Ward Round Today

I am infected with acute tonsilitis, the annual kind thanks but no thank to my housemate whose been seeding germs all over. I wouldn’t want to risk exposing sick patients in ward with it, so I don’t do any clerking today (I know it’s a lame excuse but bear with me). So I choose to go around ward with my female friend, wearing face mask to cover my red excoriated nares, only to be mistakenly identified as Chinese doctor, TWICE.

I told you in my previous entry how fond am I to an elderly patient, well it just happens to flourish day by day. I’m not in a mood for clerking today as I can’t stay long with my runny nose behind my mask. I have toe excuse myself to wipe it every now and then, so what I did was observing procedure and surveying case for write-up.

I chatted with a frail bed-ridden elderly woman who couldn’t remember much, she’s so adorable when she laugh at my joke upon teasing her that she look kinda 16 to me, when she actually 86, and how embarrassed she was when I asked her to smile and show me her prosthetic teeth of which she called ‘gigi batu’. She was a case of diarrhea to be discharge that afternoon.

Then I chatted with a 53 year old lady with left hemiparesis, hypertension, reduced renal function (to initiate dialysis), that seemed complicated but interesting enough as she has AV fistula. I shared with my friend how to appreciate thrill and what bruit sound like. A specialist once thought me last year that “If you want to know how to feel for thrill and how to appreciate bruit, go to patient with AV fistula, palpate and auscultate it,” So I am just sharing with her what tiny minuscule knowledge I have.

Next as I was surveying and looking for a hepatitis case for my friend, I was called frantically by a Chinese lady who muttered Chinese words unintelligible to me, I was like, “No way, don’t freaking tell me she’s coding,” because I am really damn sure didn’t know what to do. Turned out she wants to show me a referral letter that she forgot to show to housemen. She is a case of acute exacerbation of COAD. We chat for minutes after I half-heartedly told her I could not understand Chinese. This is the moment that I desperately wants to take Mandarin class, I really think I should. She then asked me to prescribed her some sorts of inhaler because she finished off the one she had. My reluctance to admit to her that I am just a medical student instead asked her to direct that request to a housemen was responded with, “Aiyo, sula jadi lokter pun tak boleh kasi ubat ah?” to which we responded politely with “Auntie rehat ye, jangan cakap banyak-banyak, nanti auntie susah mau nafas.” and we walk away.

Next patient was a Malay lady presented with failed suicide attempt with obvious ligature mark on her neck. She claimed that she was being possessed by a bad spirits since two months ago after she got into some disagreement with some people. She claimed that she’s has been harming herself and she has no control of it. She couldn’t fight it as she was not in control of her body. She has peculiar behaviors and abnormal strength. She has no motive to commit suicide and I believed her. Attending doctor has go such length as referring her to Tanjung Rambutan, but the attending psychiatrist of whom we managed to discuss with told us that she is not a mental case. In medicine you can never be sure to classify case as solely with organic causes, sometime we will encounter cases of which we could not pinpoint the causes. Mystical or x-files we might call it.

Last patient before we decided to call it a day is an old lady with unilateral swelling of her knee that rendered her immobile. It just swelling and pain but not warm and red. I spot diagnosis her as gout and I was right. Guess those orthopedic posting was not a waste anyway.

There you go, my day of having a make believe ward round. At the end of the day, I decided not to take any of those case as a write up. Maybe tomorrow I’ll get lucky.

I know this entry is boring, but I am feverish, bear with me.