1) In the blink of an eye, we have finished our first rotation in surgery/orthopaedics, and have begun our first week of medicine. We are still based in Seberang Jaya Hospital, but this time we clerk patients in the medical ward. So far, medicine has been by and large the same as surgery, with the only difference being its breadth and scope. While surgery is quite organ-specific, medicine is really quite broad, and literally anything under the Sun is examinable. The plus side is we've gained a lot of exposure even in our first week of rotation alone.
2) After seeing a fair share of patients in the ward, I have begun to reflect a little on the things we take for granted. The other day, I was clerking a gentleman who had been hospitalised for bacterial meningoencephalitis. That basically means he had a bacterial infection of a part of his brain, probably caused by an accident he had two weeks earlier. The more I talked to him, the more I realised how lucky he was to be alive.
3) So apparently he was involved in a motorcycle accident recently (I'm being selectively vague on details), in which he had intracranial bleeds and fractures. He was hospitalised for a week, then discharged back home without complications. He returned to hospital after two weeks, complaining of headache, neck stiffness and photosensitivity. Some of you will immediately be thinking of meningitis, and in this case - you would be right to suspect it.
4) After one day onset of symptoms, his condition rapidly deteriorated, and on day 2 in hospital, he became increasingly agitated. His GCS later on was 3/15 (3 is the lowest score possible, and indicates no eye response, no verbal response, and no motor response). He had to be intubated (to ensure oxygen levels were maintained), and as culture and sensitivity of his lumbar puncture CSF (cerebrospinal fluid) was positive for resistant strains of Klebsiella pneumoniae (ie ESBL), he was placed on IV meropenem.
5) For one week, he was in a coma. He was informed by the doctor that he was basically touch-and-go at any point during that period. And despite all that, barely two weeks after the incident, he's walking about with his cup of Milo greeting the nurses and talking to me with no apparent speech deficit. He still has minor headaches especially at night, and a recurrent 6th CN (cranial nerve) palsy - which means he has diploplia (double vision) over the left lateral gaze. That was due to the trauma from the motor vehicle accident. But otherwise, you would be hard pressed to distinguish him from anybody down the street.
6) Somehow, talking to him made me hyperaware of how indispensable modern science and technology is. The medication and treatment he had been given, managed to revive someone from the brink of death back to relatively normal. It made me realise how indispensable the medical team is - everyone from the specialists to the medical officers, the nurses, the staff, and caretakers - all had a role to play in his wellbeing (and indeed, survival). It also made me realise how important it was for us medical students not to study to pass exams or get good grades, but to become safe and competent doctors. Finally, this experience also made me realise how lucky I am to be fit and able, and how foolish I was to complain about a variety of things (a habit I feel most of us are guilty of).
7) For medicine, the requirement is to clerk a list of 10 symptoms, and to practice at least 10 different systems examinations on the patients in the wards. We have a portfolio requirement as well, but the notes can be typed (a huge relief I'm sure). I have been really lucky these past few days because I've gotten really cooperative patients, who were not just cooperative but also extremely friendly. I can only hope to soldier on with my studies and hopefully one day contribute in any small significant manner to the wellbeing of our patients.
8) That has been it for today's blog, thank you very much as always for tuning in, and have a great week ahead. Cheers!
Just a close up of our school as I don't think I've ever taken a photo of the front :)
That is the Malaysian Campus of the Royal College of Surgeons in Ireland and the University College Dublin, or RUMC for short
That heaping plate of food costs only RM6.00 - or around €1.20 - beat that XD
