Sharing A Case: Wilms Tumour

Last night, i have had a dream...it was an odd incidence which i actually dreamed of a Wilm's Tumor.

in a random day,a toddler was brought to the emergency department because of an irregular mass felt by the mother on the left hypochondrium. and, the mother also added the toddler has not passed motion for quite some days with no urinary system problem.

as typical student, we are interested with something presented abnormally rather than normal. hence we approached the caring mother with a sympathy tone and ask about the toddler. after a while, we were palpating the child's abdomen and felt the mass. it was a firm to hard, irregular oval shaped mass, sized 5X6cm, poorly demarcated margin, located on lower left hypochondrium and upper left lumbar region of the abdomen.

initially,the caring mother was expecting the mass was just feces secondary to the constipation, however, as the attending approaching, the facial expression of the mother changed and become worried. slowly the tears was running down unstoppable. as the they delivered bad news to the mother, they had suspected the mass was actually a tumor, Wilms tumor and further investigation is needed to confirm the diagnosis.

any parents would like to see their child or children always at the pink of health. they were working tremendously to keep their children comfortable and saving the best for them. we felt bad for the sick child and the poor mother, besides sending our regards and show our sympathy to the mother, we barely can do anything. Giving hope to the mother seems to be the wrong move to pinch in. hence, wishing them and hoping the treatment will cure the child are the least thing we can afford. May God bless the child and the family.

Sympathetic Tears

Grayish background decorated the usual baby blue sky that i've seen daily, accompanied by the symphony of thunder and the wheezing of wind. Dark, black, massive cloud, sign of Stratocumulus is incoming. at this time, everyone's pace seem to appear faster than usual, marching impatiently towards all the entrances of the hospital. "Cepatlah, adik" shouted by the worried mother. in her hands, holding side by side, there were a bag and some water bottles in a basket. from the observant point of view, someone has been sick and brought to the ward. she is just non other than a typical visitor to the sick.

in the ward, the crying pitch of the unwell toddlers has broken the silence.....
i saw worried faces, anxiety parents, exhausted mothers, busy doctors, caring nurses were scattered all over the space. voice of comforting and support has been filled up the entire room. i was there, staring towards the crowd and search for calmness. rarely, it can be found! added with the routine morning prayer. and it was melancholic. i was thinking. as the pitch moved to a higher frequency, the cleaner was shaking her head to show the helpless circumstances, they just could share the feelings of the patient but not to their pain. She walked off and continue her duty.

the world can come out 10 points, how a doctor can be a good spouse or draft another 10 points to mock the doctors. this is the realistic world as we are living within, as student, we were already trained how to deliver a bad news, no matter what is the degree of the worst, it has to been passed on. unnecessary tears and touch is avoided, because it has to keep a certain gap from a doctor and the family member. i don't know about the others, but i choose not to show over sympathy or attention to a particular patient because of what they are going through but rather looking for other way to pinch in. this does not make a person being cold, or mean but another sadness or grief has serve no objective towards the sick.

what we are doing now is a way of learning, and behind those sympathetic tears, it has its own story to tell. we learned the way our lecturers had taught us, and we hope that we learned it well, and some day we can stand alone and perform well in the field. but, what should we bear in mind is, besides the lecturing and classes taken, patient is the one who taught us the most. without them we were just a bunch of human poking each other to draw some blood, scanning each other as if we have tumour and taking history from one another as if we are the story teller. to whom we actually appreciate the most is our patients. Maybe we don't see them after they got discharged, but during the staying, they are part of us. we hope they can get well and leave the ward. we share their story in the cafeteria, we laugh at them because they are naive, we feel sympathy when they become more sick, and finally we come to a point of realization that, what ever we do daily in our life is and for the patients. we are bonded with them since the first day we step into the clinical posting.

we are the students who were wandering in the wards everyday and presented as fools in front of our lecturers because, we are dumb in our way. i really hope that, 3 years from now, as all of us graduated and posted all around the country or world, and all the scoldings we had taken and the tears we had shed, is a way to mold us and make us be prepared and enable us to face the world in real.

Historian

It's just like a historical day, familiar and 'knowing' was creeping my neurons inside my skull. I tried to elicit every single storage in my brain and compare with the day. Slowly it recalled and reminding, it was shooting the day she left. My heart was freezing, cold and senseless that day. I was stunted in the middle of noway without a goodbye message from her. what i can recalled is, i was roaming and biting the lamp pole with some uncertain rhythm. i have forgotten, the color of her iris, the shirt she wore, the high heels she likes the most and the smell of her perfume. not a single thing of her i can remember. i let her go...disappears~

History repeats itself. No, it's not, it is the mistake that keep repeating. it was the exact setting, but played by a different being. Here she goes, leaving this place for a brief vacation. She left without a word of adieu. Was she wearing her darling bracelet, or bringing her travel dairy along? No one knows..mysterious ..It supposed to be a saddening scenario, but no one was reacting as it supposed to be. it's against the script-play. the summer wind blew away the dust of poignant, blended and mixed with the air and up-high. i exhaled.. disappeared~~

my mind is loaded with all these history books..its time to place them on the shelf, let go is the hardest things to do. Im signing off..gone!

Kampung Nelayan_Tg. Dawai_Kedah Darul Aman

Community Diagnosis Posting, 2010

Hat Yai, Thai

think globally act locally

well, its exam season again. this is the only period that i have time to write, write and write. things around me become more magnifying as well. i can pick them up and pause on them. people will laugh of my insanity or mock me like a fool, and i laugh at them because they just don't SEE it. in here, i usually dont talk on something that sounds pleasant or joyful. if some of you has been reading my posts for all this while you will realise that the tone that i used mostly, is regularly melancholic and sarcastic. occasionally, it will be more sympathetic, and rarely joyful. why? i think most probably, happiness and joyful moment usually we will remember and secure them inside our encephalon or myocardium. on the other hand, those angry and saddening scenarios will be placing behind and get forgotten. thus, here it is, i have recorded most of them. somehow i believe it has something that worth learning and remembered.

think globally act locally! here, it doesnt apply for any health purposes nor 'gotong-royong' motive. its just something that happened in my surrounding and it has become more obvious recently. however, it has been reversed. at first, we deny all the facts of politics, power, fame or something in return, because they cant be positioned in this community. we don't mention about hierarchy as well, it looks as ugly as those in front. here, we only talk about teamwork, giving and respect one another.

i like a Chinese quote, 'don't judge a person with a coloured spectacles'. at your position, you shall not see only the bad but ignore the good. you shall find the lost and guide them. for those who are ignorance and rebellion, please follow the flock and stay as one. don't split with your kind and done ridiculous. you will not be praised but be ruined.

you should give rather than receive. you shall not be 'everything is me'.and, i do understand the pressure and burden you bear with. share your stress and your unwillingness with your peers, and shall not be showered upon your flock. take advice and away yourself from emotional duties. it will decay your supportive poles. believe on rules and regulation, no one shall be above it. sometimes being an idiot is a blessing, there is no necessity to fight back.

last but not least is respect one another. it is hard for everyone, i agreed because i also get myself struggled within it. but at least we tried, care less if the others don't respect you. maybe it is not an ideal advice from one who respect-less the others. but you are different, you need this quality. in return you will be respected.

im writing this is not to against anyone, and zero motive to lean on somebody. it is the thing that has been magnified somewhere that i recalled of. please don't take this personally and negatively, it is only a person's thought. i hope that you will be stronger and 'global' in the coming days. all the best...

the one who called me fridge face!

Picture of Shaun Ng

a simple dedication to you, jess,

i tried to hate you, indeed im trying! unfortunately, i failed to hate you... as the morning sun shines upon my face today, i think of you. i think of your little evil smile, and is your smile that bugs me this morning. thinking of you is like a morning call, reminds me daily, so that you are always in my mind. i like the way you talk, the way you smile, the way you act, and of course at the top of those i like you are always who you are. you are pure, but not as pure as the driven snow, instead you have a little evil in you. indeed, it is the little evil that makes you outstanding from the other roses, your charming buds won the the hearts of the hundred bees. gosh, i start to miss you, girl. now, im wondering when will be the next time we go for a walk, or perhaps dinner at The Little Cottage and footing on the sandy beach...how i wish that moment will be realised in a blink time..how i wish....Jess, i missed you, so much......

if someone had read this post, i can assure that they will be so confused and shocked. an unintentional made rumour. this is because of a FRIDGE! and we are in the middle of war.....well, apparently im kidding here...anyway, jess is real charming! seriously...

last sight

you are a fool!! you had spent some pleasant moments with your consort, is that the only thing that you care the most?? your erotic vocal utterence is disgusting, anyway! you are still an idiot! you had obeyed the law of nature, but when liablity is to be spoken. you are like an ostrich, hiding your pea-sized brain into the sand. hundreds of preys are out there. but you rather believe the most dangerous species will take care of your poor cubs. undeniable, most of the homosapien do have the feeling of love and sympathy, but some are more cruel than your fellow preys. they are inhuman human, show zero mercy upon your innocent cubs. interference of their territorres, will make you pay up a lively debt.

the first time i saw you, was your pure innocent look. when i took the last sight on you, you are already a piece of art~~ how pathetic??