Recently..

..I do question myself on how badly do I actually desire to see that something come to past.

It's a personal struggle. I don't know why it arose lately, compared to previous years where I have taken steps of faith before.

And then that soft, still voice came this morning through a thought, "You see, you have been trying to catch a certain feeling / perspective / encouragement through reading certain books, watching certain videos, asking here and thinking there, but you are looking at the wrong place. There is only 1 simple thing required, that is to take that step out of your comfort zone and lay down yourself."

End of medical posting + Love never fails Part 2

1. Pretty bad coughing fits for the past week or so, then Sunday had an onset of headache, fever, sore throat (no I don't have H1N1 - I took the vaccination 3-4 weeks ago). Bedridden for days, even dragging myself to the clinic under my supervisor becomes a chore.. Paying RM1 at the outpatient clinic for bacampillin (antibiotics), panadol and loratidine (antihistamines) did not work out - though they thought it's my usual pharyngitis secondary to post-nasal drip, as I do get allergic rhinitis from time to time, so had to look around JB in a taxi for an open clinic on a public holiday. Paid RM90, but the GP felt that it could be an infected rhinitis with underlying mycoplasma infection, so he gave me some stronger drugs (Azithromycin, Theophylline, Eterocoxib and Pseudoephedrine). Today felt much better..

2. Did my MCR with my academic supervisor for a 2nd time coz he expected and drilled me and my partner to do better. Really thankful for the privilege of having such a bedside tutor. Not to say it was my best performance (I know its formative), but I thank God for quite high marks, and the joy of discovering what the patient had (initially I had suspected TB / lung CA), but found nothing on respiratory examination - got told to repeat my chest examination more thoroughly, and to my surprise there WAS indeed dull percussion note on the right lower lobe, with bronchial breath sounds on auscultation!

3. Got reminded during devotion of the following verse:

When they had finished eating, Jesus said to Simon Peter, "Simon son of John, do you truly love me more than these?"
"Yes, Lord," he said, "you know that I love you."
Jesus said, "Feed my lambs."
Again Jesus said, "Simon son of John, do you truly love me?"
He answered, "Yes, Lord, you know that I love you."
Jesus said, "Take care of my sheep."
The third time he said to him, "Simon son of John, do you love me?"
Peter was hurt because Jesus asked him the third time, "Do you love me?" He said, "Lord, you know all things; you know that I love you."
Jesus said, "Feed my sheep. I tell you the truth, when you were younger you dressed yourself and went where you wanted; but when you are old you will stretch out your hands, and someone else will dress you and lead you where you do not want to go." Jesus said this to indicate the kind of death by which Peter would glorify God. Then he said to him, "Follow me!"

-John 21:15-19-

Why did Jesus had to ask Peter 3 times? Not that He is deaf, nor that He got nothing better to do, I believe it's coz:
1. People tend to be forgetful (especially when they become caught up with things).
2. We do not really mean it, or perhaps it has gradually become a routine (ie we might look fine from the outside based on the things we do, but unknowingly on the inside God is searching your heart for where your true motives lie)

4.
Watched an interesting movie titled 'I am Sam' during prayer meeting, and had a short but good sharing time with my shepherd. Synopsis as follows:

Sam Dawson (Sean Penn), a man with a developmental disability, lives in Los Angeles, works at Starbucks, and is the sole guardian of his six-year-old daughter Lucy (Dakota Fanning), after her mother abandoned them. Despite his limitations, Sam is well-adjusted and has a supportive group of friends with developmental disabilities, as well as a kind neighbor Annie (Dianne Wiest) who takes care of Lucy when Sam cannot. Though Sam provides a loving and caring environment for precocious Lucy, she soon surpasses his mental ability. Other children tease her for having a "retard" as a father, and she becomes too embarrassed to accept that she is more intellectually advanced than Sam. In preparation for a custody case, a social worker turns up at Lucy's birthday party and takes her away, allowing Sam two supervised visits per week.

On the advice of his friends, Sam approaches a high-powered lawyer, Rita Harrison (Michelle Pfeiffer), whose brusque manner, fast-paced schedule and difficult personal life have earned her a reputation as cold and unfeeling. In an attempt to prove to others that she isn't heartless, Rita surprisingly agrees to take on Sam's case for free (pro bono). As they work together to secure Sam's parental rights, Sam unwittingly helps Rita with her family problems, including encouraging her to leave her philandering husband and repairing her fractious relationship with her son.

During the trial period, Lucy is living in a foster home with Randy Carpenter (Laura Dern), but tries to convince Sam to help her run away, and continually escapes in the middle of the night to go to Sam's apartment, whereupon he immediately returns her. At the trial, Sam breaks down after opposing counsel convinces him that he is not capable of being a father. Ultimately, the foster family who plan to adopt Lucy decide to return her to Sam, with an arrangement that Randy will help him raise her.

The final scene depicts a soccer game, refereed by Sam, in which Lucy participates as a player. In attendance are the foster family, Sam's friendship group, Annie, and a newly-single Rita with her son...

It's an interesting observation to see that the very people trying to take away Sam's parenting rights (the lawyer, judge, department of children services etc) on the basis of his inability to provide financially and intellectually for his daughter, these people who actually lived normal lives and whose children have access to every physical need (ie money, education etc). However at times, these are the people who turned out not knowing how to take care of their own children (depicted in the movie through various relationship problems behind the scenes). On the other hand, I think we can learn from people like Sam, though intellectually disabled, in the area of going the extra mile when we care for someone, and being real (rather than putting on a projected image of oneself).

Love never fails

Currently listening: 恩典之路 (The Path of Grace)
by: 讚美之泉 (Stream of Praise)

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祢是我的主 引我走正義路
Lord, You are my guide, the shepherd of my life
高山或低谷 都是祢在保護
Through the hills and valleys, You’re always by my side
萬人中唯獨 祢愛我認識我
Calling me by name, You’ve chosen me with love
永遠不變的應許 這一生都是祝福
Blessing me abundantly, Your promise will never change

Chorus (x2)
一步又一步 這是恩典之路
Every step we take, You lead us with Your grace
祢愛 祢手 將我緊緊抓住 (牽引我走這人生路)
Your love, Your hand, will hold us close to You (will guide us through the path of grace)

Lifegroup's praise and worship reminded me of 2 things:
1. Because God loves us, He is our enabler
Tuesday was a long day which started at 7.30am, then 5 hours of medical clinic with my consultant supervisor, clerking, examining, presenting and writing prescriptions for each patient who came in (already like MO already, seeing all your diabetes, asthma cases)..then after lunchbreak, ward work, and rounds until 5.30pm. Went to gym (probably a mistake? :p), then on call until 10pm. Too exhausted to do anything, next morning had to clerk patient for bedside. Nevertheless, really thank God for his favour the next day, and a good teaching session. Even as we sang 'God is the strength of my heart', got reminded that that He will continue to sustain us, even through difficulties (sometimes through little bits of encouragement), as during the times of Nehemiah, when the people faced opposition to the rebuilding of the wall of Jerusalem. As long as we try our best and continue to remain in God's purpose, he will help to accomplish the task (the wall was rebuilt in 52 days).

2. Because God loves us, He sees beyond our transgressions
One section of the song 'Power of Your Love', reads '..Lord I've come to know, the weaknesses I see in me, will be stripped away..' A part of John Bevere's book, 'Extraordinary' makes note that there's nothing we can do to make God loves us more or less, whatever we have done. Able to see how despite the many ridiculous things which the Israelites did and complained in the past which resulted in them wandering in the desert as punishment, how God remained faithful and patient in providing them with food, clothing and guidance. In the same way, many times we probably don't love God enough to look beyond the shortcomings / annoying side of our fellow brothers and sisters / family / colleagues etc. Probably should serve as a reminder from time to time..

Thinking process..

Currently listening: Matt Maher - Empty and Beautiful


Currently reading (as a Lifegroup): The God Chasers (by Tommy Tenney)


Some things are just difficult to lay down.

Got reminded of Paul Ang's sermon on finishing well.. scary to see how time and time again, stories of people who did great things and whose hearts were faithful for long periods of time (eg the life of King Asa), ended up self-destructing towards the end..

In Psalm 44, the author remembered God’s faithfulness in the past in helping the Israelites through many battles. Our source of victory / strength is in God, not our own abilities. But later, the author finds no reason for defeat, oppression, devastation which befell them, but yet he chose to put His hope in God, as mentioned 3 times ("Why are you downcast my soul? Why so disturbed within me? Put your hope on God, for I will yet praise Him, my savior and my God."). How is our response towards commitment despite things not going our way?

A leader commented that although I can share the many things I have seen and learnt, and how God has helped me through various things over the past 2 years, but these are visible things / experiences. Hence, if you take everything out of the picture and strip it bare, with nothing left (no people, no church, no testimonies, no teaching etc) - you are by yourself.. then what will the basis of your faith be grounded in when it comes to decision making? Putting aside the circumstances at hand and the pros and cons of each option, really ASK what does He want you to do after graduation?

Reminded of a reunion last month with a person who encouraged me to press on despite the odds, a brief encounter which yielded the words, "The joy of the Lord shall be your strength."

It's never about programs / methods - it's about one life impacting another.

We may never fully understand a mother's love for her children.

Currently listening:
讚美之泉 - 你愛永不變 (Your steadfast love. By: Stream of Praise)



I have actually seen a Chinese grandmother in a similar situation as the video above on arrival at Melbourne airport in 2006. She got off with a warning after Australian customs told her off.

There was a sharing session today about the impact of our parents on our lives, since we celebrated Parents' day (especially mothers). Didn't really share, but got reminded of a few things.. the times spent with my mum at home, where she will boil 'tang yuen' for me, and I will help her make Chinese New Year cookies. You can take me to any hawker stall in the country, but I still think the 'meehoon kueh' (ie pan mee) she makes is the best.. I stopped coming back from outings late at night coz she will always wait for me in the living room before locking up.. Many times failed to appreciate the fact that she was willing to call every 2-3 days while I was in Australia (and even here), asking me the same list of questions which I have pretty much memorised already (eat already? what am i doing now? got do this (or that) or not etc?).. I do remember though while in YANA CG, mailing back home a card designed by a fellow friend, in it was 'Thank you' written in quite ugly Mandarin, (my 1st attempt), but she loved it. One incident which really struck me was when during an occasion when we tried to get a tailor at a market downtown to mend my torn pair of shorts (we don't have a sowing machine at home for this kind of damage). All the tailors along both sides of the market atrium refused to take up the job (coz it pays them too little). At that point, I was thinking of just going home and not wasting time, but instead, she went from shop to shop to personally and persistently beg them to take up the job, enduring multiple ridicules in the process..You might say that my mum is a typical 'kampung' lady who did not finish secondary school, but the little things here and there which she does, really touches me.

Thank you mum. Happy Mother's Day.

Medical mumbo jumbo and stuff

Lesson learnt: when you see a patient with chronic liver disease secondary to alcoholic liver cirrhosis, always take the psychosocial history (finances, family situation at home, history of accidents / fights due to subdural bleed), psychiatric history (Wernicke and Korsakoff encephalopathy), gastrointestinal history (variceal and GI bleed).

Woke up early to observe a kidney biopsy on a patient under my follow up. Before I could finish introducing myself, already got scolded by the specialist to stand at the corner - managed to watched the biopsy though, amidst the firing received by the nurses and MO. The houseman whispered, "You are lucky that this is one of the extremely rare cases when she didn't mind, usually she will chase everybody away when she is doing the procedure."

2 on calls this week. Duno why when I follow a particular specialist, you can be sure the night will not end early..

Interesting cases seen:
1. Middle aged Chinese patient with 6 month history of chorea (ruled out Huntington's), CT shows generalised cerebellar atrophy and small vessel ischaemia, the housemen went hunting for autoimmune causes of vascular disease (due to his young age). MRI came back with a long list of findings (which the 3rd years would know better), I could only remember cerebral atrophy and nasopharyngeal carcinoma compressing certain regions.
2. 5-year old girl presenting with exacerbation of asthma, has an incidental finding of dextrocardia.
3. Patient diagnosed to have pemphigus vulgaris by dermatology, but the history sounded to me more like an outbreak of herpes simplex (painful oral and throat ulcers), treated with antibiotics (?URTI) which led to Steven-Johnson syndrome (lesions on upper limb, trunk, lips and neck).
4. Patient with atypical pneumonia, probably due to Legionella from air conditioning.

Old lady from mainland China admitted for pulmonary embolism. Can see that she was really unwell and could not sleep (the nurses transferred her back and forth in the wards to make way for sicker patients).. tried my best to reassure her, the husband and daughter that the cardiologist needs to see her before she gets upgraded to a higher class ward. I think the husband appreciated the concern, despite my broken Mandarin. Looking from a distance, specialist asked my friend, "I thought his Chinese was extremely limited? Looks quite ok to me.." Anyway, need to start reopening my 'Learn Mandarin in 40 days' book.

It's pretty tough being a foreign worker in this country, especially when it comes to healthcare. You fall sick, your employer not willing to foot your medical bill (coz foreigners get charged more on hospital admission), so you see doctors getting phone calls from bosses asking when their employees can be discharged, or requesting a letter to certify him/her as having a medical illness and needing to be deported back to their home country.

Sights and sounds from a mortality meeting

"So this week we have a couple of old people who dropped dead. Not interesting.. next."
"Clearly there is a lack of brain in this room!"
"Next time call the specialist because the cardiology MO didn't know how to read ECG, he will look at it and tell u 'don't worry, coz it's N-O-T-H-I-N-G..!'"
"You are all USELESS and HOPELESS, do you know that? The whole town knows it, all 13 states in Malaysia knows it.. can you get any more famous than that?"
"Why do you guys put a TB/H1N1 patient who is coughing away left-right-centre in the SAME cubicle with the HIV/immunocompromised patients??!!"
"Renal failure patient from another hospital, choked on a piece of bread while undergoing haemodialysis. Intubated, CPR unsuccessful, sent to our hospital and died. Nobody know how to do Heimlich Manoeuvre ar?"
"Renal failure patient, started on medication for gout (supposed to stop when gout resolves or patient develops diarrhoea).. houseman copied the 3-times daily dose onto the prescription slip for discharge for 3 months. So the patient being a stupid fellow kept on taking lar despite having diarrhoea. Later admitted to hospital urea and creatinine was sky high and you go and pump in fluids on the assumption patient was dehydrated?? Patient developed myocardial infarction and died in the ICU."

And people wonder why MOs and Housemen kept telling me off over the past couple of weeks "Don't be stupid enough to think of working here - it's like a MAD house."