Sunday, June 24, 2007

NUS is possibly the most ridiculous Tertiary Instituion yet

after learning the shocking news that NUS Faculty of Medicine had decided to accept the applications and offered places to 2 Poly Graduates, they have placed the final brick into the wall of disdain that I built for them. Not much more can be said of their idiocrasy, and their insatiable need to make headlines with the most ridiculous of achievements. For example, actually believing they are 18th best Univeristy in the world, ranked ahead of universities like Columbia and U.Melbourne. Nonetheless, this amusing instituition of higher learning never ceases to amaze me in the crazy little things they do.

Saturday, June 23, 2007

when procrastination becomes sloth.....

so the 3rd week of my extended Swot Vac has ended, but still I have yet to accomplish any of the goals I set upon before. Revision wise, I have only covered weeks 7-11 of the lectures, now that's only 2.5 weeks of work, as weeks 9 and 10 are irrelevant. Head and neck anatomy went pass quite quickly but i have yet to review the larynx. In place of this revision, what I have done instead, is finishing seasons 1-5 of my new addiction Scrubs, in 1.5 weeks, and I must add season 5 in 8 hours. Also, i have finshed reading 2 very very intersting books on surgery which I have mentioned in earlier posts. you will find that this blog is particularly because I have some mental notes on the book which I would like to put down to paper.

Firstly, "Complications - A Surgeon's Notes on an Imperfect Science" by Atul Gawande, now this man is a Harvard Medical School Graduate, koodos to that. One of the chapters that stood out was 'Whose Body is it Anyway?'. Now in this chapter comes the endless debate about paternalism vs. patient autonomy, very relevant to recent developmetns in medical school education, involving the indoctrination of the belief that 'What the PATIENT wants supercedes the DOCTOR's recommendations'. This debate goes far back, to the time where doctors were idolized and worshiped, and from that pedestal, whatever being said by the doctor was the absolute truth. No Questions Asked. Then came along, a doctor by the name of Jay Katz, author of the revolutionary book 'The Silent World of Doctor and Patient' which had strong critique for the whole idea paternalism, which obviously did not take too well with the current mindset of clinicians. some would say, ' if doctor's have difficulty choosing the best options, how can the patient then be capable of doing so?' Patient ideology vs. Treatment outcome. In my opinion there is no hard and fast rule about this. Some patients feel that to live a life with some fear of a returning cancer, by preserving a social image is more important to them, hence choosing a lumpectomy over a total mastectomy, some will be smarter. Of course there are many considerations here, patient's age, degree of metastesis, patients occupation and other emotional, psychosocial babble. Now having being socialized into the medicine paradigm, naturally I would raise my hand for the treatment that boasts the best MEDICAL outcome, and whether a patient decides to follow your lead is purely their business. Now you might say, ' where is the empathy that doctor's are suppose to have?' Like I said before, it depends on the situation at hand, while a doctor may recommend a radical mastectomy for a 65 year old post-menopausal woman, he may not do the same for Kylie Minogue.

Whilst inundating the patients with a mountain of information regarding their options and then leaving them to decide might be the 'cover-my-ass' way of having a malpractise free career (as much as possible), it most certainly is not fair to the patient. At the same time, patients who say," don't tell me all that stuff doctor, i won't understand it, do what you think is best." also is unfair to the doctor. Then comes the idea of a partnership, that is being proposed in my med school, where the lay person with his -5 years of MBBS education but lifelong learning from Wikipedia and Google actually has a more important decision making role. Certainly even when give this position of authority, one question comes to mind, who gets the blame when something goes wrong? Is it the doctor? or is the patient left to live a life carry the burden of his mistake? At this juncture, the idea of a partnership ceases to exist and the blame-game starts. Such decisions which can lead to life and death situations carry a huge burden, neither the patient nor the doctor would want this. childish regression from the patient partnership vs. Aggressive Paternalism. The debate continues.

i quote from the book," whilst there is an art to becoming a doctor, there is an art to being patient." this is absolutely essential to YOUR/MY overall treatment outcome. just because you choose to absolve yourself of all responsibility in decision making, or decided to disregard the expert opinion of your doctor, a good and CLEVER patient must always question the doctor about the treatment. Ask questions that pertain to your lifestyle, how is the treatment goign to affect your work? can you play sports as aggressively as before? what ultimately is important to you in your time of sickness? These are all important questions, as they help the doctor in determining the best treatment for you. If patient's don't tell, doctor's dont ask (well good doctors like the one im going to be) will ask, and when you sign the form acknowledging the potential risks involved, i hope patient's don't start behaving like morons when things don't turn out their way. doctors make countless decisions everyday, some of them in emergencies some not. so the hard and fast rule of the ethicist about being partners cannot always be applied. These people, especially those without MBBS should realize that their idea of ULTIMATE patient AUTONOMY cannot exist in a blemished society. Whilst doctors must always act to serve in the patient's best interest, patients must remember that doctors are only always HELPING them, and the thing to do is to voice concerns and TRY to work towards an agreement, rather then play the blame game later on. This debate will continue for as long as existence goes and will only get more complexed as patient are enlightened by the resources of google and Wikipedia.

One quote i would always remember is " the real task is not to banish paternalism; but to preserve kindness."

What i really like about this book, is how it gives a really good insight from both perspectives of the patient and the doctor. As it the pages open to exciting surgical stories, it also brings with it important lessons that have strengthen the foundations my current MBBS education is giving me, allowing me to see the bigger picture of medicine and also understand that whilst some classes in med school might seem irrelevant now, they are absolutely important in any doctor's career.

Friday, June 15, 2007

crazy cold....

its been 1 week since the last day of school, and a good break thus far. The weather has been rather insane as of late. Early mornings being around 2-3deg C and average day temperatures hovering between 8-12 Deg. played insane golf, in antarctic ocnditions on tuesday, and random city stuff on Wed. I've been spending too much money as of late, fuck I need to get a hold of myself.

The Gym routine has been going well, and I'm not snacking as much,but thats possibly because my snacks were devoured in a space of 2 days and I haven't been able to get of my ass to get more...

to anyone who might stumble upon this blog, DO NOT WATCH ZODIAC. It is perhaps one of the longest, most boring, and retarded movies ever made, especially when you are made to share a bean bag otherwise known as the 'love sack' thats meant for a cozy couple with 2 other people instead. Am I going to write a movie review here? I guess not, it pains me to think of those 3 precious hours i wasted my life away...
On the side of the books, i've been able to get my first step down in revision, starting with anatomy of the HEAD and I've been reading these 2 books; autobiographies of a surgical adventures. the first being Complications: A Surgeon's Notes on an Imperfect Science by Atul Gawande and Brain Matter: The Adventures of a Brain Surgeon by Katrina S. Firlik.

Haven't completed them yet but I'll be sure to put my thoughts about them down to paper pretty soon.

The weather today has been insane. all FOGGED up, and you can't see further than 100m I reckon. not a safe day to drive.

Friday, June 8, 2007

Done with Med 2031!

I just can't belive how fast medical school is going by.It seems just like yesterday when I got on the plane and came back to Melbourne to start 2nd year, and now I', half way through it. 6 weeks of Holidays ahead, but then i'll have to study for the stupid exam that got postponed. This past semester has been really relly hectic and exhausting. I've seriously never felt so drained and at the same time STUPID. Going to school everyday attending lectures that seem ok, but walking out of them totally clueless as to what was going on. Back in my room, reaging book after book, and feeling like nothing is being absorbed at all.

Reflecting on this semester.Haven't been as participative in class as I wanted to be this semester, so think will have to change after the holidays. The social scene has been okay, despite the immense workload, getting to know more people and not having to put in as much effort as I thought previously. i'm looking to get a good break this holiday, work on my golf and hit the gym as often as I can. Really excited about Tasmania which is coming up in a few weeks.

In the meanwhile, I shall have to force myself to finish some miscelleanous assignments for next semester, get them out of the way so that I can maximise my Free TUESDAYS, yes I say again FREE TUESDAYS next semester. I need to organise my study material and get my anatomy up to mark for the exam. Timetables haven't exactly worked well for me till this day, but i'm going to have to get into a more regular routine. I'm going to make myself proud next semester. fuck the mean time, its time for PFE at The Croft Institute which is going to be so awesome..

Tuesday, June 5, 2007

4th June 2007

and so I turned 22 yesterday. 1 year older, 1 year wiser ......had plenty of birthday wishes coming in, mostly on facebook, that seems to be the latest fad in communication these days, and i'm getting addicted to it. I hope. Not being a fan of birthday celebrations. I did the usual small dinner with some close friends. and what better way to have a good meal than possibly the best steak around at Hog's Breath Cafe. the Juiciest and Chunkiest prime ribs you could find, is here. I must admit I was very surprised when Shuwen sneakily went off, to organise some really really good mudcakes to be served after main course. I had a singing waitress too, who was quite attractive. so that was rather delightful. bithday songs in public still bugs me though,never once felt comfortable having that song sung for me ever.

the weather is getting much colder, and waking up in the morning is getting harder as the days go by. Finally handed in my CPP report, which took ages to complete. 1 Assignment down, and plenty to go. OSCE formative exam is coming up, but since its formative I just cant be bothered.

can;t belive it already the last week of the semester. after this the holidays, then a new semester, and very quickly the end of 2nd year. How quickly time flies.

5th of June, that is today. something happen that totally made my day. it was a simple gesture, but from a special someone.