Hello

It is 2018 and I am still alive! Blowing the dust off this space, if anyone still reads this, it would be nice to reconnect.

I sometimes trudge along in life wondering how and what and why. My usual response to how's life is a typical good, still surviving. One wonders what that means. I enjoy my work mostly, deal with some unpleasantries from time to time, and indulge in pet projects that interest me. Half the time I wonder if whatever I am doing makes any difference to anyone at all. I only hope that my existence does not cause any detriment to another. Home is where snuggling a little fatty bring an inexplicable joy, when she returns that with unsolicited hugs and kisses - hug mama! 

Confess that things have been down on the spiritual front. Excuses like no time, no energy abound. Constantly reminded that this world is not our home and I need to get my butt up for kingdom work. This feeling of being dry is for myself to blame.

An inspiring story of late, of my boss who adopted a child from China. Such great generosity, such great love.

https://www.channelnewsasia.com/news/cnainsider/china-orphan-keyuan-singapore-family-chinese-new-year-9969640

Year End

What a wonderful year, with Zoe joining us as a bonus.

Back to work, not drowning yet, but paddling like crazy. Remembering how life was like just 6 months ago, compared to now. Thankful, nevertheless. Being a new Mom has given me many new insights into Life and being responsible for another human being. There are many spiritual truths that are illustrated with parenthood, and it makes me all the more grateful for my own earthly parents and Heavenly Father.

How the world has changed from 1 year ago. We were young, carefree and frolicking in the East Coast blizzard. Looking forward to the new year, having the little bubs grow up and travel the world with us! :)

An Olympic gold

Coming to about a month since we've been home. Lots have happened since. We celebrated the nation's 51st birthday, and J Schooling won the nation's first Olympic gold medal today. The weather gently eased us in from rainy and cool to the hot and humid that this country usually is.

Just enjoying the last few weeks of my maternity leave, spending time watching baby grow (they grow quickly!) and also preparing myself for return to work. Mixed feelings about that, with some anticipation and also trepidation.

No real point to this post. Just a random mental note to be thankful for each day.

Last things

Thinking about Last things often triggers a sense of melancholy. In the final weeks of my pregnancy, I often thought about how whatever I did would be "the last time I" did it before I popped - the last time I could go out shopping on a whim, take a stroll to the nearby cafe for an ice latte, go to the gym with my gym buddies and even just take a long luxurious shower. So it is not unexpected that this Last Week in NYC should trigger a similar sense of unwillingness and sadness toward ending this phase of life.

Two years ago, when SJ first mooted the idea of pursuing a Master's degree overseas, I was ambivalent. I had been spending long hours in the hospital training for my final residency exam and did not think much of it. I was worried that if I flunked that exam, the residency program directors would never approve of me taking off anyway. At that time, I was also in the midst of chosing my internal medicine subspecialty, and knew that if I were to take a gap year, my chances of getting into the most competitive specialties would diminish. I nonetheless was of the opinion that if he were to be given the chance to do so, then I would be fully supportive.

So my exam came and went and so did SJ's application for both financial support and the universities he applied to. We prayed for God's direction and leading. It was quiet for a little while, with no response after all the necessary documents had been submitted. I thought, hey maybe God does not want us to go after all, and went back to thinking about my residency applications. And then within the next week, we received offer letters from two universities, and with full support from SJ's office. He took up the offer from NYU and the rest, as they say, is history.

So a whole year has gone by, and many have been wondering what I've been up to. I tried to get involved in some clinical work, but that didn't work out due to medical liability and insurance issues. So I ended up doing the US medical licensing exams (spending my MOHH PTF right to the very last cent, yes!), partnering the Doctors without Borders NY office with an antimicrobial resistance project, and jumped into the Hope for New York partnership with the Salvation Army homeless feeding program. SJ and I also volunteered together with ISNYC in their English classes for international students, from which I joined and started my own seeker Bible study. In between all this, I jumped at an opportunity to attend course at the Harvard Business School, and do distance learning courses.

And the cherry on top? I finished watching all 8 seasons of Desperate Housewives lol. Go me.

All these seem rather random indeed, and does nothing much to enhance my CV, which was why I didn't think much of my chances at senior residency applications. God has opened (as well as closed) doors for us and all in all, it has been a good year. No regrets whatsoever.

And to deal with the elephant in the room, Zoe's arrival was the real icing on the cake. I don't think anyone can truly ever "plan" a good time to have a child. There is no good time. Having a child is inconvenient, full stop. In retrospect, God's timing was perfect is so many ways. Zoe means Life, and as we return to home to many new uncertainties and even death, may Zoe remind us always of the gift of Life that God has given us all.

In good time

Final countdown to back home! Just about 7 weeks before we fly and bid this land that we have called home for the past 10 months or so goodbye. Bittersweet, even as I type this and gaze out my window at the Empire State (yes this new apartment that we are in has an amazing unobstructed view).

Two nights ago SJ invited Kyle, the new Dwell intern, out for dinner. Fresh faced and 21 years old, it is his first time in the city. First time smelling the rotten subways, enjoying street art and the food scene. A stark change from the suburban life he is probably used to in Washington state and Michigan. Brought me back to the first time we landed in the city. Now we are not so fresh faced (eye bags ++) and can probably do a little tour of the city for a newcomer. Not quite the New Yorker, but enough to say been there, done that. SJ wants to do a little drive out to the Jersey countryside before we leave. Not sure how we're gonna do that with Zoe, but we'll try!

The other Singaporean fellas are heading home from their grad trips one by one. They've been a wonderful bunch, and am glad to have had the chance to know them. Very brilliant and rising young lawyers, each with their own great personalities and quirks. Will be interesting to see these young men years down the road!

I feel like God's timing couldn't have been better. From this opportunity for SJ to be here on the Masters program, to my gap year, Zoe's birth and our return to Singapore. Everything has happened in good and perfect timing. Wouldn't have had it any other way.

March

Wow it's March! And it's almost the end of winter (hurray!) The perennial question, where did all that time go? I feel like I've been doing everything but also nothing at the same time. Just the other day, I went to snuggle in my bed at 3 O'clock in the afternoon to read a book and slowly fall asleep, and just thought about how awesome it has been do be on this "sabbatical" (read: holiday). I'd admit that some days I do miss the challenges of clinical work and earning my own keep, but when the sun is up and it's 5 degree celcius outside and I'm snuggled under my sheets, I can't help but feel a sense of wonderful bliss as I wander off to my nap. No regrets!

I've thought recently about Life and it occurred to me how we (myself included) often feel compelled to live it as a race. There is this sense of oh no I need to keep up when we hear of counterparts moving on the "milestones" in Life. Oh he graduated! He's doing his second degree? No way, she got promoted again? Wow, she got married. First kid! Second kid on the way! And we feel like we got to hurry and catch up or our lives remain empty and stagnant. What a folly, I'm sure Qoheleth would proclaim. This probably becomes especially relevant in this particular season of my life, but I also am reminded of the wonder and beauty of slowing down to smell the roses. There remains but a couple of months before I am called, first, to the higher calling of parenting, and second back to the daily grunge of clinical medicine. So as I am typing this enjoying the luxury of time and being without worry, I just hope I remember the feeling of having the God given privilege of being here and doing so. :)

W was in town for the week to experience NYC and we had country BBQ for dinner :) Having been proclaimed the most underwhelming NY travel guide ever, we head to the Cheesecake Factory this afternoon!

Melancholic

I feel sad.

:(

Wanderer

The rumbling subway screeches deafeningly to a halt.

Commuters on the platform lean away and cover their ears, bundled up in down jackets and woollen gloves as temperatures dip below single digits in celcius. The underground provides but a brief respite from the chilling city wind.

"Local train to Far-Rockway", goes some mumbling voice across the public announcement system, quite unlike the booming voice that usually accompanies trains in complex and developed public transportation systems.

There is an African American standing on the opposite platform, shouting something incomprehensible and making vigorous hand gestures. He seems to be talking to someone, something, but there is no one else around. Curious eyes peer from a several feet away, cautious to maintain a distance. Mental illness, perhaps. Not uncommon in a city where the homeless roam the streets and seek refuge in the warmth of the subway station...or even just a night in custody. In this city, you often smell homelessness before you see it. The rancid smell of city sidewalks, pot, and despair.

We scramble close to the doors as the subway pulls over. At 4:30am, there are a surprisingly significant number of commuters. Perhaps why the subway system never sleeps, running 24/7 all year round.

Memories flash back to the day we landed in the middle of summer. Sweltering, unrelenting summer. The first thing that hits you is the Smell. Garbage, piss, pot. Walk along the narrow sidewalks for no more than two blocks and you will probably encounter piles of trash, someone lying under the shade of the awning looking wasted in midday and always, the smell of piss. Then you begin to notice how skinny people are, and how much running is of a big deal. Sun, wind, snow or rain, someone is jogging along the sidewalk, rather forgiving of the city scent and congestion. There is little regard for traffic lights, cross at your own risk. When ordering coffee, skim milk, please.

The city folk are wanderers. Some have wandered in, some away. Does New York tire you? A friend had asked. The bright city lights draw people like moths to a lamp. When the lights one day dim, they too, leave. One year, two, ten. It's hard to stay, they hardly do. I can count the number of born and bred New Yorkers I've met with a single hand.

A city of opportunities, rights, freedom, they say. Three weeks ago, someone was robbed at gunpoint two streets down from my apartment. I guess freedom to bear arms overrides our freedom to walk down the streets safely at night. Who is truly free?
But back to the subway. It is almost 5:30am and we are pulling into Howard Beach. My mind has wandered far over the past hour, time for a jolt back to reality.

Four months gone by, wandering. New York, New York. "So good, they had to name it twice." So much like home, what a wonder.

Homesick

I'm hardly an effusive person, but I have to say that lying here in bed, in my maiden AirBnB experience, all alone makes me really homesick and husbandsick. I've barely been here over 12 hours. No one to pour me a hot drink while I'm freezing under the quilt, worries about whether I'll be able to wake up on time for my exam tomorrow and having instant noodles for dinner just because eating out is no fun when you're alone. I can't wait for tomorrow to come and just be over and go home to the arms of a loving husband.

I remember what M had once shared about his PACES experience. The night before his exam, his cousin suddenly died. Then, it dawned on him how trivial it was to worry over an exam. A silly simulated exam of which failing may bring additional expense and effort, but really is nothing compared to the greater things in life. So as a reminder to myself, to rest assured in God's faithfulness, and that there are far greater things to consider.

Over dinner I watched the Channel News Asia documentary on the Sabah quake that struck Mount Kinabalu earlier this year. It wasn't about the Singaporean children who lost their lives, but instead the local guides who risked, and gave, their lives in order that their "clients" may live. Tragic stories of a newly engaged young man, and another young father leaving behind his wife and a 6 month old child. Heartbreaking.

So as I wind down for the night, I hope I don't ever forget what a privilege it is to be a doctor. That I may give myself for the betterment of another.

Maybe, baby

I've had these thoughts for a long time.

I always wonder how people are so confident to say, "I will have 3 children", "I will have my first child by 30", or "I want my child to become an XYZ". Perhaps it is an occupational hazard, but pregnancy is probably one of the most unpredictable processes in a woman's body. Sperm + egg = baby, sounds easy enough. But there in between lies about another 42398309182 different steps for a human to be formed. Any error in one of these steps results in miscarriage, birth defects, life threatening conditions to the mother, and everlasting consequences that show up maybe only years down the road. How women bear with vomiting 40 times a day in "sacrifice" for the growing child baffles me - I mean, a pregnancy like this literally has become a disease that is causing suffering. The growing foetus literally is a parasitic growth in one's body.

And worst still, it doesn't even stop at childbirth. A perfect pregnancy followed by a difficult labour may result in cerebral asphyxiation and cerebral palsy, shoulder dystocia, or even subtle medical conditions that are only detected several years after birth. Then there is the uncertainly of intelligence, social quotient, morality of the human that one brings to life. Sigh, parenting.

As such, it is truly a miracle that I am sitting here typing this because cells in my mother were fearfully and wonderfully made, and it is certainly by no chance that it was made randomly.

So to all my pregnant or potentially pregnant friends, it truly is a gift. And may life, God willing, grant you a healthy and wonderful child. I would cautiously report it as maybe, baby. 

Seasons of Life

Brother just diagnosed with stage 4 colorectal cancer.
Mother had recurrence of previously disease free breast cancer.
Pregnant with her first child.
Father took his own life.
Had a near miss with losing his eyesight completely.
Still unemployed.
Finishing the 8th cycle of chemotherapy for pancreatic cancer.
Grandmother fell out the window, broke her neck and died.
Worried about money for the future.
Thinking about school options for his special needs child.

We are all fighting our own battles. One at a time.

Off the face of this earth

I guess it's not difficult to...just disappear.

Kiss92 FM musings

No fruit is quite as divisive as the King of the Fruits. You either love it, or hate it. Hardly do I find anyone feeling ambivalent about the durian. It either gives you sweet dreams of the thick, creamy and buttery flesh melting in your mouth, or evokes nausea at the vomit-inducing smell each time the thorn-ridden shell is skillfully broken by the durian uncle. Durian season ftw!!

Source: foreigngeek.com

Feeling patriotic, and also regretful that I won't be in Singapore to celebrate this year's SG50 National Day come August 9. While driving home from sending SJ to work this morning, I just marvelled at how wonderful it is to live in Singapore. When I was maybe 15 (just slightly over 10 years ago), people kept on saying how Singaporeans only love to complain, Fast forward to today, I think the local community has ?matured somewhat, and social media has given the opportunity to the once silent majority to highlight the wonderful facets of our society. Even in light of the recent SMRT breakdown saga, attention was brought to acts of kindness of people giving out free drinks, free rides and the works. This is on top of our ever-efficient work ethic, opportunities for all, a government worthy of respect and a UNESCO World Heritage Botanical Gardens! PM Lee recently chided Singaporeans of thinking of the Singaporean identity as only revolving around yummy food. I think we should be proud of the Singaporean reliability to make things happen, and I think a growing spirit of caring for a fellow Singaporean :)

Dinner date

SJ was dreaming of some French food so we headed to St. Regis for our belated wedding anniversary dinner. We had gone to Brasserie less savers last year and enjoyed it, so why not again.

This was not without some minor pre-dinner domestic squabble, a reminder that marriage requires continued nurturing and investing in.

It was a quiet night, ended off with some pinot noir that we got at a steal. Ending this week off on a sombre note, thinking about the young lives who were taken by the Sabah Quake, the 47 year old man whom we could not save, road traffic accidents, and also, polyps. Our lives are but a stalk of grass swaying in the winds of time...

Weird

I feel like this is getting too weird for me. All I want to do it stay at home and snuggle in my bed all day.

If I could choose an age to be in for an extended period of time, I would like to be either in my secondary school days spending my time at sleepovers/doing useless projects, or be very old and retired and drinking kopi all day long at the kopi shop.

27 is a bad age to be. Sigh #growingup

Off day

In MICU, we are on call, post-call and then get an off day. I am off today.

It's kind of weird. I mean, having lots of alone time. My off day is usually spent waking up at 6:30AM anyway so that I can send SJ to work. Poor chappy has been tortured together alongside me during this posting in waking up at before 6:00AM every day so that I can reach work on time, so 6:30AM is still considered a luxury. After dropped SJ off at work, I make a 3-minute ride down to Tiong Bahru Market to pick up some breakfast and have it in the luxury of my home.

I usually aim to get some work done on a day like this, but today I feel so under the weather that I've just been watching Star Awards youtube videos and laughing at Rui En's famous resting b*tch face. Now I am just lounging around and contemplating if I should go swimming in this glorious sun.

I think I will.

Serving Notice

The best breakfast consists of meepok ta jia hiam jio he yu yuan and 4 pieces of Tiong Bahru Jian Bo Shui Kweh. Throw in one Kopi C siu dai. Absolute bliss and reminiscent. You can taste it already, no photos required.

So we have gotten some sort of assurance and direction in the coming year. I was surprised at my own reaction. On one hand it was something that SJ and I had been praying and hoping for; on the other when it did finally come through there was great sense of uneasiness and anxiety. Lots of checklists and things to organize. So much more uncertainty than it would have been otherwise.

It occurred to me recently how human behaviour changes in light of imminent departure. Being a doctor bonded to the public service, we don't quite seen that often since no one can really leave anyway (at least not after a long time). Nonetheless, with the approach of every end of posting, people start to loosen up a little more, become more heck care, after all, "I'm not gonna be here sorting out this mess in X number of days." That is probably only human nature. We could not afford the time and energy to invest in something that would neither last nor affect ourselves (save for causing harm to others of course.) Over conversations with my friends in other industries, my very suaku self realised how sensitive it is often to tender a resignation and serve notice. People could not care less about you any more, important work is directed away from you and well, I suppose maybe relationships change since one no longer becomes a part of the company hierarchy. Simply put, a declaration of departure changes ones perspective of work, and others of ourselves.

If the workplace is but a microcosm of our universe, what then, does it mean for me to be a stranger in this world, with heaven as a destination? I might be absolved of all responsibility if so, since a selfish me could easily think this world is not my own and proceed to exploit all of its resources. If I thought so, I would be clearly misguided. Scripture reminds Man to take care of the land and work it, and goes on to reveal that the new heaven and new earth does not equate to the cartoon-illustrations of floating up to the skies. There is no mass destruction of our buildings, wiping out of all that is pre-existent. The revelation is that of restoration of what is old, to make new once again. In light of this, it would be consistent to believe that God has charged us to be stewards of whatever we are doing now, contextualized to a view of eternity.

Going back to my departure, this random muse of mine serves as a reminder to myself to continue to uphold and honour the work that I do even in this time of "serving notice".

Flowers from Marc and Xiuli's wedding, 16 March 2015

You've survived, what next?

Six weeks into Neurology, I can see how Death could be far more enticing than Life. A burst aneurysm, classically described as an ironically beautiful starfish shaped hyperintensity on the plain CT brain scan, leaves one helpless at the hands of the Neurosurgeon. Depending on the time at which you arrive at the doorstep of the Emergency Department, you may be subject to a decompression craniectomy in which the surgeon takes out a part of your skull to allow the brain to swell beyond its usual enclosed brain space. A tube is then put into your lungs to help you breath, medications are used to support your blood pressure, while you get at least 4 different tubes put into your veins and orifices.

So you've survived. What next? 

A week later someone, because recovery is slow is any severe brain insult, there begins talk of putting in a tracheostomy - essentially a hole at the front of your neck through which a shorter tube is put to help you breathe. One cannot stay intubated through the mouth forever, and hence the tracheostomy remains the only better alternative. No one can predict what kind of brain recovery you will make. Whatever damage has been done, is done. Any form of intervention done at this stage remains to damage control and not to reverse any of the cell death that has occurred.

So you've survived, what next?

I've seen too many large MCA infarcts and massive posterior circulation strokes come through the doors of NNI in these past 6 weeks. "Surgery is life saving, but not brain saving", my stroke consultant would say. A life is saved, but saved only never to be able to talk, to walk or to meaningfully live as one would have before the stroke.

We all live, only to die another day.

So when we talk about medicine saving lives, I really wonder if that is what we should be doing. I cannot tell if this is my jaded-3-year-doctoring-self talking, or if modern medicine has failed to convince me that the lives we save are worth saving.  Prof U would say "Don't be demoralized! When people get demoralized they start talking about things like max ward et cetera. We must do all we can."

Specializations like medical oncology and cardiology are popular and sexy because to the layman, people die from cancer and from heart attacks. The poor Neurologist is jeered at for having little brain saving to do. They journey with the 23 year old with multiple sclerosis who cannot walk through the prime of her life, the 40 year old who discovers that he has dystrophic myotonia, a genetic disorder that causes his muscles to weaken. To add fuel to fire, he discovers that this disease has been passed on to all of his offspring. These people don't die, they live on.

Perhaps what people don't realize is that the things that don't kill you, could be far worse than dying. 

Babyboom!

At the rate baby photos are appearing on my Facebook newsfeed, I'm certain we do not have a baby boon.

< Insert cute baby photo >

Existential

On a day like this, I really wonder why people go on living. Life is hard, full of suffering. If not now, later. There is sickness, pain, death and separation; anger, hate, hurt.

We are so quick to judge. Oh, too noisy. But I wonder, when the noise stops and the air is still, will you still say the same?

Choosing to be a parent should be one of the hardest lifetime decisions to make. I think people make it too flippantly (oh judgemental me). Why did you choose to have children? Oh,  because it would make my life complete. Oh, so that our marriage would be enriched! Oh, so I can nuture another human being to be of value and contribute to society. Yes, all valid. But what if the child is sick? Grows up to harm someone else? Rebels against all law in his or her teens? Hurts you with stinging words? Then one day, you will die. And yet another relationship truncated. Heartbreak. The cycle goes on.

I was recently made aware of a potential change in life circumstances in my family. I am a creature of habit and dislike change. I thought about what would happen next, and felt scared. Fear of the unknown, fear of the future.

A small part of me often wishes that I never existed. The philosopher would argue that that itself is an invalid thought. I honestly think it is not always true that it is better to have loved and lost than never to have loved at all.