entering the last weekend in this trip

April 22, 2007 § Leave a comment

Mulai dengan bahasa. The most striking for me now is how it has been 3 months in Holland. I tried to live out every week, enjoy and cherish everyday, and have a nice trip all over The Netherlands and West Europe every weekend, have a great time in the hospital, meet my dutch colleagues for drink or dinner, and just have a pleasant stay. 3 months is a long time, to put time in perspective. That’s 1 big rotation plus 2 small rotations in Indonesia (say… Pediatrics plus Neurology???), or 3 small rotations (eg Neurology, Ophthalmology, Psychiatry????). That’s also more than half a semester, from the beginning of a course until 2 weeks before final examination. That’s a quarter of a year. If you put it like that, 3-months is a long time.

For me here, it’s 2 months of courses and 1 month of clinical internship. Although, the reality has been more complicated and more busy. The first month is just so full of lectures and groupworks, although I did have several chance to have dinner with a dutch friend, have a drink with different people in the city center, and do some sports in the sport center, and travel to Amsterdam, Rotterdam, France and Belgium. The second month is still filled with dinner appointments and a lot of time in the library, and traveling to Den Haag, Den Bosch, and Arnhem. Then in the third month, I attended an extra course in the evening once a week, Honours Programme for a mixed group of 20 students from different faculties in Radboud University; I’ve also been working for a paper with a professor here, traveling to Maastricht Utrecht, Spain, Keukenhof and of course it’s 8.30am to 6pm daily in the hospital.   

Everyone here has been asking me, "Are you looking forward to go home?"

Well, easy answer, "NO!", of course not. I like the food, I can adapt to the way of living here, people respect me and who I am and how I looked as much as I respect them. I’ve had the chance to travel to France, Belgium, and Spain, and to most cities in Netherlands that my Dutch friends have never traveled to. I experience a great learning environment which I feel I can excel with. This is the place to learn. But Indonesia is the place to practice what has been learned, the place to serve.

I just got back from Keukenhof today, a tulip haven in Netherlands, a place to be for tourist. They only open from 21 March to 22 May I think, so this is the perfect time to visit the place. And indeed, it’s so beautiful there. I went there with a Dutch friend, and we stopped by at her parents place to have dinner. Well, I was invited, and yeah, that would be nice: have dinner with a family. When you’re away and living alone on your own for some time in a foreign country, it’s easy to just walk into a family and have a good time being with them. Well, at least it has worked like that for me several times already.

So, what am I doing this week in Nijmegen before my flight back to Jakarta on 30 April? Let’s see. Have several dinner appointments, continue coming to the hospital, continue working for my paper, continue packing my suitcase, and contemplate on how much I’ve learned and how much blessed I am to be here and have so many new possibilities.

Thank you for the ones who’ve joined my experience through this blog so far. Your reading is what keeps me writing. Thanks for the ones in FK Undip who’ve supported me all this time from back home, I hope what I’ve learned here can be yours as well. Thank you thank you thank you.

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Ajeng. http://docere.antiblog.com

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BARCELONA, SPAIN!!! I’d finally been there…

April 15, 2007 § Leave a comment

Fountain Barcelona. Only one word: INSPIRING! Beauty beauty beauty. It’s a treat for the eyes. I had only two days to visit the city, but even such limited time with careful planning has been enough to make me enjoy the city and have a great time.

I booked the flight 3 weeks ago, Eindhoven-Girona, going on Friday and returning on Sunday with Ryanair. Someone in my class here who’d been to Barcelona 5 times suggested the must-see places that couldn’t be missed. Corry informed me about the hop-on hop-off bus, tourist bus, that’s easy and convenient. I booked a hostel after devotedly searching online, and found what seemed like a nice spot with available bed for that weekend. I booked late and most of the top ones on the search list were already fully booked. I decided on Alberg Pere Tarres Hostel, 10 minutes from the city center, close to Metro station, and good review from the people who’ve been there. Good review from the people who’d stayed there. I also looked up all kinds of things including info about bus from Girona airport to Barcelona and what kind of transport is best to use in the city. I’d decided to use the tourist bus because I’d be alone and be there for the first time, I’m not sure about the metro (eg. When I went to Paris last month I only used metro to get everywhere because I’d known the metro system already, I’d been there in 2005).

Everyone warned me: SPANISH DON’T SPEAK ENGLISH. Yeah, I kinda knew that. But, having been in Italy, I was quite confident about my skill of non-verbal communication. So, language is the least of my worries. And I would stay in tourist route anyway, that’s not too challenging.

I checked the weather forecast on Thursday: Barcelona would rain. But, I have learned that expecting storm on our holiday is not a good way to live: you might just get what you wished for. So, I kept being optimistic about the weather and the possibility to have fun outdoor in Barcelona.

FIRST DAY

I left early from Nijmegen on Friday, and the flight was 2 hours long. It’s my very first time using Ryanair, which is easy and comfy.

I arrived at Girona airport, took the free Barcelona map there, then used the bus to get to Barcelona. It was a 1 hour trip with beautiful hilly landscape (reminded me of Italy, because The Netherlands is pretty much a flat terrain). After arriving at the bus station I immediately bought the ticket of the hop-on hop-off bus (those unfamiliar with this bus: the bus is a double decker that stops only at the main tourist attractions). They told me to go to Sacrada Familia first and take the tourist bus from there. And they gave me a GREAT map with a discount booklet and info book.

SACRADA FAMILIA is a real treat. Although the first time I saw the cathedral, I laughed: it’s under construction. SPAIN is a country under construction. However, it’s obvious that this cathedral is an original work of art: creative and daring. The original construction began in 1882 and still not being completed until today. I went to the tower, just 2 euro to get up with the elevator: that’s freaking cheap. The view of the city was amusing, plus, we got a closer look at the top of the tower: the colourful latin crosses that are the hallmark of this cathedral.

I took the bus to Espagna, which I thought would be close to Fountain of Montjuic, highly recommended. There’s a fountain show everyday, 7-9pm. I saw a tourist office and asked where the fountain show would be, and it turned out to be 10 meters from where I stood and I didn’t know because it was completely off before 7pm. I went into the MNAC (museum of Catalanyan art) first, which has brilliant collection of Catalan paintings, from 5pm until 7pm. Then the fountain show started: SUPERB. Really. I watched it for half an hour. Then I took the bus and went about with it. The bus stopped at Catalanya, the city center, where the service finished by 9pm. So I finally had to use the metro anyway to get to the hostel. It turned out that the metro is nice: new, air-conditioned, and spacey. I got off at the station then just asked the information guy, "Numancia?" which was the name of the street where the hostel was. He pointed the way. Then I walked out of the metro, it was already dark outside. I saw the big street and all the traffic lights, and got confused with the direction again, and found a policeman. I asked again, "Numancia?" haha… that’s not even one sentence. Then he pointed where I should go. I walked about 10 minutes, quite worried coz I couldn’t see any street signs. Then I found some policemen again, then ask, "Numancia?" He then pointed that I should go straight and turn right at the first street on the right. Trust me, he gave me that information with spanish and hand movements. I found the street, 15 minutes of walk from the metro station, and almost missed the hostel because I had expected an old crappy building. Well, I was so impressed: it was more of a hotel. The building was new. They already had my name registered, and I would even get a breakfast. Perfect. I got a mixed dorm with 6 people in it. I was really happy to see that my roommates are all Japanese!!! Omigosh… it’s so nice. I mean, I’ve known many Japanese before, and they’re fun and friendly, and Asian! That’s a bonding factor. 

I got the top bunk of the bed. I planned what to do the second day: Parc Guell, Casa Battlo, La Pedrera. More of Gaudi’s work. Afterwards I dozed off, just exhausted from all the walking.

SECOND DAY

It was raining when I left the hostel. I originally planned to visit Parc Guell first, but since it was raining, I decided to do the indoor activity first: Casa Batllo. I walked to the metro station again and went to Catalanya to get the tourist bus. Then I went for Casa Batllo. It was a wonderful experience. Gaudi was not just an architect, he was an artist and an explorer. He understood what creation is all about. Beautiful shapes and colors. I want a Gaudian house for myself when I have the money Insya Allah. I was there for two hours. Then I stopped by at La Pedrera, but there was a long queue and I decided to not enter. Then I wanted to go to Parc Guell, but I took the wrong bus and realized too late to change bus. So I went back to the city center with metro and took the bus to Parc Guell with the right tourist bus this time. Well, getting lost is quite inevitable when you travel… It’s a manageable risk.

It was an uphill walk to Parc Guell. But then the whole atmosphere of the park is just wonderful. This place really has a good vibe. Very special. People, this is why you want to visit Barcelona. This park is a treasure… My words can not do justice in describing it. The sun came out, I had ice cream and just explore the park. Surprisingly, in a park that huge, with so many people, I met my Japanese roommates.

Then I went to browse the souvenir shops: a must-do.

Then it’s tourist bus to Catalanya once again and after getting there I walked along  La Rambla, the street full of shops and street performer.

BEAUTIFUL, INSPIRING. It’s a perfect weekend getaway. I’ll let the pictures speak for themselves.

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More pics in the album BARCELONA!!!

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Grey’s Anatomy ep.1 BLOOD SPURTS AND BLACKOUT

April 11, 2007 § Leave a comment

Corry told me about her very first day in surgery rotation. She was in orthopedics and that exact first day also she attended a surgery. And… the job of the co-ass is to hold the foot of the patient. She showed me, she had to lift the whole leg, hold it by the ankle, and make sure it stays in that position so that the surgeon can operate on the femoral area.

And at some point, the surgeon accidentally cut an artery, and the next thing she knew, blood was spurting to her face mask. Of course, it’s the artery!!! She was wearing a protective plastic mask which covers her entire face, so at least it’s safe. She said the blood had spurt 5 times before someone put his finger on the sliced artery to block the leakage. She really couldn’t see anything at that time because of the massive amount of blood covering the mask. And after a while the surgeon yelled, "Can someone please wipe the co-ass mask!!!"

How thoughtful of that surgeon.

Anyway, back to Corry. By then she was covered in blood, and the nurse wiped the face mask. So instead of having red blood spurts on the mask, the wiping spread the blood more evenly on the mask. Then she had to see through the plastic face mask, which by then was pinkish of the thin layer of blood. She said that all she could think of at that time was how she could keep the leg still, otherwise the surgeons wouldn’t be able to fix the leaking artery.

She then felt lightheaded and after a while everything looked darker. And she then asked to the nurses, whether someone can hold the leg for a while. Nobody would, they said she was just spoiled and just couldn’t see so much blood. Corry said to me, "Well, I actually wasn’t seeing blood anymore. I was seeing black." So one nurse took over, and Corry walked out of the room. "I leaned against the wall, I couldn’t see anything, everything was black. And then I actually felt myself sliding down to the floor."

This whole story made me laugh into tears. Seriously.

I told her, " I can totally see this as an episode in Grey’s Anatomy!!!" Blood spurts and Blackout. She seemed to agree on that. We then hypothesized how lightheadedness during procedures is a combination of hypoglycemia and focusing your eyesight too much on one spot for a long time.

can you we recognize our patient today?

April 11, 2007 § Leave a comment

Yesterday, when we entered the room of Mr. Link, we were a bit puzzled. He sat on the chair instead of lying down, the way we remembered him from our visit the following day. Corry did the talking as usual. After we went out we started discussing about how different he looked, and whether or not it was actually Mr. Link. We’re quite confused because he simply looked nothing like the Mr. Link we’d known for several days!!! Could it be someone else? We contemplated on this, because… yeah, mixing up the patient and the room number and the medication can have serious consequences. Well, we checked. It was the right room number, even the right name on the chart by his bed. And… I am very sorry to say this, but my brain still can not register nor differentiate Caucasian male over 70 years old well enough. Meaning for me, all white men over 70 years old looks similar to each other, at least during the first few times I see them. I’m certainly ashamed to expose this, but hey, gotta honest once in a while. Perhaps it was also because in my mind, somewhat I had expected to see a sick old man lying on his back, and now we see this fighter sitting on the chair and having his lunch.

Anyway. Today we went there again to follow up on him. Before entering, Corry said to me, "Let’s see if we can recognize him today!!!" Terrible "joke", but so true, and absolutely funny!!! I mean, yeah… this thing can happen guys…

THE LOOK

April 11, 2007 § Leave a comment

Last month, I had asked BIG BOSS (the boss of both Corry, my supervising resident/tutor, and me) about the possibility of me having a Friday off at the hospital. And she basically told me how interesting all the things I was going to do in the hospital, how everything would be tailored to make sure I can learn as much as possible. And by that she meant "Well, you’re better not have any day off!!!" although she didn’t explicitly say the words. And she was right: everything was so interesting, and I’ve learned SO MUCH. However, me being me, and Barcelona being the city that it is, I simply decided to have a trip there. I’ve been in Madrid in 2005, but Barcelona is… Dunno man, just the thought of visiting the country really makes me excited.

And this weekend is the only weekend when I can go. The flight to Barcelona will be on Friday morning, so for sure I will miss a Friday at the hospital. I decided to book the ticket anyway. And… yesterday, I tried to speak to BIG BOSS about me going to miss a Friday. I didn’t receive the response I had expected. She looked at me with such… disbelief (?) which I can only imagine as exclamation marks without any words spoken. Then she had to leave immediately, so she told me to talk to her more about it later on. I emailed her to explain about the plan and that, well, I’d booked the flight so I would go anyway, and I would be back at the hospital on Monday.

I finally confided to Corry today about BIG BOSS’ reaction yesterday and that I emailed her. I told Corry, "I hope she would just give me a break on this one and let me have a day off."

Corry then, being the nicest most supportive supervising resident said, "Yeah, you deserve it. It’s not much, one day in one month."

YEAH, EXACTLY!!! I wished BIG BOSS was the one saying that.

But then Corry said again, "BUT. There’s something about the way BIG BOSS reacts to what you’re telling her. She would LOOK at you, with her eyes wide open. Like you made a… (trying to find the most appropriate wording)" I suggested "… big mistake???" Corry continued, "… FATAL MISTAKE!!!" That was so freaking true. SO. It wasn’t just me whom she gives THE LOOK to, it’s also Corry, and perhaps just everyone! My gosh… We then had a good laugh about it. BIG BOSS and THE LOOK.

After lunch I got an email from BIG BOSS, and she actually wish me a pleasant trip to Barcelona. So… yeah, somehow, my BIG BOSS managed to be a nice and supportive supervising consultant of infectious disease, and let me have a Friday off. Extreme action needed for extreme plan. And sometimes, it involves enduring THE LOOK that made me feel like I just did a fatal mistake.

Pakistani Journal of Obscure Disase

April 11, 2007 § Leave a comment

The residents seem to enjoy life and funny jokes. One of them is referring to less important medical journals as "The Pakistani Journal of Obscure Diseases". Which of course, DOES NOT exist and is another way of saying that the journal is not an influential one.

What’s a day like

April 10, 2007 § Leave a comment

What’s a day like for me, an Indonesian medical student in a dutch hospital?

Well, first of all, today I a bit unlike other days. I woke up at the normal hour and decided to leave a little earlier for the hospital this morning. Yesterday my bicycle was broken and I left it (to be more precise: I parked it in front of a house) very close to the city center. And… somehow, luckily, there’s a bike shop just across the street from where I parked my bike. So that’s PERFECT! But, I still had to have my bike repaired today because yesterday everything was closed. Packed my daily dutch lunch (which, of course, by definition is sandwich with cheese).

Anyway, so I left early and walked to the hospital. And… met an infectious disease resident who tutored my research proposal group in my first course. And he had a fantastic news (apart from the fact that he’s TANNED, BROWNISH, and HAPPY, just getting back from a week holiday in Portugal), that he’s going to SUMBA, INDONESIA for ten days next week for a research. That is so cool. I hope he’ll have the chance to enjoy Bali and Lombok.

And, after a little chat I went to see my resident, my FAT MAN (Sorry guys, this is a HOUSE OF GOD reference once again, and not the last I’m afraid), Corry. She updated me on the new patients, and we had a short discussion with dr. Monique, the supervising consultant of the day, about a new consult patient. She’s admitted with pneumonia and the internal medicine was questioning the possibility of her having TB and had to be put in isolation for fear of aerogenic transmission in the ward. Corry again informed me about a newly admitted patient and his test result and what I should know and what I should not mention to anyone.

Anyway. Then we started to go around and see the patients. Corry had thought that today’s gonna be a busy one because she’s covering for Ralph, another resident whose on holiday. And I was alive and kicking, hot and ready, and totally prepared for THE BUSY DAY, as I had a very laid-back long weekend without much activity, physically nor intellectually. And… We did go around (visit and discuss patients in cardiology and general internal medicine) until 13.00, during which time Corry managed to stop herself from excessive work and let us have some proper lunch time.

Oh yeah, when we visited patients, I went to see them with Corry, and pitched in for auscultation sometimes, and patiently waited and paid attention when Corry talked to the patients in DUTCH. So… I am able to recognize words like pain, days, references to date, time, place, or picked up dutch words similar to english… but otherwise, I have to wait until we left the room and have Corry tell me all of what they’re talking about.

After 30 minutes of luch break, we went to the microbiology meeting, where the infectious disease people and the microbiology people meet daily to discuss the patients, their culture results, their antimicrobial sensitivity and new symptoms or signs, and the plan: further diagnostic tests, antibiotics, stop antibiotics etc. This one is conducted in english due to my presence.   

After the microbiology meeting (which lasts about 1 hour), we went again to see more patients in orthopedic ward. We then went to see a patient in the out-patient department (poliklinik), to see one patient and confirm a Mantoux test she took last week.

Then we went back (again! Today is so relaxed…) to Corry’s office for a tea break. Wow. This is luxury I must say. I left Corry for a while to see Dr. Barten, and got some homework, more stuff to write. Good news: no more abstract submission with crazy deadline; challenging news: to finish a first draft of the whole paper, about 5000 words, before I return to Indonesia.

Then… Corry and I went to the ICU to see some patients, and after that head back to Corry’s office to finish off the day. We then had a short talk about DNR (Do Not Resuscitate) consent here in Netherlands, and what the situation is like in Indonesia. And… yeah, it’s different. Maybe more about this in later time.

Then. Precisely at 17.00 I left the hospital to get my bike from where I left it the other day and have it fixed. STUPIDLY, I left my wallet at home today, and I had NO MONEY TO TAKE THE BUS. Well, actually, it’s 30 minutes on foot, but let me tell u, it was a very long 30 minutes walk! I had no luxury to go slow this time, as the bike shop will be closed at 18.00. So I rushed a bit, and finally found my poor bike (cold, alone, and abandoned for two days) and took it across the street to the bike shop (I told you, by chance it was broken very close to a bike shop). The chain was completely messed up and it would cost 15 euros. Hah. Never mind…

And… I walked back to my place because the bike will only be finished tomorrow afternoon. I even had to cancel a dinner appointment because I had been too tired to walk to the cafetaria. I just wanted to get home, sit down and have dinner!!! It’s been a long day… 

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Ajeng. Nijmegen, 10 April 2007. Http://docere.antiblog.com

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