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?
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,
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)
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?
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.
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.
"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.." --------------------------------------------------------------------------------------------------------- ""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." ---------------------------------------------------------------------------------------------------------- "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..." ---------------------------------------------------------------------------------------------------------- "#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"" --------------------------------------------------------------------------------------------------------- "Just realised the recent top hitz Y__ is staying in N__... damn... haha..." -------------------------------------------------------------------------------------------------------- "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." --------------------------------------------------------------------------------------------------------
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.
"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 ?"
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.
OK. Fine, I am probably fed up with studying microbiology and their pharmacology counterpart. I wonder how can one make to remember all the odd names of microorganism and the worst part the therapeutic name of chemotherapy drug for infectious disease. Salute to ID physicians. Not to mention lots of laboratory characteristics, clinical pictures and therapeutic regime to remember. Phiew! Now I am doubting whether I can continue with Med.
ESBL - Extended Spectrum Beta-Lactamase producing organisms, usually referred to Gram Negative Enterobacteriaceae. The un-ending war between human and pathogens had started since the early beginning of human species in the written or unwritten history. Well, pathogens simply way older than us, photogenically speaking. Human and pathogen stories also made up of great part of history of medicine. We can say we are co-evolved with them. Somehow, there are quite novel suggestion that we, human are made of viruses? see video:
The first antibiotic being discovered is Penicillin, by Dr. Alexander Fleming on 28 September 1928. It had marked the start of the an era of modern medicine where people try to come out with various biologic missiles and bombs to fight against human pathogen in this un-ending war. It seems like, we are winning the war initially, but halt! Don't mess up with ancestors or our human seniors, they are master in adaptation. It has not even been a century from where human first discovered these seemingly effective "weapon" until now where resistant strains of microbes, the titans are flaring out to bash human critically.
Eradication of microbial disease is a will-o'-the-wisp; pursuing it leads into a morass of hazy biological concepts and half truths.——Rene Dubos
If the world fails to mount a more serious effort to fight infectious diseases, antimicrobial resistance will increasingly threaten to send the world back to a pre-antibiotic age. ——Gro Harlem Brundtland,
Lesser and lesser effective antimicrobial been discovered, while more and more resistance strains of pathogens are emerging, we are almost left with no option eventually. Perhaps aggressive fight is not the solution? This let us to ponder how human can live peacefully with pathogens.
Well, back to the post title, ESBL - Extremely Sedative/Seductive/Sexy Boy's Love. It is a good example of how human behaviors are closely related to human health and infectious disease. Well, I am not trying to stigmatized people of any sexual orientation, but using gay/man homosexuality as an example would yield great impact because most people have the stigma towards this group of people.
When we think of gay, what comes in our mind? SEX! I am not sure why people made this association, but yeah, GAY-SEX-HIV-SATANIC are kind of synonymous? No for me while YES for those who not concern enough.
Ok, let me illustrate how human behaviors shaped our health and affects the human-pathogen relationships. To start off, I would illustrate that there are microbes all around us and all over our body, which is known as normal flora. The relative distribution and abundance of normal flora would depends on the local factors, such as humidity, pH, temperature and so on. Well,normal floras are "normal", most of the time, but if they went left astray to some odd parts of the body where they not usually belong to they are not so "normal" after all. Speaking of sex, let me mention that the warm and humid condition of anogenital region of human being serve as a good paradise or vocation spots for many microbes, they are simply having party there.
While they longing a bacchanal, human too are having parties, where a lots of bodily interaction can occurs to satisfy our bodily lustful desire and will sometimes end up with the intimacy of sex-homosexually or heterosexually. Phallic-vaginally, Phallic-cephalic, Phallic-anally. Choices are there. Don't assume anal sex is the privilege of gay people, man and woman can have such mode of sexual activity. OK, now, sexual activity can be viewed as the grand migration of microbes having party. Two human being at sexual intimacy, be it same sex or opposite sex, we are exchanging microbes all over with our partner, be it temporary or permanent. Well, I would like to add on that love is blind, we tends to accept everything and every bits of our lovers, then should we welcome also all the bacteria and viruses into our body with each thrust and stroke, each moans and groans. Penis, Anus, Vagina, Mouth are heavily housed by enormous microbes.
Back to gay. people having stigmas with these group of people because historically, the they are first group of people who were documented to be suffered from AIDS, well, sometimes being the first is not so good after all. But now, of 3 millions of people who had infected with HIV, most are people who practice heterosexuality.
In my opinion, human behaviors and stigmas will continue to worsen infection diseases spread, not only HIV but also others Sexually Transmitted Disease. Also, the openness and attitude of physicians and a country to notify the world about an ongoing or emerging infections is important to break the chain of transmission of communicable disease. The worst sometimes go to health care workers that is not concern with the hygiene in clinical practice. Poor hygiene is related to prolonged hospital stay, secondary infection with hospital bugs, poor clinical outcomes and increase hospital burdens. With many evidences to illustrate the effectiveness of hand hygiene, the compliance rate of this practice is not 100%. Well, we should start to think twice when we complaining that patients are not compliant, as we too are stubborn, this is perhaps the reality of human being. Health care workers, are we given the power to kill or to heal?
There had been one occasion where I attended a talk entitled "no more option" that discuss about the emergence of multi-drug resistant pathogen as human succumb our strategies of infection control to use of various antimicrobial drugs. The over-emphasized of treatment rather than prevention had it place for this problem. The awareness on prevention is not deep where a doctor actually ask the panel about the effectiveness and evidence of hand hygiene in controlling health care acquired infection. How ignorance, well, historically, Dr. Ignaz Semmelweis had shown us how tragedic and arrogant people can be. Read the evidence here .The ignorance among Dr.s also shown in the talk when everyone who were at least a clinical specialist or specialist-to-be tried to run off when the main speaker suggest that everyone stayed back for 5 minutes at the end of the session to learn proper hand washing techniques with the nurses. Well, Dr. I know you're Dr, but do you know you're Dr. ?
Going back to stigma, if we keep stigmatized those who are HIV positive, chances are they will find their own way to hide themselves out. It is a good thing, you would think. However, what if, one day, when you're in the same party as they are, and at that time your heightening urging libidos that drives you almost crazy, lead you to have sexual intimacy with one of them? Of course, they won't admit they are HIV positive if you're going to judge them. Also, at the emergency and burst of sexual urge, how many of us would bother to wear a condom as a protective barrier? At the end, the stigmas hurts everyone. Those who stigmatize get the disease, those who being stigmatized being torture psychologically. What for?
Well, this essay is written ad lib in a sleepless night, so you might not find any continuity, I do hope some of you might get some of the main idea. Well, ESBL - Extremely Seductive Boy's Love I would say(in my opinion). Still, I am not sure why gay is being depicted in an exotic sexual way, even most of the gay people "communicate" solely with each other in a bodily way. If it is a true love (haha, again, love is blind, we have to accept every part of our lovers?), there should have a emotional and spiritual aspects that we can go for. I know social pressure had led LGBT community being peripherized from the norm and development of the society, but I do hope one day, we can be more open-minded to these group of people. I am not encouraging people to be homosexual, but asking yourselves/pondering about it, can sexual orientation be encouraged? How many straights out there would volunteered or be encouraged to be "bent" ? LoL. We are simply born this way. Perhaps social stigmas towards LGBT society can be liken the antimicrobial selection pressure on microorganisms, eventually resistance and highly virulence strains emerged and neither human and pathogen can live with ease. Peace is the way, not the destination or result of assimilation. Things that make sense and created by straights are not necessary meant the same to LGBT, not to mention there is always some discrepancies among same group of people too. This is life, embrace the variations and celebrate the diversity, this is make what we are human.
Well, what ESBL meant to you? If I am gay, would you date me? hahaha. Don't judge! I am just a bit hyper, sleepless and imbalance for my friends are having holiday and vacation and I stuck in university, alone, wondering where's my next meal.
Well, girls don't emo, most hot, good looking guys in the market are gay? a weird phenomenon to me, or maybe it is just meant for creating the dramatic effect in gay film industries? I am confused, while people are celebrating LGBT in straights' films(do we need to categories strictly? aren't they should be just films to entertain us and to spend our past time with our love ones?), like depicting and make fun of sissies in movie scene, why when discussing about LGBT issue in society, they turn their eyes like the are not even involved/be responsible of !?
Well, good night and I hope I am sleepy, while in fact, I am not.
"If your friend
who doesn't have medical knowledge asked you about The
Ebola Outbreak, how would you explain it to them?" Friends, I wish to share with you a story:
“I woke up in the morning, looking for my mother,
wanting a pacifying warm hug, for I had a nightmare yesternight about an
unknown, realising that she’s no longer there…
Just 2 weeks ago, she fell very sick; she became extremely
exhausted never like this before. Her
body was very hot and she was in great pain! I cared for her like what
she did when I was sick last time.
I
remembered there was mystery men in horrifying white costume came to my house
and brought my mother away to the hospital. They told us that she might have
got “Ebola Viral Disease”. I think I’ve heard of it, many of my
neighbours were brought away by the same white car with a bright red cross, but
most of them never came back… I have seen a dying man abandoned by his
family at the road side. I am so afraid!
Deadly, Killer Disease, Bleeding, Painful, No Cure, No
Vaccine, Highly Infectious, Filovirus, Uncontrolled Outbreak... These big words
are more than what a 10 year-old boy can handle. I pray to God that this
is not real; there mustn’t be any disease…
Last week, my mother passed away. I was in grief. I
couldn’t get closer and caress my mother for the last time during her funeral,
like what I did for my grandmother few years back. Contact can spread
the disease, they said. Will air, water and food do the same to me? Is it true
that by simply washing my hands the deadly disease can be prevented? I was
confused!
Again, the nurse came into my cubicle and replaced a new bag
of fluid that hung on icy cold metal stand beside my bed. I can’t see
her face, it was tightly covered, but I bet it was fill with fear, as
most of them who seen me. I heard they said something about me; I
am a positive case of Ebola Viral Disease.
Deadly, Killer Disease, Bleeding, Painful, No Cure, No
Vaccine, Highly Infectious, Filovirus, Uncontrolled Outbreak... My mind was
blank, and these words kept bugging me. I was lost and did not know if
tomorrow’s bright sun and the future still belonged to me. I felt dizzy,
my vision gone blurred and gradually everything became dull and black out.
If only Ebola remained known as the motherly river that flows
peacefully, nurturing her children at the northern land of Democratic Republic
of Congo... I prayed. ”
I hope that silent prayers of West Africa can be heard by my
friends, knowing that Ebola Outbreak is not “just another wave of
infectious disease” per se, rather it triggers our consideration on how
harmonious humankind advancement can be attained in midst of intense conflict
between human and pathogen. Everyone in this world has the responsibility to
take dynamic and radical action for ensuring a sustainable tomorrow, for we are
dealing in the same biosphere, our motherly Earth.We can hardly short
of any accessible, comprehensive description of a disease but the motivation
that drives us there.
again, bacteria existed in this world long before us. The dynamics relationship between human and bateria never get equilibrium or reach steady state. How human be selected naturally by these microbes? What limits our growing capacity?
I am an imposter in a white coat. I’m not sure if anyone knows yet, I hope I am good at hiding it. It’s a well-kept secret amongst all medical students. In the hospital, I am at the bottom. I know the least and have the least power. Most patients don’t realize this and look up to me like I’m an all-knowing, wise muse or something of that nature. Sometimes, I seem to play it off well. I fooled them all! They think I’m actually smart! Then the attending asks me a basic question during rounds, and I’m back at baseline thinking I’m stupid and incompetent once again.
This is a cycle medical students experience once they get to the wards. We put on the short white coat that we were once so proud to wear on the day we matriculated into medical school. Now, after completing most of my clinical rotations, I find every excuse not to wear it. It’s not just because I always seem to spill a drop of coffee onto my sleeve every damn morning (of all colors, why white?), but also because I literally feel like I don’t deserve to wear something that presumes such greatness and authority. With it carries a huge responsibility, and I just don’t want to disappoint. Heaven forbids a medical student being a disappointment to society. We’d rather get hemorrhoids and drown in our own blood from our anus.
Every medical student is pretending to be smarter than they are and less stressed than they really are. We study way more than we claim we are, have much less fun than we brag about on Facebook, and are much more insecure than we put ourselves out to be. I know this to be true because I am guilty of this. I’ve been faking it till I make it since the beginning of time. It’s contagious, and it’s toxic.
Why do we put ourselves through this misery? For me, it’s because I have these unrealistic expectations of perfection. We’re a unique group of people, chosen from the top of our class from an elite group of students from each college. We’re used to achieving and striving to be the best at what we do, whether it’s academics, music, sports, art, or drinking. When you put a group of similar high-achieving, neurotic people together, you raise the bar exponentially, as well as individual expectations and competition. Our sense of self-worth, confidence, and thus degree of happiness then plummets. The medical school environment does not alleviate this disastrous outcome, especially since the root cause is us, the students.
It’s not really our fault either. From the beginning, we have been drilled to succeed and rewarded for our academic (and non-academic) achievements. That’s how we got here to begin with. I’m sure some of us did so at the expense of someone else. Not everyone could win first place in that piano competition, be valedictorian, or captain of the soccer team. Some of us are so used to success, that we don’t know how to handle failure. In medical school, many of us experienced our first failures, and many don’t know how to cope with that. We forget what made us truly happy, and why we came to medical school in the first place. It’s easy to get lost in our self-destructive thoughts: “I’m not good enough for this. I don’t deserve to be here. Why is (insert name) so much better at biochem than me? Why did (insert name) get a higher USMLE Step 1 score than me even though I studied so much longer? How come (insert name) has time to publish all these research papers, when I don’t have any? …”
You can tell how vicious this process of thinking can get. I know, because I have been through this.
To provide a sense of comfort to other medical students who feel the same as me, you’re not alone. I’m just as insecure about my abilities as the rest of you despite my determined attempts at hiding it. I hope that one day, this will all be behind me and I will truly be a competent physician who doesn’t have to pretend anymore. I hope that I will stop comparing myself to other “more competent” people who seem to have everything put together. I sincerely make an effort to try to only compete with myself, but some people make that extremely difficult when they are advertising their 250s in public and posting their publications and other vast achievements on social media. (And even after I get rid of Facebook, somehow I still hear about it.)
I genuinely try to feel happy for them, and part of me truly is proud, but there’s always this other side of me that feels jealously and shame towards myself — a nagging voice asking, “Why couldn’t that be you?”
I know I can’t avoid all of this thinking process completely, but I have taken steps to at least calm the waves down. I focus on the positive things in my life and have stopped placing unrealistic expectations on myself. I hang out with similar-minded people who make me happy and don’t patronize others. I reconnect with my old friends who I have seemingly ignored for the past three years. I rediscover the real things in life that make me happy — family, friends, my dog, nature, Ellen Degeneres, and wine.
Don’t get me wrong, I still study my ass off, but am not obsessed about it anymore. When I put on my white coat, I think about how privileged I am to have this incredible and rare opportunity to do so. Instead of feeling stupid after not knowing an answer, I think of it as a positive learning experience — why would I even be here if I knew all the answers anyway? I try to avoid people who can’t stop talking about how many clerkships they honored, how many clinics they started in a third world country, and how many attendings are so impressed by their knowledge of the purine synthesis pathway. I’ll be friends with them once they get over their own insecurities and stop having to constantly prove how “good” they are.
We’re all in the same boat here. Let’s keep the sea as calm as possible until we land.
