Internal
Medicine is over. For this year at least. 8 weeks plus 1week exam. Khalaas.
This post is
also rather old but I promised Fadiosis a post on Internal Med so here goes.
Pelonomi
Hospital – General medicine.
The reality
of the HIV/AIDS struck me here. We get really excited when our patients
actually test negative. It’s true. And it’s sad. The biggest need is to get rid
of the stigma attached to the disease. If people start accepting Aids like they
accept diabetes and come for tests earlier, then we can use ARVs as Allah has
provided us. Which (just like diabetes), doesn’t cure but controls the course
of the disease. Ok, let me get this
clear – I am in no way condoning promiscuity – it’s just frustrating to see so
many people discarded for palliative care. And often patients are
victims of their circumstances. Sigh.
Anyway, the
three weeks at PH were long and tiring. Pelonomi is hot and sweaty, devoid of
purposeful air-cooling systems and lacks stock. Get used to making do. This is
Africa. Also it seems to be constantly under construction so you have to
quickly learn the labyrinthine ways of getting around. At night we have a security guard that escorts
the girls around because of previous ugly incidents.
But all’s not
bad – the consultants & regs & interns are really cool and I learnt a
lot.
Endocrine (Univeritas Academic Hospital)
You never
want to get fat after rotating there!
Geriatrics (UAH)
It happened
to be my birthday again during my rotation at geriatrics. (On a side note, one
of the birthday messages I received said I should count years by the number of
friends I have. Bleh. By that calculation, I should be dead already.) One of my
patients was quite excited about it being my 21st birthday. I smiled
fakely at her - my thoughts were contrary to this big smile. As a child, I always
yearned to be older.*rolls eyes. And to reach a super-old age like my grannies
(86 and 90years)(May Allah grant them Jannah). I associated old-age with
wisdom, experience and big families. With being retired and having free time to
recite pages of Qur’an. True, it is an opportunity to be forgiven. Naively, I
associated it with being without responsibility. I didn’t think that loss of
elasticity meant more than wrinkles. It means being blind and deaf and
incontinent and demented. It means being dependant on other people’s good
nature and values to not laugh at you when you say something silly, to be
patient when you can’t hear. To walk you to the bathroom in case you fall and
get a death-sentence-hip-fracture. To speak for you coz most people can’t understand
what you’re saying after that stroke. You are stiff all over. Your hands are
tied coz the nurses complain about you pulling out the drip. The problem list
fills the page. Somehow, you seem in the way.
I don’t want
to get old.
View from Geriatric ward, Universitas Hospital. Lol, I can see my flat in this pic!
Haematology (UAH)
The haematologists
seem to be the happiest people around (and the cleverest IMO.)(All the internal
people are too clever. I could never specialise in Internal Med – its too
clever). Shame, the dr that assessed us at the end of the week kept asking us
if we were satisfied with the mark he gave us. He really felt bad about the
possibility of under-assessing us. J
Imagine me saying: “I don’t like this mark.”
:D
Neurology (UAH)
I think I
could probably write a separate blog-post for each one of the patients that we
saw in our two-week rotation here. Neurological disease always seems to touch
some softer part in me – I really pity most of them. Or indeed, I more admire
their resilience and strong coping mechanisms. Neurology is very interesting but
the frustrating thing for me is the most you can do for your patients is
diagnose their condition and identify the lesion. Not many treatment options,
many of the available treatment options have such horrid side-effects.
The OSCE
The most
stressful thing ever. Read the question, enter the room, examine the patient
with a commentary, say what you find and think the possible diagnosis and get
out. Total of 6minutes. 9 patients (plus
7 rest stations).
Station9
This was my
first one and I’m glad coz it was the easiest give-away BMI & blood
pressure measurement. Wow, they even
have a stethoscope with two ear pieces so the examiner can also hear those
korottkoff sounds!
Station1
In
retrospect I feel like quite an idiot for not identifying the mitral stenosis.
The dr was trying to give so many clues and I still didn’t figure it out.
Whatever.
Station2
COPD – this station was fun enough. I had episode of blankness – not knowing what to do
next. Then it all came back in time so Alhamdulillah, went wellJ
Station3
I thought I
would have failed this station (surprisingly I didn’t). I’m not sure what I was
doing or what was wrong with the patient L
Station4
Our
instructions asked us to complete another respiratory exam – and apparently the
patient had SLE. I didn’t get that far. Lol, the dr had his eyebrow raised
throughout my examination –not a good sign.
Station5
Thyroid exam
– honestly wasn’t all that bad. I could have given a better differential though.
Station6
Examination
of lower limbs – patient had spastic motor paralysis. And hyper-reflexia. Also
wasn’t all that bad.
Station7
This patient
had the most awesome lymph nodes ever. I never felt such large ones before!
Missed the epitrochlear one though.
Station 8
The epic
fail station. Abdominal exam. There was no way I was going to know what was
going on that obese patient in less than 5minutes. I had no clue what I was
palpating there. I got nervous. And I failed L.
I heard afterwards that saying the examination is difficult would have got you
some decent marks. Abdominal exam and I scarred for life.
We had to
get over 60% and fail only a max of two stations in order to promote. Alhamdulillah!
I promoted so I don’t have to go through that torture again. Well... at least for Internal
Medicine. JJJJ
