I’ve just made a new discovery. Get a blue ball pen. It doesn’t matter what brand it is. Wet the tip and then smell it. Smell anything familiar?

Yes, the needle is a sharp object. Poke one into your flesh and some of you will squirm, some will merely utter an “ouch”, some grimace, some scream, others take it like just another harmless pinch at the arm.

I was taught to give intramuscular injections for vacccination against tetanus to a number of Form 3 students in a local secondary school this morning. Before that the nurses gave short anti-smoking speeches to class after class of young brats and oh boy, they sure had a difficult time keeping those monkeys seated on their chairs just to pay attention! Not only did they refuse to listen like they have ears, they shot nonsensical questions which made your blood boil. When the nurse gave them a grave look, they giggled and rejoiced in their victory. The next instant, they were hatching more cheeky questions and pranks to attack the medical staff. I stood at the back of the class and watched the entire drama. I’m sorry for feeling relieved not being the person in front giving that speech and facing these youths. I seriously don’t know whether to laugh or to be mad. How did students these days become like that? Or have they been this way for centuries?

When the students are ushered to the injection stations set up in the school hall, the “tough” and “cheeky” ones began to show their true fear. It was an amusing sight. Most were avoiding the needle, cooking up various tales and excuses to be exempted from the prick. Some were in pure denial - walking around the hall, subconsciously rubbing their left arm just to stall time. A few became expert researchers… moving from station to station interviewing their classmates before, during and after the prick trying to decide which nurse/medical student gives the least painful injection. Some had to be coaxed. Other had to be forced or shouted at.

So much drama for just one simple anti-tetanus injection which is for their own good. Truly, the smart-aleck and the big bully may not be the bravest!

The next time you are irritated by a naughty student like that, look them in the eye and say, “Shut up. Here comes the needle.”

The past one week has been pretty eventful. As I mentioned in the previous posts, I’ve been involved with the school health survey, home visits, blood donation drive, aedes survey etc.

These are the few lessons and reminders that came to my mind over the past 5 days…

1. It is not easy to be a teacher.
If you have nice and obedient students, then I guess it may be alright. But if you have a class filled with cheeky students who don’t give a damn about what you say or teach, well, that is another story.

2. It is not easy to be a school-health nurse.
Giving health talks in schools daily when nobody wants to listen is really a test of patience. While the poor nurse was trying her best to educate the class on the dangers of Estacy pills, some students were chatting among themselves, others were glaring/sneering at her, while one student was actually fixing her hair while staring at her reflection in her pocket mirror. Argh!

3. When you hold a needle, you have the upper hand.
When these same annoying students lined up for their anti-tetanus injection, they weren’t looking as smug as before. Hrmmph. The ball is now in our court. Better be nice to us, or we’ll jab your arm really really hard…

4. The blood donation needle is huge.
I’ve never donated blood before as I have been conveniently underweight previously, therefore being ineligiable to donate. Now that I’ve seen the needle up-close as well as inserted a few into other people’s arms, I am all the more determined to remain underweight.

5. People in small towns have bigger veins.
I postulate that it could be due to the fact that they have a tougher life and exercise more. These small-town people are also much more forgiving when you miss their veins, unlike those in the metropolitan city who would just scold you and demand for your qualifications.

6. Giving birth is a painful process.
5 of us watched 3 deliveries in a row on Wednesday night, and that was enough to put us off giving birth once again. The first mother gave birth so fast, it was as though she was laying an egg. The 2nd mother on the other hand took quite some time before the baby actually came out. As for the 3rd mother, she was screaming and crying and not wanting to push. She needed an episiotomy and the nurse was waiting for the right time to cut. As the baby’s head kept popping in and out, she was also deciding whether to cut or not to cut. Each time she nearly cut, our blood pressure shot up, we stopped breathing, only to repeat the cycle until she finally snipped it…

7. 10.00 am is tea-time.
In government service, morning tea is a very important meal of the day. No matter what you are doing, you’ve gotta stop for a drink, a kuih or something lah. Then only got energy to work mah.

Well, I guess this is all for now. Perhaps there will be more to come in the future…

People always wonder why we have never opted to share a room in hostel after moving back from Klang. Well, “good” friends as we are, we also need our own space lah. Apart from that, we’ll probably be talking crap all day that neither of us would be able to get any studying done.

Anyway, we finally did it. We are currently sharing a room in the so-called spooky/eerie hostel of Banting Hospital. As expected, we hardly did any studying over the past one week. Most of the time in the room was spent talking rubbish or sleeping.

No prizes for guessing who’s staying on which side of the room…

This past 1 week 4 days has been long. And when I mean long, I mean really long. It feels as though we’ve been here for a year. But it’s only been 4 measly days.

While CN-’s been “busy” with hospital work, I’ve been trampling around Banting town and its peripheries doing various Nepolitan-like postings. Monday was filled with briefings , Tuesday morning was the school health programme, evening was the home visits, Wednesday was spent at a blood donation drive at the nearby police station (which one of our coursemates mistook for the hospital and drove right straight into that station on the way back from dinner), while today is fogging. Yup, MORE fogging. As if we haven’t seen enough of mosquitoe fogging. Back in UM, they even fogged us while we were sleeping

As for paranormal activities, I believe that it has a lot to do with one’s imagination. It’s not that I deny the existance of spirits and ghouls, but well, the more you believe that a place is haunted, the more prone you’ll probably be to have a sighting. Anyway, our room fan is now permanently left at dial number 2 as it gives CN- a slight peace of mind that it won’t just fly down and disfigure her while she is sleeping.

Just to end this crappy post, which has almost nothing to do with Nepolitan ice-cream except for the variety in the stuff we’ve been doing, we’ve noted another 2 places in our room where we could trip and cause serious morbidity or even mortality.

1. Tripping over my slippers (which is always laid someplace totally strategic for that purpose)
2. Slipping on the bathroom floor and smashing head first onto the sink

The END

This is our third day of our posting in the Kuala Langat District Hospital in Banting. Every night Jel and I ask each other the reason we are posted here for. We could not provide the question a satisfactory answer. Each morning we drag ourselves out of bed and wonder if we are nearing the weekends so we can return to PJ - to our own cozy rooms in 6th college, to a less haunted place, to home.

“What day is today?” Jel muttered at the second snooze of the Crazy Frog tune of her cell phone alarm. It usually rings when I’m washing up in the bathroom and never failed to make me laugh with my mouth full of toothpaste.

“It’s only Wednesday.” Another thousand light years from Friday, I thought to myself. Looking at the mirror in front of me I allowed my imagination to run wild a little. Maybe there’s a non-Jellio` figure floating just behind me. One with long black hair, perhaps entangled due to lack of daily combing. A red eye globe almost popping out of its socket. Skinny and ash-white hands sticking out of a white robe and reaching out for Jel me the door.

“When is Friday gonna come?” Jel mumbled from her pillows. The long-haired figure in my imagination vanished and instantly replaced by the March calander. Soon, I hope?

Our friends from another room brought old newspapers and scotch tape to cover up the tall mirror and another on top of the sink, both facing the beds - for fear of “paranormal sightings”. Another friend was imagining noises since our first day here while a male coursemate refused to stay in the room alone when the roommate is on night duty in the hospital. They tried with all their might to shut away any possibility that may invite “unwanted guests” into their rooms.

Even before we set foot on this place, we’ve heard numerous ghost stories and personal experiences from coursemates and seniors. It sounded like this hostel houses a large population of lost souls who failed to gain entrance to Heaven, Hell or Purgatory - like a temporary Ghost Camp on earth. Two weeks ago, Jel and I were joking about bringing crucifixes and crosses the size of our heads, Holy Water, etc to “bless” the room and keep away spirits. Yet we travelled to Banting on the past Sunday packed with Tommy and Azeroth (our laptops), speakers, loads of food and some books - anything but huge crosses and the Holy Water.

Upon arrival, there were Jel and I in our twin sharing room. 24 hours later, there’s still only us. And perhaps a mosquito or two. Finally, we decided that this hostel is not as creepy as we thought it would be. No floating robes, female weeping sounds, flickering lights, etc. Perhaps I watched too many horror movies my threshold for spooky stuff is rather high. But the ceiling fan certainly spins at an amazing speed no matter it’s switched to any level from 3 to 5. The spinning blades gradually grow loud in movement and the air in the room will turn so fast it seems like there’s a mini hurricane brewing in the room. For fear of it suddenly comes crashing down on me, disfiguring me or chopping Jel into chunks of flesh and bones I’d always get up to slow it down to 2. Then there’s this long extension cord Jel bought to plug our laptops, lamps and handphone chargers to the socket so inappropriately located at the other end of the room far from the tables which we always trip over. We agreed that one fine day one of us will really trip and fall horribly with a fatal trauma to the skull and brain. Then we’ll haunt the room and the hostel will live up to its spooky legend.

“Eh, bangun la!” I said when I emerged from the bathroom only to find Jel still nicely tucked under her covers.

I’m not sure what she said. Guess it must had been some sort of a grunt, moan or groan. We’re 5 minutes late. And it’s only Wednesday.

CHiQ made an Oreo Cheesecake for Dobbs, and I had the golden opportunity to sample it. Frankly, I thought it was simply delicious Much better than the Oreo Cake from Secret Recipe, which taste mostly of cream than anything else. Way to go CHiQ!!

I have the priviledge to perform the Mantoux’s test on a patient fellow medical student today! Yay!

Mantoux’s test is an intradermal injection of tuberculin, a clear solution containing protein derivatives of the bacteria causing tuberculosis (TB)or commonly known as Mycobacterium tuberculosis. It is done on patients suspected to have contracted TB. However, it is not a diagnostic test as it only confirms the presence of immunity against TB bacteria. The patient may find an enlarged, slightly raised or even reddened patch at the site of injection. Fear not, as this is the common skin reaction to Mantoux’s test. The patient has to return three days later to have the skin induration measured by a doctor or an experienced nurse. If the diameter measures more than 10mm it means that the person has immunity against M. tuberculosis. The activated defense system against TB may be due to a past infection, an on-going infection or immunity as a result of vaccination against TB i.e. the BCG (Bacille Calmette -Guerin) injection we receive at birth. A induration size of 15mm or more is likely to suggest an on-going infection with an active defense system battling against the bacteria in the body. Nevertheless, it is important to bear in mind that TB is not diagnosed via Mantoux’s test but by sputum examination for acid-fast bacilli (AFB). Usually there are also positive lung markings in chest X-ray.

I injected my coursemate with the tuberculin and vice versa. It hurts just a little. I think a red-ant bite is more painful than a needle prick. It was pretty easy but the nurse commented that both of us had injected a little too deep into the skin. This might affect the readings. We weren’t able to produce the nice, raised, circular formation of orange-peel appearance on the injection area once the tuberculin was pushed in. Anyway, I’m looking forward to measure my induration (if there’s any at all) three days later. Hah…

This afternoon I shall get my hands on the kids :p If I’m lucky I might get a chance to immunise babies or toddlers! Too bad the diabetic clinic was not opened today or I’d get to self-inject insulin on my own abdomen, as what insulin-dependent diabetic patients are supposed to do. Of course, the insulin will be substituted with normal saline instead to prevent inducing hypoglycaemia (a state of low blood sugar level) in me.

It’s not that I love getting pricked. But I thought it’ll be interesting and meaningful to really put myself into patients’ shoes and feel the pain. Not a sickening hobby… just for experience’s sake

Lesson of the day:

Work for the government. Reason? Your medical expenses are well taken care of. Now and until the day you meet your Maker.

Not so much of patriotism, really. You’ll either die of old age (this is getting rare nowadays as a result of our hectic lifestyle, bad social habits, improper diet, sedentary living and city pollutions) or sickness/injury one day and as we all know, medical expenses are on the increase following the improvement of modern medical management in terms of drugs, equipment, etc. Unless you’re born with a silver diamond spoon in your mouth, a key to the latest BMW in your hands and a family fortune that will last you for more than a lifetime, then you may need to sell of your every possession, mortgage your property or appear in local news to make a plea for financial aid to the public in order to settle your medical bills if you were to be inflicted with diseases like cancer. *TOUCHWOOD*

Think about it, it can be really difficult for someone out there just to stay alive. Nowadays, the poor can’t even afford to be ill. Yet the rich are spending their money in a ridiculous way just to satisfy their wants, upgrade their social status or to keep up with the Joneses. Who says the world is fair?

But then again, for those who agree with me - fear not… for there are angels around this world. I’ve seen some. God will find you.

I’m most ashamed of myself today. Absolutely.

Home nursing trips this morning were truly depressing. We followed a home nursing nurse to houses of dependent patients, most being bedridden patients as a result of stroke and spinal cord diseases or injuries. Besides pain and suffering, I see desolation and hopelessness in their eyes. They were no longer embarrassed to have their private parts exposed in the presence of strangers during urinary catheterization procedures - be them doctors, nurses, medical attendants, medical students or relatives.

The first patient left the strongest impression in me. She was a 40-year-old stroke lady confined to bed following bilateral middle cerebral artery infarcts (stroke) with a nasogastric tube sticking out of her left nostril for feeding purposes and a urinary catheter draining urine into a plastic bag attached to the bed side. Her lips were parched and she had a large gaping pressure sore at her lower back. Her eyes teared when the nurse inserted a new nasogastric tube into her. She winced in pain. She would have used all her strength to push us away but she couldn’t move a muscle. She was paralysed from the neck downwards. She would have screamed at us yet she couldn’t even utter a word of protest throughout the agonising procedure. Her elderly mother stood by the door and looked on. There were 5 young children playing by themselves on the floor beside the bed. I looked around and thought if things could have been worse… the small house stank, the floor certainly needed some hard scrubbing, the wooden walls seemed to be eaten away by termites, ventilation and lighting were poor. Suddenly there’s a lot to be done for the patient and her family yet it just didnt seem to be enough. Depression, coping abilities, financial difficulties, responsibility of care for the young and dependent, the poor health of the caregiver, etc began clouding my head. I thought I was fainting. Then I saw the patient looking at my direction. For once I didn’t know what to say. I just smiled. And she continued to look on. After the necessary work was done, we left with heavy hearts. I felt so helpless.

The next patient was an old lady who was also bedridden as a result of a stroke attack several years ago. I was instructed to insert the urinary catheter into her. After cleaning her genitalia and preparing the necessary equipment, I was ready for action. I separated the labia and thrusted the lubricated tube into what I thought was the urethral opening. It wouldn’t go in. I asked aloud for help, “I’m inserting this into the correct orrifice right? This is the urethral opening right?”.

A male coursemate said from my side, “Yeah, that’s the right one.” It must be. The clitoris hood was over it. The “vaginal opening” was right down - huge and looking like what it is - a vaginal opening. When I was about to give up, the nurse finally came nearer and peered. “That’s the clitoris, my dear”. That instant I was… horrified. Yes, horrified. What?! That’s the clitoris? Can a clitoris actually be that huge it almost look like a hole?! My coursemate who was equally horrified couldn’t control himself and blurted, “Oh my god, that’s the clitoris?!”

Yeah, I tried inserting a urinary catheter into a clitoris, mistakening it for the urethral opening.

I looked up to the patient’s face and apologised frantically, changed position and finally eased the tube into her vaginal opening urethra just beneath the clitoris. And the nurse was grinning, “Better brush up your anatomy”.

Yes, I’m truly, honestly ashamed of myself. Will go read my anatomy books right away lest I get confused again with the many openings at a female’s genitalia which don’t look the same at all in every patient. A lesson learnt the unusual way. Enough for today.