Med school (mis)adventure #1

Recently, I had my first experience of being “on call” at the hospital. I don’t know why it’s referred to as being on call though. It’s not like I’m an actual doctor who is on call for emergencies, etc. Maybe because it’s on the weekends. I thought the university would slowly ease us into going to hospital but apparently not. The 1^st week and already I got on call.

My current posting is medicine. Medical school has a subject called “medicine”. Imagine that.

The hospital is different at night. A lot easier to find parking, for sure. Less people around as well, slightly creepier as the hallways are quieter and some parts aren’t well lit.

As a student, I’m just required to clerk the patients and perform an initial physical examination if I think that would help me get a differential diagnosis. It all hinges on good history taking in the first place and I haven’t had much practice of that. The houseman says it’ll get better with time and that’s probably the case.

Many of the patients interviewed didn’t provide me with good histories. My partner and I randomly chose 6 patients to clerk and 4 were scheduled for discharge, 1 gave a good case and another was schizophrenic. The latter patient was giving me confusing history until I asked if he was on any medication. He said ‘olanzepine’ which is an antipsychotic. Then the confusing history made sense. In a roundabout way.

The patient that gave a good case sort of scolded me, I guess. So I and my partner were asking the usual questions then I got to asking if he had any other medical problems. He replied “semua ada” (all got). The patient being a middle aged man, I assumed “semua ada” means diabetes, hypertension and heart problems. I was right and that’s when it went wrong.

So I then asked if he was compliant to the medication regimen for those things. He then said, rather loudly “you belajar perubatan tanya soalan pun tunggang terbalik. Kalau tak ambil ubat nanti mampus lah” (you study medicine also ask nonsense question. If don’t take medicine then die lah).

I wasn’t embarrassed though. I was annoyed more than anything. There’s a reason that is a standard question and the reason is that many people either don’t take their medication at all or don’t take them exactly as prescribed.

My colleague continued the interview from that point onwards. As much as I would have wanted a shouting match (he was hard of hearing) in the ward near bedtime, it probably wasn’t a good idea. The experience wasn’t very pleasant but he did give a good history so it worked out for me. One “on call” down.

I’ve still got a long way to go.