last day.

ahh, last day already. ): ): ): ): ): ): i really enjoyed this attachment, thanks to all the doctors who guided me everyday. i really really want to be a doctor now :\ nvm, shall talk about that later. i wanna put all the memories into words first before i forget.

today, the last day, im attached to dr lee guan huei, a gastro registrar. all i can say about him is that he is very friendly, and very patient! among all the doctors im with, he is the one who explained about the medical stuffs to me! although he said, there is no point of he explaining to me cos 1st, small chance ill be accepted into med sch, 2nd even if im accepted, i may not take gastro. but in the end, he really answers all my questions and explain to me about EVERYTHING! today was whole day of scopes, and EVERY scopes he explain to me everything. so so nice. now i think i can read scopes! abitabit :p

first few hrs was ward rounds, with dr lee and also prof ho. because he is a registrar, he need to explain the patient condition to prof ho, so he have no time to explain to me, it end fast. then we went for liver biopsy! i din know that the technique to do a liver biopsy is very unique! with 3 tries, he managed to get a clean sample of the liver tissues. first, he inject the anesthesia, and at the same time try to locate where is the liver. after that, he took something that looked like a penknive to make a small cut. then he use a bigger syringe, go through the cut, locate the liver, ask the person to inhale, at with one swift motion he push the large needle in, using some force, and taking it out with a little bit of suction. then the tissue will be inside the syringe. woo exciting. and then we went for scopes! the most interesting scopes in this whole week. (:

scoped from around 11am till 9pm today. whoee, but it was not at all boring! because dr lee was so nice he let me stand beside him and he keep explaining. very interesting, eye opening, and he told me alot of thing about medical stuffs (:

i got to see, as usual, some polyps, that he removed using a hot snare, and hot forceps. there was this patient with 3 humongous (relatively) polyps around the antrum, really big and red. dr lee asked a consultant for her opinion, scared that it is malignant and will cause excessive bleeding. finally he only took multiple biopsies from there and also some urease test. still bleed quite alot.

i got to also see some ulcers, both at duodenum and stomach. theres one particular big ulcer on one persons incisura, i guess its really painful cos theres alot of stomach acid there :X removed with adrenaline injection (to contract the blood vessels) and then using heater probe to burn the ulcer.

there is this one particular lady who i really pity, everyone think she is abit crazy, and also bulimic, totally skinny, and when we enter her oesophagus, from upper to lower, all evidence of acid reflux. scary. really. when we enter the stomach, it was full of food leftover, we were saying, this lady never do her preparation well maybe, still drink and eat. but as we continue to go through, sucking all the liquids to find the antrum (entrance to the duodenum) we cant find it! and finally something appear beneath the food leftovers: entrance to the antrum, just that it is blocked, by a huge tumor. and dr lee, after seeing it, said that more than 90% chance that it is malignant. took multiple biopsies, sent for histology. never proceed to duodenum because even the food cannot go through. i cant imagine the pain and the vomitting she endured. :x i must take care of my body.

theres one unusual case also, one man, when we enter the antrum, we saw two ways! left and right! (if you know, there should only be one way, which is to the duodenum.) it turns out to be a really really big diverticulum. (which usually is found in the ending part of the colon, sigmoid) lucky dr lee can tell which one is the diverticulum (theres a vegetable stuck there), and to entertain my request, he removed the vegetable xD haha, i complained that if it is left there, later there will be infection xD haha, he told me he is not required to remove it (because anyway later something will get stuck again) but he still remove it because of my request! wah i feel so honored :p, anyway, if you enter the wrong hole, the thin lining can burst. and the person will straight away be sent to the emergency surgery. haha.

haha, yea, stayed all the way till the end today! finally! i feel so accomplished. it was really fun. i wish i can be a doctor one day :\ i wanna scope myself! haha, dr lee said that to get from stomach to the intestines, theres one research said that it depends on how long u spent gaming! HAHAHA, i feel quite confident now :p haha, it was so fun predicting how many dose of midazolam and fentanyl to give to the patients, and the nurses went higher and higher as the night come, so fun lah! keep laughing, i helped to push the patients down too! haha, keep making fun of the patients xD oops actually cant do that. and joke joke with dr lee too :p and the nurses keep calling me doctor also. ahhahaha, so so fun, they are funny :p

aniwae i just confirmed that coffee doesnt work on me! grr, today drank 2 cups during the endoscopy, when i got onto the bus, ZZZZZZZZZZZZZZZZZ.. hahaha, i want to adjust myself to doctor working hours (which means no lunch, and dinner at weird hours and coffee all the way xD)

and i met dr martha again today! in surgical outfit, she said it was her pajamas! haha, she is still a house officer, 3 days per week stayover in hospital. she again said to me if im not 100% sure, dont apply. dr lee also said that.

but im 100% sure now :x grr. irritating.

okay now lets talk about yesterday.

wards and clinics, nvm la, not so exciting, the exciting part was the liver transplant surgery. its killer! hmm we started at 1pm. liver is harvested at around 10am in the morning, so, dr chang started to cut the patient. different from what i thot it will be (with a scalpel like in movies), they used some heat/electicity thing to burn and cut. and i tell u, the intestines really flows out when the stomach is opened. the small intestines. haha, if u cant take it i guess u will throw up. the medical student beside me said that during her first year, when she saw the internal organs, the colors, etc, she cant eat chicken for one whole month. traumatized. haha, she asked me what i feel when i look at all those, (small intestines, large intestines, liver, bile, stomach, etc) i dunno what to say, i dont really feel anything. haha, she asked me whehter i feel dizzy. i said no. and she also asked me wheter im okay with the smell

(got alot of different smells in hospital, the one i really like is the alcohol swab smell xD, and different wards got different smell, different division got different smells, of course during surgery got blood smell, and the strongest smell is the burnt tissue smell. which fortunately, is the same smell if you ever used an electric racket to burn a mosquito/fly, yea that smell. and also fortunately, i like that smell xD) haha, so its quite a pleasant smell in there (except when u start thinking that its human flesh :P)

so, what can u see basically is the overflowing small intestines, the jejunum. and also small part of the large intestines. the abdominal muscle and tissue is quite thick, (therefore i conclude that the comic, battle royale is completely fake.) yea, and its really quite disgusting, the flesh. one gory part is also when they pull the rib upwards with a retractor. it just look like its breaking xD oh and this time, the surgery was bloody. bloodily BLOODY. during the time i left, the blood sucked out is nearing 5L. imagine. bloody. and its spurting out here and there, on the surgeons robe, gloves, and even eyes. but seriously, i dont mind being a surgeon (: although i prefer just being a doctor. haha, you really should see. not for the faint hearted, but if i were to say, after you see the real thing, the ones in the movies seems like a PG show.

but maybe i also need to thank saw, saw II, saw III, saw IV, hostel, and hostel II, and other gory movies for their training xD ahahahahahahah.. no, wenhao im not a hannibal lector.

so basically, 1pm we started, and at 4pm, dr chang was requested at the other OT, so i followed him. when i went into the other OT and see the body, it was even more gory. hahaa. the stomach is opened, totally opened i mean, like u cut them in the centre with a + symbol, and then retract all the corners, and bring it up. so there is like a BIG hole in the stomach, and all is pulled up! wah, when i see, i was like, woa crap man, so eerie.

ok i managed to somewhat illustrate it. ahahaha.

but i learnt alot of things too (: like how to scrub, green means sterile, etc etc. but anyway not important. being a great surgeon, dr chang quickly finish it and by 530 he is back at the liver transplant. but theres one irritating surgeon, again from india, took over dr changs place. wth.i bet hes the one making it so slow. dr chang said that probably by 5pm, the new liver will be in. but in the end, at 6pm, the old liver came out. it took 1.5 hrs more to close all the open veins and arteries, at 730, the new liver is put in, and by 830 perfusion of liver is completed. but theres still a long way to go and dr chang ask me to leave first. haha, so i left at 10pm. where the operation havent finish yet.

it was definitely an eye opener experience. that made me die die wanna be a doctor now :X okay, i dont mind wasting one year and try to find other alternatives to pursue my dreams (: pray for me! (x

a very big thank you to ms jasyln, dr reuben, prof ho, dr eric, dr dan, dr chang, dr lee, dr martha, and everyone who has guided me throughout this one week. this experience is really invaluable. thank you.