Monday, May 30, 2005
Bungling fool
So. Haven't blogged in quite a long while, mainly because there's nothing much to update. I tried writing something over the weekend because I was feeling frustrated, but realised after some tries that there's no satisfaction in bitching about people and trying at the same time to conceal their identities so that the people you're talking about don't know that it's them you're talking about. Encryption is useless and totally dumb, and no one really cares anyway. This is probably not the first time I'm saying this, apologies.
I realise I come across as sounding really bitter or pissed about something, but I'm actually not. Well maybe I'm irritated at myself, because I can't be more forgiving of things that people do that drive me crazy. Which, yet again, is the bajillionth time the same thing is happening and yet here I am bitching about it again. I hate it when history repeats itself. Well other than my little irritation at the way I get easily irritated (so it's meta-irritation?) I'm perfectly fine and won't snap at people unless you severely annoy me, like some people do rather easily. And taking care to not reveal names is not helping my frustration at said people.
I had my Medicine end-of-posting test today. Was pretty eventful as well as eventful depending on which perspective you take. From my personal viewpoint it was scary as hell, but as compared to my other CG-mates it was really a breeze. Which is something I should really be thankful of. I am, but knowing me, you'll understand that I still need to grumble and bitch a bit and tell you the dramatically boring story of my life. So here goes.
I did the long case first, and it was remarkably easy, being a case of angina pectoris. Nothing very remarkable except on cardiac examination I heard a fourth heart sound in the tricuspid regurgitation when the patient inspires. Now knowing my history with hearing additional heart sounds (last week I thought I heard a gallop rhythm and the case notes said "normal S1S2") I was quite mystified, but I think decreased right ventricular compliance can cause S4 right? I presented the case and I think the S4 part wasn't wrong because the doctor did not look at me like I just flew in from outer space, so thank goodness for that. But my history-taking was full of holes. I have no idea how to ask questions relating to complications of diabetes, so I'll definitely have to read up on that.
Short case: Dr GL brings me into a ward and shows me an elderly Chinese female, tells me to check the cranial nerves. I panic. She doesn't look like she can sit up, and all the alarm bells in my head go off screaming "Patient has to be sitting up!" It's disgusting the minor things your brain can devote all its attention to when you're panicking. So I swooped in and asked the lady if she could sit up. This is where I thank the tutor for being really nice and saying "No, no you don't have to ask the patient to sit up, do what you can with the way she is. Don't freeze. Think. Observe the patient. What do you notice about her"
So I observed, and said, "Patient has a mask-like expression."
Doc: "Very good, now do you think you really need to do a cranial nerve examination?"
Me: "Erm, no?"
Doc: "Okay, then please do whatever you think is necessary"
Me: "Erm, tone?" So I immediately grab the patient's wrist and start rolling it around.
Doc: "I think you should ask the patient if there's any pain before you do that."
Me: "Oh. Ok. (in Hokkien) Auntie, does your wrist hurt?"
Patient: "(also in Hokkien) It's painful.."
Doc: "Oh. Dear."
Me: *ded
So began the downhill slide to oblivion. After checking for cogwheeling I had absolutely no idea what else to do and suggested reflexes and power which the doctor told me not to do, and only after much prompting did I come to talk about tremors and the gait. And then he started asking me about Parkinson's plus syndromes which left me totally flabbergasted. So in the end, "to justify giving [me] a better mark", he asked me more about Parkinson's management (which I dumbly answered "drugs and physiotherapy?" and got right, thankfully) and whether it was related to dementia. Please kill me now, I feel so stupid. Overwhelmingly so.
At the end of the test he said "It's a good thing you didn't panic you know, otherwise you would have failed the short case." I'm like, are you joking, I was panicking like there was no tomorrow.
Ah well, thank goodness for examiners who don't stand around criticising your every move. And my deepest sympathies to the people who get such examiners. I really shouldn't be complaining about my test when it was mostly smooth-sailing, but I feel so completely bereft of any shred of intelligence when thrown in front of a patient, it's shameful. Woe.
[Edit: a few more paragraphs, because I'm so aggravated I'm about to blow a blood vessel]
Back to alphabetically-named people. I is (no no it's I am) good friends with J. Argh shouldn't use I. Erm, A and B are good friends. I think I should mention that both are female. One day A wears an outfit that B likes very much, and the latter asks A where she bought that outfit. Now A has several pieces of clothing from this shop where she got the nice outfit that B likes so much, and she hesitates to tell B where this shop is because she doesn't want B to buy the things that she has. But B pesters her and reassures A that she is only going to look around and not buy anything. So A tells B where this shop is.
Thing is, the next day B turns up in an outfit from that shop, which A has also bought but has yet to wear. Their friends praise B on the pretty dress that she has. A confronts B but B says that she had no idea that A already has this particular outfit, and tells A that she has in fact bought several pieces of clothing from the shop. To make matters worse A finds that these pieces of clothing are the same ones she bought.
Is it petty for A to be angry at B for a small matter like this, or is B in the wrong for "cheating" A? I'm trying to give a balanced view but you can tell I'm one of them. Hrmph. I think the other person might be quite oblivious as to who I'm talking about here, but oh well. I'm just ranting for the sake of ranting, not to kill people.
Avaris / 5/30/2005 08:48:00 PM
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