have the last laugh

3 Idiots might be a 2009 movie but i'm watching it today. Now it make sense. I laughed at myself for letting people messing up with my head. I was under constant scrutiny for the past few weeks..ummm glad it happened. What have i learnt today? I understand human on wider spectrum of differences. Still believe that world will be a better place with LOVE and CARE for others. Work with human nature- never go against it.

Over♔Out (⌐■_■) farah AJ

breaking bad news (the unfinished bussiness)

Here's the dialogue that i've construct base on BBN lecture notes. It turned out my partner have another idea and we agreed for a remake. To be entitled as script writer i decided to publish the original script *carmina burana O fortuna played*

Choose a private quite place. Doc turn off her phone (show it)

D: good morning, mam. How are you feeling today? Have a seat please.

M: good morning doc.  I’m feeling very anxious and i have a sleepless night for few days.

Doctor looking at the result. If possible pretend you are using a reading glasses . Take it off after reading.

D: Is your husband or any family member are waiting outside?

M: Well i'm here by myself doc. 

D: Mr. Gump is not here today mam?

M: No…it happens that he’s out of town will return this afternoon.

D: so how’s your son is doing?

M: I think better after you’ve changed the medication he don’t cry much but I noticed that he’s been feeding a lot slower lately.

i dont understand.....why so many tissue
D: Here’s the thing mam, I’m sure Dr. Hanh had told you before. There’s no 100% in medicine. We definitely doing the best that we could.

M: yeah…I know that. But I’m in the position where I’ll hold on to whatever I can. What is it? I can sense something is wrong.

D: I want you to stay calm (while showing the result ). The result is back. From the latest echocardiogram we found that you sons heart is going into failure.

M: What do you mean by failure? We haven’t tried all the options yet. I know there’s many option out there

D: It’s not that simple mam, heart failure is a progressive condition. And for a child I’m not sure if he can hold on for long. It’s time for heart transplant but in our country donor is hard to come by and even if there is a donor we have to make sure it match.

M: But I do everything you said. I let him to undergo many procedures. God know how heartbroken I am when I see him cried.Can't you buy us some time.

D: I understand Mrs. Gump. But circumstances have changed and so do our focus. Now we have to focus on his quality of life. I will call Hospice for you and help him feel better.

M: Feeling better is not good enough. I want him to get better.

D: even though i was hoping for the best I'm sorry to tell you that's all we can offer.
Moral of the story: organ donation can save lives. I'm still in quest of finding the artistic side of me#UPDATE: i should watch karen mcClusky reunited with Roy before the play (so much bereavement in Desperate Housewives Season 8, Episode 15) 

put yo gloves on

exam is around the corner...tic toc2. this is the time when i need all the caffeine booze here's to worsen insomnia and gather all nota2 picisan that were made intentionally or unintentionally while masking my sleepyhead. this is the time when i will truly madly deeply reflect myself as a medical student *depressed and manic at the same time*

fav parody of the month

i wonder what would it be like for my school to direct and act in our own parody. what song would we choose? which hospital should we use? umm..isn't that obvious but i kinda need a hospital with helipad + a heli (of course) for the victoria secret wind effect. Since i'm in surgical posting...top in my list would be Like A Surgeon by weird al-yankovich. some madonna touch can't go wrong.....even better if we can feature our dean. hell yeahh
 

stop the vicious cycle

i've been thinking and do some reflection. I dont wanna slack off this time. i have step up the game and the stake is getting a lil' bit higher.

Dream came true…..ALHAMDULILLAH

The psychiatry result was out today. So grateful I passed. Things that I love about psychiatry are:

• The psychiatrists are not stressor-genic: they don’t blame you if you suxx instead they’ll keep encouraging verbal and non-verbally.
• The subject itself was not so complicated; therefore you are determined to do well
• Psychiatry has its own art which other field doesn’t have. Requires you to be the people’s people

they made me love psychiatry.....pic courtesy of Budak Sepet

I'm sure my friends that will be doing PSY posting after this will love life in there. Perhaps lots of shouting and sedation but it shows you the other side of medicine. After this I’ll proceed to medical posting. I want to keep this momentum.....it's a great beginning.

xoxo
farah AJ

Understand psychology, u can handle human

Been in psychiatry posting have made me realize many things.

1. Human understand humane language
2. Stressor-genic people are the reason of psychiatry illness in this world

3. People can live and function with psychiatry illness as long as they take medication, dont expect a total cure

4. People can fall into psychiatry illness just because they made a wrong choice once. Took recreational drug or slimming pills (contains amphetamine) become psychotic

First day in psychiatry ward i thought that patients are monsters with no insight. I also heard a case where a student was grabbed by the patient. Its true that they're mentally unwell and we need to be in constant vigilance but it doesnt mean they cant be treated nicely. Whenever in ward i always maintain a closed position like your face must always be facing the patient, not your back. Speak firmly and at the same time being nice. I met a patient who'd always on restraint when the first time i came (too psychotic) but through the end he gain lil' insight(if full that means he already fit to go home) and able to express his feeling. He said he wanna go home, get some money from jkm monthly and get married. Never thought he would say that. I just listen(listening is crucial) and try not to be a bad guy here. When he's throwing tantrums its good to know that he able to stay put when i ask him to SYYHHHH~ towt i'm silly too. These are the kind of patient that you would remember for life, not to mention all the classic songs he sang were lovely.

I came to conclude (even though not as reliable as british medical journal but hey its my blog) that many genius or excellent people prone to get psychiatry illness. If you watch Beautiful Mind you would know what i'm saying. The bottom line is if you are immeresed in stress, surrounded with stressor-genic people and have poor social support that could increase your risk of getting psychiatry illness. Think about it; our society is a stressful society. According to a survey conduct by Nielsen (non-medical) stress among women in developing country: Indian women topped the list and Malaysian women at number 16. All of the stress are mainly caused by financial problem. I'm not surprise coz i know we easily come into conclusion and judge people, we dont communicate but blatantly shoot, we hardly care about others either coz as it is our own life is difficult. When i watch japanese show i really hope that Malaysia will filled with polite people. Empathy is one of the quality that really lacking in malaysian people, malaysian company or malaysian employer. See, this is the reason malaysia experience brain drain.

My love for psychiatry blooms after i met datin dr.fauziah the child psychiatrist (Nurturing a child in our nature is indeed challenging-maybe another entry) Anyway, its really sad that many people stigmatize psychiatry patient or profession. Yeah, psychiatrist were stigmatized by their colleagues too; simply because they cant prove schizophrenia with ct scan. But it doesnt mean the problem isnt there if you cant pick it up. I believe psychiatry intervention is necessary if spiritual or any measure didnt work. Its time to say yes to help and psyco medication(scientology definitely oppose this). The psychiatry professionals are targetting on educating our people that it is okay to see psychiatrist. It takes time to change this nation perception.

kudos to people who care for psychiatry patient. ouh ya, i'll be barred from ward coz exam is coming soon. this is the entry that will mark my cortisol level....shooting up of course 

I Dont Attack My Own Species

I'm a huge fan of respect. If people are illiterate i can just let it pass provided they know they should repent, shouldnt be stuck up and correct it. But if a senior staff just barge in and said something like "you are wrong. The student will learn from you and keep following your wrongdoing. Isnt it student?" i was startled coz i thought my presence in that room is insignificant. Plus i juse took a photograph with the cute patient in a procedure room. So for being safe i juse show my startled face plus blurred effect to the picture.

Pheww!that was close. I was there to learn from the house officer. She was kind enough to let us be there and assist her. How can i ruin it rite. Plus a senior stuff shouting from the door make me feel a lil' bit off. It would be nice if the senior staff come in and said "you should do like this... If not there will be..." if we can correct people and they follow it for the rest of their life dont you think that God will bless us more.

I know there's no room for mistake but learning from mistake also a way of people becoming great. Eventho a bulb is not a living creature i wud love to use Thomas Edison as an example here. Never get tired with failure.

My Assignment-Short Movie

The video titled Global Warming in Media. Actually I blindly pick the topic coz "MEDIA" sounds awesome. I have to do this for Community Medicine. So my group leader said "clip sikit2 pun dah ok sebagai penutup je" I was thinking about showing my class the Al-Gore speech on eleventh hour but i'm sure it's gonna put the whole class to sleep. Besides download and show is kind of too easy. 


Since presentation day is the day when everyone is putting up with crap OR come for the sake of marks+attendance i think i should think myself as an audience. Then, i watched few youtube videos and decided....I'm gonna learn & practice how to use Windows Movie Maker right now!


Well this is the finalized clip. I'm happy when my group members were satisfied. Of course shud coz they looks good in the vid ;) I left creativity long time ago so this is the time i feel i'm a colorful person again.

thanx a million friend...LOVE the books

yesterday was like a phbbtttt day for me. wait....actually everytime i met a new specialist the crises of inadequacy will recur. neway i need to get out from my routine, take a break from my everyday friend and meet another friend & gain a new perspective, go HOME and READ.

To kay kamal...all your books have reached a new home. I'll be so happy to adopt them for a while *wink.

tandas cangkung lebih baik

lamanya tak publish entri baru. sebenarnya saya berniat nak buat entri 'kek raya tahun ni' tapi xsempatla. exam dah dekat *wat am I doing. ini adalah penemuan saya yang terbaru hari ini. boleh dikatakan accidental finding. saya disuruh baca pasal Vasalva Maneuver (terpaksa belajar) dan terjumpa gambar ni. saya dah cuba maneuver ni tapi rasa cam pening kowt. manuever ni sebenarnya lebih kurang spt meneran ketika di tandas tapi dengan hidung dan mulut ditutup. ei..orang boleh mati sebab sakit jantung ketika di atas mangkuk tandas taw

tandas duduk membuat onar kerana ada otot yang tercekik.....ikutlah sunnah agar muscle itu lurus. oleh itu kita mesti cangkung untuk qada' hajat

http://www.toilet-related-ailments.com/crohns-disease.html
website ni sangatla menarik

Newcastle mark my spiritual journey

             Ada pun semboyan telah berbunyi berpindahlah hamba beserta bala tentera bagi melaksanakan titah baginda. Jika benar bagai dikata 3 tahun jualah hamba berkelana. Medan perang bukan sebarang…..tersilap langkah MBBS ku melayang. Ku sangka panas hingga ke petang rupanya hujan di tengahari. Belum pun dua purnama hamba berjuang, sirih dipanggil pulang ke gagang. Ibarat negeri berubah rasam;  ibarat tahun berubah musim.
             Sesungguhnya cinta itu membutakan. Dek kerana cinta dan luhurnya rasa hamba turutkan jua titah diberi. Kesimpulanya lepas ni kena sambung klinikal di HTAR klang…..namun hrpz akan sentiasa diingati. Kota bharu telah mengajar hamba banyak perkara yang tidak diajar jika berada dibawah lindungan orang tua. Sepanjang perkelanaan ini, hamba telah mengenal erti persahabatan dan peri pentingnya kebergantungan pada Yang Maha Esa. Senduk dengan belanga lagi berlaga, sudah memang resmi manusia pabila nasi habis budi bersua. 

                                

Pohon mengkudu tumbuh rapat,

Rapat lagi pohon jati;

Kawan beribu mudah dapat,

Sahabat setia susah dicari.

Hormat dulu diri sendiri,

Itulah tanda orang yang mulia;

Jangan dikejar gunung yang berlari,

Hilang kabus nampaklah dia.

Anak ayam turun enam,
satu mati tinggal lima;
Minta doa tetapkan iman,

Minta mati dalam agama

OnG posting: female body is surprising

After sometime being in labour room i gained a new perspective. I think female is one of the greatest creature on earth. Like you'll wonder how much your mum endure all the pain to get you into this world and how flexible the vagina and cervix could be. Damn, it is hard to become a woman.

Kesimpulannya seorang suami itu mesti cuba really hard untuk berada di sisi isterinya yang sedang melahirkan. Tapi kadang2 kaum ayah ni bukannye sengaja xmahu masuk labour room, it just that they are busy with their job *like wat happen to my dad: zaman xde telefon + my dad is working in sarawak~ aisy kesian mak.

Moral of the story: I salute a guy that come to the labour room + wipe the wifey's tears + hold her hand & azankan anak di situ. Tak mampu diluahkan dengan kata2 tapi sungguh menginsafkan. I can see that the wife is religous. The delivery process also was so short with minimum tear.

But i still dont understand why men were so obsessed about ranking a women as cun...x cun...cantik...x cantik. Yang lawa akan dapat layanan istimewa like ayam goreng AND leher, kalau yang mediocre like me dapat ayam je. Of course it is personal but shallowness is soo irritating. I hope that i will be surrounded by people who can be fair and have respect to everyone no matter who.

Beauty isn't worth thinking about; what's important is your mind. You don't want a fifty-dollar haircut on a fifty-cent head. ~Garrison Keillor

Everything has beauty, but not everyone sees it. ~Confucius

1st posting: surgical department

*cant upload my precious pic coz this broadband is sengal

Chief complaint: afraid of coming to surgical posting. The fact that surgeon will cut people open and my anatomy is not that amazing (at this moment) I rather stay at home. Moving from klang to shah alam has drained all my energy throughout the journey. Half day journey had made me think enough that I shouldn’t go home so often.

Day 1 at surgical department is ok. Dato’ hasim show us around and I am so amazed with the smell of the male ward, surgical urology. It smells like urine, the ward is packed with occupied extra bed. Not to mention there’s a lot people with white coat gathering around one bed. Prognosis is not good.

I tried to make myself comfortable in this place so the next day I went to clerk a patient. I think I am hitting a jackpot….this madam is a nicely speaking lady, cannot BO normally, and there’s a pic of her colonoscopy with an abnormal finding. While I was clerking there comes a troop of doctors *man, I towt they’ve done round…what r they doing here.

Actually there’s nothing bad happen, in fact I enjoy being around surgeon which is 100% male (coz the all the female have been transferred to Tanah Merah). After sometime it can be said that male doctors are more relaxed and didn’t throw tantrums *60% from our observation. I’m so blessed that surgeons are welcoming the student to their OT and see how the ACTION happens.

Moral from the posting:

1. Always eat a humble pie. Some afford to use blackberry but they didn’t (wonder with that salary why use a normal Sony Ericsson). Surgeons here really respect the patient & student.
2. They also live religious + easy to talk to and understand students well.
3. Surgeons only scary when they ask question and you didn’t know the answer *actually nothing bad happens
4. 1^st time I heard people in ward said “u shud grab an early lunch” ~ coz surgery will take lots of your time

Even though I have long way to go + my anatomy is suxx…..i got a feeling, I wanna be a surgeon. I was thinking about a scene:

The desperate housewives scene

Husband: why must u become a surgeon? I hardly see you.

Me: why don’t u come earlier and decide what shud I be.

The muslim family scene

Husband: I think surgeon is a noble job.

Me: Thank you for understanding, dear.

Anyway, i've draw a line here:

Student =learn + not paid + not reponsible to the patient

Staff= work + paid + dont screw up

Analisis pasca-attachment

Clinical attachment dah sampai ke minggu terakhir. woooohoooo Jumaat ni last day. sekarang adalah masa terbaik untuk buat rumusan tentang 4 bulan usiaku yang telah dihabiskan di 4 tempat berbeza. Lepas ni aku sibuk buat laporan (huargh...banyak gler, muntah kertas la aku kali ni). *nama tempat ni korg pandai2 la cari ek~ala2 P&C sket

Tempat 1: membentuk professionalisme, mendapat bimbingan yang diperlukan. Datin & barisan doktor pakar adalah mentor yang bagus. Jururawat~sgt2 membantu di wad, they'll just let you do your stuff. Asalkan ada keinginan nak belajar anda boleh hidup kat sini.

Tempat 2: Perlu extra effort to build rapport with the staff, so that you can do your job and get their assistance. In district posting, being people's people is sooo important. Rasa bosan adalah cabaran utama di sini kerana kes tak banyak kadang kala membuatkan anda loose interest. Tangani rasa bosan agar anda dapat mengekalkan minat hingga ke akhirnya.

Tempat 3: Kembali ke bandar...forensik adalah tempat yang membantu anda menguasai anatomi dengan lebih baik. Perlu fokus pada sikap kerana setiap tingkah laku anda sentiasa diperhatikan dan dinilai. Layanlah staf dan Prof seperti keluarga~ u'll be so happy to be part of forensic family. Kat sini aku berdisiplin sesangat...terbaek :-bd

Tempat 4: Sama seperti tempat 2 tetapi tempat 4 lebih sibuk dan pelbagai kes boleh dijumpai. Cabarannya, di forensik kita terbiasa berkomunikasi (kuliah, perbincangan) dengan ketua jabatan. Di tempat 4 komunikasi menjadi terhad+rasa halimunan. Perlu lebih berdikari agar dapat mengekalkan minat dan mencapai objektif.

Kepada sahabat2 yang bakal ke clinical attachment semeter depan atau semester yang akan datang....selamat berjaya. Aku rasa sesiapa sahaja boleh survive~ perlu kuatkan semangat dan bersedia untuk perubahan.

forensic taught me

Di forensik, banyak kes kematian mengejut yang diakibatkan oleh sakit jantung. Ada satu kes yang membuat aku insaf....seorang lelaki dalam usia 30-an jatuh di tempat kerja dan mati. Bila dilihat bentuk badannya yang athletic (ala2 US army pn ada- sgt tegap untuk seorang berbangsa asia) tidak ku sangka salur darah koronari-nya tersumbat teruk. Complete occlusion di kebanyakan artery.

*Pengajaran-beringat2 kalau nak makan, kurus/gemuk tu isu estetik jer. Sekarang aku dah x excited makan goreng pisang....

wee....forensik adalah tempat yang best untuk belajar dan networking. kalau dulu xdenye aku nak borak2 ngan orang2 dewasa (i mean aku ni kecik lg kan). semenjak berada di forensik hosp serdang beberapa kemajuan telah aku capai:

1. kemahiran memulakan perbualan dengan orang yang tidak dikenali
2. dah kurang takut ngan polis-sbb tiap2 hari ada je inspektor hensem bawa body
3. dah tak menganggap rumah mayat tu berhantu...seram sket2 adala
4. dah pernah pegang revolver
5. main dart
6. pandai guna pisau ;)
7. merasa gak pkai baju ala2...grey's anatomy
8. belajar cara2 nk guna canon~eos 300d
9. menjadi sebahagian daripada kemasyhuran penjenayah (dpt kes gunshot taw-i know exactly wat happen)

Berada di dalam keluarga forensik telah membuat aku menyedari potensi diri dan bertuah kerana dikelilingi orang2 hebat. sangat bersyukur dan bertuah kerana dapat berguru ngan prof.karim(pakar forensik+memasak), dr.fatimah(sup meletup) & dr.salmah(hai-o) serta sume staf forensik serdang yang sanggup melayan ke'clumsy'an aku nih. THANKS A MILLION

Di sini aku nak share gambar buat tatapan pengunjung blog ni ;;)

that's all folks~

The Legal Escape

Yay…kembali ke klang. Stress jgak duk seminggu di Jempol. Bukan nak mencari kemewahan atau kesempurnaan tapi agak2 la kalau nak student berdikari. Ada hikmahnye perjanjian ptptn dijadualkan esok.

Aku bengangs bila:

• hosp jempol bitau MSU tak hantar surat kepada management sana menyatakan kami 10 orang akan ke sana untuk attachment.
• Supervisor xdak….rumah sewa lak cam umah tinggal (ayam masuk umah, air xde kt bilik air, jiran sebelah umah dak laki yang xbley blah), rumah retak, anai-anai lagi- adui kenapa lah aku tak amik gmbr umah tu yer
• Ada sister wat t*#k ngan member aku

Ak Akhirnya banyak pengajaran yang aku belajar…off record ye. Nway sekarang aku dah kenal jalan ke kualo pilah + dapat umah baru=dah hepi da

umah sewa yg fully furnished

1st time g autopsi la katakan

yet i still miss Datin, Dr.Goon, auntie zarina and everything about IPR~ inilah wad TB

Hari 1 di wad (sebahagian tanggapan)

Situasi 1

D: kenapa awak kat sini?

Me: attachment

D: Yela klu baru 3rd year kenapa dtg sini? Tempat ni kan untuk spesific case. Sepatutnya awak pegi GH.

Me: Umm..(dalam hati~well i dont have chance to choose either)

Member: Tak DR..management yang hantar kami ke sini.

Situasi 2

D: Awak tau ke apa yang saya buat ni?

Me: Umm...(dalam hati~ obviously saya nampak DR tengah tulis rekod perubatan)

Aku ternampak slip darah makcik rokiah, ada spO2.

D: Awak tau tak ABG tu apa?

Me: Tak tahu (dalam hati~ bagitau la nama penuh ABG, ntah2 aku tau kowt.)

Dalam bas aku terpikir, maybe arterial blood gass-dammit

Kesimpulan- manusia itu pelbagai macam, dugaan akan selalu datang tetapi destinasi tidak pernah berubah. So, you only give a damn to things that matter. Jangan lupa untuk rileks supaya sume idea mahal korg tak retarded dalam otak.

bring it on

p/s: berkat kesabaran dapat tengok demo gastrointestinal examination, belajar jgak la aritu. Jarang jumpa hepatomegaly kat ward.

Kekal Termotivasi

huh..rasa macam akan hidup dengan sihat 50 tahun lagi selepas berjalan pantas pagi ni. Luv it when muscle dissipate the tension and feel the fat burning.

Teringat result spirometry di LFT (lung function test). Aku bajet aku fit, alangkah segannye bila dapat result~ usia paru-paru anda ialah 40 tahun. Hey ru kidding me? mungkin ada ralat sebab sume dok tgk aku tiup mouthpiece tu ;)

Sekarang aku ingin renew impian...nak kekal sihat dan fit. Kalaulah kolam renang UPM dekat2 sini bolehla aku membina kapasiti torasik yang lebih baik.

skill that never improved

omg~ i am far from excellent