Beautiful Life!

Ron pernah cakap kat aku. “Can you spell your name for me, pls?” I was so flattered. Tak pernah ada Australiam yg curious nak tahu how to say my name sampai nak suruh aku eja.

Waktu tu dekat tutorial public health. So, aku malas lah nak cakap sebab tutor duk ader kt situ. Instead, I wrote it down. A-F-i-Z-A.

Ron’s face cleared. He smiled. “I thought it was aphasia. That’s why I asked. When the tutor called you just now, it sounded like aphasia.”

Damn!

Aphasia is a disease. Definition: the loss of ability to produce and/or comprehend language (wikipedia).

I was no longer flattered that my name could sound like a disease! I glared at Ron. He quickly looked away. Tahu takut! Nak make fun of my name pulak!

I knew he was either joking, or he was really trying to find out whether or not any parents were stupid enough to name their child after a neurological disease. So, I smiled at Ron, my way of saying “don’t worry about it. Not everybody can have excellent hearing. You might want to have your hearing checked, by the way.”

That was one of the funniest episode dgn budak OZ yang aku still boleh recall. But that’s not what I want to talk about.

Sem lepas, I had neuro clinical skills with Dr. W who is the head of neurology at the hospital. (He is one of the scariest doctor I have ever met! One day, I would devote one whole post just about him,iA).We have seen many neurological patients previously. But none of them were as attrative, as neat as this elderly lady. Also, none of them looked just as miserable and lonely as this lady.

When we approached her, she was sitting on her bed, Indian style. Dr. W greeted her. “Good Morning, Mrs. X. How are you today?”

The lady just stared at Dr. W and all eight of us. Her eyes lingered a bit longer at my hijab.

“Can you spare a bit of your time with me and my students?”

Again the lady said absolutely nothing. Her mouth were zipped shut. She simply looked at us as though she could not understand a thing of what had been said by doctor W. Or maybe she did understand, but she just could not be bothered to entertain us.

“They are second year medical students and we will go through some procedures of neurological examination, if that’s all right with you?”

The lady just stared at us. She did not bother to reply. Neither did she think it was proper for her to just nod or shake her heads in agreement/disagreement. Ni lah the real-life situation of ‘bercakap dengan tunggul” ( i mean no disrespect. I am just trying to illustrate exactly how the situation was for those without medical background ).

I started to feel uncomfortable. Bagi aku lah kan, kalau patient memang tak nak layan tu, baik kita blah jer lah. I don’t like to force my presence on an unwilling person. If I detect even the slightest of discomfort, I would feel myself unwelcomed and I would accordingly excuse myself.

Tapi Dr. W tak berganjak. Instead dier terus proceed with his teaching. Style Dr. W ni is such that he would go around the circle and ask each and everyone of us what physical observation have we noted on a patient before any specific examination has been conducted.

“She looks comfotrable. No breathing difficulties or any distess.” Said one person. Selalunya tu lah ayat yg semua org nak cakap dulu supaya dier dah terlepas drpd kena buat any other observation. Memang benda yg paling senang nak observe adalah whether or not patient ni comfortable ke, distress ke. And then kita note ader IV drip ke or ader cathether apa ke yg attached.

Tu general observation yg kalau boleh semua org nak cakap dulu. We don’t want to be left with nothing to say when other people dah cakap benda2 lain yg obvious. Masalah aku at that time, aku duduk enam dari kanan Dr. W. So sebab Dr. W ni mula tanya dari kanan, giliran aku lambat lagi. Maksudnya, aku mmg kena perah otak cari apa nak cakap. And I have to find several just in case org lain dah sebut benda yg aku nak cakap.

So, in desperation, mata aku melilau tengok this old lady dari atas sampai bawah. I was staring and I was not at all subtle about it! I was damn obvious. I could feel that the lady was quite annoyed with me for staring. Ah, lantak. Ko stare aku tak per, aku nak stare ko tak boleh! Mana aci!

Lady ni sgt cun! Boleh dikatakan pesakit yg vogue. Dier pakai make-up. Ader lipstik, ader blusher, ader eye-shadow. Mascara aku tak perasan pulak.

That is rare in a patient! Aku tak pernah jumpa pesakit yg melawa, melaram di katil hospital! Aku perhati muka dier betul2. Ader apa2 ke yg aku boleh sebut kat situ? Memang muka dier mcm senget sebelah sikit. Tapi ader jer muka org yg tak simetri. Dier tak der lah obviously senget mcm pesakit stroke tu. Bagi aku, muka mcm tu tak senget pun. Just a bit skewed, I guees.

Sekarang dah giliran org ketiga bercakap. I still could not find anything to say. Takkan aku nak cakap. “She looks very pretty with her make-up on?” That’s not medical observation!

“She is a bit thin.” Org ke empat cakap. Aku rasa dier pun dah tak der benda nak cakap sgt.

“Yes, but that is not uncommon in elderlies.”  Dr. W cakap.

Orang kelima (I think it was Chantelle) “Her face is a bit droopy on the right side.”

Dr. W nodded. “Exactly.See this bit here.” Dr W pointed at the lady’s chin. “And also this bit here. It is not very obvious, but you could see…-”

And all of a sudden the elderly lady cried! She cried and cried, non-stop. I was astonished. Dalam hati : Nasib baik bukan aku yg komen muka dier mcm tu.

Imagine kalau aku duduk tempat Chantelle, and that’s the only observation yg aku dapat. Nak ke tak nak, kena juga cakap. Tak pasal-pasal buat patient menangis! Sure rasa guilty punya!

Chantelle pun nampak terkejut. Dr. W pun stop in mid-sentence. Semua org rasa bersalah kot. Tak tahulah kalau aku sorang rasa mcm tu. I mean, imagine how you would feel, kalau ko tengah sakit…and then nak dekat 10 orang keliling ko kat katil, ignoring you, but talking about you and pointing at you and staring at you. (Okay, aku bersalah juga sebab staring. Aku admit.) Mesti ko rasa sedih. Rasa mcm ko ni rare species in a zoo. Kalau komen benda baik, tak per jugak. Ni komen muka dier senget!

Dr. W took the lady’s hands konon nak comfort lah tu. The lady looked like she was trying hard to say something but all that escape her thin, pinkened lips were sobs and more sobs. It was heart-breaking. We, the students, did not know what to do. I looked away and the rest of us looked down. Some tried to school their expression to look appropriately sympathetic. I never bothered to do that. I was puzzled and I knew my frowning forehead indicated just as much.

While Dr. W was holding the patient’s hands, my thoughts ran wildly. Okay, kenapa lady yg tak pernah nak bercakap, doesn’t make any sound tiba-tiba boleh menangis bila org cakap pasal muka dier?

Because this is neuro punya subject, mesti ader kaitan dengan aphasia. To simplify, aphasia ni ader 2 important pattern (byk lagi pattern actually but I am not trying to write a medical book here) :

Pattern 1) You could not understand what people say to you, but you can talk.

Pattern 2) You do understand but you cannot talk or reply (expressive aphasia).

When we first me thet lady, she did not say a thing. So, kita tahu dier ader aphasia. But we didn’t know which one. Mungkin dier tak bercakap sebab dier tak faham the situation (pattern 1) or maybe dier tak bercakap sebab dier tak boleh nak cakap walaupun dier faham (pattern 2).

So when I saw the lady crying, I deduced that perhaps aphasia dier ni pattern 2. Maksudnya, dier faham what we have been saying all along. And we have hurt her feelings by pointing out at her facial deficiencies. So, dier menangis.

Satu lagi theory aku: I think this lady used to be a very beautiful lady. Someone who cares a lot about how she looks. She was neat, she wore make up on the hospital bed, for God’s sake! She was the best-looking elderly patient I have ever seen! I think she was someone who wanted to appear beautiful regardless of any situation whenever she was in the presence of other people. So after the disease (perhaps stroke yg affect her Broca’s area of speech) dier tak boleh terima yg dier dah tak se-perfect dulu. So bila Chantelle sebut jer pasal muka dier, she immediately broke down and cried. Because beauty was important to her.

Beauty is important to all of us, I am sure. Kalau tak, the cosmetic industry would not be as lucrative as it is. But some take it more seriously than others.

Aku bisik kat dayah theory aku. I told her that I think this lady ni depress sebab she cares a lot about her beauty. Dayah cakap “cakaplah kt Dr. W ko punya theory ni.”. Hmmph! This was only a speculation, on my part. Nanti Dr. W kata aku ni pandai-pandai jer mereka cerita! Ingat ni drama ke?

There is wisdom in dressing modestly. It’s a psyhological barrier against the depression that would ensue when you lose it. How many western women turn to cosmetic surgery to enhance their beauty; it’s a psychological dependence of some sort! It’s because they are depressed with how they look and they want to make themselves feel better.

Macam ketagih. It affects your mesolimbic dopamine pathway kan. Anything that gives you pleasure would cause dopamine to be released in your mesolimbic dopamine pathway. Maybe (ni theory aku jer, i dunno if the theory is limited to drugs only. Tapi ader org yg sex-addict and sex is not drugs! So aku rasa theory aku ni maybe boleh pakai.) bila kita buat surgery, and then kita rasa gembira seeing how beautiful we are. The pleasure that we feel cause dopamine to be released. So, ketagihan.

Thus, no surgery is enough! You will want for more, and more and more! Hahhaha. I have lots of theories in my head. Kalau Dr. W tanya pasal theory, mesti best aku nak jawab.

Masalahnya, waktu dier keluar from ward, dier nak sambung balik observation. And I still did not have any!

Damn!

Filed under: The life of med student and