03-04-2025
THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HER SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR PATIENT'S PROBLEMS THROUGH SERIES OF INPUTS FROM AVAILABLE GLOBAL ONLINE COMMUNITY EXPERTS WITH AN AIM TO SOLVE THOSE PATIENT'S CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUTS.
[03-04-2025 22:33] PA: Sir, ami nijer akta case history lekhar chesta korechi . Seta ei group a pathalam
[04-04-2025 07:00] PPM 1: Thanks. Please share the above hand written version in text if possible for our case reporting team as hand written version will be difficult for them to google translate and understand. Also handwriting is a potential patient identifier and can compromise her confidentiality.
Please don't address the patient by name or share any of her identifiers here.
After reading the hand written note I have provided a brief summary in the title
[04-04-2025 07:01] PPM 1: Any clinical images of her hair fall areas of the scalp would be useful
[04-04-2025 09:24] PA: Okay
[04-04-2025 11:55] PA: Particulars:
Age: 24 years
MBBS Student (Final Year)
Residence: Coochbehar, West Bengal (Currently living in College Hostel, Kolkata)
Complaints:
1. Gastrointestinal Issues:
Frequent abdominal pain, bloating, acidity, and loose stools. A slight change in dietary routine triggers these symptoms.
Symptoms have been present since adolescence but have worsened in the past few years.
Diagnosed with Irritable Bowel Syndrome (Diarrheal type) in 2024.
2. Recent Symptoms (Last 15 Days):
Feeling of stomach fullness in the evening, lasting through the night, along with loss of appetite.
Symptoms appeared during final-year exams (ongoing for the past month).
Slight relief with PPIs.
3. Headaches:
Frequent headaches, primarily in the evening.
4. Psychological Issues:
Experiencing depression for the past five years, since entering medical college, mainly due to academic struggles.
Symptoms have worsened significantly over the last year.
Difficulty concentrating on studies or engaging in previously enjoyable activities like drawing or writing.
Increased mobile phone addiction since entering medical college.
Experiencing suicidal thoughts.
5. Polycystic Ovary Syndrome (PCOS) (Diagnosed in 2017):
Menstrual cycles were usually regular but have become irregular over the past three months.
Associated symptoms: Acne, male-pattern hair loss, and facial hair growth (male-pattern hirsutism).
6. Vision Problems:
Diagnosed with myopia.
Last power and retinal check-up was in May 2024.
Current Power:
Right Eye: -4.25 (S), -0.75 (C)
Left Eye: -3.75 (S)
Medications:
1. Propranolol 10 mg BD – Taken for the past month for exam-related palpitations. Stopped two days ago after the exams ended.
2. Escitalopram 10 mg – Taken at bedtime for the past 15 days under psychiatric guidance.
Daily Routine (Mostly):
9 AM: Wake up, freshen up, have breakfast.
1 PM: Lunch, followed by bathing.
4 PM: Evening nap.
7 PM: Tea and evening snacks.
10 PM: Dinner.
2 AM: Sleep.
[04-04-2025 12:32] PPM 1: Well written @~PA 👏👏
[08-04-2025 08:48] PPM 1: Residency welcome note from a final year student:
"Over these years, these young men and women will be challenged working long hours, bearing witness to how the title “resident” originated. They will be doused by every type of bodily fluid. Through study and direct experience, they will confront the nuances, surprises, and tragedies of human illness. They will meet patients who will leave a mark on their soul. Through it all and with time, the young resident fundamentally changes into a different type of person altogether. Residency training is a journey of a thousand miles, with the very first step taken on that fateful first day of joining!
And how could this process be anything less than transformational? It is, after all, the most profound vulnerability of the human condition that medicine seeks to address — that of injury, disease, and death. In the grip of such vulnerability, patients seek trustworthy advocates that they can turn to for help. And while learning is life-long, it is in residency training that the aspiring clinician first acquires the techne of medical practice.
They will feel something that cannot be explained in technical language, and in many ways it will remind them of what drove them to pursue medicine in the first place.
Unfortunately, residency training brings with it distractions—prioritization of efficiency, the so-called “hidden curriculum”, and systemic barriers—all of which can obfuscate the true focus of the physician’s practice, the patient. This has been described in the literature as moral injury or moral erosion. Therefore intentional practice, guided by mentors whom one wishes to emulate, is of paramount importance.
Enjoy the journey
The adage that “the days are long, but the years are short” is true. The road will be tough but set aside moments to reflect and commend yourself on how far you’ve come. In training as physicians we have the privilege of joining a beautiful tradition, refined over millennia, and experience humanity in a way that very few people do
For @~PA who is also a writer and I'm sure she will have better experiences than the one written above to share with us eventually very similar to @~~PPM3 @PPM4 @PPM5
[08-04-2025 10:32] PPM 3: Sometimes, I feel scared of how I will survive prospective residency, but then my conscious mind answers:
1. You will have friends, family and mentors to support you
2. You would be doing something you are passionate about, so at least the tiredness would be a result of doing something you love ☺😄
3. on tough days: have a scoop of ice cream and follow “Ignorance is the bliss”
[08-04-2025 11:45] PPM 1: 👏 @~PPM 6 can you facilitate the file and patient transfer to dermatology now? She's in medicine OPD
[08-04-2025 11:48] PPM 6: Yes sir coming
[08-04-2025 16:14] PPM 1: Please prepare her discharge and complete her formalities today as they will leave by tomorrow morning
[08-04-2025 17:13] PPM 6: Okay sir
[14-05-2025 20:10] PPM 1: Any updates from this patient's advocate?
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