Child and Adolescent Psychiatry

“Striving for success without hard work is like trying to harvest where you haven’t planted”
David Blye

Almost all successful people always have big dreams; John F Kennedy dreamt to send a man to the moon finally his dream came true, Writhe brothers dreamt to fly on the sky as freedom birds finally there is the first airplane, Beethoven dreamt to be musician despite deafness finally he came to be one of the greatest musicians of the world. By the way, only dreaming is not enough, we must also have the strong will to realize those dreams. I am only a little girl that has her own dream to be a Child and Adolescent Psychiatrist as well, and these are the reasons of my will.

Throughout my several years of my life since I was grown enough to read books especially after Buddhist meditation program when I was in high school, I found out that I was interested in religious matter, philosophy, the books about positive thinking and self-improvement. Because of my character, there is no doubt why psychology becomes my favored aspect.

As a medical student, I realize that not only the patients’ symptoms and medication must be considered by the doctors but also psycho-social as well as understanding we must concern about. Hence, I always approach in mental aspects even though I was not on Psychiatry. Reflecting patients’ feeling, counseling, touching, being silent and active listening; these are techniques from my Psychiatric Professors that I normally apply to all of my assigned patients. Even though I am the youngest doctor of the care team, the patients and their relatives usually trust me and express their feeling to me .That is my motivation to do my best on taking care of patients.

Due to loving psychiatry and also children, I decided to be enrolled in elective program in Child and Adolescent Psychiatry in order to clarify the roles of physician in this field and also explore myself. The responsibility of Child and Adolescent Psychiatrist is divided into 2 parts which are firstly being physician in hospital that serve not only the patients but also their parents and family. I realize that it is not easy to endure with long term management and repetitious advice for this group of mental disorders, however I am certain that I can stand.

The second important duty is the health promotion and the prevention. I have a good chance to follow my Professors for school mental health. The group process is arranged that is leaded by child psychiatrist. I like this style of work; teamwork that psychiatrists have to work together with psychologists, social workers, teahers, etc. In my view, group process has a lot of benefits, for instance, learning how to work together with others, face the conflict, solve any facing problems, create new benefits by lots of idea, improving the responsibility, think maturely and perform in several role in teamwork. Because throughout my academic time, I always do activities including the position of team leader, member and staff of several works, I am supposed to do well in the leadership role of teamwork certainly.

In conclusion, I think Child and Adolescent psychiatry is not only my favorite subject but also the most perfect job for my character. Therefore I definitely decide to be trained as a Child and Adolescent Psychiatrist.

By the way, I realize that application of this position of internship is not definitely meant to be Siriraj staff. However I wish to be one of the staff of medical school because of these following reasons.

Firstly, I love teaching since I was a young student in the primary school. My teacher usually assigned me to tutor my classmate that got poor scores. When I was in high school and medical school, I had several chances to be a volunteer in Academic Camp for poor students in rural areas of Thailand and be a volunteered tutor of Blind School. I always feel proud and valuable when my teaching and speaking attempt can simplify and clarify lesson to those children.

I realize that the teacher as well as doctor is such a sacrificed profession. It is an honor for those ones who perform this obligation. One good doctor can save a lot of people,additionally, one doctor and teacher can make much more benefit to the mankind. With no doubts I would like to get that opportunity as well.

Secondly, I wish to study abroad in order to open my view and apply update medical knowledge to Thailand. In my opinion, the purposes of studying abroad consist of, firstly, achievement and lots of salary that is advantageous and secondly, being staff in medical school for making a benefit to society. I have desired to go abroad since my fourth year, absolutely, not for the former reason but the later. Therefore this is one of my reasons to apply for this position.

Thirdly, research is one of the beneficial works. We can improve ourselves and sharpen our brains by creating new question or hypothesis and seek for the way to prove and answer those questions. Unquestionably, technology and knowledge can be developed by the researches, reasonable study can create the great benefit to the mankind. In order to get more experience, practice and also learn how to do the research. I have already asked Professor Nuntawach to assign me as an assistant in his pilot study. I realize that as the position of staff of medical school, research is one of compulsory duty and I believe that I can do it.

Eventually, with my strong determination to accomplish my purpose, I decide to apply for this position. I realize that working in my beloved aspect can create the most effective outcome and also my everlasting happiness. Without hesitation, I will sacrifice myself for making benefit to the mankind and society and cultivate my blessing for the needy people. Last but not least I have never forgotten as a doctor, I must continue this valuable profession, and hopefully my skills will bring good health to the people of my mother land

“Life is happiest when you are needed by others and can do things for others”
Master Cheng Yen

Making a decision

Do you have “Dream”.

Absolutely, everyone has their own dream and make an effort to catch up their destination.

Life seem boring without challenging. Motivation and inspiration drive one’s breath to go on.

And my own dream is being child and adolescent psychiatrist…

By the way, any ways aren’t covered with carpet, the rough and difficult route color life colourful.

I found out myself 2 years ago when my rotation rotated to psychiatry department. I do love the way to approach the patients in mental aspect that rarely be met in other department. Most of doctors search for organic or medical condition and manage by medication and surgery perfectly but few of them search for the real cause of bio-psycho-social. Most of doctors try to advise the patients based on theory but few of them try to support and understand their patients’ feeling seriously.

Actually I realize that mental problems are the most common trouble of one’s life. No one never face suffering but how many of them can fix the trouble with matured coping. Mental problem vary from normal variant to mental disorder that closed relate to science and neurotransmitter which some of theory are proved already but most of them are questionable. I think it is such an interesting field and suitable with my character.

Once I dream to be the staff in medical school, have USMLE exam and train in residency and fellowship in USA…

The day of psychiatry training application is coming, this position is special due to the chosen one is internship only 1 year and start residency course immediately as well as get a special opportunity to be considered as a staff of Siriraj hospital, comparing with the common compulsory line to be intern 1 year follow by 2 years in suburb before coming for training. However only 1position is required.

Anyway this time I’m confused and still cannot make my decision.

Between applying in position of child and adolescent psychiatry resident that is my dream and being a doctor in suburb that no progression and waste my time 2 years … nothing must be confused, doesn’t it??

I desire acquisition of knowledge but lesson doesn’t appear only in school. I love teaching and being a teacher as well as doctor but class not only in a square room and in medical school, I can teach my patients, my junior doctor or my crews anywhere.

Progress can make my life flourishing, but I also yearn for experience of being real human.
I would like to going abroad to be an excellent physician, on the other hand I can be a good doctor that can take care of many patients after graduate in Thailand as well.

I’d like to go to rural district to get more experience…. It’s such an odd idea comparing with many of my friends who scramble for the way to be as close as downtown and facility for instance applying for fixing ward in large hospital or being in preclinic in medical school.

But I would like to make some benefit as a general practitioner as much as I can before I’ll take the rest of my whole life for psychiatrist. I do love to learn more in other aspect other than medical viewpoint for instance being in the position of community hospital administrator, being leader of hospital staff for health care, health promotion and health prevention, creating new project that is beneficial for my folk.

I have ever been suburb for 2 months when I was the 4th and 5th year for community research and family folder… I found out that I love this lifestyle. I can learn more from there for example lifestyle of folks, how to get along with nurses or other hospital staffs smoothly without conflict, how to be not only a good doctor but also perfect leader in community. I would like to be a little candle in dark place that much more valuable than being a common light in luminous area although merely short time of my life.

I realize that I’m too young including my though, my vision and my experience. hope to be much more matured and understand life better…

Am I a stupid girl if I will leave behind my best opportunity to apply as a staff of Siriraj hospital and go on being such a common doctor in rural area before coming training psychiatry.
Or apply as a staff of medical school to fulfill my dream to be a doctor as well as a teacher and I can make a benefit to society as well…

How can I do???

Community medicine

It is the compulsory programme for the fifth year to make a project in community hospital. Absolutely, I got a memorable time again at Bang Pla Ma, Supanburee. Firstly, I got a good chance to make a satisfied thing for my patient. Secondly, I found out that being in a community hospital is not too bad at all, I learn more from there especially the way to work happily with others… such as nurse, etc and how to manage the health care system in a small hospital that only 3 doctors are on responsibility. Lastly, nice trip with my nice companions.


Ok… I will start my story … hope you can follow my proud matter till end.><

As I told you already, every fifth year students must go to a community hospital.. 5-6 students a group for our project of family folder. We must search for the most interesting family, make family folder, and approach the patient in aspect of bio-psycho-social. 2 family folder must be completed.

Our patient is a 72-year-old woman that got stroke for 5 years. The problems are environment and care giver’s health. Once the patient could move; stand, walk, sit by device and herself. Due to she lie on the floor so long and has not got appropriate rehabitation, hemiplegia from stroke is worse gradually,she can just lie still on the floor. Her daughter,52 year-old carer, must carry her from the floor to toilet and take a bath many times a day. Absolutely myofascial pain and osteoarthritis of care giver progress rapidly.

We consult a physiotherapist of Bang Pla Ma Hospital and we found out that being on bed is more beneficial for rehabilitating. She can use another site of extremities for sitting by herself when they are strong enough, touching floor of her feet can develop motor, sensory and power of muscle, besides being on bed safe the carer’s energy to carry and move the patient.

Because of these advantages of bed, we ask for donation from Bang Pla Ma Hospital. Luckily, the authority of the hospital agree and support our idea. Moreover in order to fix care giver’s health problem, myofascial pain and osteoarthritis, wheel chair which was useful only when go outside and lay down silently with lots of dust at the corner, is adviced to be used for transfer the patient instead of carrying.

The special exercise device that we created ourselves was set up on the ceiling over the position of donated bed. I proudly present that the device consist of just simple and economical component such as rope, PVC, rubber tube.. thanks the Bang Pla Ma technician for gratuitous material. The goal of this device is rehabilitate paralyzed upper extremity, prevent the bad one from further joint stiffness, on the other hand, maintain the power of another site. I suppose that the patient pretty like it (you can see from pic) she look happy to exercise with her new toy.

In addition, to prevent bed sore, we create a clock for recall care giver to turn the patient every 2 hours and advice her to use bed pan instead of carrying the patient to excrete (lie down position) on the floor

change from the floor to the bed

set up device

ok... get a new toy ><

the clock for remind care giver to turn the patient every 2 hours
advice

change from lie down excretion on the floor to bed pan

training rehabilitation

demonstration transfering

Absolutely, everyone is happy, the patient has better quality of life as well as her daughter, the care giver, especially my friend and me.
This memorable experience tell us….

“One of the most fulfilling feelings you can experience is
when you do your best at this moment to do good for others”
-Master Cheng Yen-

Child and Adolescent Psychiatry

It seemed not any portent that I would be a doctor untill I had attended “wish been DOCTER”, the camp for high school students of Siriraj medical school, before entrance examination….

Likewise that time, I’ve just found out that I’m falling in love with enchanted PSYCHIATRY…. There is not any omen as well…

The 4th year medical student must pass department of psychiatry for 3 weeks, due to this department was my last one of my 4th year, this field has never been in my choices and I had somewhat disliked psychi because…..
- I wouldn’t like to work with insane patients,
- human thought was too complicated to understand
- my 3rd year score was very poor.

But in the 4th year, After studying psychiatry, I realized that it is one of interesting subjects. Moreover communication skill is important for therapists, you can realize that speech is only one confident and proud talent of mine… I love talking with the patients as well as my friends (when they face any problems and ask me for my advice). I am always happy if ones’ suffering are lessened after our conversation.

In order to explore myself… I applied for child and adolescent psychiatry, elective course in my last 2weeks vacation of my student life.
1 week pass rapidly… I suppose I’m falling in love psychiatry sincerely…

The way that professor approach the patients is different from other kind of specialists. They notice thoroughly verbal and non-verbal language, behavior, communication, social skill, cloth, the reaction of patient and patient’s family members, etc… , predict one’s personality and thinking. Specially they care of ones’ feeling, each speech sentence is produced careful and reasonable. Absolutely, I can apply this subject matter in my life to be a good mental health person as well as good communication skill.

In aspect of child psychiatrists, it’s no doubt that they must be excellent parents that bring up their children perfectly.
Dr. Wanpen, I can touch her warmth and think of my own mom and my granny when studied with her... she is my respected model and such a nice woman..
Dr. Suporn, another one of my model of child psychiatrist said that she had applied the theory for her own child and found out that though these methods are too difficult to continue all along (in thailand) but if parents are steady, these ways are very effective for child rearing… moreover she supposed she might not be able be a good child psychiatrist if she had never tried by herself (with her child).

Absolutely, I have never known what the right method of child rearing is… so do most of parents, I suppose. Child psychiatry department arrange weekly “Parent Training program”, and I had a chance to attend this activity last week, I realize that it’s extremely useful for everyone (not only for parents). The lesson consist of how to use “I” message to present one’s feeling directly that is better than “U” message or BLAMING which discourage listener’s feeling and useless way for behavior improving, including emotional reflection practice, the method to cease bad mood expression that result in arguing, etc.
In conclusion, this class was beneficial and I realize that I’m the one must practice these lesson as well.


By the way, Psychiatrists are extremely deficient; 400 general psychiatrists and only 100 child and adolescent psychiatrists in Thailand, on the other hand, I suppose you cannot imagine what a numerous psychiatric cases there are; including the admitted patient and psychiatric problems that are anticipated to solve.

Hopefully, I can be a good and excellent one same as my respected Professor in the future…
Wish my dream come true..

Pediatrics

Pediatrics is one of the busy and exhausting department for siriraj medical student...
Due to lots of task and my laziness, I’m far from writing any mail or updating my blog. However I still think of this classic way, writing blog can give me a chance to revise my daily story. ok i'll try to write my story as much as i can...

I’ve been in Anan building 4th floor for 5days ago, just today I have known n’ dance(TeamB, I’m in Team A), the well-known chronic disease girl that my friend usually told me about her behaviror, she is just a common girl that usually prefer to play with any male doctor other than female ones obviously... and i just got that experience today, she deny to play with me and call out keng, my wardmate to talk and play with her… I cannot believe what a 5-year-old flirtatious girl she is…. Hahaha

now I have 5 cases in my responsibility... arriving ward to progress them around 6.30am before morning ward round with resident and progress them again after my class in the afternoon before eveing ward round....
the new case just admitted yesterday and I hurried up to finish my pneumonia report last night(1.30am) … the case presentations are usually prepared so i'm quite busy and exhausted every now and then
moreover In pediatrics we, the medical students must be on overnight duty, that's the first time in my life

Being in Pediatrics department is somewhat exhausting however I usually proud to be a part of team and take care of my patient myself... that is such a nice feeling....

Ortho EXAM

EXAM is coming again l..a

so sorry my dear friends if you haven't met me in your blog this week l...a

Good luck to me
and miss ya guys
><

Bye bye SURGERY, hello ORTHOPEDICS

6 weeks in Surgery Department seems to pass too slowly for me….

Normally, as a position of Clerkship, in OR, we could merely observe, stand beside the operative field, crane for seeing something for hours… but only the green suit of surgeon we can see obviously especially in small field of operation…. It’s somewhat boring… however in case you would prefer being a surgeon or experiencing closer view of operation, asking for the professor to be an assistant in operative field is much more useful.

Being on duty in Trauma room is different. I perceived the Docter feeling, approach the injured, primary survey (A: airway, B: breathing, C: Circulation, D: Detection abnormal neurological sign, E: exposure), resuscitaltion, secondary survey (taking the history and doing complete physical examination from head to toe), record the information, do dressing and stitching the wound, inject drug via intramuscular or intradermal…. Absolutely, It seem to be worthy when you do something yourself, besides this is a good chance to practice and improve your basic operative skill. If you are the one that love American series, Grey’s Anatomy or ER, you must love working here as well.

The examination passed…. It’s not too bad however Surgery has a numerous things to study.
Now …. Surgery is excluded from my choices absolutely…

My new rotation have started already. This week I’m in Orthopedics….
If you have passed Gross anatomy already, you must realize that your smart brain cannot memorize everything especially about your own Anatomy…. I’m the one that is very dull in this subject…

In Orthopedics, I must review lower and upper extremities anatomy; muscle, bone, joint, neurovascular…. Oh my god… I dislike orthopedics as well as Anatomy…I must be for 6 weeks here …T_T

Yesterday I had an physical effeciency test… measure your weight, height, waistline, fat at biceps triceps subscapular suprailliac, lung capacity, cardiovascular response (maximum oxygen uptake), quadriceps power, flexibility….

My height is 155cm, weight 44.5kg, fat is moderate level, lung capacity and Quadriceps power are excellent(wow), cvs response is very low (oh my god!) and flexibility is moderate…
totally my physical efficiency is in level 2 (good) :
(level: 1 excellent, 2 good, 3 moderate, 4 bad, 5 very bad)
wow! It’s not too bad, I suppose….
And you… have you had a test like this??

By the way Most of orthopaedist are sport man, their body shape are very nice with powerful muscle… such a good looking man in my opinion
…
In my class… my professor induce us to care our health by usually exercise. I realize that my physical efficiency is not good enough….
In order to decrease risk of chronic disease in my elderly age, have a good appearance, get good health and firm body shape and muscle, My LAZINESS must be defeated and I must exercise more…. Ok!! It’s time… start now…

Though I quite hate Orthopedics, Being here is a good motivation to make me determine to exercise more…

And you , have you exercised today??

ON DUTY

last night I was on duty since finishing my class (5.30pm) till 1am (dinner at 9pm, very very hungry)

Trauma duty is somewhat busy however it's a good chance to practice my basic surgical skill such as Suture, Dressing, intramuscular injection, intradermal injection... etc.

5 suture cases in 4 times of my duties, a plenty of dressing...

many stories in Surgery department make me fun on the contrary my boring and depression happen here either...
I'll write them after finishing examination ...

HuH!!! hope I'll be all right in my next week exam...

SURGERY

I’m in Surgery Department now, 6 week duration in this one.

Surgery department for 5th year is separated in 2 parts, both of them have 2 weeks and a half for duration.
First one of mine consists of Plastic surgery, Pediatric Surgery and CVT, then being in Trauma and Neuro surgery in last 2 weeks and a half… it’s beneficial for us, we will have free time in the whole sixth week for preparing ourselves for examination

3days in Surgery have passed already that are not too bad.. Our work starts at 7am for ward round, lecture, OR, OPD or bedside teaching in the morning then small group lecture in the afternoon.
Absolutely everybody must get cases for attending and writing report… and I must have ones either. My first case is 47-year-old flame burned man that stay in Burn Unit…

It seems nothing is too hard for us in surgery, no evening ward round, no ward work, no overnight duty however I still feel somewhat exhausted. After my class, Other than approaching, taking care the patient and writing my report I have not any free time left, even for studying or preparing myself for the next day… so don’t mention about my exercise or nonsense activity

Today class just finished recently with practicing ICD (Intercostal Drainage). After watching demonstrating video, we moved to practice with a cadaver. The bad smelling of many days corpses could not be prevented by mask and made me feel a little sick. The cadaver’s skin is much more difficult to be sutured. Because they hadn’t been exam for HIV, we must be careful specially.

I’ve just realized that entering ICD tube is not as difficult as I suppose…
The MORE PRACTICE, the MORE YOU GAIN. Absolutely, if we collect many experiences in practicing, nothing is too difficult for our endeavor..
Anyway, in emergency time we usually make a plenty of mistakes, consciousness is the precious thing for that , hopefully, we can manage it safely for our patients in real life.

Good Bye OBSTETRICS Hello SURGERY

6 weeks in Obstetrics passed with my 3 labor assisting and 3 perineorhaphy cases that I did myself. Due to everyone must get at least 3 experiences in delivering childbirth, there are usually some problems between classmate in each rotation that pass this department.

SELFISHNESS, GREED and LUST are fundamental Id in one’s mind, nobody can deny being that every now and then. We usually yearn for more experience, more knowledge and more chance though it may be recompensed by others’ loss…

I’ll exemplify the real case in OBS.
If you are the one that has got 3 cases already and you get a chance to do more… it’s your absolute right to assist labour of your own attending case, WILL you choose to follow this rule to complete your desire or to grant this privilege to some of your friends that haven’t done yet…?
I’m certain you must choose the latter right now, aren’t you?.. However PASSION is usually influence one’s mind when we are not too strong enough, you may choose the former on that occasion same as some of my classmate, who know…
If the former choice is chosen, Exactly, You must receive one more experience but you must be guilt all along and face to others’ blaming either,
On the contrary lots of gratitude from your friends to you and your pride for that, though you lost one chance to add one in many of your cases if you choose to give your mercy.

Hence… keep in your mind BEING STEADY AND GIVE YOUR KINDNESS TO OTHERS you will get a chance to learn more as well…

Finally, we finished this department without too severe problem.. most of us choose to help our friends first..

Anyway. though I’m somewhat happy in Gynecology last year, Obstetrics is absolutely excluded from my choices now. My favourite departments this time are Psychiatry, Medicine and Pediatrics…

PSYCHIATRY: I impressed in my professors’ way to approach the patients, most of doctors always treat only disease not human while the psychiatrist’s questions usually express their caring..

INTERNAL MEDICINE has most of challenging cases and this sort of knowledge can help a numerous people.

PEDIATRICS is one of my interesting just because of children’s prettiness. ><

By the way, learning in any FACULTY or any DEPARTMENT can cultivate your blessing and make a benefit to society as well…. Just choose your favourite and proper one, be responsible in your job and try to do everything your best…

And SURGERY is waiting for me this week, though I wouldn’t like to be surgeon, surgical knowledge is interesting… hopefully, I’ll enjoy there. ^^

THE WEEK BEFORE MY EXAM

5 weeks in OBSTETRICS passed rapidly, the last week with my examination is coming.

2 things that influence me happen in the week before my exam.

FIRSTLY, my residual volume decrease with my tight uniform T-shirt and skirt.
OH! It’s very difficult to breath and do anything after my meal… if my abdomen is palpated, you may misunderstand I’m a pregnant girl but absolutely, uterine fundal height mustn’t be found, you will touch only my soft fat… haha

MY HYPOTHESIS of my increasing abdominal circumference are…
Firstly, because of I am vegetarian, just vegetable and rice are permitted by myself. While the food seller usually give rice much less than before because of the extremely high price of RICE, my received calories decreasing significantly, it’s not enough for me until my next meal. Hence I am hungry more often and have something little by little almost all day. ><

The second hypothesis is my examination coming, the lesson I concentrate on, seem a kind of effective sedative. My eyes can close easily while my studying, Eating can awake me all along my reading.. do you have an experience like this??

I solve this problem by taking fruit instead of high calories biscuit or sweet (*^_^*)
Haha^^ the first matter is nonsense, isn’t it? Just relax you, the readers.

THE SECOND ONE is I applied to be a member of Tzu Chi foundation in Thailand already… it’s such a good news for me!!
As I mentioned in my former post, I haven’t heard this name until my opportunity to go there.
After coming back Thailand, I searched for Tzu Chi in my country and this is my first time to do something for that..
It’s very exiting, I’m going to wear Tzu Chi uniform, do activity such as being volunteer, donating for a charity and making some benefits to society same as my friends in Tzu Chi University and Tzu Chi members around the world. However most of Tzu Chi members in Thailand are Taiwanese... very few thai people know this foundation

I am very surprised to find out that most of Tzu Chi books which I bought from Taiwan are translated in Thai language as well … wow!! But I still prefer reading in English to practice my skill ^^

But do you think I can participate in that volunteering works really???
everything may be just my dream..
Because of busy time in hospital, early morning and late evening ward round, a lot of case reports, many classes on weekday and my duty and studying on weekend..
All of my works in my responsibility can completely separate me from any other works..

It’s a pity that I may not do them as many as my wish..

Anyway, I realize that studying medicine must be my priority… An excellent and conscientious doctor is my dream as well. I cannot reach that destination without my endeavor..

Imagine if I’m a stupid doctor… because of my laziness, no responsibility, no paying attention in patient cases, not enough knowledge in my skull..
When graduate medicine… how many cases that be maltreated, how many patients that get disaster by this.. I may kill somebody accidentally because of my dullness who know…
So if you are a doctor either … I’m sure you realize this as well, don’t you??

Then let’s make an effort together in order to safe others and keep ourselves away from guilt in the future…

(Ok I must go on my studying for my OBS exam on this Thursday… see ya after that.. Byebye ^^ )

Curettage!!

today i am in LR septic and postpartum..
many curettage cases came..
if you are doctors, it's certain that you must be used to attend some of these cases..
it's such a savage method, i think. i can touch the patients' suffering..

"Be gentle, soft and careful" that is our professor's teaching to avoid many complications from curettage such as uterine perforation, uterine synecia and lots of next gestation's complication : placenta previa, abruptio placenta... all above, keeping away from ultimate distress of patients.

i have ever seen professor's curettage case, the procedure is gentle and professional.. but every cases of my resident are very cruel...

the patient cry loudly and ask for a break, without caring of any voices, the resident still did violently...
HuH!! what's a pity patient, she is!!
i cannot imagine if it's me to lie on that bed and be treated like this.. how painful i am!!

my Name in BiRth Certificate

On last sunday i was on duty... in Obs the clerkship must b on service everyday until 10pm including holidays...

i had an exiting situation...
deliver childbirth by myself 2 cases...

the first case of my life start around 9am... i ask the Resident to do it myself... immediately after she accepted my request, i scrubed my hand , wore operating suit and gloves by sterile technique rapidly...

the head of newborn passed mom's vulva already.. i must do episiotomy then..
because of my excitement, my awkward action appeared obviously, my hand shivered... Accidentally, i touched mom's FECAE!!!... oh! my god... so sorry about it...
the resident scolded me loudly as if i make such a numerous mistake... her loud and fierce voice made me clumpsy more...
however i could still change my gloves and do episiotomy... eventually.. the baby was borned safely by my hand... HuH!!! everth passed rapidly...

i delivered the placenta and do perineorhaphy at the end...

many times i had reviewed the childbirth procedure and concentrated on observing the processes, i still made many mistakes and get lots of resident's condemning along the procedure... it's not a first impression at all..
Extern came to support me that every1 usually b clumpsy at the first time..

however i had no more time to think much coz after finishing the first one, my second attended case was going to deliver again... and i must do the second case without rest time!!

finally, my second case finished with better result... and my name is typed in Birth cirtificate as the doctor who deliver a child.. oh my god!! ... it's such a great dignity in my life...^^

have u ever heard a joking believe that if ur first delivery case is same gender as u, u'll have no chane to marry and b single everlasting...

would u like to guess about my first case l..a..^^
haha fortunately, both of mine are boys...... it's such a funny and nonsense tale, isn't it? however hope u'll get an opposite gender in your first case ... haha

all of sunday afternoon i attended the third case... she had some complication, finally she was sent to do Cesarian at 9pm...

my first duty day finished with lots of my exhaustion...

FiRst Labor Case in my life

this week i'm still in septic and postpartum part of Obstetrics...

In our rotation we're seperated in 3 groups; antepartum, intrapartum and septic&postpartum
the intensive whole day lectures passed already..
today i have only morning class and a duty in septic and postpartum room..

i have not specific task.. just self learning in patient charts and attending in any cases; labour, curettage...

the first time in my life... to observe childbirth,
my first case is G1P0 pregnant with HBsAg positive ... by normal labour

1 hr and half passed, the patient hadn't delivered her child yet... we must cheer her up to force and contract her uterus by cry out "Uddddd Uddddd........" all the time... just voice, i'm quite tired... it's no doubt that how exhausted the mom is

Mother's endeaver achieved, we could see black hair of newborn soon.. then the nurse do perineotomy and finally a tiny boy was born...
that is a touched feeling .. it's too difficult to explain but most of us (my wardmate) have tears in our eyes...

though the Buddha said "Ring is produced after childbirth"
i am still one of dull human that wish have my own child and get a great mission of motherhood...

Am i a stupid girl??

Obstetric

i have a lot of obstetric lectures ...

the first 2 weeks i haven't attended in the labour room yet.. however i must learn how to deliver a baby from video demonstration and practice with a model before...

i think it's such an exiting situation and feeling to assist in childbirth... and it's not easy for mom to carry a child for 9 months and confront ultimately pain... oh!! such a big task...lots of gratitude and gratefulness give her more...

Buddha said 'Ring is produced after childbirth' however delight and happiness fulfill in all of parents' heart after that... though they must start a great duty to b mom and dad.. they still b willing to bring up their children to b good ones...

it's such our great destinies not to have any disorders and have a nice supporters to patronize us...