Saturday, December 23, 2006

Bidii Yangu (5 years worth...)

I think it must be all the time that i've spent during the last month partying that has kept me from my beloved blog this long! Yep, partying mbaya!!
Nilimaliza shule... Must have been that Surgery MCQ paper.. rumour has it ati only 3 people pita'd the 50% threshold mark, (aka: a pass, yo-ok-since-u'll-only-kill-half-yo'-patients mark... etc) ps: MCQ - multiple choice question. I've not sat for a harder paper than that in, well a very long time...

Some questions went like.. "the number of successful laparascopic procedures in specialist clinics in Guatemala was 85% ... True or False?" (ok, i'm kiddin about the Guatemala part.. lakini still!) I must have been the first person to finish the paper, coz enyewe, there's no need to try thinkin about stuff you've never read.. really. Everyone was complaining, ok, maybe not, coz i probably never got to talk to those 3 nut jobs that actually passed!

So when during my clinical exams, my confidence seemed to unfold, i felt a bit exposed... u know, shaken that i might not pass that exam..
It started with the long case. So i take a history from this dude. H was like 45 if i recall...

1 month history of yellowing of the eyes, similar period of pale stools and pruritus (med speak for itching..), and an tender hepatomegally (.. that's an enlarged liver that is painful to the touch.)

"Great!", i thought. "Surgical jaundice, secondary to gall stones..". Had read on it a while ago. Tho't it will be a walk in the park, this. Surgical jaundice simply means that the yellowing of his eyes (jaundice) has been caused by some sort of obstruction that requires surgical intervention to relieve it - hence the often other used term, obstructive jaundice. But enough with all this medical lingo.

I proceeded verify my diagnosis and the easiest thing to do, was simply to ask the patient what he had been told he has. Indeed, i was spot on. They were "mawe fulani. Walisema watatoa next week." Fabulous. Now i just had to have my story straight, do a proper system examination of the patient, and i'll be D.R in no time...

To cut a long story short, the examiners came and they insisted that this dude had cancer! Head of Pancreas cancer or Biliary tree (gall bladder) cancer. Which were actually on my list of differentials but further down than the stones. Apparently, the patient had lost weight during this time, but i tho't it was coz of the poor appetite he had developed. He had no abdominal masses, that would have pointed more to a tumor cozing the obstruction, or enlarged lymph nodes...

Any way, i gave in and admitted that that was wat he might be havin, altho' in my mind, i believed my line of thought was more consistent with findings on the patient. In med school, however, one thing you learn early on, is not to imagine that you know more than your consultants., or ever let them know that you think so... Saves you a lot of trouble.. and pain.

One week later, we camped for 5 hours (yes, 5!) outside the dean's office waiting for our results, to know whether we have been recommended to be awarded the degree, given the power to read, whether we were now doctors...

To say the wait was nerve-racking wouldn't come anywhere close to describing the feeling! It was terrifying... This was it. The last wait for results.. 5 years of work was coming to an end. The tension was palpable (i read that in a book, or was it someone's essay back in school? hmm...)

Hayawi hayawi huwa. After hours of waiting, the verdict was out...

Yes folks, it was then that i become a doctor!

Happy holidayz,
The latest mEDiCinEmAn in the hut.