Saturday, May 31, 2014
Stupid things we get into together
Stupidity is a chronic metastatic disease, like breast cancer
Dr. Ahmed Fikry of Neurosurgery once told the class a story. The patient was a respectable decent judge happily married since forever. One day his wife brought him to the clinic to have his brain checked. She was suspecting a brain pathology because her husband was behaving strangely all of a sudden.
"We went to a club the other day and suddenly he was flirting with some young girls. This is very strange," said the wife.
They did an MRI and it was a tumor.
Thursday, May 29, 2014
Light shower in early summer
Today we finished our Urology one-week-compressed course, discussed the answer for the exam and took a picture. Like every loyal fangirl, I went up to Dr. Ahmed and said "May we have your autograph?"
He laughed and the fan-signing session commenced. I was among who stayed back as he finishes his autographing, dutifully and because he was using my pen. He answered some questions and talked as he signed.
How the treatment options in a disease is to give the patients the best service we could. "If you think of your patients as your father, mother, brother, sister, you will do your best for them. Even if you have to revise your books or consult your colleagues, there is no shame in that."
Yesterday's class, he apologised for the lack of hands-on clinical Urology sessions because he pitied the patient. "They are poor people and some doctors even shout at them when they refuse tutorial sessions, saying that they have to cooperate because this is a teaching hospital. But I disagree. The patients didn't come here because this is a teaching hospital, they come here because they have no money."
All our great professors will tell us the same thing; be kind to the patients. Which I hope I will forever keep in my heart, mind and practice however easy or hard it is for me to do so. Regardless the patient is humbled as I do my best to help or the patient is hostile seeking to cause trouble. It is not how people treat us that define who we are, but it is how we react. And that includes defending ourselves respectfully when trouble arises.
He summed this up during a few class back when we took the topic infection. "Give advice in the best way and take it in any way."
He talked about Egypt and halfway through this point my eyes watered because I can feel his love for his country as he spoke. His gentleness was so palpable it made my heart ached at how Egypt is going on right now. And I almost cried because I realised then I really love Egypt. Stupidity, donkey-like people and all, I love this country. This is where I matured during the last six years, this is where I was humbled by life.
But I have to keep it together because I was sitting right in front of him and you don't cry in front of the man you respect.
How his people don't know anything and the tendency of their heart to just believe whatever the media says. How it was very strange that a knowledgeable scholar could say a fatwa with vague definitions yet teaches his students something else. How he could feel the hatred coming out from a person's words. How strange it was that family could break up because of lies in the media, how a man could sell out his neighbour who looked after his family while he was abroad for ten years just because of what the media says. How strange that people would fall for what the media says and not believing their interactions with their neighbours since tens of years.
How the joke goes that Egypt is the richest country in the world because "they have been robbing us since 7000 years and there's still some money left."
How despite all this, despite voting since 1992 hoping for improvement except for this latest one, he has hopes for his country that Egypt will become better.
How a person who has just enough competence could reach his target so long he is keen to advance and in the right track, even if it may take years.
He loves his country, you can tell even without him saying so. He did told us during class that they have a number of Egyptian Urologist in Cleveland doing cool things, but when asked why wasn't he in Cleveland as well, he answered "Of course not! I love my country."
How however frustrating a situation is, with love and responsibilities you could never give up on this.
He is a very cheerful man, with smiles reaching his eyes that make the usually solemn me really light up. Gentle as he spoke of all the corruptions and his face showed no malice at all. His commitment in teaching us, sitting on the table facing the class, crinkling a smile and "it's okay" as I apologetically greet him a couple of minutes late, his simplified ways to understand, his repetitively telling us to "don't worry, be happy" in his happy tone, advising us to "take a deep breath and answer"...
This is going to be my first time pledging using this word, so I will make it worthwhile. Fa 3uqsim billahil 3azim, I love this man. I really love Dr. Ahmed and I'm going to miss his classes. May Allah grant him and his family the highest there is in paradise and I meet him again, in the near future, in paradise, if not as a great doctor. Allahumma ameen.
Shit there's something in my eyes again.
Wednesday, May 28, 2014
CBD insertion 101
"Don't worry, be happy."
These two days Dr. Ahmed Shenoufy's class dismissal words were the same.
"Don't worry, be happy.
Stay at home, try to avoid unnecessary places.
InshaAllah it will be safe. I think it will."
Yesterday I forgot it was the election and I already decided to go for a walk after class. So I went walking.
Some of the people in my path had red ink painted over their pinky. Some waved the national flag around. Some yelled out the zaghlatouh or whatever it was called. Some stores played the dance song celebrating the army forgetting those were the same group who killed their own people. And everywhere I look, there was posters of the people-killer that brought out the pyromaniac in me.
Those some made me realise how stupidity is infinite. I don't know what they want or why they're doing futile things. They get excited over an election which is illegal and pointless in the first place. They forgot they locked the real president somewhere in the desert.
Tun M said "Melayu mudah lupa." These people however have chronic ignorance, lack of tact and planning and advanced Alzheimer's to boot.
All those inner cursing made me forget where I was supposed to be going. Had to step inside a restaurant to reset my mind. Fortunately it had a better taste in music.
Nevertheless, most people I met on the road were ordinary, walking towards their destinations uneventfully.
Thursday, May 22, 2014
Today only I will refer you by your given name
It's that time of the year that makes me feel a heavy longing in my heart. You always make me feel so, but I guess that's what I got myself into.
I went out for cake tonight. Sorry for the lack of candle, but I wish you the best in everything. Happy birthday. I will always love you a hell lot.
Two crazy girls and a guy
Iskun: Why. Is he even here?
Me: He should be. Guy said he sleeps in the department.
Ume: We will go and take a selfie and I'll upload on FB and I'll tell him to like it.
Ume: (laughs)
Iskun: What was the name of the doctor that you guys are scared of?
Me: You mean Dr. Raafat?
Iskun: Yeah. He wrote a book right? What book is it?
Me: Art of Clinical Examination, evidence based. His book is.. deep. MD level.
Ume: He's a renowned breast surgeon. He proposed a mechanism for metastasis.
Me: You should have seen him teaching us. He gave us a lecture on breast cancer and he said "this is useful for your fellowship.." and I was like :|
Iskun: So he treats you like MDs. Wow.
Me: Yeah. Tough.
Me: Well Dr. Maged said he sleeps on the couch in the other room.
Ume: Yeah.
Iskun: What?
Me: The report. "Findings are suggestive of thyrotoxicosis."
Ume: You don't need an ultrasound to tell you patient is thyrotoxic.
Me: Should we leave the file here?
Ume: Here. Did he took it from the shelf?
Me: Yeah he did. Okay just leave it on the table nice and neat. Let's go.
Wednesday, May 21, 2014
Aleppo
Dr. Maged doesn't like the majority of Egyptian students very much. "They're undisciplined and they don't attend the class. Before your round, Dr. Raafat gave a session at 10 on Monday. He came and waited for 30 minutes. Nobody showed up. He didn't give a session to Egyptians after that."
Our resident is a 28 years old Yamani who studied in Aleppo University which according to him "is the best. Better than Kasr el Ainy." He graduated in 2009 and proceeded with the paediatric surgery fellowship in the university. The program was for six years but he only completed three years of it, until one fated day the army came to the hospital and attacked. He fled the hospital at 3am.
He came to Egypt leaving behind his books and belongings and started his residency in surgery at Kasr el Ainy Department 11B. He lives in Manial and pays LE2000 in rent for a place he uses for shower and storage for his clothes. "I have been in this department for about 4-6 months and I think I've only gone home properly for six times. I usually sleep here."
"So you sleep on the patient's bed?"
"No, on the couch."
Waaah that sounds fun. I haven't slept on a couch since last summer. But really, too much of it and you'll get back pain.
"Why are you here and not at the paediatric hospital?"
"I have to complete the residency in general surgery first, after that I can continue with paediatric surgery."
"Do you get paid working in Kasr el Ainy?"
"I get paid by my embassy, about USD630 a month. I pay Kasr el Ainy about GBP3200 per year for my fellowship."
"Wow. So you have to go back to Yaman once you complete your MD?"
"No.. there's no contact there. I have no contract with my embassy."
"We do. Our government pays us around USD420 per month and we have to go back after graduation to Malaysia with a contract of ten years."
"Ten years!?"
And it seemed like anyone studying under Dr. Raafat will feel pressured by his strict ways. "But I think he likes me."
"We know he likes you, Dr. Maged."
"How do you know? Because I am always with him? But he really is hard on me."
"I know because he lets you study and follow him around. And because he's tough on you so that you will learn. It's his tough love."
Tuesday, May 20, 2014
Radiologists are supposed to be more than yes-men
For our assignment with Dr. Raafat, we clerked and followed the case of Mr. Khalid. Our provisional diagnosis was diffuse toxic goiter and he was referred for an ultrasound. It was done yesterday so this morning I asked the resident about his result.
The report said diffuse heterogeneous enlargement blablabla and the radiologist concluded it was "suggestive of thyrotoxicosis".
Huh? For God's sake, I got more data by examination than this piece of A4 provided. I scowled at the report and returned it with thanks to the resident.
Went to Ara and complained.
"Remember that time when we had a breast discharge case and Dr. Raafat said the ultrasound didn't tell him anything more than what he already knew from clinical exam? He even said the doctor had limited knowledge."
"Yeah. What about it?"
"I totally understand his feeling. Our patient's ultrasound report is a waste. I don't need an ultrasound to tell me he's thyrotoxic, duh."
"Who signed it?"
"Some doctor named xxx. I hope he isn't on our Radio class rooster."
Ara scrolled through the schedule for our Radiology class and stopped. "Dr. Xxx?"
"Yeah."
"He taught yesterday."
"Bwahaha. I skipped yesterday." My bad, I even missed Dr. Hussein. I was too sleepy.
Don't get me wrong, I think highly of all professions we have in medicine, especially the janitor who takes a lot of merit by keeping the environment clean for us. Today's Radiology class with Dr. Edward George was fun and informative and specifically made me think highly of radiologists.
But the ultrasound report was just.. urgh.
---
"Hold up the first slide. There are eight of you in this group? Is the patient treated?"
"Well he's on medical treatment waiting for surgery."
"Eight of you! Why haven't you done the surgery on him?" Dr. Raafat laughed.
Hahahaha cmon Dr. Maged let's send Mr. Khalid up, you may scrub in and assist me. "That would be a crime, sir."
I'm starting to think I always get this case
Me: (walks from the patient towards my bag, I still have a pair in it)
Humaici: It's okay, she doesn't need gloves. Not clinically indicated. (laughs)
Me: Screw you. Scabies! (found the gloves, puts on)
Dr. Shedy: Oh you are prepared.
Guy B: Good job Hana.
I don't discriminate
If you chat with any HOs or senior doctors, the one mutual advice they give us medical students in order to survive houemanship is having the right attitude.
Behave humbly and politely.
Eager to learn.
Be diligent.
Yadayada.
They all repeat the same thing. I assume they tell us this in advance is for us to develop the right attitude right now, from this moment, now, before we step into the workforce. So that keeping a good attitude is easy for us by that time.
Go to class and respect your teacher and classmates.
Help each other out.
Be reasonable.
Be eager to learn.
Have depth in your knowledge to stand up for yourself.
Be nice to the patients.
I clerked this stuporous uncooperative patient once. She'd rather sleep than hear me out. She denied any previous operation while I was clerking her but when I examined her, there was a scar of previous hernia repair. Took everything in me not to smack anything.
Anyway. My batchmates are all grown up, at the age of marriage, they can do whatever they want and I should worry more about myself (I have difficulty sleeping early to be up for the 7am class. If this persists, how would I wake up before 5am for work?) But when you see your classmates ditching class, shoving clerking after clerking to you, shitting out bullshits like "if you assign me to present the case, I won't show up for class", you start to wonder how long does it takes before housemanship kills them and they drop out.
Dr. Ayman Gado told us that we should save the patient and try not to scandalize our colleagues. Today I learn that in medicine, you have to save a patient's life and your colleague's ass.
I hope I don't trouble people by having them wipe my ass too much. And I certainly hope I stick around in this field.
Thursday, May 15, 2014
Study well and don't make the doctors lose faith in us students
The other day our doctor had been telling us about the clinical indications for wearing gloves, which was examining mucous membrane and ulcer.
"But of course you will wear a glove during genital examination because you are grossed, but a difficult doctor might ask you about it."
So I was adamant after that that I won't be grossed out by genitalia. Which of course was big talk and totally short-lived, because for the next class we had a hydrocele patient and I immediately put on a pair of gloves. And thanked God for it as I stood near the patient and realized his last bath was probably days ago.
I know not everyone has the privilege of shower and I have to be grateful I naturally smell nice (or as Kak Junaidah said "you smell like trouble") but.. but.. I can deal with blood and organs and smelly kids but I can't stand to come near people who doesn't bathe. Extremely repulsive. I hate crowded trains.
Fast forward to today. I was going to examine the patient and Dr. Mohamed told me to wear gloves so I did, eventhough at the back of my mind I reminded myself this was not a clinical indication for gloves.
"You have to wear gloves because of scabies. There is high incidence of scabies and you don't want to catch it from the patient and then pass it to another patient."
Enough to say I was horrified and stunned. Dammit I forgot about scabies!
Saturday, May 10, 2014
I want to marry a fisherman and together we will smell like the sea
"... and diabetic gastropathy in the form of indigestion and delayed emptying."
"Do you know the name of this condition?" He asked with a mischievous twinkle in his eyes.
She gave him a dirty look over her glasses. "Gastro.. it's gastroparesis diabeticorum."
"Excellent, excellent!" He laughed. "You may go."
"Thank you doctor. Have a nice day."
Tuesday, May 06, 2014
Wolf
Sunday, May 04, 2014
Pitiful Ghoul
Disclaimer: Rated 18+ for profanity deliberately written long after the storm has passed thus on purposeful calmed and rational mind. This is me in crude and vulgar mode. Do not proceed.
I am blessed with this particular good friend. I know for fact she is because she befriends me. I'm a difficult person; part-time amiable, most of the time taciturn, analytical and understanding but not usually bothered to soothe people emotionally. In a social setting I am functional but cross slightly into intimacy and I turn into a glaring potato.
But she's a good friend, she tolerates me. I am not pressed to change because she accepts me and my stupidity. And as a sign of gratitude, I try to behave and do my best not to mistreat her.
And I get especially pissed off when a mutual friend misbehaves and mistreats her.
The both of us were in this project where I was the consultant and her assistant. The night before it was due, a mutual friend of her peer position had a meltdown that made him react in a way that defied the existence of our organized team.
My first respond was to laugh cruelly. "Did you tell him the F word?"
When you call yourself a partner and part of the team, you do not make significant changes to the project without prior consultation.
You ask for support when you're emotionally in need keeping in mind that everything you say and do will have an effect however small to the sail of the project.
You pay attention to suggestion and discussion and they become a basis for your decision. Do not suggest last minute changes towards your rejected suggestion when the project had long decided to go along with your relatively troublesome suggestion in the first place.
Good teamwork supports each other's strength and weaknesses. However it is not a scaffolding to be used as scapegoat for anyone's ego.
I know first-hand she needs time to adapt to sudden changes thus how hard she had been working to plan and rehearse everything this whole week. And suddenly, the night before.. something unnecessary and totally avoidable.. no respect whatsoever to organization..
I was livid and I told her analytically why the scum deserved pity but no mercy and how I would proceed.
She was scared. "That moment you wished he sleeps well, your face was really psychopathic."
Morning came and the afternoon the project sailed, I was also there as they talked over the problem. Our mutual friend said sorry and I nodded, accepting it. We make mistakes, we apologise, we rectify it and we don't do it again. This is the way of the esteemed dean of Kasr el Ainy.
But then the princess laughingly followed his apology with the stupidest lame excuse to cover up for the holy jerkiness. He reasoned that what he did was to test her. "If I did it to Hana, she'll rebel back. But you only rebelled a little."
"You didn't see me last night!" I commented in anger but quickly bit my lips in an effort to not make things harder for my good friend, whose face already tightened as she played her polite friend role.
Do we look retarded? If it was a joke, that was the most untimely insensitive joke of the year. I prayed that he will just shut up to save what little remaining of respect and pity I had for him, but no, in poor judgement he made a turn for the worse in a pitiful attempt at covering up for his meltdown.
If the night before I pitied him at his inability to manage his meltdown despite the selfish bastard pulling the effingest back-stabbing scum, that day I thought he was the epitome of uncool. Pretty hair and brilliant brain wasted on such a rotten heartless ghoul.
I told my good friend that I hate him for heinously mistreating my good friend. That I am going to stay away from any work and what more personal relation with said bastard. He is a mere last-resort colleague now.
"But he was a friend in need," she reasoned for me not to give up.
He was until the moment he used you as a scapegoat for his ego. I will not accept such attitude. "So you're still going to consider the bastard friend?"
She laughed sheepishly. "Yes. I hope he realise that I know he was covering up and he know I was being polite to save his face."
Of course. Despite that he didn't bother to save any of our faces, we should never regress to his scum level of doing the same to him. It will be cruelty to humanity if I corrupt her out of her kind way, so I decided to keep watch on them. "Good for you. Please confirm that he realised that. You really are a.."
I deliberated on my choice of word and decided to leave it hanging. I turned around towards my apartment.
"I'm a what?"
"You're the kindest creature God ever created." Truly she reaffirmed my belief that Allah is The Most Merciful, and He bless chosen servants with some degree of His merciful character.
She laughed. "But I don't want him to think I'm a gullible easy friend."
My good friend, I call him a bastard because he clearly treated you like what you just said. "I just hope you remember that this isn't the first time he did this to you, neither is this going to be the last."
Her face changed. She memorises things better than me, but obviously I remember and understand things better than her. I bid her adieu.
When the next time comes, I'll slash the guy's throat myself.
Friday, May 02, 2014
Resident in 1967
Last week Roy went for umrah with her family who came from Malaysia and thus she was absent from class. On that Wednesday class, Dr. Mohamed sat down and said two words about the day's patient and suddenly he stretched his neck to observe the last row. "Where is Raihanah?" I laughed and told him where she went. He went "Ahh okay okay." The next day he asked again. Hahaha.
We all know the MERS outbreak in Saudi that is killing people and risking more and more pilgrims. Alhamdulillah Roy came back safely that Saturday. On Wednesday's class, Dr. Mohamed made his grand entrance asking "Where is Raihanah?"
Roy stood slowly from her usual last row seat. He inquired about her quarantine status, mentioned how it was riskier for people his age when coronavirus attacks and then he laughed. He turned to her gently. "Alhamdulillah ala salamah."
We started to examine the day's patient and Dr. Mohamed remained seated in his chair as we gathered around. Roy came forward to examine as well and upon seeing her coming closer to the bed, he swiftly stood up and moved away from her.
"I like you, but I don't like corona." He admitted. "You all are young, so it's okay. But I am not so young."
I thought it was amusing that he went to such extents so I went home that day and read some articles on corona. Then I realized why he didn't like corona. Patients infected died of acute pneumonia and acute renal failure and most of them were 60 above. Talk about badass strain.
Our doctor is 70-ish.
