PROF WHO?

When I was young (primary school age), I used to read Borneo Post, a Sarawak based paper as my mum (she’s a journalist) was one of its regular contributors then. I often read about the state’s politicians, such as Datuk Amar Sulaiman Daud, Datuk Amar James Wong, Datuk Amar Alfred Jabu & etc. I used to wonder why all these VIPs seem to have similar first names.

I guess that’s excusable (or forgivable) considering I was only 9 or 10. Recently, a friend of mine, L, was at the Radiology Department to look for a certain Professor (in Radiology), who reported the CT scan of her patient. The report stated that the CT films were read by Professor Madya so & so.

L asked a Radiology staff where she could find Professor Madya. Obviously the staff replied, “Which Professor Madya?” since there are so many Professor Madyas in the Department. It took L a while to realise that Madya is not the Professor’s first name, but part of the academic title. Can L be excused (or forgiven), you think?

YOU OKAY?

I frequently hear my nurses (here at UMMC’s Oncology Unit) say “UOK” when they are calling people at other deparments, for example, to trace scan report from Radiology or to get blood investigation result from the lab. And every time, I would be wondering to myself what they mean. Are they being polite & asking how their counterparts at the other departments are doing or UOK actually has some other meaning?

It took me 3 weeks & a half to figure out that UOK stands for “Unit Onkologi Klinikal” – my own department! How shameful, I must admit. By fellow blogger Fibrate’s (It’s a doc’s life – geddit?) definition, I would be considered a “complete lulu”. In fact, I did feel “lulu-fied” when I realised how silly I was. I guess this is probably an example of the Malay saying, “malu bertanya sesat jalan” (though I didn’t actually “sesat jalan” lah) or perhaps, as a “neonate” at UMMC, I have yet to learn all the “jargons” to “gain full entry into the club”.

* Fibrate, sorry for the little violation of your copyright. I’m going to link you soon.

JARGON

I was reading my Manual of Clinical Oncology & came across a little footnote (on one of the pages on cancer terminology) which read, “Jargon is the use of pseudo-words plucked from a “word salad” to make the simple appear arcane, to disguise one’s ignorance of a subject, or to have secret codes that can be used to gain entry into a club.”

The medical profession is often mistaken as a “prestigious club” by many, including medical professionals themselves. Of course, medical professionals are able to speak a “different language”, one which is taught only at medical institutions. It seems reputable to be able to speak this language, but is it so in real life?

Here are 3 examples of conversation (between doctors & patients at my old hospital in Kuching) which illustrate the above meaning of “jargon”. I’m exaggerating a little bit, just so that you get a clearer picture:


Case 1
Patient: (who has breast cancer & not that highly educated) What do I have, doctor?

Doctor: You have Infiltrating Ductal Carcinoma of the breast, where the surgeons have performed total mastectomy & axillary dissection.

Patient: Infiltrating what?

Doctor: Infiltrating ductal carcinoma, which is a cancer, so what you need now is chemotherapy, radiotherapy & possibly hormonal manipulation.

Patient: (confused) …chemo….and…?

Doctor: Yes, chemo. Do you agree for chemo?

Patient: Must I have chemo? What if I don’t want chemo?

Doctor: If you don’t have chemo, you are going to die. Do you want chemo or do you want to die?



Case 2
Patient: (who has breast cancer & highly educated) I have a friend who went for FISH test …

Doctor: (who didn’t really know what the test is all about) So?

Patient: I was just wondering if I should do that same…

Doctor: You’re here today for your chemo, but your total white cell count & neutrophils are low, so we have to delay chemo for a week …

Patient: (got distracted by doctor) Oh? I can’t have chemo today?

Doctor: Yup.

Patient: Why is is so?

Doctor: Well, chemo causes myelosuppression, that’s why your total white cell is low. You can’t do anything about it. Just go home & wait. Come back next week.


Case 3
Doctor: Kenapa bunuh diri?

Patient: (who attempted suicide an hour before, by consuming excessive Paracetamol tablets -- keeping her head down & remaining silent)

Doctor: (lifting patient’s chin in a rough manner) Saya tanya kamu, kenapa bunuh diri?

Patient: (still keeping quiet)

Doctor: (turning to junior doctor & nurse) Do a gastric lavage & take PCM level. If exceed, just give N-acetylcysteine. Follow the “black book”.


* Sorry, this is not exactly something that fits “Laughter the best medicine” though I did laugh when my former nurses told me about them. Maybe it was the way they told me, with the gesture & the imitation of various doctors, but what had transpired is actually a sad thing & certainly a disgrace to the medical profession.

MISCALLEANOUS IV

• “If a patient with diabetes is called a diabetic & someone with an amputated limb is an amputee, what do you call a person who has a stoma?” our Consultant Surgeon (in Sarawak General Hospital, Kuching) Mr. WCM, quizzed us during ward round. I actually didn’t know the answer, but one of the House Officers replied confidently, “Stomee”. It sounded funny that even the patients laughed. The correct term is “ostomate”.

• During an MRCP (Member of the Royal College of Phycisians) teaching session, one of the candidates, HT, was asked a question about a physiological condition which can aggravate a certain medical problem. HT was also given the clue that the particular physiological condition occurs only in women & not in men. He thought for a while & gave the answer, “Menstruation”. The other candidates thought HT’s answer was outrageous. Perhaps he had forgotten that pregnancy is also a physiological condition that occurs only in women.

HUMAN HAIROMA VIRUS

I attended a CME (Continuing Medical Education) on HPV (Human Papilloma Virus) vaccination recently at UMMC. It somehow reminded me of the Human Hairoma Virus.

Human what virus? Never heard of it? But of course, the virus does not exist. Human Hairoma Virus, or HHV for short, was “fictionally invented” by yours truly back at IMC (International Medical College), together with a senior whom I was pretty close with. We wrote about HHV in the college’s newsletter, “Med About U”. We even drew cartoon pictures of the virus.

HHV was supposed to cause hairoma (tumour consisting of hair) of the male & female genito-urinary tracts. I think we also included cartoons of what hairomas of the uterus & cervix looked like.

Those were the crazy & care free days…

COMMUNICATION BREAKDOWN

• Effective communication is actually very important between medical personnel (doctors, nurses etc) & patients. I’m sure many of you have heard about the “heart murmur” & “hot mamma” joke.
  
  Well, this is a real life conversation between my former nurse (at the Radiotherapy Unit in Sarawak General Hospital) & the husband of a cervical cancer patient undergoing radiotherapy. The husband was upset after being told by the radiographer that they would not be able to have sexual intercourse during the treatment period. He wanted to confirm with another medical staff. Both husband & wife are Indonesians.
  
  
  Husband: Nanti bila balik rumah, bisa ranjang?
  
  Nurse: (Heard ‘ranjang’ as ‘telanjang’) Bolehhhhh………
  
  Husband: (Surprised) Bisa??
  
  Nurse: Bisaaa….
  
  Husband: (Confused) Ngapa tadi orang bilang ng’gak bisa?
  
  Nurse: Bisa. Kenapa tidak bisa? Di rumah, tidak ada orang tengok. Bisa buat apa saja.
  
  
  * Ranjang, in Indonesian language, means “bed” or “bed-related activities”.

• Communication between medical personnel is equally, or in fact even more important. Before radiotherapy treatment begins, there is a pre-treatment session called “simulation”. A simulator is a machine which can produce conditions similar to radiation therapy & the process of simulation is important for an Oncologist to plan the area to be treated.
  
  Once, a House Officer (HO) from the Surgical Ward called up the Oncology Unit (at UMMC) to get an appointment date for a patient for simulation. WZ, the Senior Oncology MO, had informed the HO to indicate on the referral form, “patient for simulation under Dr. A”. (Dr. A is one of the Oncology Specialists & the head of department).
  
  When the patient turned up at Oncology, the staff had a good laugh as the referral form read, “for stimulation under Dr. A”.
  
  

4 F's

This is not the 4 F’s (risk factors) for developing gallstones (ie. Fat, Female, Forty/Fifty, Fertile) but my new discovery of the 4 F’s of University Malaya Medical Centre (UMMC), KL.

Far

I live in Old Klang Road & it takes me about 20 to 25 minutes to get to UMMC. My colleagues who are from KL think it is “super fast” (since under an hour is considered “fast”). In Kuching, my rented place was only 5 minutes away from the hospital (Sarawak General).

My housemate & I car pool to work everyday (we work in the same department & there is no oncall, for now). We normally park at the Medical Faculty of University Malaya (most doctors do that) & walk across to the Medical Centre. The daily morning walk should help me to stay slim, hopefully :)

The Oncology Department is situated at the newer wing called Menara Timur & it is miles away from the Menara Utama (main building). Oncology patients are admitted to different wards (namely Medical, Surgical, ENT & Orthopedic) because we don’t have our own ward. Most of the in-patients are situated at the main building so I’m getting daily late morning & afternoon walks as well.


Flooded

Recently we hear about burst pipes in various Government deparments. Well, UMMC doesn’t have that problem (I hope) but along the walk way from Menara Utama to Menara Timur, you can find pools of water here & there. This is indeed an eye sore, especially for an established medical institution like UMMC.


Freezer

The Oncology Unit in UMMC is by far the coldest place I’ve ever been in my lifetime. Okay, I’m exaggerating. I’ve survived below zero degrees at winter time during my final year (medical school) in Hamilton, New Zealand, but that was okay because I was equipped with winter clothing & a heater.

The clinic area is quite alright (I mean the cold is still bearable) but the radiotherapy treatment area is just horrendous. The temperature is such because of the radiotherapy machines.

My fingers were cramped on at least 2 occasions that I could not write (on patient’s notes) properly. Thank God they did not turn blue. I swear I would turn up for work in full winter wear (including gloves) if this happens again.


Faded

On the way to work, we have to drive pass the Law Faculty before reaching the Medical Faculty. My housemate never fails to comment on how nice the Law building is. The Medical Faculty, on the other hand, is very ancient looking & gives us the creepy & eerie feeling everytime we walk pass there to go to the medical centre. None the less, it has produced many prominent doctors in the country, namely the current Director General of Health & the Minister of Health.

As medical students at the International Medical College (IMC), we made occasional visits to the Anatomy Department of University Malaya for Anatomy sessions as we did not have our own wet lab. Someone told us that Botak Chin’s (the notorious criminal) head was being kept there. Now, when I walk pass the Anatomy Department, I can’t help but think of the specimen, which could still be there, floating on preservative fluid, inside a huge glass container……I guess that explains the creepy feeling.