I stand alone, horrified at the scene of depravity before my eyes. Every breath I take I smell the scent of fear and sadness. I close my eyes but cannot block out the cries of those who weep and gnash their teeth.

With fumbling steps, I try to make my way out of that wretched abyss, but alas, it’s too late, for he has locked me in his gaze, and now makes his way towards me, ready to ask me about differential diagnoses and critique my history-taking techniques.

I am in the hospital ward as a third year medical student and HE is approaching.

He is an associate professor in Surgery. He splices skin with his scalpel and cuts egos with his tongue. His cold, lifeless eyes would make Professor Snape blush, his pupils reflecting the fiery glow from the flames that he has for a moustache.

Where he walks, those brave enough to remain are reduced to whispers of terror, while those smart enough to run away never return.

I will call him Mr X because he might know where I live.

My very first clinical teaching session was with Mr X on a gloomy Monday morning, a day when even the sun was afraid to come out.

Mr X likes to start his day early and as a result, we were there at 7.30am, a time which I never knew existed.

Somehow, we ended up on the subject of right iliac fossa pain (pain in the lower right part of your stomach).

“So, what’s the differential diagnoses for right iliac fossa pain?”, asked Mr X, as he slowly stroked his tie, the source of all his powers. The fear and the heat from his Fiery Moustache made us sweat.

Immediately remembering a hastily read paragraph in a forgettable textbook, I blurted out “Appendicitis!”

“Okay, and what are the causes of appendicitis?” asked Mr X again, this time letting his tie hang loose, a sign that he was relaxed.

This was entering dangerous territory. Causes? I could only remember one.

“Inflammation!” I cried. Like a dying mother bargaining with Death to let her see her child one last time, I was stalling for time.

“I know it’s inflammation! Quit stalling!” roared Mr X, as he looked around my group members, stroking his tie with renewed vigour.

My group members, showing deep loyalty as medical students, laughed at me. My good friend Chris, who is eternally superior in brainpower, shook his head sadly.

I began to panic. He can read my mind!

“Uh… is it due to hardened faeces trapped in the appendix?”

That was it, the tank was by now truly empty. I looked to my other groupmates in desperation. Chris furrowed his eyebrows, mentally comparing my intelligence to that of a rambutan.

Mr X looked at me as one would at a dog with rabies. He smelt blood. ”Okay, but what is the most common cause of appendicitis??”


“Come one now, don’t waste my time!!” he roared with the intensity of a ship’s foghorn. In the adjacent ward, seven people died. Half my group members defecated on the spot. I remember thinking, “okay so at least they don’t have hardened faeces.”

I looked at Chris. He did not return my gaze. He looked very sad and disappointed, like he was at a funeral.

“My goodness, your basic pathology is atrocious! Fine, let’s forget about the appendix. What are the other differentials for pain in the right iliac fossa?”

By now he was tugging on his tie so hard, he was basically strangulating himself. I was wondering what I had done to deserve such treatment. His tie was probably wondering the same.

Still blank.

“So right iliac fossa pain is ONLY indicative of appendicitis, is it? The one and only organ in the right iliac fossa is the appendix and nothing else, is it? No nearby intestines, stomach, fallopian tubes, nothing of that sort ,yes?”

At this stage, I myself began to develop acute appendicitis. For some strange reason, Chris began stroking his tie.

“You’re as useless as a geriatrician in the paediatrics ward! Okay, you!” said Mr X, pointing at Chris. “Prove to me that you are not all idiots.”

Chris smiled as if he was appointed the new owner of the Playboy Mansion, and began a long monologue lasting for almost 10 minutes on the wonderful pathology of appendicitis, the aetiology, clinical features, investigations and management and then continued with a comprehensive list of the causes of right iliac fossa pain.

When he finished, the people who died in the adjacent ward came back to life, awed by the brilliance of his delivery and the whole room erupted into a standing ovation, with the exception of Mr X, who remained seated and looked down at his tie and said: “Okay, fine.”

It has been many years since I last saw Mr X. One of my favourite quotes from him was: “Remember, you give your patients the first opinion. If your patients want a second opinion, make sure you are the one to give it also”.

What an unforgettable character. Every year, he inspires more and more students to become surgeons.

Many who do become surgeons credit Mr X as an inspiration. I too, at one point, was supremely interested to become a surgeon but alas, I couldn’t grow a moustache. But many in my group wanted to be surgeons.

But not Chris.

Chris went on to become a rheumatologist. What a wuss.

Dr Jason Leong is a comedian. Follow his madness on his new YouTube channel (!

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