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Kak Milah said their Surgery paper today asked Anatomy questions like something-fistula (no not AV fistula) and anterior rectal fascia and whatsit. Their doctor comforted them pre-exam that the questions would be crystal clear but they didn't expect such crystal clear questions were of minor topics.

"We expected Anatomy questions would be like hernia.."

"Or neck, thyroid."

"Yeah."

So Ijud advised us to study minor topics well and #crystalclear had become a running gag.

It's cold today and the weather forecast warned of showers so I put on my usual winter coat this morning. But I didn't expect it to be that cold. The weather sure is bipolar around here.

There was an anti-coup demonstration on campus today but apparently I missed out because I was still at the hospital at that time auscultating a 41 years old female with double mitral, aortic stenosis and tricuspid regurge.

Dr. Abeer said the patient has small volume pulse so I checked her pulse and compared it with mine. It was similar. Damn.

"Does this mean I have small volume pulse as well?"

I had palpitation at rest a few days ago and with this revelation, I felt like going down to the ER and hook myself to an ECG machine.

And in Al-Azhar University, the military continued to violently dehumanize the students in particular and us human in general. There is an illusion of peace in this country with targeted and localized dehumanisation and if you stop caring, you will forever be a fool.

Our midround Internal Medicine exam was announced to be next Monday at 8am. Which is brilliant because we have Tropical Medicine endround exam at 12pm. On top of that, my group was scheduled to present our seminar on Fever of Unknown Origin at 9am same day but I couldn't confirm with the doctor whether it is still on or postponed (though logic dictates it is postponed but you never know, we do have Murphy's Law). We were scheduled to compile our work tomorrow.

Because it's cold, I am planning to skip out on our hospital session tonight. It's either that or be dependent on turbohaler.

To balance this post, an Arab colleague of Ijud commented on his status that the only good thing that happened to him today was when Dr. Hussein Khairy passed in front of him in the exam hall.

Now that is a sight for any sore eye.

random advice

it hurts. it's okay if you want to cry. you were so brave.
you are strong. you will learn from this. you will survive.

you will be okay.

We could feel tired at one time, I don't care about it either, give me a few more minutes

When I went to the 7.30am class this morning, my friends told me my eyes were puffy, didn't I get enough sleep last night?

Last night I crashed somewhere not my own and I more or less sleep less when I don't have Kevin with me, so the latter part was a possible. But I used the mirror this morning but I didn't notice anything amiss. I think I looked about normal.

Is it possible that my eyes are puffy every morning that I forgot what normal looks like? This is bad, I thought. If this goes on I wouldn't be able to differentiate mild eyelid edema in a nephrotic patient.

"Kenapa kata sembab? Kenapa bukan eyelid edema?" I asked her. "Kenapa tanya tak cukup tidur, kenapa tak kata nephrotic syndrome?"

"Kan nak kerja kat Kota Bharu!" She laughed at me. For the life of me, I didn't get the joke. "Orang sebut sembab la."

"Oh." Moments like this makes me feel so skema and need to get a life.

Class ended at 11. I went home, prayed Zohor and skipped Dr. Husam Mowafy's class in favour of catching up with my sleep.

Magnanimous

It has always been a habit, one of the things I do to remind myself of independence, to never let a guy pay for me. But Acap wouldn't take my money and if I try to slip the money into his jeans pocket, I'd be called a pervert. His sweater pocket was out of question because he kept his hands inside it all the time. With his slouching posture (I suppose it's the side effect of being so tall living among the rest of us minions lol) and hands inside his pocket, he reminds me of the ever cool Kakashi. 

Minus the hardback porn. Or maybe it's hidden somewhere..

Anyway, it reduced me to a sheepish "Thanks Acap." and later "Sure I don't have to call you Abang Acap?"

One of the things I learned today is that you cannot live being a frugal and minding person. We should limit our passion to effort and friendship.

The both of them were behaving like big bro and big sis today. They were taking the babysitter thing seriously, bullying me around and paying for my food. Using the Syria card to make sure I mop up my ice-cream when I was already full with dinner, it was evil. I was on the verge of throwing up and there they were, laughing at me. If it was anyone else they'd be long dead.

It was then that I realised it was a belated birthday treat. Ehehe. Friends don't usually celebrate my birthday, so it was a first in a very long time for me.

---

I believe that there must be balance in life, and since I bully pretty much anyone I can, I allow myself to be bullied by the people I respect at intervals.

Plus I'm more masochist than I am a sadist, so yeah..

Nuclear Bomb

The first Paediatric case I presented in class was a 6 years old boy named Ziyad complaining of abdominal distension.

His mom told me during the course of history-taking that her son was admitted 12 times because of respiratory infection, but that week we were supposed to cover Gastroenterology so I was too caught up with the abdominal part of the case and my pissing off with myself for not understanding some of the mother's word, his pneumonia simply went loss on me.

And so I presented the short case to Dr. Samuel Makar that day.

He asked about chest symptoms. I told him the mother mentioned but I didn't understand everything. He turned to the mother and asked her in their mother-tongue.

"12 times admitted from chest infection," the doctor turned to me. "This is a nuclear bomb you missed. A nuclear bomb."

You should have seen his face when he said those words to me. It was grim. I was stunned. I felt damn stupid, I was a disgrace to my family, my Paediatrician dad would be so ashamed of me I wouldn't blame him if he declare I was actually adopted.

"Abdomen and chest symptoms. What do you think?"

I don't know, so I told him so.

"This case might be tough for you, it's not a very common case," he continued. "This is a case of cystic fibrosis."

I reemerged from my self-pitying state with those words. Cystic fibrosis. I swore I will not forget that disease, the importance of good clerking and Dr. Samuel Makar who taught that class.

Anyway, since I presented the case, I got to examine the patient. Dr. Samuel seemed strict and firm with us but he was gentle with the boy, distracting him by asking what was his favourite show on TV and his favourite characters while examining his abdomen. He showed us the trick of palpating a kid's liver (running your fingers like playfully poking the child, but you're expected to palpate with the lateral border of the hand in an exam) and he let me palpate Ziyad's hepatomegaly.

I used that trick a month later while independently taking history of a naughty 4 years old boy with ITP. He chuckled.. so cute.

Other classes we had with him include a rheumatology case in which he taught the sheet for Rheumatology (a first for us) and a sad case of complicated hydrocephalus boy. I could see clearly his grim face as he addressed us, away from the mother, at the poor overall condition the baby was in and how his mother sought medical help late. Hydrocephalus was a relatively straightforward case, the boy's condition was generally preventable.

"I will not comment."

I learned the value of teaching without judging, how medicine is an art of educating people to do good to them without passing off judgement. We all have our battles.

Which reminds me of a story my dad told us about when he was stationed in Sarawak.

One time he frowned at a patient's son for bringing the patient late to the hospital. The son answered him calmly, that they lived far away from the hospital and the trip took a week or so via the river if the water-level is up to it, or else it would take a fortnight.

Dad was rightfully humbled.

Sex Ed For Dummies

When we studied Sexual Education under Andrology, our doctor told us that sex ed must be taught regardless the community we are in. But first let us define the basics.

Sex ed is organized information on sexuality that is related to the ethical principles of the community. The basic is that we are teaching about how to deal with the physiological, anatomical, and psychological changes that relate to growing up, so that everyone will have a positive attitude towards sexuality.

Since it is based on the principles of your audience, for a Muslim community, we are teaching people those basics I mentioned before. In the west, safe sex, prevention of STD transmissions and avoiding teenage pregnancy are probably a crucial part of their syllabus. Again, because of the principles of the community.

For a Muslim community, we are not teaching how to practice safe sex because extramarital relationship is against the principles of a Muslim community and we are not teaching how to have sex because this is innate, even animals do this and no one taught them how to. Though some people might need help in this department.. that is why Andrologists and Sex Therapists exist.

This teaching is ideally the responsibility of the parents to be implemented at a young age, as young as 3-6 years old. During this time, a child is going through the phase of gender identity. Teach him/her the differences between male and female, teach him/her humility, and teach him/her that some areas are sacred and not to be exposed/touched even by the opposite-sex parent. Also, the parents should answer simply and correctly if ever the question "How did the baby get inside mommy's tummy?" pops up.

That class made me wonder. With the easily-available porn of various degrees in our daily life and with news like this one no longer surprising, perhaps it is time to revamp sex ed curriculum among our Malaysian community.

That, or the doctor who taught us lives a happily oblivious or the idealest life. Hehe.

Why hello there, drug abuser

Monday night and it itched too much and I had petechiae all over my body, some bruises even. I couldn't sleep. So I read over the symptoms and signs of antihistamines overdose and decided I'd risk the somnolence and tachycardia.

"Tachycardia is just tachycardia, right?" I'm tachycardic every time I reach the fifth floor.

"Arrhythmia," my housemate said.

"Oh," it took me seconds to contemplate cardiac arrest and then "CPR me if I don't respond."

I popped another dose of antihistamines.

The next morning, I woke up at 11am and groggily dragged myself to class.

Wednesday, I got up for my 7am but remained sleepy all day, even after food and healthy dose of coffee. Nearly skipped the hospital that night in favour of sleeping on the floor but I went anyway as grumpy as a bear kicked out of her hibernating cave.

On Thursday, Kak Milah forced me to go to my 9am class. It hurt no one but myself but I still rebelled and purposely grumped myself 15 minutes late. And skipped the extra class that afternoon because I needed sleep before I started to go homicidal.

Kak Milah woke me up (for the tenth time) near Isya'. She touched my forehead. "Are you feverish?"

"Somnolence," I croaked.

First love is a fever, it pains us and makes us an adult

Walked to the hospital with Syak and her husband Anas. Balqis cried when Syak left her at Umair's and as we walked, the doting mother worried that she was cruel to leave her baby to go to hospital at night.

"Najwa (another mother in our batch) didn't go to tuition and she stayed at home with her son, but here I am.." She held my arm and asked, "Am I cruel?"

"Hmm." She shouldn't be comparing herself to anyone because I know she's already trying hard to be a great mom. We all have our battles, we just didn't know what other's are. "No you're not."

"You took a while to answer. You probably think I am."

She sounded dejected. I shouldn't think when consoling was top priority. "Is going to the hospital an option or a necessity for you?"

"Necessary, I didn't really get to fully examine the patient in class.."

"It's a necessity, so you're not cruel, Syak. Don't worry." Life will always demand sacrifices from us, so we make our choices wisely.

Anas turned around and grinned at me. "All women are hysterical."

"Then what am I?" Why do I have to keep asking people that? This is a worrying trend.

"You're a guy." Syak replied.

I wanted to shot that she was holding on to me, a guy's arm in the presence of her husband, but no, we don't joke when it comes to Hana and her gender issue.

"I think I have gender confusion." Another quarter-life crisis.

---

There's another classmate who probably thinks I'm a guy by his enthusiastic discussion of Andrology with me. I am uncomfortable and could easily admit so to him, but that's too much work for a lazy ass like me. I'd rather just ignore or answer per se without much elaboration. He's smart, so he should get the hint.

Or maybe he's not.

Slapped

Dr. HK in his 7am class today kept making references to past classes and since I had irregular attendance since two weeks ago from generalized myalgia (lulz) and that break of habit thus diverted me off my hardworking course, I merely nodded in acknowledgement.

He stopped teaching.

"You're not following me... You have to come to class everyday. Everyday. Otherwise you will only get a glimpse of what I'm saying and not the whole picture. Come to class. Every. Day."

I am not that conceited as to think he noticed my absence (though I do have my preferred seat at the first row bench on the right side of the hall) and I believe this whole telling-off was directed at the class in general, but he did looked at me a few times while doing so and all I could do was offer an apologetic smile.

"I can come everyday, any day. Even on Saturday. But you have to come to class everyday and study a little bit before."

Another apologetic smile.

"You don't believe me." He gave up and resumed teaching.

*_*

Some people are born to make others happy

while some others observe.

It had been a long day for some of us at the faculty today. Starting with the dean's surgery class at 7 (which I skipped because I needed to sort out some financial issues, I miss Dr. Hussein huhu) and our last class for the day, a double dose of surgery general lecture, ended at a sweet 4.30pm. Dusk in half an hour.

The day didn't end there. We had a meeting with the dean and our coordinator afterwards. I felt sorry for them to have to meet us at the end of the day and hear us commenting this and that, but they were steadfast and unrelenting in honouring their duties.

Except that the dean looked a little bit tense. It wasn't that he was expressive by default and he did look like he normally looked, but there was an aura of exhaustion coming out from him. And he wasn't smiling, there was no spark in his eyes. Ara told me earlier that he appeared to be in a sour mood during his class that morning. This meeting probably wouldn't help uplift his mood.

"I thank Dr. Hala for insisting with this meeting, although at first I was a bit reluctant," at this point we all laughed. "But thank you all for attending today."

At the end of discussion, Khadijah stood up and thanked the doctors profusely for setting the time to meet us. "Thank you for always helping us, for listening, for hearing our voices.."

I was staring at the dean and there was a change in his expression. Just subtle.

"... although not everyone of us is attending, but deep from our heart, we really really love you."

And there was a smile on his face, just a slight upward lift of his right lips that showed a hint of his teeth. There was a little more spark in his eyes.

He looked contented. That made me smile, too.

He is a great man, a humble dean, an inspiring teacher, and he did so much for us Faculty of Medicine students. He taught us to always be inspired and to be the best that we can, and much more.

Maybe we never told him how great we think of him and how much he was doing a great job. It probably never occurred to us that the dean may need some encouragement and praise, too.

We thought he knew how great he is.

Dr. Hussein took the mike and said, "You made our day and night" with such sincerity, my smile widened.

Uplifted.

---

"Is there anything you would like to add, doctor?" Our MC the batch boss asked at the end of the meeting.

"No," but the dean was already reaching for the mike. "I wish you success ba'a and a nice stay in Egypt."

What Weekend?

We sixth year Malaysians started our academic session one month later than the Egyptians and to catch up, compensations must be made in the form of sacrificing our two-weeks winter break. It was understandably non-negotiable, but some of us still wanted to try.

Dr. Hala: We can give you two days.
Dr. Hussein: Yeah, a long weekend.

Hahaha.

Universally, weekend means two days off but apparently in the medical profession, you're more than lucky to even have one.  

Lariii

Malam tu, Umair gila. Dia nak merayap mencari ketenangan. Orang ajak pergi hospital dia taknak maka terpaksa layan dia merayap sekitar sungai. Bapis teman.

Entah kenapa kitorang decide nak ikut jalan yang tak pernah lalu selama ni. Bapis layan je. "Kalau sesat, kita boleh patah balik."

Kitorang jalan satu deret; saya tengah, Umair kiri saya dan Bapis kanan saya. Jalan gelap, takde orang. Masuk lorong lain nampak dua orang Arab.

Umair timbulkan persoalan ape nak buat kalau Arab serang. Saya dengan semangatnya "Takpe aku bawak pisau!" sambil genggam Swiss knife dalam poket sweater. Kalau mama baca, mesti dia tension anak buas sorang ni.

Bapis kata "Kalau Arab kacau, lari la. Sape paling pendek mesti dia paling last."

Dan mereka berdua pun gelakkan saya, sebab antara kitorang bertiga, Bapis paling tinggi pastu Umair. Argh.

As innocent as a white bear

I brought Kevin with me to Umair's because I have grown sissy nowadays and wouldn't want to sleep without him. Played with Huda the niece, studied a bit and went to roll on Umair's warm bed.

Throwback last 7th November, we had a sleepover watching thriller in which everyone screamed exasperated at the characters' stupidity.

Kevin was in the air being jostled by me. I told Umair I always wanted to rename him but I kept calling him Kevin again.  "Like, Jonghyun."

Iema liked that name."Bears should be named Korean. Try KwangSoo."

"No way, KwangSoo is stupid. Kevin is not."

"Norman," Umair supplied one of her cheesy Malay names.

"Pfft."

"Zahri. Kevin Zahri."

"That's weird."

Umair then offered a classmate's name and I laughed. "How would I sound if I say I'm sleeping with (insert random classmate's name)?"

"Gila!" And Umair hit me. I rolled around laughing.

Umair then likened Kevin to Huda, a baby. I told her Kevin is two years younger than me (because arwah Grandpa Jamil gave me him when I was two) and that makes him 21. Definitely not a baby.

I get lonely when he does his 45-minute breath-holding practice.

"I'm sorry. Did you mind me bringing a 21-year-old guy over?"

"Gila!" She hit me again.

Stupidity session over, we then discussed worldviews. As usual, she was always the better informed between the two of us, but I like to think I am not so bad myself.

But then as I presented my opinion, she exclaimed that I was "innocent! So innocent!" and that really caught me. She called me innocent again for a second time and I was officially not enjoying myself anymore. I rather be called crazy than a prude.

I think my innocence was sacrificed the day I had to examine a patient's scrotum. But yeah, innocence is culturally defined.

Simplex

For mature readers only. Yaya! Pergi baca buku sekarang!

At the end of the class, the doctor gave us a question. When can herpes virus type 1 causes genital infection and herpes virus type 2 causes oral infection?

The answer was simple enough. I nodded in understanding and class was dismissed.

Outside, a friend rushed past me. "All this time I thought oral *** means kissing! Wth."

I chuckled nervously. I wasn't sure whether she was so innocent or I am a know-it-all or a downright pervert.

Another friend nodded in agreement to her. She turned to me, "But it is abnormal, right? Surely it can't be normal."

It had to be a trick question, right? This one had to be answered delicately. I realized I had early exposure to a different culture yet living in a different one entirely. Talk about socially displaced.

"I think the word normal itself depends on what culture you are in."

She accepted my answer. "Medically, religiously, it has to have some sort of drawbacks, right?"

It would be interesting to Google this one up. The resident showed up to take our attendance and I was saved from answering her.

This is going to be an interesting week.