DAY 1719-1732

May 18-31

1) Since my last post, the COVID-19 situation in Malaysia has reached a critical state - the usage of ICU beds nationwide is now at 104% (that's not a typo) capacity, while COVID-19 hospital beds are at 85%. This means that soon enough, Malaysian doctors will be forced to make the tough call over which patient should be prioritised for an ICU bed. Penang General Hospital is overwhelmed - many wards have been converted to COVID wards and the hospital is now running 4 ICUs to cope with the patients who require more intensive care/ ventilation. In line with this, the Ministry of Health has made the very wise (if long-overdue) decision to impose a full nationwide lockdown (similar to the first lockdown we had when COVID-19 first hit our shores), for the next two weeks. Essentially, all businesses and schools are closed, as well as any dine-in at restaurants. Yesterday, the number of infection was at an all-time high of 9,000, although today has seen a sharp decline, with "only" 6,999 infections. However, we cannot afford to be complacent - we currently have the unenviable record as the country with the highest infection rate. 

2) A few days ago, we were informed of the changes that this lockdown would have to our education - clinicals have been completely cancelled, and replaced by ever-changing online schedules. At the start of the semester last year, our elective period was 8 weeks, and I had been very fortunate to be selected to represent my university as a bilateral exchange student to the National University of Singapore (NUS). After all the necessary preparations, this was completely scrapped, and the electives shortened to 4 weeks. We were once again required to look for elective opportunities, and only locally this time (amid fears of another lockdown). Once MCO 3.0 rolled along, this was cut to just 2 weeks, and then it really was not worth seeking out another elective placement. True enough, electives have now been cancelled entirely, and all the time, money, and effort spent in securing those placements - all for nothing. But you can bet your last dollar I'm adding the NUS elective to my CV. 

3) Speaking from a medical standpoint, it is difficult for me to envisage all of this going away anytime soon. First, vaccine uptake has to be sufficient to ensure herd immunity (to protect those who are vulnerable and/ or are unable to receive the vaccine). Second, we need enough time to build up that immunity, so it is not feasible to just remove our masks the moment we have been vaccinated. Third, there is a possibility of booster shots being required in the future, as lifelong immunity is unlikely after just two shots. Fourth, there is a chance of seasonality in COVID-19, a bit like the influenza virus which spread seasonally each year due to a phenomenon called antigenic shift. In the case of COVID-19, we are seeing variant strains and even hybrids of these strains of virus in the community, making it all the more likely that infection rates may never disappear completely, but instead remain endemic in local areas. This may not be the news that everyone wants to hear, but it is something that we have to keep in mind.

4) But I would much prefer to end on a more positive note, which is that pandemics do end. The 1918 Spanish flu ended. The H5N1 influenza pandemic (Avian flu) ended. The 2003 SARS pandemic ended. Undeniably, at some point in time (in the very near future, I hope), the COVID-19 pandemic will end. Then it will become a thing of the past; a story to regale our children and grandchildren with. For as the old saying goes - this too, shall pass. And with that, I end my blog post here today. Stay safe, stay healthy, and stay strong in this most trying of times. Take care, and have a great week ahead. Cheers!

Okay, so this cat has decided to call my front doorstep home :)

DAY 1705-1718

May 4 - 17

1) Malaysia is currently undergoing its third iteration of the Movement Control Order (stylised as MCO 3.0). While initially limited to a few key states, the MCO has since been expanded nationwide due to new coronavirus variants with higher infection rates, increasing constraints on the capacity of the public health system, and suboptimal compliance of the standard operating procedures (SOPs) amongst the general public. This includes a blanket ban on inter-district and inter-state travel, to last until June 8th. 

2) So what does all this mean for us as medical students? Well, all education has switched from face-to-face to online. This has put a halt to our clinical training in hospitals and wards. For now, our learning is conducted via lectures and online tutorials, with new timetables being circulated every now and then to accommodate the latest updates from the Ministry of Health. 

3) Group B (my group) is in their final rotation for the year, obstetrics and gynaecology (O & G). Assuming no changes, we have one week after this rotation before having to sit for our exams. Having the constant reshuffling of timetables and disruptions to our learning is not ideal, but I agree that it is necessary and in our best interests. On a positive note, the MCO extension gives us more time for self-study and revision, which can only be a good thing given our upcoming exams.

4) Just yesterday the fifth years finished their final year medical exams - a massive congratulations to everyone! I'm sure the coming weeks will provide a much-needed break for most of you, and richly deserved indeed. I've been really lucky to call many of you my friends, and I look forward to seeing where you will go from here. All the very best in your future endeavours :)

5) Yesterday was also Teacher's Day - a very special day where we showcase our appreciation to all the teachers out there. As a secondary school student, there was a particular poem by Malaysian poet Usman Awang that I really enjoyed, called "Sajak Guru O Guru" (lit. "Teacher Oh Teacher"), and which is commonly read during Teacher's Day celebrations. Here is a particularly poignant stanza from the poem (in the original Malay Language and then translated by yours truly into English):

Jika hari ini seorang Perdana Menteri berkuasa
Jika hari ini seorang raja menaiki takhta
Jika hari ini seorang Presiden sebuah negara
Jika hari ini seorang ulama yang mulia
Jika hari ini seorang peguam menang bicara
Jika hari ini seorang penulis terkemuka
Jika hari ini siapa sahaja menjadi dewasa
Sejarahnya bermula oleh seorang guru biasa
Dengan lembut sabarnya mengajar tulis baca.

English translation: 

If today exists a Prime Minister come to power
If today exists a king ascending the tower
If today exists a President of a nation proper
If today exists a noble scholar
If today exists a lawyer upholding one's honor
If today exists a famous writer
If today exists someone who became wiser
Their story started with the humble teacher
Teaching in calm collected demeanor

6) I liked the poem so much that I actually committed it to memory, in anticipation of our SPM Malay Language examinations back when I was in secondary school. Unfortunately, the theme "Teachers' Day" did not come out for our exams that year. Nevertheless, I've never forgotten my teachers, not even those from primary school. Hopefully, I'll be able to come back and meet up with some of them in the near future. And on that note, I shall end my blog post here. Thanks very much for tuning in, and hope you have a great week ahead. Take care and stay safe, cheers!

Happy Teachers' Day 2021

To all the teachers out there, thank you for being so kind and inspiring!

DAY 1690-1704

Apr 19 - May 3

1) Having finished our eye posting at Bukit Mertajam Hospital, Group B1 has continued with the ENT (ear, nose, throat) posting in Penang General Hospital. ENT medicine, or to give it its proper name, oto-rhino-laryngology, is a surgical subspecialty within medicine that deals with the surgical and medical management of conditions affecting the ears, nose, throat, head, and neck. For the past week, we'd had clinical teaching at the hospital, where we learnt how to use an otoscope (a medical device used to look into the ear canal and eardrum). We also had a chance to see how hearing assessments are conducted (usually in sound-proof rooms).

2) Throughout our two weeks in ENT, we are attached to two different doctors, with three 4-hour sessions each week. At the end of the second week, we have a clinical exam, which involves an otoscopic exam and a short viva requiring us to interpret results of various ENT diseases. So far I am really enjoying this posting as the workload is not too heavy, giving us time to self-study and revise. I like to think that less is more - by focusing less on exams, case reports, and group presentations, there is more time for the medical student to actually focus on what they are weak in, as well as to delve further into what they might later specialise in.

3) After obstetrics and gynaecology (O&G) posting and the ensuing fourth year finals that I've repeatedly mentioned in previous posts, we will commence our clinical electives. The idea is to give students a chance to explore an area of their own interest, in any hospital of their choice (subject to approval of course). Initially, the duration of our electives was to be eight weeks (2 months), but this was slashed in half due to the ongoing pandemic. The only problem now is that most hospitals have closed their doors to external medical students, leaving very few options behind. That being said, I have been really fortunate to be accepted as an elective student at Raja Permaisuri Bainun Hospital (otherwise known as Ipoh General Hospital). 

4) I guess that is all for this edition of my blog post. I wish it were more fun and exciting, but I suppose that is the downside of being smack in the middle of an ongoing pandemic. Anyway, thanks very much for tuning in, and have a great week ahead. Stay safe and stay healthy, cheers! 

Lovely decor spotted at Gurney Plaza, 

to commemorate the beginning of the fasting month of Ramadan

Tracheostomy tube - a tube inserted into the trachea of a person who is unable to breathe using their nose or mouth (can be used in emergency situations or for long operations)