psychiatry exam

another 6 hours to go....

stress...

surgeon:)

Last day of elective practise in surgery,plus the 1st time assist in operation!
operation was opened cholecystectomy by Kocher incision!
i was allowed to do stitching!this was taken when i was helping to retract the costal arch!
it was a fruitful day for me!

(plus,on call with sir Panin stanilov,he did 3 urgent operations during midnite!cool!!!)

surgery

外科(surgery)终于告一段落，心中还真有点舍不得这位严师。
实在难以表达对他的那一份敬佩与钦慕。

他的严肃是众所周知，他每一堂课都问得每个人头昏脑涨，但却富有挑战性。
尽管如此，他把我的压力化成动力！
我对外科的兴趣又再更一层楼了！

他严肃，有时也有逗趣的时候，
有一天看到他膝盖上的伤口，也不懂如何得来，
他孩子气地拉起裤子观察他的伤口，
素不知被我发现他的神情举动，
他突然看了看我，两人不知所措之下，突然两人大笑了起来！
真是搞笑！

希望有缘可以在跟他学习！

surgery

在俄罗斯要真正examine 病人，常常得看老师，护士，病人的脸色，往往得挨骂，最后还被拒绝，所以常常得厚着脸皮走向病人。
这一天elective practical，到了surgical department，总算有学到一点东西。
我与同伴看了两个癌症病人，一个胃癌，一个还没找出病源。
胃癌的病人，已经消瘦到皮包骨了，胃口大减，只能依靠水分补充养分，在palpation可以看到病人喊痛，也触摸到硬块。老师便安排病人去找胃镜，让我们见识什么是癌症。
看到病人努力的却忍痛地吞下胃镜，他的眼泪都要流下了，我们要负责安抚病人的情绪，也要同时按奈自己的情绪，老师也快准狠的第一时间找到tumour的localization-large curvature of stomach.即时在当下作了biopsy,送去lab进行化验。
事后，病人当下就变得更弱了。于是带他回病房好好休息了。

再来另一个，病人已发烧三个星期了，胃口有稍微变差，便秘了整个星期。病人有过去前列腺腺瘤(prostate adenoma),已做了prostectomy前列腺切除术，老师担心过去病症复发，癌症转移到大肠或其他部位，便老师让我们做了直肠检查rectal examination,看看有没有肿大或流血现象，幸亏一切正常，于是又待考察。

生命无常，下一次是否可以看到他们吗？

Babies

pediatrics cycle
babies,please be kind...

眼睛课

进了opthalmology这posting，
日子变得更加颠倒，
看到朋友草草了事，过一天算一天，反正考试还是可以顺利完成，
在俄罗斯读书，就是这样，完全自由选择自己的读书方式

我倒可以选择过那样的生活，
但给自己的交待呢？
自己以前的理想去了哪里？

还是坚持吧
至少是给自己有了交待。

再难过的日子 还是会过去的
opthalmology!我跟你拼了！！

VE

今天是去到妇产科实习，
每次走到怀孕妈妈们，都感到很紧张。
今天妈妈们成群结队地在我周围谈天，看到她们大大的肚子向着我，
突然感到有点窒息。

天哪，我可以落荒而逃吗？....

突然老师说要让我做VE(bimanual vaginal examination)-阴道检查
什么？ 天哪，我又兴奋，又紧张，又害怕....

老师牵着我的手，慢慢把我的手放进阴道里，
慢慢的跟我解释如何检查阴道，
41岁的妈妈（ 高龄产妇），小孩已38-39星期了，
宫颈还没扩张，但阴道有出血的状况，
过去有胎盘早剥(abruptio placetae)的历史，
可能不排除有难产的可能性。
可能需要 剖腹产 (caesarian section)，又待观察小孩情况。

妈妈露出担心的表情，老师耐心地安抚妈妈，
看了真有点感动。
终于深深感觉到妈妈们真的不简单
她们总是先关心小孩 而不是自己的健康。


真的很感激老师给我机会学习，
这是很难得的经验，
也许对很多医生来说 这是家常便饭，
但对我而言 我上了一堂宝贵的课。

planning for step?

After months of thinking,i decided to take USMLE step 1.

will start preparing it after my ENT exam and winter holidays.
of course,this big decision comes with fear and hesitation...
but i know i can change this.

take a deep breath in,and keep trying.
i will come to you!

medical students

We are high-strung, "type A" personalities that seek perfection in ourselves and everything we do. When there is a dent in the armor we are quick to hide the flaw in any way possible, in effect hiding the "imperfection" and living in denial.

Medical school is hard. We have worked endlessly to get here and we work even more just to stay here. The list of reasons why it is so challenging is long. We stress about the current work load in the classroom or clinic, the future residency or career we have not yet obtained, and our past experiences or grades that may keep us from meeting these goals.

As if that is not enough, we have relationships to feed, family to nurture, and service or occupational responsibilities to fulfill. Mix it all together with little sleep, high expectations and the occasional public mistake and you have the perfect recipe for burnout or depression. The study authors state, "Medical students experience depression, burnout, and mental illness at a higher rate than the general population, with mental health deteriorating over the course of medical training."

Medical students are stubborn. We want to put forth the image that we can hold up the world even when everything inside is falling apart. Worry that peers, residencies or future employers will view oneself as inadequate if depressed simply compounds the problem. Rather than seek needed assistance, students will flounder alone to avoid stigmatization.

As students, we can carry a lot on our shoulders, but this does not mean we have to do it alone. Medical school is intended to be difficult, because one day we will be responsible for the health of someone else. This education is difficult and can often lead to depression among students. If you need it, take time now to heal yourself so that you can function at your optimal level later. Hands down, this is the hardest thing I have ever done in my life. It is also one of the most rewarding experiences of my life. Focus on the positive and hang in there, you can do it.

from
Joshua Batt medical student
Touro University Nevada College of Osteopathic Medicine,Las Vegas,Nevada

very true...:)

2010结尾篇（2）-medicine

2010最尽责的老师-Olga Victorovna

不知不觉在她言教的一年半
成长了不少
她让我跌进谷底
过后在扶你一把
让我感受到苦尽甘来！

2010最莫名其妙的老师-Alfarova
但她还是那么可爱....

2010大手术

虽然病人只是一只猫，但它还是个生命！
对于初次动刀的经验，体验到当surgeon的经验！

2010 最惊心动魄的场面
在实习的期间，被医生临时叫去procedure room,目睹了这病人的伤口。
在搞不清楚情况下，还被医生当场考了考:" what you can see from this wound?"...
"erhhh..tendons are tearing off and pulsation of artery..."吓呆了。
"Now,hold the hand,and nurse,assist him and clean the wound"
医生检查了伤口，就把这"烂摊子"交给我和护士！
花了不少时间 洗了伤口，打了止痛药和ATT,包扎好了就送病人去surgical 了。
虽然不是什么大case，不过还蛮有成就感的!haha

还留了照片作纪念！不好意思。。。


2010- 至今还是搞不懂的东西

与CT scan 永远沟通不了，smiling face,crying face...congestion?...一头雾水。
那天，还记得又被医生打枪。
唉，就有待努力吧！

即使还有很多不足的地方，希望在来临的2011勤能补拙！加油。

续。

medicine

a HO is asked to do a presentation about acute MI on 8.30am,every HOs in the department and me were there for the specialist.

Hmm,not a good start,she couldn't even draw a nice ECG waves.
and she forgot some leads correspond to the site of infaction.
she started murmuring,was looking for help from her colleagues..

the specialist started yawning...
" semua doctor baru inilah yg dari oversea,mesti pergi travel sana sini masa holiday,tak study baik-baik.i wonder how you all pass your exam?"specialist started rumbling.
"which uni are you from?"(what?!is she talking to me...")....
"Russia,doctor..."everyone was waiting my answer.
after that,the hall back to quiet again..
am i making the atmostphere worse...

"now you can see how your senior perform here ahh,makesure you study properly before you'll meet me next time"....is she warning me?....
i just smiled and nodded my head and better kept quiet..

i wanted to run away,but i know i have to face it.

this event happened in the last few months.

this is still a shock for me,i didn't believe those bad comments about russian graduates

Until i saw a scene like that...

Here we used to say:"chill...don't worry too much"
"skip whenever you don't understand.tomorrow you won't be asked about this question...
don't simply answer,or else your marks will be spoiled...
make your teacher happy,be her favorite student...
Don't worry,seniors have notes and answer for the test..
just memorize the answer and get an excellent mark...
and continue enjoy your life here in Russia.

"we are still learning...HO is just a period of training,after that we will slowly adapt in malaysia lah!Chill man...."
"what you scare of?we can overcome russian language,the largest barrier,the biggest culture shock in life,you think you can't overcome criticism in Msia?"

if you keep telling someone like this,
don't you think you need to stop it?

C.Sec..

today is the second last day of obstetrics,until this time,i would say that it's not boring because it's exciting to witness how obstetricians save 2 lives at one time.today i saw another cesarean section operation.
The 42-week fetus with 4.2kg(overweight) and brow presentation,is detected having distress syndrome and severe bradycardia,termination of pregnancy has to be done as cesarean section urgently.

During the operation,everyone is overwhelmed by stressfulness seeing our lazy buddy still want to stay inside her mother's womb.our teacher was trying so hard to push her out,it can't take long time because the baby is distressed inside.

After the hard push on fundus by our great teacher,the baby is borned!How Great~:)
i love seeing the new life is born...
but if anyone asks me to become an obstetrician,hmmm....think again...

obstetrics

"any one of you wants to be obstetrician?"by professor Sharkin.....
i kept quiet for few minutes.
anyone could make me love obstetrics?...
trying hard..sigh..