Humanity in Writing

"Your manuscript is both good and original, but the part that is good is not original, and the part that is original is not good."

Samuel Johnson, LL.D MA

With a stiff cup of piping java in one hand and a fistful of reluctance in the other, I peered cautiously into Seminar Room number 4; the place where I was suppose to spend two full hours unwillingly writing a full-length essay using my hand on a topic I don't give two flying fannies about. One of the contestants was already there - last year's First Second Runner Up. Her promptitude and the business posture she adopted in her seat spoke rather assertively of her determination to stamp my ass out this year. Me, with my just-got-out-of-the-bed-which-I-was-in-since-last-Tuesday hair, caffeine tremors in my fingers and buzz tics in my cheeks, was heckuva lot less formidable sight to look at.

I popped right in the back and wordlessly studied the participants that came in after - all of them looked a lot more better for wear than I was ("a wreck" describes me best). I was a bit surprised that lingghezhi, Stephanie and that smart specky bloke from Batch 19 were some of the people who I would have to contend with this year, since all they had to fight for the glory of their class last year was a Malay girl who wrote for 30 minutes, and then left for the Maghrib solat. What a disgraceful time slot to hold the competition! Racism, that's what it is!

That Malay girl didn't join this year though - she probably figured that half an hour is one-and-a-half hour short of sufficient time to write a masterpiece. lingghezhi looked to be a real tough nut to crunch. Considering my beaten up shape of mind, a chimp at a typewriter would probably cream me too.

Then in a replay of last year's amateur writers' smite-down Dr. Surekha Bhat sauntered into the room and everyone hushed up like in anticipation of certain, terrible doom.

"Humanity in Medicine" she wrote on the chalkboard, and remarked crisply that we have two hours. Then she left. I think everyone was a bit stunned for like 5 seconds after.

Shit. I'm not very good at medicine, to be honest (watch out, future patients of mine!) and I've never been particularly humane either. "This is a damn stupid topic" I said aloud but no one took notice of that because they all have already started planning out their essays. I craned my neck and took a gander at Miss First Second Runner Up's manuscript, and found that she already had this octopussy mind-map thing drawn out.

Fifteen minutes into the competition, I was still wrestling with my blank manuscript and my brain - which strangely, for reasons unknown, kept replaying scenes from previous episodes of House over and over again. That's when that biggish Seychellois girl I mentioned in my previous post walked into the room as cool as a penguin in a freezer, glanced at the topic on the board and remarked, "I can be creative with that!" Way to go. Psyche me down more, wontcha. And before she settled into her seat, she asked one of the other participants to lend her a pen. Oh Em Gee. How much more nonchalant and confident can one get? I actually felt my butt deflate and me sinking into my chair.

By the time I wrote my first word, most contestants have already filled up half a page. I think I'm pretty screwed this year. Oh well - no use crying over a flat butt. Here's my piece. I think I deserve "A+" for effort. It's hard to write when you keep thinking that the paper in front of you looks remarkably similar to a white, fluffy pillow,

2nd of January, 2008

Dear Diary,

My name is Julie and I’m 12 years old this year. I’d ask you to introduce yourself but you can’t talk back very well, can you? You’re just paper stuck together between two covers – but I guess you would have to do. Dr. Colbert gave you to me yesterday because I told him I was lonely and that I kept wishing that I have somebody (or something!) to listen to my thoughts. I have so many, many things in my head and if I don’t let them out somehow, I think I might just explode. Dr. Colbert comes by every morning for a few minutes to keep me company but he’s a terribly busy man. Mommy visits every evening, right after she gets off work at the canning plant but I find it so hard to talk to her. All she does is hold my hands and cry every time she looks at my face.

I have no Daddy.

I wish Dr. Colbert is my Daddy because he’s such a clever man. And nice. And he always brings me Terry’s books for me to read. Terry is his son. He’s about my age.

I remember meeting Dr. Colbert for the first time when I had to come live here at St. Marcy’s General. He told me I was ill and needed "chemotherapy". He taught me how to spell that – he knows so many big words. That’s why I said he’s frightfully smart.

I’m glad he gave me you.

***

29th of February, 2008

Dear Diary,

Today is my birthday. Mommy brought brought me my favourite cake; Strawberry Chiffon from Constance’s Confectionery! I asked her if I can have a kitten for to play with here in my room but she said she couldn’t afford it - what with all the bills she's paying to make me better. She promised that she’ll get one for me next year though.

Albert, the boy in the bed next to me, said that Mommy was lying. He said I am going to die here.

I don’t believe him, of course. He’s just jealous that his mother doesn’t visit him as often as mine. Besides, I remember asking Dr. Colbert if I am going to die, and he smiled at me saying 'Not if I can help it, Julie'. I know that he will fix me. He’s a very clever man – didn’t I already tell you that before?

I want to celebrate my birthday in the park next year – under the sun and blue sky and cool, green grass between my toes. I have enough of hospital rooms to last me for this life and the next. And the one after that too.

I shall call my kitten, Colbie. I think it’s a nice name.

***

21st of March, 2008

Dear Diary,

I think it’s unfair. It’s unfair that I can’t go outside and play, or do anything at all. It’s unfair that God gave me two legs, and then take away my strength to use them. It’s unfair that I have to stay in this smelly room. It smells of disinfectant and sick people. I used the think that it was bad enough that I’m always weaker and smaller then the other girls in school, that I’m never as pretty as they are - but now it’s just so much worse.

I yelled at Dr. Colbert this morning. He’s the reason I can’t go home. All he wants to do is keep me here and give me horrid "chemotherapy". And now "radiotherapy" too. I thought all these therapy things are suppose to make me better – Dr. Colbert said they would. But HE LIED! All they ever do is make me throw up. I’m feeling so much sicker than even before I came here. Mommy won’t take me away either. She just keep telling me 'Soon, baby'.

I cried last night. I cried because my hair won't stop falling out. I know I'm not beautiful, but I have always thought that my hair is the prettiest part of me. Now that's going to be taken away too.

Why is God killing me? Why does he heap all these misery on me?

I hate him. I hate him I hate him I HATE HIM!

***

29th of March, 2008

Dearest Diary,

It has been nearly three months since I came to St. Marcy’s. I really, really miss home. Do you think God is keeping me here because I said nasty things about Him before? I’m sorry I did that now. I promise that I’ll never EVER do such a thing again. I promise I’ll always pray and be a good girl from now on. I’ll promise anything – anything at all. Just let me be well again, please.

I finally said sorry to Dr. Colbert for throwing a tantrum and yelling at him last week but he told me not to worry about it. He said he was not angry at me in the least bit. He told me he understands just how difficult everything is for me and that I am a very brave little girl.

I’m feeling terrible pain these days and I can barely even hold this pencil steady now. The medicine Dr. Colbert gave me to keep the pain down doesn’t seem to work so well anymore. I asked him to give me more but he said that my body can’t take so much of it. God, it hurt SO BAD!

Yesterday, Dr. Colbert and his friend, Dr. Thomas was talking softly between themselves beside my bed while reviewing my charts. They didn’t know this, but I wasn’t really asleep. I think they were arguing about something or other.

Dr. Colbert said a lot of things but I only caught one word because the pain medicine made me drowsy. I remember it because it sounded weird and I’ve never heard it before. It sounded like "Youtha-naysia".

I asked him what that word meant today and he was a little taken back at that. He asked me where I heard that word from and I lied to him. I said that Nurse Grace said it while talking to Nurse Eva. I didn’t want him to know that I’ve been eavesdropping on their conversation.

He wouldn’t tell me what it means though.

***

4th of April, 2008

Dear Diary,

Albert died this morning and they covered him completely with a blanket, and then took him away. To be honest, I never really like him. He’s always so morbid and he kept saying horrid things. But I’m going to miss him anyway. I don’t know why. Maybe it’s because he understands that unhappiness I experience with my sickness – because he has the same illness too. Now, there’s just me in this room. I never realised that it’d be so quiet without Albert’s breathing sound coming from the bed beside mine.

I talk a lot less to Dr. Colbert and Mommy these days. I’m just so distracted by the pain. It’s in me all the time, never letting me rest. Sometimes, I wonder if it would be better for me to just die. Do people still feel pain after they are dead?

I asked Dr. Colbert if there’s anything he can give me to make it all stop – to put me into a sleep I’ll never wake up from.

He said yes. I think he must have really felt sorry for me at that moment because his eyes watered a little behind his glasses. I must have looked really pathetic then – with my few single strands of hair left on my bare scalp and my small, broken body. And my crying because of the terrible, terrible, terrible pain – and for it stop.

I asked him if he would give it to me but Dr. Colbert said it isn’t "ethical" to do that.

Is it "ethical" to let me suffer this way?

***

6th of April, 2008

My Dear Best Friend and Diary,

I can’t write a lot because I can barely move my hand. The pain. But it’s going to stop. Tonight. Dr. Colbert whispered to me that he will make it go away but I must not tell anybody.

I said 'Thank you, Daddy'. I don’t know why I said that but it just came out of my mouth. Dr. Colbert burst into tears and hugged me close to him. It feels so good to have a Daddy – even for a minute. Daddy’s going to make the pain stop tonight.

Tell Mommy that I’m sorry for making her cry everyday. Tell her I said goodbye, and that she won’t have to cry anymore after I’m gone.

Bye bye, Dear Diary.

For the more perceptive of the lot of you, you might have noticed that I have loosely structured the essay after the Kübler-Ross model - more commonly known as the "Five Stages of Grief". I picked that up from the first episode of season 2 of House, "Acceptance" (House called it the "Five Stages of Dying"). They are Denial, Anger, Bargaining, Depression and Acceptance.

I had problem deciding initially which perspective I wanted to tell the story from - the doctor, the mother or the dying girl herself - but I finally picked Julie. Had I chosen Dr. Colbert's PoV, I would have to spend a lot of time struggling to decide what sort of cancer the little girl would have, describe the accurate clinical course of said cancer and maunder on the tedious technicalities of treatment regiments just to make sure my essay is convincing enough for the judges, who would most definitely be part of the faculty (doctors, the lot of 'em) - time I don't have because I already took half an hour to do a big fat load of nothing.

Also, the Mom's side of the story didn't seem to interest me the least bit.

Writing from a 13 years old girl's perspective allowed me to hand-wave all the medical bits aside. Plus, I would be required to dumb down my choice of words as well - something I don't really need to work at considering my desperate need for relief from my prolonged sentence of forced consciousness (that's a whole mouthful of bull saying "lack of sleep"). Besides, her limited vocabulary allowed me to insert that minor plot wink about mercy killing.

I have a terrible sensation that I was not sticking close enough to the topic while I was writing. My interpretation of the title was much more subtler than my entry last year - and I think, a lot less clever too. But then again, if you're broadminded enough, what I wrote is precisely that too; the humanity in medicine. I took the most serious theme in the line of health care - Death - strip it of its IV lines, life support and expensive scanning machines, and gave my take on what's beneath it all.

How come I got this feeling that someone else wrote about the same thing? And yeah, I know my essay sucked pig.



All hail King of Crapland,
k0k s3n w4i

Feeding Frenzy

"You are what you eat."

Unknown author

I am rice.

I have tons of more interesting posts and pictures pending that I would rather write about, but seeing that this particular post has an expiry date on it, I suppose I better write it up before it becomes too stale to tell.

Yesterday, I visited the annual MSA Malaysian Food Fest for the first time (I do so hate crowds) which crash landed for the night on campus ground. MSA either stands for Malaysian Students' Association, Multiple Sexual Assault, or My Sorry Ass - I don't give two pence worth of care about it because acronyms are such a waste of time.

I was there really early, of course - about 7 pm-ish even though I was suppose to meet mi compadres at half-past-seven. I couldn't help that because my dinnertime is about 5 pm everyday. Considering that I customarily skip my lunches these days, it's amazing that I even managed to shift My Starving Ass there without suffering a hypoglycemic crisis on the way.

Of course, no stall was opened yet then. Dammit.

Here's an aerial... well, semi aerial picture of the fête taken from the fire escape beside the lecture hall complex,

Miniature Scene from Above.

I pretty much spent a whole half an hour sitting by my lonesome self at one of those tables they've laid out on the square.

Then the people started to mill in,

Motley Sauntering Aimlessly.

I didn't take many picture, and none at all of the nosh I scarfed. My hand was oily, sticky or covered in some unidentifiable sauce most of the time - I didn't want to grease up my camera's clicker, naturally.

Many Supper Aficionados.

I entered with about 300 rupees in my pocket and went home without two coins to rub together. Everything was grossly overpriced, with the exception of a few odd cheap 'n' chompables here and there. The muachi (some squishy, mucoid stuff which was apparently glutinous rice flour balls covered in peanut bits) from a Batch 17 stall was pretty awesome, costing me only 25 rupees. My personal favourite from the fest was definitely that chicken congee I bought from a Batch 19 all-girls booth, reasonably priced at 30 rupees per cup (yes, paper cup - quaintness to da max).

Besides those and Tze Hau gang''s luo hon ko and dried longan drink, Nana and crew's fusion murtabak Maggi, Su Lin's team's handmade fishballs - there's not much I can remember now. Apologies to all the other maker of goodies whose creations which I could not sample for want of gut space and moolah. My Starvation Act have left me with a Much Sissier Appetite and Massive Stomach Atrophy these days. Trust me, I am truly sorry I couldn't eat everything. Same time next year?

Mess of Stuff we Ate.

Oh yeah, I forgot to mention - the main reason I was there was for good ol' Sanjeev's 21st birthday! He's our classmate from Repiblik Sesel, or Seychelles for the rest of ya. That's his cake in the picture right there and he wasn't there yet when this was taken. I have no idea whose hand it was that appeared to be grabbing at the key-shaped strawberry confection though.

I was sorely disappointed that no one was selling Indomie goreng though. What sort of ripoff Malaysian Food Fest is this? Bah OMGsorrysorrydon'tbanmefromvisitingnextyearplease


P.S. Jen pointed out that Many Stupid Acronyms fits too. I still can't believe I missed that! Shit, I is becoming dumberer everyday.


Foodie extraordinaire,
k0k s3n w4i

Socks and Little Booties

"We are here on earth to do good for others. What the others are here for, I don't know."

W. H. Auden, Anglo-American poet

You remember Socks, don't you? Socks, the Incredible Supine Bitch;

Her default pose in an older picture 3 months ago.

Socks loves her tummy rubs so much that she would flip over every single time I walk by (I can't help wishing that I have that same power over supermodels and beach babes, though). But in the past few weeks, I realised that Socks is getting ridiculously rotund. I mean, she can't even lie on her back anymore;

OMGBALLOON.

I gave her a little shove with the sole of my sandals and she flopped right over like a bloated sack of wet cement. Seriously, she had been a really greedy bitch and I have caught her stealing Fifi's food from her many times (by growling at Fifi till she freaks out and drops whatever she's holding in her mouth). I have to shoo Socks away and close the gates to the stairs leading up to my room on her every time I wanted to give Fifi a bone or biscuit. She's just so tiresome sometimes.

Now that she's oh-ho-ho-bese, I find it an excellent opportunity for me to practice some hard-learned doctor skillz on her. Okay, I know I'm still only in my second year in med school and I have not attended a single Surgery lecture yet - but any old quack with a scalpel can perform lipoplasty. Worse case scenario; I poke a hole in her spleen or create a fat embolus that bobs all the way to her lungs and kill her. But those are risks I'm willing to take.

So here's the rough schematic diagram for the procedure with the postulated outcome.

Yeah. I'm sure it will ooze right out.

Oh, there isn't a vacuum cleaner lying around so I can't like, make a small incision, stick it in and suck it out like what they do for them big, shiny Hollywood royalties - but the basis of good doctoring is improvisation, I think. Just like how I use ice to substitute anaesthetics. Brill, ain't it?

Anyway, the operation was a rip-roaring success...













...except for one teensy, little hitch. The bits of fatty tissues we recovered from the patient's abdomen are... err... extremely bizarre in shape, colour and consistency.

They also squirm a lot and make real cutesy yelping and whiny noises;

Patient in recovery bay.

This will redefine our perception on fat and flab! I mean, you won't diet and exercise these little fatheads to their doom now that you know they are alive and quite literally kicking, right? Liposuction will be made illegal. Before you know it, everyone will want to be tubby and grow their own litter of downy cellulites. This is the dawning of a whole new era, ladies and gentlemen! Fat will be the new fab! Watch out for my name in all the major medical journals - I'll be mailing my research papers as soon as I locate an envelope.

"Mama?" *Kiss*

Life is amazing, isn't it?

Particularly new ones.



Surgeon-in-n00b
k0k s3n w4i 

Saturate My Saturday

"Requesting help from Chinese guys and girls for four volunteers. Dr. Manjunath needs your help. He wants your presence tomorrow at Room 5 at 2.00 to 2.30 pm at the dental clinic."

Inn Shan, in a mass-sent SMS

I woke up this morning at about 10.30 am to the din of my dastardly doorbell, which had conspired with forces unbridled with a sense of propriety and the concept of privacy to ensure that my weekend sleeper-inner would not extend beyond midday. I can't remember when was the last time I truly lazed in bed beyond all natural hours - it must have been a Saturday so long ago that nothing remained of it but a pathetic whimper in the big photo album of happy memories. Two Saturdays ago, it was my birthday. Last Saturday, it was the despicable evil known as the Persistent Encyclopedia Salesman (who nearly had butt-sex with the rusty metal tip of my umbrella).

This morning, the Stone-for-Brains-of-the-Week were a couple of Indian blokes in white coats, sporting name-tags which proclaimed smugly that their bearers are students of the Kasturba College of Medicine, a sister college of my school. I was informed that they were distributing medicinal freebies; prophylactic drugs against filarial parasitic infections. 3 little pills. To be downed at one go. After meal.

As a kid, I was taught never to accept candies from strangers - and I obeyed like the model child I was. If I wouldn't take their candies, I sure as heck aren't going to start popping their pills.

But that wasn't the only reason;

See anything wrong?

It struck me immediately that the centre pill is different from its other bunkmates. Upon closer scrutiny, it was obvious that the packet had been tampered with, and the two side ones have been switched. I looked up the inscription on the middle pill on the internet and found that NVBDCP stands for the National Vector Borne Disease Control Programme - all apparently legal and aboveboard. Did someone stole the real stuff and replaced it with duds? Or with something more sinister?

Perhaps some people thought that they can make a bit of cash by stealing government-issued drugs intended for the protection of the rural populace from filarial worms. After all, why give a flying fuck about those poor uneducated peasants, right? Corrupted bastards.

I'm showing these pills to one of my Pharmacology lecturer on Monday to see what he or she make of it. If any of you reading this post right now received these same drugs, I advise you to refrain from eating them.

If you already did, you have my sympathy.



Moving on, regarding Inn Shan's SMS announcement;

Ugh! Hwa' huh huck? Geh id owt! OHW! Tha hucking hhhurkh!

The lesson to be learnt here is: Never agree to what Inn Shan want you to do.

"This is going to be painless," MY ASS.

Leh meh goh!!!

Dr. Manjunath is a faculty member of the Forensic Medicine Department from the Kasturba College of Medicine (yeah, where those blokes who gave me the dud filarial meds came from) and he is doing some "very important" research on palate prints. Run your tongue along the roof of your mouth behind your front teeth. Can you feel the rough, ribbed surface there? That's your palate "rugae", as the good doctor call 'em. According to him, they are as individualistic as fingerprints.

He said that they would be of immense value in identifying char-grilled air-crash victims when we asked him about the practical implications of this research.

I hate to break it to the guy that dental records are already employed pretty successfully these days to the same end.

Check out the huge hall decked with dentist chairs! I call it the Dungeon of Dental Horrors. Oh, that's Jun Man in the chair, by the way. On a good day, screams emanating from this establishment can be heard in the next town.

Anyway, my palate print was lifted by pressing a pink putty against the roof of my mouth with a steel, spade-shaped thing that the contours of my teeth and gum are suppose to fit into snugly. The orthodontist working on me must have inserted it off-centre into my mouth or something because the friggin' thing scraped my gum nastily on the right side and drew blood. Plus, she was pressing pretty hard on it, digging the metallic edge right into the cut. I thought I was going to fucking die.

Then, after a minute, she wiggled the metal watzisname, trying to loosen it before pulling it out. Scrape. Scrape. Scrape. I wanted to scream my head off but I couldn't because - well - why don't you try screaming with a spade-shaped dental thingamajig full of pink stuff with the consistency of shit in your mouth?

That's mine on the left.

I was test subject number 33, Chinese Male.

Lai Yin, Jun Han and Yin Yee also volunteered for this gig but the lucky trio were pronounced unsuitable in the end because they all wore braces. But they did stick around to watch Jun Man and I experience Death by Play-Doh.

Damn, I feel like I'm on fucking CSI!

The above picture is proof of the god-awful torment I experienced on the chair. See that exposed metal bit not covered with putty? That got me good. And if you look carefully enough, you can also see my blood.

Yes, blood. You heard me.

A plaster model crafted from the putty mold.


A boxful of 'em.


Dr. Manjunath giving us an impromptu lecture on palate prints. It was about as interesting as it sounded.

After I got home from the dental clinic, I immediately tossed a notebook and a tape recorder (which I borrowed from Ilyani) into my messenger bag and headed out again. This time, I got business to attend to at Sonia Clinic;

Ooh, blue.

Remember that I mentioned in passing in my last post that I was intending to interview someone there?

Well, I finally did it! Stick around for my next update, okay? There's a lot of stuff I need to iron out before can I put it up.

Till then.



Recently rendered odontophobic,
k0k s3n w4i

Something All Medical Students Must Read

"Check out today's MSN feature stories. There's one about being some doctors' first ever patient. The characters seem very familiar. There's definitely a Lai Yin type in there."

Shaki, in an SMS right after I wrote
my previous post two hours ago

For non-MMMC student readers, Lai Yin is my class' prize student.

I don't want to waste you time, so here's the article. I have NEVER featured any article in this blog, so you know this one must be awesome, mind-blowing good!

I managed to salvage the article before MSN changed its feature stories. If there's any way to access the older articles, I am not aware of how it can be done. But why go to MSN to try when you can read it here?

Playing Doctor

Oh, no! I'm the first patient these 23 medical students have ever examined.

By Emily Yoffe
Posted Wednesday, July 4, 2007, at 8:33 AM ET

Over the course of three days recently, I had 23 head-to-toe physicals from 23 second-year students at the Georgetown School of Medicine. I was the first person these would-be doctors had ever fully examined on their own. Some were shaking so violently when they approached me with their otoscopes—the pointed device for looking in the ear—that I feared an imminent lobotomy. Some were certain about the location of my organs, but were stymied by the mechanics of my hospital gown and drape. And a few were so polished and confident that they could be dropped midseason into Grey's Anatomy.

Georgetown allowed me to be a "standardized patient"—that is, a trained person who is paid $15 an hour to be poked and prodded by inexperienced fingers, so that med students can learn communication and examination skills before they are sicced on actual sick people. In Human Guinea Pig, I try things you might want to do but don't have the time or opportunity. However, even if you had the time or opportunity, you probably wouldn't want to be examined by 23 medical students.

The concept of the standardized patient has been around for decades, but only in recent years have medical schools made training with them a regular part of their curriculum. I talked to a 50-ish physician friend about my experiences, and he said when he was in medical school and it was time for the first rectal/genital exam, the students were told to pair off and examine each other. "So, do you pick someone you like, or someone you don't like?" he recalled. "Either way, it's lose-lose."

Now there are standardized patients trained for genital duty (they're called GUTAs, for genitourinary teaching associates), but I signed up for something less invasive. Mine was the simplest possible assignment. I was to sit on the edge of a padded table in one of those awful, flapping hospital gowns, in a room equipped with recording devices in the ceiling. Each doctor had 30 minutes to conduct a standard head-to-toe physical: from my vital signs, to my nerve function, to my reflexes, etc. Then I was to go to a computer and check off whether they'd done all 45 parts of the exam ("Palpated for fremitus," "Auscultated carotids"), and write my comments on their bedside manner.

There are some obvious things you hope no doctor ever says to you, but on this assignment, I discovered there are a few others:

"I have to admit I have some butterflies."
"I've never felt anyone's liver."
"I'm so sorry! Are you all right?"

I actually was charmed by the students who acknowledged their nervousness, and it was adorable the way most of them would stop after finishing one body part, look upward as if at a floating textbook, mumble some mnemonics, then continue the exam. Before he left the room, Dr. K (although they can't yet call themselves "doctor," I'll call them that here; they're so eager, they deserve it) ran his eyes over me and said, "Let me check if I forgot any major systems. That would be bad." But nervousness in a doctor can be dangerous. Dr. F had a relationship with her instruments that reminded me of Edward Scissorhands. She apologized profusely after stabbing me with the otoscope.

Sometimes it was hard for me not to laugh. Dr. A was so sweetly flustered that in a perfect Chaplinesque slapstick, he would drop his reflex hammer on the floor, bend to pick it up, and then discover that his pen had fallen out of his white coat. Dr. N wasted the first eight minutes of the exam trying repeatedly to get a blood pressure reading. The panic in his eyes seemed to say, "She appears to be alive, yet she has no vital signs." He finally solved the dilemma when he realized he was listening to my arm with the wrong side of the stethoscope. (My blood pressure readings, which require technical skills on the part of the doctor, varied from 87/60 to 125/90.) Sometimes it was hard for the student not to laugh. Shy and mousy Dr. B, after peering into my eyes and ears, said, "Now I have to look up your nose!" and let out an embarrassed snort.

From the moment petite, blond Dr. C came in the room, she took command. Before she started, she briefly told me what the exam consisted of, then explained each procedure before she did it. Her touch was confident, and she did all 45 parts of the exam without hesitation. She asked me to tell her if anything hurt or made me uncomfortable. After she listened to my abdomen and proclaimed, "Good bowel sounds," I felt gratified I was able to please her.

Dr. C made me wonder what it is that makes some people glide elegantly as swans, while others stumble awkwardly as mud hens. My main mud hen was Dr. I. He began poorly by asking me where the recording camera was, then addressed all his findings to it. For example, after I successfully stuck out my tongue, he said to the ceiling, "Patient's cranial nerve No. 12 is intact."

Like many of the students, Dr. I was baffled by how to assess my heart and lung function without breaching the fortress of my bra. Most students, while listening through the stethoscope to my back, simply worked around the bra. But Dr. I informed me he needed to unsnap it (no, he didn't use the one-handed technique). Then he stood in front of me, looked at my gown like a colonel contemplating an incursion, and struck. He peeled off the top of the gown, dropping it into my lap, slipped the bra off my shoulder, and left me hanging while he protractedly listened to my heart. (Dear Male Readers: Doctors don't strip their female patients.)

I sat there, as the tape ran, debating whether to stop the exam. Sure he had on a white jacket and was using a stethoscope, but in reality, Dr. I was no doctor, but just a pimple-faced kid who'd taken off my bra. My pondering was interrupted by an abrupt knock on the door. We looked over, and standing there was the real doctor in charge of the program.

"No breast exam!" she said firmly to Dr. I. He was left sputtering as she closed the door. I redid my bra and put on my gown. Dr. I gamely tried to continue, but he was so shaken he forgot to take my blood pressure, and before he could get to my reflexes, an announcement over the PA said the time was up. He had to put down his hammer like a contestant on Top Chef forced to drop the spatula before plating the side dish.

After every three exams, standardized patients take a break in a private lounge. There were about 20 of us divided into two groups. My group was undergoing the physicals, while a group of older SPs were pretending to have hurt themselves in a fall. Almost all my fellow patients were professional actors who supplement their income by appearing in a repertory circuit at the medical schools of Georgetown, George Washington, and the military's Uniformed Services University. I envied that some really got to exercise their acting chops. One told me she recently portrayed a depressed alcoholic with irritable bowel syndrome who wasn't even supposed to know she was depressed and alcoholic—the medical student was supposed to figure that out.

An older SP had recently been at George Washington, where she had to portray a sex-crazed senior citizen. Her story was that she had been frustrated during her entire marriage because she wanted sex daily, but her husband would only satisfy her weekly or monthly. When he died, she moved to assisted living, where she cut a swath through the remaining men and ended up with a sexually transmitted disease. She says of the students required to take her history, "They were freaking out with embarrassment."

When I went back to my examining table, I tried to think what my reaction would be to my students if they were real doctors and I was a real patient. In response to most I would have thought, "This is disturbing." A few would have made me wonder whether I was in an episode of Punk'd. But a handful were so ready, so ordained to be physicians, that I simply would have been impressed by my young doctor.

Sometimes I got to see their excitement at playing doctor while I played patient. Dr. S, a future McDreamy with a hand in a cast from a rugby collision, moved in close with the ophthalmoscope to examine the fundus (OK, the interior lining) of my eye. Just as we were almost touching he said, "There it is!" with the same delight a sailor would cry out, "Land ho!" Some tried making doctorly conversation. "Have you ever had a physical before?" one asked. I nodded yes, but wanted to add, "Lately, I get one about every half hour."

Finally, I felt privileged to be there at the beginning and help send these healers on their way. So, to you Drs. A through W (even you, Dr. I), I hope your nerves settle down when you examine your patients' nerves, I hope you never get sued for malpractice, and I hope you make a lot of people better and even save some lives.

Credits to Shaki for giving the heads up.

EDIT: Managed to figure out how to access the site's archive. Here's the LINK.


Giving props to some else's article,
k0k s3n w4i

A Night in the Life of a Medical Student Who Procrastinated

"Haha, you asking Kok? He's the guy that called me two days before the University examination asking me for the time, venue and the order of the subjects we are being tested."

Shaki, answering before I could,
when someone asked me about a class test

This is just another short, filler post. You'll get a lot of these this month.

Right now it's past 4 am. I just completed my insane load of backed-up Self-Directed and Independent Learning Microbiology assignments. There's a visible dent on the lateral side of the middle finger on my right hand where a pen rested on for the past 5 hours. The proximal interphalangeal joint of my little finger (on the same hand) is now killing me after being scraped repeatedly over and over again across the page of my assignment notebook from carving out lines after lines of condensed factoids which I harvested from three Microbiology textbooks that are probably heavy enough to kill a small elephant with adequate trajectory.

On my desk was two empty cans of Amul's Kool Café which I favoured over the other brands (mainly because they use 'K' instead of 'C' for 'Kool'). Sitting not to too far away from them is an empty packet of Cheetos, which was my dinner and supper all-in-one because I simply couldn't find the time to get away for a bite. There's another packet of Cheetos on the floor beside my chair but I seriously doubt that I'm going to open it anytime soon. Synthetic cheese flavoured cornmeal crisps do not agree well with my stomach (or my epicurean taste buds either, for that matter). I have 261 songs on my Winamp playlist (plus a few thousand more stored up somewhere), and most of their lyrics have already been committed to my memory through a constant regimen of overexposure and chronic conditioning. Sometimes, I even leave the music playing when I sleep. I have less nightmares that way.

A little more than an hour ago about 3 am, the fluorescent tube that functions as the sole illuminant of my bedroom come study-room come media-room began to flicker rapidly. Had I been a photosensitive epileptic, I'd seize up like one of House's patient o' the week, hit my noggin on the corner of my desk, and die bleeding like a pig. Thankfully, I'm not a photosensitive epileptic - or an epileptic of any kind. Now, where was I? Oh yea, fluorescent stroboscopic discotheque WTF.

After each successive blink, the fluorescent lamp dimmed perceptibly. The room became darker and darker, and soon, I found myself sitting in total inky blackness with my pen still resting in its groove in my middle finger and my lips making the shapes of the syllables "Oh" and "Fuck" mutely - in that order. Then a minute later, the fluorescent-lamp-that-died began to flicker back to life again; an encore of its earlier light-and-soundless show, only this time, in reverse. I'm no expert when it comes to electrical stuff, but I'm quite sure fluorescent tubes aren't allowed to do that. I'll go check with their union.

A year ago, such a bizarre domestic phenomenon would no doubt kick my ultra-fertile imagination into hyperdrive. I would have panicked and started praying to the gods in all the world's major religions. I might have even leapt into bed and curled up like a... err... wuss¹ under my blanket. But just now when it happened, all I did was grope about for my cellphone for a bit of light, and wonder if I can substitute the the dead tube with the one in my anteroom so I can resume my mountain o' work.

Medical school does that to people, y'know? It kills your imagination.

Okay, my self-alloted break is now over. I'm going to start swotting for that stupid Haematology test I'm going to sit for in a few short hours. Pretty pointless post, huh? I thought so too.

Back to work,
k0k s3n w4i

¹ I'm trying hard not to use the 'P' word here.

You Know You're in India When...

... your university has a Yoga Department;

It's as much a science here as surgery and psychiatry, I tell ya.

"Time is free, but it's priceless. You can't own it, but you can use it. You can't keep it, but you can spend it. Once you've lost it you can never get it back."

Harvey McKay, businessman and columnist

Something for my med school colleagues, this quote.

The head-hunting season hath cometh. Our heads that is, and the lecturers are out for blood.

Yep, it's the dreaded block exams again. Love to stay and chat, but gotta run (at least for tonight). I know I promised a proper post this time, but I try as I could, I was not able to finish writing it today. And in case you're wondering; yes, I really do put a lot of thoughts into my (proper) posts when I pen them - and this one I'm writing is particularly personal.

Maybe tomorrow, okay?

Or, next week.

Running man,
k0k s3n w4i

I Hate Thursdays

"These lecturers must know how to bend time or something. I swear that the last ten minutes felt like a whole hour. Come - let's grade all them on a scale of 10 by how much they can slow time down. Dr. Yoga from Forensics would be 1, because time goes by pretty quick when he's in class. Dr. Surekha from Physiology would be a 10 - that woman can practically stop time, I tell you."

Me to Shaki, last Thursday

Every Thursday, lectures start at 8.00 am instead of at the usual, comfortable 9.00 am we enjoy on the other weekdays (Fridays don't count because the lunch period starts at 11.30 am instead of 12.30). Plus, there's a Pharmacology SDL presentation class after lunch at 2.00 pm (which I usually have to prepare for by skipping lunch because I'm just too bloody lazy to do it the night before).

Today was particularly sluggish because half the time in the lectures, I have to struggle to stay awake (I spent the other half of the time sleeping). Had a couple of bad dreams the night before. Don't wanna talk about them.

So, I when Shaki told me that SDL was canceled today, I was so overjoyed that I actually spent the whole Pharmacology lecture (which replaced the SDL) paying my full, unwavering attention to Dr. Yeshwanth Rao while he gave a long, meandering talk on immunosuppressive drugs.

But I did skip lunch anyway to grab a short nap. So when I saw this, my stomach growled audibly, beseeching me, its master, to feed it;

No, it wasn't the cow that made me hungry. Look closer;

Nope, it wasn't these two heifers either. Closer still;

There! The Pearly Gates are painted blue and red.

A while ago, Domino's expanded and opened an outlet just two minutes' walk away from my place in Acharya Compound. They must have heard that Sir 'Scarf-a-lot' Kok¹ have just moved into the neighbourhood.

Why are all the powers in the cosmos aligned against my fitness and diet plan?

My resolutions crumbled like a pathetic house of cards (no surprise there) and I bought myself a personal combo; two personal pan pizzas, cheesy garlic bread and a bottle of coke. Why on God's green earth is there two personal pan pizzas in a one-person combo? I didn't dwell long on that particular philosophical question though - I simply can't think straight when I'm starving.

As soon as I stepped into Acharya Compound, guilt gripped me. I suddenly decided that two personal pizzas were simply too many. I spotted Lai Yin and I wondered if she could take one off my hand.

"Hey, Lai..."

"Hey Kok! Autopsy. Over at the mortuary now. Wanna come?" she said, cutting me short.

"I... err..." I began lamely, pointing at the big plastic full of obesity delights I was carrying.

"No time. Leave them in my house first," said Lai Yin.

I obeyed and immediately hopped into an auto with Lai Yin and Nina (haha, going to an autopsy in an auto). As required by my course, I must witness four autopsies at least in my second year in medical school. Most of my batchmates have already seen one while I've seen zilch (they couldn't wake me up on the Saturday they went). Guess, I didn't really have a choice since I was already behind schedule anyway.

The wait.

A whole crowd of people were already there when we arrived.

Only in medical school would you get to see so many happy, excited faces on people who are about to watch fresh corpses being hacked apart. I got a feeling we are all going to hell.

Warning: Potentially disturbing images ahead

Yeap, I'm only showing you the disturbing ones. I'm keeping the really grisly, visceral, insanely gory pictures for myself.

On the table.

The guy we're "doing" this afternoon was a 39 years old, 71 kg², Indian man who was admitted into the hospital 6 days ago. Apparently, he lost control of his motorcycle, hit his head on the asphalt and didn't regain consciousness since. He died in the ICU this morning. Let's call him Joe, okay?

For those that harbour illusions that death is a solemn (and possibly even a beautiful) thing; boy, do I have news for you. Here's basically what Joe went through after he had given up the ghost³;

1. Joe was stripped and photographed.
2. He was cut open from his chin till the root of his penis and opened up like a sports bag.
3. His tongue was cut from the floor of his mouth while his rectum was tied off and was severed from his anus (tied off to prevent his "last meal" from spilling out). Then, all of his innards (between the tongue and the rectum) were hoisted out and dumped at his feet like some macabre ceremonial garland, leaving behind an empty shell.
4. Every organ (heart, liver, lungs, spleen, kidney - everything) was harvested from that 'garland', individually weighed and sliced apart like cuts of meat so the coroner(s) can see how they looked like inside.
5. His scalp was sliced from ear to ear, flipped, and draped over his face like a ski-mask.
6. His skull cap was removed using a saw, a hammer and a chisel.
7. His brain was dislodged and was sliced from several different angles.
8. After the coroner(s) were satisfied, all the bloody, minced visceral organs were stuffed back into Joe's chest and abdominal cavities. Joe's colons are now at where his heart and lungs used to be. And yeah, his diced brain was stuffed into the chest too. The coroner managed to herd everything back in by using Joe's own breastbone like a prod before finally tossing that in as well and sewing him up again. The skull cap was replaced and the scalp was sutured (but now, Joe's head is literally full of air).
9. All this happened in front of a whole class of eager medical students who looked on with morbid fascination.

So, where was I? Oh yeah, death sucks.

Turns out what probably killed Joe was blunt force trauma to the left temporal region of his head. A straight 6cm fracture was discovered there and underneath it was a pretty mushed up temporal lobe of his brain. Both subdural and subarachnoid hemorrhages were evident.

Now listen here;

Joe's did not hit a car or a bus or a truck or anything. There were practically no other injuries elsewhere on his body. He merely fell off his bike and hit his head on the ground. Had he been wearing a helmet that day six days ago, he could have picked himself up, dusted himself off, and rode home.

No amount of gore can disturb me more than that.

The weighing machine used to weigh Joe's organs.

This was a whole different experience compared to the Anatomy dissection classes I had last year. The bodies we used in those have already been pickled for years in formaldehyde and their blood had long been drained. They looked just like - well - really, really dead people.

In an autopsy, the guy lying on the table in front looked no different than if he was just having a peaceful, quiet, afternoon nap - while we play butcher on him. Looking at Joe's face, it really wasn't that hard at all to imagine him opening his eyes, putting on a pair of pants, and walking out of the mortuary whistling the latest Bollywood ditty.

You may find my narrative callous and unfeeling (It's a fucking human being you insensitive bastard!). Trust me when I say that we would have all gone mad if we weren't so hardened up inside⁴. It's necessary for us to lose a bit of humanity for this job. Is it too big a price to pay? Does any of us even realise that we are paying it?

There was also another autopsy (on a suspected case of organophosphate - an insecticide - poisoning) on a 52 years old, 75 kg, Indian male. Boring case. Shan't waste your time talking about that.

I reached home at about three-quarters past five. As expected, my pizzas were already cold and the Coke was warm.

I ate both the pies. I finished the garlic bread as well.

Damn, I was famished.

And I still hate Thursdays.

P.S. If you don't like my dumbed down account, try - kye -'s slightly more technical report on the autopsies. He even covered the organophosphate poisoning guy.


Not quite human anymore,
k0k s3n w4i

¹ Other nicknames include, Fat-ass (Shaki), Mr. You'll-die-of-heart-attack-at-30 (Shaki again), Free Willy (Yeap, same idiot), and You-make-me-look-thinner (ex-girlfriend).
² Ironically, though he was bigger than me, I was the heavier one.
³ Autopsies are done in unnatural deaths. Live well, die old - capiche?
⁴ In fact, the Associate Professor of Forensic Medicine, one Dr. Vikram Palimar (excellent chap, by the way), was talking to the pair of coroners about some restaurant or canteen that one of them wanted to try out. Over Joe's dead body. Literally.

The Quintessential Guide to Surviving Manipal

"Study in Manipal. Get inspired by life."

manipal.edu

10. Get all the vaccines and immunity shots known to mankind prior to coming to India;
Polio, Tetanus-diphtheria-pertussis, Measles, Typhoid, Japanese Encephalitis (if you’re visiting the boondocks *coughManipalcough*), Rabies, Hepatitis A-to-Z… If you survive all these needle jabs, you might possibly survive this country.

9. Bring your own homegrown, Malaysian flavoured Maggi mee.
Regardless how “quaint” and “exotic” Masala Maggi sounds, I assure you that it tastes pretty much like horse-sh!t – only with less horse and more sh!t.

Horse-sh!t.

8. Learn how to say “Less sugar,” when you order anything from a local eatery – even things that don’t usually contain sugar (refer also #7).
There's apparently a national obsession with the sweet stuff; your standard cup of tea here is one part water and two parts sugar, and there are cakes so sweet that you'll actually screw up your face in sugar agony as soon as you take a bite. One out of every four diabetics in the world is an Indian; that's some seriously insane amount of sugar pee if you ask me.

7. Invest in a good, anti-halistosis¹ mouthwash or breath-freshener.
The staple vegetable here is onion. The pasta here is smothered in onions. The pizza here has more onions than cheese. Heck, even if you specifically ordered a bowl of fried rice with NO onions, you’ll still find onions hidden somewhere at the bottom. If you don’t like onions, you will die of starvation.

6. Practice a good, forbidding frown in front of your mirror.
I found that the beggar kids will scatter and run when you frown at them like this;

"This oughta put the fear of God in them scruffy whippersnappers!"

5. Take swimming lessons.
During the monsoon season, you might have to swim to get anywhere at all – class, meals, shops, the swimming pool, etc. You might even want to consider buying a yacht if you're rolling in paper Gandhis. Imagine non-stop torrential rain. Back-to-back. Day and night. For months.

4. Pork can be found at Tasty Bites and Thai Lin. Mutton (and beef)² can be found in the Valley View Hotel.
What everybody needs to know.

Forbidden pleasure.

3. Watch old reruns of Fear Factor to prep yourself mentally.
Ever wondered where the producers get inspirations for those stunts where the contestants get locked up in claustrophobic chambers full of icky bugs and are forced to eat god-awful, disgusting animal innards/juiced insects/beastie genitalia? That’s right; from the life and day of an average student studying in Manipal, India.

Ant infestation in my room.

Deep fried hemorrhoids³

2. Own a laptop and apply for broadband.
This will be your sole source of entertainment. Your holy shrine. Your altar of worship. Your meaning of life. The nearest mall (which is about as big as two good-sized shop-houses) is located a fair two-hour bus ride away. The nearest decent bookstore would require you to board an hour-long domestic flight to get to it (or 12 hours of butt-busting bus journey, whichever works for you). Don’t even get me started on movie theatres and McDonald’s.



… and the number one pointer to surviving Manipal is…









































1. Don’t come here. Stay away if you value your life. What the hell is wrong with you? Malaysia not good enough for you is it?


The Manipalite,
k0ks3nw4i

¹ A fancy and scary sounding way of saying 'bad breath'. Boy, I can't wait to tell my patients in the future that they have halistosis and prescribe them Tic-Tacs in pill bottles.
² Cows are practically royalties in India. Seriously - all vehicles would even stop and wait patiently for cows to cross roads in their slow, sluggish cow-pace. When I tried the same thing, I got honked to kingdom come.
³ Okay, fine - it's cauliflower. In spite of its appearance, Gobi Manchurian (that's what it's called) actually tastes pretty good.

FLAVA 2007

"... we all know that it is possible for humans to get a porcine or bovine tapeworm infestation from the consumption of undercooked pork or beef. Can anyone tell me how it is possible for someone to contract a case of tapeworm infestation from a dog?"

Miss Daphne Vincent Santhosh, Microbiology lecturer

"Eat a dog."

Me

"Eat an undercooked dog"

Shaki

"Rape a dog."

Li Lian

FLAVA 2007.

Yesterday night, I was suppose to be swotting for this week's Pharmacology SDL* topic, but being the artful procrastinator culture-lover I am, I have opted instead to take in the yearly Indian cuisine and ethnic-culture fair held at the KMC** Greens. I rationalised that this was a real gem of a chance for me to get out of some potentially productive hard work sample the exciting flavours and culinary creations from all over India. Should I have missed it, I would have to wait for next year's fair. Yes sirree, I must definitely go!

*SDL: Self-Directed Learning. Every week, a couple of hours is alloted for each subject where students will be picked at random to stand in front of the class to give an oral presentation of a preordained topic. It's also known as Sudden-Death Lambastics because ill-prepared students who performed poorly would be screwed/insulted/lambasted proper by the lecturer (especially when Ms. Daphne Deathstrike takes the class)
**KMC: Kasturba Medical College, the local nerd vivarium.

One hungry nation. Welcome to India.

The fair is called FLAVA, which I guessed was an acronym for something forgettably lame. In this FLAVA thingy, KMC students which came from different parts of the the Indian subcontinent would set up stalls to vend food/snacks found in their respective locality.

The Canadian stall. I wasn't aware that Canada was part of India.

Unfortunately, I lost my appetite after seeing just how difficult it is to make fight my way through the throng to actually get to the front of one of these stalls. No one queues at all. Bloody piranhas.

Ever have a picnic after dark before?

Ravin' - Bollywood style.

Aside the eats, there are also dance performances all through the night. The Indians are really big on dancing. I mean, there's a dance and singing scene in practically every Hindi movie ever made. Not to critique but when I first watched a Bollywood film, my jaw dropped clean off my face. It was a bloody and vendetta-ish kind of flick with lots of brutal fights, rapes, and things that explodes - and groovy dancing with a streetful of strangers?

The incongruity upsets my tidy (haha) mind.

Long way from home.

For a sum of Rupees (I don't know how much but I'm sure it's outrageous), you get to ride a camel for a measly minute from the middle to the side of the field, and back again. After that, you'll get off and find your butt hurting, and that you smell like a camel. I got pretty close and I can tell you this; You DO NOT want to smell like camels.

I'm sure forcing the poor beast to carry obese medical students all night long amounts to animal cruelty. And if the fat-asses doesn't kill the camel, boredom probably will.

TRIVIA: This big guy is properly called a Dromedary or Arabian Camel, identifiable by its single hump. It's a native of North Africa and Western Asia. The ones with two humps are called Bactrian Camels, and are found further east.

Sashini (front) and Lauren, my class rep.

No camels here.

It took us just half an hour to agree that we're not having fun at all (all we had between us was a plate of greasy Canadian fries and one ugly Canadian sausage). We headed straight to the Coffee Day*** in the library after that. Sze Yin ordered a cup of hot lemon tea (which she insisted that she liked very much and ordered regularly, and which I thought tasted like vomit). Halfway through the cup, she stopped drinking and said, "Yer, after you said that, it really tastes like vomit now!"

Thanks to me, hot lemon tea is one of those simple pleasures in life that is forever ruined for her.

And no, I did not study for the Pharmacology SDL later that night. I watched episode 18 of season 3 of House instead.


Does not smell like camel (honest!),
k0k s3n w4i

***India's answer to expensive, pseudo-sophisticated cafés that calls coffee funny Italian names like Cappuccino, Americano, Ikano, Espresso Con Panna and Tesco Kanina