No WORRY-Lah, Be HAPPY

A Medical Student‛s Motivational & Inspirational Guide

Dr. Phang Cheng Kar M.D.

The contents of this book may be reproduced and reprinted in part or in whole ONLY after prior notification & permission

pckar@yahoo.com 1st edition – 2001 2nd edition – 2004 3rd edition – 2007 4th edition – 2010

An online sequel to this book is available at http://upmedic.wordpress.com/ ISBN 978-983-43335-0-8

NOT FOR SALE !

 COMMENTS FROM READERS  "I found Dr Phang's book to be so useful and encouraging that I wish I had his book when I was a medical student. It would surely have made my medical student days that much easier and more rewarding. After reading it, I immediately pass a copy to my nephew who was entering medical school so that he may benefit from it. But, this book is not just for medical students. It's for anyone walking the path of life. When you're down or feeling discouraged, read this book to perk you up again."

- DR. ONG TIEN KWAN (M. B. B. S. ), General Practitioner “This book contains visually captivating content that can inspire students that life is about being intelligent in medical studies and being wise in life management as well”

- ALWIN AW, Student in Psychology “It is really easy and interesting to read as it is full of illustrations and posters. All the short stories really gave me a lot of moral values on being a useful human being. Thanks for writing such useful and wonderful motivational book”

- SIEW WENG KEONG, Student in Educational Science “Your generosity towards your fellow men is inspirational and I feel honored knowing you. This book has helped me to get thru some frustrating moments. Thank you for being you…a true treasure”

- WAI CHIN, NGO Volunteer – “I think Dr. Phang’s book is really very interesting and has a lot of funny pictures, jokes and stories”

- TIFFANY LEE, Primary School Student -

“Inspirational, funny and illuminating!”

- NICOLE LEE, Secondary School Student -

 COMMENTS FROM READERS  “Having done the first two years of medical degree, I had thought that the worse was over. But, this clinical year surprises me with a greater amount of amazing challenges. I'm enjoying every bit of it, but reading No WORRY-Lah, Be HAPPY had equipped me with better skills to handle those challenges (especially the illusive art of saying 'I don't know'). You would think you know most of the lessons in the book, but I certainly need to be reminded of them. May this book help more students out there”

- TAN LAI LING, 3rd Year Medical Student in Edinburgh "Simple yet powerful messages to uplift our spirits and edify our minds" - MITRA CHONG ENG BENG, Trainer, Speaker, Consultant & Co- author of "Secrets of a Successful Student" –

“Dr. Phang’s book provides useful and easy way to cope with stress and worry – with humor thrown in, making it an enjoyable book to read. If you work in a fast paced and stressed environment with endless deadlines, this is a must to have book”

- LOW YIN THENG, Customer Relation Officer “Attractive & impressive style of presentation!”

- CHAI WEN LEE, Financial Planner -

“It is simple and easy to understand, and it gives a deep impact, especially to those who are too serious about their learning life!”

- AGGAPHALA, Counselor “A book that guides you through your career, not only for medical student but for all those who want to have an inspiring career and be able to tackle the problems along the way until you achieve your career objective”

- TEH SOO TYING, Assistant Management Consultant -

This book is specially dedicated to all the first batch of doctors who graduated from UPM Medical School

On reading this book, I promise myself that no matter what happens during the course of this medical programme, I’ll always tell myself,

“NO WORRY-Lah, BE HAPPY”

CONTENTS FOREWORD ACKNOWLEDGEMENT PREFACE

Chapter 1 : THE BEGINNING • • • • • •

Yeah! I’m in medical school Greatest mistake in life My true story A new day Why worry?

Pioneer

Page 1 2 3 5 6 7

Chapter 2 : A PRE- CLINICAL JOURNEY • • • • • • • • • • • • • • • • • • • • • •

Medicine – too difficult?

I can Awaken the giant within Bullied by seniors?

Asking Histology – whose angry?

Microbiology – does size matter?

Aim high Thinking Detachment Teach a friend Forgetting This is very important!

Optimum stress I don’t know Smoke gets in your eyes One thing at a time Burn all the mistakes Bookworm Pakto-logy Choose a door Kiasu-ism

8 9 10 11 12 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

• • • • •

Last batch was better!

Meaningful difference I can’t stand you!

Footprint Sail the sea

31 32 33 34 35

Chapter 3 : A CLINICAL JOURNEY • • • • • • • • • • • • • • • • • • • • • • • • • •

Looking Cannot see Learn with a purpose Practical Physical examination Habit On patient’s bed Uninteresting patient – NBM Seeing is believing Risk K.I.S.S. Malu-ism Courage Systematic You should know!

Bullshit Shake it off, step up A great lecturer Nasty lecturer Napoleon Bonaparte Pleasing everyone Common things are common The big rock Anxiety and depression Great mind Medicine is an art

36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61

Chapter 4 : DEALING WITH PATIENTS • • •

The most important customer One, one, one Attitude

62 63 64

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

Money talk What money can’t buy Money – the root of evil?

Better to be safe than sorry Loosing your head Chaperon X-Ray view Final judgemental Making a difference Doing small and simple things` Scorpion stings frog Mother Teresa Effect 4 therapeutic thoughts Antibiotic Common cold Vaccination of goodness Changing people Practising your profession Patch Adam Could you just listen Symptoms How long am I going to live?

Power of words Social clerking A terrible noise Mind-body medicine Plastic surgery Old or young Evidence based medicine Prayer

65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94

Chapter 5 : PATIENT AS A TEACHER • • • • • • •

A doctor instead of a patient Important but not urgent Good health Health is wealth Bell’s palsy Smile Laughter is the best medicine

95 96 97 98 99 100 101

• • • • • • • • • • • • • • • • • • •

Allergy to bullet Bottle ghost I didn’t drink, Mom! Alcoholic illusion Caring for others Beauty Blind Happy Birth-day!

Flower delivery Blood Breast Guchii! Guchii! Guchii!

Paediatric lesson Aging What do you think of me?

Death – Are you ready?

A sorrow free death Quality of life To remember me

102 104 105 108 109 111 112 113 114 115 116 117 118 120 121 122 123 124 125

Chapter 6 : PREPARING FOR HOUSEMANSHIP • • • • • • • • • • • • • • • • • •

I’m a good doctor Community service The lost horse – Shit!

Creativity As cool as cucumber Excellence Initiative Giving your best My boss and I A cracked pot Same value Teamwork Everyone counts Work should not be…..

Contented fisherman Volunteer Doing good for health The trouble tree

126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143

Chapter 7 : EMERGENCY MEDICINE • • • • • • • • • • • • • • • • • • • •

Give yourself a break Don’t you quit I’m only human I’m still gay no matter what you say Don’t sweat the small stuff Marathon Mushroom vs Oak Tree Fly high Perspiration No pain, no gain!

Confront!

Nobody to Somebody One more time Failure Be thankful This too will pass It could have been worse Yesterday and tomorrow Mental immunization Moso – the bamboo plant

144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163

Chapter 8 : GRADUATION • • • • • • • • • • • •

The end of the beginning Declaration of Geneva Convocation Fresh medical graduates Changing the world Sharpening the axe Postgraduate study?

Slow down the speed of life Doctors have no social life?

Three rings in life End of the day That’s all

164 165 166 167 168 169 170 171 172 173 174 175

BONUS • • • • • • • •

The art of saying, “I don’t know” Be our guest Re-Search Promise yourself More humane working hours for interns Experience at what cost?

Medical students wellness guide Don’t worry, be happy – a song

176 180 181 182 183 184 186 187

FOREWORD I consider it a special honour to have been asked to write this foreword by the author. The author had managed to capture his various experiences over the five years spent in the Medical School of Universiti Putra Malaysia. For those who have been his contemporaries, this book will be a diary of their life at UPM. For the new students, it helps to throw some light to what life at our Medical School is all about. It can act as a guide and remove some of the apprehensions they may have. For the teachers, you get a glimpse of how the students view our teaching and us in general. It is a learning process for all.

I must congratulate the author for having shown that despite the heavy work schedule of a medical student, there is always time to take a second look at life and enjoy it. This is a good lesson not only for the other medical students but also for us the teachers. There is more to life that the medical text. I am sure as the author goes through his career as a medical doctor he is going to produce more gems.

ASSOCIATE PROFESSOR DR. JAMMAL AHMAD BIN ESSA DEAN OF FACULTY OF MEDICINE UNIVERSITI PUTRA MALAYSIA 16TH JULY 2001

ACKNOWLEDGEMENT I would like to state on record here that in the compilation of this book, I have taken some graphics, some portion of writing, quotations, stories and similes from many sources. If due acknowledgement has not been made, I sincerely regret the omission and apologise for the oversight. I hope this acknowledgement would serve as my sincere request for permission, in order that many will benefit from the compilation of this book. However, some of the articles that appeared in this book bear the name ‘Unknown Author’ or without the name of the writer. If you happen to know who the writer is or the source, I would be very happy to hear from you.

I would like to especially thank the following people who have directly or indirectly contributed to this book in various ways: DR. JAMMAL AHMAD BIN ESSA • DR. ZAINAB BINTI ABDUL MAJEED • DR. NOR HAMIDAH MOHD SALLEH • DR. NIK SHALIZA HUSSIN • DR. TEE BEE CHIN • DR. NG LIP YANG • DR. LIM CHERN SEARN • DR. JULIAN LIM JIUN HOW • DR. DERRICK PANG CHEE GENN •

& ALL PATIENTS, LECTURERS, COURSEMATES, HOSPITAL STAFF AND FACULTY STAFF WHO HAVE CONTRIBUTED TO MY EXPERIENCE AS A MEDICAL STUDENT

•

PREFACE I still remember vividly the joy I had when I was offered a place in medical school. I accepted the offer gratefully even though I had to start from scratch again after spending two years in my previous programme, Veterinary Medicine. As I am writing this, I am actually very happy because I have just completed my medical programme, after a long journey of seven years in university. Any regret? Definitely NO! Having said that, my perception towards medical student and doctor’s life has evolved over the years. It is now crystal clear to me that life as a medical student or doctor is not really glamorous, efficient or even sexy as portrayed in TV series like ER, Chicago Hope and so on.

Instead, it is generally stressful especially towards the final year and during house-officer year. This is particularly true for myself as I was a pioneer medical student of a new medical programme in my university.

Thus, I had to live with tonnes of worries and uncertainties all year round. Medical student training is certainly not something easy. There were a lot of hardship and obstacles that I had to endure in the five years of training. When I knew I passed my final exam, the joy I had was tremendous and I felt as though I was on top of the world.

Besides those difficult times that I had as a medical student, I also had a lot of wonderful and inspiring experience that I would eagerly like to share with all medical students. The result is the birth of this book, “NO WORRY-LAH, BE HAPPY – A Medical Student’s Motivational & Inspirational Guide”, which I compiled after my final examination in conjunction with my graduation, and also to prepare myself for my housemanship in Kuala Lumpur Hospital.

With the publication of this book, I wish I could do my part in helping medical students to relieve their stress, and to inspire them with various meaningful life lessons that can be acquired from a medical student’s life. I have also specially designed Chapter 7 : EMERGENCY MEDICINE for those medical students who are under extreme stress.

So, you may bypass the initial chapters and go straight to chapter 7 if you need urgent and large dose of motivation and inspiration.

I hope you would all enjoy reading this book as I much as I do, and I wish you all well, happy and always free from all worries. No WORRYLah, Be HAPPY 

PHANG CHENG KAR 21ST JULY 2001

HAVE AN

OPEN MIND! THE MIND FUNCTIONS LIKE A PARACHUTE IT FUNCTIONS BEST WHEN IT IS OPENED! -Frank Zappa-

If we can find truth from any source, Then accept that truth without any prejudice

Chapter 1

THE BEGINNING

☺ DON’T WORRY, BE HAPPY

YEAH! I MANAGE TO GET INTO

MEDICAL SCHOOL

Be GRATEFUL that you are the lucky one!

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 DON’T WORRY, BE HAPPY

MISTAKE! MISTAKE! MISTAKE! TAKING UP MEDICINE IS THE

GREATEST MISTAKE IN LIFE, BUT IT IS A

GOOD MISTAKE! - Associate Professor Dr. Sabariah Abdul Rahman (Deputy Dean, Faculty of Medicine & Health Sciences, UPM) - in reminding us that studying medicine is challenging and needs a lot of hard work but is very rewarding -

WELCOME TO MEDICAL SCHOOL

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MY TRUE STORY Once upon a time in 1996, a medical course had sailed and landed in UPM. Together with its pioneer batch of students, they marched bravely into the realm of medicine. And here is how my story goes………

First to be implanted into my memory, Happened to be Anatomy, Physiology & Biochemistry, Day in day out, week in week out, Nothing is without a doubt.

This took some time to be completed, Then goodbye to them, I greeted, For the farewell party I waited, But with my heart they departed.

That was when my ice cream MELTED!!

And emotions affected.

Then comes the 2nd year, Hercules and Snow Whites were my lecturers, There they led me without fear, And nurtured me so dear.

The research with white rats was great, Their “brains” and “adrenals” became my playmate, Unfortunately, they made me lost 4 kgs of my WEIGHT!!

I managed to get rid of them before it’s all too late.

A new beginning in HKL, About the experience…….I could almost YELL!!

But it’s the journey, I would rather tell, Which ended up so well.

The “BEST”, they are training us to be, So, U should know everything from A to Zee,

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☺ DON’T WORRY, BE HAPPY

As for me, tough life is what I see, Coz there’s no time for even a cup of tea!

Vocab! Vocab! So much to grab, Jargon! Jargon! They make me U turn & turn, Everything sounded like French, Even when I stood on a bench!

Posting after posting had past, Time after time all so fast, Closer & closer I’m heading my final, Nearer & nearer I’m getting to my title.

Not so much of the salary that they pay, As long as, at the end of the day, “I’m well, Thanx Doc” is what my patients say, Then, that will really make my DAY!!

Till the end of time from now, To U…….UPM, I shall bow, For who I am, It’s all thanx to UPM.

“MISTAKE MISTAKE……….

THE GREATEST MISTAKE IN LIFE………..

BUT IT’S ONE OF THE WISEST - Dr. Lim Chern Searn (Pioneer medical graduate, UPM Medical School)

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☺ DON’T WORRY, BE HAPPY

A NEW DAY This is the beginning of a new day God has been given me this day to use as I will I can waste it or use it for good But what I do today is important Because I am exchanging a day of my life for it When tomorrow comes this day will be gone forever Leaving in its place something that I have traded for it I want it to be gain and not loss Good and not evil Success and not failure In order that I shall not regret The price that I have paid for it

As a medical student, I pledge that…..

I WILL MAKE FULL USE OF THIS DAY TO ACQUIRE MEDICAL KNOWLEDGE, SKILLS & EXPERIENCE

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☺ DON’T WORRY, BE HAPPY

WHY WORRY?

A study was conducted in University of Columbia and it showed that an average person spend a great portion of valuable time worrying over unnecessary problem.

Things that never happen Things past and cannot be changed Needless worry about health Petty worries Real and legitimate worries

40% 30% 12% 10% 8%

Thus, 92% valuable time is wasted

TWO MEN LOOKED OUT FROM THE PRISON BARS, ONE SAW MUD AND THE OTHER SAW STARS Choose to be HAPPY, not to be WORRYING!

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FIRST FEW BATCHES OF DOCTORS ARE ALWAYS THE BEST IN ANY MEDICAL SCHOOL

Ooooops, they are treating us like guinea pigs again!

7

Chapter 2

A PRE-CLINICAL JOURNEY

☺ DON’T WORRY, BE HAPPY

MEDICINE - TOO DIFFICULT? There was a young woman who had taken ballet lessons all through her childhood and finally she felt that she was ready to commit herself to it. She wanted to become a prima ballerina but first she wanted to be sure that she had the talent. So when the ballet company came to town, she went backstage after the performance and spoke to the ballet master.

“I want to be a great ballerina, but I don’t know if I have the talent,” she said. “Dance for me,” the master said, but after only a minute or two he shook his head and said “No, no, no! You don’t have what it takes.”

The young woman went home, heartbroken. She tossed the ballet slippers in the closet and never wore them again. Instead, she got married, had children and when the kids were old enough, she took a part-time job running a cash register at the corner store.

Years later when the same ballet troupe came to town, she attended it and on the way out she ran into the old master who was then in his eighties.

She reminded him that they have spoken before. She showed him photos of her children and told him about the job at the corner store and then she said, “There’s just one thing that has always bothered me. How could you tell so quickly that I didn’t have what it takes?”

“Oh! I barely looked at you when you danced,” the master said, “That’s what I tell all of them who come to me.”

“But…..but that’s unforgivable!” she cried. “You have ruined my life! I could have been a great ballerina!”

“No, no, I don’t think so,” the old master said, “If you had what it takes, you wouldn’t have paid any attention to what I said!”

TAKE CHARGE OF YOUR THOUGHTS, YOU CAN DO WHAT YOU WANT WITH THEM! Am I intelligent enough to study medicine and be a good doctor? YES! You can as long as you are willing to work hard and don’t give up no matter what happens. Anyway, one of my O&G lecturers said that he could even train a monkey to practice medicine. So, you definitely CAN unless you are……….

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 DON’T WORRY, BE HAPPY

I CAN If you think you’re beaten, you are If you think you dare not, you don’t If you like to win But you think you can’t It is almost certain you won’t If you think you’ll lose, You’ve lost For out of the world we find Success begins with a fellow’s will It’s all in the state of the mind If you think you’re outclassed You are You’ve got to think high to rise You’ve got to be sure of yourself Before you can ever win a prize Life’s battle don’t always go To the stronger or fastest man But sooner or later The man who wins Is the man who thinks he can - C. W. Longenecker –

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☺ DON’T WORRY, BE HAPPY

From the embryology lesson,

WE HAVE UNLIMITED POTENTIAL IN

DEVELOPMENT

Let’s awaken the giant within!

We have 12 BILLION brain cells and most of us only make full use of a small portion of it. Deep down within us, are powers we know nothing of and never use.

EXPLORE THOSE POWERS! Why do some people have very good memory while some people don’t?

The reason is that those who have good memory have tapped into the power of the mind and know how to make full use of it for memory work.

Sad to say, students spend more than 10 years in school learning, but most have never been taught the art of learning e.g. how to have good memory. Anyway, we can never change the past but we can decide on our future. Get a book on ‘learning skills’ immediately!

LEARN HOW TO LEARN BEFORE YOU START LEARNING! 10

☺ DON’T WORRY, BE HAPPY

BULLIED BY SENIOR?

DO NOT DO UNTO OTHERS, THINGS THAT YOU WOULD NOT LIKE OTHERS TO DO UNTO YOU! Treat your seniors how you would like to be treated.

Don’t be ARROGANT! If your senior is really nasty, make sure you don’t treat your junior likewise. Else, you are no different from your senior.

Think positive! Thank your senior for being so nasty because they have helped you to develop ‘antibody’ to the ‘nasty-peopleantigen’. You will meet many of them when you come out to work – in the dog-bite-dog world

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☺ DON’T WORRY, BE HAPPY

EVERYBODY NEEDS SUPPORT DON’T BE

SHYTO ASK

FOR HELP

PRIDE IS AN EGOISTIC STATE OF MIND WHICH IS WORTHLESS BUT A FOOL IS WILLING TO PAY FOR IT

Don’t allow SHYNESS and PRIDE to stop you from ASKING for help

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☺ DON’T WORRY, BE HAPPY

ASK FOR

HELP

AND YOU SHALL RECEIVE

Help! Help! Help!

If you don’t ask, nobody will know that you need help.

Don’t blame people that they don’t help you.

It is your responsibility to ask for help if you need any.

If a person refused to help you, that doesn’t mean others would also say NO. For your own sake, give people the OPPORTUNITY TO SERVE YOU.

Make sure you ASK and do it before it’s too late.

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☺ DON’T WORRY, BE HAPPY

From the histology lab,

HISTOLOGY

Are you scolding me?

Which part of me are you scolding at?

System? Organ? Tissue? Cell? Organelle? Molecule? Atom?

Particle? Energy?

Sorry, nobody is at home.

No ONE is angry!

And you will never be angry no matter how terrible people scold you.

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 DON’T WORRY, BE HAPPY

From the microbiology lab,

DOES SIZE MATTER?

Have the HUMILITY to admit that human being, despite being the most advance creature in the tree of evolution, is not almighty!

BE

HUMBLE!

HUMBLE PEOPLE DON’T THINK LESS ABOUT THEMSELVES THEY THINK ABOUT THEMSELVES LESS -Norman Vincent Peale15

 DON’T WORRY, BE HAPPY

AIM HIGH A college professor prepared a test for his soon-to-be-graduating seniors. The test questions were divided into 3 categories and the students were instructed to choose questions from only one of the categories.

The 1st category of questions was the hardest and worth fifty points. The second, which was easier, was worth forty points. The third, the simplest was worth thirty points.

Upon completion of the test, students who had chosen the hardest fiftypoint questions were given As. The students who had chosen the fortypoint questions received Bs. Those who settled for the easiest thirtypointers were given Cs. The students were frustrated with the grading of their papers and asked the professor what he was looking for. The professor leaned over the podium, smiled, and explained, “I wasn’t testing your book knowledge. I was testing your aim.”

MAKE NO SMALL PLANS, FOR THEY HAVE NO POWER TO STIR YOUR SOUL (Niccolo Machiavelli) Aim for DISTINCTION & if don’t make it, you’ll at least PASS Aim for PASS & if you don’t make it, you’ll be called for BORDERLINE viva Aim for BORDERLINE PASS and if you don’t make it, you’ll FAIL

AIM HIGH & YOU NORMALLY HIT WHAT YOU AIM FOR - Byrd Baggett -

Have you been planning for your academic pursuit? Remember that when you FAIL TO PLAN, YOU ARE ACTUALLY PLANNING TO FAIL - Alan Lakein -

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☺ DON’T WORRY, BE HAPPY

THINKING STUDENT I ASK A LOT OF QUESTIONS I’M A

Thinking, thinking, thinking!

Questioning exercises the mental muscles.

For every question you ask, you develop a new group of brain cells. It was figured out that you have enough brain cells to create 150 new ideas every minute day and night for seventy years.

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 DON’T WORRY, BE HAPPY

DETACHMENT

Preparing for examination?

DISINTERESTED students say, “Who cares and why bother to study?”

DESPERATE students say, “If I don’t pass, I’ll sure die!”

DETACHED students say, “If I don’t pass this time, it’s OK and I’ll try harder the next time.”

Which type of STUDENT are you?

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☺ DON’T WORRY, BE HAPPY

EXAM IS A TEST OF HOW FAST WE CAN RETRIEVE INFORMATION FROM OUR NEURONS

Practice output learning!

If you could teach or share information with a friend, it shows that you have understood the subject well!

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☺ DON’T WORRY, BE HAPPY

TO

FORGET IS HUMAN

I swear I read it somewhere but I have forgotten where and what about it!

FORGETTING IS IMPORTANT IN LIFE. Imagine you keep on remembering all the unhappy events in the past. Life will then be pathetic. So, it’s OK to forget as long as we know where and how to look for the forgotten things.

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☺ DON’T WORRY, BE HAPPY

YOU DON’T NEED TO KNOW MANY THINGS TO PASS YOUR EXAM, IF YOU KNOW THE FEW THINGS THAT ARE

IMPORTANT

This is very important!

Lecturers are trying desperately to pass all students.

Make sure you study things that they emphasize!

THE HARDER AND SMARTER WE WORK, THE LUCKIER WE GET 21

☺ DON’T WORRY, BE HAPPY

FROG IN THE POTHOLE A frog was hopping about one day when he happened to slip into a large pothole along the country road. All his attempts at jumping out fell short.

Soon a dog came upon the frog trapped in the hole and offered to pull him out. He, too failed. After various country animals made gallant attempts to help the poor frog, they finally gave up.

“We’ll go back and get you some food,” they said. “It looks like you’re going to be there for a while.” However, not long after they took off to get food, the frog hopped past them. They couldn’t believe it!

“We thought you couldn’t get out!” they hollered out.

“Oh, I couldn’t,” replied the frog, “but you see, there was a big tractor coming right at me, and I had no choice.”

OPTIMUM STRESS IS NECESSARY FOR US TO STUDY HARD & DO WELL IN EXAM

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☺ DON’T WORRY, BE HAPPY

THE MORE YOU

KNOW,

THE MORE YOU WILL KNOW THAT THERE IS A LOT MORE THAT YOU

DON’T KNOW

Why can’t I finish studying this?

LOOK AT WHAT YOU HAVE

ACCOMPLISHED, NOT ALWAYS ON WHAT YOU HAVE NOT

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☺ DON’T WORRY, BE HAPPY

SMOKE GETS IN YOUR EYES

Be careful not to BURN OUT! Exam stress is common amongst students.

Good study habits, exam techniques and exam readiness reduce stress to manageable levels. Keeping up with other students socially and academically, regular attendance at lectures, group studies and discussion, pooling of resources and information with classmates, and balancing academic work with social and leisure activities are crucial to peak in exam performance.

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☺ DON’T WORRY, BE HAPPY

DO

ONE THING AT A TIME

My God, I have tonnes of books to read!

Try to concentrate on one task at a time…and don’t forget…

YOUR TASK IS NOT ONLY TO FINISH EVERYTHING YOU NEED TO DO, IT’S TO ENJOY WHILE DOING IT AS WELL

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☺ DON’T WORRY, BE HAPPY

BURN ALL THE

MISTAKES!

Computer attacked by virus and you have lost all your precious files?

The great inventor Thomas Edison’s factory once caught fire. As he helplessly watched it burn, his costly experiments and equipment going up in smoke, he called his son Charles. “Come Charles!” he said, “You will never see anything like this again!”

And then he called his wife. As the three stood gazing at the blazing inferno, Edison smiled and said, “There goes all our mistakes! Now we can start over afresh!” Immediately, he started rebuilding his factory and it was not long after that, he invented the phonograph.

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☺ DON’T WORRY, BE HAPPY

DON’T BE A

BOOKWORM

Be an ALL-ROUNDER! There are a lot of lessons in life, that cannot be acquired through reading! &

THERE IS A LOT MORE IN LIFE BESIDES MEDICINE Be ‘promiscuous’ in acquiring knowledge! A good doctor must be supported by other important skills and knowledge e.g. leadership, management, communication, information technology, emotional intelligence, spiritual intelligence etc.

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☺ DON’T WORRY, BE HAPPY

From the pathology lab,

PAKTO-LOGY (“Pakto” in Chinese means dating)

I’m sure many of your course mates are in love.

Have you ever wondered how would the children be in the future?

George Bernard Shaw was once approached by a seductive young actress who cooed him in his ear, “Wouldn’t it be wonderful if we got married and had a child with my beauty and you brains?”

George Bernard Shaw who was hardly a handsome man replied, “My dear, that would be wonderful indeed, but what if our child had my beauty and your brains?”

People say that you usually can have either BEAUTY or BRAIN and not both simultaneously. People also say that doctors are brainy. What is your comment?

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CHOOSE A DOOR Dealing with mad people in the psychiatric posting was a wonderful experience. Here’s a silly yet profound story about a man’s consultation with a psychiatrist.

A fellow in New York whose life was bungling along rather miserably, and so decided to consult a psychiatrist to help him change. He selected an address on Park Avenue and entered the doctor’s reception room, tastefully appointed but without a receptionist. There were two doors, one marked “Men” and the other “Women”.

He went through the door for “Men” and came upon two other doors, one marked “Extrovert” and the other marked “Introvert”. Knowing he was an introvert, he opened that door and found himself in a room with two more doors. On read “Those making at least $ 20, 000 and the other, “Those making less than $ 20, 000”. He knew he made less than that sum so he entered that door and found himself on Park Avenue!

Happiness, success, peace, well-being, and growth result from our own choice and decision, not other’s. So, choose your door wisely.

IF YOU DO WHAT YOU HAVE ALWAYS DONE, YOU WILL ALWAYS GET BACK WHAT YOU HAVE ALWAYS GOTTEN -Anthony Robbins-

If you have always studied very hard and still do badly in exams, it means you have used the wrong technique to study. Insanity is doing the same thing over and over again and expects a different result. Change the way you study. Study smart!

29

☺ DON’T WORRY, BE HAPPY

WINNING Kenneth was excited and eager about participating in a day of Special Olympics events. He won first game and was proud of his ribbon and the cheers from the crowd.

He ran in the second race.

Just at the finish line, when he again would have won, he stopped, and stepped off the track. His parents gently questioned him, “Why did you do that, Kenneth? If you had continued running, you would have won another race.”

Kenneth innocently replied, “But, Mom! I already have a ribbon. Billy didn’t have the ribbon yet.

Many students are very KIASU in learning medicine. KIASU people won’t share knowledge with you. They won’t share exam tips with you either.

Neither would they feel happy when you do well in exam. They will only be happy if they do well and all other people do badly. Remember,

YOUR TASK IS NOT TO COMPETE WITH OTHERS YOU SHOULD COMPETE WITH YOURSELF We should practise WIN-WIN and not WIN-LOSE!

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 DON’T WORRY, BE HAPPY

WHY DO LECTURERS LIKE TO

COMPARE STUDENTS?

A lecturer was very frustrated and said, “You people are worse than the previous batch of students!”

The students responded in their whisper, “And you are the worst of all lecturers!”

WHEN YOU DON’T JUDGE, YOU WOULD NOT BE JUDGED (Matthew 7:1-5)

Be constructive in criticism!

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IT’S GOOD TO HAVE MEANINGFUL

DIFFERENCE! ELSE LIFE WOULD BE VERY BORING

Are you having problem with roommate, housemate, course mate, toilet mate?

IT’S EASY TO SEE ONE’S

WEAKNESS BUT IT TAKES YEARS TO DISCOVER ONE’S STRENGTH WHEN YOU UNDERSTAND, YOU DON’T HAVE TO TOLERATE ANYMORE

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HEART NOT THE BEHAVIOR LOOK AT THE

I can’t stand what you are doing!

Sometimes parents do things that are intolerable to children.

Bear in mind that their intention is always good.

Parents always do the best for their children.

They have tried very hard to love you with THE BEST WAY THAT THEY KNOW, EVEN THOUGH IT MIGHT NOT BE THE BEST WAY FOR YOU.

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F R I E N D S H I P Oooo Some people ( ) come into our lives )/ and quickly go.. (_/ oooO ( ) \( \_)

Some people stay awhile

and leave footprints on our hearts...

oooO ( ) \( \_)

Oooo ( ) )/ (_/

and we are ~ never ~ the same

“Many people will walk in and out of your life, But only TRUE FRIENDS will leave footprints in your heart” (Eleanor Roosevelt) The A – Z of Friendship A Friend………

(A) ccepts you as you are (B) elieves in you (C) alls you just to say “Hi” (D) oesn’t give up on you (E) nvisions the whole of you (F) orgives your mistake (G) ives unconditionally (H) elps you (I) nvites you over (J) ust be with you (K) eeps you close at heart (L) oves for who you are (M) akes a difference in your life

(N) ever judges (O) ffers support (P) oints out your mistake (Q) uiets your fear (R) aises your spirit (T) ells you the truth (U) understands you (V) alues you (W) alks beside you (X) plain things to you patiently (Y) ells when you won’t listen and (Z) aps you back to reality

THE BEST WAY TO ATTRACT GOOD FRIENDS IS TO BE ONE YOURSELF

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SAIL THE SEA A step towards the throne of knowledge Is like a seaman’s first onto the deck bridge Knowing nothing Always groping He stumbles, he trips Trying to find a grip Lo came a seasoned seaman A captain who has sailed to many lands He guides and teaches the newbie The knots and ropes to challenge the sea He heads and guides The way through the tides At last the freshman’s ready To test his mettle against the sea With a word of wisdom and a pat in the back The captain sends the seaman to the deck Now the sailor looks at the future smiling For with him is his captain’s teaching - Dr. Pang Chee Genn (Pioneer medical graduate, UPM Medical School)

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Chapter 3

A CLINICAL JOURNEY

☺ DON’T WORRY, BE HAPPY

FOR ONE MISTAKE MADE FOR NOT

KNOWING,

TEN MISTAKES ARE MADE NOT

LOOKING - J. A. Lindsay -

That’s when you

LOOK

36

but don’t

SEE!

☺ DON’T WORRY, BE HAPPY

WHAT THE

MIND DOES NOT

KNOW, THE

CANNOT SEE Good doctors are ‘medically paranoid’ They have,

HIGH LEVEL OF SUSPICION & INCREASED CLINICAL AWARENESS

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LEARN WITH A

PURPOSE DEDICATE EVERY DISEASE YOU LEARN TO A FRIEND OR RELATIVE WITH THE DISEASE

Daddy! I would like to dedicate what I have learnt about toothache to you!

Let me see….toothache is…..

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AN OUNCE OF

PRACTICE

WORTHS MUCH MORE THAN A TONNE OF

THEORIES

- Mahatma Gandhi –

Practical is important!

You can never deliver a baby…

You can never do venepuncture…

You can never do suturing…

You can never do cardiopulmonary resuscitation…

You can never do funduscopy…

NEVER, NEVER, NEVER

BY JUST READING A BOOK

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PHYSICAL EXAMINATION MORE MISTAKES ARE MADE FROM WANT OF A PROPER PHYSICAL EXAMINATION THAN FOR ANY OTHER REASON - Russell John Howard –

All skills are difficult before they are easy!

Practice makes perfect!

TO

MASTER A SKILL WE MUST BECOME ITS SLAVE 40

☺ DON’T WORRY, BE HAPPY

HABIT IS DIFFICULT TO CHANGE

Take away the H, you have ABIT, take away the A, you still have BIT of it, and even after taking the B, you will still have IT. So, make sure we pick up

GOOD CLINICAL HABIT

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☺ DON’T WORRY, BE HAPPY

DON’T SIT ON PATIENT’S BED! (A common advice for medical students as it may be culturally inappropriate)

…..even though

MEDICINE IS LEARNED BY THE BEDSIDE AND NOT IN THE CLASSROOM To study phenomenon of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all.

- Sir William Osler -

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A HOSPITAL IS A LIBRARY, THE WARD A BOOKSHELVE AND EACH PATIENT A BOOK

This is an interesting patient!

Medical students commonly say, “Seen any interesting patients in the ward?”

All patients are interesting.

It’s just that you might not be interested.

Imagine you are on a hospital bed with a tag,

“UNINTERESTING PATIENT (NBM = nil by mouth or fasting)

NBM”

That would really be an interesting PATIENT.

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PICTURE PAINTS A THOUSAND WORDS

SEEING IS BELIEVING

The optic nerve is 17 times larger than most other nerves.

So, we usually remember what we see much better.

Make the initiative to SEE more clinical signs!

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To learn to walk, we must risk falling over To make a dollar, we must risk losing it To influence people into business venture, we risk losing friendship In loving and caring, we risk breaking our hearts Getting a job is a risk Crossing the road is a risk Eating in the restaurant is a risk Starting a family is a risk Life is a risk Winners take more risk than losers do That is why they win so much more But they also lose much more than losers do They are playing so often that their wins add up Which do we prefer to merely exist or to be truly living?

- Unknown Author -

TAKE RISK AND BE PROACTIVE IN LEARNING 45

☺ DON’T WORRY, BE HAPPY

K .I .S .S.

Whatever you attempt to study, try to (K)eep (I)t (S)hort & (S)imple Don’t complicate things & Don’t waste unnecessary memory power!

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☺ DON’T WORRY, BE HAPPY

‘MALU…ISM’

ACE, you must learn with the ‘NO FACE’ attitude.

In order to be

Don’t be afraid to make mistake.

Don’t be shy when people tease or laugh at you,

A’ star student!

and you will be an ‘

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COURAGE IS NOT THE

ABSENCE OF FEAR IT IS ACTING IN SPITE OF FEAR - Mark Twain -

I’m afraid to take blood.

Therefore I should do it more often!

THE ONLY WAY TO OVERCOME FEAR IS TO CONFRONT IT

IF YOU

CAN’TYOU MUST 48

☺ DON’T WORRY, BE HAPPY

ALWAYS SHOW EXAMINER THAT YOU ARE

SYSTEMATIC IN THINKING

Information STORAGE and RETRIEVAL should be GROUPED systematically but APPLICATION OF KNOWLEDGE and THINKING should NOT be COMPARTMENTALIZED!

What do you THINK?

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☺ DON’T WORRY, BE HAPPY

YOU SHOULD KNOW & I DON’T KNOW Once, there was a king in the city. He called someone, saying, “Come, my good man, go and gather together in one place all the men in the city who were born blind.” “Very good,” said the man and he did as the king commanded, and when he had done so, the king said to him, “Now my good man, show these blind men an elephant.” “Very good,” said the man, and he did as the king commanded. He presented one blind man with the head of the elephant, one with the ear, one with the tusk, another the trunk, the foot, the back, and tail and the tuft of the tail, saying to each as he did so, “O blind man, this is an elephant.” Having done this, the man went to the king and said, “Sire, the elephant has been presented to the blind men. Do what you will.” So, the king went to the blind men and said to them. “O blind men, have you seen the elephant?” “Yes, Sire, we have,” said the men. “Then tell me what an elephant is like.” Then the one who had been presented with the head said, “An elephant is like a pot.” The one who had been presented with the ear said, “An elephant is like a winnowing basket.” They said the tusk was like a plough pole, the body was like a granary, the foot like a pillar, the back like a mortar, the tail like a pestle, and the tuft of the tail a broom. Then, they began to argue, shouting as they did, “Yes it is” “It is not!” “An elephant is not like that!”

“Yes, it is!” Soon they began to hit each other, and the king was delighted with what he saw. None of the blind men had a complete picture of an elephant.

Nobody knows everything in the medical world. Have the humility to admit that we don’t know certain thing. It is absolutely OK if we don’t know certain thing as long as we make the initiative to find it out later. No doubt lecturers will always pressure us by saying, “You should know this.

It is so basic.” It seems that everything is basic to them. Please understand that lecturers are paid to do that, to tell us what we do not know. Anyhow, we should not be demoralized and we should have the wisdom to comprehend that…..KNOWING WHAT WE DO NOT KNOW IS PART OF KNOWING & NOBODY KNOWS EVERYTHING.

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IF YOU DON’T KNOW THE ANSWER, IT IS BETTER TO SAY “SORRY, I DON’T KNOW” THAN TO…

Do you know the art of saying,

“I DON’T KNOW”?

If you don’t, please turn to page 176 in the bonus chapter

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☺ DON’T WORRY, BE HAPPY

SHAKE IT OFF & STEP UP! A parable is told of a farmer who owned an old mule. The mule fell into the farmer’s well. The farmer heard the mule braying or whatever mules do when they fall into wells. After carefully assessing the situation, the farmer sympathized with the mule, but decided that neither the mule nor the well was worth the trouble of saving. Instead, he called his neighbours together and told them what happened. He enlisted them to help haul dirt to bury the old mule in the well and put him out of his misery.

Initially, the old mule was hysterical. But, as the farmer and his neighbours continued shovelling and the dirt hit his back, a thought struck him. It suddenly dawned on him that every time a shovel load of dirt landed on his back, he should shake it off and step up! This he did, blow after blow.

“Shake it off and step up…..shake it off and step up!” he repeated to encourage himself. No matter how painful the blows, or how distressing the situation, the old mule fought panic and just kept on shaking it off and stepping up! It wasn’t long before the old mule, battered and exhausted, stepped triumphantly over the wall of that well. What could have buried him blessed him, all because of the manner in which he handled his adversity – Mikey’s Funnies

I always reflect on this story whenever any lecturers scold me and I’ll tell myself, “You have the right to say whatever you want about me, and I have the right to choose how I want to response to you. I choose to response positively and constructively and I CHOOSE TO BE HAPPY.”

IT IS NOT WHAT OTHER PEOPLE SAY TO YOU THAT MATTERS, IT IS WHAT YOU SAY TO YOURSELF AFTER THAT

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A GREAT

LECTURER

Bad lecturers Complain Mediocre lecturers Teach Good lecturers Explain & Demonstrate Better lecturers Motivate Great lecturers Inspire

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☺ DON’T WORRY, BE HAPPY

BE

GRATEFUL

TO YOUR LECTURERS

“You stupid fool!

It’s so basic! You should know!”

Nasty lecturers?

Be grateful to them anyway, because they have taught you

PATIENCE and TOLERANCE

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YOU MEDICAL PEOPLE WILL HAVE MORE LIVES TO ANSWER FOR IN THE OTHER WORLD THAN EVEN WE GENERALS - Napoleon Bonaparte -

Dr. TS Ng, the head of UPM Medical Department frequently quoted this saying whenever students gave a wrong answer to his question. Recently, I found an interesting response to this saying in the Malaysia Medical Association (MMA) newsletter,

MOST MEDICAL DOCTORS HAVE MORE LIVE PATIENTS WHO HAVE BEEN GRATEFULLY SAVED THAN THE GENERALS WHO FRIGHTENED THE PUBLIC AWAY FROM GOOD MEDICINE AND PROPER HEALTHCARE

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☺ DON’T WORRY, BE HAPPY

DONKEY Once, a man and his son were taking a donkey to the market. As they were walking, some people saw them and remarked, “Look at these fools, why don’t they ride the donkey?” The man heard this and asked the son to ride the donkey while he walked alongside. An old woman seeing this remarked, “What is the world coming to? Look at that young man riding comfortably while he makes his poor father walk!” So, the young man got down and this time the father rode the donkey. As they went along, a young woman passing by said, “Why don’t both of you get on the animal?”

So, they listened to her and both rode on the animal. Yet another group who saw them and said, “Oh! What a poor animal. It has to carry those two fat good-fornothings! How cruel some people can be.”

By this time the father and son were getting quite fed up. They decided to dismount and carry the donkey instead so as to stop everyone from talking. This led people to laugh and said. “Look at these human donkeys carrying a donkey.”

When you try and please everyone, you will end up pleasing no one, and in the end, you will only land yourself in trouble. YOU CAN NEVER PLEASE ALL LECTURERS. As long as you are not totally wrong, it would be good enough. YOU CAN NEVER LISTEN TO EVERYONE AS WELL. You may listen for opinions but eventually you have to listen to your heart and make a decision that is best for yourself. Nobody knows you better than yourself. Trust your instinct and decide what is best for yourself.

DON’T TRY TO PLEASE EVERYONE, WHEN YOU TRY TO PLEASE EVERYONE, YOU WILL END UP PLEASING NO ONE

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☺ DON’T WORRY, BE HAPPY

YOU CAN NEVER FINISH STUDYING MEDICINE

IMPORTANT ONES SHOULD ALWAYS COME 1ST

COMMON THINGS ARE COMMON …..except MCQ of course

(MCQ is multiple choice questions.

MCQ or objective questions are usually easier in any exam but in medical exam, it’s the killer and many people fail because of it)

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☺ DON’T WORRY, BE HAPPY

THE BIG ROCK One day, an expert on time management was speaking to a group of business students. To drive home a point, this expert used an illustration that those students will never forget. As this man stood in front of the group of high-powered overachievers, he said, “Okay, time for a quiz.”

Then, he pulled out a one-gallon, wide-mouthed mason jar and set it on a table in front of him. Then, he produced about a dozen fist-sized rocks and carefully placed them, one at a time, into the jar. When the jar was filled to the top and no more rocks would fit inside, he asked, “Is this jar full?” Everyone in the class said, “Yes.” Then he said, “Really?” He reached under the table and pulled out a bucket of gravel. Then he dumped some gravel in and shook the jar causing pieces of gravel to work themselves down into the spaces between the big rocks. Then, he smiled and asked the group once more, “Is the jar full?” By this time the class was unto him. “Probably not.” one of them answered. “Good!” he replied. And he reached under the table and brought out a bucket of sand. He started dumping the sand in and it went into all the spaces left between the rocks and the gravel. Once more he asked the question, “Is this jar full?”

“No!” the class shouted. Once again he said, “Good!” Then, he grabbed a pitcher of water and began to pour it in until the jar was filled to the brim. Then, he looked up at the class and asked, “What is the point of this illustration?” One eager beaver raised his hand and said, “The point is, no matter how full your schedule is, if you try really hard, you can always fit some more things into it!” “No,” the speaker replied, “That’s not the point.

The truth this illustration teaches us is that if we don’t put the big rocks first, we’ll never get them in at all.

Try to prioritise the things we want to achieve in life. There are 2 disasters in life: 1. Not getting what we want 2. Getting what we want but found out later, that that’s not important. So, know WHAT you want, WHY you want it, and do it FIRST.

PUT FIRST THING FIRST

- Stephen Covey, 7 Habits of Highly Effective People –

58

☺ DON’T WORRY, BE HAPPY Psychiatry from the exam hall,

ANXIETY AND DEPRESSION IN EXAMINATION! Emotionally, there is ANXIETY as long as you are trying to control an unpredictable situation, then DEPRESSION and giving up when the situation seems beyond control.

When you step into the exam hall and try to answer as many questions as possible (TRYING TO CONTROL), you have ANXIETY. When you come out of the exam hall finding that you could not answer many of the questions (BEYOND CONTROL), you begin to have DEPRESSION

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GREAT MINDS TALK ABOUT IDEAS - Eleanor Roosevelt -

AVERAGE MINDS

TALK ABOUT EVENTS

SMALL MINDS TALK ABOUT PEOPLE

I HOPE YOU DON’T MIND WHEN I SAY THAT IF YOU SPEND HOURS ARGUING OVER SOMETHING THAT IS ‘NEVER MIND’ YOU ARE REALLY OUT OF YOUR MIND. 60

☺ DON’T WORRY, BE HAPPY

MEDICINE IS AN ART

CLINICAL DIAGNOSIS IS AN ART THE MASTERY OF AN ART HAS NO END YOU CAN ALWAYS BE A BETTER DIAGNOSTICIAN - Logan Clendering -

61

Chapter 4

DEALING WITH PATIENTS

☺ DON’T WORRY, BE HAPPY A saying at the ‘mamak’ stall,

A CUSTOMER is the most important visitor on our premises.

He is not dependent on us.

We are dependent on him.

He is not an interruption to our work.

He is the purpose of it.

He is not an outsider to our business.

He is a part of it.

We are not doing him a favour by serving him.

He is doing us a favour by giving us an opportunity to do so - Mahatma Gandhi -

OUR MOST IMPORTANT CUSTOMER IS

PATIENT 62

☺ DON’T WORRY, BE HAPPY

ONE, ONE, ONE I never look at the masses as my responsibility.

I look at the individual.

I can only love one person at a time.

I can only feed one person at a time.

Just one, one, one .....

So you begin .... I begin.

I picked up one person Maybe if I didn't pick up that one person, I wouldn't have picked up 42,000.

The whole work is only a drop in the ocean.

But if I didn't put the drop in, The ocean would be one drop less.

Same thing for you, Same thing in your family, Same thing in your business, Wherever you go Just begin ... one, one, one.

- Mother Teresa -

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KNOWLEDGE SKILL

ATTITUDE A man visits his doctor and said. “Doc, my elbow hurts.

What can I do?”

The doctor slams his foot on the patient’s toes.

“Owwwwww! Hey, what did you do that for?”

The doctor asks, “Do you still feel the pain in the elbow?”

“No”, and the doctor shouts, “Next.”

- Robin William -

Knowledge can be gained, skill can be acquired, but bad attitude is resistance to change, but MUST be changed!

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$

NO NO TALK?

Patient’s life should always be the first priority!

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MONEY CAN’T BUY…….

Money can buy HOUSE but not HOME Money can buy BED but not SLEEP Money can buy CLOCK but not TIME Money can buy BOOK but not KNOWLEDGE Money can buy FOOD but not APPETITE Money can buy POSITION but not RESPECT Money can buy BLOOD but not LIFE Money can buy MEDICINE but not HEALTH Money can buy SEX but not LOVE Money can buy INSURANCE but not SAFETY -Daniel Olsson -

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MONEY CAN BE THE ROOT OF ALL EVIL IF WE ARE NOT CAREFUL

Can I have an MC, please?

When we cheat for money, our MONETARY BANK account can be increasing, but our ETHICAL BANK ACCOUNT will be decreasing.

We have spend so many years to be in this noble profession with high social status. Don’t ruin it!

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IF YOU DO NOT KNOW

ASK ASKING NEVER KILLS IT MAKES YOU APPEAR STUPID FOR A FEW SECONDS BUT WISER FOR LIFE

IT IS BETTER TO BE SAFE THAN SORRY Be a safe doctor!

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YOU CAN LOOSE YOUR

HEAD

BUT DON’T LOOSE YOUR

MIND

Be Mindful!

It’s OK if we don’t know how to treat a patient with the best ways available since nobody knows everything.

But, it’s not OK if we are NEGLIGENT and irresponsible.

Always tell yourself that you are dealing with a HUMAN LIFE, something very precious and priceless.

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DOCTORS HAVE NO SEX 1 BUT

CHAPERON IS

STILL REQUIRED 2

Even when you examine an 80-year-old lady, make sure that you have a chaperon!

1. A common reminder for medical students so that they don’t feel shy in examining patients of opposite gender.

2. Another common reminder for medical students so that both patient and doctor are protected should there be any alleged sexual harassment.

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TRUE LOVE IS TO LOVE EVERYONE WITHOUT

DISCRIMINATION

Don’t be judgemental!

All patients look alike from an X-Ray point of view.

Treat all patients equally, as though they are our own PARENTS.

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DON’T MAKE UNNECESSARY JUDGEMENT! It is time to elect the world leader and your vote counts. Here are the facts about the three leading candidates:

CANDIDATE A : He associates with crooked politicians, and consults with astrologist. He’s had two mistresses. He also chain smokes and drinks 8 to 10 martins a day.

CANDIDATE B: He was kicked out of office twice, sleeps until noon, used opium in college and drinks a quart of whisky every evening.

CANDIDATE C: He is a decorated war hero. He’s a vegetarian, doesn’t smoke, drinks an occasional beer and hasn’t any extramarital affairs.

Which of these candidates would be your choice?

Avoid making unnecessary judgements e.g. negative ethnic stereotyping.

Judge only when it’s useful e.g. making early clinical impression.

We may think we have all the facts.

In reality, the consequences can be disastrous.

How often are we guilty of being judgemental?

A is Franklin D. Roosevelt Candidate B is Winston Churchill Candidate

Candidate

C is Adolph Hitler 72

 DON’T WORRY, BE HAPPY

MAKING A DIFFERENCE There are so many patients in the clinic. How can I be kind to everyone? Does it make a difference after all?

Once upon a time, there was a wise man that used to go to the ocean to do his writing. He had a habit of walking on the beach before he began his work. One day, he was walking along the shore.

As he looked down the beach, he saw a human figure moving like a dancer.

He smiled to himself to think of someone who would dance to the day. So, he began to move faster to catch up. As he got closer, he saw that it was a young man and the young man wasn’t dancing, but instead he was reaching down to the shore, picking up something and very gently throwing it into the ocean. As he got closer he called out, “Good morning!

What are you doing?” The young man paused, looked up and replied, “Throwing starfish into the ocean?”

“I guess I should have asked, why are you throwing starfish in the ocean?”

“The sun is up, and the tide is going out. And if I don’t throw them in, they’ll die.”

“But, young man, don’t you realize that there are miles of beach, and starfish all along it. You can’t possibly make a difference!”

The young man listened politely. Then bent down, picked another starfish and threw it into the sea, past the breaking waves and said, “It made a different for that one.” (Loren Eisley)

IT MAKES A DIFFERENCE FOR THAT PATIENT

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LEARN TO DO

SMALL &

SIMPLE THINGS WITH GREAT LOVE - Mother Teresa –

Blood pressure again?

Taking blood pressure can be a very small and simple thing to do. But, if done with great care can help to establish a GOOD RAPPORT with patient.

The same goes for greeting patient, taking history, performing physical examination, taking temperature and pulse rate, blood taking, giving injection etc.

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SCORPION & THE KIND FROG As I looked at the drug addicts cum retro positive patients in the last cubicle of the ward, I asked myself, “Should I be kind to them and treat them wholeheartedly. These patients might not even appreciate what I do for them and some don’t even bother to get well for themselves. Should I treat them kindly just like any other patients?”

One day a frog was sitting by a stream. A scorpion came by, and said, “ Mr. Frog, I would like to cross the stream, but I am a scorpion and cannot swim.

Would you be so kind as to swim across with me on your back?”

And the frog said, “But you are a scorpion and scorpion sting frogs!”

Said the scorpion, “Why would I sting you? I just want to get to the other side!”

“OK”, said the frog, “Climb on my back and I will take you.”

They were just halfway across the stream when the scorpion stung the frog. Writhing in agony, and with his last breath, the frog said, “Why did you do that? Now we’ll both drown!”

“Because,” said the scorpion, “I am scorpion, and scorpion stings frogs!”

I’m a doctor, and doctor helps patients. It’s my nature to save life & be kind to all patients.

KINDNESS IS THE LANGUAGE THAT THE DUMB CAN SPEAK AND THE DEAF CAN UNDERSTAND - C.N. Bovee -

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MOTHER TERESA EFFECT Joan Borysenko reported her interview with Dr. Dabid McClelland, Harvard Medical School, USA, regarding his work called the Mother Teresa Effect. A group of Harvard students was shown a documentary of Mother Teresa lovingly ministering the sick. The immunoglobulin A (Ig A) level in their saliva was measured BEFORE and AFTER seeing the film. Ig A rose significantly in all students, even in those who considered Mother Teresa too religious or fake. Ig A is the antibody that protects the mucus membrane from virus and bacteria.

BEST MEDICINE BEING LOVING TO PEOPLE IS REALLY GOOD FOR HEALTH 1. TENDER tds 2. LOVING tds 3. CARE tds •

J. Borysenko. 1985. Healing motives: an interview with David McClelland. Advances 2: 29-41

☺ DON’T WORRY, BE HAPPY

4 THERAPEUTIC THOUGHTS FOR PRESCRIPTION - Sukhihotu -

“May you be well” LOVING-KINDNESS

“Hope you will get well soon” COMPASSION

“Great to see you well again” APPRECIATIVE JOY

“Hmmmm….I see” EQUANIMITY 77

☺ DON’T WORRY, BE HAPPY

ANTIBIOTIC His name was Flehming, and he was a poor Scottish farmer. One day, while trying to make a living for his family, he heard a cry for help coming from a nearby bog. He dropped his tools and ran to the bog. There, mired to his waist in black mud, was a terrified boy, screaming and struggling to free himself. Farmer Flehming saved the lad from what could have been a slow and terrifying death.

The next day, a fancy carriage pulled up to the Scotsman’s sparse surroundings. An elegantly dressed nobleman stepped out and introduced himself as the father of the boy Father Flehming had saved. “I want to repay you,” said the nobleman. “You saved my son’s life.”

“No, I can’t accept payment for what I did,” the Scottish farmer replied, waving off the offer. At that moment, the farmer’s son came to the door of the family hovel.

“Is that your son?” the nobleman asked. “Yes,” the farmer replied proudly. “I’ll make you a deal. Let me take him and give him a good education, If the lad is anything like his father, he’ll grow to a man you can be proud of.”

And that he did. Flehming’s son graduated from St. Mary’s Hospital Medical School in London, and went on to become known throughout the world as the noted Sir Alexander Flehming, the discoverer of Penicillin.

Years afterward, the nobleman’s son was stricken with pneumonia. What saved him? Penicillin. The name of the nobleman? Lord Randolph Churchill, His son’s name? Sir Winston Churchill.

Don’t underestimate the vicious effect of kindness. Who knows it can produce another great discovery in the medical world.

AN ACT OF KINDNESS CAN BRING HAPPINESS TO COUNTLESS PEOPLE 78

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COMMON COLD The 7 stages of the COMMON COLD in the life of a young married couple is as following:

The 1st year : “Sugar, I’m worried about my little sweetie pie. You’ve got a bad sniffle and I want you to go to the hospital for a complete check-up.”

The 2nd year : “Listen, honey, I don’t like the sound of that cough. I’ve called a doctor and he is rushing right over.”

The 3rd year : “Maybe you’d better lie down, honey. Nothing is better than a little rest if you’re feeling bad. I’ll bring you something to eat.”

The 4th year : “Look, dear, be sensible, after you’ve fed the kids and washed the dishes, you’d better hit the sack.”

The 5th year : “Why don’t you take a couple of aspirin?”

The 6th year : “If you’d just gargle on something instead of sitting around like a seal, it might help.”

The 7th year : “For heaven’s sake, stop sneezing! What are you trying to do, give me a pneumonia?”

It sometimes appears that medical students and junior doctors are the ones much more kind and understanding to patients, as compared to senior doctors. Probably senior doctors are already immune to patient’s needs by the time they have seen hundreds or even thousands of them?

So, make sure we immunize ourselves from the common COLD and always be WARM to patients.

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VACCINATION OF GOODNESS Growing up in Africa, the son of English settlers, I often accompanied my mother, a doctor, on her rounds. My mother’s single biggest lifesaver was he vaccination programme. Grand tours to inoculate people against smallpox, diphtheria, tuberculosis and polio became part of our dry season routine. I helped with the polio vaccine for the children. I had a tray of sugar lumps and would give one to each person. My biggest problem was to prevent them from coming around to get a second sugar lump. Those were days of relative peace.

As I came to manhood, I left for England and took up journalism. In 1986, the paper assigned me to South Africa. I was unlucky enough to be caught as a spy by armed guerrillas and I was handed to their leader. I distinctly heard the commander gave orders to his servant in chiNdau, a dialect used by the Ndau people. I listened a little longer to be sure, and then tentatively greeted the commander on what I could remember of chiNdau. He was amazed. “Where did you learn this language?” he asked. I told him I had lived in the mountains, as a boy. “What’s your family name?” he asked.

“Godwin.”

GOOD BEGETS GOOD, EVIL BEGETS EVIL Be careful with how you treat your patient!

“Godwin,” he said thoughtfully, turning over the name. “Was your mother the doctor on that side?”

“Yes,” I said.

He smiled and put out his hand for an African “low five” handshake, “She was the one who vaccinated me when I was a child.” Pulling up his sleeve, he showed me a small vaccination scar on his shoulder, “Ah…ha..you gave me the sugar medicine. I remember now. Look, I grew up strong.” He stretched his body proudly. In a few minutes I had been elevated from hostage to honoured guest.

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WHEN A STUDENT IS READY A TEACHER IS ALWAYS AROUND

If people are not ready to change, we can never help them!

We spend a lot of time trying to educate people to improve their quality of life. In the process, we sometimes become frustrated and dissapointed. This often occurs when those whom we try to educate are our loved ones, and particularly so when the reason is that they don’t trust you.

Don’t let those people stop you from your noble effort!

There are a lot more others who need your expertise to bring light and happiness into their lives.

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PRACTICING YOUR PROFESSION A fountain man salesman persuaded a merchant to order 500 dozen pens. He was writing the order in his notebook when suddenly the merchant exclaimed, “Hold on! I’m cancelling that order!”

Then, he turned to wait on a customer.

The salesman left the store perplexed and angry. Later, the merchant’s bookkeeper asked, “Why did you cancel that fountain pen order?” “Why?” responded the merchant, “Because he talked about fountain pens to me for half an hour, using a number of forcible arguments, and then booked my order with a lead pencil. His practice did not agree with his profession.” – Jerral

Kay

Do we ourselves in the medical profession practice healthy lifestyle before counselling patients?

NONE PREACH BETTER THAN THE ANT HE SAYS NOTHING BUT PREACHES BY EXAMPLE - Benjamin Franklin -

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THE PURPOSE OF THE DOCTOR IS TO ENTERTAIN THE PATIENT WHILE THE DISEASE TAKES ITS COURSE - Voltaire -

Hello ! It’s me again I recommend you to watch the movie,

ROBIN WILLIAMS

PATCH ADAM Laughter is contagious!

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COULD YOU JUST - Unknown Author -

When I asked you to listen to me, and you start giving me advice, you have not done what I asked When I ask you to listen to me, and you begin to tell me why I shouldn’t feel that way, you are trampling my feelings When I asked you to listen to me, and you feel you have to do something to solve my problem, you have failed me Listen! All I asked was that you listen, not to talk or do…..just hear me Advice is cheap Radio, TV, magazines and newspaper are full of it I can do for myself, I'm not helpless, maybe discouraged and faltering but not helpless When you do something for me that I can do for myself, you contribute to my fear and inadequacy So please listen and just hear me, and if you want to talk, wait a minute for your turn and I’ll listen to you

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SYMPTOMS They come, like poets to a reading and begin to recite their symptoms, Migraine. “A circus hand putting up tent, His sledge-hammer pounding stakes into the ground of my head.

Even the clowns cannot coax laughter From my spectator frowns.”

Manic depressive. “Most times I’m a ragged doll In the lowest shelf of the store-room.

In between the charming hostess in the kitchen.

Of course both rooms are in the house of my mind.

And that’s where my address is but no postman can find it.”

Parkinsonism. “When it came, it was not an earth shattering quake, But little tremors of fingering, As I’m chasing away invisible flies, As if I’m quick-signalling you to float Like a butterfly and sting like a bee….”

Alzheimer. “Bible, pen, newspaper, wallet, ring, I remember them only because I’ve forgotten where I placed them.

Today’s events are written in invisible ink And tomorrow is not remembered as a day to come But as another blank page in my diary.”

These words are not just symptoms, Certainly not just emotions recollected in tranquillity But moments of terrifying clarity challenging pain, Giving suffering a music beyond that played by juke-box.

And I look, I the doctor dancing at the edge of vertigo-verse!

- Dr. Ng Kian Seng (MMA News – November, 2000) 85

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HOW LONG AM I GOING TO LIVE? A prophet was made to foretell his Sultan’s future. He said, “Sir, you will live to see all your sons dead.” The Sultan enraged, handed him over to the tormentor. Then, the potentate sent for another prophet to inquire the future from him and the hope of better things.

“Excellency,” announced this one, “I see you blessed with long life, so that you will outlive all your family.” The Sultan was delighted, and rewarded him gold. Both prophets knew the same truth but the second one knew the Sultan.

Do you know your patients close enough to make them happy?

WORDS MUST BE COUNTED AMONG THE MOST POWERFUL DRUGS MAN EVER INVENTED - Leo Rosten -

Don’t forget to prescribe therapeutic speech!

THERE IS NO WORSE LIE THAN A TRUTH MISUNDERSTOOD BY THOSE WHO HEAR IT - William James -

Explain things to patient thoroughly and patiently!

THERE ARE TRUTHS WHICH ARE NOT FOR ALL MEN NOR FOR ALL OCCASIONS - Voltaire -

Are you going to tell patients all the 101 possible side effects of a particular drug or treatment procedure?

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WORDS HAVE THE POWER TO

HEAL & ALSO TO KILL

Never use the word CANCER unnecessarily in front of patients!

To most patients, CANCER = DEATH Don’t cause unnecessary worry to patient!

Breaking of news should be done skilfully and with utmost care.

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A PHYSICIAN IS OBLIGATED TO CONSIDER MORE THAN A DISEASED ORGAN, MORE EVEN THAN THE WHOLE MAN, HE MUST VIEW THE MAN IN HIS

WORLD

- Sir Harvey Cushing -

It is more important to know what kind of a patient has a disease than what kind of a disease patient has!

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A TERRIBLE NOICE Once, there was a baby boy who was born deaf due to a rare congenital disorder. So, since birth, the boy never had a chance to hear anything.

The world was just silence to him. The parents were very worried and travelled to many places to find a doctor who could cure their little boy’s deafness. After a great deal of effort, they managed to find a very good surgeon who claimed that he could cure the little boy’s deafness. Without delaying, the little boy underwent an extensive surgery and his hearing was restored. Very excitedly, the parents hugged their little boy and said, “Oh boy! Can you hear us?”

“Yes, Mummy, Daddy, I can hear”, said the little boy who somehow looked miserable.

The parents were very surprised and asked their sweetheart, “My dear, you can now hear everything clearly but why do you still look so unhappy?”

The little boy answered back, “Daddy, Mummy! When you asked doctor to cure me, why didn’t you ask my permission first? The sound of ‘life’ that I hear now is so terrible. Everything was so quiet and peaceful before this. Now, how can I live with such horrible NOICE?”

TREAT PATIENT, NOT THE DISEASE - Sir William Osler -

We very often become too preoccupied with our medical facts and knowledge to the point that we fail to realize that different patients with similar disease can have different needs.

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MIND-BODY MEDICINE

Listen to patient’s heart!

Share their FEARS & WORRIES Share their DESIRES & DREAMS

A GOOD DOCTOR IS THE ONE WHO HEALS THE BODY AS WELL AS THE MIND

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PLASTIC SURGERY Dr. Maxwell Maltz, the developer of selfimage psychology is also a plastic surgeon. In his book, Psycho-Cybernetics, he tells of thousands of cases in which he did remarkable plastic surgery, only to discover that patient still felt he or she was unattractive or outright ugly. A negative self-concept was not changed by even the most drastic change in appearance, unless the patient worked at changing his feelings about himself before and after the surgery.

HEALTH IS A COMPLETE MENTAL, PHYSICAL AND SOCIAL WELLBEING, AND NOT THE MERE ABSENCE OF DISEASE - World Health Organization -

A HEALTHY MIND COMES FROM A HEALTH BODY & A HEALTHY BODY COMES FROM A HEALTHY MIND - Dr. Noordin Darus, Art of Total Wellness -

WHEN THE BODY IS SICK DO NOT ALLOW THE MIND TO BE SICK - Buddha -

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OLD OR YOUNG?

You tend to see what you expect to see!

Have an open mind.

Always have a

DIFFERENTIAL DIAGNOSIS!

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EVIDENCE BASED MEDICINE

Have you looked into the medical literature to agree or disagree with a certain medical claim? Or do you just agree and disagree according to your sceptical belief?

Mummy Therapy?

HAVE AN OPEN MIND DO NOT ACCEPT OR REJECT WITHOUT THOROUGH INVESTIGATION! - Buddha -

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DON’T UNDERESTIMATE THE POWER OF

PRAYER

IN HEALING

You say a prayer in your religion, And I’ll say a prayer as I know it, Together we will say this prayer, And it will be something beautiful to God. - Mother Teresa -

For those who are interested to find out about the clinical evidence of prayer in healing, please read Dr. Chris K.H Teo’s (PhD) book,

“FAITH & PRAYER IN THE HEALING OF CANCER.”

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Chapter 5

PATIENT AS A TEACHER

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HEALTH IS THE GREATEST WEALTH H

BE GRATEFUL THAT YOU ARE NOW STRONG & HEALTHY, A DOCTOR INSTEAD OF A PATIENT

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DO SOMETHING THAT YOU DON’T LIKE EVERYDAY HAVE THE DISCIPLINE TO

A lot of things in life are initially IMPORTANT but NOT URGENT until it is too late! e.g. EXERCISE

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HEALTH IS THE GREATEST WEALTH

How much is health?

Good Health When you are healthy and fit, the world outside is yours to roam, When your mind is well trained and strong, the world comes kissing at your feet Then life unfolds its cherry pink cheeks, Gold glowing in throbbing rich veins For a while the world’s temporal light shines It’s time when fellas ride high But health is fragile, so take care Brittle like thin crystals, The happy world too may break, Many strong men barely make forty, Many sickly ladies drag on but with frail bodies, So will it be a spring too short Or a winter too long?

What matters finally will be how life is lived - Sujiva -

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HEALTH IS WEALTH A man spends most of his life In pursuit of his dreams…..

To amass fortune and fame And make himself a householder name.

He would climb the highest mountain, Traverse the ocean wide And push himself to the limit For country and personal pride He would endure countless punishments In training for title fights But the ultimate wealth will evade him If, in dreaming, his vision he loses sight.

When all the glory days are gone And great fortunes have been won What good wealth and fame If you’re wheelchair-bounded or maimed?

After all is said and done The only enduring wealth is HEALTH So, it would be best to count our blessings And take time out to smell “Life Roses” For success is fleeting and just a feeling And should not encompass all of Life’s meaning - Dr. Lung Jien Kien (MMA News – January, 2001)

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BELL’S PALSY

(Facial muscles paralysis commonly due to viral infection) BE GRATEFUL THAT YOU CAN STILL

A lot of people can’t!

IT TAKES 72 MUSCLES TO FROWN AND ONLY 14 MUSCLES TO SMILE MOST SMILES ARE STARTED BY OTHERS SO, SMILE FIRST

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SMILE A smile is quite a funny thing It lightens up your face And when it’s gone you will never find It’s secret hiding place But far more wonderful it is To see what smile can do You smile at me, I smile at you And so one smile makes two Smile, smile, it isn’t hard to do Smile for a while, let one smile catch two Smile, smile, the magic’s shining through Smile from your heart And the world smiles with you Smile in the morning, smile in the night And, when you see another smile It’ll make you feel so right Smiling makes you feel so right Smiling makes it pleasant Smiling shows you care So smile and smile and don’t forget That smiles go everywhere - A Malaysian Smiley Song -

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LAUGHTER IS THE BEST MEDICINE

Life is not that serious Let’s take humour more seriously!

Laughter is the cheapest tonic and vacation. It stirs the blood, exercises the chest, stimulates the nerve, chases grief, fear and wrath, wins friends, cures the blues and gives all a cleansing rehabilitation.

Medical research has shown that laughter triggers the release of two neuropeptides called endorphin and encephalin that are body’s natural pain killer, and the release of catecholamines that are believed to speed up the healing process.

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ALLERGY TO BULLET Chee Kong was the kind of guy you love to hate. He was always in a good mood and always had something positive to say. When he was asked how he was doing, he would reply, “If I were any better, I would be twins!” He was a unique manager because he had several waiters who had followed him around from restaurant to restaurant. The reason the waiters followed Chee Kong was because of his attitude. He was a natural motivator. If an employee was having a bad day, Chee Kong would be there telling the employee how to look on the positive side of the situation.

Seeing this style really made me curious. So, one day I went up to Chee Kong and asked him, “I don’t get it?” Chee Kong replied, “Each morning I wake up and say to myself, ‘Chee Kong, you have two choices today. You can choose to be in a good mood or you can choose to be in a bad mood.’ I choose to be in a good mood. Each time something bad happens, I can choose to be a victim or I can choose to learn from it. I choose to learn from it. Every time someone comes to me complaining, I can choose to accept their compliment or I can point out the positive side of life. I choose the positive side of life.” “Yeah, right, it’s not easy,” I protested. “Yes, it is,” Chee Kong said. “Life is all about choices. When you cut away all the junk, every situation is a choice. You choose how you react to situations. You choose how people will affect your mood; you choose to be in a good mood or bad mood. The bottom line: It’s your choice how you live life.”

I reflected on what Chee Kong said. Soon thereafter, I left the restaurant industry to start my own business. We loss touch, but I often thought about him when I made a choice about life instead of reacting to it. Several years later, I heard that Chee Kong did something you are never supposed to do in a restaurant business. He left the back door open one morning and was held up at gunpoint by three armed robbers. While trying to open the safe, his hand, shaking from nervousness, slipped off the combination. The robbers panicked and shot him. Chee Kong was rushed to the emergency ward at the general hospital nearby. After 18 hours of surgery and weeks of intensive care, Chee Kong walked out from the hospital with fragments of the bullets still in his body.

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I saw Chee Kong about 6 months after the accident. When I asked him how he was, he replied, “If I were any better, I’d be twins. Want to see my scars?” I declined to see the wounds, but did ask him what had gone through his mind as the robbery took place. “The first thing that went through my mind was that I should have locked the back door,” Chee Kong replied. “Then, as I lay on the floor, I remembered that I had two choices. I could choose to live, or I could choose to die. I chose to live.”

“Weren’t you scared? Did you lose consciousness?” I asked. Chee Kong continued, “The paramedics were great. They kept telling me I was going to be fine. But, when they wheeled me into the emergency room and I saw the expressions on the face of the doctors and nurses, I got really scared. In their eyes, I read, ‘He’s a dead man.’ “I knew I needed to take action.” “What did you do?” I asked. “ Well, there was a big, burly nurse shouting questions at me,” said Chee Kong. “She asked if I was allergic to anything. ‘Yes, ‘I replied. The doctors and nurses stopped working as they waited for my reply. I took a deep breath and yelled, “Bullets!” Over their laughter, I told them. “I am choosing to live. Operate on me as if I am alive, not dead.” Chee Kong lived thanks to the skill of his doctors, but also because of his amazing attitude. I learned from him that every day we have the choice to live fully. Attitude, after all, is everything.

Of course, there are certain things in life that we have no choice e.g. choosing our parents, getting old, sick and dying. But, most of the time, we have a CHOICE to do what we want in life. Everything is possible in life. It’s just a matter of having the RIGHT ATTITUDE, using the RIGHT SKILLS and the extra advantage of the RIGHT STRATEGIES.

DESTINY IS IN YOUR HAND, NOT ON YOUR HAND Don’t let palmist decide your future!

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☺ DON’T WORRY, BE HAPPY From the post-mortem room,

THE MOST SCARY GHOST IS THE BOTTLE GHOST

ALCOHOL

Aren’t you afraid of me?

Spending time in the post mortem room can be quite scary.

Don’t worry! Ghosts are not harmful if you do not harm them.

Furthermore, no ghost is scarier than a person intoxicated with alcohol.

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I DIDN’T DRINK, MOM! - Unknown Author I went to party, Mom, Remembered what you said, You told me not to drink, Mom, So, I drank soda instead.

I really felt proud inside, Mom, The way you said I would, I didn’t drink and drive, Mom, Even though the others said I should.

I know I did the right thing, Mom, I know you’re always right, Now, the party is finally ending, Mom, And everyone is driving out of sight.

As I got to my car, Mom, I knew I’d get home in one piece, Because of the way you raised me, So responsible and sweet.

I started to drive away, Mom, But, as I pulled out into the road, The other car didn’t see me, Mom, Hit me like a load.

I lay here on the pavement, Mom, I can hear the policeman say, The other guy is drunk, mom, But I’m the one who will pay for it.

I’m lying here dying, Mom, I wish you’d get here soon, How could this happen to me, mom?

My life just burst like a balloon.

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☺ DON’T WORRY, BE HAPPY There’s blood all around me, Mom, And most of it is mine, I hear the medic say, Mom, Most of the blood is mine.

I just wanted to tell you, Mom, That I swear I did not drink, It was all of the others, Mom, The others did not think.

He was probably at the same party as I, The only difference is: HE DRANK AND I WILL DIE

WHEN YOU DRINK DON’T

Why do people drink, Mom? It can ruin your whole life, I’m feeling sharp pains now, Pains just like a knife.

The guy who hit me is walking, Mom, And I don’t think it’s fair, I’m lying here dying, Mom, And all he can do is stare.

Tell my brother not to cry, Mom, Tell daddy to be brave, And when I go to heaven Mom, Put “Daddy’s Girl” on my grave.

Someone should have told him, Mom, Not to drink and drive, If only they had told him, Mom, I would still be alive.

My breath is getting shorter, Mom, I’m becoming very scared, Please don’t cry for me, mom, When I needed you were always there.

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DRIVE

☺ DON’T WORRY, BE HAPPY I have one more question, Mom, Before I say goodbye, I’m not the one who decided to drink and drive, So, why am I the one to die?

FIRST, A MAN TAKES A BOTTLE THEN, THE BOTTLE TAKES ANOTHER BOTTLE LATER, THE BOTTLES TAKE THE MAN

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 DON’T WORRY, BE HAPPY From the psychiatric ward,

DANGER OF

ALCOHOLIC ILLUSION

- Dr. S Pathmakanthan (MMA News – October, 1999)

Even the elderly are not spared!

ALCOHOL IS THE ANAESTHESIA

BY WHICH SOME ENDURE THE OPERATION OF LIFE!

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CARING FOR OTHERS Two men, both seriously ill, occupied the same hospital room. One man was allowed to sit up in his bed for an hour each afternoon to help drain the fluid from his lungs. His bed was next to the room’s only window. The other man had to spend all his time flat on his back.

The men talked for hours on end. They spoke of their wives and families, their homes, their jobs, their environment in the military service and where they had been on vacation. And every afternoon when the man in the bed by the window could sit up, he would pass the time by describing it to his roommate all the things he could see outside the window. The man in the other bed began to live for those one-hour periods where his world would be broadened and enlivened by all the activity and colour of the world outside.

The window overlooked a park with a lovely lake. Ducks and swans played on the water while children sailed their model boats. Young lovers walked arm-in-arm amidst flowers of every colour of the rainbow. Grand old trees graced the landscape, and a fine view of the city skyline could be seen in the distance. As the man by the window described all this exquisite detail, the man on the other side of the room would close his eyes and imagine the picturesque scene. One warm afternoon, the man by the window described a parade passing by. Although the other man couldn’t hear the band, he could see in his mind’s eye as the gentleman by the window portrayed it with descriptive words.

Days and weeks passed. One morning, the day nurse arrived to bring water for their baths only to find the lifeless body of the man by the window, who had died peacefully in his sleep. She was saddened and called the hospital attendants to take the body away. As soon as it seemed appropriate, the other man asked if he could be moved next to the window. The nurse was happy to make the switch and after making sure he was comfortable, she left him alone.

Slowly, painfully, he propped himself up on one elbow to take his first look at the world outside. Finally, he would have the joy of seeing it for himself. He strained to slowly turn to look out the window beside the bed. It faced a blank wall. The man asked the nurse what could have

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CARING FOR OTHERS Two men, both seriously ill, occupied the same hospital room. One man was allowed to sit up in his bed for an hour each afternoon to help drain the fluid from his lungs. His bed was next to the room’s only window. The other man had to spend all his time flat on his back.

The men talked for hours on end. They spoke of their wives and families, their homes, their jobs, their environment in the military service and where they had been on vacation. And every afternoon when the man in the bed by the window could sit up, he would pass the time by describing it to his roommate all the things he could see outside the window. The man in the other bed began to live for those one-hour periods where his world would be broadened and enlivened by all the activity and colour of the world outside.

The window overlooked a park with a lovely lake. Ducks and swans played on the water while children sailed their model boats. Young lovers walked arm-in-arm amidst flowers of every colour of the rainbow. Grand old trees graced the landscape, and a fine view of the city skyline could be seen in the distance. As the man by the window described all this exquisite detail, the man on the other side of the room would close his eyes and imagine the picturesque scene. One warm afternoon, the man by the window described a parade passing by. Although the other man couldn’t hear the band, he could see in his mind’s eye as the gentleman by the window portrayed it with descriptive words.

Days and weeks passed. One morning, the day nurse arrived to bring water for their baths only to find the lifeless body of the man by the window, who had died peacefully in his sleep. She was saddened and called the hospital attendants to take the body away. As soon as it seemed appropriate, the other man asked if he could be moved next to the window. The nurse was happy to make the switch and after making sure he was comfortable, she left him alone.

Slowly, painfully, he propped himself up on one elbow to take his first look at the world outside. Finally, he would have the joy of seeing it for himself. He strained to slowly turn to look out the window beside the bed. It faced a blank wall. The man asked the nurse what could have

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CARING FOR OTHERS Two men, both seriously ill, occupied the same hospital room. One man was allowed to sit up in his bed for an hour each afternoon to help drain the fluid from his lungs. His bed was next to the room’s only window. The other man had to spend all his time flat on his back.

The men talked for hours on end. They spoke of their wives and families, their homes, their jobs, their environment in the military service and where they had been on vacation. And every afternoon when the man in the bed by the window could sit up, he would pass the time by describing it to his roommate all the things he could see outside the window. The man in the other bed began to live for those one-hour periods where his world would be broadened and enlivened by all the activity and colour of the world outside.

The window overlooked a park with a lovely lake. Ducks and swans played on the water while children sailed their model boats. Young lovers walked arm-in-arm amidst flowers of every colour of the rainbow. Grand old trees graced the landscape, and a fine view of the city skyline could be seen in the distance. As the man by the window described all this exquisite detail, the man on the other side of the room would close his eyes and imagine the picturesque scene. One warm afternoon, the man by the window described a parade passing by. Although the other man couldn’t hear the band, he could see in his mind’s eye as the gentleman by the window portrayed it with descriptive words.

Days and weeks passed. One morning, the day nurse arrived to bring water for their baths only to find the lifeless body of the man by the window, who had died peacefully in his sleep. She was saddened and called the hospital attendants to take the body away. As soon as it seemed appropriate, the other man asked if he could be moved next to the window. The nurse was happy to make the switch and after making sure he was comfortable, she left him alone.

Slowly, painfully, he propped himself up on one elbow to take his first look at the world outside. Finally, he would have the joy of seeing it for himself. He strained to slowly turn to look out the window beside the bed. It faced a blank wall. The man asked the nurse what could have

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 DON’T WORRY, BE HAPPY compelled his deceased roommate who had described such wonderful things outside this window. The nurse responded that the man was blind and could not even see the wall. She said, “Perhaps he just wanted to encourage you.”

There is tremendous happiness in making others happy. So, the next time when you are unhappy, try doing something for the happiness of others.

THE BEST WAY TO FIND YOURSELF IS TO LOSE YOURSELF IN THE SERVICE OF OTHERS - Mahatma Gandhi -

SORROW IS HALF GONE WHEN SHARED BUT HAPPINESS DOUBLES

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☺ DON’T WORRY, BE HAPPY From the labour room,

BIRTHDAYS SHOULD BE DEDICATED TO

MOTHERS

Happy Birth Day, Mother!

Be grateful to your mother for bringing you into this wonderful world

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☺ DON’T WORRY, BE HAPPY From the labour room,

FLOWER DELIVERY Obstetrics and Gynaecology (O&G) was an extremely hectic posting. Each and every one of us had to deliver 30 babies and do 20 episiotomies. Seeing 30 mothers delivering their babies was a very touching experience. I love you, MUM.

A man stopped at a flower shop to have flowers delivered to his mother 200 miles away. As he left, he noticed a little girl sobbing on the curb in front of the shop. When he inquired what was wrong, she explained that she wanted to buy a rose for her mother but it cost $ 2. 00 and she only had 75 cents. He bought the flower for the girl and offered a ride home.

She agreed if he would also take her to her mother. She directed her to a cemetery where she placed the rose on a freshly dug grave.

The man returned to the flower shop and cancelled the order.

Instead, he got in his car and drove 200 miles to his mother’s home to personally deliver a bouquet of local flowers.

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☺ DON’T WORRY, BE HAPPY From the blood bank,

HAVE YOU DONATED YOUR

BLOOD?

The gift of blood is the gift of life!

THE MOST VALUABLE GIFT WE CAN GIVE IS A PORTION OF OURSELF - Emerson -

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☺ DON’T WORRY, BE HAPPY From the breastfeeding room,

BREAST WHO ARE MORE CIVILISED?

The traditional way of dressing among the women of a hill tribe was to leave the upper part of their bodies bare.

They did not draw attention among their men who went about their daily duties as they had been doing that for generations.

However, when they were about to be visited by some officials undertaking a study on their way of life, the young girls were told by their chieftain to hide themselves.

They were safe among the men of their tribe, but there was no telling what the so-called educated men from the civilised world would do to them.

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DON’T BE SHY! COME AND LEARN FROM US

Mummy!

Why are those little doctors so shy?

Come, come, guchii… guchii…

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☺ DON’T WORRY, BE HAPPY From the paediatric ward,

PAEDIATRIC LESSON Going through paediatric posting was not a bed of roses. It was one of the toughest posting with a lot of facts to remember and a hard time trying to coax the children. Nevertheless, there is a lot of wisdom that we can learn from children, that we have left behind, as we become adults.

1. Children are very CURIOUS. Everything is new and interesting to them, and they want to know everything on earth. That is why they learn new things with incredible speed.

2. Children DARE

TO FAIL. When they learn to walk, they

often fall and cry many times, but never fail to stand up to try again until they are successful. They don’t get disappointed easily.

3. Children

LIVE IN THE PRESENT. They are very

spontaneous. They rarely waste their time thinking of the past or future unnecessarily. Life is just enjoying the present moment, engrossed with toys or whatever new things in life.

4. Children are very ENERGETIC. Mothers often suffer from sleep deprivation. The word ‘tired’ does not exist in children’s vocabulary.

5. Children

have

extraordinary

IMAGINATION

and

CREATIVITY. No wonder why life always seems interesting to them. We rarely hear them complaining that life is boring.

6. Children are GENUINE and HONEST. They don’t put on

mask and practice hypocrisy. When they don’t like us, they would just say, “I don’t like you”, straight from the heart.

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☺ DON’T WORRY, BE HAPPY 7. Children FORGIVE and FORGET easily. One minute they don’t like you, another minute they will invite you to play with them.

They are very accepting and don’t hold grudge against people.

8. Children have an OPEN

MIND. It is much more easy to

improve a child’s attitude than an adult’s attitude.

9. Children LAUGH a lot. They don’t need much to laugh at. They can laugh at almost anything, naturally and unshamefully.

10. Children dare to CRY. They don’t try to hide their emotions and practice ‘macho-ism’. They allow themselves the freedom to express themselves, to cry and it is absolutely OK to do so.

BODY IS OLD THE MIND SHOULD REMAIN YOUNG WHEN THE

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 DON’T WORRY, BE HAPPY From the geriatric posting,

AGE

IS A QUALITY OF MIND

If you have left your dreams behind, If hope is lost, if you no longer look ahead, If your ambition fires are dead, Then you are OLD. But, if from life you take the best, And if in life you keep the jest, If love you hold, No matter how the years go by, No matter how the birthdays fly, You are not OLD! - H. S. Fritch -

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☺ DON’T WORRY, BE HAPPY Case presentation,

MIRROR, MIRROR ON THE WALL

WHAT DO YOU THINK OF ME?

“Mr. XYZ is a ?-year-old Malay…from…”

(A typical way of how medical students present their medical history) At the age of 20, we are very particular about how other people think of us. At the age of 40, when we are already rather successful in life, we care less about how other people think of us. At the age of 60, when we are old and useless, nobody will think of us anymore. So, don’t allow others to decide who you are. You are always GREAT!

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What I have learnt over the years is that, NOBODY can be free from OLD AGE, SICKNESS & DEATH You could be the NEXT! Are you READY?

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DEATH

IS NOT CAUSE FOR SORROW BUT IT WOULD BE SORROW IF ONE DIES WITHOUT HAVING DONE ANY SERVICE FOR ONESELF & THE WORLD - Ven. Dr. K. Sri. Dhammananda -

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☺ DON’T WORRY, BE HAPPY From the palliative care unit,

QUALITY OF LIFE IT MATTERS NOT HOW LONG WE LIVE BUT HOW - Philip James Bailey –

Hello death, goodbye life!

When you are born, you cry other people rejoice.

Live your life fully so that when you die, other people cry, you REJOICE!

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 DON’T WORRY, BE HAPPY From the post-mortem room,

TO REMEMBER ME (Robert N. Test) The day will come when my body will lie upon a white sheet neatly tucked under four corners of a mattress located in a hospital busily occupied with the living and the dying. At a certain moment a doctor will determine that my brain has ceased to function and that, for all intents and purposes, my life has stopped. When that happens, do not attempt to instil artificial life into my body by the use of a machine. And don’t call this my deathbed. Let it be called the Bed of Life, and let my body be taken from it to help others lead fuller lives. Give my sight to the man who has never seen a sunrise, a baby’s face or love in the eyes of a woman.

Give my heart to a person whose own heart has caused nothing but endless days of pain. Give my blood to the teenager who was pulled from the wreckage of his car, so that he might live to see his grandchildren play. Give my kidneys to one who depends on a machine to exist from week to week. Take my bones, every muscle, every fibre and nerve in my body and find a way to make a crippled child walk. Explore every corner of my brain. Take my cells, if necessary, and let them grow so that, someday, a speechless boy will shout at the crack of a bat and a deaf girl will hear the sound of rain against her window. Burn what is left of me and scatter the ashes to the winds to help the flowers grow. If you must bury something, let it be my faults, my weaknesses and all prejudice against fellow men. If by chance, you wish to remember me, do it with a kind deed or word to someone who needs you. If you do all I have asked, I will live forever.

As I saw the bodies and organs in the post-mortem room, I started to reflect on organ donation. It’s a great waste if we do not make full use of our bodies for the happiness of mankind. Have you pledged your organs?

AFTERLIFE IS WHAT YOU LEAVE BEHIND FOR THOSE WHO ARE LIVING AFTER YOUR DEATH

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Chapter 6

PREPARING FOR HOUSEMANSHIP

☺ DON’T WORRY, BE HAPPY

I AM A GOOD DOCTOR

I love myself and my patients love me too!

GIVE YOURSELF A REPUTATION TO KEEP UP TO

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COMMUNITY SERVICE

Our parents, government and community invest a lot of money on us.

Don’t disappoint them!

I have always considered myself as ‘striking lottery’ when I was accepted into one of the local medical schools.

It would have cost my parents probably half a million if I were to do medicine abroad. Even though it is much cheaper doing medicine locally, we have to understand that we are actually highly subsidized by the government, who of course obtains revenue from the community through various taxes.

So, we owe the community and should…..

SERVE THE COMMUNITY! 127

☺ DON’T WORRY, BE HAPPY

THE LOST HORSE An old man once lost a horse. His neighbours all came to console him. But, the old man said, “It may turn out to be a good thing.” A few months later, the horse came back by itself and brought another faster horse with it. The old man’s neighbours this time came to congratulate him. But, he said, “This may turn out to be bad.” One day, the old man’s son went out riding on the fast horse. The horse ran too fast, and his son fell down and broke his leg, became crippled and handicapped. So, what do you think, is it bad? Later, the country was at war and the commander was recruiting young and strong men to join the army. The old man’s son was exempted due to his handicap.

BAD MAY NOT BE BAD, IT MAY BE GOOD GOOD MAY NOT BE GOOD, IT MAY BE BAD Shit, the exam is so soon!

Shit, I’m in the same group with that idiot!

Shit, that lousy lecturer is teaching us!

Shit, the silly computer is not working!

Shit, I got this bad place for my HO (internship) posting!

There are 101 things that we can SHIT in life!

BLESSING IS EVERYWHERE

COUNT IT

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DOING WHAT YOU LIKE IS A SOURCE OF HAPPINESS, LIKING WHAT YOU DO IS A GREATER SOURCE OF HAPPINESS

I enjoy doing all the boring operations!

“This is an order!” Very often we don’t get to decide what we wish to do in life. We have no choice, but we can always try to do things with CREATIVITY and FUN and we will be able to enjoy the ‘no choice’ work much better.

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KEEP COOL

Wow, so many patients!

A study published in the Journal of the Royal College of Physician of London, showed that levels of psychological morbidity are higher amongst doctors than in general populations particularly in the HOUSE-OFFICER year.

DON’T BECOME A MAD DOCTOR!

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EXCELLENCE

Yeah, I’m houseman of the month!

Going far beyond the call of duty Doing more than others expected This is what excellence is all about And it comes from in search of excellence Striving and maintaining the highest standards Looking after the smallest details and Going the extra mile Excellence means caring It means making a special effort To do more………..

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EVERYBODY, SOMEBODY, ANYBODY,

NOBODY

There were four people named Everybody, Somebody, Anybody and Nobody. An important job had to be done, and Everybody was sure that Somebody would do it.

Anybody could have done it, but Nobody did it. Somebody got angry with that, because it was Everybody’s job. Everybody thought Anybody could do it and that Somebody would do it.

But, Nobody realized that Everybody thought Somebody would do it. It ended up that Everybody blamed Somebody when Nobody did what Anybody could have done (Charles Osgood)

INITIATIVE IS DOING THE RIGHT THING AT THE RIGHT TIME WITHOUT BEEN TOLD - Victor Hugo 132

☺ DON’T WORRY, BE HAPPY

YOU GIVE YOUR BEST IN WORK NOT BECAUSE YOU NEED TO

IMPRESS PEOPLE, BUT BECAUSE THAT’S THE ONLY WAY TO

ENJOY YOUR WORK

Always do more than you are paid for and one day you will be paid for more than you do!

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MY BOSS & I When I take a long time I am slow When my boss takes a long time He is thorough

When I didn’t do it I am lazy When my boss doesn’t do it He is too busy When I do something without being told I am trying to be smart When my boss does the same This is initiative When I please my boss I am apple-polishing When my boss pleases his boss He is cooperating When I do good My boss never remember When I do wrong He never forget YOU DON’T WORK FOR YOUR BOSS YOU WORK FOR YOURSELF AND YOUR PATIENT

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A CRACKED POT A water bearer in India had two large pots, each hung on each end of a pole, which he carried across his neck. One of the pots had a crack in it, and while the other pot was perfect and always delivered a full portion of water at the end of the long walk from the stream to the master’s house, the cracked pot arrived only half full.

For years this went on daily, with the bearer delivering only one and a half pots of water to his master’s house.

Of course, the perfect pot was proud of its accomplishments, perfect to the end for which it was made. But, the poor cracked pot was ashamed of its own imperfection, and miserable that it was able to accomplish only half of what it had been made to do. After two years of what it perceived to be a bitter failure, it spoke to the water bearer one day by the stream, “I am shame of myself, and I want to apologize to you.” “Why?” asked the bearer. “What are you ashamed of?” “I have been able, for the past two years, to deliver only half my load because this crack in my side causes water to leak out all the way back to your master’s house. Because of my flaws, you have to do all of this work, and you don’t get full value from your effort,” the pot said.

The water bearer felt sorry for the old cracked pot, and in his compassion he said, “As we return to the master’s house, I want you to notice the beautiful flowers along the path.” Indeed, as they went up the hill, the old cracked pot took notice of the sun warming the beautiful wild flowers on the side of the path, and this brought cheer. But, at the end of the trail, it still felt bad because it had leaked out half its load, and so again it apologized to the bearer for its failure. The bearer said to the pot, “Did you notice that there were flowers only on your side of your path, but not on the other pot’s side? That’s because I have always known about your flaw, and I took advantage of it. I planted flower seeds on your side of the path, and every day while we walk back from the stream, you’ve watered them. For two years I have been able to pick flowers to decorate my master’s table.

Without you being just the way you are, he would not have this beauty to grace his house.

Be proud to be a medical student or a houseman because everyone has a role to play in management of patient.

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THE SAME VALUE A well-known speaker started off his seminar by holding up a RM 100 bill.

In the room of 1000, he asked, “ Who would like this RM 100 bill?” Hands started going up.

He said, “I am going to give this RM 100 bill to one of you but first, let me do this. He proceeded to crumple the bill up. He then asked, “Who still wants it?” Still the hands were up in the air.

“Well,” he replied, “What if I do this?” And he dropped it on the ground and started to grind it into the floor with his shoe. He picked it up, now all crumpled and dirty. “Now who still wants it?” Still the hands went into the air. “My friends, you have all learned a very valuable lesson.

No matter what I did to the money, you still wanted it because it did not decrease in value. It was still worth RM 100. Many times in our lives, we are dropped, crumple, and ground into dirt by the decisions we make and the circumstances that come our way. We feel as though we are worthless. But, no matter what has happened or what will happen, you will never lose your value.

Houseman should take note of this.

LOVE & RESPECT YOURSELF BECAUSE YOU ARE YOU 136

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TEAMWORK …..is the ability to work together towards a common vision …..is the ability to direct individual accomplishment towards organizational objectives …..is the fuel that allow common people achieve uncommon results Simply stated, it is less ME and more WE

NO MAN IS AN ISLAND

Nobody can work alone to manage a patient well!

It doesn’t matter whether you are a doctor, nurse, medical assistant, pathologist, physiotherapist, occupational therapist, dietician etc., you are very IMPORTANT because you are part of the T E A M (Together Everyone Achieves More)

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EVERYONE COUNTS During my second month of nursing school, our professor gave us a quiz. I was a conscientious student and had breezed through the questions, until I read the last one: “What is the first name of the woman who cleans the school?” Surely this was some kind of joke. I had seen the cleaning woman several times. She was tall, dark-haired and in her 50s, but how would I know her name? I handed in my paper, leaving the last question blank.

Before class ended, one student asked if the last question would count toward our grade. “Absolutely,” said the professor. “In your careers, you will meet many people. All are significant. They deserve your attention and care, even if all you do is smile and say “Hello!” I’ve never forgotten that lesson. I also learned her name was Dorothy.

HELLO! WHAT’S YOUR NAME? Do you know the security guard?

Do you know the ‘roti canai’ man in the canteen?

Do you know the clerk in your medical department?

Do you know the person who sweeps the floor in the ward?

Do you know the person who cleans the toilet?

Do you know the librarian?

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WORK

should not

damage, degrade, humiliate, exhaust, stultify or persistently bore the worker

INTEREST and SATISFY It should utilise worker’s valued SKILLS and ABILITIES It should enhance worker’s other major LIFE ROLES It should

– wife, husband, parent, and citizen

It should provide a

LIVING

- Kahn –

Just because you spent 5 years becoming a doctor, that doesn’t mean you must spent the next 40 years doing something that you hate. DON’T TORTURE YOURSELF! Make the choice to start doing what you love in life.

(There are lot of great people in life who had studied medicine but do not practice medicine e.g. our Prime Minister, Datuk Seri Dr. Mahathir Mohamad)

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CONTENTED FISHERMAN (Anthony De Mello) A man was strolling on the beach when he saw a fisherman fishing on the cliff. He went up and asked the fisherman how was his catch. The fisherman replied that there weren’t many fishes but he was contented and happy with his catch.

The man went on and told the fisherman that he should go out into the ocean, that way would get more fishes to sell. If the fisherman was really good, he could set up a company and buy up trawlers, catch even more fishes and earn even more money. Having achieved all these, the fishermen could buy all the things he wanted, that including a beach resort, do the things he wanted like relaxing down at the beach e.g. fishing recreationally.

The fisherman looked puzzled, “I don’t understand this, you are suggesting that I should go one big loop so as to end up where I am today, happily fishing on the cliff?

One of the favourite topics of discussion besides exam during our final year was pertaining to our future, “Should I become a specialist? What field should I choose? How far should I go in my medical career?

Would I have time for social life? Would I regret and be too late by then?” The above story doesn’t suggest that we should stop improving ourselves.

It only teaches us about contentment. It reminds us to ponder on what we really want in life and do we need that to be happy? It is an individual choice to decide how far we want to go in our medical career. Don’t follow the crowd! Whatever decision we make, we must remember that:

PEOPLE WON’T CARE HOW MUCH WE KNOW UNTIL THEY KNOW HOW MUCH WE CARE - Theodore Roosevelt 140

☺ DON’T WORRY, BE HAPPY

VOLUNTEER YOUR MEDICAL EXPERTISE

VOLUNTARY WORK LED TO LONGER LIFE! A study on 2, 754 people in Tecumseh, Michigan, USA showed that the following were more likely to die during the course of the study than men who volunteered their help regularly and had more social contacts: • Men who did less volunteer work • Those who had less social contacts • Those who were relatively sedentary

•

J.S. House et al. 1982. The association of social relationship and activities with mortality: prospective evidence from the Tecumseh community health study. American Journal of Epidemiology 116:123-140.

☺ DON’T WORRY, BE HAPPY

DOING GOOD IS GOOD FOR HEALTH

Charity shoeshine!

In a study in United States, it was noted that people who helped others reported the following: • They consistently reported better health.

• Their health markedly improved when they began volunteer work.

• 95% of them said helping others gave a physically good feeling. Nine out of ten experienced physical sensations of sudden warmth, increased energy and a sense of euphoria.

• They reported long-term calmness and relaxation

•

Allan Luks. 1993. The Healing Power of Doing Good. Ballantine. New York.

☺ DON’T WORRY, BE HAPPY

THE TROUBLE TREE The carpenter I hired to help me restore an old farmhouse had just finished a rough first day on the job. A flat tire made him lose an hour of work, his electric saw quit and now, his ancient pickup truck refused to start. I drove him home and he wanted to introduce me to his family members. As we walked toward the front door, he paused briefly at a small tree, touching the tips of the branches with both hands.

When opening the door, he underwent an amazing transformation.

His tanned face wreathed in smiles and he hugged his two children and gave his wife a kiss. Afterward, we walked to the car. I asked him about what I had seen earlier.

“Oh, that’s my trouble tree,” he replied. “I know I can’t help having troubles on the job, but one thing for sure, troubles don’t belong in the house with my wife and the children. So, I just hang them on the tree every night when I come home. Then in the morning I pick them up again.

“Funny thing is, “ he smiled, “When I come out in the morning to pick them up, there aren’t nearly as many as I remember hanging up the night before.

Working in hospital especially as a houseman can be very stressful. Make sure you don’t bring home problems from the hospital.

WHAT YOU FOCUS ON

EXPANDS WHEN YOU LET GO OF PROBLEMS THEY LET GO OF YOU - Andrew Matthews -

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EMERGENCY MEDICINE

☺ DON’T WORRY, BE HAPPY

GIVE YOURSELF A

BREAK

Medical student life is not that bad!

It’s WORSE

At one medical school in US, 12% of the students became clinically depressed during their first year and 30% of the residents during their intern year. In another study, suicide ranks second among the leading causes of death among medical students.

Clark DC, Zeldow PB. Vicissitudes of depressed mood during four years of medical school. JAMA 1988; 260(17):2521-2528.

Valko RJ, Clayton PJ. Depression in the internship.

Dis Nerv Syst 1975;(36):26-29.

Hays LR, Cheever T, Patel P. Medical student suicide, 1989-1994.

Am J Psychiatry 1996;153:553-555.

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DON’T YOU QUIT When things go wrong, as they sometimes will, when the road you're trudging seems all up hill, when the funds are low and the debts are high, and you want to smile, but you have to sigh, when care is pressing you down a bit, rest, if you must - but don't you quit.

Life is queer with its twists and turns, as every one of us sometimes learns, and many a failure turns about when he might have won had he stuck it out; don't give up, though the pace seems slow you might succeed with another blow.

Often the goal is nearer than it seems to a faint and faltering man, often the struggler has given up when he might have captured the victor's cup.

And he learned too late, when the night slipped down, how close he was to the golden crown.

Success is failure turned inside out The silver tint of the clouds of doubt and you never can tell how close you are, it may be near when it seems afar; So stick to the fight when you're hardest hit It's when things seem worst that you mustn't quit.

- Clinton Howell -

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I’M ONLY HUMAN I am human I am not perfect I am just trying to be a better person Please understand and do not expect me to live up to your expectations Please accept me as I am with all my failings and shortcomings and I shall try as time goes by to improve and become a better person In the meanwhile please be patient Thank you for listening

- Unknown Author -

IT IS PERFECTLY PERFECT TO BE IMPERFECT

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I’M STILL GAY NO MATTER WHAT YOU SAY No matter what you say I’m still a lovely person No matter what you say I’m still a useful person I’m just a human being Like the rest of you I’m just a human being That errs like you I have done my best Although it’s not your standard yet I have done my best And there’s not a single regret Seek no fault from others Seek no fault from thyself Tomorrow will be a whole new day Another improvement day And I’ll always say I’m still gay No matter what you say - Dr. Phang Cheng Kar -

* Gay = cheerful & happy

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DON’T SWEAT THE SMALL STUFF IT’S ALL

SMALL STUFF

MEDICAL EDUCATION IS A LIFE LONG PROCESS LEARN TO RELAX! Relax! Relax! Relax Studying medicine is rather stressful. A study on Ohio State University medical students studying for their major exams, and so under stress, showed that they had significant drop in T-cell and B-cell levels, as well as a higher number of cold and flu. In another study, it was found that students who in psychological testing showed the greatest need for power were the ones with greatest drop in immunity.

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STUDYING MEDICINE IS A

MARATHON

Don’t run out of fuel!

MORE

SPEED LESS HASTE Don’t rush!

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MUSHROOM GROWS FAST BY FEEDING ON SOFT FLABBY NOURISHMENT

OAK TREE GROWS SLOWLY BY SINKING ITS ROOTS DEEP INTO THE GROUND FOR SOLID NOURISHMENT

YEARS Good doctors take time to grow!

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BUTTERFLY One day a small opening appeared on a cocoon, a man sat and watched for the butterfly for several hours as it struggled to force its body through that little hole. Then, it seemed to stop making any progress. It appeared as if it had gotten as far as it could and it could go no further. So, the man decided to help the butterfly, he took a pair of scissors and snipped off the remaining bit of the cocoon. The butterfly then emerged easily.

But, it had a swollen body and small, shrivelled wings. The man continued to watch the butterfly because he expected that, at any moment, the wings would enlarge and expand to be able to support the body, which would contract in time. Neither happened! In fact, the butterfly spent the rest of its life crawling around with a swollen body and shrivelled wings. It never was able to fly. What the man, in his kindness and haste, did not understand was that the restricting cocoon and the struggle required for the butterfly to get through the tiny opening, was a way of forcing fluid from the body of the butterfly into its wings, so that it would be ready for flight once it achieved its freedom from the cocoon.

HARD WORK MAKES GOOD DOCTOR

THAT WHICH DOES NOT KILL ME WILL MAKE ME STRONGER -Nietzche151

 DON’T WORRY, BE HAPPY

HARD WORK NEVER KILLS

Aiyuh, so much of work!

GENIUS IS 1% INSPIRATION &

99% PERSPIRATION - Thomas Edison -

Transform all the hardships, “S T R E S S E D” in life into sweet experience, “D E S S E R T S”

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OUCH! NO PAIN No pain, no gain!

THERE IS ONLY ONE THING THAT I DREAD; NOT TO BE WORTHY OF MY SUFFERING! -DostoevskiApproximately one out of every 400, 000 babies born each year fated to live a short pitiful life which none of us would envy, a life in which he will frequently hurt himself, sometimes seriously and not knowing it. That child has a rare genetic disease known as Familial Dysautonomia. He cannot feel pain.

Such a child will cut himself, burn himself, fall down and break a bone and never know that something is wrong. He will not complain of a sore throat and stomach-ache and his parents will not know when he is sick until it is too late. Would any of us want to live a life like that, without feeling pain?

(Dare To Fail by Billi P.S. Lim) 153

☺ DON’T WORRY, BE HAPPY

Confront problems and watch them calmly, as trees confront each and every on-coming season.

Welcoming, they stand through rain, winter and autumn, growing up spontaneously by degrees.

They both shed and bud their lays and thus develop their rings of maturity.

Let us so welcome happiness and suffering by seeing them as the year-round seasons.

Why should we be perturbed?

Step forward in wise repose, inwardly still and filled with calmness - Unknown Author -

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PERSEVERANCE TURNS NOBODIES INTO SOMEBODIES

Never give up no matter what happens!

Colonel Sanders went to more than 1, 000 places trying to sell his chicken recipe before he found an interested buyer.

The fact that we can buy Kentucky Friend Chicken today attests to his perseverance.

How many times have you attempted?

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NO MATTER HOW MANY TIMES I FAILED, I MUST ALWAYS

ATTEMPT AGAIN

I will never give up!

IF THERE IS A WILL, THERE IS ALWAYS A WAY AND ALWAYS A WAS (Life history can be changed with DETERMINATION)

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FAILURE Failure doesn't mean you are a failure, It means you have not succeeded Failure doesn't mean you accomplished nothing, It means you have learnt something Failure doesn't mean you have been a fool, It means you have a lot of faith Failure doesn't mean you've been disgraced, It means you were willing to try Failure doesn't mean you don't have it, It means you have to do something in a different way Failure doesn't mean you are inferior, It means you are not perfect Failure doesn't mean you have wasted your life, It means you have reason to start afresh Failure doesn't mean you should give up, It means you must try harder Failure doesn't mean you'll never make it, It means it will take a little longer - Dr. Robert Schuller -

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Be thankful that you don't have everything you desire, If you did, what would there be to look forward to?

Be thankful when you don't know something, For it gives you the opportunity to learn Be thankful for the difficult times, During those times you grow Be thankful for your limitations Because they give you opportunities for improvement Be thankful for each new challenge Because it will build your strength and character Be thankful for your mistakes They will teach you valuable lessons Be thankful when you are tired and weary Because it means you have made a difference It is easy to be thankful for the good things A life of rich fulfillment comes to those who are also thankful for the setbacks - Unknown Author 158

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THIS TOO WILL

PASS

No matter what hardship I encounter in life, I’ll always be patient and try to convince myself by saying, “This would not go on forever.

Good time will soon be coming.”

Everything in life is IMPERMANENT!

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IT COULD HAVE BEEN

WORSE

- Andrew Matthews -

Whatever happens to me in life, I’ll always count my blessings!

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THERE ARE TWO DAYS IN A WEEK THAT WE MUST ALWAYS FORGET

YESTERDAY & TOMORROW

TODAY is the most important day!

LEARN FROM THE PAST, BUT DON’T BROOD OVER IT, PLAN FOR THE FUTURE, BUT DON’T DREAM TOO MUCH ABOUT IT Doing what should be done now, is the best guarantee for the future!

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MEDITATE FOR MENTAL IMMUNITY

Spend some time meditating everyday in whatever way you are comfortable with to STRENGTHEN THE MIND

For those who are interested to find out about the clinical evidence of meditation in health, please read Dr. Herbert Benson’s (MD) book,

“THE RELAXATION RESPONSE”

•

For those who are allergic to the word ‘Meditation’, you can substitute it with ‘Mental Exercise’.

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MOSO THE BAMBOO PLANT The moso is a bamboo plant that grows in China and other regions of the Far East.

After the moso is planted, no visible growth occurs for up to five years even under ideal conditions. Then, as if by magic, it suddenly begins growing at the rate of nearly two and a half feet per day, reaching a full height of 90 feet within six weeks. But, it’s not magic.

The moso’s rapid growth is due to the miles of roots it develops during first five years, five years of getting ready.

It takes 5 years just to get ready to become a good doctor. Don’t be disappointed if you have worked very hard and still find yourself apparently inadequate. You have planted the roots well. Continue to work hard and a good doctor is in the making.

Don’t forget that common things are common and you should know them first – ‘THE ROOT PRINCIPLE’

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Chapter 8

GRADUATION

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GRADUATION! NOW, THIS IS NOT THE END IT IS NOT EVEN THE BEGINNING OF THE END BUT, PERHAPS IT IS THE END OF THE BEGINNING - Winston Churchill -

Learning medicine has no end!

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DECLARATION OF GENEVA I SOLEMNLY PLEDGE myself to consecrate my life to the service of humanity

I WILL GIVE to my teachers the respect and gratitude which is their due

I WILL PRACTICE my profession with conscience and dignity THE HEALTH OF MY PATIENT will be my first

consideration

I WILL RESPECT the secrets that are confided in me I WILL MAINTAIN by all means in my power, the honour and the noble traditions of the medical profession

MY COLLEAGUES will be my brothers I WILL NOT PERMIT consideration of religion, nationality, race, party politics or social standing to intervene between my duty and my patient

I WILL MAINTAIN the utmost respect for human life, from the time of conception, even under threat, I will not use my medical knowledge contrary to the laws of humanity

I MAKE THESE PROMISES solemnly, freely and upon my honour

•

Adopted by the General Assembly Of The World Medical Association, Geneva, Switzerland - 1948

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CONVOCATION OF MEDICAL GRADUATES Shiningly gowned, knighted by the sun Faces transfiguring changed by the summer light, They trooped in, measured steps Dancing to the rhythm of the organ music.

My daughters took their appointed places, The slant of the mortarboard Like a hand’s triumphant salute.

They’ve weathered the autumns of Fast food and bland salads, The colourless winters Of assignments thawing into examinations And now have arrived at the summer of their graduation.

Have the seasons of sacrifice been worth it?

I cannot answer the question for them But outside the vertical sun throws short shadows And light up clouds that dream gold and silver - Dr. Ng Kian Seng (MMA News – May, 2000)

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FRESH MEDICAL GRADUATES I’m proud of them Daughters Cheryl-Lyn, Andrea Their friends Andy, Kay, Victor, James Recent medical graduates, Pentium-sharp minds computing every diagnosis, Exam-fresh answer for every irksome viva question, Prescribing a sure cure for every pain.

And, I’m a physician of 27 years Mind blunted by age, Diagnosis no longer the lines of an MRI But the smudge of an ultrasound, I’m no longer sure of a cure for every pain But always, always I try to feel The every pain of a cure Inexact, yet I feel more fulfilled, I guess it is privilege of growing old - Dr. Ng Kian Seng (MMA Newsletter – October, 1999)

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TRYING TO

CHANGE THE WORLD?

Old man wisdom…

An old man said this about himself, “I was revolutionary when I was young, and my prayer to God was, ‘Lord, give me the strength to change the world.’ As I approached middle age and realized that my life was halfway gone without changing a single soul, I changed my prayer to, ‘Lord, give me the grace to change all those who come into contact with me, especially my family and friends, and I shall be satisfied.’ Now that I am old man, and my days are numbered, I have begun to see how foolish I have been.

Now, my prayer is this, ‘Lord, give me the grace to CHANGE MYSELF.’ If I had prayed that right from the start, I would not have wasted my life.”

We are often over ambitious, especially when we just come out from university to work in the society. We can waste years trying to change other people. But, we can only really change one person – OURSELVES. In the end, that is probably enough.

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SHARPENING THE AXE Once upon a time a very strong woodcutter asked for a job in a timber merchant and he got it. The pay was really good and so were the working conditions. For that reason, the woodcutter was determined to do his best. His boss gave him an axe and showed him the area where he was supposed to work. The first day, the woodcutter brought 18 trees. “Congratulations,” the boss said. “ Go on that way!” Very motivated by the boss’s words, the woodcutter tried harder the next day but he only could bring 15 trees. The third day he tried even harder but he could only bring 10 trees. Day after day he was bringing less and less trees. “I must be losing my strength”, the woodcutter thought. He went to the boss and apologized, saying that he could not understand what was going on. “When was the last time you sharpened your axe?”, the boss asked. “Sharpen? I had no time to sharpen my axe. I have been very busy trying to cut trees – A. Beuregard

When was the last time you went for CME (continuous medical education)?

A MAN WHO GRADUATES TODAY & STOPS LEARNING TOMORROW IS UNEDUCATED THE DAY AFTER - Newton D. Baker -

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POSTGRADUATE STUDY? • • • • • • • • •

Medicine Surgery Orthopaedic Paediatric O&G Psychiatry ENT Ophthalmology Dermatology

GENIUS IS 1% INSPIRATION AND

99% PERSPIRATION -Thomas Edison -

Do not allow your not-so-good medical school exam results to interfere with your dream in medical career. As long as you passed your undergraduate exam, you are free to pursue whatever specialization you are interested in, provided that you are willing to WORK HARD

LOUIS PASTEUR was rated as the slowest learner in his chemistry class.

THOMAS EDISON, at the age of six was sent home from school with the note saying, “TOO STUPID TO LEARN.”

ALBERT EINSTEIN was once a high school dropout.

Why do you think these great people were so successful in the later part of their lives?

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SLOW DOWN

THE SPEED OF LIFE

Don’t forget to spend time to enjoy whatever you have NOW while striving for greater achievements in life!

SUCCESS IS A JOURNEY NOT A DESTINATION - Arthur Ashe –

Enjoy the Journey!

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DOCTORS HAVE NO

SOCIAL LIFE

- Andrew Matthews – (Adapted)

Oh, Master! Please help me to find a partner!

One of my lecturers always say, “Don’t be a fool to get married so soon.” I was already a fool by the time I graduated from medical school. But, I have no regret. I’m a lucky fool! and I have known much earlier that, DOCTORS HAVE NO SOCIAL LIFE.

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THREE RINGS IN LIFE • ENGAGEMENT RING • WEDDING RING • SUFFER-RING

Should I get married?

BY ALL MEANS MARRY IF YOU GET A GOOD WIFE, YOU’LL BECOME HAPPY, IF YOU GET A BAD ONE, YOU’LL BECOME A PHILOSOPHER - Socrates -

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END OF THE DAY Today has been a day well spent for acquiring medical knowledge, skills and experience.

I wish to say “WELL DONE” to myself, for all my effort and hard work throughout the day.

I also wish to thank all the patients, lecturers, course mates and everyone whom I have encountered today, for contributing to all the wonderful things that I have learnt.

May all of them be well and happy.

May all their wishes come true and May they be successful in whatever they do in life.

Now, it’s time for me to completely shut myself OFF To have a good night sleep To prepare for another great day tomorrow Goodnight! and Sweet Dream!

- Dr. Phang Cheng Kar -

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May this book brings joy and happiness to all medical students in the past, present & future

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BONUS

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THE ART OF SAYING ‘I DON’T KNOW’ - Dr. Lim Jiun How (Pioneer medical graduate, UPM Medical School)

Too often patients, colleagues, lecturers and consultants ask questions and expect answers instantaneously. When we know the answers, we certainly look intelligent and knowledgeable. On the contrary, not knowing the answers usually implies negative connotations. Giving the right answer is always the best reply. The next best reply is saying something that is not wrong but neither the right answer. This is better than keeping silent or pretending not to hear the question. Saying ‘I don’t know the answer’ is being honest in a way, but somehow gives the impression that you are defeated either by the difficulty of the question or the complexity of your ignorance. The worst of all answers is the wrong answer.

At various stages of medical training and practice, I have observed and learnt not only the art of medicine but also the art of saying ‘I don’t know.’ This subtle art is practised by all levels of medical personnel, from medical students to consultants, knowingly or unknowingly.

BLAME THE EDUCATION SYSTEM When you are in your pre-clinical years, if you don’t know the answer, just say that it is difficult to remember so much of facts when you are not sure how clinically significant they are. That way you will look so practical and clinically orientated, unlike other nerds who mug books just to pass exam. Then, when you are in your clinical years, if you don’t know your basic sciences, just say that you knew the answer so well when you were in your pre-clinical years. You cannot remember now because you studied it years ago and you would remember better if you were able to apply those information clinically then. Some of us may have gone through the integrated system that is supposedly better in eliminating such problems. Then again the integrated system only makes us jack of all trades but master of none. Therefore tell the clinician, ‘Well I’ve heard

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☺ DON’T WORRY, BE HAPPY of it, but I am not exactly sure about it.’ It certainly sounds better than ‘Sorry Sir, I don’t know,’ doesn’t it?

IT IS A TECHNICAL PROBLEM This technique works most of the time. When your aunties or uncles who knew how clever you are to make it to medical school ask you about their cholesterol levels and you forgot the values, what do you say?

‘I don’t know?’ It would be so embarrassing especially when they just wanted to make sure what their friends in the ‘kopitiam’ said was true.

You can save your skin by saying, ‘Well, things are never so straightforward. Many factors have to be taken into account. There is no absolute value for cholesterol levels. It all depends on which lab, which hospital or which machine was used. Different centres have different values.’ Doesn’t that make you sound so well informed?

Then you have some patients showing you their X-rays and you have no idea about the pathology, tell him that you cannot make an accurate diagnosis from the substandard X-Ray because it was not properly aligned, sub-optimally exposed or taken from an inappropriate view.

If there is any abnormal biochemical results that cannot be accounted for, before labelling it as ‘I don’t know’ (i.e. idiopathic), try blaming the laboratory first. If you are wrong, it is all right because you are just trying to rule out the possible factor. If you happen to be right, your other colleagues will have the impression that you are smart and astute.

USE MAGIC WORDS ‘Well, it depends, every case is different. However, it is not uncommon nowadays because although rare it is still possible. More often, that is the case but not invariably so because usually it is operator dependent.’ Such reply sounds sophisticated to the layman although in actual fact it is as good as not answering at all.

REPLY WITH A QUESTION This tactic is most commonly used by houseman and medical officers who have forgotten their basics. Often junior clinical students 177

☺ DON’T WORRY, BE HAPPY ask the HO or MO questions but instead of answers, they get questions.

When you do not know the answer, reply with a question. Ask the students basic things like, ‘How do you define…’, ‘Tell me the pathophysiology of …’, ‘How do you classify…’, and you can go on until he get stuck and you can say confidently, ‘Come on, this is very basic. Go back and read. Come back tomorrow morning and tell me the answer.’

BLOWING THE TRUMPET This method is most commonly used by senior registrars and consultants. Students are students, always fascinated and curious about rare things. If you have noticed, the more senior doctors become the rarer it is to hear them say ‘I don’t know.’ So, when medical students ask questions about rare things, you often hear them say, ‘Common things are common, forget about the rare things’, ‘In my 30 years of experience I’ve only come across 3 such cases, so why do you concern yourself with such thing?’, ‘You will never get such cases for your undergraduate exam. This is for postgraduate level, it is irrelevant for you, so don’t bother for now.’

Those unfamiliar with new drugs and current treatment live by saying ‘old is gold.’ ‘I have been using this drug and treating my patients this way for the past 25 years and it is very safe and effective. The drug company is just trying to make money by introducing a new drug.’ ‘What has always been done that way should be done that way’ is a dictum familiar to many senior consultants. If the junior doctor shows you the paper on a new treatment that you are unfamiliar with, you can quote established and popular studies that are more widely accepted. Otherwise you can educate the junior doctor to critically review the paper. As an experienced clinical consultant, you can always find fault and discredit a research paper if you want to.

HARP ON CONTROVERSIES Tell your audience that you have read a lot of research papers pertaining to the issue concerned and you found that contradictory opinions were expressed so much so that until this point of time no clear conclusions have yet been made. There you are, off the hook and sounding so up-to-date with current literature.

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☺ DON’T WORRY, BE HAPPY BEAT ABOUT THE BUSH This is a very impressive technique to say ‘I don’t know.’ When someone asks you, ‘Doctor, what is my headache, chest pain, abdominal pain, fever, etc, due to?’ The level of difficulty of those questions depends on the circumstances. In the clinical setting you can ask a detailed history, perform a thorough physical examination and order relevant investigations to narrow down your differential diagnoses. If you are still unsure of the cause just say that the lab reports are pending or further investigations need to be done to determine the actual cause.

Meanwhile, ask the patient to have patience.

Sometimes non-medical friends ask you similar questions while playing tennis or while having coffee, I’m sure you wouldn’t want to take history or perform physical examination in such a setting. Just tell your friend, ‘Your symptoms are non-specific and the causes are multi-factorial such as…(bla, bla, bla)… Do feel free to drop by the hospital for a check up.’

Your friend will find it educational talking to you so much so that he feels better already. Isn’t that magic?

This list of how to say ‘I don’t know’ is by no means exhaustive. Although this art is not formally taught in medical schools, we unwittingly pass down this art we learned from one generation of medical students to another. We were often told not to commit ourselves too quickly when answering questions in clinical exams, otherwise we are just digging our own graves and jumping into it ourselves. So, you see. It has got survival value. Thus, we have to come this far to graduate as medical doctors, to perpetuate the art of medicine and of course the art of saying ‘I DON”T KNOW’.

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A Tribute To Donor No badge of service does he wear, He lives a “HERO” unaware.

A man who rolls his sleeves, To give his blood to help another live Who gives without return or fee In simpler answer to plea, That flush of health again may glow On cheeks of one he’ll never know His blood a new baby may save From yawning brink of early grave, That child, so weak and small today A hero’s role may later play.

Or one prey to accident, By his life’s blood new strength is lent, His blood may help a surgeon’s knife, To bridge the gap from death to life No, none of them will know his name, Nor see it carved on walls of fame.

But we who toil, that man may live A hearty, humble “Thank You” give.

- Unknown Author -

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RE-SEARCH FAILING IS THE STEPPING STONE TO SUCCESS

How many times have you failed your experiment?

Once two dejected assistants of Thomas Edison said, “We have just completed our seven hundredth experiment and we still don’t have the answer. WE HAVE FAILED.” “No, my friends, you haven’t failed. It’s just that we know more about this subject more than anyone else alive”, said Edison.

Thomas Edison actually tried almost 10, 000 times before he succeeded in creating the electric light. If he had given up, you would be reading this in the dark.

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PROMISE YOURSELF… - Christian D Larson -

To be strong that nothing can disturb your peace of mind To talk health, happiness and prosperity to everyone you meet To look at the sunny side of everything and make your optimism come true To think of only the best, to work only for the best and expect only for best To be enthusiastic about the success of others as you are about your own To forget about the mistakes of the past and press on for greater achievements in the future To wear a cheerful countenance at all times and give every living creature I meet a smile To give so much time for the improvement of yourself that you have no time to criticize others To be too large to worry, too strong for fear and too happy to permit the presence of trouble

No WORRY-Lah, Be HAPPY

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INTERNS SHOULD HAVE MORE HUMANE WORKING HOURS!

I need a good SLEEP! In a study of interns working in ICU, it was found that they made substantially more serious medical errors when they worked frequent shifts of 24 hours or more than when they worked shorter shifts.

Eliminating extended work shifts and reducing the number of hours interns work per week can reduce serious medical errors in the intensive care unit.

* Christopher PL et. al, 2004. Effect of Reducing Interns' Work Hours on Serious Medical Errors in Intensive Care Units. The New England Journal of Medicine, Vol. 351:1838-1848.

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EXPERIENCE AT WHAT COST? –News Straits Times, 4th December 2006-

It is my duty and social obligation to address the issue raised in the statement by the Malaysian Medical Association president (“MMA: Doctors lucky to get housemanship” – NST, Nov 30). As someone who has been in service for 20 years, and worked as a house officer abroad and resident medical officer in the Kuala Lumpur Hospital, I think it is time I stood up for doctors.

Yes, house officers and resident medical officers gain “valuable hands-on experience” by working long hours in government hospitals, but at what expense? It is not wise and counter-productive for us, the seniors, to say “I did it before, why can’t you?” to our juniors. In Australia, no doctor is allowed to work continuously beyond 12 hours. It is dangerous and unethical to make the brain, mind and body work beyond 12 hours as a doctor. It is unthinkable to make any doctor work 34 hours continuously.

On returning to Malaysia to work as a resident medical officer in the Kuala Lumpur Hospital, that is what I was made to do. So, these long working hours are not confined to house officers. As a specialist who deals with the organ that thinks, I can say that sleep deprivation causes irritability, irrationality, poor concentration and poor judgement. Does the public want doctor to treat patients when they are tired, irrational and lacking judgment? Could some of the deaths and mishaps that have occurred in government hospital been avoided if doctors were more rational and able to make reasonable judgments? And, this could also explain why some medical officers get upset and temperamental with their junior house officers.

Sleep deprivation may cause migraine attacks and cause daytime sleepiness. What is the point of more modal insan (human capital) for the nation (in the form of doctors) when excessive daytime sleepiness makes

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☺ DON’T WORRY, BE HAPPY them less productive or unproductive during normal working hours? It is time the government and university hospitals reviewed the working hours of house officers and resident medical officers. This can be done. It does not require parliamentary policies. It is a matter of hospital administrative thinking of ways to shorten the working hours with the limited number of doctors. Some may argue that developed countries like Australia have many more doctors, but they also have more hospitals.

At the hospital I worked at in Australia, the doctor-patient ratio was the same as any government hospital in Malaysia. I know that the medical officers in anaesthesiology in most hospitals in Malaysia have started practicing new improved working hours. Doctors who work nights should only work nights, and then go home in the daytime and get the weekends off. Doctors rostered to work days should go home at night, but also work on weekends (which are normally less busy and have no clinics anyway).

Of course, there must be adjustments to call allowances and teaching hours if medical officers are in the master’s programme. The improvement of working hours for doctors can and must be carried out by stakeholders.

Professor Dr. Raymond Azman Ali, Medical Faculty, University Kebangsaan Malaysia.

HE WHO HAS A WHY TO LIVE CAN BEAR ALMOST ANY HOW – Nietzsche-

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WELLNESS RESOURCE GUIDE FOR MEDICAL STUDENTS

http://www.amsa.org/AMSA/Homepage.aspx by

American Medical Student Association

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DON'T WORRY, BE HAPPY -Bobby McFerrinHere's a little song I wrote You might want to sing it note-for-note Don't worry, be happy In every life we have some trouble But when you worry, you make it double Don't worry, be happy Don't worry, be happy now Ooo-oo-hoo-hoo-oo hoo-hoo-oo-oo-oo-oo-ooo Don't worry Woo-oo-woo-oo-woo-oo-ooo Be happy Woo-oo-oo-oo-ooo Don't worry, be happy Ooo-oo-hoo-hoo-oo hoo-hoo-oo-oo-oo-oo-ooo Don't worry Woo-oo-woo-oo-oo-oo-ooo Be happy Woo-oo-woo-oo-ooo Don't worry, be happy Ain't got no place to lay your head Somebody came and took your bed Don't worry, be happy The landlord say your rent is late He may have to litigate Don't worry, (ha-ha ha-ha ha-ha) be happy (look at me, I'm happy) Ooo-oo-hoo-hoo-oo oo-oo-oo-oo-oo-oo-ooo Don't worry Oo-oo-oo-oo-oo-oo-ooo Be happy Oo-oo-oo-oo-ooo (Here, I'll give you my phone number. When you're worried, call me. I'll make you happy.)

Ooo-oo-hoo-hoo-oo oo-oo-oo-oo-oo-oo-ooo Don't worry Woo-oo-oo-oo-oo-oo-oo Be happy Woo-oo-oo-oo-ooo Ain't got no cash, ain't got no style Ain't got no gal to make you smile But don't worry, be happy Cause when you're worried, your face will frown And that will bring everybody down So don't worry, be happy Don't worry, be happy now

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Ooo-oo-hoo-oo-oo oo-oo-oo-oo-oo-oo-ooo Don't worry Oo-oo-oo-oo-oo-oo-ooo Be happy Woo-oo-oo-oo-ooo Don't worry, be happy Ooo-oo-oo-oo-oo oo-oo-oo-oo-oo-oo-ooo Don't worry Woo-oo-oo-oo-oo-oo-oo Be happy Woo-oo-oo-oo-ooo Don't worry, be happy Now there, is this song I wrote I hope you learned it note-for-note, like good little children Don't worry, be happy A-listen to a-what I say In your life, expect some trouble When you worry you make it double Don't worry, be happy, be happy now Ooo-oo-hoo-hoo-oo oo-oo-oo-oo-oo-oo-ooo Don't worry Oo-oo-oo-oo-oo-oo-ooo Be happy Oo-oo-oo-oo-ooo Don't worry, be happy Ooo-oo-hoo-oo-oo oo-oo-oo-oo-oo-oo-ooo Don't worry Woo-oo-oo-oo-oo-oo-ooo Be happy Woo-oo-oo-oo-ooo Don't worry, be happy Ooo-oo-hoo-oo-oo oo-oo-oo-oo-oo-oo-ooo Don't worry, don't worry Oo-oo-oo-oo-oo-oo-ooo Don't do it, be happy Oo-oo-oo-oo-ooo Put a smile on your face Don't bring everybody down like this Ooo-oo-hoo-hoo-oo oo-oo-oo-oo-oo-oo-ooo Don't worry Ooo-oo-oo-oo-oo-oo-oo It will soon pass, whatever it is Ooo-oo-oo-oo-ooo Don't worry, be happy (fading...)

Ooo-oo-hoo-hoo-oo oo-oo-oo-oo-oo-oo-ooo I'm not worried Ooo-oo-oo-oo-oo-oo-oo I'm happy Ooo-oo-oo-oo-ooo

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ABOUT THE AUTHOR

Phang Cheng Kar, M.D., received his medical degree from the Putra University of Malaysia (UPM) & postgraduate training in psychiatry from the National University of Malaysia (UKM).

He's currently lecturing in the UPM Medical School & practicing as a psychiatrist at the Kuala Lumpur & Kajang Hospital. His research interest is on mindfulness-based psychotherapies & he has developed MINDFUL-Gym, which is a local mindfulness-based stress reduction & wellness program.

He's the founder president of the Kuala Lumpur Buddhist Mental Health Association (BMHA). His hobbies include meditating, doing voluntary service, reading, writing and watching trees. He's joyfully married to an arts teacher, and maintains a blog to share his interest at pckar.blogspot.com.

No WRRY-Lah, Be HAPPY ! is a compilation of stories, quotations, poems, similes, cartoons and articles that the author used to motivate and inspire himself when he was a medical student.

As a mental health professional now, he would like to share his treasures with the community as a way to promote mental health. May you be well, happy and peaceful after consuming the nutritious mental food found in this book.

HAPPY READING!