Logic is not taught in books

Yep it's not. 

I am now in my 4th week of surgery rotation. So today i presented a thyroid case for our group's bedside teaching with surgeon X. Surgeon X is usually a cheerful, nice and kind person. But today....today X wasn't in a good mood. My first time ever seeing X that way. For all the wrong things that i mentioned, X would make that irritated-menyampah face and shout at me. I know you are having a hectic week and today is your bad-mood day, but do you have to do that? Looks like positive criticism and encouragement still have a long way to go in Malaysia. 

In thyroid chapter clinical examination books, it is outlined that we have to assess neck lump during swallowing and tongue protrusion. Today i learnt that for any lateral lower neck mass, do not ever assess them with protrusion of tongue! It only demonstrates how stupid you are. Protrusion of tongue is only used to clinically diagnose thyroglossal cyst. And one of the features of thyroglossal cyst is that it only lies in anterior mid-line neck. Logic that is not taught in books. 

But the thing is, different surgeon has different opinion on certain things. Surgeon X said that we never really do Pemberton's sign because by the time we see flushing, patient will collapse any seconds later. When i was in Vincent's hospital last February, a registrar excitedly demonstrated Pemberton's sign to me. I saw flushing on that patient's face. He didn't collapse, his face was all red but he was happily smiling at us. But of course we didn't keep him that way for a long time la. My logic is, why would they even mention about Pemberton's sign in books if we should not practice them?

On a different occasion, surgeon A said we no longer do renal punch these days as it elicits pain in patient. But surgeon B in another hospital said we have to do it! And many other different opinions on many different things. Oh God....can you surgeons not make us medical students confuse?!

I'm not asking to be spoon-fed, i just wish for a better guidance. Time evolves, so do human. The teaching style back then might suits the earlier generation, but it may not be for the later. Menjadi kepantanganku during teaching session lecturers bukak cerita on betapa lebih teruk mereka kena hentam back then. And calling us useless medical student, useless houseman doctors. Have some respect for time. We came for knowledge, bukan untuk di maki. Although i must admit i am often not fully prepared during teaching. Maki dan motivasi adalah dua perkara berbeza. There's a thick line separating the two. 

Irish lecturers often wonder why us Malaysian students susah benau nak bukak mulut masa discussion. And bila jawab soalan, suara macam suara itik kena kepit. The above is the reason why! In Malaysia, bila jawab salah selalu kena maki. I always feel discouraged when that happens. Lama-lama jadi takut nak bukak mulut dalam kelas. Hasilnya, jadilah kebanyakan generasi sekarang yang kurang keyakinan diri. Kemudian kena marah lagi sebab tak participate. Deadly cycle.

I remembered back in Dublin, Dr. Bund was asking a few of us Malaysians during tutorial about some vascular question. Sesungguhnya pada ketika itu diri ini memang clueless tak paham satu apa pun soalan itu. But i still remember very vividly of what Dr. Bund said, "Come on, I'm sure you know this. You just don't remember. Think harder", sambil mata beliau bersinar-sinar dan tersenyum cuba nak membantu dan mengajar. Diri sendiri pun rasa bersalah sebab tak tahu benda simple, lalu cuba lebih gigih nak membaiki diri. That is positive encouragement. 

Rindu Dublin.

p/s: I was hungry when i was writing this post. Hungry + frustrated + annoyed = Not a good combination. That explains why it's a bit emo-ish.