Semester 7 -- Psychiatry Posting

I am doing nothing in the library, waiting for the variety night to begin soon at 7.30pm. Now I am a Sem 7 senior. Seeing all those juniors, I only knew some of my batch mates who repeated their semester. All the juniors looked familiar as I've seen them in Bukit Jalil before, but now I couldn't recognise one is junior or senior. My memory is getting deteriorate.

I started my Sem 7 with Psychiatry posting, which is a very good posting to start with. It is quite relaxing, not as hectic as O&G (Obstetric & Gynaecology). Psychiatry is actually one of my list of specialising, so I must study hard, cannot be as relax as in Sem 6 anymore.

The 1st day of our posting, we had a briefing from Dr. Xavier. As usual, he likes to ask us to introduce ourselves which I hate most. I am not good in public speaking and I'll have thought block. After the briefing, he took us to the psychiatry ward which is located behind the KKS (Klinik Kesihatan Seremban). The male ward was named Wad Zamrud and the female ward was named Wad Mutiara. The psychiatry patients are very 'friendly', they looked so normal from appearance, just like other patients in medical ward and surgical ward. They looked at us as if we are animals behind the gate. They are so frinedly that they come and approach you and say hi to you. It might look scary, but I am actually not afraid of them. Some of my batchmates are so scared of them and they don't like the posting. We did not talk to them as Dr. Xavier just wanna brief us around the clinic.

The second day, I am posted in the female ward. The female ward is an open area, unlike the male ward, the patients are locked up in the cell. So we get to sit beside all the patients, talk to them, watch TV with them. They will come to you whenever they see you. When you switch your place, they will follow you. Then they will tell you their stories without you asking them.

The 1st patient who I clerked in detail had paranoid schizophrenia. She kept telling me that she had bone cancer, asked me to tell the Chinese doctor to give her 'antibiotic' to treat the bone cancer. Then she said every1 in the world is bad, every1 wanna rape her, her brother and sister-in-law wanna kill her and take her shophouse. she said she doesn't like M'sia, wanna move to Taiwan as there is more Chinese there. At first I really thought what she said was true until I looked at her case file. She was admitted due to aggressive behaviour at home, used a parang, trying to kill her brother and nephew. Couldn't imagine she was so violent. She kept talking about the bone cancer whenever she sees me, ask me for a favour to tell the doctor to give her 'antibiotic'. I promised her, told her that I would tell the doctor if I see him.

The next day, she came to me when I just entered the ward, asked me if I ask the doctor. Then I kept thinking excuses, tell her that I didn't see the doctor la, the doctor is not in-charge of the ward la and bla bla bla.... Then she told me the whole story again. She underwent ECT (Electroconvulsive therapy) in the morning and forgot things. Now she was telling me that she wanna go Spain, then I asked, wat about Taiwan. And she just couldn't remember that she said that before. The next few days, she kept telling the same story over and over again until I fed up. However I can see the improvement after the ECT. 1st day, she thought she got one course of medication and after eating the medication for 1 month, she will recover. Then she said she wanna go Nilai Cancer Institute and UH to treat her cancer. 2nd day, she forgot about the medication and the Chinese doctor but still thinking about where to treat her cancer. 3rd day, still talking about bone cancer, still thinking where to treat that. And today, she only think that she got bone cancer but forgot about Nilai Cancer Institute. Hopefully the next week I see her, she can forget about the bone cancer thingy. Haha....

P/S: A lesson I learned from the posting: Don't trust your patient totally, always think that they have delusion and hallucinations.