Thursday, July 19, 2007
I Fucked Up Again
Or I think did.
Yup, exams over. And this is one of the few exams I actually studied for, so why is this exam the only one that made me so nervous?
Reason #1:
Stressing out over the fact that Dr. Wittmann may be my examiner.
Reality: No worries, I did not get him. But bad news: I shall remain the idiot that does not how to do a proper PE in his eyes.
And instead I had another male doctor who played the Good Cop and a female doctor who played the Bad Cop. And it was a little funny to see her playing Bad Cop because she is so slim and neat and fragile and when she tried to look angry, it was just hilarious. Not that I laughed out loud or anything.
Reason #2:
Stressing out over not being to get a good history for long case because we have a lot of demented and old patients.
Reality: I actually had a very, very nice lady who gave me her ECG results, troponin levels and echo results when I asked her about her condition. So it was pretty ok. I just mixed her age and her marriage up a little.
The lady was born on 1937.
Me doing my presentation: Mrs So-so is a 80 year old -
The doctors looked up in surprise and I went rattling along, a little confused on why they looked so surprise. It was only after that and I went to talk to the patient again that I realise that I calculated her age wrong.
I forgot to ask about her husband and because she seemed reluctant a little to talk about it, I thought he died and I happily reported that she was a widow. In actual fact, they had a divorce and I was like WTF?!!!
Reason #3:
Stressing out of not being able to hear murmurs or crackles during short cases.
Reality: The murmur I heard was pretty audible. But it was heard loudest over the aortic region and instead of radiating to the carotids, it radiated to the axilla. I was like, what the freaking shit? And I could not hear a fucking single thing over the mitral area. Screwed?
Until my colleague who had the same question heard the murmur over the aortic region, radiating to the carotids but not to the axilla. Strange patient. And she had an awesome high arch palate. It was like the ceiling of a cathedral! And the uvula was like the bell hanging from it.
Reason #4:
I fuck up on presentation.
Reality: Other than the minor setbacks, my presentation was pretty okay.
Dr: So what did you think of the enlarged liver? The surface?
Me: Erm... when I palpated over the liver, I felt craggy surface.
Dr: Craggy?
Me: *remembering that the patient came in for alcoholic disease* But it may be the dilated veins. On palpation for the liver, the lower border was smooth.
Reason #5:
It is the hardest exam in our entire career as a medical student.
Reality: It is the hardest exam in our entire career as a medical student.
So now it is finally over. Another 2 months gone, and 1 week holiday to be enjoyed.
During my Medicine rotation, I was attached to a Mater Hospital in South Brisbane. Unfortunately, a large part of the hospital was under renovation during that 2 months, so it could be pretty frustrating and funny at times.
Imagine trying to here a murmur with drills going off at the background. There was one time when I was listening for crackles and there were bloody saws sawing something somewhere. I actually thought it was crackles.
And it is uncanny how the hammers coincides with the heart sounds.
Me: S1 is louder than S2.
Dr: No, I think it is the construction workers.
Me: Really?
But the good thing about Mater is, it has very very few patients. And almost all of our patients have either stroke, cardiac failure/infarction, pleural effusion/pneumonia/pneumothorax and diabetes. So we are pretty certain what cases are coming out for our exam.
And I actually talked to the patient that became a colleague's long case patient. And we even went through his case together. And I even did a short case with my short case patient before the exams. That is how lucky Mater students how.
"It is so unfair, you guys get the same short case patients, you have seen all your patients for the exam!" - Richard, about me, Raj and Daniel.
Looking back, Mater Adult Hospital (the hospital I was attached to) is going to hold many fond memories.
Johannes Wittmann, Dr. J Wittmann, Dr. JW, Dr. W...
Shut up, brain! There are many other things other than a cute doctor.
We have a cynical doctor.
Patient presents with muscle dystrophy.
Dr: There is nothing we can do about it. (Said with a BIG smile)
When the patient walked out:
Me: So what is her prognosis?
Dr: Not more than 2 years.
Patient presents with idiopathic weakness of right hand.
Dr: We will send you for an EMG. (Said with an encouraging smile, and even taught the patient what EMG is all about).
After the patient left:
Me: So you do the EMG because you think that the weakness is due to radiculopathy?
Dr: Nope, to stop her whining.
But overall, Dr. CS is a pretty cool doctor. For one patient he pretends to care for, there are three that he really do care for (or so I think). And in that aspect of pretending to care for patients, I totally
him.And we have our ward doctor, who is tall and has hands that can never stay still. The patient would be telling him stories and he will be bending and unbending paper clips. During ward rounds, he would be fiddling with his stethoscope and fidgeting with the patient's drip. And he is the doctor who likes to send people home.
Patient in bed, looking really ill and on oxygen.
MK: What the hell is she still doing here?
And from the next medical team is a doctor who talks really cryptically and somehow he sounds really good when he presented it to the patients, but after when you try to write in the charts about his plans, you have no freaking idea what he is going to do.
We also have a nephrologist who does not have anything to do in Mater because all our renal cases are sent to another hospital.
The last doctor I met the day before my exam is Dr. David Serisier. You may remember him as the doctor with all the blings blings. Well, I found him flirting with the Year 2s, and decided to join them for their tutorial.
And after following him for 3 patients, he turned to me.
DS: So what year are you?
Me: Three.
DS: Ah, so when is your exam?
Me: Tomorrow.
DS: Ah... then I don't think it is a good idea for you to follow us anymore.
Me: Damn.
I would have posted Dr. Wittmann here as well, but I guess you guys would have been bored to death about him, so I'll move on.
And not only the consultants are brilliant, their registrars are superb as well. Richard was telling us how he never had a chance to perform procedures on patients, his registrars never wanted to help him with short cases, they are always 'busy'. Well, that is not the case in Mater. We need countless cannulas, ABG is kinda our forte now, and hell, Raj and I even assisted in an endoscopy courtesy of Dr. Wittmann and an ICC insertion courtesy of the Respi reg.
The funny thing I find about Mater is that about 80% of their doctors are not Australian Australian per se. There was once we were doing ward rounds, and we had only one Australian who was an intern. The consultants and registrars were all non-Australian.
Dr. Malcolm King is South African. One of our endocrinologist reg is Danish. We have about 4-5 registrars who are either Indians or Sri Lankans. There are at least 2 senior registrars who are Taiwanese/HongKee/Chinese. The GI team led by Dr. Johannes Wittmann is entirely non-Australian: Dr. Wittmann is German, the registrar is an Indian, and the intern is a Filipino.
So who said non-Australian getting work in Australia is tough?
When all is said and done, I am really looking forward to getting Mater for my Medicine rotation and I am so going to beg the lady in charge to give me Gastrointestinal and put me under Dr. J Wittmann. YAY!!!
***************
News update:
The lady in charge of the exams just emailed me that I can ENJOY my holidays. Hmm... I wonder what that meant.
I just want my journey to be full of laughter.
- Yuna, Final Fantasy X
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