Congratzz

to Jason, my ex-shepherd in Melbourne for his scholarship

Read more here

and to Joseph (ex-unit leader in PJ) and Christine on their wedding



and yay, found the video I wanted for a previous post :-)

3 days..

Currently listening:

Wednesday
Because of my headache, I slept early at 10 pm, but woke up at 3 am. Thought to myself why the heck did I wake up so early for.. Slept back until 5.30 am, then attempted to do a bit of reading for bedside teaching and PBL. Was supposed to do quite a bit of things which somehow ended up not getting done anyway.

Went to the female wards for bedside teaching. Since our Professor was not there yet, went to look for a few patients to clerk. 1st thing that greeted me at the entrance was the wrapped body of a dead patient being wheeled to the mortuary.

Anyway, came across an old diabetic lady, whom I was having difficuty clerking coz she spoke some Kelantanese Malay dialect (which I can't quite grasp what she was saying, but we both laughed since I can't understand her, and she looked at me one kind. at least i tried..). Then there's this lady houseman who came along for her rounds, and looked at me one kind. Duno lar what was her problem that day, she asked me whether I'm a medical student, and what year I am in, but in an apparently snubbing type of manner before going back to the old lady's case files (I'm inclined to think that she looks cocky lar, but shall give her benefit of the doubt, maybe it's just me being too sensitive).

It's a bit harder to do physical examination at the female ward if you are a guy, as you need a chaperon, and patients tend to be reluctant to allow you to examine them. But it's a nicer ward (in terms of being less hot and stuffy, and also more eye-friendly and relaxed, can spend time talking to patients).

Wanted to clerk a particular patient whose bed was at the corner of the ward. Somehow she doesn't seem to be in the mood to entertain me, but she tried to smile lar. When asked of her reason for admission, she told me that she was a housewife married to a police officer with 2 kids, she came in for overdose of sleeping pills. Apparently she was stressed over 'family problems', and the husband always goes out at night after work. Couldn't get much information from her, so looked at her case files. Under Family / Social History; 'Domestic abuse by husband'. I was quite stunned, but not sure how else to respond to her (or what to say), so I just smiled and wished that she gets well soon. *walks away, as much as I want to do the right thing for her, not sure what else I can do*

At night, watched American Idol.. both finalists were outstanding on the way to the final, but on this night, I really liked David Archuleta singing from the bottom of his heart. From the songs he chose, I mean (Don't Let the Sun Go Down on Me, by Elton John; In This Moment written by Ryan Gilmore; and Imagine by John Lennon).. I guess it reflected what he feels lar.. his performance gave me a hair-raising moment :p (seriously, don't laugh!)


Thursday
3rd day of headache, but getting better I guess. I walked into the Long Case discussion rather unprepared.. and like my tutor forewarned, "You come unprepared, you DIE." lolz I mean, it turned out ok lar in the end, we like our tutor, and since it was our last class with him (probably for now), he took a photo with us :-)

p/s: Tutor's comments after looking at photo: "Umm.. what is Gary trying to do ar?"
Night time.. rushed back from CG to watch American Idol. David Cook won. Ok lar.. I try to be neutral, I support both of them. It's just, not really a fan of Cook's song choice for the finals. But you have to admit that he is a risk taker to be admired. And somebody was screaming the roof off last night + got high until cannot sleep :p

Ok lar.. at least the final song was nice :-)

Friday
Slept early, but still felt tired when I woke up at 7am. Supposed to wake up at 5 am to study for MCR (ie practical exam). Stressed, havent' really studied for it, but I don't want to re-do, coz not much time already, plus the backlog of work no thanks to my procrastinating. Since 10am til 1pm, stuffed myself into 1 of the clinical skills room, trying to somehow study.. but nothing seems to be going into my brain, so pacing up and down the corridor to the washroom and drink water (signs that I'm stressed).. can I not have the practical exam today? Sick and stressed lar..

When the time came, don't know what to do, just prayed and surrender it to Him, as long as I try my best. Initially, I thought I'm doing the respiratory exam wrongly, but it turned out ok, was surprised myself at how well it went.. The examiner gave feedback that I should be more authoritative (ie not hesitate too much with the patient) and confident. Just need more practice and put in more relevant positives, instead of relevant negatives. I'm happy with my scores!! I PASSED!!! With higher marks than the previous MCR, not coz I'm smart or what, but by God's grace (thank you :-)).. and the sight that greeted me when I exited the staff room was this Indian girl in the cardio ward pointing her finger at me as she walked past hand in hand with her mother, telling her mum, "Mummy, doctor.. doctor.." lolz so cute.

Not again..

I had a throbbing headache today, and was not in a very good mood. And just when I thought I had buried something 2 Sundays ago and decided to start anew..

Anyway, we had our last dermatology clinic posting today. Skin diseases are rarely life-threatening, but it's hard to believe that the stigma associated with it can lead to patients with psoriasis commiting suicide. There was an incident when the dermatologist whom we were with got into trouble with a fellow nephrologist when she prescribed a cytotoxic drug for psoriasis, but it led to renal impairment. But what to do? The patient was begging that if the skin condition doesn't get treated, she doesn't want to live anymore.

On a separate note, there was a lady who came in thinking that she has lupus, was diagnosed with lichen planus, but her husband is refusing to sleep with her because the last time they had sex, his genitals became itchy and he assumed that she has a form of STD. The doctor offered to do a vaginal examination, and it turned out she did not have signs of STD. Good lar in that case, hopefully her domestic problems get resolved soon. One of the many ways a disease can cause problems in relationships.

Ramblings over a long weekend

Friday
In the afternoon, helped cover for a friend in terms of examining a patient for Long Case discussion this coming Thursday. The patient was a child psychologist, who apparently had an episode of headache and fainting. We talked abit, for 2 hours (disappointed lar, missed the Thomas cup badminton semi-finals between Malaysia and China). Being very stressed, he tried to convince me why 2-3 cigarettes a day is good for your health. But I guess, he shared it coz I tried to see things from his point of view lar, non-judgementally..

I think it is a rather tragic story that his mum fainted while he was in India studying, and passed away of unknown causes. Then, after he flew back the next day, his dad fainted while nagging him about the fact that he is the only bachelor left in the family, and passed away at that moment. Learnt he hard way not to try to be funny with patients when asking questions, coz I kind of joked with him earlier about him being single.

It was a rather long time spent there.. Imagine lar a patient offering to share his tea break cake and Milo with you. He was upset that the nurse gave him panadol on an empty stomach, he told me he scolded the F-word at the doctor.. *swt* Then, he asked me to say Hi to one of my HK classmates who was 'cute'.. *swt*

He was commenting that the tutor who took them was a very good teacher. You can see that he was really determined in imparting what he knows to his students wholeheartedly. Of course lar I know, coz that tutor happened to be my tutor also for long case. Initially when I 1st met him, he seemed to be a rather strict, no-nonsense person. But I guess, it's only at the end of your posting, when you are swapping tutors that you appreciate nice people like him.. Respect lar..

Went for gym later with a few friends, and had a chat when we finished. A friend was sharing about a young patient with a terminal disease in the wards, comforting his crying mum in the wards, trying his best to remain calm even though his prognosis is poor. It reminded her of an incident from the past (I'll not mention what). And as much as I don't want to, I got reminded of Year 1 Australian rural week, when I got news of a fellow secondary school classmate dying after a fall from the 18th floor of his university hostel. Then a few weeks later, an uncle whom I was very close to (just spent time with him during Chinese New Year that year, and he seemed fine then before I flew off), passed away 2 days before my mid semester 2 exam due to terminal liver cancer Time span of say, 5 months? The fragility of life.. Here today, gone tomorrow.

Anyway, duno lar how I would have reacted in her shoes in that case, or is it that I have already been desensitised already from a previous incident..

Saturday
After a short interrupted nap, went and watched Narnia at Pelangi. I was lazy to change my Monash t-shirt, so I just put on a pair of jeans. To my horror, somebody who came along decided to copy me (NO, I HAVE NO INTENTIONS OF MAKING YOU MY FASHION ROLE MODEL). Pfft.. Well, minus all the hoo-hah about the Susan + Prince Caspian love scene, it was a pretty good film. I enjoyed it. I guess there are a few things I can sum up from the movie:
1. There is a need to be wise and plan ahead, otherwise rushing into doing something may result in disastrous consequences not only for us, but people around us.
2. The need to be united and humble.
3. It pays to have a simple, child-like faith, even if adults don't believe you (ie go and talk to trees more :p lolz).
4. Sometimes when the going gets tough, it is so easy to want to cheat / take the easy way out.
5. Look at what you have, not what you don't have.
6. God is never late, even at the last minute. And hope never fails.
7. Rodents can be so funny :p

Ok lar, kidding for the last part.. but at the end of the movie I was getting a little emo / high (gazing up at the cinema ceiling).. nothing really lar. As much as I shouldn't be worrying, just reflecting long and hard on a few things lar.. among them was myself having come quite a long way since Melbourne, where I am now at this point, having transited here and there (ie my current state, things I'm going through in JB), and like the movie, me going back there in my final year (kind of completes the full circle right, of a journey which kind of started there). How is it going to be like? What will I bring with me over there? Looking back at that time, what will I see? And what next after that?



Ok.. better stop, thinking too much :p Move on.

Father And Mother I Love You (F.A.M.I.L.Y)

Sunday School kids performing the song 'Thank You' last Sunday. Sorry for the quality though. Happy Mother's Day :-)

Fruit Coketail

Ingredients:
1 mango, sliced
1 seedless navel orange, peeled and divided
1/2 cup kiwi fruit-flavoured (actually any flavour also can) nata de coco, remove the accompanying juice / fluid
1 can of vanilla coke, chilled (any soft drink will do)

Just mix everything together :p I made the mistake of putting ice (dilutes the soft drink) and some people may not like mango, so yeah..

Dermatology (ie skin clinic) posting

Just a couple of things passing by..

Part 1
My Mandarin still suck, but slowly picking up (I think progress 1%, despite having learnt quite a bit). And just when I thought knowing little Mandarin is bad enough, my group asked me if I could help translate for them a Chinese patient whom they were clerking (had a feeling it's going to turn out to be like the blind leading the blind, but nevertheless, I agreed to sit in and try lar). Guess what? Patient decided to speak to us in Hokkien. *swt*

Part 2
An extremely thin, wasted old lady came in for review. Apparently had quite a bit of bruising lar.. she was super thin to the extent that it was as if it was just a layer of skin covering a skeleton. She wasn't eating much lar, coz she is a diabetic, and according to her son, was not happy to be asked to refrain from her favourite foods (ie roti canai, cakes, noodles, sweets etc). So old already still have cravings for such things :p Don't feel like growing old leh, if not then this and that cannot eat pfft..

Then she looked at me as I smiled at her, and thought I was the dermatologist whose name was written on the door. When the actual dermatologist said I'm not, she was like, "This is which doctor ar? Doctor Tan ar?" *swt* My reply: Dr Leong, in a few years time lar :p lolz"

Part 3
16 year old Down syndrome girl lives in Putrajaya, presented with psoriasis. Her mum was sick, and she didn't have a referral letter for Putrajaya hospital, so the aunt had to bring her down all the way to JB for treatment. No follow up, so last treatment was more than a year ago.. Accoring to aunt, she seemed rather depressed and withdrawn lar.. no longer looking forward to going to school. Joint involvement meant that she required a cane to walk, and took a very long time to try to stand up and balance herself in the midst of the pain..

Makes one wonder how lucky we are, especially in a rather pampered, rights-demanding generation who complains a lot at times..

Let the rain of Your presence fall on me
Every day that I live
With every breath I breathe.
Let the rain of Your presence fall on me
Everywhere that I go.
Lord, let Your presence flow.
Rain on me.

Love divine, joy unspeakable,
Overflowing in my soul.
This heart of mine is refreshed and at rest
In Your presence, in Your presence,
In Your presence, in Your presence.

Rural reminiscence

As the juniors went for their rural placement, I can't help but look at back at ours back then in Rawson (some place around 4 hours by bus from Melbourne).. well, all the nonsense we did, whatever you wanna call it :p embarassing.. basically we were playing a game, where the loser of the round will have to forfeit (ie punishment: sing song or dance etc)








The summary of what we went through..


Oh, and not to forget some rather disturbing moments from last year in Segamat :p lolz


Now why do I have a feeling I'm so gonna get screwed by certain people for putting these up..?

What the..?

I find the following article rather amusing :p lolz

The Star
Thursday 1 May 2008

MAT Rempit* in Kelantan will be allowed to show off their skills at a special track to be built by the state government soon, Kosmo! reported.

Kelantan Mentri Besar Datuk Nik Abdul Aziz Nik Mat said the track in Tanah Merah was not a waste of money.

“They (Mat Rempit) always make their mothers and wives worry.

“With the track they will have a proper place to express their feelings and show their bravery and heroics,” he said during the winding-up of the supplementary Budget at the State Assembly.

Went to the Utusan Malaysia website to find the full version of the story, and here's an extension to what was being said.

"Budak-budak ini mempunyai keluarga dan kalau benda buruk berlaku, ibu bapa mereka akan susah, polis dan bomba terpaksa kerja keras bagi menahan mereka dan membantu yang cedera dalam kemalangan."

"JKR (Jabatan Kerja Raya) pula terpaksa membaiki jalan atau penghadang jalan yang rosak akibat dirempuh," katanya.

Only in Malaysia.

*group of daredevil motorcyclists who are a menace to road users

An evening in JB

It's Labour day (ie holiday!), so I went on a bit of a haphazard attempt to capture sunset photos in the evening, something which I hadn't got the opportunity to do (would had loved to joined a fellow Sunway CF friend on the Monash library rooftop back then).. well, I guess, no thanks to somebody, I almost managed kill 2 birds with 1 stone (ie I fulfilled my 1 week exercise requirement in 20 minutes), and nearly got a the perfect JB sunset photo (can be improved, if I had made it to that perfect spot at the right time, and by the way; I want a new camera!!)):p lolz but along the way I managed to snap some photos I didn't really expect to capture lar..

I guess 1 thing I learnt is that there are times when a once in a lifetime opportunity comes by, if you feel like wanting to do something about it, even if not all your requirements / expectations fit in perfectly, just go for it (provided it's not something which is wrong lar).. you might just be amazed at what comes your way. So here are pix from my walk (or should I say 'run' :p) along the way from Samudera to a spot on Jalan Abu Bakar and back..











p/s: Now I have a headache, hurting feet and a sprained toe.

Addendum: Another photo which I took last time around. Rather blur though, but I like this one..