STigma on Doctors..

Salam..

Finally, i manage to import internet connection from KL..long story..no need to elobrate.Now I'm in Malacca.In two days I'll start the O&G posting which is the toughest posting of 3 year..Hopefully I can cope with that.

Today i would like to write about Stigma on doctors..

When you feel something wrong with you...do you straight away seek help from the doctor?
Or..you decided to wait untill i resolve by itself...
or... you decided to do self-treatment by taking painkillers or do anything that might relief the problem..

well, majority will prefer to choose those two later options than seeing doctors.. So, far non of my family members are doctors yet. Only me and my 2 cousins are still in medical school.Some of my family members are the typical people who are afraid of doctors. For them, doctors are only for severe cases.If possible, they want to avoid seeing one.

This is one the reason why people delay their treatment. When they decided to see doctor their problem has already worsen or only can be relief but not totally cured..

WHY are they afraid to the DOCTORS?? certain people even develop white-coat syndrome where their blood pressure rise up in the presence of the doctor.

Public/Patients' stigma on doctors:1. They like to prescribe patients pain killers, might as well I just take pain killers and save my money, time and energy of going to the clinic.
2. They might ask me to undergo invasive procedure like taking my blood, thus doctors=dracula..hehe
3. the point above can also mean DOCTOR=PAIN4. Doctors are my chance to get extra holidays-Medical certificate (MC)5. When you see them, you can be diagnosed with some serious/chronic illness
6. Doctors are INCONSIDERATE when they ask you to STOP doing things you like.
7. They are harsh when you dissobey them
8. WHen I meet the doctor, he'll be 'the BOSS'..no point of voicing up my opinion or decision.
9. I will get sick if I see doctors.
10.If you see doctors..it means something is WRONG with u


So, can we say it is the Public/Patient's fault to have these stigma??
NOpe..

It all come back to us DOCTORS and FUTURE DOCTORS on how we should behave in treating them appopriately and ethically.

However there are other reasons why people didn't want to seek early help from doctors.It doesn't rest on the stigma on doctors alone.. there are other reasons also like patient's education, social life and economical background.

WSlm..

Stigma is prejudism!!

Salam(peace),

What do you think when you see these pictures??

Down syndrome- they don't choose to be like this and it is not a transmitted disease!!


leprosy- it can be cured(if get early treatment),the picture on the right is after the treatment.


obesity-there are many reasons on why they become like this


mental illness and starvation-a boy that was locked in his house and doesn't get proper treatment.


dwarfism-they don't choose to be small, regardless their size,they are like normal people too


You might think of avoiding them...staring at them because they don't look normal or worse tease them.

DOn't you think it is inappopriate?? Aren't they human being too like us??
These people have stigmatized illness who usually gets stigma from the society.

What is stigma? Stigma is a negative impression or prejudism on a certain group of people who have stigmatized illness(eg: mental illness, skin diseases, HIV,Down syndrome).

They tends to get stigmatized and neglected by the society.

Moreover, they receives less social support. In addition to their own problem, they can get depress because of less support. Not many employeers want to employ them. Since they don't have income, the can't afford the medicine or treatment they need.
Due to their limitation, they need special public facilities or consideration that we tends to neglect.

Some of them may not have support by their own family members. The health care system also do have stigma on them.Sadly, some health care workers too doesn't understand their condition and have stigma on them

What we can do???
First, UNDERSTAND their condition and erase the myth you know about them
Next, ACCEPT them as who they are.Let them live with us without feeling inferior
Then, CHANGE and let others change wih you by educating them to UNDERSTAND & ACCEPT

To learn more about STIGMA and STIGMATIZED illness...you are invited to attend this forum under Hari KEsihatan Sedunia 2009.The theme this year is STIGMATIZED illness-To Understand, Accept & Change organized by AMSA UKM in conjunction with PERSIAP,PPK & JAKSA.As one of the high committee members, I'll be glad if many people willing to join us.

Title: ''Penyakit Stigma, Masyarakat boleh berubah''
Panels:
Prof Fuad Ismail- Jabatan Onkologi, PPUKM
Prof Madya Dr. Ruzanna Zamzam-Jab. Psikiatri, PPUKM
Dr Azmi Mohd Tamil-Jab. Kebajikan Masyarakat, PPUKM
Where?? Pusat Perubatan Universiti Kebangsaan Malaysia, PPUKM
When?? 18/07/2009(Saturday) from 2.00pm till 5.00pm
Fee?? FREE of charge

Contact person:Siti Juliana 017 370 2023, Noradila Salmi 017 953 9608

Publics can also join the blood donation, medical check-up and mini exhibition.
Where?? PPUKM
When?? 17-18/07/2009(friday and saturday) from 10.00am till 5.00pm

Hopefully our small effort will make the difference..by making people aware of the stigmatized illness.Hopefully many people will change and make world better place to live.

Poster of HAri kesihatan Dunia 2009-Peringkat PPUKM



Wasalam..(",)

P/s: Stigmatized illness patients can be pretty and live happily like them...so, CHANGE to make the world a better place for them to live.

Engaged not yet MARRIED

Salam..

Yes i'm ENGAGED but not yet married to MEDICINE with white coat as the prove of our agreement . Gotcha...think i'll engaged to someone for real huh??(",)Hopefully i will wear the 'white gown' and get married to medicine in 3 years time. May god forbid any failures that can cause my engagement to be extended(repeat year) or ended(drop out)

This is my 6th week in surgical posting and i followed 5th year senior's long case assessment(thank u abg shah for inviting me and few other 3 years).MIne will be next week(huhu..takut nye). After everything comes towards the end,their supervisor Mr Azizi( a neurosurgeon) share some of his insight on medical life..He said "students,u all are married to medicine. Your future husband or wife will be your second (madu la kot)"

Marriage itself means COMMITMENT to someone else other than yourself.

From my understanding is, once you accept to enroll into Medical school, you have sign an agreement to become a doctor. Being one is not easy..A LOT to cover..memorise..skills to apply..Having a good communication skills is an advantage. We have to put OTHER PEOPLE 1st than your own need.Helping people is your priority.NOT money, power or social status

The MAIN JOB to medical students is STUDY and mastering taking patient's history. History taking is not somthing that you can take light. I use to think that it only need memorization. The truth is, it also needs some intelligence and thinking. It is like a maze that you have to solve.

First of all you have to identify the patients' main problem,ask relevent questions and then try to find other possibilities that might contribute to the problem.

Afterwards, base on your knowledge to differentiate the 1001 diseases manifestation, you have to choose the hypothesis of what might be the disease.At the end, you have to present your finding in the most concise way which may sounds easy. However,it also needs your ability to concise it the right way.Pratice Makes PERFECT!!.

Regardless the reality of the work, it is NOBLE to choose to be in this profession. Lesser burden to whoever think that the knowledge they gain from the patient is intresting and motivating.You'll think your life is more meaningfull to see patients leave you in better condition.

Wasalam (",)

P/s:
1. feel bad for patients who have bad prognosis...huhu. May they have strength to face it with courage and determination to live their life better.
2. I saw an amputation operation(below-knee) during my on call on friday.cool...bu kesian that pakcik to have a leg amputated.

Sensitive question....

Salam,

What do you feel when someone ask you about your sexual activity?? In medicine, it is relevent to ask this question to the patient when necessary regarding to the problem.Definitely,we will keep it private and confidential. Today is the end of my 5th week and so far I had some 'shocking information' from two different patient.

I bet you it is not easy to ask those question in respect to the patients' feeling. It is a bonus when the patient really confess to you which means they do really trust you.We in the medical field cannot banned or stigmatize certain group of people(even though we don't agree with their conduct) by treating them differently.It is the rule of ehtics to be beneficience,non-maleficience, justice and autonomy in giving our service.

So, what are the shocking news??

PATIENT 1, an old indian man. he confess having multiple sexual partner since 20 years old.Most of the reason is due to influnces from friends.He admitted that he have high sexual drive. It happend since his early twenties.He said that its common with his Malay MUSLIM friends. He even saw some of them have sex with dogs(tak masuk dek akal btol manusia ni).
He spend some of his money to support the 'prostitution bussiness'.Up till now his family especially his wife doesn't know about his extra activity. He was admitted to the ward because of difficulty in urination due to benign prostatic hyperplasia(BPH).BPH is enlargement of the prostate that constrict the urinary tract causing a person to have slow flow,increase frequency in urination etc.It is common in middle aged men..

PATIENT 2, a 27 years old Malay Muslim man who is practicing anal sex.FYI, he is well educated man with a degree. He admitted to still have feelings on women but not in any relationship with them.He agrees with the idea of marriage and have have kids if he find the women he likes. The activity is painful but according to him,is not painful to do it if he likes the man.He do it at least once a week since the past 3 years.He started with oral sex and then advancing to anal sex due to influences from friends...

out of curosity,i asked him a few questions and here are the summary...
1. each week will be a different partner
2. they meet through their special website
3. some of them are married man with kids
4. it happen to all kind of people: students, teachers and even doctors..
5. muslim men also involve with this...
6. usually they are man with soft personality(usually they will be the receiver)
7. normal looking man also do it(usually they are the giver

He was admitted to the ward due to problem with the fistula of anus(the anal canal is communicating with the skin surface).It happen mainly due to hygienity problem. The predisposing factor in this man is his sexual practice that can cause infection to happen easily on the anus.

Regarding practising anal sex with strangers...he have high chance to get other uncurable infections like HIV and hepatitis B or C. I pray that he will stop the conduct and try to appreciates his live more in a better way. I can only give my advice but the decision is in his hands to change.

My own tought......
I don't know why people still do things eventhough they know it will harm themselves.If they believe in god, don't they think about afterlife(hari akhirat). Don't they care about the sins they've done?? (tekejut juga ramai MELAYU ISLAM yg terjebak)

Maybe the pleasure they have right now win over their guilt of sins..

If you have the will to change, anything is possible.
Wasalam(",)

P/s: tau pasal ni, takut pula nak kawin..huhu.kpd bakal2 isteri diluar sana check background bakal suami anda.kepada lelaki, kami perempuan ada tak payah cari lelaki lain..hehe

I feel small.......

Salam..

For Surgical posting, I was assigned to vascular team and all the registrar are taller than average Malaysian man. So, imagined what happened to me during the ward round(visit patients bed).I have to find any posible potential space to fit my 5 feet tall self in able to have a good view and be apart of the team.Sometimes i just stand behind them and see the patient through any spaces exist between them.

However the title above isn't about size issue.It is a methaphore of what i feel since this pass few weeks.

I feel small as i feel my knowledge wise is still not enough. The discussions i have with my study group mates and team members does really helps me. Questions bombarded to us during ward rounds or teaching from our supervisors, registrar, Medical Officer or any seniors do give us clue in what should we know. Well, they are a lot.Sometimes I know the answer but the way I convey it is wrong. I hope I can master the skill of answering 'maturely' according to what they want.

I feel small as I am hopeless to see and hear people crying of pain. There is nothing I can do except doing anything I can to relief it.During certain painful procedure what i can do is only provide some supportive words and pat their hand or back. To be in this profession we can give our emphaty but not total symphaty. If you are emotionally liable to them you cannot perform your duty towards them well.

I feel small as I never think I can do everything alone. As a medical student, I do rely on my friends to relieve my studies burden.Knowledge are for sharing, it is not for keeping. We learn and remember more through discussion rather than reading alone.

I feel small as Allah's humble servant as anyone can get sick. Sometimes death comes within a short notice and you don't realise it until its too late. A patient that i clerk(interviewing his problem) and do a bit of examination on last tuesday was only 27 years old. He was detected to have liver cancer stage 4 within a month. What puzzled the doctors was he doesn't have risk factors to have it and the cause was idiopathic(unknown).He passed away on wednesday(the day after I clerk him).May he rest in peace...AMIn.

I praised the mother to be very supportive and never leave his bedside to be with him.The father is a responsible man to take care of their other 3 daughters at home in Malacca.The neighbours back home are caring enough to hold Yassin recital and Hajat Prayers for him. She told me about her sons' problem without any single tears in her eye. I guess she accepts her son's fate as Qada' and Qadar from Allah. I am sure the there are reasons for all the things happening to us (good or bad).The way of how you accept things will determine what will happen next.Being always humble to him(Allah) does make you always put Allah first in your heart. Hope I can maintain that.

Moreover,doctors are not superhuman, they can get sick too.Patient comes to you to get better regardless you are sick or not.

Today, alhamdulillah I manage to do venopuncture(taking blood from vein) from a patient at Internal medicine ward for my logbook.I've already practice this procedure with my friends a few times and as the consequence, we get bruises at the site of needle puncture on our arm.Well, no pain no gain.hehe.. We willingly to injured ourselves in order to be competent in doing the invasive procedure to the patient.

Wasalam (",)

P/s can't wait for the weekend to have a nice jog by the Taman Tasik Permaisuri...and i'm Not going home.Have case write up to be done!!

Time is EMAS..

Salam,

Demi masa sesungghuhnya manusia kerugian,melainkan mereka yang beramal beriman dan beramal soleh...I have to agree with this verses from Al-Quran taken from al-Asr(Time).I would like to apply this verses to show how precious time is(not in a religous angle). We never realise it till we get really busy or into trouble.

I realise now that only those who have passion on medicine can survive the life long learning years.Encouragement from parents or intrest alone can't isn't enough to satisfy the needs you have to satisfied in order to be a DOCTOR!

Why??
1. STUDY always is the top most priority(after Allah the CreatoR)..i get this habit of reading anytime i can as I always feels that my knowledge is still shallow.

yup, we need to cover a lot of things..

2. Time is EMAS(gold)...everytime is valueble and you have to learn to put 1st thing 1st. Thus, time management is very important. I have to sacrifice my sleeping time..huhu

3. Have to always think POSITIVE and raise up from any failure with dignity and a promise to work harder (This is what i get from stories for those who fail and have to re-sit exam or even repeat their year without giving up).Though, i never plan on repeating year, may Allah forbid that from happening

4. Understanding from people you have comitment for is very important. Alhamdullh i don't have comitments to anyone except my my family so far. Lucky i trained myself to only call my mum once a week or only for important things since i left home to further studies at Indonesia. I always told them my life now is not as easy as before,I hope they understand me..

Regardless all I mentioned above doesn't draw me back so far....because

Alhamdulillah,I have passion on becoming a doctor...

Since i get bored of only watching and clerking,today I assisted the nusres at procedure room of surgical clinic doing wound dressing, removing the suture and changing the suprapubic catheter.

I feel happy doing those thing regardless the smell and view that might cause people have nausea or loss of appetite..This is because i learned a lot(knowing the way of handling equipments) when i do it rather than watching.I'm glad Kak Fiza & Kak Dijah let me assist them..

For me to be good in something you must know everything from the basic till the complicated one. Its a good thing also to learn about the hospital policy and the fee the patients need to pay(saja ngada nak tau lebih2 la pula...",)

Today also i met the patient i clerk during first week of posting. I help up cleaned his wound and glad to meet that uncle again.His wound looks ok and I'm happy with it.

Good communication skill also the key point in becoming a good doctor. I have to get patient's trust and intrest during taking their history of disease. I was told by a Medical officer, to be a good student, you have to clerk at least one patient a day and do general basic physical examintaion on him/her.Since then i try to apply that.

As a clinical student, i have to be creative in finding the opportuninty to learn wisely. Like what i can conclude from Prof Hanafiah(my group spervisor) advice, there's nobody will tell you what to do. You have to find it yourself the opportunity to learn and not wait someone to come and teach you.

I had a valuable lesson earlier this week of not preparing much and not revising well on my basic knowledge.I hope to not repeat the same mistake again an always alert on that. Hope i can perform better.

May Allah make my journey in life smoother and easier..AMIN!!

Wasalam..

Ps: I still think that life is wonderful and meaningful in its own way each day..hehe(",).

2nd week.

Salam,

First of all Allhamdulillah(thank u God) for given me the chance to live till now and celebrate my 21st birthday today(June,6th).Key of freedom they say..I think its key to responsibility to make the right decisions in life!!

Second week just ended today.I and my housemate take the half day off,go to KLCC and watched gorgeous Zac Efron in '17 again'.For me, i feel kind of weird to exposed around people after only go back & fro to hospital for the rest of my days. The white coat really have an effect in changing my personality,psychologically in a positive way. With the white coat on I am ready to mingled with patient, seeing dreadfull wounds...Without it I'm just Me someone's daughter, friend and sister.

After a few times reschedule,changing groups we finally settled with our original group during 1st week. I'm very glad with that decision as i really LIKE my group. I am very thankfull to have a nice group members that are dedicated to our group and the most important thing is cooperative and willing to share. Sharing is caring right??

As a group leader, i make sure everyone gets the opportunity to fill up their log books,arrange teaching meet with our busy supervisors and our schedule.Extra thing we do is we set up our own tutorial meet at the end of certain procedure or OT and discuss what we have learned and what we should read more.Thus, i makes the learning process much more benificial to everyone in the group.

This week also,my study group just started our meetings and I learn a lot from it!It consist of 5 members (3girls,2guys).I think everyone should have study group once you enter clinical.

AFter 2nd week, i can see a few ADVANTAGES that i have as coming from UKM-UNPAD twinning programme:
* Our SKills lab really exposed us too the clinical. Here, i had a workshop yesterday and learned 6 skills. Each skills was taught for 10minutes in rotation of seven groups of 10 students. The skills that we learned were:
1. Urine catheterization
2. Pre Rectal examinationa(aka Digital rectal exmntn)
3. Suturing and holding the equipments
4. Nasogastric tube insertion
5. Breast examination
6. Brannula insertion(aka IV insertion)
Imagine how lucky I was to learn one skill for 2 and half hour€s in a group of 10 in a week and get evaluated in the second meet in the same week at UNPAD. Everyone get the chance to memorize,learn and use all the equipments adequately.However, as people have variability, the skills are slightly different but allahamdulillah I can adapt to that.

* We learned more cases.Logically we learned more as the regular students learned pre-clinical for 2 years and ours are 3 years.However, i still have to re-read as i forget some of it..hehe

* Since we know certain things more, we become quite confident to do things.yeke??(kembang kuncup kembang kuncup)hehe..Maybe some of us do...A radiologist told my friend that he heard that UNPAD students are confident.It must be from talks among his colleages since our postings doesn't majorly involved radiology yet.

I'm glad that so far my friends from UNPAD manage to be OK in here. So far i didn't here any negative comments on us..I hoping to not hearing about it at all i the future.

Wednesday was my lucky day as I get to do all the things i planned on that day.What are they?
1. Clearking a very cooperative patient in the surgical clinic.

2. Presenting a case in front of a registrar(doctor that is going to be a speacialist).He corrected me and i'm glad that i learned my weaknesses at last in presenting case.Will try to present case again next time.

3. Watched an operation on removing the gallbladder(cholestectomy)by Open surgery method on a cholelithiasis patient whom i clerk a day before for my case assessment report.After it was removed, a registrar disect it and i get to feel the content(bile stones-moxed type)while collecting it into the specimen bottle. I get to feel a real gallbladder too.It was a WONDERFULL experience after standing for about two hours straight..The patient also a nice lady.She was very helpfull during the clerking me & my friend conduct befor the operation.She also let us practise some general physical examination on her.

So,those are some view of my posting this week..My inquisitive and motivation level is still high.Hopefully it will go on forever..(",)Till then, bubye.

Wasalam.

P/S: i got a sister in my family at last...a sister IN LAW (",). May happiness will always be with you Abang Yayai and Kak Yah.Can't wait for a nephew or niece and becoming and aunty..