Life..

There were once 2 brothers who lived on the 80th floor. On coming home one day, they realized to their dismay that the lifts were not working and that they had to climb up the large number of stairs. After struggling and making it to the 20th floor, panting and tired, they decided to abandon their bags and come back for them later once the lifts are working again. So they left their bags there and climbed on. When they were coming up to the 40th floor, the younger brother started to grumble and both of them began to quarrel. They continued to climb the flights of steps, quarreling all the way. By the time they reached the 60th floor, both were exhausted and have no more strength to quarrel anymore. They then realized that they had only 20 levels more to climb and decided to continue climbing in peace. They silently climbed on and reached their home at last. Each stood calmly before the door and waited for the other to open the door, only to realize that the key was in their bags, left on the 20th floor ..

---------------------------

Many of us live for the expectations of our parents, teachers and friends when we were young. We seldom get to do the things that we really like or love. It is under so much pressure and stress. After the age of 20, as we 1st enter university/college, it felt as if most of us have dumped the weight of expectations off our back, and we work enthusiastically to achieve our personal goals and dreams.

But by the time we reach our 40s, we realise that the struggles in life is not as easy as it seems, and start to lose our vision and along with that, our dreams and goal in life. We began to feel unsatisfied and start to complain and criticize anything and everything under the sun; this government lousy lar, that not good lar etc. We are miserable coz we are never satisfied.

Reaching 60, we realize that we have little time left for complaining and we began to walk the final phases of our lives in peace and calmness. What to do? People don't live that long :p We think that there is nothing left that could disappoint us, only to realize at the age of 80 that our greatest hopes and dreams still lay unfulfilled back when we were 20.

Thinking point: It starts with you

Acts 3:1-10

One day Peter and John were going up to the temple at the time of prayer—at three in the afternoon. Now a man crippled from birth was being carried to the temple gate called Beautiful, where he was put every day to beg from those going into the temple courts. When he saw Peter and John about to enter, he asked them for money. Peter looked straight at him, as did John. Then Peter said, "Look at us!" So the man gave them his attention, expecting to get something from them.

Then Peter said, "Silver or gold I do not have, but what I have I give you. In the name of Jesus Christ of Nazareth, walk." Taking him by the right hand, he helped him up, and instantly the man's feet and ankles became strong. He jumped to his feet and began to walk. Then he went with them into the temple courts, walking and jumping, and praising God. When all the people saw him walking and praising God, they recognized him as the same man who used to sit begging at the temple gate called Beautiful, and they were filled with wonder and amazement at what had happened to him.

There is a saying that the art of communication is very important, be it among ourselves or to other people. There was a story about a blind man, who sat begging for money by the sidewalk. In front of him was a sign, "I am blind, please help me." He has been there for a long time, but only a few people cared enough to dropped several coins into the container in front of him. One morning, a man walking by dropped a large sum of money into the container, paused for a while, then proceeded to take the blind man's sign, turn it around, and wrote something on it. Soon, the blind man started to hear coins pouring into his container, as many people gave. One thing about blind people is they tend to be sensitive in their hearing, so upon recognising the footsteps of the man who came in the morning, the blind man grabbed him and asked, "Were you the one who changed my sign this morning? What did you write on it?" The man answered, "I wrote what you meant, but in a different way. It read, "Today is a beautiful day, but I cannot see."

Peter was a short-tempered, brash person who tends to talk or act before thinking. John on the other hand, was more of a reflective person who would think through something before expressing himself. Put 2 such people together and you might witness a clash of egos and personalities sooner or later. If we look at the context of the church today, how can 2 people from seemingly diverse and extreme backgrounds walk and serve together? There are bound to be conflicts, but if not because of this vision, it would have been impossible.

Some people may be able to do something faster and more effectively than others, but when you are assigned the job despite your lesser ability, are we willing to be faithful in such little things to be a blessing to others? On the other hand, there might be times when we felt annoyed at other people's apparent weaknesses / slowness. However, God has given you the best, He puts people in your life to mould and work with you. At the end of the day, you never know that you might probably gain more out of the relationship. John Maxwell pointed out that 'The journey with others is always slower than the journey alone - for the friendship of 2, the patience of 1 is necessary'. Therefore, when we felt like complaining / annoyed over somebody, always remind ourselves that we ourselves are the one that needs to change, whether the other person eventually improves / changes its not up to you to decide. It starts with you, don't point fingers at other people, 10 fingers will point back to you, coz everybody has shortcomings. Learn lay down yourself to appreciate and be a complement to one another, not look at others as a thorn in our eyes.

We might cover up the superficial and pretend as if everything is ok on the outside, but what is actually inside your heart, God knows and He is able to change it. Everything starts with a change of heart. Looking at many problems around us today, if you trace the root of the problem, the origin and what needs to be changed starts from the heart. Example: Some say that better education can eradicate the problem of crime, since most criminals come from lower socioeconomic and educational backgrounds, but its not necessarily true as it can also produce criminals who are smarter at what they do.

When John and Peter looked at the beggar at the Beautiful gate, the person only wanted money. Born lame since birth, he has depended on others throughout his life coz he can't work for a living. Peter and John could have given him money, but they gave him something better, a new beginning in a person's life. Do we dare to believe and claim God's miracle from His word? Maybe we are looking at the wrong places, expecting big things (eg blind seeing and the lame walking) but we missed that every life transformation (big or small) is a miracle. John and Peter may not have much, but they gave what they have wholeheartedly, and in that moment, God accomplished more than they could imagined.

Currently listening: Hillsong - One thing

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And I will seek Your face
Call upon Your name, Jesus
All I want is You, Jesus..

Believe

Currently listening: Hillsong - Believe

3 weeks spent in O&G.. a short time, but not that productive for me, coz need to get my modules done, and exhaustive ward rounds in the mornings and afternoons leave little time for reading up stuff (what more, with the World Cup going on right now :p)

O&G is filled with various characters, you have a medical officer (MO) who apparently doesn't quite like me (he frequently stares at me with a fierce look), you have registrars who clown around and talk nonsense, you have fierce specialists scolding housemen like nobody's business for not meeting their expectations. And then you have.. me - the final year medical student who roams the wards, supposedly to function like a pre-tagging houseman, but due to the high medicolegal risk of the department, ended up wandering around like a blur case.. Of course, conducted a few deliveries along the way.. am thankful for an MO who willingly supervised my 1st episiotomy from beginning to the end. Was glad because I didn't really get a chance in medical school to actually suture a REAL patient, all my sutures were on models (and pork bellies in Melbourne :p).

1 houseman who saw me in the changing room asked me, "You like to hang around in the hospital is it? Coz for most of us, if there is no reason to stay, and it's already 5pm, just go home. Don't really bother giving a f*#%ing s%#t to what goes on.." No wonder a patient's wife walked up to me the other day to complain that doctors in government hospitals don't have this thing called c-o-m-p-a-s-s-i-o-n.

Need to train myself to sleep less and exercise more.

Got reminded that just as I myself would like to have someone believe in me, I too should not stop believing for a breakthrough, be it in certain situations / people. Especially when you are presented with a half-answered prayer, not knowing what to do, and trying to tell yourself not to be distracted by the time factor.

Retreat

Currently listening: Hillsong - Hosanna

As I try to get something going, I think I got too many questions in my mind at the moment.
Is it too late? Is it worth it? How do I overcome certain weaknesses?
How to carry out certain things? Is there a guidebook? What are the do's and don'ts?
What should be my goal or aim? What should be my focus? How to balance certain things?
It is like something is so near and on the verge of happening, but can't push through the ceiling, and I duno what is it..
But at the end of the day, need to learn to trust and not lean on my own understanding.. hopefully this week's personal retreat will yield something as I quieten down myself..
Time is running out, but I try to remind myself to be patient.. and wait upon His perfect timing.

Where to from here?

Currently listening: Sound the bugle
by: Bryan Adams (OST: Spirit - Stallion of the Cimarron)

Sound the bugle now, play it just for me
As the seasons change, remember how I used to be
Now I can't go on, I can't even start
I've got nothing left, just an empty heart.

I'm a soldier, wounded so I must give up the fight
There's nothing more for me, lead me away
Or leave me lying here

Sound the bugle now, tell them I don't care
There's not a road I know that leads to anywhere
Without a light, I fear that I will stumble in the dark
Lay right down and decide not to go on.

Then from on high, somewhere in the distance
There's a voice that calls, "Remember who you are"
If you lose yourself, your courage soon will follow
So be strong tonight, remember who you are.

Yeah, you're a soldier now
Fighting in a battle
To be free once more
Yeah, that's worth fighting for.

Psalm 143:5-8, 10 - I remember the days of long ago; I meditate on all your works and consider what You hands have done. I spread out my hands to you; my soul thirsts for You like a parched land. Answer me quickly O Lord; my spirit fails. Do not hide your face from me or I will be like those who go down to the pit. Let the morning bring me word of your unfailing love, for I have put my trust in You. Show me the way I should go, for to You I lift up my soul. Teach me to do Your will, for You are my God; may Your good Spirit lead me on level ground.

End song: Sing of your great love
By: Planetshakers

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11th Southern Region Church Camp

Theme: A Seed Church
Date: 17-20 June 2010
Venue: Tiara Beach Resort, Port Dickson

Hard to imagine right? The sequoia, one of the largest trees in the world, started off as a tiny seed. Within a seed, no matter how small it is, lies the potential to become a whole tree and bear fruit.

Time also to prepare to do some soul-searching as to what next, since I'm in my final year already..

Photo acknowledgement: kahncious.net

Week 2 - Neonatal ward

Out of nowhere, the paeds MO asked me to follow her.
Me: Where to?
MO: Have you ever done neonatal resuscitation before?
Me: Err... we have a workshop which 1 of our tutors went through with us about the basic stuff lar, using a dummy.
MO: Ok lar then.. take this resuscitation box, follow me to labour room OT. Baby undergoing emergency Caesarean section with thick meconium stained liquor..
Me: *swt* Ok...?? (but I have never actually done 1 before)

That was nice of the MO to try and explain stuff along the way.. in the OT can be really different as compared to simulated environment.. everything must be prepared in advance in anticipation of the baby.. then as soon as the baby is out, its a mad scramble.. (I helped to auscultate the fetal heart - bradycardic), direct suction done as well as use of the meconium aspirator.. we were taught to insert the suction tube as far as our eyes can see, so I was shocked at how deep they actually shoved the tube down the throat and nose.. Baby started to cry.. Situation not as bad as we thought :)

Got bored looking for patient in the ward for my modules, so decided to play high-five with 1 of the kids :p

Excitement in paeds can come in unexpected ways lolz (that is, depending on the type of kids you get)..

International lifegroup :p

Students from Nigeria, Iraq, France (and of course 1Malaysia).

Defining moment

Currently listening: City Harvest Church - Because of You

There was a story about a man who fell off the ledge of a cliff, as it was quite dark and difficult to see. Fortunately, he managed to cling onto a branch at the edge. He looked up and shouted, “Hello??!! Is there anybody up there? Help me!!” Suddenly a voice answered, “Hey there, it’s me – I am God. I can help you, but you will have to let go of that branch.” The man was silent for a moment, and then shouted again, “Err.. Is there anybody ELSE up there???!!!” A group of people who came by later would come across a weird discovery, a dead body with the person’s hands basically 'glued' to the branch, but the ground only a few metres below his feet.

Some do-or-die situations lead people to come to their defining moments, where decisions need to be made which will determine where many things will end up. Today, what is yours? If there is something today that you are perhaps clinging onto tightly at such a time, perhaps God wants to remove that item so that you will once again take that step of faith and look to Him as your source of security.

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."

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-

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?

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!!!