Killer paper Part 1

SAQ 1 (5 marks)
Write FOUR brief sentences explaining to the patient in layman terms what is a shoulder examination before you obtain the patient's consent to perform the procedure.

SAQ 2 (1.5 marks)
List THREE goals of a culturally competent clinical practice.

SAQ 3 (4 marks)
Discuss how might a cross-cultural experience influence medical practice.

SAQ 4 (4 marks)
Explain how might globalisation lead to an increase in developing antibiotic resistance.

SAQ 5 (5 marks)
Exercise helps to prevent heart disease in many ways. List FOUR.

SAQ 6 (3 marks)
Explain what is meant by medical negligence and discuss how the courts determine whether a doctor has been negligent or obmitted some information.


Anxious mood
Auditory hallucination

Compulsion

Delusion
Depressed affect
Depressed mood
Euphoric mood
Flight of ideas

Illusion
Impaired judgement
Incongruent affect
Obsession

Overvalued ideas

Pressure of speech

Psychomotor agitation

Psychomotor retardation

Restlessness

Restricted affect

Suicidal thoughts

Tactile hallucination

Visual hallucination

EMQs
Using the vignettes above only, select the most suitable explanation for the following situations.

1. Ming Na is a born again Christian, who only managed to get 3 hours of sleep for the past 5 days. She claimed to have received an instruction from God, in which she is to rob money from the banks and evil corporations to be distributed to the poor people.

2. Although her grandmother had passed away a few months ago, Sally still sometimes sees her standing at the corner, watching her eat her icecream.

3. The stress is too much to bear, that Sally sometimes wishes that she would go to bed and never wake up.

4. Alex is having trouble sitting still in his chair while being interviewed.

5. I know that you are talking bad things about me in lectures, I can read your lips.

MCQ

In 10 - 20 years from now, the biggest disease burden on the society in Australia is predicted to be

A. heart disease

B. cancer

C. diabetes

D. mental health problems

E. kidney failure

Crunch time

15% of the year's assessment marks hanging in the balance in tomorrow morning's exam..
and here I am wondering how in the world am I going to finish covering the anatomy of the back and upper limbs.. (i hate memorising origins, pathways and supplies of blood vessels and nerves) Lacking sleep and coughing for the past 4 weeks, i'm just flipping through other subjects' notes for this semester, don't even know how much is going into my brain...

What i REALLY don't need at this moment of urgency popped up:
Woken up by Sam at 6am, asking for time and place of his surgical selective (forgot to tell him that he was supposed to go at 8.30 am.. ARGH!!!)
Parents smsed some bad news from back home..
Seniors told me that they got slaughtered last year by behavioural sciences, health enhancement, medical sociology and some stuff from last semester.. stuff nobody bothered to read.. that's in the SAQ where huge chunks of marks lie..
Great.. What now? I shouldn't even be typing this..

Probably need to restructure my study methods a bit.. If a lecture doesn't have notes, I don't really bother listening to the lecturers when they speak.. (yes, i'm a bad listener.. preferring to scribble down every single word they say, go home and draw up my own notes with some references, then do some rote memorising).. that system has served me well all the way til A-Levels, but with up to 26 - 30 contact hours a week now, it's starting to backfire..

Things coming up:
Tomorrow - after exam, either sleep or go for haircut (haven't cut my hair for more than 2 months already leh..), pay bills, research for PCL.. still thinking whether to go for taekwondo (since i'll probably be so worn out by then.. don't afterwards collapse midway through due to exhaustion)
Thursday - Classes 8 til 5, visiting my cousin in city after that.. probably staying overnight..
Friday - Need to get up early to catch train back to campus.. Classes 8 til 4, then need to bake some brownies for CG event..
Saturday - Grocery shopping, meeting regarding surgical selective poster project, need to tidy up my room, need to start doing an assignment which is due in 2 - 3 weeks..
Sunday - church.. 9 til 2 something
Monday - Surgery selective (neck dissection and laryngectomy) at 8.30 am at Monash Medical Centre (MMC).. probably need to wake up at 5am.. excluding classes.. need to also find time to read up 12 pages of detailed procedures of the surgery (from a book the supervising surgeon gave)
Tuesday - meet up with surgeon at 7.00 am.. MMC.. after that classes til 3 something..
Wednesday - taekwondo grading or wait a further one week? (haven't been training lately, still considering.. otherwise money can throw into dustbin already)

Looks like it's going to be another LONG LONG LONG LONG week ahead.. crap.. I was hoping for my misery to end tomorrow..

Med Ball 2006

honestly this is something that i've been saving money for, since i've never been to a ball before, and i'm leaving Australia at the end of this year.. but there's a problem.. quite a number of my mates are not going.. (probably coz of the attire, transport and alcohol involved).. to go or not to go.. dilemma leh..

No hope?

Hope never fails. We are called to be the salt and light of the world, and we should be the ones to offer support in other people's time of need, to care and to love, to bring them hope. But what if the situation which requires our help actually ends up pulling you down with it? I mean, lets say what happens if someone who has reached a point of desperation asked for your help, desperately in need of hope? And you know that the person has the potential to ruin and turn your life upside down (be it your studies, relationships etc). Ok, maybe I am passing judgement too early but assuming that's the case..

You have the right to be 'smart' and say no. Nothing will happen to you then.. I might probably have to think deeply and in a worst case scenario, the most I can probably offer is prayer for him.. But will you step forth and say yes? Suffering builds perseverance, perseverance character, and character hope. However, sometimes I tend to wonder whether we have a right to leave any room for selfishness in certain situations to safeguard our needs.. but wait, that means I am worrying already.. Worrying indicates lack of faith.. How much do you actually love that person? But what do you do then?

12

The following takes place between 7 am and 7 pm (haha.. sounds like 24? :p)

7.20 am - Wakes up, realises I'm late.. has a gut feeling that today will be another miserable day..
7.30 am - Finishes brushing teeth
7.40 am - Packs bag
7.47 am - Dressed up, ready to go.. skips breakfast coz no time
7.50 am - Bumps into a few batchmates and walked along with them. Wonders how many legs they have since they are strolling at a slower pace than a tortoise..
8.07 am - Arrives at lecture theatre. Lecture has not started yet.. hooray.
9.01 am - Short break.
9.08 am - 2nd lecture.
10.05 am - Rushes to Campus Centre to look for Sam, Chris and Aishah - leaving for surgical anatomy selective, crap - have to miss law tutorial.
10.15 am - Chris called - rushes off to Matheson library carpark
10.20 am - Sam drove us to Casey hospital in Berwick.
11.00 am - Arrives in Casey hospital Berwick.
11.05 am - Hungry. Grabbed a quick lunch at Zouki cafeteria.
12.00 pm - Meeting with our supervisor.
1.05 pm - Meeting ends.
1.35 pm - Driven back to Monash Medical Centre.
2.08 pm - Supposed to start our sit-in session at the Head and Neck clinic, observing patient consultations
3.55 pm - Tolerated rantings from an ENT specialist (he's a Melbourne uni graduate anyway) that the current Monash course is crap, we are suffering coz they took out some anatomy chunks and throw in tonnes of rubbish like law, ethics, epidemiology, biostatistics and medical sociology - all courtesy of consulting people who are not in the medical field (ie idiotic patients and nurses) bla bla bla...
4.00 pm - Decided to leave when there are no more patients. Felt like a total waste of time.
4.05 pm - Raining. Waited for bus. Wonders why in the world did I choose Surgical Anatomy as my selective when some friends in the pathology selective were having fun writing nursery rhymes about basophils while others in the complementary and alternative medicine selective were learning tai-chi, yoga and herb mixing..
4.15 pm - Arrived at Monash University bus loop. Thinking of skipping dissection but popped in anyway.
4.30 pm - Didnt have time to read up much, so didnt really know what was going on while listening enviously to others answering the demonstrator's questions with ease. My demonstrator asked me which group am I from (duh... he can't recognise me??? crap.. Need more read-up to participate!!!)
4.55 pm - Thankful to have attended anatomy class. Tutor explained what I had trouble looking info for - Crutch palsy and Saturday night palsy.
5.20 pm - Withdrew cash from ATM.
5.40 pm - Prints notes for tomorrow's lecture in the library.
5.50 pm - Rushes to bus loop to catch bus back to Halls. Need to get return Gray's Anatomy before incurring a $5.00 fine.. hopes to settle everything and beat the 7.00 pm deadline (Bus ticket valid til then)
5.55 pm - Bus off to Halls.
6.00 pm - Dashes up to my room.
6.03 pm - Dashes out of the elevator.
6.04 pm - Sprinted across the road without looking (fortunately the car was still far away) only to nearly miss the bus.. Crap.. Next bus at 6.15 pm
6.15 pm - Wrong bus came.
6.16 pm - Just realised that I forgot to take my Doxicycline (no wonder coughing whole day)
6.19 pm - Bus was late. Hopped on it to get to Pinewood. Need to do some quick shopping for tomorrow's Care Group dinner.. Cooking sambal vege since Ivy wants it very badly (joking..)
6.25 pm - Jumped off bus.
6.36 pm - Finished shopping, grabbed a foot-long Subway for dinner.
6.45 pm - Crap, missed the 6.38 bus, need to wait til 6.50 pm.
6.50 pm - Bus comes.
6.52 pm - Rejoices as bus sped past traffic light which is turning orange.
Still got time... still got time..
*Ting!* NO!!!!
6.53 pm - Grimaces as passenger presses the bell..
6.54 pm - Bus stopped at traffic light..
6.55 pm - Bus heading to Monash Uni.. looks good..
TING!
6.57 pm - ARGH!!!
Arrive at Monash Uni 7.01 pm.. tired with all that running.. now having a slight cold.. Wondering how in the world am I going to finish revising 6 weeks of lecture notes plus Sem 1 stuff for next Wednesday's exam..

Giving in too much to others?

Took a break from studying to attend the Rod Andrew Oration (basically means Dean's Public Lecture of the Year). The speaker was Professor Barry Marshall from UWA (remember that Nobel Laureate in Physiology and Medicine who discovered that Helicobacter Pylori caused peptic ulcers.. Wonderful lecture I must say, he was showcasing his groundbreaking discovery - with some humour, and we watched a video of the prestigious ceremony at the Karolinska Institute in Sweden.. (basically a once in a lifetime experience - I mean, how often do you get to listen to a lecture from a medical Nobel prize winner? unless of course, you are an IMU student going to the University of Western Australia) Honestly I was considering doing some research at some point along the way (although I hate biostatistics), BMedSc --> PhD

After the lecture, he was signing autographs and there were photo opportunities (students normally took photos in groups, those who did get a personal photo with him pretended to ask him for autographs).. My friend was like, "Go lar faster if you want it so badly.. what in the world are you waiting for?" Unfortunately, for some reason I decided to let other people finish before my turn (since it's too crowded and I wanted a personal pic to put on this blog.. maybe also coz I am the 'pai seh' type - a bit reluctant to speak out) but when I did get to shake his hand, he apologised and said he had to go...



..............................................................................


He had to go.....


...............................................................................


Why?


Disappointed that I did not take my shot and cut in for a fair share when I had the chance..
Sigh.... That missed opportunity felt miserably like crap, but I got exams next week to worry about...
- need to go back to studying-

Lame joke courtesy of Chris

Chris: Romeo and Juliet were found dead on the floor. Nearby, there were shattered pieces of glass in a puddle of water. What happened / Why?
Ben: They were dancing gracefully when they slipped and fell onto the shards of glass.
Chris: Wrong.
Anna: Heart attack while having sex since they had too much too drink?
Chris: Wrong.
Me: Sleeping pills?
Chris: Wrong.
Somebody: Food poisoning?
Chris: Wrong.
Me: Any stab wounds?
Chris: No.
Anna: Any bruising?
Chris: No.
Ben: Is the answer logical?
Chris: Yes.
Somebody: Did this happen at night or daytime?
Chris: Irrelevant.
...............................................................................................
After some time, and numerous other guesses,

Everybody: Ok, we give up.. what's the answer?
Chris: Romeo and Juliet are 2 goldfish.
*VVVL

Absent-minded

Take home messages from Ivy during Friday's CG lesson on impatience and anger management: Worrying indicates lack of faith. Anger and impatience if not managed properly leads to problems..

Don't you just love the effect of pre-exam stress.. first it's the missing pendrive, now it's the missing testpad with notes from the first 4 weeks of 2nd semester.. (probably left it in the engineering computer lab while in a hurry to finish my group assignment due yesterday at 5pm)

Rural Placement: Rawson Village - Day 4 (2 August 2006) Part 1: Disability services

Day 4 - We visited a centre near Monash uni Gippsland campus, which offers disability services.
We had the opportunity feels what it's like to be disabled (ie blind, hearing loss, paralysis etc) plus find out more about the services and equipment to assist them.. overall a fun day, where we also went shopping!!

First picture was from yesterday's trivia night group challenge to make a supermodel from newspapers :p
It's actually pretty hard to move a wheelchair on uphill or grassy terrain..

Looks familiar? haha..
Dinner (actually not s good as previous nights coz they didn't wash the brocolli properly (contains sand).. well, can't complain since it's rural..

Crisis back home

Hmm.. shame to be a doctor in Malaysia.. will be interesting to see how this issue boils down..

Angry doctors issue ultimatum to MMA leaders
NST 17 Aug 2006
KUALA LUMPUR: In all his 20 years as a doctor, Datuk Dr Teoh Siang Chin has not seen so much anger being vented by medical practitioners.

They are unhappy with the Private Healthcare Facilities and Services Act 1998, which makes it compulsory for doctors to upgrade their clinics and have equipment for emergencies.

As president of the Malaysian Medical Association, Dr Teoh is also feeling the brunt from the several thousand members, who have issued this ultimatum to MMA office bearers: resolve this issue or resign en bloc.

"We just cannot believe the amount of anger they are venting," said Dr Teoh when asked to comment on doctors planning to stage protests against the Act which came into force on May 1, this year.

The MMA leadership is caught in the middle between a group of angry doctors and the ministry which is firm on its implementation of the Act and Regulations 2006.

Dr Teoh said the MMA has already submitted a 37-page memorandum to Health Minister Datuk Dr Chua Soi Lek a month ago.

On Tuesday, Dr Chua said, he would take into account what was in the memorandum when proposing amendments to the Act as he acknowledged that there has been a lapse of 13 years since it was mooted before being passed, and now to be enforced.

Dr Chua, who is to meet MMA leaders and doctors on Aug 24, agreed that some sections in the Act needed amendments as they were no longer relevant to current times.While awaiting the amendments, the minister has asked the over 7,500 private practitioners to register. So far less than 10 per cent have done so.

The MMA is also equally concerned that only a small number of doctors have registered to date.

Dr Teoh said: "We know it’s their rice bowl and some have been practising for 30 years. They have been very professional about their work but the demands in the Act have really angered them.

"Among them are the RM1,500 registration fee with which they have to submit details such as the plan of the organisation, which includes the location of doors, windows, air-conditioners, ventilators, toilet, staff identification, billing procedures, infection and vector control and basic emergency care services.

Dr Teoh said many of the requirements were not relevant for lone practitioners.

"I agree that the hesitation in registration may be due to the lack of clarity regarding the details of the requirements for registration. Many doctors have not got a copy of the Act and the information they get is from the MMA and the ministry’s road shows," he said.

(Dr Chua admitted that some of the confusion was also due to those who conducted the road shows were not able to give the best answers to questions raised by doctors.)

On Dr Chua’s statement that the MMA was a party to the discussions on the Act, Dr Teoh said: "We would like to point out that this was only in the early stages, the last briefing being in 2003. There have been no meetings to discuss the final version of the Regulations."

He said some of these regulations would inevitably lead to defensive medicine and additional bureaucracy. He said many doctors’ attention would be diverted from patient care as the real and opportunity cost of registration, renovations and upgrades required by the specifications of toilets and taps (among others) may be in excess of RM20,000."

These costs will inevitably be passed on to the consumers," said Dr Teoh.He said for clinics in rented premises, some of the structural changes were impossible and the frustration vented by many experienced GPs practising in the same clinic for decades was surely a prelude to them prematurely giving up practice, which would be a great loss to the communities they have served for so long.

Federation of Private Medical Practitioners Association president Dr Steven Chow said they were against the call for boycotts and street protests."We urge all private practitioners not to join this call for such drastic action as it will be counter-productive to the positive development thus far. The association is in the advanced stage of working out an agreement with the ministry to approach issues arising from the implementation of this Act," he said.

He said the ministry has agreed to consider most of the proposals and recommendations made by them for amendments to the Act and the Regulations.

Rural Placement: Rawson Village - Day 3 (1 August 2006) Part 3: Other sights and sounds of Walhalla

Haha..
The historic stone wall, with forest in the background
Me with the town in the backdrop
Su Wen, me and Ben



Spastic pose
The town from a hill top view
Mountaineer hut or something..

Group photo

Rural Placement: Rawson Village - Day 3 (1 August 2006) Part 2: Long Tunnel Gold Mine, Walhalla

Gold panning (mendulang emas) at the creek - something to consider doing after retirement. Water from the creek contains arsenic..
Gold mine entrance
Resemble Petronas Carigali worker? :p
Entering the gold mine
Inside the "not so dark afterall" cavern :p

Wrong time to be sick, seriously..

Exams are 12 days away.. and i hate falling sick when i need to pay a visit to Monash Medical Centre for my surgical selective, plus study 13 weeks of semester 1 stuff as well (why in the world do they have to include it in this mid sem exam..). Runny nose and coughing for more than a week already, yet i'm stingy to the point of not wanting to let the university's doctor rip me off.. Currently self-medicating with tonnes of cold and flu meds plus Robitussins' (wait, isn't that what unethical doctors do..?)

Rural Placement: Rawson Village - Day 3 (1 August 2006) Part 1: Mount St Gwinnear Snow Trip

Day 3 is basically Field Trip Day = loadz of fun.. so enjoy the pix :-)
Breakfast!!
Me and Shehara on the bus

Trees on the roadside (taken from the bus on the way)
For those of you who don't know what snow looks or feels like..
What does a person who has never seen snow before do?
Scandalous moment between Ben and Su Wen (hey, it rhymes! :p lolz)

Me and Ben with our "baby" :p lolz
Group photo 1 (all getting ready to throw snowballs at the camera)
Group Photo 2 (somewhere on the way up to the peak of Mount St Gwinnear)
Descending the mountain

The things people say..

2 things i learnt today.. thanks to this morning's bombardment..

Lesson 1:
The frontal lobe of your brain exists for a reason.
Hence think BEFORE you talk. I've been guilty of blurting out the first things that come to mind without thinking first of the consequences or the proper way of saying it. People used to get offended by it. This habit of mine seemed to be gaining prominence down here, probably due to the pressure on my behalf to try to participate as much as possible in tutorials since the locals here are very outspoken (comapred to Malaysians thanks to our education system) and if you don't crap something, your tutor's marks for participation usually tends to go down.

Lesson 2:
A person's hatred for something or someone to a certain extent (be it rational or a result of one's childish mind) can lead to unjustified expressions or actions which damages himself in one way or another in the eyes of others. (eg resulting in a permanent black dot(s) on a piece of white cloth).

Sorry lishun.
1. Reemphasising: I don't rejoice when people are in pain.
2. Stop glaring at me.

Sometimes...

...you only realised how much an important item or person really means to you when it's gone.. and you go on pondering on how you could have treated the item or person better, or what can you do to get it back..

...*lost my pendrive*...

Poser Shot

Anna asked me about this photo of mine on my Friendster, "Is this REALLY you posing with the 12 Apostles in the background? Or is it just a billboard poster in the background?"

I was like thinking, "What the..?"
(Anywayz, like mentioned in my Friendster, even if cannot become doctor, at least got a bit of potential to become supermodel :p can see some people going to the toilet already lolz)

A Tale of Unconditional Love

Too bad I'm not in Malaysia.. Would love to watch this production. Touching and wonderful storyline. Is there a CD recording of it? (If they are selling CDs of it, Philip owes me a mamak treat for promoting it. lolz)

Rural Placement: Rawson Village - Day 2 (31 July 2006)

Nothing much went on today. Rain continued on from last night (bathroom floor was freezing cold). About 9 rooms (2 people each room) shared 1 common bathroom, which contains 3 showers, 3 toilet cubicles,and 2 sinks.. Oh, I forgot to mention.. our shower cubicles have no doors (o_O" only blinds, lolz)..

We did our PCL entitled 'Lost in the Bush', about a 13 year old playful girl named Samar of Turkish descent (she wears a 'tudung', which was mistaken for a scarf in our handout) who was separated from her friends during a camp as a result of falling into the bush while playing a foll with her friends. Mapped out learning objectives which included hypothermia, fractures and some touchy-feely stuff. We had a briefing from a police officer and a park ranger regarding emergency services and the mobilisation of resources in the event of a Search and Rescue operation in such mountainous and snowy terrain. Later we were given the opportunity to interview some of the local residents to get their views on their experience of living in a rural area. Surprisingly, there was a Malaysian who has been living here for 14 years (she's originally from PJ :p). I was amazed by her view on the pros and cons of living in metropolitan areas and why she chose to come here. Others went on a visit to the local community health centre here, which was manned by a few nurses (GP comes by 2-3 times a week), my visit will be on Friday..

That's about all for today.. but wait, check out the food!! :p In sequence: Breakfast - bacon and eggs, Lunch - Fish and chips, Dinner - Roast Beef. (I forgot to mention dessert - chocolate pudding and vanilla icecream, plus tim tams, biscuits and chocolate cake for tea breaks)..
by the way, did i mention that this is all free? (other groups were given $AUD20 allowance and have to go buy food, cook and wash up, but not us)
being in one of the pioneer batches (2nd intake), hmm.. really does feel like a VIP :p

Rural Placement: Rawson Village - Day 1 (30 July 2006)

We set off a day earlier compared to other groups (Monash Malaysia group special mar :p) and arrived in the evening.. so this is what the place basically looks like. Stayed in a lodge with double sharing rooms (at least better than the girls' lodge which is quadruple sharing :p), but my room heater doesn't work.. did nothing much, other than socialising and getting to know other Monash Malaysia students..
Rawson Village
A view down the road we came
Dining hall
The lodge where the boys stay in
Never really seen a fireplace before
Dinner
Us hanging out at recreation hall. Played some games and the loser ends up doing stupid stuff as forfeit (will show later when video has been made). Watched LOTR: Return of the King before going to sleep..

Would you..?

Before that, one message goes out to a friend of mine, Ms Chan Sue Anne from IMU who is currently in Melbourne for holiday:
VERY SORRY, I AM UNABLE TO COME DOWN TO THE CITY TO VISIT YOU. ANYWAYZ, HOPE YOU ENJOY YOUR HOLIDAYS!!! :-)

Back to the topic. How much do you love your mum? To the extent that you are willing to sacrifice your medical career to be with her? There's a friend of mine who is considering whether to transfer from the Malaysia course to the Clayton course, failing which she would quit and reapply to Monash Clayton to start from scratch.

There are risks involved, though. One may not get the offer a second time around. More time, money and effort to be put in. Considering the fact that medicine is not easy or cheap, and with so many inconveniences and uncertainties, some people just could not understand the rationale behind it. Yet I admire the fact that she is willing to do it out of love for her mum. Sometimes I myself wonder whether I am able to bring myself to do that when the situation arises..(don't get me wrong, I love my mum)

Losing myself

Just came back from rural placement (down with cold, cough, runny nose and sore throat at the moment). And with plenty of things to do there, I enjoyed the time of my life there.. I really did.. i don't mind the fact that there is no reception for my mobile phone in the middle of nowhere. However, a few incidents that happened really made me ponder on whether I am losing sense of what is going on around me, the ability to express myself emotionally and to be sensitive for other people's needs and feelings.

Incident 1
Life is short. On the cold and wet night before the field trip to the snow, I received a message from my friend back home in Malaysia (somehow there was mobile phone reception at that very moment). A friend of mine had passed away (I found out later that it was due to a freak accident). I knew him since Form 1 in secondary school. Although he is Chinese-speaking most of the time and tends to mix around with his own former primary school mates, I do remember the times when he used to be our class joker. The last time I saw him was somewhere around last year when he and a few of us went out for tea at a popular hangout back in my hometown. Most people would usually break down emotionally when such news hit us right smack in the face. For some reason, I find myself not being able to express myself (ie lost for words, I didn't know how to react at that time, I couldn't cry or bring myself to grief). I just don't know why. I didn't want to tell others because I didn't want to become a wet blanket and ruin the fun trip and stuff which everyone was looking forward to. Hence, I just let it passed, hoping that it is just a bad dream and I can sleep it through to clear my head. But being unable to do so, I went for a walk in the rain to clear my head. The next day, we had fun at the snow, but I just felt like letting a friend of mine know about my situation and the fact that I did not feel so good, with a bit of remorse deep down inside. According to him, there are cases where people just don't feel sad immediately after a loved one's passing, but the reality that the person is gone only hits you maybe sometime later.. It's just something that cannot be explained in detail (he shared with me about his grandfather's passing, and how as a little boy he couldn't be bothered about it until later). I really don't know what to think, here I am stuck in Australia, unable to be there to see him for the last time. I was on the phone with another ex-classmate of mine in Sydney. He cried all night long when he first heard about it, feeling disturbed that our dear friend may not have left in peace.

Incident 2
I realised that I tend to be a rather technical and perfectionist type of person (ie constantly scribbling down notes and always trying to follow things exactly by the book).. and patients tend to dislike me for that.. We were supposed to gather information for our project about living in rural areas by interviewing a few local town residents, and there was a friend of mine who came and had a chat with the resident. I could see that although she was not taking notes (in fact later she did not seem to bother remembering what the resident told her), she and the resident sort of "clicked" and I could see that the guy really enjoyed talking to her. No, don't get me wrong, I'm not feeling envious. It's just that I don't like the feeling of not being able to interrelate with patients, as if I have no feelings or concerns for them.

Incident 3
There was a trip on day 4 to the headquarters for an organisation providing support services for people with asbestos-related diseases. The speaker delivered a powerful and emotional presentation on the hardships and discrimination surrounding the people with mesothelioma and asbestosis. It is a killer disease that results in a slow and painful death. No one deserves to die from it but yet not many developing countries have widespread awareness on safety when dealing with asbestos. In South Africa, mothers bring along their young kids to asbestos mines to earn a living. It's heart wrenching to accept the fact that these people are willing to put their health of lives of their children in danger just to survive for another day due to poverty. To big companies, these workers are nothing. Life is cheap in Africa. The presentation struck me at some point because once in a while I do consider working for similarly related organisations in the future (probably after my PhD if I manage to get 1). It would be a bitter pill to swallow to think that I am actually going to be part of an organisation and indirectly inflict such misfortune upon these people.

When my medical interviewer asked me why do I want to become a doctor, at some point of my long answer, I told him about my experience working at the hospital, when I used to enjoy chatting casually with patients and when they used to tell me about themselves and their life stories.. How is back then different from today? Now I have a pen and a paper to jot down what the patient says. What is being asked is taken note of seriously for assignments and exams. Maybe a bit too seriously.. A friend of mine once asked me, "Wah lau eh.. you guys have a script / list of things to say to angry / grieving patients wan ar? Just memorise only lor right? Aihz.. The medical profession today seems to have lost the human touch."

Has it? Or is it just me drifting away, losing my sense of sympathy and compassion.. I am starting to hate myself.. Every single passing day seems so fragile, with endless possibilities of what is going to happen to you and me..

*I shall upload my rural placement photos later..