im a fat boy?!?!?

for the past 4 days i've been following the progress of this HIV patient who was admitted for left sided paralysis. due to HIV status, it was suspected that the left sided body paralysis was likely to be cause by a cerebral infection(eg: toxoplasmosis, cerebral abscess, neurocysticercosis).

the dude doesnt have much visitors except for his sister who visits him periodically. all his family members had disown him cause of his HIV status and plus he is a pimp by profession and an active IV drug user.

anyway, on the first few days he would tell me he is hungry and that he wants to eat but no one is there to buy him food and the he does not agree with the hospital food. so i bought him some simple cake during my break time. the next day, he said he wanted coke with the cake. so i got him. on the third day, he wanted two packets of cake and a coke. on the 4th day, he wanted the same plus cigarettes. wah lau, melebih man!!!! i bought him the everything but the coke.

on the fifth day i was pretty busy with other stuff so i did not follow up on him in the morning. but in the afternoon, i went to his ward to observe a pleural tap (they stick a needle into your lung to remove whatever fluid or pus thats in it. oh yeah, and the doctor that did that procedure, well he stick the needle into the left lung when the lesion was on the right lung). during the procedure suddenly i heard him calling out "FEH CHAI!! FEH CHAI!!!" (fat boy)

i didnt bother looking at his direction as i was to engrossed looking at the procedure. i thought he was calling out for someone else. and he kept calling out, "WEI FEHH CHOO!!FEHH CHOO AH!!!(fat pig)

when i turned at his direction only did i realised he was calling me.

ME??!!!! he is calling me a FAT PIG!!!

MAI CIBAI!!!!!

i walked towards him with ego also bruised up and mood suddenly being real foul,

me: ah, why you calling me for??
pts: why never buy food for me??
me: how i know you want food?? you also never tell me you want food.
pts: who said i never tell you?? you promised you'll buy this morning!!

kanineh!!! i was not in the ward the whole day, how the hell i could have promised you to get you food. and some more call me a fat pig in front of the whole fucking ward then expect me to buy food for you. KNNCC!!!! Tiu leh lor mor la!!!

me: ok ok. i'll get you later.
pts: make sure ah!! you dont forget again. if not i wont trust you fat people again.

yah, like your trust means a lot to me.

po-dah la!! pandi sutek na ket

anyway, i left the hospital in the afternoon forgetting to get him food.

and i dont feel bad bout it.

i feel death approaching

surgery posting is this monday

oh yes, im meeting HIM again

Toilet paper please, im chinese

i have a serious bowel problem. when i say i need to take a dump, it means i REALLY need to shit. no gaps or buts in between.

so the other day after having a huge dinner with a few friends, i headed back to the library to continue studying for my mid semester (coincidentally i was studying bout the colon and rectum). then out of the blue i had this great irrepressible urge to go take a dump. so i headed straight to the library toilet only to find that there were no toilet papers in all 3 cubicles. each student pays a quater of million and they cant afford to stock up toilet papers. i would have curse the college outloud in hokkien if i wasnt focussing my entire energy on my anal sphincter.

i had no choice but to run up to the second floor and use the toilet there. by this time my arse was on the verge of exploding and releasing whatever foul contents it held. and i didnt dare climbed the stairs 2 steps at a time for fearing that excessive spreading of my legs would lead to a toxic waste disaster at the stair well and ruin my image and my medical career even before it started.

so when i eventually reached the toilet, i rushed into the first cubicle, removed my pants and
PPPPRAAAAAAAPPPPPPPP...........poot....

ahhhhh!!! what a feeling. what a relieve. at times like that it makes wonder if the satisfaction you get from emptying your bowels is better than having an orgasm.

but when my right hand reached out to grab some toilet paper there was none. NO TOILET PAPER??!?!?! MAIII CHEEEPET!!!!

WTF!! does the college administration realise that chinese students make up 35% of the student population??? we are chinese!!!! we use toilet paper. we use pangsai chua. how to pangsai and not have pangsai-chua after that.

Kanineh!!! had no other choice but to cebok (thats ass washing to the uninformed). i grabbed the bitet and aimed blindly at my arse( i dont know how those buggars can aim without looking). when i squezzed the trigger, no water came out. not a single fucking drop.

ARRRGHHHHHHHHHHHHHHHHH

this is turning out to be a real nightmare. how the hell am i going to clean my ass now?? no tissue papers. no text book. no A4 pad. nothing. (back in secondary school, i was once caught in the same situation but i had with me my buku undang-undang. so....go figure).

this is a serious shit (literally) of a problem.

one option is to walk over to the next cubicle. since there is nobody in the toilet at that time and taking into account my dire situation, i decided it was worth the risk. now i cant pull up my pants and walked out cause that would mean soiling my underwear and pants. so i had to leave my pants hanging mid-thigh with my right hand clinging on to it while my left hand held on to the back part of my shirt. as i left my cubicle, i was hoping for 3 things:

1. that god has had enough fun with me
2. there is actually toilet paper there
3. and no one walks into the toilet at that time

and i was off.

it was crazy. i was like donald duck in a sprint race.

wobble wobble wobble.

and my dick was swinging like a pendulum.

thank god there was toilet paper in next cubicle. but before i could wipe my ass my hp rang.

me: yah harllo
mamat: hello MR tan!!! how you man??
me: eh mamat. i ok. eh i busy now. call me back later.
mamat: you busy with wat balls??
me: i making a "deposit" now la.
mamat: serious??! so late at night?? can ah??
me: ya ya ya
mamat: which bank is this man??

fucking moron!!!!!!

mindless conversation

me: oii mat
mamat: acam china pek
me: kucing you acam??
mamat: baik baik
me: boleh pinjam kejap??
mamat: kenapa pulak??
me: oh tak de la, anjing gua bosan.
mamat: bapak(stressss giler).....

World Cup fever

patient walks into the doctor's chamber limping with a broken lower leg...

Dr: aisay, asal kaki boleh patah?

patient: pasal macam ini. semalam masa tidur gua mimpi gua sedang main bola kat world cup. kat mimpi saya tendang bola tapi mana tau sebenarnya tendang isteri pulak.

Dr: ohh, pasal itu kaki patah la.

patient: oh bukan la. isteri bangun dan kasi patahkan kaki....

why England wont win the World Cup

Cranky Old Fart

two days ago, i was assigned to take the history and examine this 81 year old chinese(hokkien) man. buggar is the crankiest patient i've ever came across. he was admitted for shortness of breath and productive cough for the past 2 weeks. at the same time i noticed he had echymotic and purpura lesions all over his upper limb, lower limb and chest. so i enquired bout it and this was the conversation went

(conversation was in hokkien)

me: ah pek ah, how long you been have this lesion??
COF: lu see tenang ah?? (are you chinese??)
me: ah see see. wah see tenang lang(yes yes im chinese.)
COF: lu gong balak eh tenang la!!! lu men chai chee geh semua eh lau tenang lang pun tiok eh!!! haiyahhh. see beh gong eh loh kun lar lu!! (you stupid chinese la!!! dont you know that all old chinese men will have this skin lesion!! what kind of stupid doctor are you.)

according to his file he is also a known case of congestive cardiac failure, hypertension and chronic obstructive airway disease.

me: ah pek ah?? lu ooh see mee see mee pee boh?? (ahpek, do you have any other illness)
COF: boh la boh la!!! lu mai chah see chah lang la(no la no la!! dont bug me)
me: lu ooh chak yok boh??(are you on medication)
COF: ooh(got)
me: eh yok chak choh see mee leh?? (what are the medication for)
COF: AIYAH!!! men chai lar. (aiyah, i dont know lar)
me: lu boh mui loh kun ah??(didnt you ask the doctor)
COF: MUI LAI KAM LAN AH!!?? ee kong see mek wah pun boh bim pek. loh kun kioh wah chiak, wah mai chiak lor.Hai yah!!!(ask for what, to suck cock isit!!?? what he said also i dont understand. doctor asked me to eat, i eat lor. hai yah!!)

on his social history

me: ah pek, lu see kah siang kiah? (ah pek, who are you living with)
COF: kah wah eh boh kiah la!! na wei!! wah mui lo, lu see kar lu eh lau boo kiah see boh?? wah lau weh, lu ah. meng ang kan eh gong mee kia (im staying with my wife la. na wei!! i ask you, you are living with your mother right?? wah lau weh, you ah. asking stupid questions)

following day, when i was following up on him he just got up from his sleep and was drinking a cup of milo.

me: ah pek, kia nid oo kar ho boh?? (ah pek, are you feeling better today)
COF: wah lau weh!!! koh see lu lagi ah!! ho sim lu la. wah see puek chap it hueh liao la. lu eh sai hor wah see huah hee tampuk boh. mai lai cha wah la.( wah lau weh!!! its you again ah!! for goodness sake, im 81 years old now. can you pls let me die in peace ah and dont come and disturb me la)

death in the ward

two weeks ago, i had a patient who died on me. this was not the first time that a patient i knew died. what made this different was that i actually saw it happening in front of my own eyes.

i was about to leave the ward with the rest after a massive round of ass jacking from our orthopedic lecturer when we noticed the emergency. so some of us thought of staying back and skipped lunch to see and gain experience on managing an emergency case.

the poor guy was involved in a road traffic accident. according to friends in the A&E, he was vomitting out blood there. the doctor thought they had stabilized him so they shifted him off to the ward. that decision probably caused him his life.

once in the ward he was coughing out massive amount of blood. when the doctors inserted a tube into his lungs, blood came gushing out. within a minute or two, there was more than a liter of blood in the container. they had to clamped the tube to control the blood lost while they arranged for a blood transfussion. in the mean time, the patient became restless and started to struggle. so they had to restrained his arms while me and a few others held on to his legs. blood was just pouring out from everywhere. his lungs, his ears, his iv line and his pants were soiled with urine. he probably was bleeding into his abdomen as well cause from visual inspection, it was grossly distended. CT scan revealed a skull fracture.

in other words he was a goner no matter what.

as the doctors tried valiantly to resuscitate him, he suddenly just stopped moving and went blank. his eyes were opened and was starring blankly into space. then his heart stopped and his PO2 stats started dropping. one of the doctors started doing cpr while the rest continued to resuscitate him. the blood lost was so massive and quick that the doctors had to manually transfused the blood by injecting it straight into the veins instead of letting it dripped by itself from the beg.

in situations like this and in everyday life, i feel very useless if i just stand there doing nothing. since cpr can be tiring after a while, i asked if i could help them with it. and they allowed me to do it. i've done cpr many times on a mannequin but having a real dying person under your hands is totally totally totally different. i have no problem recalling on my earlier training but the difference between a dummy and a real life person is that you can break a man's rib if you do it to hard.

and thats what exactly happened to me.

i heard a bone cracking sound under my hands and immediately felt my hands tensed and turned cold. did i just break the man's rib??? the question kept on repeating itself over and over again in my head but my hand kept on with the compression albeit with lesser force. then this female doctor whooped my ass from behind and said, "eh kenapa lemah sangat?? you tak makan ke??"

"takut patah tulang dia nanti," i replied

"tak pe. kuat lagi."

so i went backed with the original force of compression but within a few minutes i heard the same cracking sound. and the whole mental torture raged on in my mind. i told myself it couldnt be a fracture cause the chest contour and resistance was still the same. i did it just so that i can continue with the job at hand and not be paralyzed with guilt and self-doubt.

after 30-40mins of cpr and other forms medical resuscitation, the guy's heart still failed to beat on his own and he was declared dead. his family members who were near the bed were informed of his death. we just moved away in silence.

at that point i was not sad or anything. i didnt even know the guy in the first place. i was just worried that i did more harm than good. and somehow or rather by my inexperince, i helped pushed him to the other side. these issues bugged me for two whole days. it kept on creeping into my mind and every attempt to shrug it off was futile. friends told me it probably the sound of the the bone moving in the joint space, just like when you crack your knuckles. and if it was a complete fracture, the chest resistance and contour would be different.

the issues was finally put to rest a few minutes back when i spoke to a dear friend who is practicing medicine in the UK. she said the A&E doctors there told her if you dont break at least a rib during cpr, you are doing it wrongly. it indicates that you are not compressing hard enough hence blood flow to the rest of the organs is insufficient. and judging by the severity of the patient's hemoptysis(coughing out blood) he probably had a couple of rib fracture from the accident itself.

whatever it is, it was a good learning experince. i just wish it wasnt such a traumatizing one.

breakin a bone

after spending 3 weeks in the orthopedic ward, i've come to two conclusions:

1. i will never be an orthopedics doctor
2. i never want to break a bone

breaking a bone is not something nice. getting the bone back into place is even worst. 100 times worst!!! especially if you have a low pain threshold level like me.

i have no problems looking at disfigured and deformed limbs. but the treatment, lord god....

if they say surgeons are butchers, then orthopedic surgeons must be the king of them all.

there was this guy(who looks like a bangla but has a Jamaican name) who broke a bone in his leg. so they had to do something called below knee skeletal traction where they connect a weight(around 5kg) to a metal rod in his leg. in order to that, they had to manually drill a 10cm steel rod through the guy' leg just below the knee.

they gave the guys some anesthesia over the area and they proceed to drill the steel rod into the skin through the bone and exiting on the other side. drilling through a bone is no easy job. on a scale of 0 to 10, i will say its around 12. one doctor will be pushing the guys' leg and another doctor will drill the rod from the opposite side. if ever these doctors loose their license to pratice, i bet they wont have problem getting a job Petronas CariGali.

it took 3 doctors to complete the job. there was a female doctor who tried drilling the rod through but i seriously doubt she contributed anything to the cause except to cause more pain and misery to the poor guy. below was the conversation that took place during the procedure:

D1: kasi kuat lagi!!! kuat lagi. ah, tangan jangan bengkok. nanti rod senget boss marah.

D2: ERGHHHRHHH....sial la!! tak boleh masuk!

D1: kakaka...kau ini lemah la. suruh pigi gym tak mau. ah X(akaD3) baik kau warm. nanti you punya turn.

*D3 really starts doing stretches while D2 continues to drill the rod. at the background, you have the pseudo-jamaican patient muffled groans.

D2: ARRGGHH....huh!huh!huh! wei penat la. hahaha. betul betul tak boleh la.

D3: ah biar saya buat sekarang.

D3 starts drilling with a vengence.

pseudo-jamaican: argh.....

D1: ah lagi lagi!!!! kakaka....fulamak. ini X kurus la tapi kuat macam badak.

pseudo-jamaican: argghhh....

D1: lagi lagi!!! jangan stop!!!

pseudo-jamaican: WARRRGGHHHHHHHHH.....

D1: apa pasal you jerit???

pseudo-jamaican: wah, banyak sakit man.....

D1 looks at the patient's leg.

D1: oh, rod dah hampir keluar. kasi dia bius....

skeletal traction....its the same thing that the bangla got.