Scrubs or no scrubs

You know your being upgraded when you get "called" to scrub in when others are not.
And no, its not just to hold a clamp in place or suction the oozing blood.
But suturing the tendon or actually to hold the saw on an amputation.

Score!

It pays to be hard-working after all.

You can call me stupid if i mess up. Never lazy. Ever.

                                                    Elephantisis scrotalis - operation 21/12/2009 (face left oout for privacy purposes) and no, he's not sitting on a pillow..that is exactly what it says. scrotalis.

necrotic burn wound. amputation in 2 hours. yeah. i am assisting ;)

mild contracture

auricular keloid

in other words. aesthetics scar removing operation tomorrow.

Knives and Forks

   A surgeon is like an artist, instead of using a paintbrush to create art, they use knives, a ten-blade (as you keep hearing them call out for in grey's anatomy, or ER) to help mold the human anatomy and restore function or aesthetics to their 'Art'.

   I think in every reference of surgeons in general, you can say they are the 'jock's ' of the medical field. If not i, they themselves consider surgeons the 'jocks' of the medical social scene. They walk tall, full of confidence, no fear, and just reeks of an aura i can only describe with words.

   I used to think that it would be cliche'; but being in my 3rd week of surgical rotation. I just have to say it. Surgeons are uber-cool. :P

  Of course, there are moments when i can hate them in an instant, but still marvel at their meticulous skill. Some are neurotic perfectionist which can be hard to bear, maybe even IMPOSSIBLE to bear but still.
Being in the ER for 2 weeks, i got to see first-hand, how the doctors deal with the most gruesome of situations. Imagine watching Grey's Anatomy, where they wait by the door in gloves and aprons for the ambulance that would bring i n anticipated patients? well, over here it's quite different.
We wait inside the hospital, with only our gloves as the protective barrier for us to handle the mess.

    Left right and center are patients with obstructive ileus, stab wounds, head trauma, multiple fractures, open, closed, you name it. But the worse is not the big bloody mess of a patient. But the seemingly normal one, walking in in a sarong covering a 2 year old tumor that is bigger than the patients head, oozing pus and necrotic tissue (dead skin). Oh wow, the smell will push you out of this world. And sticks on you- for days (maybe thats just my paranoia).

   And my job as the junior doctor? There are no nurses in the ER. we check the patient in, assess his/her A,B,C (Airway, Breathing etc), plug in the infusion needle, urine catheter and NGT if required.Any wounds, we get the liberty to be the ones cleaning it and suturing.

     It is tiring; but once you're in the heat of saving that patients life...it just feels worth it.
I was posted in Akademis Hospital last week on my own to assist 2 Surgical residents there. I was in charge of all operation prep procedures, clerking patients in the ER as well as rounds every day at 5   am and 4 pm in the wards.

    The best part of each day was the operations i get to see. If i was lucky, and the Attending is somewhat excited to teach, i get to scrub in and assist. (Photo of an OREF i saw, i assisted an ORIF repair on a fractured femur. but no photos. :( )

I never knew i could feel so excited about holding a clamp. Maybe its the air in the operation theatre. Maybe its the fact that sometimes you get to close up the patient. Maybe its because all is well so far.

8 weeks to go. This photo is a photo of a trepanase procedure, where Burr holes are made in the skull to release trapped air that caused an increased intracranial blood pressure.

Can't wait.

There's something wrong with Lord of The Rings

I read thi from a friends' page; Jason Leong. i thought it was funny and worth a mention. read it. :)

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When the dust has settled, and peace restored to Middle-Earth, once the mighty Sauron has collapsed, one applauds at a beautiful trilogy masterfully made by a genius equal to Tolkien himself, Peter Jackson. But now that I have time to reflect and swirl my thoughts about the plot, I realize that something is terrible wrong with the story of how Middle Earth was saved.

Here's what's wrong : I think Sauron should have won.

I mean, ya gotta give the guy credit. He was BRILLIANT! I mean, he created the One Ring, which controlled many other rings, which controlled the dwarves, the elves, etc. It gave the wearers a false sense of security, as if they were in control, but in actuality, they were not! The same concept can be seen today in pyramid schemes! Sauron was way ahead of his time man.

Okay, then he controlled Saruman, who looked extremely dodgy in the first movie, like the classic I-act-like-a-good-guy-but-

actually-am-the-bad-guy-just-wait-for-the-plot-twist kinda character. I dont trust Christopher Lee's eyebrows. Saruman then built this massive Isengard, which then had massive factories which built cruel war machines. Now we see Sauron embracing technology to achieve his goal.

First politics, now technology. Sauron can do it all.

Then, mastering genetic modification and biology, he created the Uruk-Hai ( which sounds like a bad Chinese word),a cross breed between Orcs and Men. Not only did he bred them, he assembled them into an army, giving them weapons and armor, and organizing them into an effective fighting unit.

One by one, cities in Middle Earth felt, in a meticulous decimation by Sauron's forces. Sauron was a tactical genius.

Then came Helm's Deep, and we all know what happened there. It is at Helm's Deep, where the first injustice occurs for Sauron.

Sauron had what, 10,000 soldies, outnumbering the Men. Not only that, they managed to break the fortress, something never done before. Then, in a matter of 10 minutes, his armies are defeated by Orlando Bloom skateboarding down a flight of stairs and....SUNLIGHT!!!!! The Black Evil , the Uruk-Hai, The Lidless Eye's army, the black shadow spreading across Middle Earth...were BLINDED by SUNLIGHT and then defeated? How is this realistic?

But Sauron was not one to give up. No sirree, he had perseverance,determination and the unwillingness to give up.He regrouped, and sent more armies, this time to thrash Minas Tirith. Sauron, ever the strategist, also sent warships BEHIND minas tirith to ambush them while they were preoccupied with the war at the front.

The Men were outnumbered. Many of their kind had died. THeir spirits were broken, and Legolas's hair was slightly out of place. They were about to be defeated, and rightfully so, for the master strategist had already beaten them.While the men were fragmented, Sauron's army was relatively united.

Then suddenly, Aragorn talks to a bunch of GHOSTS in a random CAVE and decimates the ENTIRE SAURON ARMY!???!!??!!?

Apa ni???

Who doesnt pity Sauron just a teensy weensy bit? I mean, cmon!

Of Birthdays, Cakes and Surprises

14th of November is a big day for me. It is, afterall, the day i was born 24 years ago.

This year, i celebrated my birthday, in a dark hallway, in the morgue, waiting for a dead body to be brought in by a paramedic. Well, it was 11.45pm on the 13th; but still..that was my birthday.

I was posted in Bhayangkara Hospital for a week; which began on the 5th of November till the 15th. And so i already knew that i wouldn't be able to do much or see my friends as i had duties to attend to. Posted in this hospital, means i have to live in the on-call room with 5 other junior doctors like myself and wait for autopsies and medical exams for legal cases (i am currently in the forensics department). It's not like what you see on CSI. get real. we do autopsies, and paperwork. nothing else. oh yeah, but reporting and reconstructiing of the crime is kinda cool. ;)

 Anyway, i was pretty down the whole day untill my fellow group mate ran out and got me a cupcake. yeah, one and it was sweet of her. At least i thought i had something to blow a candle on to make the day feel a bit special. Later that evening, my dear friends Shila, Wah, Huey, Elango and Melvin came to the hospital and surprised me with a dozen doughnuts (i love J.CO.s ) and gifts. We crammed into the on-call room and hung out till late (the cops had to call them out for disturbing said junior doctors..at 11.30pm. The hospital i was stationed at by the way is a police manned hospital.)

Sunday was spent studying for my exam on monday morning. before finally leaving bhayangkara hospital at 8pm for home.Earlier in the week,  some of my juniors had water shortage at their homes so i let them shower and wash in my house as i was not living there for the week anyway, so i rang them up to say i was coming home and i wnated my keys. So when i got home, it annoyed me that they didn't come out to help me with my things ( i was holding three bags, a chair and a fan. phew) when i knew they were inside and heard me calling. But then when i knocked and the door was open, standing in front of me was my dear junior Boo, holding up a home-made chocolate cake and to her left was a table filled with home-cooked chicken rice just for me. My neighbors were there as well, and sang along. Surprise no.2!

Needless to say, the cake was delicious, and so was the chicken rice. I guess it pays to be nice :)

Monday morning started great, finished my exam at 11 am, went for karaoke with my gal pals and then Huey called me out to try the new sushi place. And what do you know, surprise! they got me another choc cake and bought me dinner. :) did i say i love my friends? because i do.

I want to put up photos but it being all surprises, i actually didn't take any. But my friends did, so i shall put them up when i get them :)

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 November is not just a special day for me, i've been sharing birthdays with my older sister longer than i can remember as her birthday is on the 17th.

This year, i surprised her with none-other than the trendiest thing since doughnuts!

cupcakes. hand-made to perfection and personalized to a tee by my high school friend Mei Leng.She creates these art works and delivers them too!

since my sister was an avid traveller, i wanted the cakes to show that, and that she's an architect, used to live in New Zealand. so here they are. I  knew she loved em :)

Hot & Humid November

Hello November,

I usually get psyched up when i see the turn of the calendar right after Halloween.

Of course. it means a month closer to the end of the year, my birthday would come up and usually i'd be flying home soon enough.

But the extended power cuts are annoying me physically, mentally as well as emotionally. Stress can alter everything about you.

For the past week i've been stationed in Bhayangkara Hsopital, in charge of doing autopsies as well as forensics examination in legal-medicine.: rape, abortion, road-accidents and etc

So it has been a hectic week where we are not allowed to leave the hot, air-less hospital, and to add up to our misery, there is no fan, no window in our on-call room. and the electricity gets cut every 6 hours, for 3 dang hours. Even the water stops running after the 2nd day.

I get hopeless, and tired, and angry and emotional. hmm..

ok, so the upside is we get free wireless internet connection with a very limited speed. but still..only so much free browsing can happen when you're hot and sweating.

Hello November indeed.

Details

Last weekend, on the 19th, my very close girl-friend got enganged to her long-time-best bud in a very sweet ceremony which i wished i was able to attend. Sadly, not being there i could only offer my coongratulations through the technology of text messages n fb account. haha. Za's engagement was the 2nd engagement i missed this year, which hopefully i can make up for next year on the wedding day, k Za? Sha?

Am in my 3rd week of forensics and legal medicine. Presented a blunt trauma case of road accidents. Went dr. G came in and requested us to present after he had just maimed the group before us, i was quite speechless. But minor referential mistakes aside, he thought we gave an overall good presentation. Yeay! But Dr.G wouldn't be Dr.G if he wasn't critical of every word, every detail and every photo that we showcased.

"Who do you think you are?"
-Ouch.

Remember that everything in forensics is evidence-based. Always remember that when giving a statement, an objective or eve subjective point of view.

Duly noted Doc. Hopefully tomorrow goes well.

Bite Marks

Today, in the forensics lab, we were acquainted with my supervisor, dr.Peter S. and he gave us a brief lecture on bite marks, the importance of superimposing the coorect size and shape in identifying perpetrators of law. It was interesting, especially when we started discussing the famous investigation of Ted Bundy.

In Forensics and Legal Medicine, we don't just do autopsies, although in CSI its pretty much rules the show; but we investigate. And study, and deduce our assumptions in a crime scene and point fingers at the assailant; all within reasonable evidence as proof.

Are you getting the picture?

I always thought it'd be easy to watch an autopsy, or even get my hand dirty in doing one. But in truth, touching, feeling and smelling a dead body, a fresh corpse, and cutting them open is a whole other level.

I hope InsyaAllah, i will never have to go through one as the body lying cold on the table.
Its something i would never wish on anyone.