final exam

Final Exam is a searing indictment of the way in which the medical establishment often fails to provide palliative care for dying patients. The introspective Chen puts her own behavior under the microscope as well; she admits that she has avoided giving her dying patients the time and treatment that might have made their final days more meaningful and less painful.

Medicine is "a profession made attractive by the power to cure," says Chen. Few medical students yearn to care for the dying. However, as the population ages, more and more people will pass away after a prolonged illness. Physicians play a role in "shepherding the terminally ill and their families through the intricacies of the end." Chen calls this ability to help guide patients through end-of-life illnesses their "final exam." Unfortunately, most doctors, until now, would earn a failing grade.

There are a number of obstacles that prevent physicians from helping and comforting the terminally ill: many physicians (and laymen) have an aversion to death; some doctors believe that getting too emotionally involved with patients may lead to a loss of objectivity; since medical schools have traditionally avoided discussing end-of-life care with their students, most doctors are poorly prepared to deal compassionately with their dying patients. Fortunately, new programs are being established in a number of medical schools across the country that, one hopes, will help doctors treat both the living and the dying with equal skill.

Final Exam is divided into three sections: "Principles" describes how medical school teach their students to approach death; "Practice" shows how the clinical work that a doctor performs each day influences his attitude towards death; "Reappraisal" is Chen's look at some hopeful signs that end-of-life care is at last being taken seriously in medical schools and hospitals.

Chen culls examples from her fifteen years of clinical experience to illustrate her points. There is a haunting anecdote about Joseph and Juliette, an elderly couple who had been married for over fifty years. They were childless retired teachers and virtually inseparable. When Juliette developed an intractable pneumonia during a frigid Chicago winter, Joseph was bereft. He stood by helplessly while his beloved spouse deteriorated. Juliette passed away after futile antibiotic treatment, dialysis, and the use of a ventilator left her little more than a shell of her former self. Juliette's doctors edged away from her more and more as her condition worsened. When his wife died after nearly four weeks in the hospital, eighty-five year old Joseph shuffled off alone, with no one to offer him consolation or guidance. Juliette's physicians lost interest in her case when they saw that they could not save her.

"Preparing for death may be the most difficult exam of all, but it is one that will, finally, free us to live." What will help physicians pass this final and extremely important test? There are some promising ideas that are changing the face of patient care. Specially trained doctors and nurses will routinely discuss diagnoses, prognoses, and treatment with dying patients and their families. When a patient is clearly failing, the medical team will provide palliative care to relieve the patient of her physical pain. The team will also discuss with the patient and her relatives what options they have to make her last weeks more comfortable. Although Chen's prose is elegant and heartfelt, Final Exam is not easy to read because of its bleak subject matter. However, it is necessary for all of us to be more aware of how we, as a society, have failed to treat our dying with the love and respect that they received when they were healthy and fully productive members of their communities.

Problem coming up today......and i cant say it.....i hv health problem...and i just been FUCK UP from my living....that is the first time i say that words.....i cant control myself......because it been six years i have overload this problem....this gave me hot temple and high presure.....i cant sleep, cant think very well and cant do any thing properly.....this problem is vry dangerous....that i know......it really make myself have mental problem and brain damage....
that is my terrible life everyday.....

Shot cop to be questioned
By ANDREW SAGAYAM
saggy@thestar.com.my

KUALA LUMPUR: The policeman who was shot three times in the heist at the KL International Airport will be questioned over the incident.

Inspector-General of Police Tan Sri Musa Hassan said they would talk to L/Kpl Zainuddin Mat Isa, 39, to gather more information on the RM3.5mil robbery near the departure hall.

“The policeman is now warded at the Putrajaya Hospital and we will record his statement as soon as he recovers,” Musa said, adding that a manhunt has been launched for the robbers.

L/Kpl Zainuddin, from the CID division of the Putrajaya district police headquarters, was shot in his left thigh and in both hands.


Damaged: An MAB employee informing his superiors of the damage to the glass panel at KLIA yesterday. It was hit by a stray bullet in shootout between security guards and armed robbers on Thursday.
Musa also said that he had ordered the Internal Security and Public Order Department to beef up police presence at KLIA.

“There will be 12 General Operations Force personnel on 24-hour guard at the departure and arrival halls at the airport,” he added after signing a memorandum of understanding between Universiti Malaysia and the police on crime and law courses for police officers in Bukit Aman yesterday.

In the 7.30pm incident on Wednesday, six armed robbers shot five people in the three-minute heist and escaped with S$1.5mil (RM3.5mil).

Two moneychangers were walking to Gate 8 with the cash with two security guards when six robbers armed with two automatic pistols confronted them outside the automatic door

They shot at the thighs and legs of the four men. A Nepali worker who was on a flight back to Nepal was also shot in the leg.

Meanwhile, Transport Minister Datuk Ong Tee Keat said the robbery happened in a public area and could not be considered a breach of security at KLIA.

“Therefore MAB (Malaysia Airport Bhd) is not responsible. It is a public matter for the police. MAB will give full cooperation in the investigations,” he said.

life in traning

Minute to Minute...

Time to Time......

Day to DAY.......

Week to week....

Before i start my traning ,there is a first thing i have to face is not to fear in traning.....if i fear during traning there will be a problem going on during traning......

In every traning start living, there were be a thing that i will know is either.................................................................................>>>>>>press this that below or copy ..paste...



THIS





http://www.youtube.com/watch?v=mOX3OmUhQoo


VIDEO A




OR



THIS





http://www.youtube.com/watch?v=x4jEEbE-fkA

VIDEO B

That my life of traning.....BUT if i enjoy my traning V-B will be easy for me ......



This is bout my traning life.....