obstruction

this is just to reassure/ worry the population that i am still alive, you won't be one houseman short.. haha.

just spending time distinguishing between a PUD and a PDU. hence the non-replies on face book.

it felt oddly familiar, stepping into the ttsh washroom.. and suddenly remembering that i was here on the first day of clinicals almost 3 years ago. when i looked into the mirror, so startled that took few steps back. the image scared me. well, partially from the newfound eyebags.. but mostly, from that hunger and determination in those same eyes that were so filled with trepidation some time ago.. the look of pure alertness despite 4hrs of sleep, of wanting to want more, of "i will deal with the problem". the look, of someone who was ready to be a doctor (almost).

but really today's test took the cake.

don't know how i remembered all the anat /mb/ gs during the grilling...

mr k : imagine, you are the surgeon in the ot..

me: *gulp*

mr k: you open up, the tumour has spread to the ureters, bladder and retroperitoneum. what would you do next?

me: er.. resect the colonic portion.

mr k : you can't mobilise.

me: *oh! i know!!!* we could place a permanent colostomy

mr k : but you didn't counsel the patient, and he doesn't want one. so how????

me: *ok, i really don't want to do surgery. but. i. don't. have. a. choice. so li fang, think..*

and in that instance, i really saw myself in the ot, with the patient on table, and almost with diathermy in hand.. and the answer was suddenly obvious.

me: (in a voice not my own) i would resect the portions proximal and distal to the tumour, and do an end-to-end anastomosis, with a temporary ileostomy.

mr k : good.

where did that come from?

was it.. my m3 tutorial, but wait, i didn't read through them..

hm, could i attribute it to God's grace then?

it must be.

as for everything else, can't blog without make it melodramatic haha, so won't go there.

but the time spent in kluang and gunung lambak was so so wonderful and timely. and cheap. break from studying? and fellowship? anytime!