I once clerked a young man with juvenile (Type 1) diabetes. Remember the story on my previous entry of which I have to ask about his ‘microvascular’ complication, yes? That one. It happened to be I met him again by chance at Pasar Rabu here in front of Perdana Apartment last week, he is one of the hawker there. He recognized me and greeted me, and it took me milliseconds to recalled him back, it saved me an embarrassment. I mean seriously it was like almost a year ago once I’m in Medical Department posting. Well the point of this story is, it is very heartwarming when your patient recognized you. I asked him about his condition, he told me it was well controlled, he hasn’t been admitted since the last time we met. I still remember how he got scolded by a specialist because his non compliance to medication that made him having episodes of hypoglycemic attack with requirement of multiple admissions. And I am the one who mustered all my pinchful knowledge to explain to him about mechanism of diabetes in a layman term. Sometimes what it took you is a little time to make patient understand about the disease they suffered from, so with that hopefully it will enlightened them to take better care of themselves. Just like what I did with the multiple times defaulted MDR-TB cum heroin addict in IPR years ago.
Today, in a rush to look after a case to be presented for Bed Side Teaching, after much effort going up and down male and female wards, I finally settled on a case of Cerebrovascular Accident of a Malay male patient. He just got transferred from Emergency Department, a fresh case. Houseman has not yet clerked him. It happened to be the houseman who in-charge of him is a new houseman, probably on his first posting and he needed a more experienced partner to help him clerk that patient. You know what, that is sooooo UM graduates. I mean seriously, while we MSU medical students are prohibited to clerked in pair unless if you need a female chaperon, UM student walk the ward in 2 to 4 students clerking a single patient. I mean, not to boast ourselves, we are confident enough to fly solo. Because they are so acclimated with that kind of culture, it extended to their house officer life.
On the nearby bed is a pair of UM student clerking and examining abdominal case, my patient who is an elderly man (or maybe that strokes got his cochlear nerves too) required me to tune-up my volume a bit, loud enough to make everyone in that cubicle looked at me and follow through with my history taking. I tell you this, there was no privacy there. In the middle of the clerking, these pair of house officers came. I don’t know what is wrong with that male HO, he let the female HO do all the examinations while he simply jotted down all the findings, a classical UM medical student trait.
Neuro-examination is my Achilles tendon, so as what my dad told me about Math, the more you hate it the more you need to tackle it, except it doesn’t work with Math and girls. With no options at hands, in Neuro Exam I have to face it, because sooner or later I need to face this shizz like it or not. I needed this case for case write-up. My other colleague resort to abdominal case instead, and being sadomasochist I am, I took neuro case instead.
Here’s where the story got interesting, my patient (the hemiparesis), is delirious as he constantly told me that there is somebody taking a picture of us, and claiming there is something in his left thumb that making it difficult to grab my fingers as I assessing his power. He was uncooperative to that female houseman, so she gave up after tiring attempt. I have to intercept multiple time just so my patient will be co-operative to her. Finally, she request for me to repeat all the examination she failed and finished with the rest. I ended up doing most of the examination, as I already built a rapport with that patient and his wife who sat nearby. He is cooperative to me. These housemen just observed and wrote down in patient BHT every finding of the examinations I performed. Testing for cranial nerves functions, muscle power, and reflexes, sensory and cognitive functions and etc. I also got the attention of UM students nearby to observe me, maybe because we are too loud, as was my patient. My patient is too cheerful for a stroke patient, which drove his wife mad.
As my patient’s relatives came pouring in, seriously, it beginning to look like a show, as they became supporters to my patient to do whatever I instruct him to do. When it came down to test him for pupillary reflex, and I don’t have my torchpen with me neither the housemen. So I have to borrow from UM student at which she –if not because of the housemen- reluctantly lend it to me upon catching a glimpse at my nametag and ID card that probably shouted to them “Yes, I’m a medical student from MSU, deal with it.” I don’t know maybe they have some major ego complex being UM medical students that they have to look down on us, the MSU-MS. It was one of the proudest moments in my 3rd year medical posting.
I still remember a story of my friends who taught the new house officer how to do anterior and posterior drawer test in our previous orthopedic posting. It just heartwarming.
Moral of the story are:
- When you are confident enough, even with micrograms of knowledge in your head, others will respect you; patients, fellow students, even house officers.
- It is not much on what you know, but how you present yourself to them that will gain their trust.
- Don’t be too humble with our university background, knowledge is the same. 1 + 1 is still 2 no matter in which university you study.
- You will learn a lot from observation, and with your patient rather than being entirely bookworm. Be street…or shall I say…ward smart not book smart.
- Don't be afraid if you don't know everything, the beauty if it is you'll learned along the way, through experience. Nothing sticks longer than experiences.
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