Today is the first day of our 2nd week at Taipei Hospital! Karen and I will be rotating at the pediatric department this week. I was a little worried about this rotation in the beginning because pediatric covers such broad subjects and many organ systems, such as GI, have not been covered in our curriculum yet. Although I studied with Amanda yesterday to prepare myself, I am still a little anxious about it. However, once I met with the preceptors this morning, I felt much calmer because they seemed so welcoming to Karen and I. We begin the morning with a departmental morning meeting once again. But unlike the internal medicine meeting, we had about 15 cases this morning. The presentation and consequent discussion was so fast that I felt like even I need a translator too! Since it was impossible to translate verbally for Karen while trying to listen in the same time, I tried writing the translation down on the notebook for her, hopefully it was clear enough this way that I didn't just end up confusing her even more! Although all the presentations was concise and short, we actually learned/reviewed many medical facts and treatment conventions.
After the morning meeting, we went to patient round with Dr. Wu (吳文秋醫師). After mentioning that we have a non-Chinese speaker, he graciously agreed to use all English to communicate with us. His English was very impressive and was able to gave us a lecture on pediatric allergies all in English and I hardly ever had to step in to translate. During the round, we actually saw an interesting case. It was a little boy admitted for acute bacterial gastritis. What made the case interesting was it was the first time we get to see real sample of bloody stool. And because it was caused by salmonella infection, mucus were also present in the stool sample. In addition, the boy also started developed a mild form of upper respiratory infection, possibly nosocomial in origin, which reminds me all over again about the importance of aseptic practice in hospitals to help eliminate cross infection in hospital rooms.
After lunch, while going up the elevator, we notice one interesting phenomenon that is unique to Asian countries. We noticed that there was no 4th floor! At first, I thought it is only that particular elevator that do not have a button for 4th floor or the 4th floor is of special office use only, but when I think about it more, I realized that it is probably because 4 in Chinese (pronounced "si") sounds very similar to "death" in Chinese. Since hospital is a sensitive place where death usually occur, it was probably an attempt at easing the patient's anxiety going to the hospital.
While waiting for our afternoon preceptor, many doctors and other health workers were all very kind and tried to chat with us to keep us accompanied. After that, we spent the afternoon going over an atypical case with Dr. Tsai (蔡雅慧醫師). It was a 10 y/o boy with fever x3d, severe vomiting since morning, and loose diarrhea noticed only once. Physical examination revealed no other abnormalities except decrease breathing sound, positive wheezing, and soft abdomen with localized pain in periumbilical area. We were asked to provide a list of diagnosis on the symptom, of which we replied pneumonia and appendicitis. Dr. Tsai answered that there are 3 diseases. Diagnosis one, and the potentially most severe one was appendicitis, the second one was bronchpneumonia, probably caused by mycoplasmas, and the third diagnosis was acute gastritis. Although in this case the appendicitis and gastritis were both not yet fully blown to cause all of their characteristic presentations. After the the case presentation, Mrs. Lian, a PA who assists Dr. Wu, kindly showed us around in the department and also showed us the outpatient clinic location that we will be doing our rotation the next day.
Although both of the preceptors today said that their English was not good, both Karen and I thought they were both very good in English and were very impressed by their conversational skills and the ability to explain the complicated clinical scenarios to us in ways that was very clear and easy to understand. We also were very thankful to the PA's and other doctors in the ward who were so nice to us and tried to make conversations even if they were not comfortable using English.
No comments:
Post a Comment