What really happen?

 He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all

 A Pre-Clinical Year day with only Clinical Teaching sessions.

Today, I had 2 clinical teaching sessions. A day likened that of clinical year.

Lesson/Inspiration obtained from today's teaching is Don't bother about what your mind thinking, what your patient's mind thinking, what's your colleagues' mind thinking, but contemplate on what really happen!

Human mind is flawed with lots of cognitive error. We think we're correct, but still we reach the wrong conclusion, because there's systematic error on our thinking!

Patient, as a person in this society, has different background, personal or cultural.

Different personal encounter will conceived different kind of pathology! Even the same pathology will present differently in different patient.

Our job, as a medical personal, likened a detective to find out what really happened. This is not a blind or empty minded detective, we must have sufficient basic and clinical medicine knowledge! Of course, we can't denied the uncertainties and probabilities inside medicine-pathologist knows best, sometimes, postmortem diagnosis can be bizzarely different from the treated alleged provisional diagnosis.

What basic and clinical knowledge that we need to have?

Basic medical knowledge, such as anatomy, physiology, biochemistry, pharmacology, pathology, microbiology and immunology

Clinical medicine knowledge, an extension from basic medical knowledge,for me mainly consist of a clear, rational mind that can see what really happen, deduce various possible,relevant causes of disease with critical thinking, ample of bed side manners and well-practiced physical examination skills.

There's a lot of new disciplines emerges each day, for me that's the outward florishes of basic medical knowledge. Therefore our main job in medical school is to grab a firm stand on basic medical knowledge, acquire a clear, rational, critical thinking mind and last but the most important one, be courteous to patient with satisfactory attitude,ample of empathy, tactical communication, integrity and altruism.

For me this last one aspect, differentiate a doctor from a non-doctor. Any smart guys can perform the previous 2 tasks well, if they devoted some of their time on that. However, only doctor (I mean persons who are really passionate and meant to be a good doctor) can bear the pain and joy of taking up the latter skills.It will be rewarding.

Personality goodness is normally distributed, so do among doctors, who aren't flawless human, but remember to give patient, their family, our colleagues, our co-worker, our teachers and our family their due. Personality is what we are born with and can be molded.

The theme back to What Really Happens?

At times, I felt the hard time to come out with a clerking question or a case report - Because I simply don't know much about what really happen. I have only text book knowledge, or even worse, I don't have them. The tips here is to see, look! this is what happen to our dear patient, think and integrate our textbook knowledge, our common sense, our non-academic knowledge of patient background and critical thinking together. Then we'll know what really happen. Then we can come out with a rational report and plan of management.

Next time, note to self, ask What Really Happens?

Journey to be a doctor is hard. Much efforts are paid off, passion and interest are the fuel that keep us moving on. Medical education on university undergraduate level is meant for us to acquire the learning skills so that we can continue our learning even without an institution- well that's useful for a medicine practitioner.

What we get from medical school is really meant for Treat Disease, Prevent (unnecessary)Death!

However, much we can empower and top-up for our own learning sphere, so that we're well rounded, so that we're really practicing medicine that approaches sick people-We will not become Dr. who expertised in treating the leg/heart/liver/guts....so on...

Look, what really happens! It is a sick person drawn from his/her normal daily living in the society and go to your institution to seek help.

Another case of diabetic foot? Think twice before you said that next time. That poor guy/girl have their own story to tell, swallow them, but don't believe them anyway. Don't believe what your mind's thinking anyway, don't believe what's your colleagues' thinking anyway. Look, and feel and project, what really happens?

Deadly silent

This the the night view (8:00p.m.) of Library (Perpustakaan Hamdan Tahir) at Health Campus, Universiti Sains Malaysia, Kelantan.

Maybe in line with moral principle of living in Kelantan, night life is absent everywhere, even in a university campus, which serve as a knowledge hub, where campus dynamics and academic dynamics serve as an indicator of students' dynamics.

No group discussion inside library, only few students doing occasional self study inside library, needless to mention about academic dynamics among students.

All the halls are empty, except during March, April and November where Chinese Students, Muslim students, and Indian students are organizing own cultural and religion activities.

No activity on stimulating the young mind on solving social or community problems. A lots of man-powering work, i.e volunteering, which is good. However, hidden problem arises when the role of leadership is not well performed or carried out. Man power simply do not match the work done.

Perhaps, in the evening, we have the most happening event, that's sport. Sport especially football is very famous here. Even non-campus students are allow to come in our campus to use the football field. Sometimes, sport carnival being organized at inappropriate time, i.e nearing exam, somehow, affects students' life. Anyway, badan sihat, otak cerdas!

Sports might be the second most happening activities other than cultural events. We've school of sport science here. They are successful perhaps!

Where's campus dynamics? Students are all dwelling in hostels, Self-studying,Facebooking, Movie-ing, Game-ing,

How to draw them out?

Here comes the deadly silent.

Male Toilet

Male Toilet!

I feel particularly uncomfortable using this kind of toilet shown in the photo.

It is so "unprotected", even if there's a barrier for such standing toilet.

I prefer toilet inside closed space. LoL. Personal preferance though.

Additional to the closed space toilet privacy aspect, I can always tell how sound is the civic awareness of that society.

Often, I can see funny genitals drawings and telephone number for massage and gay sex at the door!

I wonder if the person is real gay guy or a horny heterosexual man who long for sex with partner of same sex.

The society is getting filthier~ All they want and can offer is FUN!

Often, I can see pieces of feces floating at the toilet bowl (high fiber diet huh!) and urine splashed all over the place. I wonder what happen when he do the job. Perhaps a T-rex attack his toilet ?

Next time, enjoy your toilet session, there's tell-tale signs inside.

Thing is more frustrating when  you actually paid to get into the toilet (Like what I had yesternight at Bus Terminal)

Where's the money goes and what is it used for ?

Anyway, this is up to the user to keep it clean!

Haiz...Guy...

Rabbit Rabbit Rabbit!!!

The photo depicts the White Rabbit Candy, milk flavor.

Gift from PBL mate, a happy Chinese New Year gift  for sure.

This candy bring up a lots of memory of mine.

Back then, when I was primary school, I can have that during Chinese New Year at my maternal grandmother house with siblings and cousins.

Now, it is quite hard to find this small candy.

I know it is available at Nirwana, Kubang Kerian.

I bought them at Nirwana before, however, it tasted differently.

Maybe the secret recipe underlies it's deliciousness is White Rabbit + Family Reunion.

I'm thankful to have this during CNY 2015, despite having short holiday,

Didn't have much chance to taste various CNY snacks this year!

The holiday will be shorter I tell everyone.

What to do?  Accept and go on.

Cherish every moment we have!

CNY day 4-everything back to normal (almost)

The photo depicts Health Campus of Universiti Sains Malaysia at Kubang Kerian, Kelantan.

It's day 4 of Chinese New Year.

We had class on Physiology of Menopause, Pathology of Ovary and Pathology of Uterus.

I reached Kelantan early in the morning, 5:00a.m. Class started on 9 a.m. I took my bus on 10p.m. yesternight. 

Though sleep deprivation, still I'm glad that I can fall asleep in the bus soundly for the first time.

Thanks to the thick sweater I bought during CNY. Transnational bus has the best air-conditional. Perhaps they can plan into delivering goods that require cold storage.

The reason I chose USM, Kelantan as my tertiary education is it is located at east coast of peninsular Malaysia, and I like the beach.

I knew how beautiful it is because I had my matriculation study at Pahang.

However, what I never know is that the monsoon season at east coast really affects my health to some extent.

I am afraid of cold weather, cold air-conditioner. Hypothyroid-oid huh!?

After CNY hopefully the sun will shine again, which I think the days are near!

They starts to established automated watering system at football field beside Nurani, to prevent the green to dry up.

The football field is another good indicator of current weather apart from my coughing due to cold weather and weather forecast apps.

Professional Exam is near, I felt so unprepared, likened unarmed soldier fighting a big group of villains? 

Anyway, move on and just do it.

Chinese New Year Song

I'm having 1 week holiday for CNY as Year 3 medical student.

The first CNY song i heard when i was back in hometown was: 《新年歌儿大家唱》 trans

I heard this old recording when I was having breakfast with parents at old town kopitiam (not franchise OldTown Kopitiam!) at my hometown. Old radio with old song in an old shop, everything is authentic.

I prefer old CNY songs, back then life's so simple, people and friends are closed. Of course society back then has less room for individuality. Life is more community oriented.

Enjoy the song!

Gong Xi Fa Chai as Med Stud ?

This is Day 2 of Chinese New Year(CNY)- Wooden Goat they said.

According to traditional custom, day 1 of CNY, Chinese will pay visit to elders, relatives and friends.

I would like to share some of my special greetings from friends and colleagues at day 1 of CNY

Happy Chibese New year Boon Seng, jusr want to ask u regarding the topics tht u spotted for me last time. U expected bilaminar and trilaminar will be coming out in osce, do u mind to giv me the dxample of question of bilaminar&trilaminar osce question. Cuz i m not sure what kind of style they gonna come out in osce with this topic.  Besides, u expect respi anatomy to come out in seq, does it include all the innervation and blood supplies?

Anonymous 1

Hi boon seng, happy CNY! wanna disturb u agn... >< about this ques: Discuss the karyotype of down syndrome, if 5 marks are allocated for this ques. what should be the answer? I only manage to think a few pts 1. results from non-disjunction (failure of chromosomes to separate during meiosis) 2. karyotype: 46, XY, 21+ (presence of 3 chromosomes 21) 3. (listing down features)

Anonymous 2

hi boon. hpy cny to u and your family. i came across smtg related to hypocalcemia and it seems to be confusing. thought maybe u can help me to solve my confusion. i read that hypocalcemia causes muscle tetany and muscular spasm. and the reason given was that hypocalcemia causes increased muscular excitability (increased Na+ permeability of cell membrane) caused by a deficit in Ca+ which will keep Na+ gates closed. This increases depolarization. Depolarization therefore becomes much more excitable. Bcause as we knw in action potential, there are voltage gated calcium channels which are slightly permeable to sodium ions, and they are present numerous in cardiac and smooth muscle. this makes sense. but what i am confused is that, at the very first place, calcium is needed to move from ECF to presynaptic membrane to cause opening of the vesicles containing Ach to be relased from presynaptic membrane into the synaptic cleft. then only the subsequent steps can be taken to ensure a proper nerve impulse transmission. so if calcium itself is low in blood, it cant even help to release the Ach, (i suppose), so hw this leads to hyperexcitability. isnt it supposed to cause weakness ?? tx for ur help boon.

 Anonymous 3

Guess what, I did according to custom in Traditional Chinese way, if people gave you gift, you must do the same. I replied their inquiries even at CNY day 1.

No life you would say.

Part of me argued, by doing so you are positively re-inforced them that you're time is less important than theirs.

Part of me argued that they must be have trust in me by seeking help from me, I must offer help that within my ability.

Part of me argued, these questions can be directed to others. I'm not the only one with answer.

It's truly a mixed feeling to received a text message that start with Happy Chinese New Year and I wish to...

I would prefer if they hit the nail on the head. At least, I don't feel the sorry.

The hidden meaning were: I'm really sorry but i have to disturb your CNY holiday anyhow, would you...

hahaha... anyway, this is my own explanation that make myself looks pathetic.

Later bunch of guys out there will criticize me as attention seeker and act pity as victim.

Let it be, Let it go.

如果你是卖菜的菜市，就别责怪别人一直跟你买菜。

If you want a duck to be a chicken, a chicken to be a duck, you suffer.
Ajahn Chah

Life's unsatisfying, thus human created festives and special events to have fun.

The happiness and the glorious moment come and go.

You'll wake up the next day discovering that life's still going on as normal.

The cycle repeats.

Stop sounds so gloomy

Let's have some CNY song!

You are a DOG ! Now, Bark! (Perhaps)

"I super agreed with #612, Y__ f*cking attention seeker, everyday post status but comment on his own... so forever alone... only know how to bodek smart seniors and dr... yes, he is an eye sore for many, just that no one dares to voice out straight to his face cause later he will post status to ask for pitiness again... so dumb.."
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""to #615 and #620.
Kalau tak suka tgk post orang lain kau unfollow atau unfriend je la, apa susah, nak cakap buruk belakang dia pulak. Cara dia belajar macam tu, mungkin dia apply apa yang dia belajar dalam posts dia supaya dia igt. Lain orang lain cara. Biarla kat dia. Nak ke tak nak mai saya bagi opinion. Saya rasa kamu semua yang tgh kutuk dia ni sebab jeles. ataupun kamu tak paham dia duk cakp apa kat post dia tu,padahal dalam kuliah belajar benda sama je."
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"Y__ indeed is very ego... can see from the way he posted stuffs on fb... forgetting abt the self commenting part, he too likes to act kind and humble infornt of others... god knows who he is although fools out there supports him... haiz..."
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"#634 "So sad to know that #630 is victim of YBS acting... what if it is not a fitnah... he himself knows and god knows... no need to defend him if you are not into his living style...
‪#‎peace‬ ‪#‎disappointed‬ ‪#‎truthspeaker‬ ‪#‎notahater‬ ""
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"Just realised the recent top hitz Y__ is staying in N__... damn... haha..."
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"Yes you are my friend but sorry day by day I'm losing respect towards you. Please mind your attitude. Public watching you and your silliness. Please stop it cause you dont know how much they make fun of you."
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First of all, this is to all Y haters. Please grow up you guys. His FB page is his own he has the right to post whatever he wants. If you dont want to read it or think it is nonsensical, then just scroll down. I bet all of you must have got nonsensical posts on your wall from liking stupid pages, if you can scroll through tht, then do the same lah. And if you think it is COLLECTIVELY annoying his whole FRIEND list, then go tell him face to face. You are just being a coward because you know you have no right to criticise and yet you do, hiding behind your anonymous posts.

Secondly, this is just proving how low you guys are and the maturity of your mentality. You go with this kind of attitude into the working life haha you wouldnt last an hour, So for your own good, try to keep your ugly thoughts in you, even if you dont like it, because it isnt helping you or anyone else.

Thanks for reading.

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"TO ALL THE MOTHERF**K**S WHO KEEP INSULTING Y__ on THIS PAGE,

Seriously keldai-keldai sekalian, Shut the F up! U tak tahu dia in person so shut up! agak clear yang u tu jealous of him. he is smart, u r nowhere near that. senang cite, u bodoh . dia distinction, u failure. jadi, sebelum kau dapat dosa irreversible haha, kau senyap je la hantu! Kau jelous yang dia tu amat bijak. kau tu pula,thought block sentiasa. oleh itu, untuk mengatasi masalah kebodohan dan jelousy extreme , anda dinasihati untuk deactivate saja fb dan balik ke tempurung. katak betul kau. bodoh jahil benor .

on a serious note, dia tu baik sampai wiling nak share ilmu dengan sahabat2 handai di FB. tapi, orang gila macam kau tak dapat appreciate kerana badanmu penuh dengan syaitan ! kau sungguh negative. tukar lah ke arah kebaikan sebelum terlambat. kelak nanti,kau nak jawab apa bila Tuhan tanya ? "

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Source: ＵＳＭＫＫ　ｃｏｎｆｅｓｓｉｏｎ　a page to express Health Campus Students' Love, Hatred, Boredom, Emotion and Everything Else. 

Many of the relevant comments are gone, I'm just way too late to retrieve them. 

I have to contemplate over the comments, to see if I'm having any tail to be qualify as a dog.

If I'm an attention seeker, I consider myself as highly successful.

If I'm innocent, then the other attention seeker is considered highly successful.

In view that the news are on air for 1 week.

IF SOMEONE CALLS YOU A DOG, LOOK BEHIND AND SEE IF YOU HAVE A TAIL. IF YOU DON'T HAVE A TAIL THEN THERE IS NO PROBLEM

AJAHN CHAH

If you are a writer, write.

If you are a painter, paint

If you are a lecturer, lecture

If you are a dog, keep barking (perhaps)

I was suffered by the harsh comments, especially i have to strengthen my mentality for an academic competition oversea at the same time.

Why suffer? I just have created the best play ground for suffering- the concept of Self.

Y_ _, YBS , etc.. are taken as me and myself. the first step of all troubles begin. When others attack this self, "I" suffer. Thus, "They shouldn't have attack me", "they should have kind to me", etc.. such thought arises.

To illustrate, just imagine how do you feel, when you heard a stranger criticizing another stranger? No feeling? It is the same thing when you do not consider this body, this mind, this thought, this emotion as yours. they are performers that come to have some fashion show and goes off the stage. they come and go. If you are the boss, if you are the manager, if they belong to you, they are yours, you can always prohibit them from coming to your playground, you can always hire "happiness" to your playground. You can't then stop thinking that they are yours!

What if I'm really the dog? Keep barking? (perhaps) Realize that, beware of that, be careful next of my next speech.. 

The talkative parrot is shut in a cage while the birds that did not talk much fly freely
Buddha

What If I'm not the dog? then let other dogs keep barking? (perhaps) We can't really control over others.

Though thousand times a thousand 
in battle one may conquer,
yet should one conquer just oneself
one is the greatest conqueror.

Dhammapada verse 103


This is a great reminder to me to observe the five precepts, Which is the supreme protection of life.
which sounds:
I undertake to observe the precept to abstain from destroying living beings. 
I undertake to observe the precept to abstain from taking things not given. 
I undertake to observe the precept to abstain from sexual misconduct. 
I undertake to observe the precept to abstain from false speech. 

I undertake to observe the precept to abstain from liquor causing intoxication and heedlessness. 

人言可畏. 害人之心不可有，防人之心不可无。 
These are the advices gave by my primary school teacher upon my graduation.

Guard over own mind is crucial, because it is where all problem arisen.

sabbe satta, sukhi hontu.(May All Beings be well and happy)

May I be blessed with the strength to be kind to being whom love me, to love being whom do not love me, to being that neither love me nor not love me.

Holding hand

执子之手与子偕老。

What do you think about 2 human being that holding hand?
LOVE, CARING, PROTECTION?

What if they are pulling each other down the cliff?

What do you think about a man and a woman that holding hand?
ROMANCE, LOVE?

What if the man is father, while the woman is his daughter?

What do you think about 2 women that holding hand ?
SISTERHOOD? CARING? CUTE?

What if they are lesbian couple?

What do you think about 2 men that holding hand?
YUCKS, AWFUL, GAY

What if they are father and son?

Yesterday I saw a gay couple holding hand in the shopping mall.
I salute their courage.
We have far too many label for leading a simple life.

I takes 3 seconds to realize that what's wrong on the sentence sounds:
儿子，今年过年，带男朋友一起回家吧！
from a china mom.

Well. Life is Wonderful afterall.