Beautiful Life!

I looked hard at the sclera of the elderly gentleman. Is it yellowish? I was not sure.

I swallowed my uncertainty, and looked up to Dr. Veysey and the rest of my tutemates (seven of us).

“The patient has a little bit of jaundice, I think.”

Dr. Veysey smiled, in his cynical manner.

“Hmm…a little bit of jaundice? What do you mean ‘a little bit’ of jaundice? What scale are you using?” He paused to look at my ID tag. “Is it Afiza’s scale?”

I was mortified, but I laughed along with the others. That’s how I cope with embarrassing situation. I just laughed.

The moment Dr. Veysey opened his mouth I knew right then and there that something was wrong with my way of reporting.

Dr. Veysey probably noticed my reddened face, and took pity on me. So he did not wait for my answer and just said, “All right, I am not trying to pick on you…I know all medical students tend to do that. But bear this is mind; patients are either jaundice or not jaundice. You do not say ‘a little jaundice’…or ‘a lot of jaundice’. Is he jaundice or not jaundice?”

Well, he was not jaundice. Just a little bit yellowish due to his old age. So basically, what I should have done during reporting is not interpreting the sign. I should just report what I see. For example, I should say ‘the patient has yellow discolouration on his sclerea. Probably due to his old age. Query jaundice.’

Before coming into third year, exams consisted of MCQ and short answer questions. But now that I am in third year, not only do we have all those exam papers, but also we have short cases; in which we have to examine a patient and then report our findings in a professional way. (and no time was given between examining the patient and presenting the case. You have no time to prepare)

This ’short cases’ is new to me, and it does take getting used to. There are certain words that you have to use in order to look the part. For example, there are two ways you can present a case:

1) This elderly gentleman, age 89 years old, came into the hospital presenting with abdominal pain on his Right lumbar region. He was coughing out blood and he has increased respiratory rate at 26 per minute.”

2)An 89 years old gentleman presented into the hospital with right lumbar abdominal pain, haemoptysis, and tachypnoea at 26 per minute.”

Obviously, the second one is the better one. Words like haemoptysis (meaning coughing out blood) and tachypnoea (increase resp rate)  makes you sound like you belong in the medical settings. The second one is more precise and concise; only takes one sentence for my examiner to get the overall impression about the patient that I have examined.

And just today, the emergency physician was saying that with ’short case’ you have to look in control, confident, and slick, and smart! It’s all about the presentation. Do I look like I am competent? Do I look like I am doing the physical examination, expertly, almost effortlessly? How do I present my case…do I sound convincing?

As with every new things, I tend to hate this at first. And I have worried about it for two weeks now. But I guess, when the exam time comes, and you know you have to go through this anyway, well…you will just do it!

Skrang nih..I am trying to come up with my own style of presentation. How am I going to sound professional and confident when I dun know what the bloody hell is going on with the patient, let alone trying to give a diagnosis and then coming up with reasons why I give that diagnosis!

If I have a heart disease, I would probably have experienced recurrent syncopes (faintings is the normal word) due to tachycardia (increased heart rate) at the mere thought of short case exam. Right now, I am just tooo tired to worry.

At the end of today’s session, Dr. Steve Cameron said something that touched me very profoundly. “You have got to be confident. You deserve to be confident. Obviously, you have to be at a certain level of knowledge to have come this far. You all have done very well. So, show your confidence.”

I almost want to cry (PMS?). Tak sangka ada juga org realize how hard it must be for us, at times. When I saw all these doctors, who have made it, it makes me think that they have always had that level of  knowledge and superiority. Some doctors (even students) nampak macam they have known some medical facts since birth…they dun even need to stop and think (like I did). But actually, it takes times and pratice. Those seemingly effortless confidence comes with burning the midnight oil, and bending over several thick hardcover medical books even at lunch time.

And me? I would never let medical books interfere with my lunch. So, how can I expect to be as good as them? Your output is only as much as your input (sometimes even less).

Yeah, I deserve to be confident. But right now, I am thinking, I dun have much confidence to project at all. And that is only one of the thousand things that I need to work on within 4 weeks from now! I am running out of time…yet I still sleep 8 hours a day?

My problem is…I dun let studying get in the way of my personal comfort until the exam got reaalllly near. Like my dad said, “Dah nak terberak, baru nak korek lubang.”   

Maybe if I just start working really hard right now, I will be as confident as the next medical student. Because in medicine, confidence comes in knowing that you are right. If you are playing guessing game, your confidence is only at the level of those who are playing those guessing games.

But then medicine is not a game! It’s high time I realize that.

Filed under: The life of med student and