Monday, August 11, 2014

Summer Project

Because of that random chat with Juan, a senior in uni, I was put in contact with a professor in Universiti Malaya. And because of that, I was fortunate enough to be offered a chance to part of a clinical research project under several professors here and thus putting my holiday to good use (instead of sitting around). Praise God for this chance! :)

So I can't really tell you what this study is about, because:
1) I am not suppose to share it out, not until the papers are published and the data are put to good use.
2) I am sponsored by my college (Yay Caius!) and I have gladly promised to contribute a story to be published in the medical association's newsletter when I get back to Cambridge. So I don't think they will be very happy if this story is published elsewhere first. :P

But I will share with you what I think is appropriate to share. :)

So this stack of paper is the result of my blood and sweat for what I have been doing for the past 3 weeks or so:

my precious - hundreds of data! :O
Ok...this is not just any stack of crumpled paper. But the process of collecting these data (the earliest phase of this project), the doctors and nurses have taught me a lot:
1) I was doing a clinical survey. I have no idea what a clinical research even is before this (how does it differ from a normal lab research?) until I started this project. It is actually based on statistics rather than models, which is completely different from a lab research in the sense that what we are doing is with real people, in real situation. It does not require much extrapolation from a lab model, just adaptations for the bigger population and into the future. It doesn't involve too many people, and I guess since I am very free, they don't really need that many people to help out in this project as well because I am very very happy to roam around the hospital for as long as I like.

2) It is a project about geriatrics. Again, I do not know what this specialty does before this. It is not very general like cardiology, neurology, ENT etc, so most of us young medical students do not know what they actually do (unless you have a relative doing this/attached to this specialty before). It is part of the syllabus for those under specialist training and beyond. So, I have not met many housemen in this ward, instead I have met many master students and specialists in this ward. This creates a bit of generation gap as these doctors are lightyears ahead of the stage I am currently at i.e. I have only completed 2nd year of medical school, I don't know anything! D: Haha...it is actually not as bad as it sounds. Through conversations over lunch with these seniors, I have learned why they chose geriatrics above others, and from those that are doing their masters, what do they think of geriatrics since this is also the first time they encounter this field.

Geriatrics is actually a very interesting subject. Unlike other fields which you most probably only care about one part of the body, it is much more holistic, much like Paeds. It encompasses the whole health condition of an elderly, from their physical condition, to their psychological condition and even to their social condition. It is definitely one of the most complex specialty I have ever seen! Because old people are frail, it is uneasy to take care of them. A single fall which means nothing to a normal adult may be life-threatening to them; bedbound plus chronic diseases could easily causes bedsores which could easily cause complications; staying in the ward for too long exposes the elderly to all sorts of infection in the hospital, which causes further complications. It is a huge, difficult task indeed, to treat these precious elderly, so that they can prolong and enjoy their final, golden years..

Not only do the doctors and nurses have to take care of the patient while he/she is here, they also have to find out what the social history of this elderly is, what care do they usually have and where are they going after the discharge. Then there're whole lot of drama about abusive maid, abusive nursing homes, children fighting over the wealth of those that are to be deceased etc, Geriatrics doctors have to care about all these social drama too! But it is also through these I have seen learned many lessons myself:

Take care of your parents when they are old, because they once took such great care of you when you are young, powerless and naive. Do NOT send them to nursing home!

Treat your children with love and care when they are young. Because they are your children, and because if you abuse them when they are young, they will learn from you, to abuse you when you are old and powerless too.

Be an example to your children. Do not show them that sending your parents to the nursing home and dumping them there is an ACCEPTABLE act.

Be prepared for your old days. Financially, socially, mentally, in anyway you could. Not to be paranoid, but just to aware of it and embrace it when your turn finally comes.

Treat the elderly with patience and care, especially those with neurological and psychological problem.
Depression, Alzhermer's, Parkinson's, bipolar and schizophrenia are common. It is not their fault that they are behaving like a huge baby, it is just Nature taking its course. Empathize them, for they have worked so hard their whole life, to lose their physical power, respect and in cases of dementia, to lose their identity. It is also the first time I encounter psychiatric patients first hand. They are actually unlike how I imagined them to be when I learned about these diseases in lectures... It is very different, in a good way.

3) Romance do last. My grandparents are (THANK GOD!) very healthy and are still very much in love with each other, so are my parents. I often seen pictures of old couple together on Facebook too. But nothing hit me as hard as what I witnessed beside these hospital beds. Many of them are widowed, but I have seen so many old couples in the wards too! They are the most loving couple I have ever seen. An example is, I overheard a few old men chatting about their wives who are currently sick:


"How old is your wive?"
"I am 79, she is 75. You?"
"I am 92! and she is 89. I want to die when she dies."
"Me too." 

Ok, I know that sounds rather morbid but...the way they pushed themselves on a wheelchair/walked with walking frames to the wards and stared at their wives for hours (very adoringly!) until the visiting hours are over, then they will leave very very reluctantly, are really touching. They have shown me what keeping to your marriage vow really means:
"...to have and to hold, from this day forward, for better, for worse, for richer, for poorer, in sickness and in health, until death do us part." 
Trust me, I am not romanticizing the whole thing at all. They have shown me that despite the fast food culture that is fast eroding into the realm of marriage in modern days, true love still exist. It is indeed, a great blessing, to have someone that loves and adores you so much even when you look absolutely horrible, old and sick. I envy those ladies (and of course those old men whose wives are there too.) :)

Of course, I do learned that to do a project, you have to be consistent, discipline, proactive, ethical etc (soft skills that you'll put in your CV/personal statement), but nothing beats the whole experience I have here. 

Thank you, UM. Thank you, Prof Tan and Dr Khor!

Now, into the next phase: analysis and discussion. 

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