Learning from our own faults

My encounter with Dr L dates back to year 3.

Dr L is a young and aspiring medical officer in Clinical Oncology. I met her during my first clinical rotation in year 3, i.e., when I was clueless about what's going on in the wards. My first impression of her is that she speaks with tremendous speed, but with focus and clarity. From her, I started to grasp the basic skills on presenting clinical cases.

Coincidently, my first rotation in year 5 is again, Clinical Oncology, under the same team as Dr L. "Oh so now you're in Med 5? Time flies pretty fast!", Dr L said to me. I was secretly jolly that she recognized me. Afterall, I am only one of the many insignificant medical students.

On the third day of attachment, I volunteered to present a case at the Grand Round. I was confident to do so because Dr L had kindly ran through it once with me and told me what to focus on. After the herd of doctors listened to my presentation, the head of department Dr C raised a question. "Which complication are you particularly worried about when you're removing the pigtail drain from this patient's chest?", he asked. I nervously hesitated and mubled a few words. Then I saw Dr L standing at the other side of the bed; she was staring at me sincerely, and she kept nodding gently. I could be wrong, but I felt that she really hoped that I give the correct answer. "Pneumothorax," I naturally replied. The head of department gave compliments. But to me, it didn't matter nearly as much as Dr L's single compliment after the round. It feels like she has witnessed my growth in the past 2 years.

Two days ago, I randomly discovered that the doctor involved in a recent major medical-legal case (where a chemotherapy agent was errorneously injected into the patient's spinal fluid causing death), is in fact Dr L. It broke my heart. It occupied my mind since then.

It broke my heart, because a doctor as competent and devoted like Dr L is still susceptible to human faults causing medical incidents as such; and to imagine the psychological burden of Dr L (and the patient's family) is painful. In this profession, unfortunately, our faults may often result in harm.

I asked my mom if it was socially appropriate for me to say a few encouraging words to her. My mom suggested it might be awkward. She may not know how to respond to a student's comfort.

We all have faults. When we are forgiven, we forgive ourselves as well, and we strive to improve ourselves. I hope Dr L will stay strong and leave the past where it should be. Each time I look into her eyes, I see a nice and caring doctor, and I know she will only become a better physician in the days ahead.

Tissue

In medicine, its always a good idea to carry a packet of tissue paper. For me, I believe it is as important as the stethoscope. This is my rationale:

The item is essential in the wards or out-patient clinics, since the hospital tends to have very cool A/C, increasing the chance of having runny nose. To make things worse, I'm stuck with chronic allergic rhinitis, hence I try to avoid having thick mucoid secretions all over my face during an examination or a case presentation (that would not be very professional).

Furthermore, it is very useful in clinical scenarios. I often find myself in situations where the patient or their relatives are crying, especially during my clerkship in Oncology and Psychiatry. Most of the time, my inadequate EQ and counselling experience renders me nervously silent. The good news is - handing over a piece of tissue paper in these situations would do the magic.

This is what I learnt most from Clinical Oncology in year 3.

Paradise

What's the rate for a night in paradise? It seems to be an over-simplified solution to reach that destination.

Social anxiety

Today I asked myself a question: do I suffer from social anxiety or social phobia?

The question stems from my occasional inability to start a conversation with particular persons, and that is often accompanied by a cascade of debilitating physiological responses. For instance, N is a respected musician/photographer that I bump into frequently at local band concerts. In the past 2 years, N and I conversed many times and exchanged photographic ideas via facebook. Yet, whenever I see him in real person, I remain silent at a distance just to combat my palpitations.

Colleagues from the medical profession would be familiar with the ICD-10, a guideline published by WHO for diagnosing psyhiatric illness. To answer the above question, I quickly reviewed the relevant chapter. Well, my symptoms are insufficient to make a diagnosis, but it is still striking that I fulfill a number of them. Unfortunately, the guideline does not offer any sort of advice.

An interesting point to note; Social Phobia is associated with a few peculiar symptoms in the feared situations: (i) fear of vomiting and (ii) Urgency or fear of micturition or defecation. That is a horrible kind of fear.

Mouse on the keys

Mouse on the keys is a trio from Japan composed of a drummer and two keyboardists. They intelligently combine jazz with math rock, post rock and some other influences, creating an experimental fusion style.

Intelligence and beauty

A friend of a friend is running for this year's Miss Hong Kong Pageant. While my friend despises her, she is apparently one of the most popular candidates. I did a google search about her - and I came across this in her official TVB profile:



It's quite hilarious to see an intelligence scale in this context . Logic dictates that a person who scores 2 or above in that scale would not enter such a competition, so why spell out the obvious?

Furthermore, how on earth did they assess the IQ of the candidates? Certainly an objective method like the Wechsler Intelligence Scale was not used. I imagine the panel of judge relied on their gut feelings -

'Wait, this candidate looks dumb. Let's give her 1 out of 5."

It's funny since the diagram reminds me of RPG (Role Playing Games) or strategy games. The level of difficulty of the bosses is usually represented by these diagrams, usually in terms of attack, defense, agility, magic power and HP. These are probably more useful parameters to measure a person anyways.