught the correct way to write a certificate of medical leave by a staff nurse – a truly essential skill to learn, to be sure.
On the so called 'OT' days, I was given free rein to walk in and out of the operation theatre and observe any surgery which takes my fancy. I was even furnished with the security password to the operating theatres, a secret I will never betray to anyone; not even under the threat and pain of death. The pristine, aseptic environment of the OT in Seberang Jaya Hospital must be zealously and jealously defended.
On one of my lasts days, my batchmate (Ms Ooi Min Ming, who was also in the same program) and I decided to thank the entire department for their guidance and patience with us by buying them a huge cake. It was a Mille Crêpe; a French cake made up of many layers of crêpe interposed with luxuriant French vanilla cream. Unfortunately, there was only enough cake for the specialists, medical officers and housemen so we ate it secretly in one of the meeting rooms in case the nurses and medical assistants go "Hey, where’s our cake?!" It certainly didn’t help that a lot of the hungry, deprived house officers devoured more than one slice each.
The cake, I am happy to report, was delicious.
I completed my elective program on the 14th of May with enviable commendations from the Head of Department who gave me the maximum score of 5 ('excellent') on every parameter in the evaluation report's checklist, except knowledge and skills for which he awarded me 4 ('good'). His rationale was that a medical student shouldn't get any higher than that, and only a MO or a specialist should score 5's for those. He also wrote in the comment/suggestion section: 'Hardworking and [a] good student. Wishing him [a] good future.' I have attached said evaluation form to this report, so no one can say I am talking through my hat. This report is 1490 (1000-1500) words long, as mandated by the academic office.
P.S. If you're interested in getting in on some Mille Crêpe action yourself, here's how to get some. The talented confectioner behind it, Amos Chong, used to operate out of Malacca's Nadeje Patisserie but have since left the establishment and went on to spread the gospel of his fucktastic french cake to Penang (island and mainland), Johor Bahru, KL and PJ. As for me, I've instituted a boycott of Nadeje 2 years ago (which I'm currently still sticking to) after they started this breathtakingly stupid policy of not allowing customers to dine-in if they refuse to also order any of their ridiculously expensive beverages along with their slice of Mille Crêpe - which Nadeje still serve, but theirs is generally considered to be inferior to Amos'.
k0k s3n w4i