Beautiful Life!

Today, I had a great day. I have done physical examination for all type of patients; respiratory, cardio, abdo, neuro and vascular. I found splendid signs; hyperresonance, tactile fremitus, obvious heart murmurs, and gosh….if u think clubbing of the fingernails is rare…you would revisist and revise your thoughts if you do your practical in Gosford. I have seen almost ten clubbed fingers.

And Alhamdulillah, today I passed my mock exam for short case. But that doesn’t mean I am going to pass the real exam…you never know what’s going to happen.

Aku selalu takut nak rasa confident. Call me superstitious…but everytime aku rasa confident, selalu the day did not end well. Huhuhu. So, aku sentiasa rasa mcm I should lower my expecation of myself…then, I would not be disappointed.

All right tajuk entry kali ini “the art of crapping”…. is about medical students yang pandai cakap tapi they talk crap! I have experienced many of my friends telling me that they found my entry on “mcm mana nak jawab bagi nampak kita konon reti lah juga sikit2″ is beneficial, so I will elaborate on that.

But you need to have a background knowledge of Malaysian newcastle students. All right, our system is PBL. So, we only have one full day of lectures. The rest of the week, kitorang study sendiri. Sometimes, ada hospital attachment. And kitorang punya tutorial consist of 8 people discussing a case, coming up with diagnosis and management. So, tutorial is basically a discussion. Tutor cuma guide and tanya soalan. Tapi yg conduct the tutorial adalah students.

Basically, org OZ selalu rasa budak mesia ni mandom…dlm tutorial tak pernah nak offer jawab soalan…nak kena jemput2 plak, nak kena prompt barulah budak mesia nak buka mulut. Mcm ada tongkol emas dlm tekak tu. We have been so stigmatized, I felt like screaming against the injustice and the discrimination. So, kadang2 dlm tute, aku try juga nak ckp and nak contribute. I want them to know that Muslim students are not silent because they don’t know a damn thing….most of the time, kitorang senyap sebab kitorang nak susun ayat lagi, nak gather the courage nak speak up lagi (sebab budak OZ sgt dominant. Diorang boleh jer senang2 potong ckp orang and they are so confident even tho they are talking absolute bullshit)…furthermore, soalan2 yg senang semua budak Aussie dah berebut jawab (they dun have to think about grammar! senang lah nak berebut)….so, tinggal soalan2 yg susah jer. Kalau dah soalan yg susah jer yg tinggal untuk dijawab, mestilah budak mesia pun tak reti gak. Bila ada soalan susah, they will look at us expectantly. Their look says quite clearly, “Well, I have contributed in the disccussion earlier, now, it’s ur turn.” Aku rasa bengang kadang2. Oh, bila ada soalan yg susah, baru nak bagi kami jawab. Time soalan senang, hangpa tak pernah plak nak tengok kat kitorang and nak bersabar tunggu kitorang jawab. Instead, they rush through like a bullet train,trampling on everyone’s feelings.

God knows, we try. Kadang2 aku berebut jer….dah malas nak layan grammar. Tunggang terbalik ke tak, ah lantak. Lagipun international students from china and korea tu lagi dahsyat grammar diorang! So aku rasa cam budak mesia nyer engliah not bad per! Tapi mcm mana byk pun aku ckp, still taklah sebanyak budak Aussie sendiri.

So, alas,the stigma is still there.

Bagi akulah kan….lebih baik aku tak payah jawab kalau aku cuma contribute crap. Apa, nak jawab sebab nak buka mulut jer? Unless kalau aku dah desperate sgt, baru aku pun talk crap.

Below is the example of craps I am talking about.

1)Nerve supply.
Tutor tanya kat group kitorang. “Triceps and Biceps are supplied by which nerve?”. Hmm…my mind wandered around time tu. I know that the arm is supplied by C5 to T2 nerve roots. Tapi aku tak pernah plak bother nak ingat specific nama nerve. So, aku pun diamlah. Tak jawab pun.

Pastu ada lah mamat Aussie ni buka mulut. Dalam hati, aku rasa kagum arr…ada org yg hafal benda ni?

“Well, the arm is supplied by nerve root C5 to T2. So biceps and triceps must be supplied by those nerve originating froms those nerve roots.”

What??? Aku rasa bengang. Tutor tu tanya which nerve? Musculocutaneous nerve ke? Axillary nerve ke? Radial ke?  The tutor wants the name of the nerve. Not the nerve roots. Kalau nak jawab camtu, aku pun leh jawab.

Yang aku lagi bengang, tutor cakap, “Good, good. Can you think of any nerve?”

Aku rasa sakit hati. Good? What do you mean good? Have you forgotten your own question? You were asking for the name of the nerve, remember?

Aku kah yg busuk hati? Kenapa aku nak kisah mamat Aussie ni dipuji walaupun jawapan dia sgt vague. Biarlah…nasib dia baik.

The thing is….aku takkan jeles, takkan marah, dan takkan busuk hati kalau budak mesia tak pernah di-stigmatized kan kerana tak ckp byk dlm tut. Cuba Kalau they dun make a big deal out of us not talking….mesti aku tak kisah kalau tutor nak puji budak OZ melambung2 sampai ke langit ke tujuh pun..what do I care! Masalahnya skrang, they dun answer the question pun, but they got praises. Tapi the malaysians were point the finger of blame for not contributing.

But I am a gemini…so, I see two sides of things. At least, budak Aussie ni ada directed thinking. Dier dah narrow down that out of all nerves possible in the body, it must be the nerve originating from c5 to T2. To the tutor, the OZ student is showing that he is at least on the right track. And at least, dia contribute dan buka mulut. Aku plak….I did nothing, say nothing. Senyap mcm batu. Who am I to criticize?

Lesson learned: When you don’t know, be vague. Say the general stuff. Bukalah mulut. Contributelah dlm discussion.

2) Anatomical position

I was doing emergency tutorial the other day. The tutor was asking, “Ok, why do we sit the patient up when the patient presents with shortness of breath.”

Waktu tu dah nak dekat mlm. Otak aku dah penat nak pikir. Bagi aku, it must be because of the anatomical position; maybe you will be able to use your accessory muscle better if you sit up. Or whatever lah…aku pun tak tahu jawapan dia.

And guess what student Aussie ni jawab. “Oh well, it’s becasue the anatomical position, isn’t it?”

Aku dalam dilema waktu tu. Should I scream or should I laugh? Should I be annoyed or should I be amused?  Which anatomy, darling? And what’s the physiology? Care to elaborate more? Nak jer aku aku perli secukup rasa… tapi aku senyap jer.

3) Cardiomegaly.
Time tu kitorang baru jer belajar cardio system. Semua org tak tahu apa sangat.

The tutor was asking us, “So, what happened in cardiomegaly?”

Aku tak tahu apa pathophysiology dier. Baru nak belajar pasal cardiomegaly minggu tu. Tapi drpd perkataan ‘cardiomegaly’ itself (cardio means heart, and mega means big) kita tahu lah apa yg jadi kat heart tu.

“Come on, does anyone know about cardiomegaly at all?” The tutor looked around at all of us.

One Aussie student cleared his throat and answered confidently “Isn’t it when the heart is enlarged?”

“Exactly. Good, good.”

Aku dah malas nak layan rasa bengang. How does that answer shed any new light or provide any new knowledge to the rest of us? The student was only showing that he was good at translation! That’s all! Apa yg good nya? Haih….geram nyaaaaa!

4)Medications
The tutor asked; “What do you give to patients with arrhythmia.”
Biasalah, aku and budak2 mesia sentiasa nak bagi jawapan yg tepat. Kitorang ingat tutor minta specific nama drugs. Time tu baru nak belajar, mana nak tahu lagi apa drugs nya.
Sekali ada budak ni jawab, “You give anti-arrhythmics, right.”

Contoh2 lain termasuklah drugs for DVT (you give warfarin and heparin). Budak2 ni jawab anti-coagulants jer, or anti-platelet.

Conclusion:
Maybe what happened was….Malaysians are perfectionist. And we think in too much details. The best way of thinking is….think general and broad, lepas tu baru narrow down. Just make sure that you are in the right track first. Ada byk jenis ubat dlm dunia ni, so untuk setiap penyakit, we have to know category ubat dulu…be in the right track first, and then baru cari nama ubat specifically.

Tapi aku rasa, bukan masalah kitorang perfectionist jer. Masalahnya ialah, soalan tu tanya lain. Soalan tu tanya specific….so, kami pun nak bagi jawapan yg specific lah. Tak sangka plak rupa2nya tutor tak kisah jawapan yg tak menjawab soalan.

Hmmph!

Tapi aku ni pun mengata dulang paku serpih. Sebab aku dah observe fenomena2 ni terjadi…aku pun kadang2 bagi jawapan yg sama vague. Hahahaha. Aku pun dah play the game now. (it took me 2 years and a half untuk discover how to play the game) You could be stupid, but you don’t have to let everyone know about it. Pandai2 lah cover line. huhuhuh. Cuma, sebab aku sgt benci jawapan2 cam ni, aku cuma bagi jawapan yg vague bila aku dah tak der pilihan. Contohnya, kalau dah memang soalan tu ditanya specific kat aku and not to everyone else….aku pun jawab lah secara vague kalau aku tak tahu the specific answer. At least aku menjawab juga, at least aku try and tak lah senyap jer. Tapi kalau tu question open to everybody, aku takkan volunteer jawab soalan yg aku tak tahu, unless kalau hari tu aku ter-extra senyap. So, nak nampak cam aku ckp juga for that day, aku pun talk crap jugalah kan…kira darurat lah ni. Huhuhu.

To pen off, let me give another crappy question-answer scenario that I had witnessed:

Tutor: What is hepatitis?
Student: Well, the liver is inflamed.
Tutor: Oh, so you could translate. You must have an excellent dictionary at home. Well done! (sarcastic tone)
Student: (tersipu2 and blushing)

Hhahhaha. Sure, you can try your luck and give craps at times. But there will be times when you happen to cross path with a tutor who is well-versed with students’ art of crapping. Then, all you can do is tahan malu jer lah.

P/S: Crap only when u are desperate. Remember, confidence comes in knowing that you are right. So really, all you have to do is work hard, which is easier said than done. But to me, it’s better if you just humbly admit that “this is the limit of my knowledge”. Or at least say something like “I don’t know but I will look that up tonight.” At least, you are showing your initiative, and your supervisor will appreciate your effort if you go to him the next morning and tell him what you have found out. In this case, show off yg ko ni rajin. Hahahah.

In two weeks time, I will have an exam. Pray for me! My first short-case style examination.

Filed under: The life of med student and