(Mis)Adventures of a Malaysian Mudphud in the land of tea and scones
September 23, 2007 at 3:25 pm · Filed under Humor
OK so I got a little bored and decided to do some internet browsing (and by browsing, I mean randomly clicking on any internet link that remotely of interest to me). This piece of article caught my eye – an interesting ‘editorial’ in the Annals of Improbable Research (AIR)
http://michel-lab.bwh.harvard.edu/pdfs/numberninepolcorr.pdf
Click on the link to read the scanned pdf file of the editorial. For the benefit of those who have difficulty reading the article (poor scan quality), I’ve taken the liberty to retype in verbatim the entire text of the article. I wish to reiterate that the intellectual and proprietary rights to the article belongs entirely to Dr Thomas Michel and the board of editors of the AIR, and my reproduction of the article is in no way an attempt to infringe on this right, but more so, in the spirit of good natured ‘intellectual’ humour.
Likewise, any opinion put forth in this article is solely the resposibility of the author, and does not represent my own opinion.
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The Guide to Politically Correct Cardiology
by Thomas Michel, MD, PhD
Cardiology Division, Brigham & Women’s Hospital, Boston, Massachusetts.
The politically correct cardiologist should become aware of the evolving terminology in the field, as it seems likely that in the near future, physicians will not be able to bill for charges incurred by patients diagnosed with politically incorrect illnesses.
It has been widely acknowledged that the nomenclature of specific diagnoses applied to a particular patient’s ailment may profoundly affect the patient’s well-being, self image, and time to full recovery. It seems only logical that diagnoses should be empowering, rather than belittling. They should reflect the patient’s ability to transcend the illnesses, rather than be dominated by the judgemental, impersonal, and paternalistic semiotics of the medical profession. The nomenclature of heart disease is particular troubling in this context.
Table 1 summarizes a variety of commonly applied cardiac diagnoses, and supplies a translation into politically correct terminology.
Heart failure is probably the most common cardiac diagnosis, but the very term is belittling. It says to the patient, ”Your heart has failed“. It is far more empowering to term the patient ‘inotropically challenged’ to reflect the fact that the contractile (inotropic) state of the heart shows room for improvement. Likewise, for diastolic failure, the fact that the heart doesn’t relax (lusitropy) as well as it might should not be branded as a failure.
Patients have long been termed having ’sick sinus syndrome’ if the principle pacemaker (sinus node) cells of the heart beat too slowly. This illness sounds rather more like an upper respiratory tract infection, and applies the value judgement of sickness to a noble, organic, cardiac structure. Better to say that a patient is ‘chronotropically challenged’ or systolically impaired.
The key here is that cardiac diversity is to be celebrated, not denigrated. The term ‘aberrant’ used to be applied to drug-abusing pedophiles, whom we now simply identify to be following an alternative lifestyle. Similarly, to brand a patient with ‘aberrant conduction’ simply because the electrical impulse travel a novel pathway from the atrium to the ventricles is an unfortunate stigma. Similarly, the connotations of the word ‘deviant’ are to be avoided when describing the electrocardiographic axis of the heart (’left axis deviation’)
The term ‘inferior myocardial infarction’ has got to go. One can imagine the scenario: a patient returns home from the hospital and curious friends ask “What kind of heart attack did you have?” To reply ”My cardiologist says that I had an inferior myocardial infarction” could lead to a cynical rejoinder. Better to use the historically and anatomically correct term ‘diaphragmatic MI’
Valvular heart disease has not been spared from the application of demeaning and judgemental terminology. It is terribly insensitive to say that a cardiac valve is ‘incompetent’ or ‘insufficient’ simply because it leaks like a Washington healtcare committee. If the mitral valve leaks, thus allowing the retrograde flow of blood, would it not be better to say that the patient’s heart is ‘retrograde mitral flow-enabled’? Similar terminology can be applied to other leaky cardiac valve, as well as to the occasional defects found between cardiac chambers.
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Funny, no? 
(if you don’t get it, please forget ever having read this post, please? Gracias)
September 19, 2007 at 8:07 pm · Filed under My Life
It’s nearly been two weeks since I officially traded my dusky black Cambridge college gown for the shiny, new white coat of the London hospitals.
Well, that’s a bit of an exaggeration, really.
My undergraduate gown is still with me, and I didn’t get any white coat (in fact, British doctors have long discarded the white coat tradition).
I’ve now started my clinical course at Barts and The London Medical School, and although I’ve finished three years in Cambridge, I’m technically a 3rd year at Barts, since the Cambridge Part II year doesn’t count towards my medical degree proper. Things have been going *relatively* smoothly since I shifted into the student halls on September 3rd.
The area which I’m living in, Barbican, is a picture of geniality of its Victorian past, most notably that of the West Smithfield meat market, coupled with visible signs of modernism, as exemplified by the giant gray behemoth that is the Barbican Centre. Not too far from my hall is St Bartholomew’s Hospital (affectionately known as St Barts), which dates back to 1123 – making it supposedly the oldest hospital in existence in England. This is one of the two major teaching hospitals that make up Barts & The London Medical School, the other one being The Royal London Hopsital (most of the time, simply referred to as The London) in Whitechapel. Whitechapel is, for the want of a better word, referred to as the ‘culturally-vibrant’ heart of East London - quite simply, an euphimism to describe the plethora of (mostly) South Asian community that populate that quarter of the city. Not surprisingly, we get a good mix of patients.
David stays opposite my room. Both our neighbours are ex-Oxonians. And our neighbour’s neighbours were from St Andrew’s. Interestingly enough, there’s also another ex-Cantabridgian living along our corridor who shares the same first name as David. (and oddly enough, we seem not to have a problem with differentiating the both of them). Call it a coincident if you want to, but I strongly suspect that this is a ploy by the higher-ups to lump all the direct clinical entry students (or ‘transfer students’, as they call us) in the same place. Possibly to avoid us integrating with the other Barts students? My suspicions were further confirmed when I found out that ALL the transfer students who had applied for student accomodation were indeed placed in the SAME student hall.
Academic-wise (you saw that coming didn’t you?), it’s a steep learning curve. That’s as much as I can say at this juncture, since it’s too early to judge.
August 12, 2007 at 4:56 pm · Filed under My Life
I’ve decided to use a new blogskin from HarvardBlogs. One interesting feature of this new blogskin is that it lets readers customize the background from a range of selections. Just click the ‘background tiles’ underneath the blog title, on the upper left-hand corner of the page to select whichever background you prefer. I’ve been experimenting around and my current favorite is the one with clouds against a blue sky.
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Summer break this year has been pretty fun, albeit the fact that this is my first full summer in Malaysia. Granted this summer has been relatively uneventful compared to my previous two summers, I feel that it has more fulfiling in terms of renewing old friendships and making new ones. Above all, the opportunity of spending this summer with my family matters more than anything else in the world. 
And what have I been up to for the past 5 weeks? I’ll save the answer to that question for another post till I get all the pictures. Stay tuned!
On a different note, another 3 weeks till I start my clinical school! I’m not sure whether to laugh (new life! new place! new course! new people! 
) or to groan (this is my last long summer break:P).
Whatever it may be, it’s definitely gonna be a start of something new! Clinical school, here I come!
July 9, 2007 at 3:58 am · Filed under Cambridge Years (2004-2007), My Life
It has finally come to an end. Three years of undergraduate studies. Gone now are the days of lectures, practical classes, labwork, punting, library-hopping, cookouts, formal halls, black tie, medieval Colleges, the frantic rush to meet essay deadlines, and eccentric professors.
On June 29th, 2007, I was admitted to my BA degree from the University of Cambridge, with a Part I Medical & Veterinary Sciences Tripos (MVST), and Part II Natural Sciences Tripos (NST Pharmacology).
It has been an eye-opening three years thus far. And the fun part being that the journey toward becoming a doctor has only just begun.
To all of you (you know who you are), thanks for being part of my Cambridge years. Here’s a toast to our times together, and I wish you best in the long road of life ahead
June 19, 2007 at 11:17 pm · Filed under Uncategorized
“… Even in the greatest of odds, there is something in the human spirit – a magic blend of skill, faith and valour – that can lift men from certain defeat to incredible victory”
Adapted from a quote on the Battle of Midway by an American write, Walter Lord, inscribed on granite at the Pacific War wing of the World War II memorial in Washington DC
To anyone of you who’s facing moments of bleakness, let this quote be your guide and motivation.
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