Monthly Archives: July 2013

BROKEN??? (Part 2)

To post or not to post? This has been the question I have grappled with for a while. Kept telling myself, Is it not just sour grapes? Get over it girl. Grow up. Really, what benefit is anyone going to derive from reading this. Most importantly, I told myself, you put yourself out there  as a strong young lady, this however, is so out  of character. Just drop it! Well, I am only human, and there is only so much I can take. When boundaries are crossed, people get hurt.

So, the day of the exam came… I wasn’t exactly impressed with myself at my first clinical station thus the plan was to go all out at station two. Examine the ABDOMINAL SYSTEM. Abdominal system? Really? I know we are all not medical students, but any fifth grader can tell you, the abdominal system does not exist.Basic Science! The gastrointestinal system is what exists. Why the fuss you ask? Well, we have all had examinations. Everyone knows that understanding the instruction is as much a part of the exam as answering the question. So I repeated, Sir, abdominal system? And he, in harsh tone replies,  I said examine the abdominal system.

This little stunt at the beginning of the exam could make or break you. Was I to examine the gastrointestinal system, where for example I could pick up jaundice in the eyes indicative of a possible chronic liver disease or was it just an abdominal exam, where all i had to do was examine the abdomen? My plan, do the abdomen then a general if I had time. After all if I was told to examine the precordium, I will certainly examine the area over the heart before attempting a general exam. God help me if any lecturer thought it within his power to ask a student to examine the precordial system or chest system, sound ridiculous, right? Yeah, so is the abdominal system.

This is Africa tho. Adults are gods. Who are you to challenge a consultant? They are allowed to do as they please. Pull stunts like this without any repercussions. Medical school examinations are so subjective, it is sickening. Get one consultant and you know you are very likely to fail, irrespective of your efforts. All the people I went with failed. U get just enough not to pass. what is called a VITO mark. Palpate deeply or lightly, you are wrong. Percuss firmly or softly you are wrong. We came out, and sharing our experiences, it was obvious, all he was there to do, was to disapprove of our actions. Case in point, for my ABDOMINAL SYSTEM exam, general exam was to be at the end, for my partner, general exam was at the beginning, guess what, we both failed. There was simply no passing with him.

Back to my exam, so I started, and he had problems with everything I did. U will think the consultants who taught me for 12 weeks were a bunch of idiots. Good thing I know better, this was just a person who had positioned himself to criticize everything. Then it happened. I started tearing up, I could not take it anymore. Was I really that stupid? Did I really know nothing at all? Was all that coming to the ward while unwell wasted. Why did I come to the wards the previous week when I was in so much pain, and yet right there during the exam, everything was wrong. Tears started rolling down my cheeks.

Then I found an enlarged spleen in my patient. Was taking out my tape to measure, which was normal practice on the floor on which I had been taught for 12 weeks. His exact words: “If you take out your tape measure you will see what I will do to you”. Sorry. Is it just me, or was that a threat. During an examination! What did I do to merit that? So, his point, estimate the size of that spleen. Maybe I should have figured it out. I didn’t. Direct communication will certainly have been more beneficial. He then proceeded to a time wasting strategy of asking about distances from Accra to London, and how they are obtained. Seriously dude, am in an exam, u really think that’s where my mind is? A colleague was asked to explain an idiomatic expression. Seriously. During an exam. It had no bearing whatsoever on the exam being done. All he sought to do, distract us and waste our time.

Back to measurements? What is the difference between 7cm, 8cm and 9cm, by estimation. Guess Mr consultant forgot that the difference between massive and moderate splenomegaly is 1 cm. A centimeter that can easily be missed. So in the end, we settled on massive splenomegaly, He wanted differentials, I gave him that, then he asks a question I obviously didn’t know the answer to. My reply, sir, I don’t know, guess what? He goes like, I knew you did not know that is why I asked you. Seriously dude!

In summary, I did it all. Was spot on with my diagnosis. Gave my differentials. Yes so I cried. No I did not do a general exam, guess what, the guy who did, failed too. He had cause to complain about my examination skills, but well, that was him just being… and I fail! Icing on the cake, I know people who straight up missed diagnoses. Located pleural effusion on the wrong side of the chest, no it was not an error in reporting. Full on got the diagnosis wrong. If your mom was the patient, with the pleural effusion diagnosed on the wrong side. Lord help her, yet somehow passed. Because they met a different consultant. Me and all those who went to this one guy, fail, for myself, after doing everything right. It is just unfair

The unfairness of this exam alone speaks volumes. Placed against the backdrop of my personal struggles to make it to this exam, I got to a point of asking myself, really, whats the point? Why go all out? If all its going to take is for one consultant on the day of exams, due to some highly subjective marking scheme, to fail me. I might as well not  put in the effort. He broke me. Never thought I will see the day. I am trying to crawl out of this pit because it can only lead to self destruction. Two more years of medical school, many more exams, I need to start caring again. At this point, no more pushing through the pain. If I happen to be feeling sick, I stay in my room. If I am in school, and I feel sick, I leave. No more all out. It doesn’t pay. Definitely not in medical school. Whats important to me now, my health, health and health. If however you are in a place where putting in extra effort gives tangible results, please go all out. I just got tired of putting my health at risk for no real value. That’s not to say I am  being lazy about my work. I am certainly doing the basics. Just cutting down on the extras, hopefully, for now.

Far reaching effects of one persons actions. It is unfortunate, but real. Please consider the full effects of what you say or do on others. A lot of people go through so much on a daily basis, so the little things you do, may have a much greater impact than you can even begin to imagine

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AFTER SURGERY EXAM. Surgery rotation was all about my health. Paradigm shift. Crawling outta the pit, gradually

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BROKEN??? (Part 1)

Sickle Cell Disease is no excuse! I went to the university of Michigan for my electives! The head of the neurosurgery department is a woman who has never walked! She is in a wheel chair! She has spina bifida…

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SURGERY! Important info on those pink sheets. BAJA textbook and of course, tea

Strong words from a colleague, one I respect a lot. She is helping me with preparations for my end of surgery rotation exams, which by the way, are just next week.  She couldn’t quite understand why I seemed so unconcerned about my upcoming exams. Considering, I’ve missed a lot of school due to ill health and I still am, due to ‘aggressive physiotherapy’ totally messing up my schedule.

I’m broken. The drive is lost. A lot has happened in the past, but nothing has ever gotten to me so much. I am even surprised at myself. Everyone says, let go of this already, but I just can’t. Sickle cell has never been, and is still not an excuse for me. I am the kind of person who goes all out. Gives a-hundred-and-ten-percent when  I am healthy, just so, if I happen to be unwell, I don’t bother about missing school and such. That’s me!

In recent times however, there has been a change. The genesis? End of medicine rotation exams. Yeah! That was one terrible time for me. Of the 12 week medicine rotation, you could say, I was only fully present for 4 weeks. My body started acting up. I knew I was unwell, just couldn’t put a finger on it. Frustrating, that’s what it was. Started seeing my doctors. Diagnosis? Relapse of pneumonia, right through exacerbation of bronchitis secondary to asthma to rib infarcts. Everything and anything.

Every diagnosis came with a new set of drugs. Went through the normal antimalarial, analgesics, antibiotics (from co-amoxiclav to levofloxacin), steroids( both prednisolone and symbicort pump and oh, I don’t even have asthma, did all the tests to prove that). Did xrays, lab tests, everything, I was still sick and in the end, my body just gave up. We had had enough.

One Friday, while doing what I usually do, stay on the wards after-hours to clerk patients, the ‘doctor’ became the patient. Excruciating back pain and there, I had my very own bed with my patients on my floor. Monday morning, my colleagues, consultants, literally my whole class knew I was on admission (I wasn’t amused). Was there for about a week in excruciating pain, and for the first time pethidine was not touching my pain.

Exams were approaching, and I needed to be out of there already. The pain meds were not working, my lab results looked good, there was no point keeping me there, so I was out. Exams in two weeks with an excruciating pain in my right shoulder (I am right handed), we resorted to an intra-articular steroid injection. Worked like magic. My joy was however short-lived.

Few days later, what do you know? Hip pain. Worst ever. On a scale of 1 to 10, I’ll say, we need a bigger scale.No kidding! Good thing, I did pharmacology, I know how to work my meds (no am not a drug addict, I take drugs because I need them). 100mg diclofenac was not touching my pain, and I wasn’t about to get re-admitted in under a week of discharge especially so, with exams staring me in the face.

So, I was limping around school. those were hard times. Now, we know it was the avascular necrosis of the femoral head. I did not know then. I would have probably ‘made reservations for a bed’ in the emergency room. Being the driven student that I am/was I went to the wards in my worst pain ever to examine patients and be the doctor. Though I more than anyone needed doctors at that time.

Then the day of the exam came…