1st few days at Geriatric Medicine

after so many months of break from S'pore hospitals, we're finally back!! the transition from yr4 to yr5 is definitely difficult... as expected. n it's worse coz we had such a long holiday!!

1st ward round after brain inactivity for 1 whole month... n i was given a printout of the full blood count and the tutor said "look at this n tell me what r ur thoughts." Hb and RBC were low and MCV was high. haha! i thought... simple... it's macrocytic anaemia and i beamed as i explained how i arrived at the diagnosis. then she said "tell me the causes of macrocytic anaemia." and i was just stunned... sheesh... i knew i shouldn't be! com'on! i've read it b4 in oxford... and all i could think of was vit B12 and folate deficiency. Did she say causeSSSS? u mean there are more causeSS? oops!

tt was just e beginning... she assigned cases for us to be in charge of... and we did try to clerk, read a bit of case notes, etc... but not to the extent of getting prepared to present it during a ward round. then this morning, she went "let's start with bed 63. who's in charge? tell me abt ur patient." hahaha! we panicked! really panicked... it's been like 2 or 3 months since i presented any proper history and physical examination.

haaii... in geriatrics, we learn this thing called "deconditioning" which refers to the weakening of muscles, deteriorating of heart and lung function such that the patient is unable to withstand physical activity as before... it occurs coz of prolonged immobility. i think it's exactly what we're experiencing now... deconditioning of our medical minds. i think we had too long a break... n it's difficult to kickstart our brains so fast. unfortunately, we dun haf the luxury of having rehab for a few months like the patients here.

anyway, in case i gave u the wrong impression of my tutor here... lemme correct it. she's a really sweet lady who's also very serious in her work. She's our posting coordinator, so naturally she's very familiar with what we have to learn and what's expected of us out of this posting. and no... she's strict but not mean at all! when we've exhausted our limited brain resources and ran out of answers, she explains everything nicely so we get a complete picture of the topic. and like we weren't that prepared for our ward round presentation, she was totally cool about it too... just correcting us as we go along. she's wonderful eh? no wonder she's doing geriatrics...

think to be a geriatrician takes a certain type of personality and lots of good traits like patience, being caring... basically, e geriatricians we've met so far are all angels in my opinion! prob not something i can do...