Saturday, May 15, 2010

CSFC in point form

Watched two surgeries:
- One laparoscopic colorectomy- got such a high during 'tumour time!' when I stood on a stool and the surgeon pulled out the bowel and
- one extremely bloody rectal fistula turned sinus repair

Patients that caused me to look at them a bit harder (discreetly) and think, 'Hmmmm something looks not quite right, but what is it??' and then 'OHHH' when the tutor points it out:
- Man with flushed and swollen face --> SVC obstruction
- Man who looked like a sumo wrestler, but no abdominal striae --> Cushing's
- Man whose skin looked very smooth and relatively hairless --> Jaundice
- Man who just looked a little odd --> Cushingnoid facies
- Woman who just looked a little odd and tremors --> Parkinsonism with mask-like facies

Other cool cases:
- Charcot-Marie-Tooth patient
- Pneumonectomy patient who knew more about his various conditions than we did
- Plus many many more

Some moments:
- We were heading to Kopitiam for lunch and we were in the lift when a patient whom we previously met, examined and took a history from was wheeled into the lift on her wheelcar. My first time feeling an irregularly irregular pulse and heartbeat (This moment was wondrous too.) Also, she had two murmurs and was scheduled for a MVR. She was always very friendly and so nice but in the lift that day, she looked very much weaker and so very tired and she struggled to answer us when we asked her how she was. She looked like she had just got a stroke actually, and I didn't dare to say that, and then my friend said it. The few moments of discussion with them after that were awful. Then I left them and went to Mr Bean to get a drink, and said a prayer and gathered myself and she stayed on my mind the whole day.

- TZ and I were taking a history from a woman who was admitted for abdominal pain and other problems. When we asked about the onset of the pain she said "Da ge si le" (Big brother died) and started crying. I'm sure the look of alarm that flashed on TZ's face was a reflection of my own. We will do better the next time. And I've learnt that we should try our best not to cry cuz that makes the patient cry more

- When a patient's daughter took us aside and told us that actually her dad had stage 2 ca and they were not going to tell him about it. Somehow I think he knew too, but both sides were trying to protect each other.

Embarrassing-please-let-me-disappear moments:
- When I finished a respi exam and got the correct signs that lead to a very obvious diagnosis but I said another diagnosis (Had just gone over it the previous week don't know what came over me), and to quote one of my CG mates, "Did you see the prof jump?" Haha :S Then she said "I would have given you full marks if you didn't say that"

Awesome tutors:
- Above-mentioned prof- An elderly lady who runs 15k every morning before rounds. Inspiring. A very very good prof whom the seniors asked us to squeeze as many tutorials as we could get from her.
- Colorectal surgeon who let us eat during his tutorials and told us his love story and grabbed my other hand and put it on an inguinal hernia (my first) when I gingerly felt it with one hand. He said I'd never forget this case and when I read up all about inguinal hernias that night the info would stay with me for life.
- Urologist who owns a chocolate company
- Neurologist who made a quiz specially for us

Lunchtime (food that I liked and quite miss eating):
- Chicken rice and Meekia
- Mr Bean!


***


Went running today and Winter ran away from another (small friendly) dog. She yanked so hard that the leash came off. And her hind legs and bum fell into a drain and she looked at me in fright. SO cute :D

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