Today, had an extremely inspiring out patient clinic teaching by Professor Thomas Chan. Very inspiring and touched. Felt pretty ignorant, naive and guilty after class though...
Anyway, it is late now. I wanna join the MO ward round at eight. So may be I will write about this later.
Friday, August 11, 2006
Thursday, August 10, 2006
Impact of death
Today, the second day in ward, a patient passed away. Should be a case of respiratory failure after long term chronic obstructive pulmonary diseases. The first patient since I started the rotation.
The family cried at that moment-- I think most relatives were with the patient when he left. They cried. But pretty strangely, I think that was pretty a relief--for the patient and for the family members. In fact, the patient's condition has been so bad that his family has been called to be with him since yesterday. The family members were obviously very depressed and stressed since yesterday. But more importantly, the patient was already on Bilevel ventilation for pretty long time-- Which essentially means that the obstruction was too severe for the patient that each breath takes a lot of effort. The patient became too weak that a machine has been connected to him to assist his breathing. And today, after uncountable number of miserable breathes, his respiratory muscle finally given up. The suffering ended. The patient has signed for no intubation which essentially offers no help other than to prolong the suffering. I think this is a relief to the patient and the family from their sufering.
But this comes back to a question-- is there such a thing called good death? This is difficult. Death is more a process, a process that leads us to the end of our life. To this special process, it would be inapprorpiate for by-standers to comment on this last journey for the traveller himself. But yet, what by-standers can do, and esp. what we, as medical professionals, can do, is to assist so that the patient may have a respectable, self-controlled death. This comes back to the goal of the medical sector: to cure, to safe life and to improves quality of life if possible. If not, we try to reduce patients' suffering and let them go with self-respect, self-control and self-independence.
What is death? What is death like? Will death be painful? How long will be the death? This sort of questions are always posed to medical doctors. But perhaps, death is more a process that no one can determine/explain except the traveller himself-- just like our lives, no one is a better narrator than the person him/herself.
The family cried at that moment-- I think most relatives were with the patient when he left. They cried. But pretty strangely, I think that was pretty a relief--for the patient and for the family members. In fact, the patient's condition has been so bad that his family has been called to be with him since yesterday. The family members were obviously very depressed and stressed since yesterday. But more importantly, the patient was already on Bilevel ventilation for pretty long time-- Which essentially means that the obstruction was too severe for the patient that each breath takes a lot of effort. The patient became too weak that a machine has been connected to him to assist his breathing. And today, after uncountable number of miserable breathes, his respiratory muscle finally given up. The suffering ended. The patient has signed for no intubation which essentially offers no help other than to prolong the suffering. I think this is a relief to the patient and the family from their sufering.
But this comes back to a question-- is there such a thing called good death? This is difficult. Death is more a process, a process that leads us to the end of our life. To this special process, it would be inapprorpiate for by-standers to comment on this last journey for the traveller himself. But yet, what by-standers can do, and esp. what we, as medical professionals, can do, is to assist so that the patient may have a respectable, self-controlled death. This comes back to the goal of the medical sector: to cure, to safe life and to improves quality of life if possible. If not, we try to reduce patients' suffering and let them go with self-respect, self-control and self-independence.
What is death? What is death like? Will death be painful? How long will be the death? This sort of questions are always posed to medical doctors. But perhaps, death is more a process that no one can determine/explain except the traveller himself-- just like our lives, no one is a better narrator than the person him/herself.
Wednesday, August 09, 2006
A Whole New World
So this is my first day to ward.
The morning started with Prof. Chan's briefing. He turned out to be a much more humourous guy than I had thought. Strict but nice + a bit of balck humour. Nice.
Then we proceed to the ward to clerk cases ourselves.
The afternoon started with ward teaching by Prof. Thomlinson,who took us to 9 C and also 11 AB wards (infectious ward) which we cannot go by ourselves. Then we went back to 9AB to ask about the ward round schedule. And also updated ourselves with a pt we clerked earlier on.
So Lilian and I clerked two patient. One with a very typical spontaneous penumothorax. One with COPD exacerbation.. and a mix of many other diseases. Pretty happy since this is the first time I see such a big tension pneumothorax. And for the second patient, I managed to pick up abdominal distension, hepatomegaly and ascitis although the histroy did not really point directly to that.
The ward is a totally new place for me--a whole new world. I mean I have been there before. But being attached to it, being a part of it, is a totally different matter. It is the first time I have the time and opportunities to feel the dynamics in the ward.
Hospital wards, are prehaps, one of the most complex places in the world in terms of emotion.
Today, a patient who has COPD was going to leave and his relatives and families were all staying with him. The family, although must be pretty prepared, looked depressed. Nurses go to them from time to time asking them to eat something, telling them that they will collapse and add burden to other family members if they don't-- a sort of alternative encouragement by the nurses I suppose.
In the nursing station and around the beds, nurses and assistants are buzzing here and there, busying handling the patient--some are cooperative, some are confused, some are annoyed. The nurses are pretty irritable-- yet, you can always sense the caring heart behind the shouting voices.
Students like me a idling around the beds and the X ray box.. willing to learn but sort of confused by the new atmosphere.
Curiosity, care, annoyance, depression, broken heart, ambition, smiles and laughter, tears... you can find all in a medical ward. What a place.
And yet, this is the place which we have chosen to stay for our career. Ah.. I really wanna mature quicker.
Finished today pretty early-- exhausted after standing a whole day on my leather shoes..sore! I was reading the relevant materials all night. YEAH, this is the feel that I need-- the feeling to relevance, the feeling of application of knowledge. Gosh, I love this!
The morning started with Prof. Chan's briefing. He turned out to be a much more humourous guy than I had thought. Strict but nice + a bit of balck humour. Nice.
Then we proceed to the ward to clerk cases ourselves.
The afternoon started with ward teaching by Prof. Thomlinson,who took us to 9 C and also 11 AB wards (infectious ward) which we cannot go by ourselves. Then we went back to 9AB to ask about the ward round schedule. And also updated ourselves with a pt we clerked earlier on.
So Lilian and I clerked two patient. One with a very typical spontaneous penumothorax. One with COPD exacerbation.. and a mix of many other diseases. Pretty happy since this is the first time I see such a big tension pneumothorax. And for the second patient, I managed to pick up abdominal distension, hepatomegaly and ascitis although the histroy did not really point directly to that.
The ward is a totally new place for me--a whole new world. I mean I have been there before. But being attached to it, being a part of it, is a totally different matter. It is the first time I have the time and opportunities to feel the dynamics in the ward.
Hospital wards, are prehaps, one of the most complex places in the world in terms of emotion.
Today, a patient who has COPD was going to leave and his relatives and families were all staying with him. The family, although must be pretty prepared, looked depressed. Nurses go to them from time to time asking them to eat something, telling them that they will collapse and add burden to other family members if they don't-- a sort of alternative encouragement by the nurses I suppose.
In the nursing station and around the beds, nurses and assistants are buzzing here and there, busying handling the patient--some are cooperative, some are confused, some are annoyed. The nurses are pretty irritable-- yet, you can always sense the caring heart behind the shouting voices.
Students like me a idling around the beds and the X ray box.. willing to learn but sort of confused by the new atmosphere.
Curiosity, care, annoyance, depression, broken heart, ambition, smiles and laughter, tears... you can find all in a medical ward. What a place.
And yet, this is the place which we have chosen to stay for our career. Ah.. I really wanna mature quicker.
Finished today pretty early-- exhausted after standing a whole day on my leather shoes..sore! I was reading the relevant materials all night. YEAH, this is the feel that I need-- the feeling to relevance, the feeling of application of knowledge. Gosh, I love this!
Monday, August 07, 2006
New Beginning
Today (i.e. in 8 hours time) is a big day for me.
Since the first day I step into the medical school, today has been what I have been looking forward to-- Clinical Clerkship.
Yes, I am starting my Junior Medical Clerkship today. For those who don't know, clerkship basically means learning through rotations in different wards in the hospitals. Tomorrow, I will be a doctor-in-training in ward 9AB of Prince of Wales Hospital.
Though I have been looking forward to this for really long time, I don't feel pretty nervous now. Perhaps the previous occupation in the organization of the AMSC has been to exhausting that I do not have time yet to look at the whole clerkship thing seriously. And perhaps I am not fully prepared for the clerkship yet too.
Clerkship is an important stepping stone to a medical student (MS). It marks the conversion from a preclinical student to a clinical student. It embarks a learning process which MS have to learn by active participation in daily running of the ward, instead of passive sitting and recitition of lecture materials. It also means that your learning process will be actively monitored by MOs and Profs in the ward--and should we be not proficient enough with our knowledge, they will make sure that we feel ashamed of ourselves. Clerkship also remarks the beginning of interaction with patients in the wards. And this is what medicine is about after all-- we finally take the leap from lecture notes and tutorial papers to the real life. The real life is not going to be easy- and in fact, will be pretty tough and demanding. Yet, this is why medicine is so fabulous.
The blog is established to remember this transection-- from a medical student to a doctor to-be. Ward life means busy life. Yet, I am expecting inspiration and emotional challenge from time to time. And this blog is made for me to record these remarkable events that hopefully, finally, will train me from a naive MS to a mature house officer (if I managed to graduate, of course). This blod, unlike my another blog, will not be a record of my daily life/emotions, but rather inspirations of my daily education in medicine.
No. I am not planning to make a big deal of the establishment of this blog. I rather this blog to be a quiet place for those who accidently come across this by chance, and among those, people who decided to share my life experience. I thank you for your sharing in advance.
I am not sure if I will be a good doc., but I will be my best to be a caring, empathetic and holistic doctor-in-training.
Since the first day I step into the medical school, today has been what I have been looking forward to-- Clinical Clerkship.
Yes, I am starting my Junior Medical Clerkship today. For those who don't know, clerkship basically means learning through rotations in different wards in the hospitals. Tomorrow, I will be a doctor-in-training in ward 9AB of Prince of Wales Hospital.
Though I have been looking forward to this for really long time, I don't feel pretty nervous now. Perhaps the previous occupation in the organization of the AMSC has been to exhausting that I do not have time yet to look at the whole clerkship thing seriously. And perhaps I am not fully prepared for the clerkship yet too.
Clerkship is an important stepping stone to a medical student (MS). It marks the conversion from a preclinical student to a clinical student. It embarks a learning process which MS have to learn by active participation in daily running of the ward, instead of passive sitting and recitition of lecture materials. It also means that your learning process will be actively monitored by MOs and Profs in the ward--and should we be not proficient enough with our knowledge, they will make sure that we feel ashamed of ourselves. Clerkship also remarks the beginning of interaction with patients in the wards. And this is what medicine is about after all-- we finally take the leap from lecture notes and tutorial papers to the real life. The real life is not going to be easy- and in fact, will be pretty tough and demanding. Yet, this is why medicine is so fabulous.
The blog is established to remember this transection-- from a medical student to a doctor to-be. Ward life means busy life. Yet, I am expecting inspiration and emotional challenge from time to time. And this blog is made for me to record these remarkable events that hopefully, finally, will train me from a naive MS to a mature house officer (if I managed to graduate, of course). This blod, unlike my another blog, will not be a record of my daily life/emotions, but rather inspirations of my daily education in medicine.
No. I am not planning to make a big deal of the establishment of this blog. I rather this blog to be a quiet place for those who accidently come across this by chance, and among those, people who decided to share my life experience. I thank you for your sharing in advance.
I am not sure if I will be a good doc., but I will be my best to be a caring, empathetic and holistic doctor-in-training.
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