It happened to me.

You wouldn’t know how it feels until it has happened to you.

Funny how sometimes the most powerful lessons were not intentionally taught, rather moved by the will of Allah. Today I learnt one of those most powerful lessons.

Today is my brother’s birthday. I asked my mom yesterday to pass him a t-shirt (since I wouldn’t be home) that I had bought for him a month ago. When he saw me online today, the first thing he said was: “Where’d you get the tshirt? It’s kinda big for me.”

This sentence literally crushed my heart to pieces. I don’t know if it’s me being extremely sensitive but being human, all I could reply was a sarcastic, “Umm Happy Birthday. Your welcome.”

Well, after that he did say thank you. But the thing is, I don’t mean to be sound like a high and mighty showing-off loving sister for having bought a present (I hardly if ever do get any bday presents for my siblings). I just felt so hurt because when I bought that shirt, it left me to survive only on RM3 for 2 days (I did not realize I was short on cash). I would have appreciated so much if all he said was, “Kak Alia, thank you so much for the tshirt :)” It would have taken one line. But it would have meant a lot to me.

This brings me to the first lesson I learnt: Gratitude.

What hit me first was anger. And deep hurt. And then the realization: Oh God, what if I was like that? And I’m sure I have been like that countless of times. Friends doing something for me that I did not acknowledge, that I didn’t have the time to say thank you for because I was too busy. Teachers giving their best to impart knowledge (who knows they might have stayed up the whole night preparing) and me as a student not giving my full attention and talking to the person next to me. Most importantly, my parents, putting food on the table (and who knows they had a rough day or my mum struggled to cook because of the pain she had in her foot) but I didn’t come down to eat or I said that “The food tastes weird.” How despicably ignorant and arrogant I would sound.

I would not (and most probably would never) know what someone has gone through to do something for me. It’s served as a great reminder to always be grateful and say Thank You. How many times have I forgotten to express my gratitude? And we forget THE most important thing is to be syukur to Allah; who has given night and day, oxygen, perfusion in our body, functional Hbs, normal RBCs, adequate levels of blood cells, sufficient iron (for our bodies)… life, everything for free. And again, we are ungrateful, by not saying thank you, by not abiding to His commands.

My mom sends me a message every morning for reminders. And this morning, her reminder was timely:

When you put your hopes for love, praise, success, happiness and recognition in the people, you will walk away disappointed with a broken heart. It is only when you put this hope in Allah will your heart and soul find peace, relief and pleasure. Indeed Allah speaks the truth in the Qur’an: “Verily, in the remembrance of Allah do hearts find rest” [13: 28]

Which brings me to my second reminder: HOPE in Allah.

Wanting to be thanked by my brother is like putting your hope for recognition by a person. And I did walk away disappointed and a pierced heart. What if I had given it with the hope that Allah will accept my deeds as a tender loving gesture toward my brother. With that kind of intention, regardless the outcome, my heart will InsyaAllah always feel content.

In life, you will always face disappointments, rejection, abandonment… The only way to keep your heart running and going is to do it for Allah.

With gratitude and this intention, will your heart find rest.

*Published with the permission from my brother. It's not served to embarrass him or whatever and he knows that. We've talked it out and settled things (he called me up!:D). This is to serve as an extremely powerful reminder, something I've known already but can only truly feel after having gone through it. That's why I love you even more, bro. Thank you *hearts*.

PDO School

I had a complete and utter culture shock when I came back to Malaysia in 2002 after my primary schooling in the middle east. In 1997, my dad was sent to Oman due to his work and the whole family too had to tag along.

I was 7 years old. A very timid and shy girl. The type who hid behind her mother’s skirt when a relative comes to shake hands during raya.

But PDO school was the best schooling time of my life.

I attended PDO (Petroleum Development of Oman) school. My teachers were from England mostly and my friends were children of expatriates.

These are a few things I would like to share about the terrific memorable time I had there:

1. I remember we only had one teacher for a whole year. One teacher for all subjects. Our classes were determined by the teacher’s name. For example, my primary 4 school teacher’s name was Miss Shearman. So our class was called Y4S (Year 4 Shearman). She taught us all the subjects; maths, english, art, science, reading, music, geography, history. So that means we had only one teacher the whole day, and that same teacher for a whole year. I used to be very confused when my cousins back in Malaysia would ask which teacher teaches what. All I knew was that there was only one teacher per class.
   
   
2. We had a theme every year. I entered at the end of Year 2 but somehow I mostly remember year 4. Maybe because I had such a lovely teacher:) We have themes every year; and everything we learn are based on that theme. For example, in Year 4, the theme for one of the first semester was “Tropical Rainforest”. We decorated the whole classroom with papers and cardboards of leaves, tree trunks and animals. Our english essays were about Adventures in the jungles. Geography was about the equator and the countries around it. Science was about plants and trees. Music was about animal sounds. The second semester was about The Egyptians (history was about archaeologists, art was about making plasticine mummies). In Year 5, it was Tudors (in art, we made tudor houses with wood). In Year 6, it was The Victorians (we even had victorian day where we dressed up, wrote with quills, and baked).
   
   
3. We had assemblies once a month. Every assembly, all the students from the class would line up infront of the door and our teacher would be at the front to march us to the Assembly Hall. There, we would sit in rows with our own class. Miss Evans (the headmistress during my time) would give an opening speech and then we’d watch a performance. Every month, a performance would be presented by a class (In Year 4, ours was The Wizard of Oz. Year 5 was Henry VIII and his wives). That particular class would be practicing for this performance. After that, we would have Special Mentions, whereby a person from every class was selected by their class teacher and acknowledged for something they have done. I remember getting a Special Mention for an artwork I did. Then, Miss Evans would call out those who had birthdays that week. And we would get a card and a mug.
   
   
4. I remember a lot about reading. In the corridors, there were rows and rows of books. But they all had levels which students progressed (starting from books with no words, to a few words and books which had full text and little pictures). There would be a time where we would choose our books and we would have to (one by one), read to our teacher. Every two weeks, we had to go to the library and choose two new books and keep them in our special red Library Bag. And almost everyday, we would have reading time; whereby just before we go home, all of us in the class sits together on the carpet and our class teacher reads us a books. I love most listening to Roald Dahl’s stories. I remember being read to about Matilda, about the BFG, James and the Giant Peach...
   
   
5. We didn't have to bring any books. All our textbooks and exercise books were left in our classrooms. All we had to bring were snacks for break time (there was no cafeteria) and for lunch, we went home to eat (school was only 5 minutes away by car and traffic jams were unheard of).
   
   
6. For sports day, we were in different houses every year. Sports shirt? Just wear anything which is a shade of your sports house. Everyone was treated to ice-cream after that.

Education system there and here are totally different. And these are only mild examples of the colossal fun I had. I don't mean to compare; different countries have varying developments and other factors which influence to its current status. But if I could, I would love to relive studying in PDO school again.

I wouldn't mind flying there and getting a look at what the school is developed into:)

32.

Things I learnt tonight:

1. Leaders are first to come and last to go. People will be more amazed by leaders who actually sweep rubbish and arrange tables and chairs.
2. Don’t lose momentum. Once you lose it, find it back immediately.
3. Being busy is good. You’ll find it easier to manage your time once you enter clinical years. Being a houseman, it’s about teamwork. Learn it now, learn being scolded, learn how to handle crisis, learn how to deal with people. Learn it now.
4. 2nd year is still soo free. Or so they say.
5. Stay active. Even after you enter 4th year.
6. Being sooo busy in clinical year is actually a taboo.
7. An organization needs strong leadership to pave the way and the direction.
8. Settle all your personal problems before handling a leadership position. Once you’re affected personally, it will affect your organization too.
9. Look at the big picture (mission, vision), and the small things will take care of themselves.
10. ASB.
11. Leaders by influence.
12. Good leaders are those who have done work even at the bottom-most level. They know how other people feel.
13. In an organization: Population, system (documentation, communication, organization)
14. In planning: Mission, Action Plan, Milestone, PIC.
15. Recruitment with your heart.
16. Always look for opportunities.
17. Prepare paperwork early. Take time for the first few weeks to strategize. Crawl, walk then only run.
18. Ayam penyet (smashed chicken) sedap and sangat pedas.
19. Financial freedom= passive income surpassing total expenses.
20. If you find something that’s overwhelmingly opportunistic, considering dropping what you’re doing now. (might be under consideration.)
21. Some people rush through life, complete degree, get masters, work. Life should be dictated by you, not others. As long as what you do are according to principles.
22. Don’t stop reading.
23. Learn how to deal with people who will be asking about Islam.
24. It’s the small things people look at.
25. Even a person who has to repeat can turn into a specialist. Imagine YOUR potential.
26. Complete MBBS, _________, houseman. (_______ = business?)
27. Once you have something in your head, write it immediately. Don’t go home and sleep and think about it the next day. Jot it now.
28. Learn to have muka tebal.
29. Meeting people who have gone through what you’re going through now, those who are active, are inspiring. Do it more often.
30. Work with everyone. Don’t be divided.
31. This is the time to make mistakes. You’re a student.
32. ...

160910. AWS.

diseases

"The real illness is the disease of the heart (the spiritual problem), who always want to go against Allah Swt. The disease that we try to treat is merely the sign and symptoms from the spiritually ill person."

Source.

For the first year :) [Updated]

To my dearest first year CUCMS juniors,

It's up to you if you wish to read this and heed the advice. They're all based on my personal experience. These are the things I wish I was told by a senior at the beginning of my 1st year. I was told by a senior friend that sometimes there is an overwhelming amount of information. But when you become a doctor, things can become routine and so what you initially need is someone to just tell you what can be more important than others. It's not everything, just a little I'd like to share if I may :)

Anatomy Block: You've gone through this. It's quite a lot since it is GENERAL anatomy. Once you enter systems, it will be more focused and InsyaAllah you'll feel relatively less overwhelmed.

Physiology: Should be no problem InsyaAllah. Mainly concepts, so if you want them really strong, discuss with friends.

Biochemistry: Also known as Molecular Basis of Nutrition and Medicine. For this, chemistry concepts would be important. You'd have Mr Muhammad and Prof Nooraini. You should prepare for all parts of the SCTLs because their teaching style is a bit different. Their style is "interactive lecture" so, be prepared to be called out (either by being pointed to or from the name list). Yes biochem is important but regarding its importance once you reach clinical years, that you'd have to ask the senior seniors.

Behavioural Science: It doesn't have a lot of clinical applications but to me, I think that grasping the ideas are important because it allows us to know more about the human being. As I've learnt, in this vocation, we are not planning to treat the disease, rather we are treating the PATIENT. This means understanding human traits and their behaviours.

Microbiology: At first it looks like there are a lot of things to memorize. Each microbe, their virulence factors, tests to determine. Really, at one point it might be even tougher than Anat. I've no particular advice than to just try and swallow everything in. For OSPE though, look at the pictures of agar plates and how it looks like for particular organisms. Again, after you've completed all the general blocks, the different microbes will be narrowed down and more focused according to the system.

Pathology Block: Ok, this should be highlighted with red lights and loud sirens. It is tres VITAL AND CRUCIAL. Prepare for it well. I'm not saying that other blocks are not as important. But this IS the crux of being a doctor. The abnormalities. Every systemic block will have pathology. Exact terms and definitions are of utmost importance to understand. Know the difference between tumours, what are benign and malignant, cancer (honestly, Prof Thuaibah says some doctors are even not so sure of definitions and can send the patient into utter depression because of the mix up), thrombus, embolism, Virchow's triad etc etc. Dr Hamidah's classes are normally based on basic concepts of Pathology; so as long as you are strong in that, insyaAllah it'll be ok:) You'll be repeating the same thing again and again alllll the way til 5th year, all the way til you start working, so get it right the first time.

Pharmacology: Drugs have really weird names. Don't worry, they will get even weirder as you learn more. Mechanism of actions are fun if you draw diagrams for them (where exactly they act on). Books are Lippincott (very much simplified, sometimes a bit too much) and Katzung (good diagrams, more detailed, sometimes more complex) and they compliment each other. Yes, you do have to know side effects; it comes out in exams.

Endocrinology Block: Endo should be okay too :) This is the first systemic block. You will start having PBLs (problem based learning), whereby you will be given triggers and progress "clues" to lead you to the disease. It might be very confusing at first because you're not very used to it. You might not see the relations and things might be awkward during the first session. It's okay if you're a bit blur during session A. But for session B where you will be presenting the case, make sure you can follow through or at least have the completed concept map/flow chart. It further strengthens your knowledge on some diseases and really helps in exam and of course life as a doctor. If you want some kind of idea how a concept map looks like, you are more than welcomed to meet up with me:) PBLs help to show how things are inter-related. You can see how signs and symptoms develop from the pathophysiology, where the treatment is applied, the causes, the management... :)

Musculoskeletal Block: This might come across as something hard... mainly because of the colossal amount of information that you need to know. It's a total of 4 weeks anatomy and 1 week of the rest (physio, patho, microb, pharmaco). You'll have your encounter with cadavers. Suggestion:

• Draw draw and draw- to see the relations.
• If you like, watch the video about musculoskeletal block, InsyaAllah should be provided, if not, remind me. It's really helpful as long as you watch it not JUST the day before exams. There are about 3-4 videos and each take 2 hours because they detail out everything. If you want to see if it suits you, try watching it earlier so you don't have to cram it in just the night before.
• Use an atlas. Read the notes while looking at the pictures. I personally like Netter's Human Atlas. The many many words from the slides can be replaced by just one picture.
• When Dr Khin says something is a 5-star (*****), it means its REALLY REALLY REALLY is important, specially for clinical reasons. We sometimes feel that it is leceh to memorize it, but it's really important because some diseases affect it. Like knowing the foramen in your skull and the structures that pass through it- that's a five star. You wonder what does that have to do with anything, but it DOES. And CONFIRMED it will come out in Finals and OSPE if not in the weekly assessment.

Cardiovascular: CVS should be okay too :) You'll have a memorable time when Prof Latiff teaches.

Clinical Skills Training: Huge lesson I've learnt from CST when we were rightfully scolded. I can only sum it up in Dr Hazian's words: Don't be too focused on chasing the marks (that is be so mechanical and technical) til you forget about the patient.

Generally...

Do discussions. Most importantly, DISCUSS. The only way for you to be sure that you KNOW something is to TEACH it to another person and to DISCUSS it. Get friends who you can discuss with. Look ahead; Pro Exam 1 is not far at all. Be comfortable with friends who you can debate topics with because once you near pro exam, you cannot go through everything yourself. The more you teach others, the more you get in return.

Notes. For notes, I personally like mindmaps. I draft a simple overview before beginning class (by looking at the objectives of the SCTL), then add more during my group discussion, add more during the lectures and SCTL classes, and add more when I'm revising again. That way, the night before finals or weekly assessments, I wouldn't feel too overwhelmed having to look through bundles of slides but instead just 5 pieces of papers (ie one paper per topic). This of course requires discipline, something I occasionally lack, but is easily done if you gain the habit.

Prevent Procrastination. Sometimes you might get agitated in class and tell yourself, "Ahh I can read this later at home." Don't worry, it happens to me too sometimes when my mind has wandered... But nothing replaces with what the lecturer says. And sometimes you might not be able to get it again or you might forget that you're meant to read it back. Even if you can't get it right there and then, I suggest that immediately after class, turn to the person next to you, try to explain it to them or ask them to explain back to you :)

Filing for the Future. Part of Affective Domain is having your academic folios, meaning all your SCTLs, notes, slides all filed. At first, you don't really see the relevance and I didn't do that for Anatomy:( But look at it this way, you'll be using the knowledge again and again and referring back to your notes especially for your professional exam when you need to revise all the blocks. Be proactive, organized and have a good filing system so that ultimately, it will help YOURSELF for the future.

USMLE Step 1 books are highly recommended. They summarize. Don't wait until 2nd year to realize.

All these advice might not apply to everyone. It might work, might not work. Passing on the knowledge so that the next generation will learn from our mistakes. There are many more mistakes to learn from. Don't repeat ours :) So that there are OTHER kinds of mistakes you can learn from :P Exploit your seniors. Ask from us, insyaAllah we'll try to help and also learn things together:)

It's your first year. Enjoy it, and you should enjoy the rest of your MBBS if you search for knowledge to be a doctor, not for the exams. It's hard to accept that now especially when tests loom in every Friday. But if you can do that, look past the test and toward being a doctor, it'll be worth it:)

All the best!

Alia