Never Let Them Know

Another tutorial today. I’ve mentioned how much I LOVE these Obgyn tutorials right? (hint sarcasm).

There was a particularly obnoxious consultant in a rural hospital running the tutorial. She was mean. She knew she was mean. But she was unapologetic about it.

In this age of technology, we do video conference tutorials. We had to sit and watch her grill our fellow med students based at that hospital as they presented the week’s case. Interrupting them every so often to tell the whole group that she would FAIL them in an osce if they had said what he just said. Then lecturing us for 25 minutes straight on what the RIGHT answer is. She even decided to tell the boys of the group that they should ALWAYS offer to have a chaperone WHENEVER they examine a woman.

But of course, I had to come into this somehow. And I almost didn’t. In a large conference room, with a small webcam, if you come in late, you get the seat just outside of the frame of the camera. Then, if you make the BIG mistake of  accidentally appearing in the frame for a second, you get called out. “Who’s that in the corner there??” “If I was your supervisor I would fail you for not participating in the group”

Why.

Then when there was a difficult question, guess who gets picked on? “Hey, what’s the name of the person in the corner? You can hide all you want but I can hear you, so answer the question. What is the indication for urodynamics?” I said I was unsure. A student behind me ventured an answer. She responded: “Well, there’s one student who is awake”.

Why? Why why why why? Just WHY?

What is she gaining? What is she achieving by saying stuff like that? What is ANYONE achieving by making someone else feel small and stupid? Does it boost their ego? I can’t see that being the reason, because she went on to say something to the effect of “I know I’m being harsh, but don’t worry you’re all going to do fine in the osce, I won’t be the examiner! Hahahaha” >___> If you KNOW you’re being a certain way, and you KNOW that way isn’t ideal, then WHY are you still like that?

I’ve dealt with bullying in my childhood. As an adult, I never thought I would have to deal with things like that. But as it turns out, when you grow up, bullying just becomes more subtle, and from sources you never imagined. And unfortunately, it’s more deadly. It makes me miss the direct form of bullying I experienced back then.

What bothered me is that she straight away assumed I was hiding or avoiding answering questions, and decided she was right, and acted on those assumptions. People need to stop assuming things. Why is it such a rare thing to give people the benefit of the doubt? Or atleast pretend to? Eugh.

So. How did I respond? Well unfortunately, this isn’t the first time I’ve been in this position. And if I learnt anything, it’s this.

“never let them know they get to you” – Nick Wilde

I put on a face. It was a smirk. It was a “what the heck” look when she told me to show my face to the camera and that she would fail me. I looked straight at the screen with this face. One of the students referred to it as a “Sass” look. That’s what I did. I wasn’t about to give her, or anyone else the satisfaction of knowing what I was feeling underneath. I told her I was not sure of the answer, with the same confidence and sass. After the tutorial ended, I joined with my colleagues and excitedly ranted about how horrible she was and how silly the whole situation was and how we shouldn’t care about what she says. Though I hate putting on a fake face like this, I’ve learnt there’s no other choice. And it’s more important to follow the whole “conceal, don’t feel. Don’t let them know” thing. No it’s not the best idea. But it’s the only thing to do when you’re and adult in this situation.

And then, when you are home and alone, succumb to how she actually made you feel..

And then blog about it.

Did You Know? 

If a woman has a tumour or an ectopic pregnancy that results in removal of one of her fallopian tubes, her fertility is NOT halved! 

The body compensates for this. The other fallopian tube miraculously moves over the uterus and alternatively catches eggs produced from both ovaries!!

The human body is amazing. 

This goes on my list of awesomely bizarre things in the body:

1. The sinoatrial node that spontaneously ‘fires’ or ‘beats’ perpetually 

2. The liver that grows back even when butchered

3. The miraculous octopus-arm-like moving fallopian tube to ensure a woman’s fertility is preserved.
So cool. ^__^

Doll and Pelvis model

The way to prepare for an osce in Obs and Gynae is to borrow the Doll and Pelvis model set and attempt to understand the physiology of labour and birth by stuffing the creepy looking fake baby’s head into the model pelvis (which is hopefully plastic) and “delivering” the very well sown together (and a bit over-stuffed) model placenta.

It’s harder than it looks, believe me.

Me and my friends:

Friend 1: “Okay so the baby’s head starts in the transverse position, then flexes as it descends in the pelvis …Eugh it won’t go in!!       Omg I dropped the pelvis! No let me start again….. The baby starts in the transverse position, then flexes as it descends.. OMG! The head is too big for the pelvis omg!! This baby has macrosomia!”

Friend 2: “As the baby passes under the pubic symphysis, its head extends and crowning occurs and the baby’s head is born- oh it’s stuck. Nice. The head is too slippery omg!”

Me: “Right so, the head is born. Now the baby restitutes sideways in order for the shoulders to be born. We apply downward pressure on the anterior shoulder, and it should just come through…. Eugh…. Omg… it won’t come!!”

Friend 1: “Pull harder!!”

Me: “Omg the shoulder is stuck!!”

Friend 2: “Hahaha shoulder dystocia!! Shoulder dystocia! Someone PRESS THE EMERGENCY BUTTON!! Call for help!!”

Me: “Omg guys it’s not funny! The thing won’t come!! *Grabs baby doll around neck and yanks* OMG!!! The head nearly came off!!”

Friend 1 & 2: HAHAHAHAHA you’ve decapitated the baby!!!

-__-”

We’re all practically budding obstetricians now. xD

Live Action Fairytales

‘Beauty and the Beast’ pulled from Malaysian release after ‘gay moment’ censored

So I saw this on the news. Sigh.

Beauty and the Beast is my most favourite Disney classic of all time. As I hear it also Emma Watson’s. It’s just really funny when Hollywood decides to take a classic and put a “contemporary” twist on it and re-release it for tonnes of money. And it’s even funnier when people around the world have serious views against these ‘twists’.

So apparently, in the live action version of Beauty and the Beast, Gaston’s 3rd stooge of a sidekick LeFou is portrayed as a gay man and the movie features several ‘gay moments’. The director stated this was to promote equality and diversity. This resulted in uproar in countries such as Kuwait and Malaysia, where these scenes were censored. And this made Disney pull screenings of Beauty and the Beast off in these countries.

Are you even serious?

First of all, I’m not a big fan of live action remakes of Disney classics. I thought Cinderella was a very lame version of not a very exciting Disney classic to begin with, and Snow White and the Huntsman was even more morbid to watch. In my opinion, the Disney classics were just that, classics. The word “fairytale” has connotations of happiness, security, imagination and love. The point of them is to step outside of dreary reality for an hour and fill children with the belief that there’s always a happy ending if you’re a good person and wish for something hard enough. Okay. I’m not saying they’re fabulous ideas, but that’s what they were made to be for.

To take such classics, change the plot line completely but have the same characters/title, but removing the comforting connotations and replacing them with morbid underlying themes, is nothing short of a crime to me. It’s like deciding to portray Mr. Darcy from Pride and Prejudice as a bipolar delusional man who actually did everything Elizabeth thought he did. I fail to see the sport in it. Why can’t the people of Hollywood come up with original ideas for movies anymore? It seems like every movie in the cinemas these days are either sequels, or prequels, or books made into movies, or remakes, or revamps of this kind. What is that about? Did they just run out of ideas?

Anywho. That’s off topic.

What’s worse is that this has become such a controversial issue. About gay rights, being conservative, etc etc. It’s a Disney movie for Feek’s sake! It should not attract this much attention. And especially for this reason. That’s another thing. Why does EVERY little statement attract so much controversy? Political correctness is becoming a bit crazy these days, I think.

Anyways, after that I read this article:

‘Beauty and the Beast’s ‘gay moment’ may have been much ado about nothing

Apparently the “gay moment” scenes were very subtle and not anything the director implied it would be. Big woop. They just lost the audience in Malaysia in Kuwait for pretty much nothing. Such a silly issue.

I want to watch it though. The reviews said it’s not too far from the original cartoon version. We shall see. Perhaps I shall review it on here.

OBGYN Rant..

Eugh. Okay I am very frustrated at the moment. This rotation has been less than ideal. I’m not sure why this run out of all the others I have been through thus far is annoying me, but it just is. And it’s also one of the shorter rotations. (5 weeks as opposed to the gruelling and usual 6). But into week 4, I am well and truly over it and would like to move on.

Why, you may ask. Well we could be here for days. But it is a realisation I have come to having spent my sick day off, pouring over online resources, the “highly recommended” textbook, notes from presentations my colleagues had put together, and my own feeble attempts at taking notes over the last 3 weeks, trying to put something together in my head for my osce (observed clinical exam – or something like that) next week. And all they have is contradicting info! Eugh!!

And remember, I’m sick. So much so that I have taken a day off from hospital which is usually a big no-no for me. I hate being absent. So this should be a pretty good indication of how bad I’m actually feeling. But having said that, I have tried to make my day very productive because the only thing that offers a better motivation to study over the motivation to sleep the day away to recover from an illness, is STRESS. And I’ve got a lot of it right now. So here is a list of things I dislike about this run:

  1. There are too many screaming women around. (And I’m not talking only about the pregnant women). Not a day has passed on this run where I’ve not heard a consultant/registrar/house officer use a string of colourful words to describe the uselessness of another health professional (nurse/GP referral/anaesthetists not showing up/ surgeons hogging theatres/ private obstetricians strutting about as though they own the hospital and the rest of the staff serve them) and then breathe deeply in and out a couple of times before telling each other to calm down….. -_-  Jeez why so much negativity la?
  2.  The freaking abbreviations on every page of every note of every piece of paper ever written on. Goddamn the APHs, PPH, TAH, IUA, TOA, OP, AP, NBF, EBM, etc etc etc. Why am I spending most of my time staring at notes with a train of abbreviations instead of words and trying to figure out what the HECK the last doctor even had to say about this patient. Doesn’t anyone write in words anymore? I remember parents yelling at kids for the overuse of text language. Though I have never been fully guilty of this, I understand their frustration now.
  3. Then there’s surgery. During which you are pretty much part of the wallpaper. I don’t know what to do with myself. The general surgeons were frankly more friendly during theatre than the obstetricians/gynaecologists. I don’t learn anything and basically just trying hard not to fall asleep. (Have to be subtle about this, I have learnt. People are apparently very quick to assume you are asleep even if you’re just tired or thinking really hard about life. >__>)
  4. The male consultants who seem very aloof and cold towards patients. I kind of mentioned the whole male/female dynamic in this specialty right? Well it’s rather obvious with the male consultants. They almost seem bored with their job. It’s like they chose this specialty just to prove a point. To prove their dominance. Again, it might just be the consultants on my team, but I sat through the most cringe-worthy situation where a male consultant told a woman she had endometrial cancer in the coldest way possible. In one sentence. “Yes Mrs. X come in, we’ve received the referral from your GP that your last smear was abnormal. The results have come. You have endometrial cancer.” Verbatim.
    He then sat in his chair, said nothing for 2 minutes straight while the woman cried. Before finally adding “I’m sorry about that” in the most un-sorry way imaginable. It was beyond frustrating and extremely useless. Obviously I couldn’t get up and comfort the woman, though I wanted to, very much. Sigh.
  5. Pregnancy is a mess. Scarred for life by all the bizarre things that happen to the body of a pregnant woman. Why do women do this to themselves?
  6. The tutorials… I feel stupid. I dislike feeling dumb and stupid. In a room full of “colleagues” and someone who I desperately want to think differently of me, I just feel stupid. And it does NOT help when the consultant who is supposed to teach, asks you a question, purely to “catch you out”. And ofourse, being me, I fell for it. I just don’t see what she was gaining from that. But I guess it’s my fault. I should not have let myself be “caught out”.

Whew. Well, as you can see, studying has made me very frustrated. But in the interest of not making this post too one-sided, I shall attempt to mention some positive things about this run.

The doctors are good. Like really good. Their diagnostic skills are amazing. And there is so much I’m able to learn from them. A registrar saw a patient and diagnosed one of the rarest phenomena in pregnancy. “Pregnancy- related intercostal neuralgia”. Never heard of it, purely clinical diagnosis, she called it, treated it, and fixed the young, pregnant woman and sent her home in 24 hours. This after several other specialties had diagnosed her with gall bladder disease.

The patients appreciate. Big time. It’s a sensitive subject. The problems are both horribly difficult to talk about, but also extremely horribly difficult to live with. And if you’re understanding, and make them feel comfortable, and fix them, their happiness and relief, is worth it.

And with that, I return to osce study.

The Bs and Gs of OBGYN

G and B for Girls and Boys

G and B for Gender Bias

A couple of weeks into my OBGYN run, I’ve noticed just how gender biased this specialty is. Now, let me explain. I know that obstetrics and gynaecology is all about women’s health. It’s about the miracle of pregnancy and the wonders of the female reproductive system etc etc. I know it’s a very sensitive topic to approach in general, but I feel bad for my male colleagues.

During our tutorials, the men in my class were told to ask questions differently. I found this a bit too much to be honest. They were taught that they must NEVER say things like “Please get on the examination BED for the examination”. Or “put your legs apart for the speculum examination”. While the girls, have none of these instructions. We’re told to be careful when doing the examination and making sure we’re being sensitive and that the woman is comfortable. But for the guys, there are words they should NEVER use, there are places they shouldn’t stand and topics they shouldn’t raise. I think this is pushing it a bit. Yes it’s a female heavy subject, and yes it’s important to make sure no mistakes or awkwardness is created that could potentially result in several ‘fitness to practice’ orders to be issued. 

But come on.

Several of my male colleagues have also been denied the opportunity to watch such examinations or births because they are male, and so may make the whole situation uncomfortable for the patient. Yes ofcourse that is the patient’s choice, but it is a bit sad.

I’m not too sure what they are gaining by making the males very self-conscious and having to think twice about what they’re saying to the patient with the fear that they may offend or insult them somehow. I’d feel super nervous. How are they supposed to learn? I understand that there was an era of time when Obstetrics and Gynaecology was a solely woman’s specialty and all the nurses/midwives/doctors were women and no woman would be comfortable going to a male doctor with their “lady problem”. But I think we should have come past that by now with the whole gender equality business (see what I did there?). 

I’m not saying they’re totally wrong about the whole thing because surely there have been some inappropriate health professionals in the past that have brought on this whole stigma, and that should definitely be prevented. But by acknowledging it so blatantly to the point where males and females are taught to approach the same patient differently, is it just fuelling the issue? Drawing more attention to it instead of making the whole thing more comfortable? It definitely feels like it to me.

Having said that though, there are quite a few male OBGYN consultants on my team. And being in clinic with them, I have found they do not follow any of the “rules” taught to the males. One of my consultants just told the patient to “slip everything off from the waist down, including your knickers and lie on the bed there” in a very blasé manner. And neither did the woman feel uncomfortable about that. Very weird. So does this difference in teaching even matter? Once you’re consultant, you make the rules? Or does the doctor -above-patient power dynamic come into play here? Or maybe this teaching differently for boys and girls is a fairly new thing. Or even scarier, they feel they are in a position of power and the rules don’t apply to them? 

I do hope my male colleagues aren’t too turned off by the specialty because of this teaching thing. Or who knows, some of them may even become obgyn consultants 

The People Who Lie…

Please be aware of whom you are lying to. You’re the kind of person who can open your mouth and spill a thousand likely stories. Each one as believable as the day. Subtle enough that anyone else wouldn’t ask a second question. You’re good at it. It’s a necessity.

Unfortunately, if you lie to someone who knows you, who knows the background to every likely story, who knows the one question that would make the entire story false, then your lies are as believable as “alternative facts”.

But it doesn’t matter. Because even if the evidence was displayed, if the question was asked, you’d still deny it. To save face? Or to convince your conscience that what you said IS true?

Either way, what hurts is not the lying. It’s the credit you give someone about how much they know you. And the fact that you believe they’re not worth the truth. Even if telling them just that is all they need to respect you more.

Lessons From Paediatrics

Well. It’s been a very long 6 weeks on my first run of the year. But I have finally crossed the finish like and thank goodness for that. 6 weeks of worrying about how to handle babies. About dropping or breaking them, 6 weeks of listening to awkward conversations in clinics, 6 weeks of internal trauma when a baby starts crying during the examination and you are unsure how to make it stop, but you have to continue with the examination, but you can’t hear the heart sounds over the loud squealing and the respiratory rate is too fast to count, eughhhhh. And 6 weeks of listening to doctors and nurses and parents all using baby talk and a lot of cooing and attempting it yourself while pretending to the parents that the baby in front of you is very cute even though she/he is kicking you in the stomach as you try to examine them.

Whew.

I can’t say it’s been the best rotation for me for lots of reasons. But I think there were some important lessons learnt from paediatrics.

  1. paedatricians can be very weird.
    I’m not sure why, but I found the paediatricians at my hospital to have an even bigger God complex than doctors in adult medicine. They are the word. I think they feel that because they are able to fix little children who are so difficult to communicate to and are so vulnerable, suddenly they are experts at analysing and fixing all the humans around them. Honestly, one of the paediatricians even felt the need to teach students about “character” and how important it is to establish who you are as a person otherwise you won’t go very far in life and be able to buy your son an iphone 7 at the age of 12. Zzzzzzz How ’bout you take a step back.
  2. Shhhh-ing a crying child does NOT make them stop crying.
    Yes it took me 6 weeks to figure that out. Well I always knew it when someone showed up to a lecture with their new baby and decided to sit in the back of the lecture theatre with the baby crying non-stop and the mother decided the most constructive thing she could do is remain in the lecture SHHHHHHHHHH her child every 5 minutes. Which was as successful as you can imagine. I have no idea what that lecture was about. The baby crying is all I can remember. But people still attempt to shush crying babies. Like what are people hoping is going to happen? The baby is going to say “Oh I’m so sorry, how rude of me. I’ll try be more quiet”? Or do they think it’s calming? I for one would NOT appreciate if someone came very close to my face and said SHHHHHHH while I am crying. I’d cry harder I think. But yes. These 6 weeks have taught me to come up with inventive ways to get a baby or a small child to stop crying  and I’m still not very good at it. Babies and children cry. They just do. Learn to deal with it.
  3. The bubble.
    All jokes aside, I really learnt something important in paediatrics. I saw some children with horrific health problems and disabilities but were still some of sweetest, happiest children I had ever come across. It’s just a bit amazing how for children, nothing deters their happiness for too long. Just a cuddle from their mom, or their favourite food, or their favourite toy is all they need, and no problem is too big to face. I really envy that. Remember when you were 5 and the smallest things made you so happy for the whole day? I miss that. Someone once said to me that I live in my own bubble of immaturity. They probably meant it as an insult, but I honestly was not offended. I wish to remain in my bubble of immaturity. I think we all should. If being ‘immature’ means that you can face all your problems without letting it affect you, and you’re able to find that genuine happiness in the smallest things, why wouldn’t you want to stay in the bubble? These are kids with heart conditions or neurological conditions that they may never recover from. And yet, they run around laughing and playing as though the world is theirs. While here I am, perfectly healthy and stressing about everything. But it made me happy to see kids like that. I’d like to think I learnt something from them. Something I should carry onward.

And those were the lessons from 6 weeks. Now, onto the next rotation. Here comes O&G. Or OBGYN or Obs&Gynae. Take your pick. It’s supposed to be a very intense rotation. But we’ll see. Done so much already, can do this too, I hope.