You can almost guess what kind of conference I am attending by the kind of dessert they serve.
I didn’t eat any…I heard they were too sweet.
Fri, 301107 @ 1800; it’s been a fruitful conferencing day.
Warning: Reading this article might put you off another local delicacy.
I was thinking, why not make it a hattrick?!!!!
Well, here’s one more. I have been saving this baby for the longest time! Heh heh…
I downloaded this pic from the New England Journal of Medicine a long time ago. It’s a picture of a worm blocking the opening of the common bile duct into the small intestine (seen though an endoscope)! The worm is called Ascaris, a parasitic nematode which originates from contaminated porcine or bovine meat, and actually looks a lot like this Chinese staple:
Sorry guys, I know it’s gross but you must admit the resemblance is uncanny!
Which reminds me of an incident when I was a medical student in India. Those days, in order to qualify to sit for the forensic science examination, we have to witness at least 10 autopsies being performed. I remember being present in one autopsy where the deceased was a woman who died from self-immolation. Upon opening up the stomach, an ascaris worm quickly reared it’s head above the murky stomach content, much like what the old Loch Ness Monster allegedly did!
It gave us all quite a bit of a scare! We later found a few more of its relatives in the deceased’s intestines.
Ugh! Gross….but definitely hard to forget!
Thurs, 291107 @ 0747; 2nd day post call ~ feeling so tired. Today’s my appraisal day, which will determine if my kids have to beg for food next year at the local bus stand. Pray for us!
Update: Some one actually vomit out a worm on my esteemed colleague. Read it here!
I made some of my students smell the organic waste material excreted from the anal end of a patient yesterday during the night rounds.
Don’t get me wrong. I am no sado-masochist trying to make my student’s life more miserable.
I wanted them to smell the unique unpleasant smell of stool mixed with blood, otherwise known as melena (actually when I googled ‘melena’ on Google Image, I got pictures of naked ladies!!!). It’s got a unique pungent smell and looks typically black and tarry; a lot like the inside of chinese dumplings with black beans paste (tau-sar-pau).
A patient in my ward had an upper gastrointestinal bleed (UGIB) and so passed out a lot of melenic stool. The ward nurses were changing his diapers just as I was passing that way with students in tow. I saw it as an opportunity to get them to take a deep breath, close enough to the patient to experience the smell.
My intentions were noble of course…I wanted them to recognise the smell, so that in the future if they come across a similar scent again while attending to a patient, they would be alerted to the possibility of an UGIB, without even having to tear open a patient’s diapers to see.
My students probably thought I have finally lost it (and the last marble in my brain) when I first asked them to do the unpleasant and unexpected task, but then they saw I was serious. And so, one by one, they gamely went near the patient and took a deep breath.
But I am certain they will NEVER forget the smell, ever. Like I told them, not everything in medicine is pleasant.
Wed, 281107 @ 1315; post-call and suffering the beginning of a major migraine! Sigh…
Yeah I wish… heh heh! At least it would bring some excitement to the work place!
We had a mock fire drill last week at the hospital. The Bomba people came, in their bright shiny fire engines and there were firemen every where, wearing their uniform (that looked like they haven’t been washed since 1957) storming into the wards, following some imaginary distress or drill. Oh ya, they didn’t look one bit like those firemen in Hollywood movies, in fact many of them need diet control and exercise, in my opinion. But I am sure they are people who are dedicated to their job.
Actually it’s kinda weird because we have firemen rushing here and there in the ward while we were doing our morning rounds, quite oblivious to what was going on around us! I mean, we were that jaded!
Which begs the question: in the event of a real fire, are we, doctors, supposed to save the lives of the patients first or just jump quickly into the first escape chute down the building? I mean, plane and ship captains are supposed to be the last to leave their burning plane/ship. Does that apply to doctors as well? What about the nurses? What about the hospital director? Is he supposed to run up and save everyone first? (btw, his room is on the ground floor ~ how convenient!)
Wed, 281107 @ 0700
After the disastrous photo shoot for my article ‘In Full Bloom’ and some disappointing comments about how lousy my phone camera is, I’ve decided to use my Canon Ixus and snap some better pics.
And By George!!!! LM was right, the whatchamacalit orchid actually has a very pleasant fragrance! But you gotta draw very near to the centre of the flower in order to get a proper wiff. That’s what I did. Here are a series of close-ups as I drew my nostrils closer and closer, deeper and deeper….
Definitely a better pic than the last one I took right?
I went a little closer…
And zoomed in to a single flower…
Placing my nostril closer and closer to the centre...
And then I caught a wiff!!! Such fragrance!!! It has a kind of apple-ish fruity smell.
And then, I opened my eyes and OMG!!!! I’ve been smelling THIS!!!! (You figure out the anatomical resemblance ya)
I checked the other flowers (another species) and I don’t see any similarity to the one above!
Not this one either…
This is very disturbing…
Tues, 271107 @ 0730; on call. Rats, I hate being on call.
This 30+ man presented with shortness of breath. He also complains of feeling stiff with neck and lower back pain. Examination of his chest revealed a diastolic murmur in the aortic area.
These are his radiographic films.
1. What are the abnormalities seen?
2. What is the diagnosis?
Tues, 271107 @ 0700
Malaysian patients are generally grateful people. In my practice over the years, most patients I encounter were profuse in expressing their gratitude. There is a spectrum of course. Most of these expressions of thanks are verbal in nature: a simple “thank you” or “terima kasih” upon discharge from the ward or after a short consult in the clinic. At the other end of the spectrum are those who are probably better off, those who will send a card, a fruit basket or a memento (usually directed to ‘all the staff in the ward’). The latter category are, in my experience, more common in those warded in the 1st class wards. Not to say that 2nd or 3 class wards patients are ungrateful, just that they may not have the means to express their gratitude in kind.
And there are those who are more personal, writing a letter or a card directed to either the physician or the director of the hospital to thank and commend on the excellent health care received.
I treasure such letters. I also treasure each verbal ‘thank you’ uttered, each look of gratitude in their eyes, and hands held in a ‘salam’ posture. Because these expressions serve to remind me that what I do daily is not thankless mundane work. Instead it is a very fulfilling and potentially life changing vocation.
With the advent of hand phones and sms services, now ‘thank you notes’ have kept up as well.
I received this sms over the weekend. Here is the translation from Chinese:
“It’s been a while since I was discharged. Just want to say thank you. Although I am not happy but (I) will take your advice to comply with my medications. Hopefully one day we will have a miracle for treatment of AIDS. Good nite.”
It was from a patient who we literally pulled from the brink of death a couple of months ago.
This is the season for thanksgiving and I believe we all have a lot to be thankful for, don’t we?
Mon, 261107 @ 1434
I had to stop at Jusco last Friday on my way to KL~ all because I forgot to bring along my tie! Gaargh! And so I had to go buy a tie (the cheapest most decent looking one I got was for RM 29.90 without discount and there was no sale on!).
Anyway, I chanced upon this deco at Jusco and suddenly I felt all Christmassy all over again.
Mon, 261107 @ 2109