Med school (mis)adventure #2

You know sometimes when you're sick but instead of seeing a doctor, you type your symptoms into Google and the search results tells you that you have a serious disease and only a few months left on Earth?

It tends to be worse in medical school.

Now, every person ever who has attended medical school has a story like this. This is mine. Some time ago, I suddenly woke up in the morning with chest pain. The pain wasn't present the night before. The human body is liable to aches and pains every now and again so I thought "It'll go away in a few hours".

It didn't.

So then I thought "Ah sleep is when the body rests and repairs itself. I'll probably feel better tomorrow". So with some discomfort due to the pain I fell asleep. I awoke the next morning still due to pain. By that point I was a little worried but still thinking "Give it a couple of days. It'll blow over".

I was wrong.

It was worrying to me because I was experiencing sharp-ish pain near the left 5th intercostal space midclavicular line. Which is a fancy way of saying about over the heart or apex of the heart to be exact. (Literal heart here, not taking about oh she broke my heart oh boohoo kind of heart)

And ladies and gentlemen, pain around your heart is usually not a good sign.

"Wow, thanks Captain Obvious", I hear you say. Am I hearing voices? The psychosis setting in.

Anyway, I started to wonder if I had been eating right and exercising enough prior to this happening. Trying to trace the etiology of this event.

The pain occurs on breathing so that kind of ruled out a heart problem. I just checked that by holding my breath but well, studying the things I do... doesn't make me feel better about the possibilities.

At worst it was cardiac problem and less worse would be a lung issue. I was experiencing pleuritic chest pain or at least I think I was.

By day 4, I couldn't stand the worrying anymore so I went to a clinic to get a check-up. The doctor did as doctors do and told me my life changing diagnosis. I had costochondritis.

Costo freaking chondritis. For shame! By this point I'd already been in med school for several years.

Sigh.
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On another note, a friend had a birthday on April 2x. This friend is also studying medicine.

Thinking I was being clever in using some medical humour, I texted (paraphrased) -

Me: Hb 2x.4 *
Them: Thanks!
Me: What for? Haemoglobin (Hb) 2x.4 g/dL. Just saying Polycythemia.
Them:
Me: It was a good joke though right?

*supposedly short form Happy birthday 2x day of April (4th month) so 2x.4.

This person still doesn't talk to me to this day.

So there you go people. Whenever you think its a good idea to use pun-based humour, don't. Especially if its medical puns.

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.