Radiology Department in Sarawak General Hospital wasn’t as boring as I thought it would be. Not only the number of interesting cases was so plentiful, the working environment there never failed to cheer me and pohsen up.
First day of attachment, we went directly to find the head of department, Dr Tan (full name not revealed to protect privacy, haha) after getting our letter of approval from the director’s office. Upon reaching her office, we were greeted by her angry tone of voice arguing with some bugger on the phone. Oh wow, wad a way to start our attachment when our boss is in bad mood!!! We waited outside her office until she completed her phone conversation. Finally, after quite some time, we went in to see her. Although she has that stressed-out look on her face, she greeted us and asked us a couple of questions after we had introduced ourselves. We were then led to CT room and introduced to Dr Agus, a post-grad student there…
The CT room has two CT machines. One older version CT scan is used mostly for brain scan, and the newer 64-slice CT scan is used primarily or heart and abdomen scan. And yeah, proud to say, Sabahans have to come to our SGH for the 64-slice CT scanning because they do not have one in their very own General Hospital. Now, who is more ulu? :p Even their cardiologists have to travel the whole way here to treat their patients.
Apparently the dept is suffering from shortage of staff this week. This explains the distressed look on Dr Tan’s face. She was the only radiologist working on that day. When she called the ministry for more radiologists to be posted to SGH, she was informed that the to-be-radiologists from USM prefer to go to the east coast while those UKM and UM dudes do not want to come out from their Klang Valley. Furthermore, most hospitals in west malaysia have 7-8 radiologists each in their dept compared to SGH which only have 3. That particular day, Dr Tan had to fly from MRI to CT scan to Ultrasound to Nuclear Medicine and to plain x-ray to….Everyone needs a piece of her as she’s the only specialist working that day!!! Haha… She was asked by her higher authority to employ relief-radiologists from the west t cover the current shortage of staff,however, she refused to do that because she had to fork into the departments operational budget which was barely enough to cover the costs of all the equipments such as films, catheter, contrast dyes, gloves etc…she had asked for extra budget to employ these reliefs BUT the money never came. According to her, there were instances when they had to use a larger catheter for some patients when they run out of the correct size due to insufficiency of operational budget, thence causing the patient to suffer in pain. imagine a larger catheter is inserted into your penis…haha!!! besides, the shortage of radiologists may extend until july-august, and imagine the amount of money that will be incurred if u employ those reliefs. These thoughts led her to some funny quotes, one of which sounds like this:-
“Those people arr, dunno what they’ve vowed last time during their interviews before getting into medical school… what serving people loh etc…one day arrr, they’ll get struck by lightnings!” (haha,so cute eh =p)
One thing about this specialist is that she is concerned of her patients need. She tries her best to give the best to her patients. However, she likes to grumble alot and because of this, her staff cannot tahan her. There were lotsa cute gestures behind her. She’s the tornado of the dept (@ a gush of wind) after she shoved down xray-film viewing board in her moment of anger. everyone is afraid of her coz she seldom carry a smile on her face. Pohsen have one question for her and until now it remained un-asked, lol…
“Are you married?” ( my guess was…she’s married, but pohsen don’t think so…coz she’s so very garang! but she’s an attractive woman despite her age, i would say. but dont get me wrong…im not interested in her. besides, we share the same surname. but why did pohsen asked? hmmm, i wonder why……Haha )
In order to solve the shortage of staff problem, she decided to call a meeting for her staff that very day to cut down the services provided to show the top officials that they really cannot cope with the workload with such limited manpower. She was even thinking of quitting the government service because she was really fed-up with the condition. in my opinion, If she does so, it’s really a loss for the public because she’s really a good specialist, a very sharp thinker…
Haha, the meeting that was held was rather funny. It was attended only by male staff and only there were 5 of them albeit there were many more staff in the room. It was rather informal. Only once in a while did Dr Tan joined in to have her say and when she does, all of them kept quiet. Finally, they’ve reached a consensus to cut down on the number of services per week and someone has to draft a letter to let the director and the other departments know about it. And when she said someone has to draft the letter for her, those men started to scratch their head… one of them were kinda bald…and pohsen postulated that its because he scratched his head too much leading to his alopecia =) haha. Everytime we see him, we couldn’t help but laugh!
And btw, there are a few more lively characters in the dept. One of them is the other specialist called Dr Lee. She likes to joke a lot and rather playful. And she laughed when she heard pohsen’s name…
Dr Lee : What’s ur name ah?
Pohsen : TayPoh Sen…
Dr Lee : Haha, Pohsen.sounds so like sepuluh sen (continue laughing and announce to the others) hey his name is Pohsen, sounds like seposen (niwe, muka seposen usually refers to cheapskates =p hence imagine my laughter when she said that)
Another thing that irks me is that people always assume that we’re yao-qin-zai(rich kid) when we mentioned that we’re from IMU. but i couldnt blame them too. if im studying in local university and graduated from there, i would also have the same mindset and same prejudice towards private uni students! But, you rich kids in IMU have shown me that I’m wrong…not all rich kids are snobs like what i think they would be! i’ve greatly enjoyed myself with all of ya ppl!
Well, there were many more merry moments there but none were so significant…haha! yeah, and now back to those interesting cases that we’ve seen. On the 2nd day of my attachment, I was shown a CT scan of a man shot by a shotgun!!! His whole body had more than 50 bullet pellets in him from the shoulder to the waist. Miraculously, these bullets never hit any important parts. two of them were a few milimetres off the right ventricle and atrium, maybe stopped by the pericardium itself! Haha! And there weremany more that got stuck on his vertebrae…if not, he would be paralysed if those pellets hit his spinal cord.
Dr Patrick : Come Come……I show u twinkle twinkle little stars. Whats ur diagnosis?
Me : Mmm…I dunno…
Dr Patrick : Aiya, u know shotgun ah?…
Me : Mmm, okie…(I was thinking that he’s asking me to tembak a diagnosis) miliary TB??!! (because of the opacification of the film all over his body from shoulder to the waist)
Dr Patrick : No la, u know when people got shot by shotgun?! Haha, that’s how it looks like la. (showing me the scannogram of the CT scan)…twinkle twinkle little stars (boy its really twinkling when u scroll up and down the axial plane of the body) he should buy toto u know…two pellets just missed his right atrium and right ventricle. So many more pellets are stuck in his backbone, not injuring his spinal cord.What do u do to this kinda patients? Do u take the bullets out?and why?
Me : well, yeah….eh, no…..i dunno
Dr Patrick : u only take them out if they’re life-threatening. If not, you just leave them there. How to take out so many bullets and cause more wounds, rite? Haha, but next time he cant walk past the airport without triggering the alarm of the metal scanner la…..and imagine how’d he de when he goes for MRI?
And yeah, the guy is still alive….! Besides this case, there were many other interesting things that we’ve seen throughout the week. We’ve also learnt a new word which was lissencephaly : a term used to desribe brains that lack gyri (smooth brain). The baby which has this condition had a super arched cervical region making him looking like a bow when he lies down. They did a barium meal studies on him due to suspicion of reflux oesophagitis. And we’ve also seen a Down-syndrome baby with duodenal stenosis. Before this, I dunno any other medical conditions associated with it….except for mental retardation and those weird facial features…but now i know that they are also prone to congenital heart disease and also oesophageal reflux disease.
There were also cases of wilm’s tumour, medulloblastoma, post-op leaking urethra, stricture of membranous urethra in an elderly man, etc…among the procedures seen are CT-guided lung biopsies, cystourethrography by fluoroscopy to detect leakage of urethra in a rectal cancer patient, venography for DVT patients (its no longer done for DVT because we can use Doppler Ultrasonography to detect it, but its done for some studies to test the effectivity of a new drug. this technique is still the gold standard for DVT), PTBD (percutaneous transhepatic biliary drainage) for a terminally ill pancreatic cancer patient, ultrasounds,….but aih, we were not allowed to observe mammography so! Haha… I saw ERCP once again and we were shot with quite a number of questions by Mr Wong, (the head of surgery dept)… and our sedentary lifestyle is very evident because we cant even remember the medical term for biliary tract which is cholangio-wadsoeva (so memalukan =0) imagine that!!! and we’re actually jpa students who’re goin to London and Edinburgh….haha,damn paiseh!
Ohya, we’ve also attended a talk at the cardiac clinic yesterday about movement disorders conducted by John Dunne, a Prof from Perth Australia.he was very good with in his explanations (although I ter-fell asleep halfway for a short moment). Now, the picture gets clearer with his explanations. He recommended www.wemove.org to learn more about movement disorders. U guys can check out the website =)
Niwe, this attachment taught me a lot and I’m quite relieved to know that radiology is a rather specialized specialty. Time is required to master this field so its not memalukan if we dunno much about CT scan etc at this stage because even the HO and MOs are similarly blur in this field. Haha, this is what a lazy bum like me would think instead of reading up more about it…next week will be heading to surgery department to see Mr Wong again. Haha! Hope it’ll be a happening one…coz I’ll be without pohsen who’ heading to the kiasu-land (s’pore) for the week! Haha. Lonely, I’m so lonely….*Mr Lonely - Akon playing at the background*
