Orthopaedics: Final Impressions

Because the mind - mine, at least - is rarely as idle as the physical body, it is only now I can put my thoughts on this virtual paper, mainly on Orthopaedics as a whole. Partly also because a few others have done the same, and there is no harm in jumping on the bandwagon...

So. MCQ was like a migraine attack, One Best Answer some sort of retribution, PMP was a breath of rather suffocating air, clinical exams was...is there a single English word or expression that incorporates the notion of what-have-I-learnt-all-this-while-oh-God-is-there-no-hope-for-me-at-all?

If anything, the finals had made me doubt whatever beads of knowledge that I have gathered during the course of this posting. Practically everything, from the site of pin insertion for skeletal traction, the antibiotic regime, and if I belong where I am.

But! One of the beauties of medicine is that we more often than not learn more than what is enumerated in the syllabus. It's not just about the disease - one must always treat the patient as a whole.

The ward is a good place to observe human behaviour, be it patients, visitors, doctors and fellow peers. When one is ill, that's when one either puts down all his or her defenses and pretences, and resolves to whatever solution - although the aptness of said solution may be subjected to debate *cough* - that guarantees escape from the predicament...which actually includes utter despair and surrender to whatever Fate has in store. Upon the infliction of pain, some would have no qualms to simply throw one's sense of self-reserve; others might even view this an opportunity throw their weight around.

And yet it is this same problem that can bring out the worst in people. I suppose in that aspect one would be forgiven in thinking that being in the wards would be no different from, say, driving on the road.

Yes, the wards, where one can see a spectrum of human behaviour, from the very good to the unbelievably bad.

The top three things (not necessarily academic in nature) that orthopaedics has taught me:

3. Diabetis is a horrible, horrible disease
Yup, we all have heard about it, from the risk of heart problems to kidney failure. It gives some selected patients the chance to poke themselves with tiny, tiny needles that hold the key to plausible delay of complications - unlike intravenous drug users who poke themselves in the name of further deterioration and corruption of the body, mind and soul.
The sight of nauseatingly, um...nauseating diabetic foot ulcers to seeing unexposed tendons and muscles, now departed from their usual healthy appearance and function. Slough, blood and necrotic or gangrenous tissues that stubbornly cling to their healthy counterparts, slowly inviting them to join them in the one way path to destruction by seeding them those tiny, tiny messengers of Death, be they Gram positive or Gram negative bacteria, cocci or bacilli.
So go easy on the sweet indulgences...in hopes that we can enjoy them for a longer time, free from any guilt and risk of premature departure from this life.

2. On the road
Trauma cases have succeeded in putting a rein on my tendency to take risks on the road. No matter how I have faith in the strength of my bones, I doubt they'd appreciate it if suddenly they become fractures or are joined by alien metals called fixators, internal or external.
And I do mean it when I said that being in an operation room where plating or interlocking nail surgeries are done, I could not help feeling that I was in, say, a workshop or a factory...

1. The sacrifice
One thing that I could hypothesize from orthopaedics is that there is no age discrimination unlike, say, paediatrics or obstetrics and gynaecology (the latter having only female patients, for logical reasons that need no expounding). Congenital problems are aplenty (some may have had seen enough congenital talipes equinovarus aka clubfoot to last them for a lifetime) although most are managed in the clinics; kids falling down and breaking (or semi-breaking in the case of greenstick fractures) their bones in the name of play and learning; adolescents, hotblooded and with an insatiable thirst for adventure, getting into accidents, whether they are truly at fault or are simply unwilling, hapless participants, and whether or not they have earned a proper driving license; adults who may have transgressed the limits of risk-taking on the road or unfortunate victims in some work-related incidents; diabetics with or without good control of their glucose level.
Where's the sacrifice? Am I referring to the medical team who manage them? Yes. The students who clerk countless cases in hopes of the sliver opportunity to be able to present, allowing them to be under siege just so they could procure that invaluable signature in the "Case Presentation" page of our insufferable logbook or - for those with a more genuine desire for knowledge - to be corrected for the sake of self-improvement. Yes.
There is one more noble sacrifice. One that some of us may view with little to no appreciation. And that, ladies and gentleman, is a mother's pure sacrifice for her child, no matter what age.
Mothers who ran out of tears to cry and breaths to lament, but their patience to remain by their children and energy to assist them in whatever way they can are worthy of mountains of praises. And yet, when elderly patients are sick, can we count on _their_ children to show the same degree of love and selflessness to the former? Or could we make allowances, considering that the children are now adults with their own set of responsibilities to their family members?
...Even now I can't give a proper answer.
One thing that I did notice, is that now I view my own mother in a whole new, brighter light.
And I pray that I would be able to serve her at least as good as how she had done in my benefit.

Current Music: Catatonie - Sherlock Holmes OST