It is always glad to know that you are on the safe side. After passing my assessment, finished with my presentations, all I have now is 30 days of smooth sailing journey ahead (I hoped!) to reach the next rotation. Apart from the long duration in the ward, Surgical rotation is never a bad posting to stay on. The work load is not too many, the patients are easier to handle and not too many medicolegal stuff to start with.
We get to do neurosurgery rotation as a minor posting here. It was fun handling the 'higher function' of human. Day in and day out, we deal with 'brain drain' craniectomy/craniotomy - for those patients that has blood clots in their skull. I have 2 patients: one is a 14 year old boy from Felda Selancar (somewhere in Muadzam Shah) while riding a motor bike, ram into the back of a school bus, and rendered him unconscious. He was not wearing helmet for one, and at this age, he is definitely with no licence. On arival to my hospital, CT brain of his shows a massive extradural blood clots, and was open up. After fourteen days post operation, his conscious level still not improved. Repeat CT brain hold the key to this mystery. During the accident, there were brief episodes of hypoxia. Now the essential centre of the brain has infacted, which may includes the conscious centre. He might be in a vegetative states, if he survived.
Then, there is another boy, a young and vibrant 17 years old Malay boy from a village in Kemaman, riding bikes to refill petrol in nearby petrol kiosk. Again, he is not wearing helmet, and was hit from sideway by another motorcyclist from sideway. After the accident, his conscious level dropped, significant to warrant a CT brain, and further admission to Intensive care unit. I assisted the evacuation of blood clots. Currently, he is still recuperating in ICU post operation. At least he is recovering well.
The similarity in this 2 patients is both of them are young adults that has bright future ahead. Yet, both failed to adhere to simple measures such as wearing a safety helmet. One might recover, the other might be in coma forever.
Neurosurgery is one of the highest mortality department. You don't open up a patient, he dies, You open up, either he dies on table, dies post op or dies later. Either way, outcome is not so bright in my settings. That's why I dont quite into neurosurgery.
