Tuesday, April 27, 2010

Post-call musings over past week

Currently listening: Hillsong - You are my strength
>
He is able and He will enable
Though the fig tree does not bud
and there are no grapes on the vines,
though the olive crop fails
and the fields produce no food,
though there are no sheep in the pen
and no cattle in the stalls,

yet I will rejoice in the LORD,
I will be joyful in God my Savior.

The Sovereign LORD is my strength;
he makes my feet like the feet of a deer.
-Habakkuk 3:17-19-

p/s: Thanks Christina!

What does it take to be able to say 'as you will' each step of the way?
Going a little farther, he fell with his face to the ground and prayed, "My Father, if it is possible, may this cup be taken from me. Yet not as I will, but as you will."

Then he returned to his disciples and found them sleeping. "Could you men not keep watch with me for one hour?" he asked Peter. "Watch and pray so that you will not fall into temptation. The spirit is willing, but the body is weak."
-Matthew 26:39-41-

Thursday, April 22, 2010

Back to chaos I suppose

Currently listening: Amy Sandstrom-Shoyer - Trust in the Lord
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My classmate commented, "Gary, how can you tell people of such misadventures of yours?! People will think you are a hazard!" It's my way of coping - just coz I tell people or laugh things off does not mean I'm proud of or find it funny, but I suppose it's a humble reminder that I'm surviving daily by God's grace. A friend of mine commented that medical training is perhaps one of the worst forms of training ever - people entrust you with their lives, and you don't know what might happen next with each thing you do.

My ward is PACKED with patients.. It's hot and stuffy, a 9am-5pm day can just leave you exhausted and drenched (patients are sweating despite bringing their own table fans), even with minimal walking. Specimen bags and patient's case notes lying strewn here and there. Things (eg forms, gloves, items for procedures) can just be SO difficult to find, and when they run out, nobody bothers to restock them. Nurses rushing to go off early not giving patients insulin at the right time (need to correlate with meals). A patient who arrived in the ward in the morning being overlooked and not clerked until evening - had to postpone a cardiac procedure. Imagine having to endure the patient's Chinese wife who kept complaining, and complaining, and complaining.. A patient with cardiomyopathy and heart failure symptoms got admitted to the ward from outpatient clinic. The management on the referral letter says '2 pints of normal saline' (ie you know the patient is probably already overloaded with fluid, and you pump in more fluids).

A trick I picked up (to reduce the number of times of the patient being poked, especially if he/she needs daily bloods), is to take blood from the IV cannula after its insertion and flush it later with heparinised saline. However, I think the patient must be wondering why a section of his hand suddenly swelled up like a balloon, but no blood is coming out into the syringe.. when the blood eventually came, it was clotted and unusable - ie houseman need to retake blood, IV needs to be re-done at another site.. *swt*

I volunteered to insert a urinary catheter for a renal failure patient with acute urinary retention due to an enlarged prostate. It seemed normal enough, with little resistance, and when it went in, there was a tiny bit of clot and clear urine flowed out. A few minutes later, I was wondering why the urine was changing to tea-coloured, and subsequently to my (and the ward staff's) horror, the urinary bag filled up with blood (gross haematuria) - had to immediately order blood tests, contact the blood bank to group and hold some blood for transfusion, refer urology for irrigation and ultrasound. Great, will only find out what actually is the problem tomorrow (hopefully not my fault) - what else could go wrong?

Monday, April 19, 2010

Final few days in Melbourne Part 2: 1000 steps and final lifegroup

Currently listening: Daughtry - Home
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1000 steps
Yu Wan sms-ed me somewhere in March while I was in the middle of ward rounds, "Gary, do you wanna go for 1000 steps? Your Facebook says you wanna lose some weight right before you go back?" *swt* And so we went - as a Lifegroup after Sunday service to once again climb the Mount Dandenong trail. 1 mistake I made was forgetting that it was already autumn - winter is approaching, I turned up in t-shirt and shorts (it was F-R-E-E-Z-I-N-G).. and guess what; when we were on the way up to the foot of the steps, it started HAILING heavily.. to avoid everybody getting sick, had to divert to a nearby shelter, everybody was drenched though.

Funny that after that you can hear "Gary, it's all your fault!!" hahaha.. hello? I did not organise this - can't blame me. Once the hail stopped, Ivy suggested making Yu Wan the sacrificial lamb if it started raining again lolz.. A decision was made to try going up a second time (of course after praying that it will not rain) - it's encouraging to see everyone (even those who are not very fit) make it to the top despite the slippery slopes, mud on our shoes and chilly winds - must persevere on!!! Then later had a picnic (in freezing weather), where we played a game run by Mang Yik requiring people to guess certain facts about me (copied from my Facebook apparently) - but the weird thing is, since when did I mention I intend to get married before the age of 30??!!!! IT'S NOT ON MY FACEBOOK!!!!!! :p lolz

But overall a good and enjoyable time :-) (except that on the next morning I had to miss morning ward rounds coz the muscles on my whole body felt like a stiff and painful block of ice)..

Final lifegroup
Had a good time of sharing on campus. Appreciated Zhi Lin and co for their effort in attempted rendition of John Denver's 'Leaving on a Jet Plane' and Emil Chau's 'Peng You (Friends)' before I left.



I suppose even as I return to JB.. quite a few things which need to think through, especially with quite a number of things which had been imparted / spoken by others. Like Jason shared before I walked into the departure lounge, take some time to quieten down, and think of what to do next.

Final few days in Melbourne Part 1: Hospital

At the final team meeting, our consultant made a mention that it was my last team meeting, and wished me all the best as I fly home, after all the hard work - surprisingly even my registrar nodded his head in agreement, and the nurses and allied health people gave some applause for a job well done *happy* :p

So the next day I brought a box of chocolates for the ward staff whom I befriended, and the nurses returned the favour by inviting me over for lunch (they had potluck since it was 1 of their colleague's birthday) - so imagine me as the odd medical student sitting at the table, with a bunch people from the 'aunties' age group :p It's actually quite a multicultural ward, with staff from Malaysia, Europe, Philippines, India etc. (even some patients are non-English speaking!) Anyway, as we were having lunch, the doctors passed by, stuck their head in, and gave the 'What is my medical student doing with the nurses?' kind of look.. :p Lunch break!!! lolz


So this is the view of my 2nd hospital from the outside and below is the medical student lounge in the hospital - it has...computers, pantry with a fridge and microwave, water dispenser, sofa to sleep on, plasma TV!!!

Wednesday, April 14, 2010

As times change..

..so do people and their priorities. I think I have come to realised that just as others have moved on in life, I should probably do so too.

I remember my promise at the end of 2006 that I will definitely be back in 4 years time, but now I don't know when (or whether) I will actually set foot here again. Farewell Melbourne, it has been a good 3 months, and I leave you with mixed feelings.

Currently listening:
Regina Spektor - The Call (OST The Chronicles of Narnia: Prince Caspian)


It started out as a feeling
Which then grew into hope
Which then turned into a quiet thought
Which then turned into a quiet word
And then that word grew louder and louder
Till it was a battle cry
I'll come back when you call me
No need to say goodbye

Just because everything's changing
Doesn't mean it's never been this way before
All you can do is try to know who your friends are
As you head off to war
Pick a star on the dark horizon and follow the light
You'll come back when it's over
No need to say goodbye
You'll come back when it's over
No need to say goodbye

Now we're back to the beginning
It's just a feeling and no one knows yet
But just because they can't feel it, too
Doesn't means that you have to forget
Let your memories grow stronger and stronger
Till they're before your eyes
You'll come back when they call you
No need to say goodbye
You'll come back when they call you
No need to say goodbye

Monday, April 12, 2010

Musings over Easter

Currently listening:
Hillsong - All the Heavens

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Blunders
By nature, I am pretty much someone who likes to get things done quickly, but the problem arises when what you hear bypasses your brain before it gets to your hands. Was not a very good week at all, nearly got into trouble when the registrar picked up that I mistook patient's A drug chart with patient B (their INRs were different) on assumption without checking. Careless mistake.

Another blunder was to follow later, when a patient with bilateral pyoderma gangrenosum and several fractures went into hypoglycemia and hypotension (her Hb was also low), so she needed an urgent blood transfusion. It's 5pm in the evening of a long day, and I didn't know that the blood bank would be SO particular with documentation (EVERYTHING needs to be exact and matching).. It was the ONLY blood sample we could not afford to lose for cross-matching and transfusion, and when the blood bank called stating that I wrote different collection times on the request form and test tube, had to rush downstairs to rectify stuff. My registrar went absolutely ballistic (4-letter swear words aside, I think he's on the verge of beating up somebody) Fortunately the technician on duty for the day was kind enough to allow me to alter the info, and no need to re-collect the blood, otherwise patient would have died that night.

Connect sharing (continuing from the above)
Was prompted to flip to the pages on the death and resurrection (I think coz it's Easter? :p), and was also glancing through 'Whose Child is This?' by Bill Wilson, and one thing which caught me was the part where the angel told Mary Magdalene and the others who went to anoint the body with spices, "But go, tell His disciples - and Peter - that He is going before you into Galilee, there you will see Him, as He said to you." (Mark 16:7)

What is so special about Peter? What did Jesus see in this fellow? Jesus' 1st words to him were, "Follow me." So were His last words. Peter never failed to follow, but stumbled pretty often too as he got along. His character can be described as reckless (cutting off a soldier's ear), impulsive, easily swayed, cowardly, and the list goes on.. Ever promised someone the world? Peter claimed, "I am willing to die or go to prison." but when the time came, he chickened out, and denied knowing Jesus 3 times (as predicted). In his heart, he truly loved the Lord, but nobody needed to tell him - he knew he had blown it, badly, and felt a great remorse for it. But in this case, God especially wanted Peter to know that Christ was alive (ie "Tell him, he needs to know"). Not only was Peter restored upon receiving the great news, he went on a journey to do great things for God.

There will be tough times in life when we need special attention from the Lord, when we have probably messed up (eg I'm too far into this to turn back, I've made a big mistake etc) When such time arises, know that we have a God who loves and never fails us - His arm is never to far away to save.

God saw the potential in Peter. What does He see in you?

Wake up call

Maybe it is time to wake up, as I think I've been sleepwalking through medical school for the past 4 years.

Cinema at Chadstone

Watched 'The Blind Side' with a couple of fellow Lifegroup meddies. Got reminded of the significance of having somebody who believes in you.


Countdown
4 more days in Melbourne, Australia. Many people asked me how I feel, and basically a bit of mixed feelings heading back to JB. Several people asked to consider staying. My LGL remarked (I think jokingly), "Aiya, his loyalty is no longer with us already."

Some stuff observed and picked up from the Med CoreTeam (new people - Ivy and Mike not counted)

Christina - way of organising, encouraging, leading and sharing (pretty well-read, a reminder that I need to pick up and know my facts)
Yu Wan - I forgot already who described her as weird.. Somehow seems to have a constant sense of joy 24/7. Someone I believe who actually goes the extra mile in doing things.
Zhi Lin - Another one who is bit crazy and wacky - but notice the commitment and ability to liven up an atmosphere.
Zepeng - Reminded me not to just look on the surface, coz there might be more to a person if you actually look underneath it with the right approach (you might just uncover a heart desiring to grow).

Oceania Convention 2010 - Gold Coast


Video acknowledgements: WorshipArtsMedia(WAM), Hope Brisbane