Ya Allah, I just had a very looooooong day. No, it was a looooooooooooooooooong day. Right now, I'm really tired physically and emotionally ( argh got a bit of drama this morning). Today, was just the day when all my energy and spirit were drained like the water from a leaked pipe I have in my bathroom now and this reminds me to call my super nice landlord to come and fix that since Ireland now charge people for water usage! Water was the only thing that used to be free in Ireland but not anymore. Where was I? Oh yeah, I had a super long day. I had exam at 5:15 in the freaking evening. We should get extra marks for staying late from 8 :00 a.m to 6:30 p.m! So, basically I have surgical OSCE today. It doesn't contribute much to our final but everything that gives marks or even 1 mark towards my final exam is BIG for me. At this stage, everything matters. So, I got a very, which i thought, 'typical' case of ascending cholangitis. For those who don't do medicine or not a big fan of surgery can click the 'x' button now ( I have a story about my handsome examiner,though) because I'm gonna be very factual and annoying now. The patient came with very typical cholangitis symptoms, RUQ pain, fever and jaundice, the famous Charcot's triad. He was treated with IV antibiotics and went for all appropriate investigations. I was very happy tbecause I just had a very intense discussion with my friends about it. Then, the patient started to explain about his hypotension problem and the examiner added that the patient also had altered mental status. I was like...okay Reynauld's pentad (since we have triad before, this guy just added another 2 symptoms. Triad now becomes pentad, and he put his name in front of it. Why do i even bother to explain this to you?). When the examiner asked me about the management of this disease I confidently listed all the management for ascending cholangitis because all I knew, Reynauld's pentad is related to ascending cholangitis. Then, my examiner who looks like Adam Levine (I was a bit distracted dengan kekacakkan beliau) said,
"Siti, you just killed your patient." I normally will argue this because my patient is my 'everything' and I will not kill patient but he's too kacak. So, I kinda let it go...
To make the story short , the patient had SIRS secondary to acute cholangitis which it hit me hard because man, medicine is hard and I can kill a patient if I miss this. This made me feel very disappointed with myself. Maybe it was too late in the evening and I forgot SIRS can happen in almost all diseases that involve infection or I just remembering Reynauld's pentade without actually understand it. Damn it Reynauld! You came out with a pentad but you didn't explain anything about it. So I went home with frustration. On the bright side, I learned a lot from that doktor kacak.
Oh well, just another long day. i mean loooooooong day.
p.s: I should book my flight ticket to Iceland but internet connection now is really slow. Argh! Can't wait to see Reykjavik, though! I always want to go to Iceland after watching Walter Mitty.