Surgical Posting at Teluk Intan

Have to finish my case write up by tonight and to study for end of posting assessment. Only managed to cover like 15% of the total syllabus-__-'''

And yet, I felt like penning down my reflections before all these thoughts are being displaced by knowledge that I hope to squeeze in my limited brain space in the next two days.

Was in Teluk Intan for the past 2 weeks for surgery rotation.

I felt like final year REALLY began there.

Rotation in UKMMC felt the same, perhaps because we were already posted there in 3rd year. What was different was that I had to cover beds, and somehow need to know about most things (I don't) and how to examine patients.

I felt accomplished as 3rd year surgery was like window shopping for me. I was there, I passed through but did not even make the effort to go to wards.

Apart from sharing house with 6 other people, having 3 roommates around, both which were new experiences for me, being in the Surgical wards was totally an eye opener.

Lesson 1:

Two of our seniors were there. They were one year more senior than me.

First thing that one of them told me was: Repeat the 6 months. Don't graduate too early.

Kinda reminded me what our senior registrars in UKMMC told us on the first day of our rotation : DO something else, don't do medicine.

I didn't give those words much thought until I see the way the houseman are treated.

The HO at TI has a relatively less workload, but they get scolded. 

It is humiliating to be scolded in front of nurses, patients, medical students and your colleagues.

I guess the intention was to make the HO realize that they are making mistakes (long list)

and especially for HO who are new, it can be very depressing. (We study 5 years, maybe more, some study REAL hard, sacrifice their social life and trying to cope with the new long working hours)

And that's not even the worst, the MOs treat the HO the same way the specialist did. Some joined in and mocked at HO at the same time instead of teaching them (maybe they teach them AFTER that). My guess is that made the HO felt worse. 

I am certain some of them have been through that. Isn't that suppose to make them empathize with what the HOs are going through? Or because everyone is so stressed out they just leashed out their frustrations and anger at their juniors??

I hope not all hospitals train HOs that way. This sort of training need time for the HO to adjust and become immune to the cold treatment from their seniors. Eventually, all HOs will learn but the process itself makes a huge difference. 

Lesson 2:

Cases come in 2, or maybe 3.

Seen 3 gastric carcinomas in 2 weeks, 2 upper gastrointestinal bleeds in the same week, 3 patients admitted to ward because of haematuria and another 3 confirmed acute cholecystitis.

Is it a coincidence or a pattern to that?

Again, our registrars told us that before we went to Teluk Intan. When they get an acute appendicitis during on call, chances are there will be another case coming in later.

Conclusion: Most of the time the seniors are right.:)

Lesson 3: Birth, Aging, Illness and Death

In medicine, I always knew we had to deal with illnesses. But death is not something that I encountered frequently before this.

Witnessed two deaths of patients in the ward in 2 consecutive days. I was there when they were admitted, and CPR instituted and when their bodies were sent out in coffins.

I saw their family members crying their hearts out and I felt detached. It's like real life drama unfolding in front of me and I was not affected. 2 years ago, I cried when a patient I knew died of cancer. Now I felt nothing. Maybe it is because I did not know these patients personally. I even shed tears when reading novels but not in real life. I am not sure if this is a good sign or a bad one, that I am getting more professional or cold-hearted?

Lesson 4: The big C

Patients in this hospital come with late presentation as compared to patients in UKMMC. Some of them have advanced diseases where only palliative care can be instituted, which is saddening, because with early detection and treatment, they can have very good prognosis. 

It's been an overwhelming 2 weeks. Guess I need to prepare myself for the real world. Or should I enjoy myself when I still can?