watching you, watching me

Illusions

2012-02-01T22:58:00.000+08:00

“The only obsession everyone wants: Love. People think that in falling in love they make themselves whole? The platonic union of souls? I think otherwise. I think you’re whole before you begin. And the love fractures you. You’re whole, and then you’re cracked open.”

Philip Roth

Sabbath

2012-01-30T17:47:00.007+08:00

Last Saturday night was a struggle. After all, Sunday was coming.

Sunday was to be the day where my friends were going to be all trooping down to the National Cancer Centre for revision lectures. Excellent lecturers with great enthusiasm for teaching were going to dedicate their Sunday morning and afternoon to give us a breakdown on difficult topics that were going to come out for the upcoming finals. Nearing the finals, exam tips are bound to leak out, hints thrown into the audience.

But, Sunday is church day. It has always been. Service was to start at 8am as usual. The youth had planned for Chinese New Year visiting and my cell group was planning to go visit Crystal's house to play Kinect.

The decision was clear in my mind. From the start, I resolved never to skip church to study. But then, I thought how illogical it seemed, to pass up on good teaching just to hang out and play kinect? We weren't even going to do anything hardcore like bible study. Even if I were absent from church, everything would still go on as usual. If I don't go for service, I can sleep in till 9am, compared to 7am to wake up in time for service...Or maybe I could go for service first...and then hurry off at 9:30 to reach NCC by 10am? It's just CNY visiting anyway...I tried to rationalize it in my mind, but deep inside knew that I was making excuses for myself.

Sunday came, and I made the decision to pass up on the revision lectures. I confess that it was no more than half hearted as I woke up at 7am to get ready.

As I slouched into the chair, the preacher began to speak on the Sabbath of the Lord. Why sabbath?

To remember, how God saved his people from slavery to freedom (Exodus 16)
To keep it holy, acknowledging how God sanctified and blessed the seventh day (Gen 20:8-11)
To worship, through imitating God in resting on the seventh day
To rest, from endless labour and striving, knowing that God is our provider and security comes from Him alone
As a sign, of the covenant between God and his people to the surrounding nations (Exodus 31:12-18)

As MBBS draws nearer, I'm thinking that seeing that 1 more patient with good signs or going for that 1 good lecture is not going to do very much to save my ass if I am already doomed. I am convinced however, that every decision I made to choose other things over my own spiritual walk will be of great detriment to my well being. It will only get tougher, and I can only ask for lots of prayer, encouragement and discipline.

Anyway, Kinect was pretty funny :D

Stirring up dust

2012-01-20T18:50:00.004+08:00

Just spent the last hour tuning my violin instead of being at Prof L's revision lecture. URTI has gotten the better of me, so decided to stay home to do something therapeutic and recuperate for the upcoming festive season. My fingers hurt like crazy now I don't know how I'm going to play for church tomorrow.

Anyway I went for my pre-employment health check up at the designated clinic in Paragon. Besides the prime location there was nothing very prime about it. Looked like any old cramped neighbourhood clinic. The attending doctor dressed like a gypsy. The cursory abdominal examination was very ticklish. Makes me really amazed at how our patients stand all that pressing!

Milestone

2012-01-19T22:41:00.002+08:00

Remember this post where I remarked about how unromantic SJ was in not doing anything fancy for our anniversary?

Well, this year, the 5th of January came...and went! And even I didn't realize it. I don't even remember what I did that day.

Wow, I have truly achieved girlfriend nirvana. -impressed with self

48 days

2012-01-17T19:02:00.004+08:00

I'm thinking how this might possibly be the best time of our lives. We have enough knowledge to appreciate what goes on in the acute management of a patient, probably enough skills to get by as a junior doctor, and have some insight into the planning and execution of medical treatment. Yet, we have absolutely no responsibility, have the liberty to wake up at 9am and decide to miss the first class, leave the hospital at 2pm and have an extended lunch break at Coffee Bean. Sitting in the cozy new Medical Library sipping kopi-O and eating snacks while reading leisurely sure beats running around writing discharge summaries and clerking new admissions. If not for the dark cloud that is the MBBS looming over our heads, this might actually be a phase of life I would love to stay in for a prolonged period of time.

Nonetheless, the future beckons.

APMEC 2012

2012-01-14T13:31:00.003+08:00

KQ and I made both made presentations at this year's APMEC yesterday, joining the ranks of of those nifty people wearing name tags and eating free food amongst gentlemen wearing suits and speaking in foreign accents. While it wasn't anything to rave about, it was a nerve wrecking enough experience, having to speak before an audience who were ready to critique and question your topic of choice. Still, I think the fact that we clearly introduced ourselves as Medical Students gave us some leeway from time to time.

What was interesting about this conference was how impressed both of us were at the amount of passion that all the conference participants demonstrated towards education. We met doctors, educators, academics, researchers and psychologists, all meeting together in the name of educating a future generation. As medical students, all this talk was certainly mindblowing. People were investing tremendous amounts of time and money into developing teaching methods, simulators, analysing past errors and designing new constructs to better teach the junior medical faculty - the entire conference was about us! It was all very inspiring and humbling at the same time. I almost felt embarrassed each time as speakers shared about struggles they faced in the classroom. Oops, that sounds like me!

All my life I've always viewed teaching (in the classic classroom Teacher way) as a very noble calling. I always dreamt of becoming a teacher day, until the day I found how how bitchy students got when talking about their teacher's behind their backs. Taking on the title of an educator is no simple undertaking. Still, I hope to be able to be part of a teaching faculty in the future, but for now, I'll need to learn how to do so.

Thought

2012-01-09T21:09:00.003+08:00

I am the kind of person who will appreciate a big smack when I am moping around feeling emo. Tell me to WAKE UP YOUR IDEA and solve the problem. A good friend will tell me that I am being stupid, wasting time, and not being productive. Then I will be okay.

That said, I must realize that not everyone is the same.

Shit happens

2012-01-08T22:04:00.002+08:00

(Source)

Dealing with each lemon as they come. Lemonade, coming up!

Tea Session

2012-01-07T16:50:00.003+08:00

Everyone had been talking about all these residency "tea sessions" to which they had been cordially invited to, described as an interactive session to meet the faculty and clarify doubts. The more unassuming candidates were often surprised with having to participate in awkwardly disguised group interviews or in your face one-on-one discussions revolving around the candidate's curriculum vitae.

So when I signed up for the NHG Internal Medicine open house a few weeks back, I had some impression that it might end up as such, and made a mental note to prepare for an interview beforehand. At the same time, I also knew at the back of my head that it was very unlike Prof K to send out an invitation for something which was not. It was just not...her style. Nonetheless, it was something that I knew I needed to anticipate and prepare for.

Procrastination got the better of me until last night when I realized that I hadn't thought through it at all! In light of my sleepiness and the allure of my warm bed, I decided to trust my instincts, and put my faith in the integrity of Prof K. If she says its an open house, it must be just an open house. I went to bed, and headed out for the open house this morning - completely unprepared.

When I reached TTSH in the morning, I was once again bombarded by horror stories of how tea sessions morphed into grilling sessions and scrutiny of research papers. When my friend started grilling me mock interview questions which I hadn't prepared for, I felt completely unprepared and defeated. I didn't even bring a copy of my CV!

2pm came. It was slightly awkward in the beginning, when everyone was standing around having lunch while waiting for the program to begin. Everyone was expecting some sort of breaking into groups, waiting areas, and interview panels. Then...Prof K made an announcement.

Hi everyone! The program will begin shortly! Will you kindly make your way into the conference room? You should have been given a table number already, please sit accordingly.

Doom. Table numbers? Interview groups? I thought that was the end. Going for an interview unprepared is a terrible terrible thing to do.

We all settled into our tables. And as my mind was running through how I would answer standard interview questions, Prof K came up again to make an announcement.

Ok everyone, thank you for joining us today! Today's session will be completely informal and is purely for you to ask questions and clarify any doubts. Please make yourself as comfortable as possible, and if there are any questions, the faculty will be around to answer your queries. Please go ahead!

Really?

And the session went on as described in the email. A meet-the-people session, to meet the program directors and core faculty members. No frills, no loaded questions, no empty promises, no contrived answers and a very cute Dr L. It was an honest discussion on the limitations of the residency matching system, and how best to improve one's chances without violating MOHH regulations. Dr L made everyone feel very comfortable and it really reminded me of the feeling I had when during one of Prof Low's MBBS revision lectures and someone had arrived late midway and walked in midway into the lecture hall. He was greated by Prof Low's very warm "Welcome home!" Such love.

Just some thoughts for today. (:

Overrated Coffee, don't bother

2012-01-01T16:59:00.003+08:00

(via enticingtimes)

Dimbulah
(60 Robertson Quay, #01-07 The Quayside)

Boomerang Bistro and Bar

(60 Robertson Quay #01-15 The Quayside)

Papa Palhetta

(140 Bukit Timah Road)

My dysfunctional CG mate

2012-01-01T13:20:00.002+08:00

Happy New Year Pull Your Ear

2012-01-01T11:24:00.005+08:00

Apologies for the lack of activity on this space. My word-finding ability fails me as to how I wish to express my thoughts in a place like this. As the year draws to a close, and with the new one a fresh beginning, I realized that I have blogged an embarrassing total of 75 times this year! Going through them does bring back certain memories though.

The year started sluggishly and I wrote a seemingly bitter new year entry, in the company of lots of pathology specimens. We were studying through the festive season, again. Well, it was certainly not without company, and I am thankful for library dwellers over every mugging season. Then came the highlight of our years in medical school. My electives were a blast, and I don't think I would have done it any differently (Ok, maybe just slightly). I met the most awesome doctor who taught me real medicine and showed me what it meant to add life to days. The month of May was spend in a faraway place, which was essentially an extended holiday under the guise of an elective placement at the St. Thomas Hospital, London. This was closely followed by exciting times travelling in Europe during which I got to spend time with friends whom I have grown to treasure.

Starting the final year was not easy. I wrote a code of ethics, of which I confess not to have fulfilled faithfully, especially when the 1st two weeks of Paediatrics threw me challenges that I did not have the moral courage to handle. We quickly hurried on to the internships, during which I had my own fair share of magic moments, learnt to eat breakfast, and also when my inadequacies were made most apparent to me. Still, there was lots of joy and grace to be thankful for. In the process of final year, I was angry at things that I didn't know how to articulate, yet continue to forgiven by people who love me. In September, my CMPS patient passed on, and I attended his funeral. I last saw him on the Thursday before he passed away.

99 days, and now 64 days. While MBBS continues to be the thing that hovers ominously over this new year, there are so many more things that lay the setting for this one big hurdle that I need to cross. Mum who cooks yummy nutritious food, Bros who crack me up with stupid jokes and friends who share this arduous journey.

Anyway just for the record, my brother almost died on the last day of 2011! 3 stitches to the head, an ATT injection and 100mls of blood loss. Still, God is faithful, and 2012 will be testament to that.

In Order of Merit

2011-12-26T15:29:00.003+08:00

Toby's Estate

(8 Rodyk Street, #01-03/04)

Jones the Grocer

(333A Orchard Road, #04-21/23 Mandarin Gallery)

Smitten Coffee and Tea Bar

(60 Robertson Quay, #01-11 The Quayside)

Forty Hands

(Blk 78 Yong Siak Street, #01-12)

Port Wine Stain

2011-12-18T23:06:00.004+08:00

Whilst studying Paediatrics, I was reminded of the good days in Porto. Nevermind the bilateral ptosis and bugs bunny teeth, next holiday please!

Meet Sam

2011-12-11T23:05:00.001+08:00

I want to meet you in my dreams, too.

Short Case

2011-11-28T19:19:00.005+08:00

So today I got owned for short case again. And I can totally imagine this happening during the actual MBBS. Generations after generations have said, practice practice practice, that is the only way you will pass your MBBS. It is times like this that I wonder what use it is of seeing a gazillion patients a day, practising the drills, getting grilled by mock examiners, only to get completely owned on the day of your exams because there was not enough time, or the patient was not cooperative, or the examiner hated the way you said coarse creps instead of just creps. How about the hundreds of patients with murmurs that you've brilliantly rehearsed through, only to culminate in a grade 2 mid diastolic murmur in the exam hall?

The examination is a show. First the dance. Then the song. Then the antagonist appears. What happens next? Does good always triumph over evil? I certainly hope so, but we all know that Dumbledore inevitably dies. There is no other way.

99 Days

2011-11-23T20:59:00.003+08:00

I haven't started panicking yet, and I think maybe I should. Treasuring the last bits of random happiness as a student for now. (:

Confused.

2011-11-21T20:32:00.001+08:00

How do you know if someone is just being condescending?

How do you know if someone is just playing along until the time is ripe?

How do you know someone's heart?

TMS

2011-11-18T23:43:00.003+08:00

In my last ditch attempt to study for the upcoming Bible Quiz in church this Sunday, I was rewarded with 3 stories that really blessed me.

Story #1: 1 Kings 19:11-13

11 The LORD said, “Go out and stand on the mountain in the presence of the LORD, for the LORD is about to pass by.”

Then a great and powerful wind tore the mountains apart and shattered the rocks before the LORD, but the LORD was not in the wind. After the wind there was an earthquake, but the LORD was not in the earthquake. 12 After the earthquake came a fire, but the LORD was not in the fire. And after the fire came a gentle whisper. 13 When Elijah heard it, he pulled his cloak over his face and went out and stood at the mouth of the cave.

Then a voice said to him, “What are you doing here, Elijah?”

Thoughts: God doesn't reveal himself in the spectacular message-from-sky way that we often expect, but instead in the form of a gentle whisper. Soft, but personal and intimate.

Story #1: 1 Kings 17:7-24

7 Some time later the brook dried up because there had been no rain in the land. 8 Then the word of the LORD came to him: 9 “Go at once to Zarephath in the region of Sidon and stay there. I have directed a widow there to supply you with food.” 10 So he went to Zarephath. When he came to the town gate, a widow was there gathering sticks. He called to her and asked, “Would you bring me a little water in a jar so I may have a drink?” 11 As she was going to get it, he called, “And bring me, please, a piece of bread.”
12 “As surely as the LORD your God lives,” she replied, “I don’t have any bread—only a handful of flour in a jar and a little olive oil in a jug. I am gathering a few sticks to take home and make a meal for myself and my son, that we may eat it—and die.”

13 Elijah said to her, “Don’t be afraid. Go home and do as you have said. But first make a small loaf of bread for me from what you have and bring it to me, and then make something for yourself and your son. 14 For this is what the LORD, the God of Israel, says: ‘The jar of flour will not be used up and the jug of oil will not run dry until the day the LORD sends rain on the land.’”

15 She went away and did as Elijah had told her. So there was food every day for Elijah and for the woman and her family. 16 For the jar of flour was not used up and the jug of oil did not run dry, in keeping with the word of the LORD spoken by Elijah.

17 Some time later the son of the woman who owned the house became ill. He grew worse and worse, and finally stopped breathing. 18 She said to Elijah, “What do you have against me, man of God? Did you come to remind me of my sin and kill my son?”

19 “Give me your son,” Elijah replied. He took him from her arms, carried him to the upper room where he was staying, and laid him on his bed. 20 Then he cried out to the LORD, “LORD my God, have you brought tragedy even on this widow I am staying with, by causing her son to die?” 21 Then he stretched himself out on the boy three times and cried out to the LORD, “LORD my God, let this boy’s life return to him!”

22 The LORD heard Elijah’s cry, and the boy’s life returned to him, and he lived. 23 Elijah picked up the child and carried him down from the room into the house. He gave him to his mother and said, “Look, your son is alive!”

24 Then the woman said to Elijah, “Now I know that you are a man of God and that the word of the LORD from your mouth is the truth.”

Lesson Learnt: What?! You mean the woman didn't think that Elijah was a "man of God" when her jar of flour and jug of oil did not run out? She was already at the point of death! It was at the point of her son's life returning that she realized the work of God. How blind we are to the miracles that happen around us. How blind we are indeed.

Story #3: 1 Kings 21:1-26

1 Some time later there was an incident involving a vineyard belonging to Naboth the Jezreelite. The vineyard was in Jezreel, close to the palace of Ahab king of Samaria. 2 Ahab said to Naboth, “Let me have your vineyard to use for a vegetable garden, since it is close to my palace. In exchange I will give you a better vineyard or, if you prefer, I will pay you whatever it is worth.”
3 But Naboth replied, “The LORD forbid that I should give you the inheritance of my ancestors.”

4 So Ahab went home, sullen and angry because Naboth the Jezreelite had said, “I will not give you the inheritance of my ancestors.” He lay on his bed sulking and refused to eat.

5 His wife Jezebel came in and asked him, “Why are you so sullen? Why won’t you eat?”

6 He answered her, “Because I said to Naboth the Jezreelite, ‘Sell me your vineyard; or if you prefer, I will give you another vineyard in its place.’ But he said, ‘I will not give you my vineyard.’”

7 Jezebel his wife said, “Is this how you act as king over Israel? Get up and eat! Cheer up. I’ll get you the vineyard of Naboth the Jezreelite.”

8 So she wrote letters in Ahab’s name, placed his seal on them, and sent them to the elders and nobles who lived in Naboth’s city with him. 9 In those letters she wrote:

“Proclaim a day of fasting and seat Naboth in a prominent place among the people. 10 But seat two scoundrels opposite him and have them bring charges that he has cursed both God and the king. Then take him out and stone him to death.”

11 So the elders and nobles who lived in Naboth’s city did as Jezebel directed in the letters she had written to them. 12 They proclaimed a fast and seated Naboth in a prominent place among the people. 13 Then two scoundrels came and sat opposite him and brought charges against Naboth before the people, saying, “Naboth has cursed both God and the king.” So they took him outside the city and stoned him to death. 14 Then they sent word to Jezebel: “Naboth has been stoned to death.”

15 As soon as Jezebel heard that Naboth had been stoned to death, she said to Ahab, “Get up and take possession of the vineyard of Naboth the Jezreelite that he refused to sell you. He is no longer alive, but dead.” 16 When Ahab heard that Naboth was dead, he got up and went down to take possession of Naboth’s vineyard.

17 Then the word of the LORD came to Elijah the Tishbite: 18 “Go down to meet Ahab king of Israel, who rules in Samaria. He is now in Naboth’s vineyard, where he has gone to take possession of it. 19 Say to him, ‘This is what the LORD says: Have you not murdered a man and seized his property?’ Then say to him, ‘This is what the LORD says: In the place where dogs licked up Naboth’s blood, dogs will lick up your blood—yes, yours!’”

20 Ahab said to Elijah, “So you have found me, my enemy!”

“I have found you,” he answered, “because you have sold yourself to do evil in the eyes of the LORD. 21 He says, ‘I am going to bring disaster on you. I will wipe out your descendants and cut off from Ahab every last male in Israel—slave or free.[a] 22 I will make your house like that of Jeroboam son of Nebat and that of Baasha son of Ahijah, because you have aroused my anger and have caused Israel to sin.’

23 “And also concerning Jezebel the LORD says: ‘Dogs will devour Jezebel by the wall of[b] Jezreel.’

24 “Dogs will eat those belonging to Ahab who die in the city, and the birds will feed on those who die in the country.”

25 (There was never anyone like Ahab, who sold himself to do evil in the eyes of the LORD, urged on by Jezebel his wife. 26 He behaved in the vilest manner by going after idols, like the Amorites the LORD drove out before Israel.)

Lesson Learnt: Wives may be truly capable, but not always trustworthy. :p

Love the Lord your God

2011-11-12T22:43:00.002+08:00

Reminder from an online sermon recently. Israel was called to listen and trust, not to find security in what is seen.

Question

2011-11-11T20:03:00.001+08:00

Is life worth living? This is a question for an embryo, not a man.

Samuel Butler

Perfection

2011-11-10T22:10:00.002+08:00

I clearly remember being a 6 year old coming home from school after a Mathematics examination one day. Like every good Singaporean mother, my mum taught me to check my paper once, twice, thrice after completing any paper, should time permit. And so I did. I checked my paper once, twice and thrice. I came home ecstatically, and exclaimed to my mum that I hadn't found any mistakes after checking the paper. In response to my delight, my mum said, "Die la, if you didn't find any mistakes, it means you probably didn't find the careless mistakes you made..." Now as much as in retrospect that doesn't make sense, it was the first time in my life that I discovered that no one could be perfect. It didn't matter that I checked my paper thrice, I would have made mistakes anyway.

Hard lesson for a 6 year old me. An equally difficult lesson for the 23 year old me. It's tough to be perfect.

Corrigan's Secret Door

2011-11-10T18:40:00.005+08:00

Feeling melancholic after a hard week and a tragic day of missed diagnoses and strange physical findings. I feel tired. And to think that it's only been three days, and we haven't even hit Friday. This is not a burn out, I haven't worked hard enough. Neither am I jaded - my heart still skips a beat in the phenomenal epiphany that one reaches on being able to apply Occam's Razor in medicine. I just feel...pathetic. Why?

I find it poignant that almost every medical text starts with a prologue, story telling of some sort, reiterating the cliche about the art of medicine. Almost every medical student who has walked through the hospital doors would have flipped a couple of pages through the Oxford Clinical Handbook of Medicine. A few pages down would bring you to a page entitled "On being busy: Corrigan's Secret Door". It documents the story of Sir Dominic Corrigan was so busy 150 years ago that he had to have a secret door made in his consulting room so that he could escape from the ever-growing queue of eager patients.

Secret doors. Where are they? When I consider all that I have invested my time in over the past few years, I wonder if I have just been building up this impossibility of escape. I might have just trapped myself in this hole that I consciously was digging, sealing up all these doors that would have become my secret doors. Music, art, photography. And now what is left? An empty clinic, and a battered human, fueled by fear. I have never felt time ticking away as much as I did on completing my SIPs. No, not time ticking to MBBS. Time ticking down to that which is the real world, where my time is no longer mine to own. I see a mental image of a self drowning in administration, confused about medicine, stuck within walls with no secret door.

When I Shall Sleep, Emily Bronte

2011-11-09T18:09:00.002+08:00

Oh, for the time when I shall sleep
Without identity,
And never care how rain may steep,
Or snow may cover me!
No promised heaven these wild desires
Could all, or half, fulful;
No threatened hell, with quenchless fires,
Subdue this quenchless will!

So said I, and still say the same;
Still, to my death, will say—
Three gods within this little frame
Are warring night and day:
Heaven could not hold them all, and yet
They all are held in me;
And must be mine till I forget
My present entity!

Oh, for the time when in my breast
Their struggles will be o'er!
Oh, for the day when I shall rest,
And never suffer more!

Bone Marrow

2011-11-05T00:20:00.002+08:00

I think this counts as one of the weirdest things I've eaten - Bone marrow mixed with wild mushrooms and parsley @ Sque. Essentially some fat globules with mushrooms. :s

Lost and Found, Oliver Jeffers

2011-11-04T00:09:00.002+08:00

This all began with someone lost and someone found. Who is say which was which? There was a boy and there was a penguin, strangers from opposites sides of the ocean...

Real Steel

2011-10-26T22:03:00.002+08:00

Awesome!

Yawnz.

2011-10-25T23:48:00.002+08:00

My blog is terribly boring. Here is a random photo to cheer everyone up!

NNI Electives, April 2011

No Chicken Wings Allowed

2011-10-22T23:16:00.008+08:00

Had the cell group over my place for a barbeque this evening. Having SJ as head chef meant no chicken wings allowed, frankfurters banned and frozen crabsticks unmentionable. Instead, we had:

Mango salsa with biscuits (Courtesy of Ning)
Home baked raisin bread
Lemon lime chicken thigh fillets
Honey roasted pork shoulder
Garlic squid with belachan chilli
Baked russet potatoes and sweet corn
Grapes

We were perhaps lacking in some wine, but otherwise a rather satisfying meal. Hope you guys had fun! I thank God for you all. (:

Brunch@40 Hands

2011-10-15T18:44:00.001+08:00

Got to treasure these lovely Saturdays. Not sure how long more we'll have the luxury of them.

SIP Failblog moments

2011-10-14T22:41:00.007+08:00

On demand ;)

Story #1

Circumstance: It is Thursday evening. I am post call, and together with Prof G, my MO and HO, had to see a crazy number of patients in the clinic (because Prof had just returned from leave). It is 7:30pm, and Prof had yet to see the blue letter referrals.

Place: Outside the KRW clinic which had just ended

Who: Prof G, MO, HO, M3 medical student and me

MO: Prof, we have 3 blue letters to see...shall we?

Prof: Sure. (Looks around at M3 student and me) (Points to M3 student) Ok you can go home. (Looks at me) You....

Me: *pitiful doe eyed look*

MO: Prof, she is post-call today...

Prof: Oh you are post-call ah...Ok la you can go off.

Me: OK THANKS PROF!

(silence)

Prof: ...THAT WAS A TEST OF YOUR ENTHUSIASM! and you just failed it!

Me: O_O

Prof: Yeah, you know you need to show your eagerness to learn and follow!

Me: O_O Ehhhh...

Prof: Ok la nevermind you can go...

Me: OK THANKS PROF!

Prof: I gave you a second chance! and you failed it again!

Me: (Speechless)

Prof: hahahaha ok you can go and do your INTERNAL MEDICINE la! Go home go home!

Me: O_O

Story #2

Circumstance: It is the next day, Friday evening. We just ended clinics where we all saw 90 patients. Prof bought pizzas for us to take turns to eat in the clinic pantry intermittently since there was no time for lunch. It is 7:00pm, and time for blue letter rounds again.

Place: Outside Clinic B

Who: Prof, MO, HO, Me

Prof: Ok thank you ladies and gentleman for your hard work. (Looks at me) Ok you can go now.

Me: Oh...it's ok Prof I can join you on your blue letter rounds. I need to round tomorrow (Saturday) anyway...

Prof: (Ponders) Hmmm, it's ok- you can take the weekend off.

Me: O_O Oh no la I can round together with GH (my MO)

Prof: It's okay really, THIS IS NOT A TEST.

Me: O_O

Prof: Yeah really!

Me: Ok thanks Prof. (Braces self for getting owned)

(no sign of getting owned)

Story #3

Circumstance: It is Monday, 8:30am as Prof is rounding quickly before he hurries off to clinic. As the HO settles some issues with the previous patient, Prof asks me to hurry along with him to the next patient and the HO catches up later. Our MO is on MC that day.

Place: In the lift

Who: Prof and I

Prof: So...how was your weekend?

Me: (damn stunned) Eh, it was okay. (Thinks to self: Am I supposed to ask him back?!)

-awkward silence-

Me: Oh Prof, GH (MO) is on MC today.

Prof: Yeah, I know. WHAT DID YOU DO TO HIM?!

Me: O_O errrr...nothing...I think?

-awkward silence-

(Lift finally reaches intended floor, marking the end of my awkward encounter)

Story #4

Circumstance: Prof took us out for lunch for a special reason (which I had absolutely no contribution to). Our MO was going to drive us out.

Who: Prof, HO, MO, Visiting surgeon Dr W and me

Place: MO's car (Seating arrangement is MO in driver's seat, Prof in front seat, and rest of us at the back with me in the centre)

(Prior to getting into the car, I had no idea who this random visiting surgeon was since Prof hadn't introduced him to any of us. He was just this random dude walking behind us together with Prof.)

(In the car)

Prof: Ok Glori, your job for today is to talk to Dr W.

Me: O_O Who is Dr W?

Prof: Eh, he is sitting beside you.

Me: OHHHHHHHHH. (turns to Dr W) Hi Dr W, nice to meet you (extends handshake)

Dr W: Oh hello (handshake)

(awkward moment - everyone laughs)

Prof: O_O Wah, like that also can ah!

Orthopaedics SIP

2011-10-11T19:06:00.005+08:00

Spelling errors. What happened to pride? Today is one of those days I feel like even in the midst of menial scud work, I have let my patients down. After all, "Whoever can be trusted with very little can also be trusted with much, and whoever is dishonest with very little will also be dishonest with much." (Luke 16:10). Need to buck up.

I opted for NUH Orthopaedics SIP with much reluctance, considering it a lesser evil compared to SGH Orthopaedics. Prior to starting the posting, I thought to myself how nice it would be to be allocated to Prof G's team, remembering how awesome his Year 3 lectures/teachings were. I had half a mind to email the admin staff to request for the particular placement, but stopped short of drafting the email, trusting that God will provide. It was on the first day of our posting that Prof G asked M who was standing next to me, who is Glorijoy? and in a state of half surprise, I said, that's me Prof. I remember his look of sian-ness mixed with embarrassment in asking that question in my face, and possible sian-ness that his SIP was a girl who was unlikely to be very enthusiastic in orthopaedics.

Week 1 in SIP was an accelerated transit from a noob M3 observer in clinic, to learning how to sound credible in giving neck care back care advice, and moving on to running my own clinic room adjacent to HO/MO rooms on the day Prof had 90 patients scheduled for the entire clinic day. Not much HO-work then, and had the chance to revise orthopaedic principles. I was also blessed with a damn steady MO and HO, who knew how to work efficiently without cutting corners. Tired, but happy.

Week 2 was when we were rotated to doing ward work - changes, letters, memos, discharges, drains etc. It was then that I realized what a haphazard person I was/am. When given instructions, I can almost certainly follow with good standard. When left to my own devices, I often find myself spending lots of time trying to get organized and not mixing up patient details/changes. I find that the only reason I am not getting into hot soup is because there are people who are trailing behind me checking my work and making up for my inadequacies. I wonder if one day I will ever become my own master.

It is now week 3, and in reflecting on the past two weeks, I ask myself - have I had fun? Most certainly. Surprisingly even, since I never ever enjoyed surgery. These 2 weeks reminded me of the time I considered pursuing Orthopaedics during my posting in year 3 and how I liked the idea of clean surgeries. Straightforward, no strings attached. No need for TLC or sayanging - just see, fix and send to rehab. Surgeons are a different bunch compared to the physicians. A lot more laid back, fun loving, not so uptight. They know how to relax, talk crap and let loose when the time comes. Always fun to hang out and go for an early breakfast on a rare day without teaching.

I also ask myself, have I learnt much? Sure. I think I have managed to patch up the gaps in learning that I didn't manage to in Medicine SIP. I guess the learning curve is always steep when your knowledge in surgery is chui max. Still long way to go, but learning nonetheless.

The final question that I ask myself is, am I satisfied? On reflection, an honest answer would be no. No, because in the midst of seeing 90 patients in clinic, running from ward to ward to track changes, I can barely remember the names of a handful of patients. There is perhaps only 1 patient who knows my name, and that patient is to be transferred to another team. There has been no sense of ownership. All I am doing is, hello Auntie, I need to take out this tube now! or Hello Uncle, the bone is broken ah, need to go operation to repair. And then I shuttle off to do admin scud work and/or pull out a drain in 5 mins. And then I never see them again. Nothing quite traditionally doctor-y about that I guess.

In the midst of lots of free food, nice seniors and good fellow SIPs, God has been truly gracious. In seeing me through presenting cases in front of The Scary as well as having weekends off (after giving the doe-eyed pitiful look on a Friday evening post-clinics at 7:30pm post call). Two more weeks to go, I want to make it count.

Only by grace

2011-10-02T16:05:00.002+08:00

Week 1 in Ortho SIP and despite being post-call at 7:30pm, there has been much to give thanks for. God's grace is truly sufficient for thee!

Did You Marry the Wrong Person?

2011-09-22T20:24:00.002+08:00

(via Challies.com)

A little while ago Stephen Altrogge wrote a small article he titled So You Think You’ve Married the Wrong Person and today I would like to add one thing to the discussion. Stephen’s article addresses an always-pertinent topic. It is a topic that is applicable to married folk who may one day wake up and wonder, Did I marry the wrong person? In fact, I think most married people wonder that at one time or another. It may not be a question filled with true angst and regret, but one that may persist at the back of their mind.

At such times you can find great comfort in this simple reality: I guarantee that you have married the wrong person. We all marry the wrong person. Perhaps I should say it like this: we all marry the “wrong” person. We all marry a person who sins against us, who sometimes exasperates us by helping us worship our idols and at other times irritates us by smashing them to pieces. We all marry a person who has stinky breath and physical blemishes and bad moods. We all marry a person who is apparently incompatible with us on all kinds of levels. To quote Stephen, “The husband is neat, the wife is messy. The wife is talkative, the husband is quiet. The husband is always on time, the wife lives more in the moment. The wife is social, the husband is a homebody.”

The differences can go far deeper than that. The differences may extend from the marriage bed to the church sanctuary, from the way we make love to the way we worship, and everywhere in between.

Stephen turns to Paul David Tripp who offers some valuable and biblical counsel:

God is in control not only of the locations in which you live, but also of the influences that have shaped you as a person. He has not only written the story of you and your spouse and determined that your stories would intersect, but he has controlled all the things that have made you different from one another.

As you struggle, you must not view your marriage as bad luck, or poor planning, or a mess that you have made for yourself. No, God is right smack-dab in the middle of your of your struggle. He is not surprised by what you are facing today. He is up to something. (What Did You Expect?, pgs. 213-214)

This is comfort in the sovereignty of God, that God has ordered all things and that he means to work in and through you. Your marriage to this person at this time falls well within the scope of his sovereign plan. God simply won’t allow you to entertain thoughts of regret or of escape.

But here is what we need to see: The wrongness of our spouse is one of the great formative influences on us. The wrongness and the apparent incompatibilities are the very things God uses to mold and shape us. A few years down the road you will look back on all of that wrongness, all you declared to be wrong about your husband or wife, and find that God was not wrong at all. He knew exactly what you needed.

What I have found is that often times, when someone fears that he has married the wrong person, or when he fears that he is about to marry the wrong person, he is looking at the differences between himself and this other person and lamenting that this other person is not more like him. He may describe her personality or preferences or passions, but what he is really doing is showing that he wants this woman, this potential wife, to be more like him. If only she was…me! Too many men, too many women, truly want to marry an image of themselves. And why not? You tend to like your preferences, to like your idols, to like your likes.

But ask any married person what his life would be like if he had married someone who was just like himself and you’ll see the folly of it. Her talkativeness was just the antidote to your quiet nature, drawing you out, filling your home with godly words. Your sexual freedom was just what she needed to release her fears and teach her how to express love in a whole new way. Her constant lateness taught you to be patient and showed you that she wasn’t late because she was selfish, but because she cared, just like Jesus when he showed up “too late” to save his friend Lazarus. In all these ways and so many more, God uses incompatibilities to produce godliness. These differences are truly glorious, the means by which God helps us put our own sin to death.

So did you marry the wrong person? Yes you did. Embrace it and thank God for it. Her wrongness is just right in God’s eyes.

(Note: Obviously there are some exceptions, such as marriages that are physically abusive. Such cases still fall within the sovereignty of God, of course, but require great care and great wisdom.)

Celebrating Love

2011-09-22T14:34:00.001+08:00

Bestest LightedPixels album. No frills, just love.

Intention

2011-09-21T22:56:00.004+08:00

Well, youth is the period of assumed personalities and disguises.

It is the time of the sincerely insincere.

Pablo Picasso. Spanish Artist and Painter. (1881-1973)

Recent experiences have made me reflect on my own relationships, and a realization that it is in this phase of our lives that trust and sincerity is no longer a by product of friendship but an entity that needs to be fiercely fought for and guarded. In reflecting, I've also been considering how this understanding translates into mentorship in my church's youth ministry.

I have been co-leading a cell group for close to two years now. In my first year I was a baby assistant cell group leader, and often hid behind the shadow of the Big Brother D who led the cell with wisdom and verve. I wrote a couple of bible studies, realized I had missed big points, and helped in prodding the cell along. By God's grace, it wasn't too difficult.

Then came the reshuffle, and I entered my second year as a now-more-experienced aCGL. By this time, D was reshuffled to another cell, and it seemed like I needed to hold a bigger stake in piloting the cell. God blessed me with an unknown courage to give my first talk ever, and continue to write bible studies. This time however, I resolved to be more intentional in the way I wanted to lead the cell. I knew that as much as I enjoyed listening and learning from academic religious debates, there was more to mentoring youths than filling their minds with knowledge. I wanted to know how they were doing, what was in their lives that they struggled with and how the cell could support them.

Unfortunately, those who know me well enough know that for all that God has gifted me with, pastoral care has never been my gifting. It was difficult keeping up with 10 people's lives all at once without sounding absent minded or insincere with "Oh so how was that exam you had? Oh you mean it was 3 weeks ago? Oops." Learning how to rebuke in love has also been a challenge in encouraging the cell to take pride in learning the Word, but it has also been rewarding in many ways. Members have come and members have gone, but for all who have passed through, I can only pray that all that I have done (or not done) as an aCGL might have played a part in leading a life toward the path of Christ.

Sincerity, something that truly eludes me. How do I keep up with a sincere effort in being involved in the lives of others without being intrusive or burdened with multiple details? Being at the bearing end of insincerity is a bitter experience, I would know. It is stark, and yet the giver may be in complete oblivion. Reminder to be mindful at all times, for our speech is an outflow of the depths of our hearts.

Come next year, I will enter my third year as aCGL with yet another shuffle. Balancing this with my final MBBS and subsequently HO-ship, I am deeply concerned. To me, the greatest challenge will continue to be consciously intentional - in loving, in serving, and leading.

He meets the love of his life for an hour each day

2011-09-17T09:06:00.002+08:00

The Straits Times

17 September 2011

EVERY day at 3pm, a nurse pushes Mr Koombri Hasan, 77, in his wheelchair to a special meeting.

Tucked in the side of his wheelchair is a gift, usually a packet of biscuits, a packet drink or a portion of fruits he saved from lunch.

He is, after all, meeting the love of his life - his wife, Madam Ong Ah Chuan, 57.

They live in separate Resident Living Areas.

Today, the couple meet in the common area. On television, American personality Martha Stewart is demonstrating how to make creme brulee.

Mr Koombri pays no heed to her tips.

He is lovingly preparing a dish of his own; dipping a butter biscuit into water and softening it before feeding it to Madam Ong, who has difficulty swallowing.

Mr Koombri, a former air cargo handler, has provided care for his wife since meeting her in a Chai Chee kampung in her youth. She has been intellectually disabled since the age of five after a fever.

His memory is hazy and he does not remember when they got married.

But it was when Madam Ong was in her 20s, judging by a wedding photo that sits atop his bedside drawer in the room that he shares with five others at Peacehaven. He does, however, remember the dates they had in Orchard Road and fishing sessions at Bedok Jetty.

These days, their hour-long daily meetings are not as romantic. Sometimes, a nurse chaperones the couple, watching the feeding process closely to make sure that Madam Ong does not choke.

Many other residents share the common area, but today they pay little attention to the couple, preferring to watch Martha.

The couple converse in Hokkien. Madam Ong speaks with an almost incomprehensible slur but her husband understands every word.

Meet-ups like this were impossible two years ago.

From their one-room flat in Bedok, both were sent to different, far-apart nursing homes in 2009: Mr Koombri - wheelchair-bound after a fall in 2006, and suffering from a painful skin infection called cellulitis - to Peacehaven; and Madam Ong - who suffers from epilepsy and diabetes - to the Moral Welfare Home in Henderson Road.

Teary phone conversations were their only form of contact.

After hearing about their plight, social workers from both homes worked to reunite the couple.

Six months later, a vacancy in Peacehaven came up.

The devoted husband still remembers the day that she arrived in June 2009 and how he rushed to her bedside to embrace her.

He now finds pleasure in knowing that his wife is well during their daily meetings.

'As long as she speaks and manages to swallow the food I bring her, I am very happy.'

SAMUEL HE

Matthew 12:34

2011-09-14T17:40:00.004+08:00

For it is from the overflow of the heart that the mouth speaks.

Mr A

2011-09-11T23:59:00.002+08:00

再见 Mr A, 老实说一句话 thank you for allowing me to be a part of your life.

Wrinkles

2011-09-08T19:22:00.005+08:00

I love wrinkles. I think it is that something about old people that makes me want to give them all a hug. In the course of my geriatrics posting, I have discovered that for every one person that talks to a child in the paediatric voice, there is another who talks to an elderly with a geriatric voice. It is that gentle, LOUD but slow voice that breaks up into a smile at each toothy grin. :9 Never fail to be amazed at clinical acumen - the ability to see an entire pathophysiology at the feeling of a pulse, and the extrapolation of an entire story from a 5 minute history given. Amazing.

M5 is zooming by too quickly. In the midst of lots of stress, practicing and exams, I have realized the importance of encouragement, and tact. It is easy to be curt and selfish, make snide remarks - but altogether not realize it. At the end of a long day, an encouraging SMS and a cold beer makes all the difference. Thankful for people who ask after and pray for me. Praying for lots of sustenance and grace.

Bus ride home

2011-08-31T19:38:00.005+08:00

Arrow, or be arrowed. I guess that's the name of the game.

On the way home today, I saw an ang moh dude in Chinese High uniform. I contemplated how strange it was. I thought about how five years in the same school is a really long time, and how while I was apprehensive about starting work, a new environment is a real welcome. Its time for new things, new people. I'm sure its a wild place out there, and my brother always warns me to watch my back. I guess it can't be very different anyway.

Here's a reminder to myself that no one owes me a living. If you want it done, do it yourself.

Angsty

2011-08-26T10:13:00.002+08:00

Sigh. Feel like a teenager all over again.

Best of MBBS 2011

2011-08-15T18:48:00.003+08:00

From Seniors Accounts, Class of 2011

Me: Mdm, what medical problems do you have?
Pt: first, i had loss of appetite
Me: ok..................... can you tell me your other medical problems? (i was trying to get her to tell me her other co-morbids so i would have a rough guide on how much time to spend on each, but auntie didn’t get my drift)
Pt: then i had loss of weight
*oh crap... had sinking feeling already*
Me: oh as in, do you have diabetes, hypertension, hyperlipidemia, heart disease, asthma? any past surgeries?
Pt: none
*felt relieved. but not for long*
Pt: then both my hands numb, then leg swollen
*zomg* ?!??!?
Me: ok the leg swelling, one leg or both legs?
Pt: right leg more swollen than the left
*….........................*
Pt: then i had constipation, then shortness of breath, then felt tired, then after i went to see my gp, he told me to come hospital, and the doctors at the hospital said i was YELLOW
*zomgggg*

* * *

Then ask about management: scope done? What does it show and which part of the intestine involved? At this point the mother said small plus large intestine and I shouted out Crohns right?!? She finally admitted and I pat my own back mentally. I asked about steroids use and side effects of steroids. She also told me about sulfusalazine and 6mp! I really did not know what is 6mp. On hindsight, maybe I should have joked with her 6mp? the doctor gave u a 6mp camera issit. lame. It is mercaptopurine, an immunosuppressive drug used for IBD, non hodgkin lymphoma, psoriatic arthritis etc.

* * *

What are the differentials for acute kidney failure in this man? (he had been previously admitted for episodes possibly linked to either his CLD or DM nephropathy) I said Hepatorenal syndromes 1/2 and they seemed to be appeased. Know some impressive shit like Hepatorenal syndrome to tickle your examiner’s balls. They probably won’t know more about it than you do so can chillax and bask in the glory of your 7-syllable diagnosis.

* * *

15 year old chinese boy who looks like he is 10 years old. I was pretty surprised when told his age. Then I started to ask about presenting complaint. I was totally hoping for a asthma and was quite sure he is one with steroids toxicity plus plus. But my balls shrunk when mummy said he had diarrhea a few years ago. I really never thought I would get things like GE, functional abdominal pain or my worst nightmare IBD! I got one such case before in an EOPT and totally flunked it. And the day before I was furiously mugging paeds when i came across this topic and I said to myself, screw it, how likely is lightning going to strike twice? I guess the MBBS is really an astounding combination of all our previous karma and the idiosyncrasies of lady luck. I wished I had helped a few more old ladies cross the road. i muttered an audible obscenity which the boy caught and looked very pleased.

* * *

Then I proceeded to give him a tutorial on IBD when I realized the indian guy (examiner) was reading from a set of pre-prepared questions and points. That showed he probably did not know IBD very well. So I started my first menthols light of my life. On endoscopic visualisation UC involves certainly rectum, plus colon. It is a mucosal and submucosal thing and show crypt abcess, pseudo polyps , cobblestones and longitudinal fissures. the lesions are continuous. Crohn’s is transmural and has skip lesions and strictures and fistulas and bah bah bah. UC more likely to bleed and Crohn will show non-caseating granulomas. I spoke real fast so that he will hear the terms and even if I make a mistake he will not be so likely to catch it. Koh Pei Ling was looking amused and nodding furiously by this time which the Indian prof was frowning as he tried his best to coordinate his eyes and ears.

Adding life to days

2011-08-12T20:16:00.000+08:00

Mr J did get married after all. :D

A Wise Man

2011-08-10T18:53:00.000+08:00

A wise man sat in the audience and cracked a joke. Everybody laughs like crazy. After a moment he cracks the same joke again. This time less people laughed. When there was no laughter in the crowd, he smiled and said, “you can’t laugh at the same joke again and again, but why do you cry over the same thing again and again?

Flight of Ideas

2011-08-09T10:27:00.004+08:00

I think I inherited my Grandma's love for kuay teow. I could eat its variants every days - chee cheong fun, hor fun, char kuay teow...yums.

I lost like 2kg since I came back from the UK. Must be the new diet that we've been having since we moved house. No more fried food - steamed, soups and poached vegetables. The kitchens in all these new condos are super lousy for cooking Chinese cuisine - no space for wok or crazy frying. :(

Being a hoarder can prove useful some days- I recently broke the clip portion of my Pilot G2 pen and was very reluctant to buy a new one when I could use refills. It dawned on me that I actually kept old pens from eons ago (like since secondary school days) and went to dig them up! Now I've got a perfectly functional G2 pen with a brand new pen refill. Saves me 90c!

I love studying medicine! Starting work frightens me though - I texted my senior who was doing his General Surgery rotation last night at 10pm and he told me he was (1) Post call and (2) Finishing up exit rounds which meant (3) He had been working for at least 50 hours straight. HM. :/

Happy National Day!

人为什么活着?

2011-08-07T22:54:00.004+08:00

Offspring

2011-08-07T15:55:00.003+08:00

Today before the altar, I was looking at parents bring their little kiddies to receive the elements of the holy communion, thinking how nice it would be to have little kiddies to bring up to learn to know and love God as they grow up.

In the same day, I encountered teenagers who walked around with an attitude, spoke like everything was beneath them, dressed twice their age and refused to participate in anything because they were too cool/too smart for it.

Children are overrated.

Awesomeness

2011-08-05T19:27:00.001+08:00

Tough luck

2011-07-28T22:44:00.004+08:00

I remember what Jon Chan wrote about the internship resounding very clearly within me, "it's the same feeling that I got at the start of M3 (Surg) - I half don't know what's going on, I'm worried because this is the rest of my life, and I'm scared because I don't know how well I'll do."

Magic moments. Of all the patients that I've encountered, I will remember Mdm T our hamster lady who was labelled as "bedbound" in the nursing home, but was reviewed by the in-house physiotherapist and found to be able to walk 50m assisted! I will remember sitting by Mr S's bedside at 4am in the morning looking at his right knee stump, watching him grit his teeth in pain from arthritis, and ask him for permission to take his bloods. He then nods with resignation, and I am glad to succeed with one try. Then there is Mdm R who came in rather drowsy and uncommunicative, and left being able to smile and wave at me when I walk by. Not forgetting Mr P, who in the midst of his chest pain and breathlessness, says "I will fight till the end!".

Over the weeks at work, discussion of NTU graduates and peers in other industries earning twice, thrice, or even ten times the salary of doctors dominated conversations. In school, we trumped them with our As, for what? Now they're owning us with their salaries. I learnt about the ROAD specialities - top earning sub-specialities with minimal effort that are most highly sought after in post-graduate training. Radiology, Opthalmology/O&G/Orthopaedics, Anaesthesia, Dermatology. Most of these conversations ended with lamentations at the fate of doctors. I should have never become a doctor. Tough luck. Most of the time, I had little to contribute. What was I to say? I have never experienced bearing the responsibility of answering non-stop calls to do changes at 3am in the morning. I have never felt the panic before a desaturating patient. I have never received a payslip that is far below what I expect for the work and hours that I put in. Who knows what I will say 5 years down the road, when I am weary and tired, have to do full calls, and feel under appreciated by the system?

In some ways I feel fearful at this fate that I'm heading for. Who knows what lies ahead? What did we sign up for? Surely nothing less than a lifetime of loving another.

Small blessings

2011-07-25T20:33:00.001+08:00

Just to remember, thank God for the plug I set today. Was really hoping I wouldn't bump!

Failures

2011-07-21T21:59:00.001+08:00

Medical school has truly failed when a moderate pleural effusion secondary to metastatic lung CA is diagnosed only on CXR and every case note entry says "Lungs: clear".

Mundane Post

2011-07-17T18:11:00.004+08:00

Lessons learnt from SIP:

1) Breakfast is the most important meal of the day. It might potentially be the only meal of the day.

2) It is very bo hua to use an ink-based pen. One refill a week is unnecessarily costly. Stick to a 0.7mm dark ball point pen instead.

3) 40mins to clerk a new case is VERY SLOW. Write faster, talk faster, think faster.

In other news, I have moved into my new house! It has been about over a week. If you meet my mum you will notice a gigantic bruise over the anterior aspect of her thigh. Our new place is so small that she has been knocking into things. -_- Got to get used to it! I went swimming this afternoon, and was more tired from trying to avoid screaming kiddies and people who cannot swim in straight lines. Zzz. Still haven't got used to taking an extra 15mins to get to work. On the bright side, we have a new Nespresso machine! Yay to angmoh coffee on not-so-early mornings, though I really wouldn't mind a regular kopi xiu dai.

Yay

2011-07-14T20:40:00.008+08:00

Job satisfaction is when not-so-hungry old lady H asks you for help to squeeze the 2 puny slices of oranges that came with her own dinner into juice for bed bound/soft diet old lady T across the room at 6:30 in the evening. What a wonderful 10mls of love in a cup. Happy days (:

Breakfast OM

2011-07-13T20:09:00.001+08:00

The first lesson that I've learnt in SIP is that to care for others, you must first care for yourself.

Black Swan

2011-07-04T18:10:00.002+08:00

Maybe its true - Only he who is closest can get the best shot.

SIP

2011-07-03T21:12:00.003+08:00

Student Intern. So familiar yet so foreign, a role that as students we have become so keenly aware of, but approach with a mixed excitement and trepidation.

I recently met an M-zero, B, at a CMDF meeting a couple weeks back. He had finished 1 year of National Service, during which he had been accepted into a prestigious Law School in the UK. In this 1 year, he thought long and hard about what he wanted to do for the rest of his life, knowing full well that signing up for medical school meant a lifelong career. Before he applied to medical school, he wrote himself a 5 page essay, detailing why he wanted to do Medicine, and making sure that he had been fully convinced, and more so convicted about his reasons for signing up. He was sure that he wanted to do something meaningful. Perhaps now is a good time for me to revisit my own convictions, to remember the heart of Medicine, and the heart of God.

Four years ago I was granted admission to a formalin filled room of people who had dedicated themselves to education beyond their lives; two years ago I was given the privilege to walk through hospital doors and ask strangers very personal questions about their bodies, families and lives; tomorrow, we will be given the liberty to make our first marks on official hospital documents, and in the process potentially save or harm someone. This journey has been so much discovery, like a child who stumbled into the realization that his feet were meant for walking.

Brace up, hang in there, enjoy the ride! Remember, every name stamp as a symbol of interest, pride and ownership. People's lives, nothing less.

Remember

2011-06-26T18:36:00.004+08:00

Examining an unaccompanied child with cerebral palsy is unethical.

Triple jinx

2011-06-16T23:19:00.006+08:00

Porto, Portugal

By the Atlantic Ocean

Brief

2011-05-29T08:39:00.007+08:00

If an unexamined life were not worth living, then my past month here in London would certainly be of little significance if not for this brief moment of silence and solitude. Of the seven of us who checked in here at Wolfson House King's College London, I am the lone occupant for the night. The rest have gone in search of French boulangeries and greener pastures up north. Before I jet off to even more touristy frenzy in another country, now is a good time to retrieve some thoughts I hastily shoved to the corners of my mind in the past month.

I started travelling independently with friends when I was 18. Then, it seemed to me that travelling was all about the thrill and fun of being in a different land, to take nice pictures and be able to say been there, done that! Five years on, it seems that my perspective on travelling has somewhat been altered by the people that I've traveled with and the places that I've had the privilege of visiting. The way being well-traveled shapes your world view, the ideas that are exchanged across continents and the brilliance that stuns you across cultures is no less than precious. In the past 4 weeks, I spent lots of time in London just walking the streets, be it shopping streets, residential streets or by the Thames, and often found myself stopping intermittently at a shop, an advertisement or a historical sight in awe of brilliant marketing strategies (think Apple Store at Covent Garden), the sanctity of heritage and the wonders of a cosmopolitan city as such. What I have learnt to bring away from each trip are Ideas, instead of megabite after megabite of photos.

My objectives in coming to London for a month was simple - to live. Not to be madly touristy or rush into doing as many things as possible, but to experience the London life, breathe in the terrible lung-aging air, walk 3km just to save £1.90, do my own laundry and cook my own food. In the past month, I finally understood why my brother resorted to eating steamed rice and potato chips over his exam periods. Coming back at 3pm from school (after a 1am night and 730am morning, and still having to think of laundry, dinner, studying and planning for outings/trips/meals is life-shortening.

Midway through my posting here, I also realized that I had flown 13 hours across 3 continents not in search of Michelin stars, the best coffee in the world or even top notch clinical training. I was really just looking for a good conversation, someone from across the world to be curious about the land I came from, and a good exchange between two people from very different worlds. After two weeks, I felt somewhat underwhelmed, being caught up with doing touristy stuff and being afraid of wasting time by staying too long in the hospital or at home. I was pleasantly surprised during the last week of my posting, where I enjoyed a short but insightful chat with the Mr E, the ward clerk in the HDU and the house officer Dr D, who was from Malta. It intrigues me greatly, how people from vastly different backgrounds are united in the commonality of humanness, of being subject to man-made systems and the weather, but yet are diverse in their thinking and worldview. Truly, the beauty of this world! Maybe I should have studied Sociology.

Museums are a big part of London, and my favourite visit this time around had to be the Science Museum, with two floors dedicated to the History of Medicine. There, I finally saw and understood what Corrigan had in mind when he described the waterhammer pulse. It was also there that it dawned upon me how while we are quick to congratulate ourselves for making medical breakthroughs in the 21st century, much of the medicine that is practiced today is not very different from what was already practiced in the 19th century! During my Intensive Care posting, I learnt all about the ECMO heart-lung support machine, and was stunned by the ingenuity of it all. My awe for it lasted for the entirety of 4 weeks, until I found that the concept and mechanics of such a machine had long been thought of and used since the 1800s. So much for medical advancement! One of the most stunning moments was when I saw an original manuscript of a journal paper entitled "An Observational Study of Gastric Acid and Physiology". To have been a doctor in those times would have been absolutely thrilling. What brilliance would have thought of connecting electrical leads to frog legs?! I want to become an inventor.

Many memories of London I will bring home with me. The man and his dog on his shoulders, the daughter talking and showing photographs to her comatose father, the incredible Apple Store, the lady who had 197 units of blood transfusion, late dinner at Nando's with YC, cooking pasta with soya sauce and a knowledge of the history of Medicine amongst many others. So many more things I have noted down and would love to write about - the NHS, terrible bleeping systems, growing up and faraway friends. Maybe another time. I leave for another land the day after - where more exciting Ideas and people await!

Cheers to the Italians

2011-05-25T03:20:00.008+08:00

Dr Valentina: "So, how do you say cheers in Singapore?"

Cogito ergo sum

2011-05-16T04:10:00.003+08:00

I am not what I do, or think, or eat.

I am, because Jesus is.

Salt

2011-05-09T06:31:00.000+08:00

“Be wise in the way you act toward outsiders; make the most of every opportunity. Let your conversation be always full of grace, seasoned with salt, so that you may know how to answer everyone.” Colossians 4:5-6

Jesus is Alive!

2011-04-24T18:16:00.003+08:00

This is most certainly my favourite Easter song! Death has lost its victory and the grave has been denied. Indeed the curse of sin is broken and we have perfect liberty. Jesus is alive! :D

M5 Code of Ethics

2011-04-15T17:47:00.011+08:00

To my Seniors, Juniors, Classmates and Counterparts:

I have come up with a list of things that I endeavour to adhere to from now till the end of M5/my medical career. I decided to come up with this list because I suspect that it will become increasingly difficult to achieve, and will require constant reminders, prods and scoldings. Everything on this list forms my convictions, beliefs, hopes (and also pet peeves), and I do not wish to compromise on any them, wittingly or not. I ask that you keep me in check, rebuke me should I forget, become jaded or give up on myself.

With love and gratitude,

* * *

1. I will always address the patient by his or her Name. I will try my best to remember their faces, names and stories. If I cannot remember I will write it down.

2. I will refer to patients who have good clinical findings by name as "Mdm X with a hepatomegaly" or if not "the gentleman in bed 15A/241 with good CVS findings" and not "the abdo case" or "15A/241 - CVS".

3. I will ensure that if I arrive too late by the bed side and find another batch of students who have arrived before me to examine the patient, I will ask the patient for permission to join and not try to sneak in as part of the group. I will wait for my turn in line and make sure that I go only after the earlier batch is finished.

4.I will be extremely vigilant in protecting patient confidentiality.

5. I will not be afraid to look stupid, but I will not tolerate being called lazy.

6. I will write in case notes legibly. My case file entry must be written and signed off with pride.

7. I will be polite to all nurses, housekeepers, porters, hospital staff and ask them for their names. I will try my best to remember their names.

8. I will collect a list of my patients whom I think would be willing to be examined and have good clinical findings and pass them on to the juniors. I will teach juniors if I am able to.

9. I will not lose my temper at or talk about other people behind their backs, even if I feel I have been wronged or short changed. I will tell them if I think they are not doing the right thing. I also hope they will tell me when I am not doing so either.

10. I will not wayang to gain favour (the exception being during exams).

11. I will be careful of what comes of of my mouth. I will not use swear words.

12. I will not skip church to study. I will continue to lead my cell group.

13. I will try to meet SJ 2-3 times a week. I will try to have dinner at home at least 3 times a week. I will eat healthily and not eat rubbish ie. Macs more than once a month.

14. I will not become depressed or dependent on caffeine. I will sleep when necessary.

15. I will try to pass the MBBS.

Do you

2011-04-10T18:32:00.003+08:00

(via thoughtcatalog)

Do you love me or just the thought of me? It’s so cliché but my mind has been going over this so many times I’ve stopped counting. Which one is it? And what’s the difference other than the ability to touch me?

If I’d pass away, you’d still talk to me before you go to sleep. You’d still tell me all about your day, your job, how there was this moment just after waking when you noticed the bed was colder. You’d probably ask me “and how are you?” and fall asleep shortly after, accustomed to the silence that follows.

On your way to work the radio would play the songs that remind you of me, because they all do. When you’d cross the bridge, images would start to pop up in your head. The two of us swimming naked in the river, our bodies tanned and sweaty. Strawberry ice cream in my hair, my fingers sweet against your lips. My long hair spread out in the grass, your dog peaceful at my feet, your hand pressed against my cheek. None of these are things we’ve necessarily ever done, but the pictures are so pretty in your head.

You don’t need me for that.

If I’m not here – what would you miss me for? Don’t miss being able to talk to me, because you still can. You’ve known me for so long, you already know what I’m going to say anyway. You wouldn’t miss me surprising you, because I never do. There’d be no void where my voice used to be. The silence after I’ve fallen asleep would be even more silent and with your eyes closed you can fantasize that I’m there next to you. You could make me as pretty as you like, finally getting rid of the mole on my right breast you find so distracting.

It would take some getting used to making breakfast just for one, but let’s be honest: that’s not something you’d actually miss, right? It’d give you time to go for a quick run, kick start your day, do something useful. Something you can tell me about later when you imagine me leaning against you, praising you for your hard work. When I’m no longer here, you could still have me and secretly add all the qualities you always wished I had.

When I’m gone, nothing would really change except maybe for the better. You’d cry, for the changes they’d ask you to make are something you’re not ready for. You’d cry for seeing yourself so miserable, for thinking you’d lost the love of your life. Don’t. Don’t cry, don’t change. Don’t tell a soul I’m gone. Keep me with you and make me better than I ever was, take all you never could from me. You wouldn’t have to miss a thing at all; what you loved in me could now never be taken from you. You’d never have to miss me.

But I’d sure miss to be touched.

Vocation

2011-04-07T18:44:00.001+08:00

"If a Christian man proposes to be a teacher, physician, lawyer, mechanic, or farmer, it must be, not chiefly from promptings of the world or self, but chiefly because he verily believes he can, in that calling, best serve his heavenly Master. If he hath not this consecration, we do not say he is unfit for the ministry only, he is unfit to be a disciple of Jesus Christ. If any man think this standard of dedication too strict, let him understand at once that he is “not fit for the kingdom of God;”" R L Dabney

Fierce.

See what I mean

2011-04-02T15:11:00.008+08:00

Remember my 2011 New Year Post on social media? SEE WHAT I MEAN. Published in Pediatrics, Official Journal of the American Academy of Pediatrics.

Note to self: I must think carefully about my blog posts in future. Aim to get something seemingly frivolous published.

Holiday Posting

2011-04-02T12:58:00.008+08:00

Elective at the National Cancer Centre

2011-04-01T11:00:00.008+08:00

“So…are you afraid?”

The candor of my mentor’s question stunned me.

Before me was an elderly Chinese woman who had been diagnosed with advanced colorectal cancer, suffered complications that caused her kidneys to fail, was experiencing metastatic bone pain and was now on palliative care. Her prognosis was not good.

In medical school we learn a lot about communication. We learn about the time, place and setting that is important for breaking bad news. We learn about body language, tone, volume and choice of words. We learn that we need to ask if they stay on a floor with a lift landing, whether they have financial difficulties and whether they were able to perform their activities of daily living independently. Yet, nothing had quite prepared me for this moment between doctor and his patient, where Death took centre stage.

It was like saying “So, let’s talk about you dying…right now.”

It was a full twenty minutes between doctor and patient, by the bedside without any writing, blood taking or COWs in the way. The conversation revolved around the patient’s hobbies, family, likes and dislikes, in between scattered laughs and periods of silence. This was exactly as Dr Simon Ong had taught his students – “exploring your patient’s psychosocial status means asking them about their fears, hopes, concerns and wants.” At the end of the conversation, Death no longer had the limelight. Talk was about spending meaningful days, finishing unfinished business and enjoying every breath that comes our way.

"It's okay," she said, "Thank for for all that you have done for me."

I chose to do an elective in Medical Oncology for various reasons, but largely because it had a stark absence in our entire medical curriculum. Four weeks at the National Cancer Centre saw me rotating through the various disciplines in oncology. From the usual morning hospital ward rounds to an extended morning round in the community hospital, followed by rotations through Surgical Oncology, Palliative Medicine, Ambulatory Treatment Unit and Radiation Oncology. Afternoons were spent seeing patients in the clinics of various subspecialties and attending didactic teaching sessions. Although I was at times unable to fully appreciate the medicine and science behind clinical decisions, I was greatly inspired by the way Medical Oncologists spent time pondering and deliberating over each case. It seemed to me that the more complex and challenging the medical dilemmas, the more intriguing it became to debate and discuss management options in the patient’s best interest. Notably, withholding treatment was often placed on the discussion table as an option. As my mentor never fails to reminds me, as doctors we are quick to give ourselves a pat on the back for treating a patient, but fail to see the value of not doing so.

In the first week of my posting, I was flatly rejected by a patient after I approached him to ask him “a few questions about his illness”. Little did I know that my "approach" in wanting to clerk him would have triggered unhappy thoughts and feelings in him. I was a lot more mindful of my words after that incident, with a good friend of mine keeping me in check. Over the weeks as I became more comfortable talking to patients on palliative treatment about death, I was surprised to discover my own underlying assumptions in thinking that all cancer patients were depressed and needed some sort of “uplifting”. (My own mother had assumed that I would become depressed by the end of the 4 weeks.) While the notion of cancer often comes as an apparent “death sentence” to most people, I encountered an entire spectrum of people ranging from those who were completely oblivious to the fact that the cancer in their body would eventually lead to their demise, to those who very willingly accepted it as a natural process of life and also those who were completely devastated. As much as I am left speechless in response to patients who question their suffering, I encounter a similar speechlessness when the laugh of a patient with end stage-disease resonates through the ward corridor, “What to do? I’ll take it as it comes!”

Some patients inspire me in their resilience in fighting the disease, persevering through debilitating treatment for reasons beyond themselves, and yet still find time and energy to speak to us students. One particular patient had been willingly clerked and examined by over 100 final year medical students over his multiple admissions to the hospital, and every time with a smile! Surely this is more than enough to spur us on to become the best doctors that we can, for those who have “suffered” under our inexperienced hands!

Cancer hits anyone and everyone, and will continue to do so. In oncology, it is through Death that we discover Life. It seems to me that the prospect of imminent death reminds us daily that each day is indeed a gift that we often take for granted. Oncologists have the privilege of walking through perhaps life’s final journey with their patients, a role that is precious and intimate. I guess this explains why all the Oncologists that I’ve encountered at NCC are always so affable and sensitive to patient’s needs, a trait possibly more commonplace in this department than in others.

It was a fantastic elective, thanks to possibly the best doctor I've ever seen in my entire clinical experience. At the end of my posting, what have I learnt? I make my own mental check list. Approach to oncological symptoms? Check. Oncological emergencies? Check. Treatment modalities? Check. Life? Maybe. Being human? Certainly.

MCF Cosy

2011-03-27T19:12:00.001+08:00

I feel like someday I'll look back at this photo and sigh.

Between a rock and a hard place

2011-03-23T22:51:00.002+08:00

Source: TurnbacktoGod

Failkid

2011-03-17T22:57:00.000+08:00

Which is worse?

2011-03-16T17:40:00.004+08:00

To be dying? Or to see your loved ones dying?

To say nothing to a dying man? Or say generic words of encouragement?

To live and have to die? Or not to have existed at all?

Work Ethic

2011-03-12T21:31:00.006+08:00

Do not work for food that spoils,

but for food that endures to eternal life,

which the Son of Man will give you.

For on him God the Father has placed his seal of approval.

John 6:27, Holy Bible (New International Version)

Strange

2011-03-07T20:06:00.008+08:00

This Oncology elective is turning out to be quite something I wasn't expecting. What I had in mind was some high level internal medicine, florid signs and complex medical dilemmas (which it often is actually). But it is turning out to be watching my mentor sit by the patient's bedside for 20 minutes, solely asking her about her hopes, fears, wants and concerns...and then acting on it.

This amazes me everyday.

(Oh, and of course there is no short of the usual getting-owned-by-tutor phenomenon)

xD

2011-03-05T21:00:00.009+08:00

Cancer

2011-03-05T00:33:00.006+08:00

Something's got a vengeance. And clerking is a totally new ball game altogether.

Small Humans

2011-03-02T19:51:00.000+08:00

Exciting Times

2011-02-28T18:57:00.009+08:00

Electives, truly the best time of medical school. Three weeks into official electives period and it's been a refreshing time. Clinical training has never been so self-directed, flexible and inspiring at the same time. No regrets starting three weeks earlier, and giving myself a week's break in between sometime in March to recuperate and run errands.

My first posting was in General Surgery under Dr C, together with Celeste. I had a terrible Surgical posting in year 3, and desperately needed to get my surgical acumen in order (I had never heard of the Alverado score prior to this year). Subconsciously, I also wanted to give myself a chance to see Surgery from a new perspective, to see a Surgeon beyond the crazy-butcher-with-anger-management-problems. Because Dr C was tied up with some other overseas students in the first week, Celeste and I were given the free reign to join other teams. Celeste had a really good time in the Upper GI team, while I had a nolessthanterrible time in Colorectal (hmmm). Still, we spent our afternoons crashing M3 tutorials, clerking and joining clinics. Celeste even got commended in the Straits Times Forum for helping to translate in the clinic! (: When we finally got to join Dr C and his team, it was more like free teh tarik from the machine in the morning, a light clinic followed by lunch and free drinks. Afternoons are either spent in clinic, or clerking before heading home for a good rest. Three weeks with Dr C gave me some food for thought as well. Anyway, to answer the question, my impression of surgeons had indeed changed for the better. It appears that my earlier description only applied to a certain hospital. :p

My second posting was at SGH Internal medicine with Professor O. I got this contact from Wenyang (senior), since Prof doesn't teach year 3/4s and I had never heard of him before. Turns out that Prof had agreed to take 6 students in total, which was great because it was an automatic CG! It was a strange mishmash of people, and Cel and I were really afraid that it would be very strange and we would totally get owned. But it turned out to be a fun group, from which we learnt much from. Prof O found his khakis to tutor us in other subspecialities as well, so we had a good number of bedside tutorials and lectures so much so that it was totally like a medicine posting altogether. Beyond academia, Prof O and Dr N were inspiring in more ways than one.

Prof O, Dr David and the group (Mok was very excited at touching Prof's shoulder HAHA)

Dr N with the sunflower we gave her for being so cute!

It seems to me that throughout my entire 4 years in medicine, the people who never fail to inspire me have always been internists. It is an unglamorous job, the pay is unrewarding because of the lack of procedures, the hours are long. When we sat in a lecture for the Internal Medicine doctors, I realized that more than half the room was filled with foreign doctors. When I asked why, I was told that no one wanted to do Internal medicine, for the reasons mentioned above. On the last day of my posting, I clerked a lady who had end stage renal failure. I spoke to her for over an hour. I had almost forgotten what it feels like to spend time talking to patients. It felt nice. (:

I had a break today, because my posting at the National Cancer Centre starts tomorrow. Its exciting, since we've never really studied oncology before, and I'm thankful that I can hide behind Yukit in times of brain failure hehe. I spent today going to the Visa office, getting the Flu jab and going to the bank. In the afternoon I had a 3 hour nap (zomg) followed by an evening run.

God is good! Coke is bad!

Ecclesiastes 5:12

2011-02-19T22:45:00.001+08:00

The sleep of a laborer is sweet, whether he eats little or much, but the abundance of a rich man permits him no sleep.

Kangaroo Obstetrics

2011-02-19T10:25:00.006+08:00

I just spent the last 1 hour watching videos on Kangaroo Obstetrics, sparked off by coming across these mind blowing three dimensional ultrasound scans of animal fetuses. Producer Peter Chin used a ‘combination of three-dimensional ultrasound scans, computer graphics and tiny cameras to capture the process from conception to birth’ of a number of animals including penguins, elephants, dolphins, dogs, and penguins. Yes, penguins. It was filmed for a National Geographic Documentary called Extraordinary Animals in the Womb. The birth process and development of a little Joey is one of the most amazing thing I've seen in a while. The process of foetal movement from birth canal to pouch is astounding! Complete genius.

Birth of the Red Kangaroo (Part 1 of 3)

Birth of the Red Kangaroo (Part 2 of 3)

Birth of the Red Kangaroo (Part 3 of 3)

Dolphin Foetus

Chi Hua Hua foetus

Elephant Foetus

Youth

2011-02-17T22:37:00.005+08:00

Young patients scare me.

And I don't mean Paediatric patients. I am talking about the lean, mean, young men, and the petite, gentle, young ladies in the adult wards. They don't belong in a ward full of elderly men coughing their guts out no thanks to a 100 pack-year smoking history, women hobbling along at 1m/min with an unsteady gait. They are schooling, fresh out of university, just got married, just found a new job. They should be in the market, in their prime, making their mark, chasing their dream. Instead they are here, in dreary hospital garb, for some unexplained sudden illness that would change their lives forever.

Youth is such a frightening thought. That said though, it only gets worse.

Failblog

2011-02-01T22:34:00.004+08:00

A couple weeks back, Celeste and I were Googling images of this particular doctor that we knew. The first picture that popped up was the person we were looking for, and we laughed at how funny/cute/strange/good-looking/bad-looking he looked.

Then Celeste scolded me for laughing at people, and asked me to Google Image my own name.

Here's what we got. EPIC FAILBLOG. Good luck to me when I become some hotshot doctor/doctor-turned-entrepreneur/prize winner. FAILLZZZ.

Chronic Grief

2011-01-30T18:43:00.005+08:00

It was the one-seater sofa we had when we first moved into this house. By the side, next to the staircase. It is not longer there now, it has long been replaced by a more fancy long sofa.

My cell group had just arrived at my house for the annual CNY visitation. We had just entered the house, and I was wondering where I should direct my guests to in my usual host-anxiety syndrome.

It was then that I noticed that he was sitting there.

Pa, you're home!

My dad was sitting in that sofa. I felt like I had not seen him in so long. I did not know why, and I did not know where he had been all this while. Had he been in the hospital? Or had he been in his room, fighting quietly?

I sat on the single-seat arm rest, and slide down the sides, my skin hitting his bones. I was afraid to hurt him. I kissed him on the cheek, and realized that my lips only sank deep into his face. He was too skinny. He turned to kiss me back.

I told my friends to go up to my room first. But my dad told me, no, just go and host them like you should, let them stay here.

I looked at his hair, it was a pasty gray, unlike normal hair. His face was sunken, and his skin was worn. He was nothing more than a skeletal frame. But I recognized those eyes, that smell. It was comforting.

I saw his left hand in a decorticate position.

Pa! Did you have a stroke?!

He reacted. And I knew I had said the wrong thing.

Huh, why do you say so?

I remembered his reactivity. When someone noticed something different about him, he worried if he had turned for the worse. He was always sensitive to change.

Oh no la, I just thought because...nevermind let me check.

I tested his upper limb power. It was normal. And the pronator drift. That feeling of immense fear that he indeed had a stroke struck with each beat of my heart. I watched his arm, wishing, hoping, praying that it would not drift.

I woke up.

I was in that same room. With his bed, medicines, wheelchair. I remember it exactly.

Chronic grief. Perhaps this is my chronic grief.

Spot the Human #2

2011-01-06T14:00:00.004+08:00

I literally gasped when I saw this photograph D: hehe. Indeed the eye does not see what the mind is not looking out for. Pathology is oh-so-poetic. ;)

Choosing Love

2011-01-05T22:04:00.016+08:00

It started with me posting a news link about the new up and coming medical school to be set up as a collaboration between NTU and Imperial College. It was to be named the Lee Kong Chian School of Medicine. The papers reported lots and lots of money involved. 150 million dollars, matched 1-to-1.5 by the government (walau they only gave YLL 1-for-1). While there was some debate about how it appears as though some philanthropists give money for the sake of having monuments named after them, it made me wonder what I would do if I had 150 million dollars to give to the community. It came as a response to the many comments on the above-pictured Facebook thread. Strangely enough, I had some difficulty thinking of what cause was worthy enough to give to. Some things came quite intuitively - give to the homeless and destitute, or fund research to cancer. Others were a little bit less palatable - set up a swanky posh hospital for the high and mighty, and make even more money thereafter.

One that that came to mind and refused to budge though, was a fund for medical students to break their bonds. Of course, it was made in jest (yes, Mr Khaw please don't come after me) and I can already see many problems with how that would turn out. But it also became apparent to me that the liberty to choose one's own path in life is truly priceless. The system is not perfect, and the admission process of a portfolio and series of interviews is seriously not going to sieve out innocent young boys/girls (haven't even gone through army!) from pledging their lives to what they have not even begun to understand. In the course of 5 years, people realize, to their horror I'm sure, that medicine was not what they had signed up for. The study of medicine perhaps thrilled their senses, but the practice of which, maybe not. In most cases, it's easy to throw in the towel and say I QUIT!! ...but in medical school, it's not without a hefty price. A couple of hundreds of thousands of dollars before you're let off the hook. No money? Too bad.

Those of us in medical school will surely know at least one other who has had second thoughts about medicine as a career. Maybe they detest the working environment, or it might be the pressure-cooker healthcare system. Maybe it's just the fact that reality did not meet up with expectation. The story of Dr Allan Ooi may strike a cord in some of our hearts. Why then, should they be forced into 5 years of a pathetic existence that they so detest? An unwilling doctor may be a functional doctor, but will never be an excellent one. I have found, with anecdotal evidence, that things done out of my own accord are always done with a higher standard and a spirit of excellence as compared to things that I were coerced to do, even if both tasks were identical. People should not be forced into doing what they do not want to do.

Today is the 5th of January, and by truly by God's grace, marks four years of being together with SJ. Facebook couples' anniversaries are typically marked by fancy dinners, romantic strolls and extravagant presents (but you only see the good things on Facebook remember?). However, at the point of writing this post, SJ is completely unaware that today is our anniversary (he forgot last year too btw). We met up for a usual yummy Japanese dinner at Ichiban Boshi (the most awesome yet affordable Japanese food!), and went home. BUT, I'm not complaining. If it isn't in his mind to remember this date as something particularly significant, then so be it. (Actually I don't even know what it is that is significant, other than another excuse to eat expensive food. Anniversary also sounds like such a scary word, only for centenarians.) What would be really weird, would be me being upset at his forgetting, and making sure that he remembers to do fancy things and then he doing it unwillingly. Hmm, I sound like I'm consoling myself for the lack of a fancy date. But REALLY, I am not :p SJ if you're reading this don't worry, you're still my favouritest boyfriend :p

A couple months back, I wrote two lines on a whim.

Where free will is withheld, Love shall die;

But choice gives Love, a chance at life.

I was then inspired by God's decision to create the Tree of Knowledge of Good and Evil in the Garden of Eden (another debate for another day). So before I deviate any further from the point of writing this entry, my thought of the day is that if the system in which are function in as medical students aspires to uphold the value of having love for humanity, then we should be given all the liberty to either love with all our hearts, or a similar freedom leave.

New Year

2010-12-31T13:30:00.007+08:00

I think social media creates an artificial euphoria, a facade of happiness in life and an unhealthy sense of envy. The number of Friends one your list, the number of likes and comments that your Notes or Photo Albums garner, the number of Blogs that link you to theirs seem directly proportional to one's self esteem.

You'll only ever see pictures of very glam events, big smiling happy faces, nice clothes, expensive food and important people. Everyone sees the 6 inch Anna Nucci footwear, but no one gets a glimpse of the blisters on the archilles. There is the awesome lava cake oozing with chocolately goodness, but no one will ever know that it actually tastes quite medicinal and totally not worth the $20. Boyfriend kisses girlfriend - awww so sweet. One of the best illustrations would have to be the mandatory jumpshot at most group outings. The perfectly captured jumpshots project this illusive happiness that everyone seems to be experiencing. But anyone at the scene of phototaking would know how silly looking the jumping people are, and how that apparent euphoria lasts for as long as that moment in the air. Smile and show your teeth! Show your better side! Hold up an expensive martini! Stand around the whos who during photo taking! Wait a minute...who's actually looking?

Maybe everyone is so busy looking at themselves that no one is actually looking at you. Have you not noticed that the first thing that you ever look out for in any photograph is yourself? Whoever notices anyone else?

Nobody ever posts photos of bad events, things, understandably of course. If anything bad ever happens, it usually is masked by some cryptic emo quote, or picture, or something reblogged via someone else. The excuse then is that its just a nice quote, or picture, or emotion and is completely borrowed, unreal, and impersonal. No one can appear weak, and definitely not vulnerable.

I suppose maybe this is what it means to laugh and have the world laugh with you; cry, and you cry alone.

Welcome to 2011.

Spot the human

2010-12-29T11:31:00.009+08:00

Me: Ok, test you. Describe the pot.

Marcus: Ok...this is a pot showing the lung. There are patchy areas of consolidation. I see...

Yiliang: I see...me! I have that shirt! That's me!

Me: O_O

Moral of the story: Study the pot. Think about the pot. Dream about the pot. Talk about the pot. Become the pot.

Blessed Christmas

2010-12-25T10:28:00.000+08:00

Destiny

2010-12-21T16:17:00.006+08:00

Remember THIS post? That was in M1.

Now I'm M4, studying for the Pathology MBBS 2nd Professionals (Part III can you believe it). Yiliang and Fred are sitting opposite me copying out Robbins and staring blankly at Forensic Pathology notes respectively (ok Fred just fell asleep). Sheila who is beside me just woke up from post-lunch nap and went for a pee break.

At the other end of the library are a couple of M5s. They had revision lectures over the entire weekend, Sunday included, and will continue to do so till the end of ~~time~~ MBBS. There is also one mysterious M3 (???) and a couple of unidentified creatures who are here despite it being school holidays.

Christmas is in 4 days, and the plan is to study through. My destiny indeed.

Small postings

2010-12-18T18:44:00.007+08:00

What a terrible feeling. One of the worst feelings in the world has got to be seeing a loved one harm him/herself. It's so bad that you just wish the consequences on yourself, hoping that he/she wouldn't have to bear it eventually.

It's December, and pretty much the entire of M4 has gone by. Four different postings in two months is really quite a mouthful - Pathology, Anaesthesia, Opthalmology and ENT. Test after test after test. I guess this is what they mean by how medical school trains you to become ~~immune~~ resilient in the face of examinations. Looking back, I'm glad it's over. Didn't really like that feeling of having to study, yet not really having to do so given the time frame either.

My posting at the spanking new Khoo Teck Puat Hospital during Anaesthesia was a pretty enjoyable one, despite the 2 hours travelling to and fro every day. New buildings, snazzy equipment and bright walls and murals - bodes well for a world class institution. My tutors were approachable and the subject was interesting, though 10 hours spent in the operating theatre just frazzles me up. It's a lonely vocation though, sitting for hours on end in the OT, surfing the Singapore Golf Open and hoping nothing untoward happens to the patient. You don't even see daylight. :/

Opthalmology was one of the lowest points in my entire 3.5 years in medicine. I had heard much about opthalmologists prior to my posting - I was told that they were all good looking people, dolled-up, speeding around with stilettos and caked in make up. Unfortunately, they didn't turn out to be very exceptionally good looking, and more often than not had an air of arrogance and a snooty tone in their voice. (There are the exceptions of course.) Didn't help that I'm one of those cursed to lack the ability of winking each eye individually, which resulted in a very miserable posting of being unable to master direct fundoscopy. Sigh. I left Opthalmology with a bitter taste, a headache and and crossed eyes.

I ventured into ENT with a very low expectation, having been sorely beaten up Opthalmology. I was pleasantly surprised when I found that these bunch of surgeons were certainly a different lot. They defied the stereotype and were polite, approachable and very willing to teach. It was a lot more enjoyable than I had expected it to be! What was particularly poignant about the posting was a 5 minute pep talk A/Prof Thomas Loh gave up about career choices and a life in medicine. It put into perspective many things that I think many of us feel, but are hesitant to admit or say.

Looking back in year 2010, I've found that many things throughout the year have made me a different person. There are some things I know I would have done better, some people I wish I didn't trust so readily, and things that I would have not done. I found that turning 22 made me become more of an adult that I've ever been, more cynical, more hardened, more untrusting. That's growing up isn't it? All in all, I feel like this year made me understand what William Shakespeare wrote in All Wells that Ends Well - Love all, trust a few, do wrong to none. Maybe my brother was right after all, no one can be trusted.

End of 2010

2010-12-15T23:25:00.006+08:00

In December 2010...

My brother got married
FMC youths had an awesome children's camp.

(: Indeed much to give thanks for.

More Photos HERE.

More photos HERE.

Stuck.

2010-11-28T20:37:00.005+08:00

Many will say to me on that day, ‘Lord, Lord, did we not prophesy in your name and in your name drive out demons and in your name perform many miracles?’ Then I will tell them plainly, ‘I never knew you. Away from me, you evildoers!’ Matthew 7: 22-23

How do I even begin to tell you?

Ring ring

2010-11-20T19:00:00.008+08:00

On days like this, I question the sanctity of love, friendship, family and life. I look at money, extravagance, success, fame and fortune, and wonder how all this fits into the Christian worldview. How much is too much? It strikes at the heart of what Jesus said about storing up treasures in heaven, where moth and rust do not destroy, where thieves do not steal. We give a token acknowledgement declaring all things for the glory of God, yet clamour for all the attention and credit that we think due to us. But Jesus is firm on this, and there is no middle ground. No one can serve two masters. Either he will hate the one and love the other, or he will be devoted to the one and despise the other. You cannot serve both God and Money. (Matthew 6:24)

Help?

2010-11-17T15:12:00.003+08:00

17th Nov - Children's Camp meeting
19 Nov - Anaesthesia end-of-posting-test, Dinner with friends
20 Nov - Core bible study, Attend friend's wedding
21 Nov - Church clinic
25 Nov - Ethics Exam
27 Nov - Cardiology Review Course
28 Nov - Children's Camp meeting
1 Dec - Brother's wedding part 2
3 Dec - Opthalmology end-of-posting-test, ?Playhouse rehearal
4 Dec - Brother's wedding part 3
5 Dec - Children's Camp facilitator's training
9 - 12 Dec - Children's Camp
17 Dec - ENT end-of-posting test
30 Dec - 1 Jan - Youth Committee Retreat
10 and 11 Jan - Pathology Professional Exams
23 Jan - God's Big Picture talk

Breathe.

What is life?

2010-11-13T08:42:00.005+08:00

You cannot die if you have not lived.- Professor Gilbert Lau, Forensic Pathologist, on why still births are not considered unnatural deaths

The tree of the knowledge of good and evil

2010-11-03T22:58:00.004+08:00

Where free will is withheld, Love shall die;
But choice gives Love, a chance at life.

Trick or treat?

2010-10-30T20:55:00.002+08:00

PS: Borrowed my brother's Halloween costume!

How the BTC changed my life

2010-10-29T17:18:00.005+08:00

Pathology has been a week full of lots and lots of revision. Along with long lunches and sleepy lectures pretending to be tutorials, things have been pretty enjoyable. Been amazed though, at the passion that some people have for their work - "Look at these slides! Aren't they pretty? That's why I became a Pathologist."

Now that we're into the so-called lull period of M4, I've found myself having more time and being more relaxed to just sit around and chat with people. I used to think that I was really averse to doing that, perhaps out of fear of awkward moments/not knowing what to say. But I realized that talking to very unfamiliar people can really be very fascinating and I was surprisingly comfortable at the Dean's Office's invitation to coffee. Well, why pass up on free coffee? :p Things like these open my mind to see the world beyond this little elitist bubble that I live in. A chat with Dr Goh WL on the phone was also a timely reminder that what matters in this world is relationship relationship relationship.

One other thing that I've been thankful for are the BTC rides to and from school with my dear BTC troopers, Ian (carrying a trooper gun) and Raymond. They are fantastic company. (: I was just thinking what I would miss about school life, with graduation looming about 1.5 years from now. I think I would really miss the BTC very much.